Monday, March 8, 2010

What would you say?

I wonder if you would feel the same way, and say the same words, if you were me, and you found yourself in the scene I just caught myself in.

I was talking to this person about professions and we touched on the topic of hours of work per week. Here in the United States, they follow 80-hour work weeks for resident physicians and they do adhere to that - strictly. The Program Director or Program Coordinator would really insist that you go home if your duty is already up and yet you are still in the hospital premises. By those measures, it is crystal clear that resident physicians in the Philippines are overworked. Well, I've been through 24-hour duties every other day because we were understaffed. You would think I got a good pay then but I even had to avail of the hospital's free lodging because my salary could not pay for the studio apartment I lived in when I was a medical student. Overworked and underpaid would therefore be more like it.

When I thought about it, back here in the United States, 80 hours of work every week is actually twice the usual number of hours work per week for the average employee who goes to work at 8am and goes home at 5pm from Monday to Tuesday. That's a 40-hour week they got there. So thinking my thoughts aloud, I commented, "So doctor's still have more hours of work per week, compared to the average office employee, don't they?"

I would have preferred silence as a reply to this comment, had I seen what the other person was about to say. I would have preferred if she did not reply at all but instead she said, "Kay sayon ra man gud nang doktor, dili man physical na trabaho. Suroy-suroy ra man nang mag-rounds." [Because it's just easy being a doctor. It's not a physical job anyway. Making rounds at the wards is just like taking a walk in the park.]

Well, excuse me madame. Being a doctor is nnnnnnnever easy. Doctors are loaded with a heavy responsibility and a great deal of accountability. We are not just dealing about anything here. We are dealing about life here, for God's sake! And about making rounds at the wards, you know what, it's not a walk in the park either. Because rounds do not just end in checking the patients' heart rates and blood pressures and asking them if they are feeling better or not. Rounds do not end after surgeons inspect their patients' surgical wounds, whether those are gaping or perfectly apposed, and do not have serosanguinous or purulent discharges oozing out from the margins. Rounds do not end after pediatricians examine the newborns to see if they are jaundiced, or after they ask the guardians if the little ones still pass out loose stools, or if the little ones still have fever.

During rounds we are actually taking mental pictures of the patients, and we are storing those pictures in the memory bank in our brains. We carry these mental pictures while we make "suroy-suroy" at the wards, as you describe it, because those will be our baseline statuses of our patients. We scan and "look" at those pictures just before we get a shut-eye while we are on a 24-hour duty. That is, if we are lucky and get to lie down on our beds in the call room or in my case as a resident before, a sofa-bed in the medical office, because just when we decide to go to bed, an emergency case comes in, or a patient in the ward deteriorates. And before I forget, we hardly get to do rounds in a one-time deal, without any pauses, I mean, because patients arrive at random. Sometimes they come in batches, sometimes one after the other. Most of the time, residents have to take a pause from ward rounds to attend to a patient who just arrived in the Emergency Room. Sometimes, patients come at 2am in the morning complaining about something that has been going on for years. My friend had a patient who came at wee hours in the morning complaining that he could not sleep. And we physicians could not drive away a patient, no matter how trivial the chief physical complaint might be. We have to make them feel better as best as we can and wring our brains dry to diagnose their conditions.

Most of the time, resident physicians hardly get a decent sleep when on duty. When the 24-hour duty is up, we can't go home yet. No, no, no, not yet. As is the case in the Philippines, we have to stay for office hours which is from 8am to 5pm. We finally get to go home once 5 o'clock strikes. That's a total of 36 hours of duty actually. Not counting the extra hours if you decide to stay a little longer in the hospital because of patient follow-up or paperwork. And you say, it's not a physically-challenging job?

You actually think a doctor is freed from hospital responsibilities once he calls it a day, but there are still the many reports to prepare for and the books to read about the cases he just encountered at the wards.

The doctor goes about his duty at the hospital amidst emotional battery courtesy of the patients and their significant others. We see there is no use retaliating because we understand how sickness and impending death can shake the balance that used to govern the lives of these people. We see faces of denial, regret, frustration, hopelessness, and even apathy, almost everyday, but we keep ourselves from being sucked by the abyss created by extreme emotions, or else we would not be able to take one more step in that hospital ward. We have to set aside being humans to be able to answer to the calls of our profession.

That conversation which caused me to grab my computer and type this blog, ended with me walking out of the scene. My alibi, Amazing Race was about to start. Those words, I wrote, I never got to say them to that person. I don't think I lost my stand, I just chose to maintain a peaceful atmosphere as possible though deep inside I was fuming mad. I have to admit, I was hurt too.

If being a doctor is easy, why isn't everybody going to school to become a doctor?

It's good that I chose to keep my mouth shut and keep all those words I wrote, to myself. I'm glad that I chose to think my thoughts aloud by not blurting them out but by typing them away, because, when I think of it, being a doctor is not a physically challenging profession at all. It is more than that. It is a physically challenging, mentally challenging, and emotionally challenging profession. That says it all.

This entry has been especially cathartic for me and once again, I extend my gratitude to you who allowed me to rant, which I don't usually do. How would you react if you were me? What would you do? Will you walk out? Would you say something? Wouldn't you be as reactive (on blog, at least) as I am if someone underestimated your profession or the work you chose to do? If I were you, I would be.


  1. Smoke would start coming out of my ears doc shing :) and I would fume for days and days... Being a doctor sometimes seems like an under-appreciated, over-criticized, thankless job doesn't it.... :P

  2. hello gay!

    i felt my blood boil when i heard that comment. my blood was boiling the way it does when I see arroyo on tv and in any poster or billboard with her face plastered on it. That bitch ehhehe :-)

    About being a doctor and being underappreciated and etc., yeah you're absolutely right.

    Therefore doctors are overworked,underpaid,under-appreciated,over-criticized and never thanked for. kaluoy nato. i hope we doctors wouldn't have to feel that way anymore. we deserve better.


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