Uncertainties and challenges: my penultimate POD month

As I was wrapping up my 24-hour shift this morning, I was also ending my penultimate POD (Physician-on-Duty) month, my foray as one of Internal Medicine's ER physicians this October. And with it was the thought that in a few weeks I'll be taking on seniorship, leading one of six charity services to sound dispositions, standing at the forefront of administrative battles that happen on a daily basis.

Are we ever ready for the tasks ahead of us? I had the same dilemma when I finished my first year of residency training, knowing that the ER would be daunting. Daunting it had eventually proved to be; and at some point it almost became impossible, what with the stronger reinforcement of the admit-all policy, something that has always been there, apparently, but whose effects became more palpable this year. The hardships that came with the doubling of our usual patient load have allowed for my personal growth: my clinical eye, I like to believe, was developed; and the same could be said about my patience.

Our experiences are never enough, I suppose, to make us ready. And the feeling of self-sufficiency—that we think we can do all, that we are ready—might be a marker of immaturity and eventual unpreparedness. It is, in a sense, healthy to feel inadequate.

At the Observational Unit, while I was waiting for General Medicine (GenMed) service to finish the disposition, I had a chat with the interns. How I have loved working with a responsible, cheerful, and rowdy block! Few things can be as refreshing as reminiscing at 6 AM. I thanked them for the great work they've done. They've surely made my life easier—by facilitating the labs, by monitoring our critical patients, by even suggesting management strategies.

"Magiging masungit po ba kayo sa Guazon kapag senior na kayo?" they asked, to which I replied that terrorizing students has never been my style. On this point, I'm not too sure, because my colleagues tell me I may have gained quite a reputation among the students—they always "prioritize" Dr. Catedral's orders, considering all my orders stat until proven otherwise.

I apologized, with all my heart, for my occasional impatience at the slow return of lab results. I have been guilty of insisting that chest X-rays be done as soon as possible, and that blood cultures be followed up without fail. I have always believed that students must learn the urgency of why we do things—a negative culture might mean an earlier discharge date for a patient, and therefore, lesser chances of getting nosocomial infections.

We were all laughing that morning, the kind that emanates from knowing that another day has ended, and there was rest waiting for all of us. More challenges will be waiting for us—for them, a new rotation, the upcoming Physician Licensure Exams, their respective residency applications; for me, the month of November, and the prospect of seniorship.

But my fears and uncertainties are calmed down by the fact God will strengthen me, all of us (Philippians 4:13). What grace, indeed!

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