So we just heard a very inspiring message from our consultant in UERM and we, with Dr. Locnen’s permission, wanted our fellow physicians to also find inspiration in her message. This was given during the Testimonial Dinner for the New Board Passers last 02 May 2018. It was so inspiring that we can’t help but share this to you here, just so we’d have something to read again when we get fed up with life.
Each time we read this, we are always left with wet eyes and matted eyelashes but altogether feeling comforted, inspired and ready to take on a few more challenges when we go on duty. Read this when you feel down or lost or just simply worn out from the daily grind.Read on and be blessed, Doc!
(But if you’re not a doctor, this will still inspire you! Or at least you get a glimpse of how it is if you’re aspiring to be one someday. Or if you know someone, at least you could understand them better.)
(Emphasis by #tandemd)
Vice Chairman Young, Dean Uy, Secretary Quinones, ,VPAA Dr Aligui, SVP Carmelita Valdez, VP fro Treasury Ms Iris Militar, VP for Research Dr Nailes, my fellow teachers, my mentors, beloved staff of UERM and to the newest physicians in the room, who in all likelihood are also the happiest people in Cubao at the moment, a very good and warm summer evening to all of you.
To say I was surprised with the invitation to speak before you on this wondrous occasion is an understatement. After the initial emotion was the realization that I am indeed getting old. Wala na rin po kasing kumukuha sa akin mag ninang sa binyag. Puro na lang kasal…..But in truth, I am equally honored and horrified beyond words to be on this podium. I have spoken before graduating residents and fellows previously, so some of the things I will say are similar to what I told them. In spite of that fact, I felt that I have been unusually preoccupied the past days about this task primarily because during my graduation/testimonial ceremonies, the inspirational speakers were always individuals whose resumes were kilometric, whose wisdom were deemed unparalleled and whose characters were of solid repute. And also a bit older than I am. How would I measure up to that? How does one become inspirational? I think the best way for me to earn my keep this evening is to look back.
One September night in 1996, my best friend and I learned that the results of our Physician’s licensure exam will be coming out the following day. Unlike the present, we had to wait for a month to learn about the outcome of the boards. So, just before midnight, we drove to the Manila Bulletin Newspaper Offices in Intramuros, to get a copy of the paper hot off the press. As soon as we entered what seemed to be then a cavernous and imposing building, a security guard, who was standing at a corner with a pile of newly printed newspapers, asked us, in a bored monotone: “Board exam? 10 Pesos” and handed us a copy. We proceeded to nervously look for our names and began shrieking like high school girls when we saw that we made it. I can still vividly remember the feeling of joy and relief, the same way you are feeling right now. Finally, I am done after 5 years of grueling work. Or so, I naively thought.
Afterwards, as some of you might do, I moonlighted as a general practitioner while I studied for the USMLE. I went on duty in a small lying in clinic where I delivered babies and knew I could never be an obstetrician, sutured wounds and discovered I did not have a surgeon’s hands, did circumcision and looked at various medical cases. And during those times, I brought around my books for reference in case I would not know what to do. Walang internet, UpToDate or You Tube. I even taught chemistry to nursing students for one semester in the Philippine Women’s University. After passing the USMLE, I got letters for interviews in some US hospitals but as I was lining up to apply for a visa at the embassy, I received a message in my “Pocketbell beeper” (Yes, there was a time when we did not have ready access to a telephone) that I got accepted to UERM’s Internal Medicine Program. At that crossroad in my life, I made a split second decision to stay in the Philippines and pursue residency and fellowship here. What followed were several years of rigorous training — sleepless duty nights, endless preparation for conferences, specialty board exams, missed family reunions and Christmas or New year Eves in hospitals. This will also likely be your life for the next years. Do not be worried. For even if the road will be full of challenges, the joy and fulfillment of being a doctor will easily eclipse the hardship. During all these years, I have certain practices that I endeavor to remember. I may not succeed all the time but I try my hardest. I share them with you tonight.
One is to always strive for excellence.
Pour your heart and mind into everything that you do in work and in your personal life. When seeing patients, exhaustively look for answers to their problems. Ask for help when you need it but develop critical thinking. Challenge your peers and mentors when you have a different opinion. Just be certain that you do it respectfully and that your opinion is based on facts. Fake news are quite abundant these days. Developing excellence needs focus and attention to detail. Oftentimes, when I go on rounds with trainees, one or two of them would be looking down on their phones while I talk to the patient. The beauty of the digital world is that information can be easily handed but it sometimes removes us from pertinent human interaction. You learn a lot by observation. I remember a mentor telling me once that “diseases do not read books”. Ordinary illnesses may present differently and serious illnesses may seem initially mundane. So beyond reading, you have to hone your powers of observation. I remember as a CCU fellow, after consultants have done their rounds for the day, I would sit inside my patients’ cubicles and observe them quietly. I would just stare at the rise and fall of the chest, the steady or changing rhythm of the heart in the monitor, feel the strength of their pulse and collect a lot more tidbits of information that make the whole. During those brief yet important moments, it was just me and my patient.
Secondly, persist beyond adversity.
You will commit mistakes. That is a hard, cold fact because you are human. Show me a doctor who tells otherwise and I will tell you that he has not seen enough. What is vital is that you learn from your mistakes and you do not repeat them. The world of medicine can be seemingly cruel to those who occupy it. You will have mentors who are exacting and may have a small tolerance for mistakes. As a first year resident, I remember being told: “you are giving the right medicine for the wrong disease” in front of the clerks who were under my supervision. My service consultant was asking me whether the heart murmur was diastolic or systolic. I answered incorrectly and as such received a dressing down. Pagkatapos nga po ng rounds, sabi ko sa mga JI’s, pahingi ng tabo babanlawan ko muna ang sabon. I had several of similar encounters during fellowship, when I trained under one of the most demanding mentors I have ever met. But it prodded me to study even harder and take time to talk to and examine patients thoroughly. Honestly, I never developed any ill feelings against those who expected that I give my best. In the contrary, I thank them for having had faith in me even when sometimes, I have stopped believing in myself. I distinctly remember that incident in the medicine ward about that murmur as if it happened yesterday.
Exactly 20 years hence, I stand before you as a cardiologist. Of all the professions, I think medicine equates most to delayed gratification. I know most of you grew up and studied during an era when answers are found in a split second, when you do not need to go to the library for your research, when you can get a ride by a push of a button. Unfortunately or not, medicine isn’t like that because humans are much more complex. It is a test of your patience and resilience. Though your intellect matters a lot, it is your emotional quotient that will sustain you in medicine and mostly in life.
Thirdly, I try to always remind myself to be kind.
People are inherently good and I would like to believe that doctors in general are inherently kind. Patients come to us because of discomfort and pain so they are anxious and afraid. In the face of their suffering, their loved ones may become belligerent and turn to you in anger and frustration. Be patient. Answer questions objectively and in a language they will comprehend. Never, ever engage them in a fight. Walang papatol sa pasyente. There will be times when you would want to answer back but exercise that superhuman effort to keep your patience. When you feel that you do need to defend yourself, do it with class and with quiet strength. And not over social media, please. Stay above that fray. The world still needs kinder people. And kindness should not only be extended to patients. We try to be kind to our fellow doctors, nurses, other hospital staff and even to strangers. Kindness should not be equated with weakness. We can be just and kind at the same time. One of the most important people you have to be kind to is yourself. In a profession where expectations may become unreasonable, you have to get out of the pressure cooker occasionally. Stop and smell the flowers. Recharge. Watch a movie. Go out with friends. Sleep. Rest makes you better physicians and allows you to appreciate the work that you do.
Fourthly, doctors take a front seat in the face of human suffering and human joy.
You will have patients who would seem to recover miraculously and leave you heady with satisfaction but you will also lose a few in the most unexpected of ways and leave you broken hearted. To keep your grace in all of these, learn to laugh and pray. When the timing is appropriate, laughing with our patients brings the relationship to another dimension, something akin to friendship. Learn to laugh at yourself, too. It induces endorphin production. One of the best pieces of advice I received from a senior consultant was to pray for my patients. I do not consider myself very religious but I do ask help from above. It always gives me a sense of peace especially when I have to make very difficult clinical decisions. It emboldens me yet at the same time it humbles me into accepting that we too, are just human, that I could not make patients’ hearts beat forever, no matter how hard I try.
Now before I close, I wish to remind or reassure the honorees of certain truths. One is family is always the priority. When you have to choose, choose family. If you are not on duty, no matter how tempting sleep is, attend family reunions. Just bring a prescription pad. You will for certain conduct a med mission there.
On the practical side of life, I know you are concerned about making a living. For those going into further training, that is a big challenge. Makikitira pa kayo sa mga magulang ninyo.. Kasama sila sa delayed gratification. For those who will go into practice or a different path, I assure you that you will lead a comfortable enough life as long as you do good by your patient. I always tell my mother that I will not go hungry with the amount of food I receive from patients. You see what they are forbidden to eat, they will give you. Now if a fanciful life is something you wish for, you may not be in the right profession because the essence of medicine is truly service. Being a doctor does not entitle you to any privilege, only to a lot of responsibilities and accountabilities. But that can make your life profoundly meaningful.
Remember also where you came from, your old schools and mentors. Knowingly or unknowingly, they helped shape what you are today. And if you have the chance, teach. It will help ensure the future.
On this occasion when most of your sacrifice has come into fruition, I warmly congratulate you, your loved ones and most especially your parents, who if they are not doctors, never had any idea of what they were going into when you chose to go to medical school.
For all my self doubt and imperfection, I must have done something correctly, for you invited me here today. For that, you have my undying gratitude. Know in your hearts that wherever your fortunes may take you, you will always have a home in 67 Aurora Blvd, Brgy Imelda, Quezon City where one of the best medical schools is proudly located.
Go follow your bliss and Godspeed. Thank you.
Sue Ann Locnen, MD
Need we say more?
Just perhaps stay #tandemd with the Lord!
Ardys & Jerald