Sunday, August 27, 2017

Sticking our necks out

It's a little less than a week before I bid farewell to the wards. I've rotated at the charity wards for three straight months (Ward in June, Medical ICU in July, and Ward again this August). No third year rotation has given me more fulfillment than being a Gen Med senior

This month has been extra-special because I was mentored by our service consultant, Dr. Ester Penserga, whom I've looked up to—even as a medical student—for her wisdom, intellectual rigor, compassion, and the fact that, whenever she asks us questions and we can't answer her properly, she gives us negative million points, effectively rendering us bankrupt in her mental account of disappointments if these were tallied.

But Ma'am Pen carries on with grace (and it's not such a coincidence that her daughter, my friend and colleague in IM, is named Grace), patiently reminding us to act as internists first of all and not as subspecialists, ensuring that we don't miss out on nutrition, that we compute for the ideal body weight and BMI, that we measure the abdominal girth in centimeters, that we do the math for the fluid requirements of a patient to the very last drop (25 mL/kg of ideal body weight in 24 hours, as a starting point)—things often forgotten or ignored by the busy medical resident but things that impact medical care. Her attention to detail keeps us all in check. She refuses to "frame" a patient based on the presence of co-morbidities and reminds us to keep an open mind and not be "swayed" by the obvious—we could be dealing with another disease entity entirely. She is not impressed with sheer eloquence, piercing through the veneer of pretensions and rushed endorsements, but she pauses, like a metronome, and probes deeply into the details, reminding us, "History! History! History!" because the patient's story is key to his cure. Her motherly queries usually worded as "Sure ka, ha?" makes us question our memory. Her presence in the room gives us a healthy kind of insecurity.

I've also worked with Inah Coronel, whom I might've stressed out during our ER rounds, but who had nevertheless remained calm and composed. 

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I've been reunited with Josh Torres, once my intern and now one of my junior medical residents in the service.  I'm certainly proud of how he has grown in skill and wisdom! I torment him with the rumor (or fact—I'm not entirely sure) that he has been called The Fourteenth Reason Why One Should Pursue Internship at PGH.

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Our clerks (who might have shed a tear or two because some of our patients had died the past weeks) are photographed here, ecstatic with the fact that they're shifting out of IM tomorrow. Medicine rotation during Clerkship is extraordinarily tough and challenging, what with the pressors and IV hypertensives that need to be titrated, and the continual, Damocles-like fear that the patients can deteriorate any time.

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They gave me cake as a parting gift. Thank you!

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Tim Chua and Hanz Carmona gave me donuts when they had shifted out of the wards! Thank you!

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We are Service Three. Our interns: Tim Chua, Hanz Carmona, Ron Castillo, Gerard Cabero, Flo Betancor, Bem Baylon, Anthony Balotro, and Julian Cabrera. Our clerks: Elleia Barcelon, Ani Batangan, Loren Bolilan.

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I wish you all success and happiness!

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