:: The Car Lot ::

Friday, April 29, 2005

Residency or practice? Its pretty useless to weigh the pros and cons, the upsides and downsides, we've all discussed it before and with scientific thoroughness and efficiency i bet. Some of us need it, for lack of skills, confidence, knowledge. It doesn't matter why. In the real world the most common really is the most common. You don't have to be a brain surgeon to successfully run a small out-patient clinic. Most of the time its medical certificates and infected wounds and circumcisions, if your lucky to even have patients. Everyone has to start somewhere. Have patience. There is no right answer, if you want to get biblical, downright religious, there is a plan, majestic and mysterious and individual. A little bit like falling in love or taking a three point shot, you know its improbable but you do it or take it anyway. You'll probably miss, be rejected, but if you hold fast and have faith and believe, there are times when you know. That when you first meet, or when that ball backspins away from your fingertips that its all good, all net. For us right now we choose to practice privately. We may be wrong but right now a residency training is not the answer, if we had the luxury we would, and some would argue that we do. But i have always believed that there's nothing like earning your trophies, and until a bigger priority supercedes this principle, that's how its going to be. Being left behind by others who have become consultants or fellows is a matter of pride and some concern, but i've never been the jealous type and don't plan to be. It is hard to practice humility and pride simultaneously. but when you have others you are responsible for that's how it is. Man up. Decide what's best for your family and stick to it, but don't be afraid to change your mind. If the situation calls for plan B then be man enough to do so. I guess it all boils down to being responsible, being held accountable, and growing up a little.

Dr. Jayson Arellano Left the Car Lot @ 10:53 PM 0 Honks

***

Monday, April 25, 2005

Yes it's the movie with Robin Williams and Monica Potter, who was killed by a mental patient at their free hospital. I was in 3rd year of medical school and the head of anatomy along with the dean had us watch this movie. It was a crappy pirated VCD and I only really just got the essense of the movie. I was thinking they made us watch it because they felt guilty. They were genuinely good professors who cared about their students, those who could keep up anyway. I did identify with William's character Patch, but only superficially. I didn't understand. Today, almost 3 years later I saw the movie again. And the brush fire is burning. I was thinking that no wonder malpractice and negligence law suits became so popular, some of these doctors were real assholes. If you remember the scene with the juvenile onset diabetes who would probably have her leg surgically amputated, you'll get what I mean. When the graduation scene came along and the speaker said in a manorly almost regal, knightly tone, "You are now doctors", it sent shivers down my spine. Maybe because it is one of the hardest things you could accomplish. Not just in medicine, in any course or profession. I was never the model student, a little too much time playing basketball, sleeping in class. I couldn't help it. I even slept during my board reveiw. Probably why I had to spend an extra semester for obstetrics. Inspite of this though I did okay. I am a doctor now and admittedly not the best, but honest. Honesty is a luxury nowadays and be glad you can afford integrity. "If you treat the disease you may win or lose, but if you treat the patient, I guarantee you, you will always win." -Hunter Patch Adams. I saw Patch Adams when he visited Manila and held a seminar during the first few months of my internship. He was onstage with baggy pants highly colorful, loud even. He is a revolutionary. Interns were allowed to comment and ask questions and once again purity was corrupted by interns who had never faced adversity in their lives. They were people defined by the watches they wore, the cellular phones they had, one even asked for a hug. You get the picture. We were the minority and I bit my tongue, my fellow interns did the same. We had a clerkship program lasting twelve months, you could spend almost 11 of them in government hospitals. Ill equiped, undermanned, overcrowded. These were not conditions for healing. They were not conditions for living. We saw it, we smelled it, we breathed it, we lived it. It is easy to lose compassion in government hospitals in the Philippines. But that's where I found it, and I have tried to hold on to it eversince. I have a small out patient clinic now with my wife and we don't have many patients, such are the trying times. It is hard to resist not treating patients who you know would better be handled by a specialist but we do resist and advice and refer them to a physician better equiped. I guess it's an unspoken rule, an unspoken virtue, an unspoken principle. Unspoken, because I think if we had to speak it, it would be purity corrupted once again. Patch Adams message is not meant to be celebrated amongst doctors, it is meant to be celebrated amongst patients.

Dr. Jayson Arellano Left the Car Lot @ 9:49 PM 0 Honks

***

Friday, April 01, 2005

"I knew where I had to go, but I did not know how to get there." -Mother Theresa

Dr. Jayson Arellano Left the Car Lot @ 2:29 PM 0 Honks

***