Exactly a year ago I learned that I have earned my license as a physician. Back then I thought all the hard work has finally paid off. Everyone was overjoyed and proud of my success. I thought the golden path to an independent and worry-free life has finally been paved.
Fast forward to present, exactly one year after, and I'm a miserable, disillusioned, penniless, bitter, insecure, spiteful, confused and lost stranger who has no direction in life. Perhaps people still see my usual cheerful facade, but I honestly don't understand who I am and what I'm meant for anymore.
In just one year, people can actually change so much. And that's not just speaking for myself. I see friends, possibly blinded by the sudden change of their status, develop a certain air of arrogance and superiority, perhaps not at all baseless, but still enough to crush what little sense of self-worth I have left. I do not know if I have been making wrong decisions for the entire year to end up where I am right now. I still believe it is God's will for me to become an instrument of healing though, yet I don't understand all of these.
During my clerkship and internship years, I was so sure that I'll take up "Surgery" for residency in Manila. Sure it is toxic, but I love the work and I love being in the operating room. But after the board exams, like most of my classmates, I chose to "rest" for a year. But unlike them, I wasn't earning that much because I chose to work in a small free clinic in some far flung area. I figured it was one way to pay back for the many years of support from my scholarship sponsor, and at the same time the job was benign and the pay was decent. But looking back, maybe I was just plain lazy and scared of practicing in a bigger institution. And the result is that my knowledge with current diagnosis and management is outdated, and my clinical skills and experience has been almost diminished to nil. I have lost much of my confidence in my being a physician. In the first place, perhaps I was not really that confident at all.
But my job isn't really bad because I get to experience and see the quality of our health care system, especially in the rural areas (as if working in two government hospitals for the past two years isn't enough yet). And I really wanted to extend my (not-so-)free services in gratitude for the many years I've gone to school without paying the tuition fees. But what I've seen for the past year is downright frustrating and disappointing. This country is so poor that health is never a priority. If you don't even have enough money to put food on the table, then how can buy maintenance medications that cost almost a hundred pesos per tablet? How can you possibly afford to have lab work-ups done, when you don't even have the fare to get to the nearest hospital? Given a case of a stab or gunshot victim too poor to pay the downpayment in the private hospital, he will only be given first aid treatment until condition is stabilized, and then he'd be sent off to a government institution. And it's not like our government hospitals are havens of immediate care. I know of a kid who broke his arm, and he was admitted for almost two weeks before he finally got his turn in the operating room. And all those time he had been placed on NPO for several occasions until his mother almost brought him home against advice because she'd rather see her kid with a deformed arm than see him frequently in a starved state. But I believe that if they were in a private hospital and had loads of money then his arm would have been fixed up without any delay and he'd be up and ready in no time. It's a harsh reality, but in this country, if you don't have the money, then you may not have the right to live.
I don't want to point fingers and blame anyone though. I understand that private hospitals need your money because they also need to pay the salaries of their employees and staff. And of course, any form of management or procedure can't be done for free because materials and instruments and other things are used, and these are quite costly. On the other hand, you can't blame government hospitals for unable to render speedy services to all of the patients because there are just too many of them. They need to carefully triage the patients to know which cases need treatment right away, and which of them can wait for a while. And trust me when I say that even the most patient and understanding medical practitioner in the public hospital can turn out to become the greatest b*tch of all, especially when he or she is inside the ER. If you haven't had a blink of sleep, haven't eaten your meals, haven't even washed your face or gone to the CR in more than 24 hours, plus your seniors and consultants are scolding you and demanding so much from you, add to that the fact that you're underpaid and you have to shell out money from your own pockets to pay for your patient's needs, plus you also have to deal with the anger, anxiety, undeserved accusations and all sorts of emotions from your patients and their watchers, then maybe those are enough reasons to break you down and turn hell loose within you. Your doctors are humans too, and they also have their limits.
Yet even with this knowledge, I still chose to apply for residency training in a government hospital. And my application says, "Obstetrics and Gynecology" instead of "General Surgery". Why the sudden change? Don't ask because I'm equally baffled. I've been praying about it but I really don't know what to do right now. When I talked this over with one well-known OB-GYNE consultant, she seemed to be hinting that I should not follow the course she had treaded on. She had a wistful look, almost regretful(?). I don't know.
And going back to Manila for training would mean a lot of things, one of which is that it would require some amount of money, which I certainly don't have right now. I've saved little over the past year, since I've used much of my salary to pay for expenses at home (although I must admit, I spent some of my money carelessly too). And just today, more concerns are added to my long list of deliberations. I think I mentioned before that I took my father to an endocrinologist for work-up, and that after he took his new meds, he started feeling weak. It turned out that he developed a systemic drug allergy (dunno which of the 4 meds is the culprit) and we've been going back and forth to the allergologist. He's been taking one oral hypoglycemic agent, but it was obvious that there was poor control, with the amount of urine he's been voiding lately and the rapid loss of weight. It was confirmed with this morning's FBS, from 256 mg/dl to a whopping 404 mg/dl in less than a month! My typically stubborn father finally agreed to insulin treatment and got his first dose today. He will be on insulin temporarily until his blood glucose stabilizes and then maybe we can shift him back to oral meds again, assuming that he would no longer develop allergies. Bought the vial of insulin already that's going to last for a month and some syringes too. But tomorrow I'm going on a hunt for a glucometer (PhP 2000+) and strips (PhP 600+ for only 25 strips), which is something I initially didn't have a budget for. But I pray he'll get better soon. No amount of money can replace your one and only father.
So with my savings going down the drain just like that, with an unsure residency application and an even more unsure budget to go to Manila, plus the fact that my father is sick and needs someone to look after him, I am once again back at the question on what to do with my life. There are many options, including the possibility of trying to take the USMLE, but none of these are really appealing to me. None of these options make me feel right or at peace. What does God want me to do? For now, I still do not know. But I am hopeful that I will soon understand His will and plan for me, and that when He makes this known to me, I will be able to make the right decision.
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