More snippets from Community

In a rare moment of sipag, I'm actually outside right now on a free Sunday, reading an Obstetrics textbook instead of absent-mindedly scrolling through Netflix. In the middle of my reading about blood volume, I had a random flashback to this patient I had a couple of days ago at the health center.

Around 12:45 PM, as we interns were eating lunch, a guy comes knocking at the door to the multispecialty clinic. That afternoon was our scheduled OB-Gyne time, and he was obviously neither an OB nor a Gyne case, so before I had even spoken to him I was sure that he was knocking at the wrong door. 

Anyway, I opened the door and asked him what his concern was. He showed me his ankle. There was a wound on the lateral side, quite big, around the size of a five-peso coin. Dry, not actively bleeding, but still unhealed. He said a dog had bitten him a couple of weeks back, and that he had kept on scratching the area. I found it weird that two weeks after the event, the wound had not yet healed. He looked young, making diabetes an unlikely cause. (Sorry, these details are actually irrelevant to the rest of the story but it's hard to stop automatically launching into medicine mode.)

We were scheduled to see only OB cases in fifteen minutes, so I told him to proceed to the center's general clinic on the floor above ours. He said that he had already come from there, but had been told that there was no doctor around. Incredulous, I went upstairs to check if Doc Shane, the center's regular doctor, was still there. True enough, she was. I returned to my patient downstairs and asked him to follow me because I would take him directly to see Doc Shane. He then wore a concerned look on his face and said, “Pasensiya ka na doktora ah, na-istorbo pa kita (I'm sorry for disturbing you, doctor)."

I don’t remember what I said to him at that time, but in retrospect I thought about replying, “Walang problema po sir, trabaho naman namin ito (It's no problem sir, just doing our job).” But then I thought about that word – trabaho (job). 

I thought back to the time surrounding my dad’s surgery, when my mom and I were standing at the billing counter of the hospital. We were cleared to go home that day once the bills were settled. From behind a glass window, the billing clerk told us that my dad's surgeon, Dr. Daniel Alonzo, had not posted a bill for his professional fees. Puzzled, I texted Doc Dan to ask about it. "Will we settle the payment at your clinic instead, doc?" He then replied, “No need to pay me." Shocked, we insisted that we pay him at least a small amount. He was firm. He replied, "No charge. It was my pleasure.” 

My family and I were taken aback – Doc Dan and his surgical team had performed back-breaking surgery for nearly 8 hours straight. It had been a very difficult operation. And now he was telling us that not only did he do it for free, but that he was actually happy to do it.

Our hearts were filled with gratitude, but at the same time, my family and I felt nahihiya. Embarrassed. Ulaw. He had saved my dad's life and accepted nothing in return - what kind of person does that?! Don't get me wrong, I was extremely grateful, but along with the gratitude came a lot of questions. In the weeks thereafter, I would become preoccupied with making lists trying to explain this behavior. Was it because of my connection to his son, my classmate during med school? Was it because he saw me as a part of the medical community, a colleague? Or perhaps doing the operation was for him purely an act of charity? What could possibly motivate someone to work so hard and not seek any compensation? To me, it didn't compute.

When Doc Dan performed the life-saving surgery for free, I felt like I could never, in all my years of living, pay him back for his work. I irrationally resisted the gift; in the hours following the event, I coped by minimizing myself in my own mind. I was internally apologetic to the surgical team. I even verbally apologized to the intern who had assisted during the surgery; she was coming from a 24-hour duty and had had to extend her hours because of the procedure. In the few times I would text Doc Dan afterwards, I resisted the urge to begin each message with "Sorry to disturb you doc, but..."

Now, six months later, I hear those same words being echoed back to me in the form of a patient. "Pasensiya ka na doktora, na-istorbo pa kita." I think it's only now, six months later, through this brief encounter with a guy with a wound on his ankle whose name I do not even know, that I am beginning to understand the source of my conflict: a false notion that my family and I were not worthy of receiving such kindness. 

That moment stands out in my life as a striking moment of clarity. It was like a light switched on inside my brain, and there illuminated in the shadow of Doc Dan's words I found the essence of the kind of doctor I wanted to become: humble, kind, generous, a tireless servant. I want to possess the kindness and courage to one day be able to erase "trabaho lang" from my vocabulary and instead, like Doc Dan, replace it with "my pleasure." Until then, I'll be here, constantly learning and growing from each patient that I see.

In other news, here is a rundown of random stuff from the community this week:

• One of my patients was an unvaccinated 1-year-old girl with measles. When asked why the kid had never been vaccinated, the mom said she had gotten scared by the Dengvaxia news reports on TV.
• One of my very first patients at the center, Tatay F.A., died this week. I only found out through my co-interns JJ and Betsey, who, during a barangay outreach, had seen his name and picture on a tarp, superimposed against a backdrop of a cloudy blue sky. He'd been struggling with COPD for the longest time. In fact, his very first consultation at the center had had to be cut short by a trip to the emergency room because his oxygen level had gotten critically low. Sadly, despite many prolonged repeat consultations at the center where we would explain his condition over and over to him, I don't think Tatay ever fully understood what was going on. 
• I wonder if there was anything else we could've done. That I could've done.
• I had an old lola coming in for a medication refill who made me aware of a habit I didn't know I had: in the middle of our interview she snapped and said, "Doktora 'okay' ka nang 'okay' diyan!" Kk p0whz.
• Towards the end of the encounter with the same patient, I said goodbye, see you next month. She strangely replied, "I hope so!" I asked, "Bakit 'I hope so'?" She laughed and said all-too-gleefully, "I'm ready to go!" (FYI: Yes, I clarified, and she meant go as in die, in case you were holding out some hope that she had a vacation planned out or something.)

Okay, now it's getting late and much like that old lady, I'm also ready to go! (As in, I need to return to that chapter on blood volume in pregnancy.)

Goodbye! Follow up po natin next month!