medical mission in jail
Today was, overall, a good day for being a doctor-in-training.
This morning I volunteered at a medical mission at the Pasig City jail. The event was organized by alumni from the Ateneo Graduate School of Business (AGSB), and there were only 6 of us from ASMPH. One freshman, one sophomore (me), three juniors, and an Ophthalmology resident.
Weirdly enough, it was my first medical mission as a med student (ASMPH is not fond of medical missions). Few things I was expecting: One, that my sole contribution would be to take vital signs (blood pressure, temperature... all the basic stuff that can be learned in college). And two, that my patients would be scary, snarling inmates with tattoos on the inside of their eyelids. It is worth noting that neither of these things happened.
We got to the jail at around 9 AM because the traffic was bad and we got pretty lost along the way. When we got inside, we were asked to leave our cellphones with the guards, and they stamped our arms with big, red text that read PASIG CITY JAIL VISITOR.
The jail was surprisingly orderly and clean (or at least the part we saw). The room for the medical mission was spacious, airy, and bright. One side of the room had been turned into a makeshift dental clinic, where the dentists (or dentists-to-be?) were already operating on patients and doing God knows what else. The other side of the room was populated by little desks, makeshift booths small enough to be used by one person at a time. In one corner, female and male inmates were patiently waiting on some monobloc chairs for their turn at the dentist or doctor.
Huddle time for Team ASMPH (aka us five students). Chuck, the freshman, was put on vital signs duty. Tiff and Mea, the juniors, were in charge of taking history. That left me with Ophthalmology duty.
"Do you have a Jaeger chart?" Tiff asked, and fortunately I had mine with me. I had bought it for 20 pesos two years ago but never learned how to use it.
Tiff and Elva proceeded to teach me how to use it: Ask the patient to read the numbers on the leftmost column. Take note of the last line that the patient can read; the denominator of the fraction on the rightmost column correspond to the grade of glasses the patient needs. For example, if the patient can no longer read the fourth line, then the denominator of the fraction on the third line, 200, should be the grade of the glasses.
Sounded simple enough. I sat down at the Ophtha booth, a simple table covered in boxes filled with reading glasses. About 80% of those glasses came in animal print frames, and about 70% of the animal print frames looked like white leopard print. The remaining 10% were of ambiguous species. The boxes took up all the space on the table, and there seemed to be no rhyme and reason in the way the glasses were arranged. Glasses with grades of varying magnitudes were mixed up with each other like a wild white leopardish disco. I proceeded to organize the glasses.
"Are you the oph-thul-mah-luh-gizt?" asked the priest beside me. He was a very old American, and the only one manning the table marked "SPIRITUAL COUNSELING."
"Just a med student," I repied. "I don't know what I'm doing right now."
I was still in the process of sorting out the glasses when one of the police superintendents sits down across me. He said, "Doc, alam niyo po, okay naman talaga mata ko, kaso lang..." After a longish story about supplements, he asked me if there were any additional supplements he could take to sharpen his vision.
My thought process:
Luckily for me, Elva, my senpai who was documenting the event, swooped in to save the day. She told the guy that vision really deteriorates with age, and no supplement can ever correct that (she said it in a much nicer way of course).
At that moment Dr. Glen, an ophthalmology resident and ASMPH alumnus, showed up. THANK U LORD FOR SENDING THIS REAL DOCTOR TO MY BOOTH SO I DON'T HAVE TO GO TO JAIL.
Before introductions or a game plan could be made, our next patient came. She was complaining of eye allergies and irritation. Dr. Glen took a look at her eyes with his ophthalmoscope, gave the instrument to me, and told me to take a look.
(Background story: The last time I handled an ophthalmoscope, I used the wrong end and shone the light in my own eye instead of the patient's.)
I took the ophthalmoscope, told the patient to look laterally, and peeked through the correct end of the scope. I nearly gasped at what I saw:
"What do you call her condition?" Doc said to me. The patient was looking at me expectantly.
"Doc, I haven't taken up ophtha yet." I replied sheepishly. Dr. Glen then told me it was called pterygium, the spelling of which I only learned now after minutes of googling "iris pathology" and sifting through lyrics for "Iris" by the Goo Goo Dolls.
I wanted to observe how he handled the patient, but then I got a patient of my own. Trouble seeing, near-sighted. Long story short, Doc and I worked out a system in which I would write down the patient's eye history, Jaeger, and Snellen chart scores on a piece of paper and then refer them to him for the diagnosis and treatment plan.
It worked quite well for a while, even though I had some duh moments. I was trying to write down a patient's complaint about a headache, but I couldn't remember the medical terms for the regions of the head, like "supraorbital" and "occipito-frontal." So I wrote, "has headache from eyebrows to top of head."
One very nice moment I'll never forget was when a young inmate mentioned that her vision started blurring after giving birth. I asked her when she had given birth, and she said December 2015. Kind of casually, she said, "Kaka-one month lang niya kahapon." Almost reflexively, I let out a big smile and a big CONGRATS! She smiled back with this really beautiful toothy grin, and I could see tears in her eyes. Suddenly I realized how conflicted and sad she must have felt, separated from her baby so soon, not being able to witness him or her growing up.
At 11:30, Doc Glen had to leave, which meant that I would have to resume my role as Fake Doctor. He gave me some useful pointers though and he even left me the huge Snellen chart poster tacked to the wall.
Fortunately, my one hour as Fake Ophtalmologist turned out fine. No one had a weird disease I hadn't studied yet, every patient just needed glasses (which, thankfully, Doc Glen had taught me to prescribe before he left). The males always firmly (but politely) requested for the plain black frames, even though the black ones weren't the right grade. But I can imagine why the male inmates were so averse to returning to their cells wearing white leopard print frames. Very emasculating. Older women also requested for black glasses because they found the leopard print too "pang-bata."
When it was time to go, I couldn't leave because people kept on coming to the booth. Towards the end of my shift, there wasn't even an orderly line anymore, just a swarm of people waiting for their turn. Chuck came to help me out, and he seemed to pick up the mechanics of it pretty quickly. As more people came, I would tell them, "Sorry last na po si [ma'am / sir] kasi aalis na kami," s/he would plead, and I would be powerless to say no. Because I have a hard time saying no to people. Especially people who follow up with "Malabo po kasi ang paningin ko," "Sumasakit po kasi ang ulo ko..." etc.
What a day. The volunteers and I were given some snacks and lunch to take home, and we even got a pouch with some vitamins from RiteMed. Honestly I'm pretty excited about that because WOW, my first pharmaceutical company merchandise! How doctor-y!
The ride home with my fellow students was filled with chatter about how we were able to apply textbooks concepts to real people. I was so excited from the people, the knowledge, the opportunity to help...
I can see myself doing this for years and years.
This morning I volunteered at a medical mission at the Pasig City jail. The event was organized by alumni from the Ateneo Graduate School of Business (AGSB), and there were only 6 of us from ASMPH. One freshman, one sophomore (me), three juniors, and an Ophthalmology resident.
Weirdly enough, it was my first medical mission as a med student (ASMPH is not fond of medical missions). Few things I was expecting: One, that my sole contribution would be to take vital signs (blood pressure, temperature... all the basic stuff that can be learned in college). And two, that my patients would be scary, snarling inmates with tattoos on the inside of their eyelids. It is worth noting that neither of these things happened.
We got to the jail at around 9 AM because the traffic was bad and we got pretty lost along the way. When we got inside, we were asked to leave our cellphones with the guards, and they stamped our arms with big, red text that read PASIG CITY JAIL VISITOR.
The jail was surprisingly orderly and clean (or at least the part we saw). The room for the medical mission was spacious, airy, and bright. One side of the room had been turned into a makeshift dental clinic, where the dentists (or dentists-to-be?) were already operating on patients and doing God knows what else. The other side of the room was populated by little desks, makeshift booths small enough to be used by one person at a time. In one corner, female and male inmates were patiently waiting on some monobloc chairs for their turn at the dentist or doctor.
Huddle time for Team ASMPH (aka us five students). Chuck, the freshman, was put on vital signs duty. Tiff and Mea, the juniors, were in charge of taking history. That left me with Ophthalmology duty.
"Do you have a Jaeger chart?" Tiff asked, and fortunately I had mine with me. I had bought it for 20 pesos two years ago but never learned how to use it.
 |
| This looks exactly like the Jaeger chart I have! The label says Rosenbaum Eye Chart though so now I don't really know what it is. (http://www.west-op.com/pocketeyechart.html) |
Sounded simple enough. I sat down at the Ophtha booth, a simple table covered in boxes filled with reading glasses. About 80% of those glasses came in animal print frames, and about 70% of the animal print frames looked like white leopard print. The remaining 10% were of ambiguous species. The boxes took up all the space on the table, and there seemed to be no rhyme and reason in the way the glasses were arranged. Glasses with grades of varying magnitudes were mixed up with each other like a wild white leopardish disco. I proceeded to organize the glasses.
"Are you the oph-thul-mah-luh-gizt?" asked the priest beside me. He was a very old American, and the only one manning the table marked "SPIRITUAL COUNSELING."
"Just a med student," I repied. "I don't know what I'm doing right now."
I was still in the process of sorting out the glasses when one of the police superintendents sits down across me. He said, "Doc, alam niyo po, okay naman talaga mata ko, kaso lang..." After a longish story about supplements, he asked me if there were any additional supplements he could take to sharpen his vision.
My thought process:
- wat
- idk
- Maybe just tell him to take some Vitamin A?
- But you can overdose on Vitamin A...
- And I'm not even a doctor
- Am I even allowed to prescribe vitamins?
- What if he overdoses on the Vitamin A
- And he dies
- And on his deathbed, he will name me, the fake doctor that I am, as his killer
- And I get sent to jail
- And I become the most hated inmate in jail
- And they decide to plot against me
- And one day I'll wake up with acid in my eyes
- And I go blind
- And in next year's medical mission, I'll be consulting some dinky med student at the Ophtha booth about what supplements I could take to sharpen my vision
- Oh the irony
Luckily for me, Elva, my senpai who was documenting the event, swooped in to save the day. She told the guy that vision really deteriorates with age, and no supplement can ever correct that (she said it in a much nicer way of course).
At that moment Dr. Glen, an ophthalmology resident and ASMPH alumnus, showed up. THANK U LORD FOR SENDING THIS REAL DOCTOR TO MY BOOTH SO I DON'T HAVE TO GO TO JAIL.
Before introductions or a game plan could be made, our next patient came. She was complaining of eye allergies and irritation. Dr. Glen took a look at her eyes with his ophthalmoscope, gave the instrument to me, and told me to take a look.
(Background story: The last time I handled an ophthalmoscope, I used the wrong end and shone the light in my own eye instead of the patient's.)
I took the ophthalmoscope, told the patient to look laterally, and peeked through the correct end of the scope. I nearly gasped at what I saw:
 |
| Something like this, but not as severe. (http://www.visioninstituteil.com/) |
"Doc, I haven't taken up ophtha yet." I replied sheepishly. Dr. Glen then told me it was called pterygium, the spelling of which I only learned now after minutes of googling "iris pathology" and sifting through lyrics for "Iris" by the Goo Goo Dolls.
I wanted to observe how he handled the patient, but then I got a patient of my own. Trouble seeing, near-sighted. Long story short, Doc and I worked out a system in which I would write down the patient's eye history, Jaeger, and Snellen chart scores on a piece of paper and then refer them to him for the diagnosis and treatment plan.
It worked quite well for a while, even though I had some duh moments. I was trying to write down a patient's complaint about a headache, but I couldn't remember the medical terms for the regions of the head, like "supraorbital" and "occipito-frontal." So I wrote, "has headache from eyebrows to top of head."
One very nice moment I'll never forget was when a young inmate mentioned that her vision started blurring after giving birth. I asked her when she had given birth, and she said December 2015. Kind of casually, she said, "Kaka-one month lang niya kahapon." Almost reflexively, I let out a big smile and a big CONGRATS! She smiled back with this really beautiful toothy grin, and I could see tears in her eyes. Suddenly I realized how conflicted and sad she must have felt, separated from her baby so soon, not being able to witness him or her growing up.
At 11:30, Doc Glen had to leave, which meant that I would have to resume my role as Fake Doctor. He gave me some useful pointers though and he even left me the huge Snellen chart poster tacked to the wall.
Fortunately, my one hour as Fake Ophtalmologist turned out fine. No one had a weird disease I hadn't studied yet, every patient just needed glasses (which, thankfully, Doc Glen had taught me to prescribe before he left). The males always firmly (but politely) requested for the plain black frames, even though the black ones weren't the right grade. But I can imagine why the male inmates were so averse to returning to their cells wearing white leopard print frames. Very emasculating. Older women also requested for black glasses because they found the leopard print too "pang-bata."
When it was time to go, I couldn't leave because people kept on coming to the booth. Towards the end of my shift, there wasn't even an orderly line anymore, just a swarm of people waiting for their turn. Chuck came to help me out, and he seemed to pick up the mechanics of it pretty quickly. As more people came, I would tell them, "Sorry last na po si [ma'am / sir] kasi aalis na kami," s/he would plead, and I would be powerless to say no. Because I have a hard time saying no to people. Especially people who follow up with "Malabo po kasi ang paningin ko," "Sumasakit po kasi ang ulo ko..." etc.
What a day. The volunteers and I were given some snacks and lunch to take home, and we even got a pouch with some vitamins from RiteMed. Honestly I'm pretty excited about that because WOW, my first pharmaceutical company merchandise! How doctor-y!
The ride home with my fellow students was filled with chatter about how we were able to apply textbooks concepts to real people. I was so excited from the people, the knowledge, the opportunity to help...
I can see myself doing this for years and years.
Hurray!!! Glad you volunteered!
ReplyDeleteHahaha can't stop laughing at your "thoughts" after the patient's complain, lol.
ReplyDeleteVery nice write-up, made me feel I was there with you.
ReplyDelete