When I entered the hallways of my medical school, I did NOT have even the slightest bit of idea what I was going into. I was not even warned how long the schooling would take to become a general practioner, or how long the training would be before you become a full-fledged specialist. I did not fathom how much money my parents would cough up to get me through med school.

Editor’s Note: This Op-Ed is penned in response to the hate that UST doctor Ana Liezel Sahagun received after she allegedly denied to admit a laboring mom. The unborn child later died inside the mother’s womb.

Fast forward eight years since I first entered my alma mater’s doors, I now found myself in the middle of a busy government hospital emergency room, considered to have the heaviest emergency room and out-patient volume in the whole of Quezon City. It is also arguably the busiest (and the bloodiest) in the whole of Manila, rivaling the business of that other good old emergency room of a hospital found in the heart of Taft Avenue. I am already a second year resident, training in the field of Ophthalmology, a branch of medicine dealing with eye disorders, refraction and eye surgery. I just came from a tedious cataract extraction case that not only tested my nerves, but also my legs. Cataract surgery shouldn’t take long, but this particular one did, the most complicated of my career thus far. The tiring day made me long for the bed found inside the homely quarters provided by my department inside the emergency room for us to stay for our 34-hour shifts (which we do at least twice a week). Our quarters were enough, although it made me miss home. I haven’t seen home for two weeks now, I couldn’t afford the trip back for now because of the brutal hospital load, so the quarters should be enough.

Ophthalmology is a three-year program detailed on eye surgery like cataract extraction, after the three years you take a two-part diplomate examination in order to earn recognition among your peers that you are more than capable of handling eye cases, way beyond the standards set by a board. That’s how we earn the letters that come after our name. “Juan dela Cruz, MD” – after you graduate from medical school and then legitimately after you pass the Philippine Regulatory Commission/Board of Medicine administered Physician Licensure Examinations, you may go on and practice as a General Practioner, serve publicly as a government physician, set-up you own clinic privately or engage into moonlighting.

Some doctors go into residency training. If you see lengthy letters you see in your private doctor’s clinic – “Juan dela Cruz, MD, DPBO or FPAO, Eye Specialist” to signify whether your MD is either a diplomate or a fellow of a specialty society, one who has more than complied with standards set by a specialty board, and is deemed intellectually, skillfully and morally fit for practice, private or public. That’s what we often refer to as consultants, and these same consultants, God bless them, are the ones whom we refer to our patients and in turn we see how they manage the patients. What we observe from them, and then fortified with textbook knowledge, that’s how most of us receive “residency training”. Most of us literally “reside” inside the hospital and receive “training” during our three, four or five years of stay. Consultancy and private practice is a resident’s penultimate dream, graduation from training is the mission we need to accomplish.

So there was I in the middle of emergency room. Instruments that are still begging for cleaning after that lengthy operation, so as my junior (my first year resident) has received a trauma patient from surgical triage who sustained facial injuries, mostly around the left side of the head. Patient was drunk, but was conscious, and we could not get a straight answer from him. Surgery service will only observe the patient but would not compel any procedures for him. Patient was your typical drunk driving fool who went on a payday drinking spree and decided to ride his motorcycle without a helmet and with reckless abandon. He slammed his motor at the corner of EDSA and East Avenue, sustained head injuries and was readily transported to our hospital.

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I patted the back of my junior, lifted the bandage the emergency response team has applied to the face. We did a full ophthalmologic examination, and it was a full thickness eyelid laceration, with a limbus-to-limbus corneal laceration and it appeared the lens was already ruptured. In simpler terms, things were already bad for the eye and we needed to close the eyelid, the eye itself and do a good clean-up. We needed to do it as soon as an operating room was available, better if we do it under general anesthesia if surgery, internal medicine and the anesthesia service will agree. I also needed to tell the relatives regarding the prognosis of the eye, for we may lost it already, but nonetheless we will do everything that we do faced with the same case. My senior and my service consultant has agreed, I searched for a relative who was with the patient.

“Doctor, wala pa pong relative yung patient,” my junior said in a meek voice, in anticipation that I would finally snap and go ballistic.

Editor’s Note: For improved readability, this piece is divided into 3 Pages. You are on Page 1



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