By By Vietrez P. David-Abella, MD
posted 26-Apr-2015  ·  
967 views  ·   0 comments  ·  

"The Philippines is worth staying for." It was June 1986, after the dust of EDSA Revolution had settled, that I was on the cusp of medicine proper. My resolve was firm.
Studying medicine is a test of one's limit in many aspects: physical, mental, emotional, psychosocial. Because of the sheer volume of knowledge and skills to acquire, keeping physically fit became instinctive: get enough food, rest, and sleep, when able. Give the mind creative breaks, such as movies or a good book. Keep a tight circle of friends, but be prepared to make new ones.
While we were improving ourselves individually, we were also learning to be team players. We had a lot of group work: from anatomy dissection, to physiology experiments, to neurology patient examination. When we became clinical clerks and stepped into the bottommost rung of the medical hierarchy, we had to rely on our seniors: interns, residents, fellows, and consultants. We learned everything from them: history-taking, complete physical examination, diagnosis, treatment. We interacted with hospital staff: nurses, technicians, utility workers, secretaries. We discovered that our white uniform and nameplate was a passport to our patients' lives: we asked, we looked, we poked, we felt.
We cried over deaths, rejoiced with births, wrung our hands in frustration over uncooperative patients and bantays. We labored through 24-hour duties, rested on post-duty days, and recharged on pre-duty, out-patient service days. We marked our days with clinical rotations, desolation in exams, consolation from occasional outings, and choir practice for the seasonal Tao Rin Pala, a showcase of talents of medical students. We made fast friends, fell in love with the idea of love, had our hearts broken and mended.
And before we knew it, 7 years a slave was over and done with! Medical boards review was a blur, punctuated by the Mount Pinatubo eruption; passing it meant another crossroads, to another 3 to 5 (or more) years of acquiring a specialization.
When it came to choosing specialty training, I had by then settled on a career in general surgery. Why surgery?  I've always imagined specialty fields as a dichotomy: medical or surgical. Although there are some areas that seem to straddle both, like the interventional fields, or pathology, a physician was either of one: a thinker or a tinkerer; a sayer or a doer; an artisan or a craftsman.  As a kid I had been more crafty than artistic; I enjoyed working with my hands; I was more visual than imaginative.
Clinical exposure also helped define my choice: in Year Level 1, after attending an autopsy, I wanted to be a pathologist. Then, seeing for the first time a baby being born via Caesarian section in the old PGH Operating Ampitheater, I realized I had more empathy for the living than the dead. I kept the torch for obstetrics-gynecology until my clinical clerkship years, when endless hours of labor-watching, inability to appreciate fetal heart tones, and difficulty in imagining cervical effacement and dilatation, coupled with the perpetual smell of loquia and decaying-fish cervical cancer, permanently snuffed it out.
While I appreciated the fine strabismus operations in ophthalmology, the luga-sipon-plema triumvirate of ENT turned me off. Radiologic heart shadows and pulmonary haziness and densities held rotational appeal. But the adrenaline rush of a night in trauma surgery hooked me: beyond the bloody knife wounds and the gore of bullet-riddled bodies, I saw persons who needed to be stitched up, opened, and explored. I witnessed tens of miracles: people on the verge of death, given a new lease on life by timely surgical intervention, some of them by my hand.
The fact that I was female did not deter me from visualizing myself in a male-dominated field. Medical school equipped me to be a healer; passing the Boards meant that the state has recognized me as a licensed physician. Work did not faze me; general surgery training would simply be a continuation of my medicine studies, albeit shorter. And I had the end in mind: a provincial practice, perhaps in Balayan, Batangas, where I had spent many a happy summer in the company of my great-grandmother. Rural enough, but not too far from Manila, where my family was.

(To be continued)

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