Reporting for Duty

I’ve been trying to write for days and days, but I can’t seem to find the words to properly describe the first two weeks of clerkship. What should I say? How should I say it?

All the years of undergraduate work and medical school has brought me to this point: being of service in front of a patient. How strange and exciting and wonderful.

Preparing for Clerkship

There’s no real way to prepare yourself for clerkship. For one thing, every rotation and hospital has its own quirks and implicit rules. Every month or week comes with its own transitional period. It’s not a lie to equate clerkship with the word ‘change’. As the environment changes, so will you.

(My unofficial motto is now: less bobo than yesterday! Maybe if I grow enough brain cells each day, I will have enough by the end of the year to form one.)

But there are some things some interested medical school student might want to know about clerkship:

  1. Complete your vaccinations early. Nothing is as important as your own health. Health care professionals are especially vulnerable to outbreaks of infectious diseases like measles and meningococcemia, so it’s better to do it now. Plus, it’s a requirement for serving at The Medical City (and other hospitals, I suppose). Trust me. You cannot accomplish all of them in the short month before clerkship begins.
  2. Prepare for long, tireless hours. As a night owl and veteran of all-nighters, I haven’t crashed and burned despite serving all 4 of my 30-hour from-duties wide awake (or close enough to it). But I think it does require a lot of adjustment. Unlike school, I can’t merrily skip out of the classroom just to have some time to myself. Beware all introverts!
  3. Don’t be afraid to ask. We don’t know everything. I felt stupid several times over the last two weeks, but it’s fine! Every doctor was a clerk once, and they all learned better (one should hope). It’s better to ask and be certain, than to guess and do worse for your patient.
  4. And at the end of the day, one of the hardest things to prepare for is missing your friends and family. There’s simply no other way around it: you will have less time for them, at least at the start. I haven’t seen my own (newly renovated! I still have to blog about it –my mom and I designed every piece of furniture from scratch—) bedroom in maybe three weeks. But I can always hope for the future.
  5. I’ll prepare a what’s in my bag type of post one of these days (or weeks). But for now: paper, lots of pens, your stethoscope, pulse ox, micropore, penlight… For the rest, you’ll find yourself becoming very resourceful. Maybe the real tip is to prepare financially. You will be spending a lot on uniforms and materials before the year even starts.

A big chunk of my unease was soothed away thanks to the ASMPH community. There are no schools in the country that are as generous as ours when it comes to support! The Friday before rotations started, we were treated to Blue Lights by batch 2022 and the rest of ASMPH.

This night was a mini-graduation, commemorating the success of each student and of their supportive families; there was food, singing, videos, and the ceremonial coating. Gracias!

The pleasure of being coated by my mom and brother! Thank you.
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My family for over a year :) Gibs, Faye, me, Trina, Bcar and Wildom. It is strange that even though we are all serving our Internal Medicine rotation, we haven’t been all together as a group. We’ve been placed into different subgroups and stations. At least we can always see each other (sleeping) during our Financial Management class!
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My girls! Lea, me, Amanda, Xtine, and Chanel. They were not kidding when they said clerkship would make it difficult to see friends. Though Amanda and I are roommates, and Xtine and I are both in OsMak, we’ve barely been able to carry a non-medical conversation. Not to mention I haven’t properly seen Lea and Chanel for weeks!
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Welcome to OsMak!

In the back of my mind, I’ve very vaguely thought of Internal Medicine as the ideal residency. After all, it’s the starting point of most specialties, if I care to have one (and it’s a toss-up between Endocrinology and Neurology –and Public Health). And I’ve thought before that first impressions will always matter, so I’m very glad my first impression of it was at Ospital ng Makati.

Even though we had to sleep on the floor in our sleeping bags and blankets and pillows –no quarters for the clerks, so we laid down our place at the very office you see here– and even though we had to bring our own laptops to fill up countless forms –and I have to thank my mother for the new Macbook Air she bought me for it, God bless her soul——

It was quite perfect.

Ah, OsMak! I will miss you until next time. And yes, that is the piece of floor where we laid down our sleeping bags at night.
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We made mistakes; we were corrected. We tried our hand at different skills; we were encouraged. I was always so excited and anxious for my first tries on actual patients–phlebotomy, foley catheter insertion, IV cannula, ECG, CBG…

Ospital ng Makati is a good place to learn, as the residents were incredibly kind (and our interns equally so). It is also a good place to serve –there is no end to the variety of cases, to the thankfulness of patients, and finally to their number.

I think my writing today is very weird. I just began re-reading Pride and Prejudice today, so maybe a bit of Austen is rubbing off on me.

Simple Pleasures

At some point in the dead of night at the Emergency Room, my brain would quiet and slow. Then I would think about all the things I’m grateful for.

Me, 23 hours into my 4th duty. I sneak in some pictures and a silent video conversation or two during the dead hours of the night.
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Simple pleasures would be:

  • Hearing a thank you from the resident for a simple thing you’ve done, such as print out an admitting history or discharge summary. It may seem odd at first and even superficial, but in the grand scheme of things –am I not helpful to the patient? Is the resident not tired too? Anything that would ease the way and speed up the process of an admission or discharge is surely beneficial. In the care of life, time is always of the essence.
  • Taking the time to reply to some entertainment, either from my family or friends. I have never wanted for encouraging words.
  • Hearing a thank you from a patient and their bantay. Such a simple thing! But powerful. I am happy I have always practiced saying thank you to servers and other employees. Now that I’m on the other side, I can now see the true impact of gratitude. That is, it gives back strength when there was previously none.

And so it would continue. You will also never know what surprises there are in store for you! Some surprises mean extra work and toxic experiences, but some can be great. Just last Wednesday I danced zumba as part of the hospital’s community work for Diabetes Day. Who knew clerkship would give me leave to exercise?

And so maybe 27 hours into my duty, I still found the strength to dance. I love exercise! I love dancing poorly! I miss it.
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And speaking of surprises, we were tasked to make this giant #4 sign with very little notice (or indeed, instruction!). But kudos to everyone, especially Bettina, for powering through!
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Future Physician

There are three things an Atenean must be (and I hope I remember this correctly): an Outstanding Clinician, a Dynamic Leader, and a Social Catalyst. It’s hard to see where and how you’re supposed to be everything at once, but after only two weeks in Internal Medicine, I can say that I’d at least dearly love to be an outstanding clinician.

Of the many places we’d go as clerks, one of my favorite parts was serving at the outpatient department. We were almost like real doctors –the patients saw us, or we saw the patients, and we took histories and examined and wrote out prescriptions. For all intents and purposes, we were doctors! Though of course we had to refer to our first-year resident doctors for correction and approval.

At the OPD! I don’t know if I can rightly say all their names here –but if there is no censure in the coming days, I will leave it up— our first-year residents and our interns, Dr. Coranez, Dr. Dorado, Dr. Gatchalian, Dr. Poquiz, Dr. Rutor, Intern Micheas, me, Stephen, Faye, Intern Paola, Dr. Nolasco, Intern Don.
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I love interacting with patients, and being a physician of a sort. I’ve always known I love medicine because it’s like a challenging puzzle everyday, with the patient as the picture I’m meant to help form back into shape.

Nothing is as rewarding as helping someone get better by means of your expertise as a physician (and of course by means of the entire health system). I won’t ever get tired of hearing thank you, doktora, no matter how undeserving I am of it yet!

Gallery of People

I think I will never want for inspiration and strength, if everyone I rotate with is as wonderful as those I met so far. Am I being romantic? It’s only that OsMak has set such a great tone for the rest of the year…

From my cluster-mates, whom I can now bond with over shared experiences and great food; my duty-mates, without whom I would not have survived; the interns, who were always willing to gently correct blunders; to the residents, who were teasing and brilliant and also very forgiving –thank you!

Our first set of interns! Intern Paola, Intern Micheas, Intern Chin-Chin, Faye, Stephen and I after our second duty. They saved our assess with the AdCon.
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When you’ve spent 70-hour working weeks with someone, you either learn to love them or to ignore them. I am very happy these two duty-mates are easy to love!
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Our last full day, altogether! I’m very lucky to have had such a good mix of 10 people for my first rotation. :( :( :( I will not pine over these very cool doctors, but close enough. Dr. Louis, Dr. Rutor, Ata, Stephen, me, Faye, David, Dr. April, Jesse, Cams, Francis, Xtine and Bettina.
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Experiences can change you, but so can people! And I think we were all changed for the better. The residents have learned a little more patience; the clerks have learned to be little less stupid. I HAVE LEARNED TO READ FLAT LINES AND SQUIGGLES. Maybe doctors CAN afford to write a bit more legibly…

Today I’ll be starting a new sub-rotation at The Medical City’s Emergency Department. It’s another time for change, but it’s also another time for adventure and learning and sleepless nights (literally! I get the night shift) and, most importantly, service for others.

I’ll tag all my clerkship posts as such, though as always you can find the med school tag worth browsing! Maybe. I don’t know. I’ll upload my latest travel blog posts…….. some day…………………

See you!

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