Pay, Check

I got my first taste of a monthly salary last 20th of November and though I've never been given that kind of money in one setting, it felt like it wasn't enough for all the stuff I've been through.

I realized, I can't hope to have a life and raise a family on this salary. Nor can I hope to help my parents, pay my rent, and other stuff we use money for.

I offered to buy my dad and sister dinner, but my dad said I'd better save it for me.

Haha, I laugh silently because my brother and my sister earn much more than I do and I've been in school the longest. The return of investment in medicine really is not much. I'd be lucky to even break even in giving back to my parents what they've spent on my education.

Such is the state of this young medical doctor today -- wishing I have a cushy (by my standards) job like Gaya's, earning more by moonlighting like Chofi and Benjo, or simply being able to bum around rich like the Mittals and Bill Gates of the world.

They say it's bad to keep and save your first salary.

I do not know if there is truth in that or it's something people make up to get a gullible co-worker to shell out for a round of beers and pizza, but I did get some stuff for it.

- Went out with Tonett for dinner
- Treated my Ward 2C station to pizzas because one of my DNR patients went home, albeit HAMA, alive.
- Bought a pair of sandals
- Bought some groceries (I, as much as possible, will not use my mom's extension credit card)
- Saving the rest for stuff like a house, a car, land and whatnot (Hahaha, well, I have to start somewhere)

I'll be going on duty again tomorrow. Gaaaaahhhhh.

Our chief, Dr. Roa, says we will be flying solo next month at the ER -- that would mean facing acute coronary syndromes, hypertensive emergencies, endocrinologic emergencies, COPD exacerbations, cardiac dysrrhythmias ALL ON OUR OWN.

Uggghh, I'm dreading next month's paycheck already.

Crossed My Mind

It's been a while since I last wrote and a couple of things have crossed my mind since then. I've finished nearly two weeks of residency and well, I'm already stressed out as heck, my calves are aching from tiptoeing through the hospital halls everyday, not wanting to make a mistake, and getting grilled during endorsement.

Gaya says it's masochism with a purpose.

Some thoughts that have crossed my mind have been:

1. Mostly DEPRESSING. I've been thinking about how tired I've been these past two weeks. Still the first two weeks of a three-year residency and still a loooong way to go. It's not going to be a cakewalk through all the consultants' uhm "lectures" and "constructive criticism." Haha, but I'll take them as such. Hopefully I make it.

2. Sometimes FUNNY. Do you guys realize that karaoke or videoke is fun only when all of you who get a shot at the microphone, suck at it? I mean you go out with friends, some drunk, some sober, sing a couple of songs, and here comes someone with Beyonce vocal cords and sings the song right on key, it just defeats the purpose of videoke.

3. At one time INCREDULOUS. Did you know that over 400 doctors a year in the United States die of suicide? And a couple thousand more suffer from some sort of depression.

4. Of MOURNING. My uncle Bobby passed away last week. Despite asking nearly all of my aunts, I still don't know his disease. Rest in peace, Tiyo.

5. PUZZLING. Why did the Pistons trade Chauncey Billups, Antonio McDyess, Cheikh Samb for Allen Iverson? That was before I realized that Rasheed Wallace and Iverson's contracts are up after this season. And we have tons of cap space to sign at least two max contract players! Woohoo. Imagine...a starting lineup of Rodney at PG, Rip Hamilton at SG, Lebron James at SF, Amir Johnson at PF, and Chris Bosh at Center. With a bench of Arron Afflalo, Tayshaun Prince, Walter Sharpe among others. YEAH!

6. Right now SLEEPY. I'm going home now to sleep. Zzzzz.

Death Becomes You

It's a difficult thing to do as a physician -- realize and accept that there is nothing more we can do to make the patient well and hold out that sheet of paper that says D N R on it, waiting for a signature.

Yet there I was, using every imaginable term, showing every imaginable scenario, and explaining every minute detail in as layman as possible to the relatives of a patient with terminal cancer with metastases to everywhere.

It was disconcerting because the patient was relatively young for a cancer patient (<40 and some) and leaving behind a family. I talked to his brother who said the patient had a brilliant mind but it was sad that people would not see it again. His wife grew teary-eyed with every thought I injected into her mind with my appraisal. Finances were also becoming an issue.

Encephalopathy had crept in slowly during the patient's stay numbing his sensorium and taking away conversation with friends and family. Now he looks like he stares into nowhere and looks at people without a hint of recognition.

There are many cases where doctors stand in the middle of all the emotional, financial, medical, physiological issues of an impending-death situation, and I've faced some in the past as an intern, a PGI, and even way back as a student, but I realize, I still take it just as hard.

Some people are given the impression that doctors are heartless, money-driven and think only of themselves from their experiences, and yes, those people exist, but not all of us become death impersonate. Most, in fact, are considerate and compassionate but misunderstood with their approach to appraisal and getting relatives to see their points.

I appraised them, and with a heavy heart, hoped they would sign the waiver. For their sake, for the patient's, and for mine (I'm barely 3 days into residency), I hope they would.

To see the hurt and pain in a wife, son, daughter, parents or friends of a dying patient is one of the worst things to see in the profession, but we deal with it. It's easier for non-medical personnel in my opinion, but for us, I think we have to draw a piece of it, carry it with us for the rest of our healing days so that we are driven not to see that pain in our patients' eyes.

Death becomes a guy in a white coat. Well, not quite. Most of us in white coats and toting stethoscopes have hearts too.

Growing Pains

They warned me.

That I was going to be tired by the end of the day and they were right.

Lost is mildly putting it.

I didn't know patients.

I didn't know what to do when referred a simple blood sugar result.

I didn't know when to call my seniors.

I didn't know lots of things.

I don't know much.

Its a blow to one's confidence that after you've gone through so much of studying in med school and realizing during your first day of residency that real medicine in wards and duties are so different from texts you get from Harrison's or Cecil's volumes of medical knowledge.

I am disappointed in myself.

But I'm determined to become a better doctor.

So forge on I shall...

And in a special quirk from other training programs, I'll be on duty at the ER this next duty.

Ugghhh.