Memories of IM past

THREE WEEKS ago I wrote this piece. Here are some of the things I'll remember the most in Internal Medicine (not in any particular order):

1. The Guazon Hall endorsements. Every day, except Sundays, we'd troop to Guazon Hall for the morning endorsements.

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The two-hour session would start with a quick rundown of mortalities and mortalities of the previous 24-hours, followed by moments of silence as the senior residents, seated at the topmost row, picked one case to be discussed for the day. The ensuing tension was similar to the choosing of Katniss Everdeen's sister to represent District 12 in the Hunger Games, where one either lived or died.

The architecture itself was daunting: five or six rows of seats in ascending fashion, the lectern in the middle, and whoever was speaking was looked down on, quite literally, by the audience.

The chosen clerk or intern would move slowly to the center, carrying the pertinent lab results, X-ray plates, and ECG tracings — failure to obtain these on time was almost unforgivable. The said student would then start narrating pertinent details about his patient. What followed was a barrage of questions, usually answered by monosyllabic, uncertain answers, if not total ignorance. There was audience participation, too, where the audience was asked for differentials or ancillary tests to request for. That was the fun part — knowing that a lot of people in the room only knew as much as you did. Ah, the joy of being an extremely average medical student!

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2. Monitoring, that underrated but extremely tedious and crucial chore. I'd have to say this was the most difficult part of the IM rotation. For three or four straight hours, the fate of all patients in the ward was left to the monitoring students. We checked the vital signs hourly, manually adjusted the Dopamine drip rates (among other IV fluids), and referred unstable patients immediately.

My monitoring schedule was always from 4 am to 7 am, which I always picked because I'm a morning person, and I like waking patients up, just about the time when the sun is about to rise. My prayer was that no patient would die on my watch — thankfully, no one did.

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3. The hot, steamy call room. And I mean that in a literal, non-sexual kind of way. The airconditioning was broken, the heat was unbearable, and the humidity was adding to our stress. Undoubtedly it was the worst call room in PGH, but it felt like home somehow.

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4. Duya-isms. Dr. Joey Duya had a way with words — and with us. A gifted teacher, he had a unique style of asking the right questions at the right time during the endorsements, finding a practical lesson in every mishap a student committed, and looking for ways to spur us to better ourselves. He was like a walking quotable quote machine, but he was real and personal.

Among the phrases we often heard from him were:

"In IM, we're not just students, we're here to give service."
"That's the perfect example of knowledge not translated into practice."
"According to the Hematology chapter of Harrison's, because there's a table there ..." 
And our absolute favorite,
"What are your thoughts, Doktora?"
5. Dr. Abi Uy. How we miss her, too! Her voice was resounding, especially when she uttered the onomatopoeic "EHHHH" after a student got the answer wrong. If the morning endorsements were a party, she'd be the life of it. She asked tough questions, exposing our ignorance, more than anything, but she wanted us to learn. From memory, she cited passages from Harrison's. She often challenged students with a probing "Are you sure?" or "Will you bet your duty?"

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6. The realization that I was the oldest in the duty team, clerks and interns included, but that I was often mistaken as an Intarmed kid, which bothered me (was I being too bibo?).

7. Jeopardy! That fun game we played.

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8. The pre-residents. We saw lots of them, all competing for the twenty-something slots of IM residency. I'll always remember Sir MJ and Jyoti, Ma'am Kat, Tinay, and Rox who helped me make sense of my cases one way or the other.

9. My service seniors, Ma'am Gelza, Sir Greg, and Ma'am Mabelle, and my interns and co-clerks!

And, of course, the best block ever (in our hearts and minds, at least): Team Clerk!

Best Block Ever

Block Three!

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Wheee!

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As I read this now, I'm filled with thanksgiving to the Lord for the strength and peace He gave me throughout my four-week stint in Internal Medicine.

I still pass by Wards 1 and 3 from time to time, and whenever I see oily, tired, and distraught faces hurrying to and fro, all of these — the memories, joys, and frustrations — come back to me; I was just like them once. And it gives me sense of relief and fulfillment that for the next few months, I don't have to prepare for any afternoon endorsement.

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