Sunday, June 24, 2012

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Sampung payo

I COULD NOT RESIST not linking to Sir Bats' blog entry, Sampung Payo Para Sa Mga Bagong Medical Clerk (10 Pieces of Advice for the New Medical Clerks), because it applies to my everyday experiences. Dr. Baticulon, a neurosurgery resident in PGH, owns one of the most fascinating blogs about life in medical training. His archive has priceless entries on med school, tips on taking exams, and unforgettable patient encounters. My favorites are those written in Filipino. They're well-thought out, sincere, and heart-wrenching—and I can relate to a lot of them because I'm familiar with the third-world hospital context of his stories.

I may have bumped into him when we referred a patient with head injury to Neurosurgery this morning, but I was too shy to start any conversation that began with, "Hello, Sir, I read your blog." (I—or was it Franco?—was also busy assisting an intern make an improvised neck brace made of cardboard which, when fitted on the patient, made her look like Magneto.)

So here's the entry I'm taking about, and I'm posting it in toto.
1. Magbaon ng maraming micropore tape. Pang-wound dressing. Pang-label. Panggawa ng collar at splint. Pang-secure ng IV line, foley catheter, at NGT. Pandikit ng natanggal na suwelas at napunit na pantalon kakalakad kung saan-saan. Matutuklasan mong guguho ang ospital kapag nagsara ang pabrika ng micropore tape. 
2. Huwag kalimutang mag-”po” at “Sir/Ma’am” kahit bantay ang kausap mo. Minsan, Sir at Ma’am talaga sila. 
3. Siguraduhing kumpleto ang bakuna, lalo na para sa Hepatitis B at flu virus. Mahirap mag-duty kapag nilalagnat, sinisipon, at inuubo. Kawawa ka. Pero mas kawawa ang pasyenteng hahawahan mo ng sakit. 
4. Huwag basta-bastang iinom ng azithromycin. Sa dami ng clerk, intern, at resident na adik sa 3-day course of antibiotics, resistant na siguro ang lahat ng mikrobyo sa gamot na ito. 
5. Basahin ang mga kasong nakikita mo bilang SIC (student-in-charge). Mas madaling maintindihan ang systemic lupus erythematosus, Whipple procedure, Kawasaki disease, choriocarcinoma, at ruptured aneurysm kapag ikinukumpara mo ang nababasa mo sa textbook sa nakikita mo sa pasyente. 
6. Makipagkuwentuhan sa mga pasyente at bantay. Tanungin mo kung saan maganda pumasyal sa lugar nila, kung paano sila naghahanapbuhay, kung sino ang gumagastos para sa pasyente, at kung napanood nila ang huling laban ni Pacquiao. Marami kang matututuhan sa kanila na magagamit mo pagkatapos ng Medisina. Hindi mo ‘yun mababasa sa Harrison, Schwartz, Nelson, at Williams. 
7. Huwag munang mag-shortcut. Hindi ka pa expert. Kaya ka nga clerk dahil marami ka pang kailangan matutuhan. Kumpletuhin ang clinical history, physical examination, at neurologic examination (Dapat [hindi] lang kasi neurosurgeon ang nagsusulat nito!). At huwag kang didiretso sa primary working impression. Lagi mo dapat tatanungin ang sarili mo, “Kung hindi ito ang sakit ng pasyente ko, ano pa kaya ang ibang puwede?” Tandaan, hindi laging tama ang diagnosis ng resident-in-charge at ng referring physician. 
8. Huwag magbilangan ng trabaho. Sa huli, magpapantay-pantay rin ang dami ng pre-duty, duty, post-duty, weekend duties, ER duties, triage, blood bank, at Cancer Institute duties ninyo.  
9. Kung hindi mo alam, magtanong. Kapag nagkamali ka, hindi na ‘to test paper na puwede mong palitan ang sagot at ayos na ulit. Kapag nagkamali ka, may pasyenteng puwedeng masaktan, mapahamak, o mag-agaw-buhay. 
10. Pero kapag nagkamali ka na, huwag matakot humingi ng paumanhin. Walang perpektong doktor. Mas lalong walang perpektong medical clerk at intern. Huwag lang kalimutan na kailangang matuto sa bawat pagkakamali. Bawi na lang sa susunod na pasyente.
I agree with him. I, too, have come to the conclusion that the micropore is one of the most ingenious inventions of man.

2 comments:

  1. Ronnie was the editor-in-chief of the school paper when I was a high-school freshman. I was a features writer then. He inspired me to later become editor-in-chief myself.

    Such a small world. :)

    ReplyDelete
  2. And it keeps getting smaller! Thanks for dropping by, Glenda.

    ReplyDelete

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