Some people are surprised when I tell them I have a class to catch, and could I see them on my next clinic day perhaps?
“Class”? You’re still in school? What are you studying? is the usual reply.
I say I’m a teacher, which doesn’t quite get the message across. Then I clarify that I’m a pro-fe-ssor, which elicits responses akin to admiration. “Professor Catedral” has a nice ring to it, like a smart, fancy, and profound human being. But nobody calls me that, unfortunately. In reality, though, much of academic life is answering emails, meeting with wayward students whose absences warrant me to be creative with their make-up tasks, and attending committee meetings that often start late and could have been just as productive as emails. But these in-person meetings are almost always moments of human connection, with the warmest and kindest of teachers, and with generous servings of crispy turon for snacks—so why not?
And I’m an assistant professor (some meetings), not a full professor (many meetings, I imagine).
The job of teaching does get easier with repeated practice. I like to think I’m a better teacher now than I was last year. Unless I find a valid reason to prepare them all over again, I rehash most of my lectures, repurposing and improving them to fit the moment for a specific batch of students in a specific point in history. My teaching-learning strategy is a hybrid of synchronous and asynchronous activities. On these last two weeks I shared my video recordings of lectures to my students. The topics are technical—better read than listened to. My students would doze off if I gave hour-long lectures in class. While they wash their dishes or prepare for sleep, they can listen to my spirited discussion about the hallmarks of cancer, the principles of cancer treatment, and the side effects of systemic oncologic treatment. They’re adult learners (I hope) and should have the internal motivation to learn things at their own pace. After some time, I meet them in person, expecting they’ve done their homework.
Last Thursday afternoon, I gave my last lecture for the oncology module of the (Internal) Medicine course this academic year. What I had originally outlined as a 40-minute summary lecture extended well into the afternoon, with my students asking me deeply profound and smart questions, both personal and technical, that they could all be topics of an essay collection.
For that afternoon, I intentionally shared stories about my patients to give the personal side to otherwise technical concepts.
I illustrated Weinberg and Hanahan’s Hallmarks of cancer through a story about my young patient with ALK-positive lung cancer. That allowed me to to talk about targeted treatments, crippling the process of oncogenesis, especially invasion and metastasis. This man had superior vena cava syndrome and was at the brink of respiratory failure because the lung mass was obstructing his airway. When he took alectinib his symptoms disappeared; he is now back at work.
When I spoke about honoring the patient’s wishes, I told them the story of one of my first patients in the city: a university professor, a single mother, who had stage IV rectal cancer. I shared to my students my mental picture of her: always well put-together, with her flowing dress and lipstick, and her remark: Hindi halata ang colostomy bag, Dok, no? She chose not to see me for a year; she felt great after all the treatments and decided it was the best course of action to resume her life. The cancer was quiet for all those months, but she came back, jaundiced, in pain. She told me: I’m ready to get treatments again. I want to live long enough to see my son graduate.
Her sister would return to the clinic and would tell me how the senior high school graduation went: the patient was inside the car, looking out the window, seeing her son get his diploma. She would die the day after, her prayers answered: she had set her son up for success. And all was well.
I delivered the lecture in the fourth floor auditorium with tiered, theater-style seating, and I could see my students’ faces. Many were in tears..
I went on and on—getting through my slide set and remembering my patients, forcing myself to hear the sound of their voices and laughter—until I was done. Any questions? I asked.
Several students raised their hands, but not all at once. They asked me things I still ask myself. How do I deal with so much pain and suffering? How do I react to patients who do not have the funds for their treatment? Do I ever get sad and frustrated?
There was some personal confessions, too. The students opened up their hearts, becoming vulnerable, understanding that ours was a safe, sacred space. A student told me I was her grandfather’s doctor and she thanked me. Her Lolo had passed away. One student said his mother died when he was 16 years old. I asked him, You must miss her, don’t you? She must be your reason for taking up medicine. She must be so proud of you.
I was asked: Do you cry?
I said, I schedule my moments of drama.
