ten weeks and four lifetimes ago

It’s hard to encapsulate the last ten weeks into words. I have blushed and laughed, bled and relaxed, lived and loved and hated. How do I begin?

head, neck, and microuniverses (s/p ENT)

Superstar! Thank you Dr. Lacanilao for guiding us in our focused physical exam skills. I finally saw (Faye’s) vocal cords via indirect laryngoscopy.
Honestly one of the last-minute highlights of my RMC ENT experience was Doc Gian! Those six hours in triage feels like a lifetime ago. Still makes me smile though!
Ahh. Eating Frankie’s on the very clean table with our lovely interns (Ate Cess and Ate Pine) and stellar TMC ENT residents. Thank you so much for teaching us how to suture (on a dummy). ❤

The Ears, Neck and Throat (or Head and Neck Surgery, Otorhinolaryngology) Rotation straddles the line between medical and surgical. On one hand you have an endless line of OPD visits with screaming children and decade-old neck masses. On the other, you have head and neck surgeries lasting anywhere from an hour to a day.

Much like Ophtha, I think it takes a special kind of viewpoint to love ENT. Somehow, the practice has magnified the reality of the head and neck. It’s not just a region of the body; it’s a universe unto itself, with many subspecialties and possibilities.

It’s still not for me (the day I say yes to a surgical field will be strange day indeed). But I loved the medical side, and I was impressed by the way people’s lives can really change with these seemingly simple or localized pathologies.

And naturally I love the people: our superstar consultants (especially our RMC CCM, who had the foresight the year before to make us practice using the headlight and the ENT tools at least 20 times each), our hilarious and not to mention hilariously attractive residents, the best interns ever.

the birth of the world to the end of times (s/p OB-GYN)

Entering clerkship, the major rotation that I dreaded the most was Obstetrics and Gynecology. There were simply so many horror stories about the patient load, the responsibility, the culture within the department. But it turns out that I feared for nothing.

There were more good days than bad days, more learnings than moments of idiocy, and more life than despair in the different halls of the OB department. Every challenge was exhilarating in its own way. And we met great (and not-so-great) co-clerks and people along the way.

And having passed through to the other side, I found that what I gained was worth the blood, sweat and tears. It’s almost true what they say: you might as well be done with clerkship, once you’re done with OB.

If I didn’t know how to insert an IV cannula before, or how to do phlebotomy with confidence, or how to insert a foley catheter without pain, I can now do whatever needs must without fear or hesitation. The demand of Quirino taught me that much, and then TMC refined me with a gentler hand –an ideal scenario, unlimited by budget and the ratio of patients to bed, how to comfort, how to educate, how to make your patient a partner in care. Anything else, in both soft and hard skills, would be a disservice.

Let’s go Blue Team! Thank you for the experience. I don’t know how to put it into words, but I feel fundamentally changed and inspired by QMMC’s brand of care.
Highlights of QMMC include the best co-clerks ever. Thank you for being reliable, friendly, competent, hilarious.
OPD! ❤ featuring our UERM clerks, San Beda, OLFU, my trusty PHP300 Adventure clerkship bag in the foreground.
I will never forget the longest “7 mins ETA” to UP Town Casa Verde. The things we do… 😭
Back at the floors (and hotel atmosphere) of TMC.
From benign to toxic, thank you to our OB interns for being the best!

I can now say I’ve delivered a baby. (I can also say I’ve lived and died a thousand times; the QMMC wards alone was an express trip back and forth hell.)

vantage point and radiographic views (s/p Radiology)

Every medical student has seen those “What Medical Specialty Are You?” kind of flowcharts or online quizzes. Radiology comes up if you answer the following questions in this way: Are you a people person? No. Are you socially awkward? Yes. Are you a vampire? Yes. Are you afraid of the light? Yes. Are you hardworking? No. How are your grades? Ok.

Clearly, radiology has a lukewarm rep. Some patients don’t even know it’s a thing. The brief 1-week rotation in that little radioactive corner of TMC was an exploration into the truth. Radiology is brilliant.

Doc Reynan is the best! His enthusiasm for radiology (and life) is infectious.
Badass intellectual Dr. Catibog raising the bar for young hip consultants everywhere.

Are you a people person? Turns out, radiologists have their own patients too! This is especially true for those who subspecialize as Vascular and Interventional Radiologists (those consultants are in a league of their own).

Are you a vampire? I’m still on the fence about this one. I have no idea how radiologists survive reading plates for an entire duty. That’s some kind of superhuman endurance.

Are you hardworking? This is an unfair question, but it does lead to the wonderful truth that radiologists have great work-life balance. The residents may have sunken and strained eyes, but the consultants look young and fabulous.

How are your grades? It’s common belief that radiologists do know how to treat diseases (if you don’t use it, lose it?) but it’s actually unbelievable that they know the A to Z of anatomy, pathophysiology and diagnostics. It’s wild how they can retain knowledge from the bones of the foot to the muscles of the shoulder.

If it weren’t for the lack of patient interaction, radiology would be a serious rule-in.

at the heart of all things: family, time, love (s/p family medicine)

After 6 months of clerkship, I still have the same 2 finalists: Family Medicine and Neurology. (Anesthesiology died a quiet death when I saw how on-call they were during OB rotation).

I love Family Medicine for many reasons. I would argue it’s the obligation of the government to invest in primary care first, before fancy systems and specialized institutions. I think every town outside the big metros need to have reliable access to a physician and a quality hospital (or at least birthing clinic). I want to grow old with my patients.

This last week of 2019 clerkship was like an early Christmas present. I don’t see myself practicing in the community, but I appreciate how meaningful and impactful home visits and family meetings can be as intervention tools.

I also saw so many of the multi-sectoral issues that need addressing: violence against women and children, child development and psychology, relative poverty, community planning, education, corporate social responsibility (shout out to Unilab for also helping the Arkong Bato community). Development.

I don’t know yet where my path will take me in the future, but I know I’ll keep choosing the road that understands the importance of psychology, society, and community in health.

Quiet days in the Arkong Bato health hub.
Clerk Jari Monteagudo, signing out (for now)!

outtakes: got7, turning 24, IMDC 2019, lec 6

In between the many lifetimes of clerkship, I apparently had the time to watch GOT7’s concert (check my blog post here), celebrate my birthday multiple times (thank you blog post here) and be the program head/co-adjudication core of IMDC 2019 (I blogged about my previous stints as a competitor in this tag).

Honestly I have been truly blessed with both time, money, and support from friends and family. To have seen the green ocean in person!
I honestly just can’t believe I got to celebrate my birthday with my family (kulang si Ate Risa though). 💎
Many many many thanks to the co-adj core members (Dr. RJ and Gaston) and to the organizers La Verne, Ari, and Josh. He’s not in this picture, but I also have to say thank you to Rem (and UPMDC) for keeping it all together!
Happy holidays from our LEC group! We’ve been through a lot this year (with a healthy dose of snide comments and tears). Couldn’t imagine it with anyone else. ❤ See you next year (well, technically tomorrow).

See you next time in Japan! Happy holidays everyone. 💎