Once upon a time, in what feels like a lifetime and a half ago, we dared to dream an ambitious dream. We imagined ourselves in white coats with matching hanging stethoscopes by our necks – transforming into Superhumans fighting off Pain and Suffering.
Then we enter Medicine only to be slapped by the greatest of realizations:
that instead of the Idealized version of doctors we watch onscreen, the Truth of our profession is this:
The Medical Student, the Doctor, is Human – necessarily, unapologetically, and understandably so.
So today, as we celebrate the culmination of our journey as medical students, instead of superhero stories, we are here to recognize, and more importantly celebrate, our often forgotten Humanity. And what better way to reclaim that seemingly lost Humanity than by looking back at our most Human moments in medical school?
- Like the inexplicable kilig from delivering your first baby, that precious sound of a baby’s first cry, the realization that your own hands brought new life to this world!
- The powerful two-word combination that is “Salamat Dok” ringing in your ears. The incomparable happiness of sending a patient home in a much improved condition
But also, equally human, the heartbreaking firsts.
- The chest compressions that eventually end in a declared time of death; the distinct sound of a loved one’s wail as they call out to ears that will no longer hear:
My first ever patient mortality: a strong woman in her forties, diagnosed with aplastic anemia, admitted for cellulitis. Every day, I would drop by for a quick 5-minute chat, enough for a short review of systems and a focused physical examination. In between she would insert a “Salamat Dok,” even if all I ever managed to do for her that day is extract blood. I made a mental computation in my head, she was gonna be discharged in a week, maybe less. Then suddenly, her platelet began to drop, she was bleeding from everywhere. Her last words to me, uttered through pain, were “Salamat, Dok”
- My first ever “Home Against Medical Advice”: a woman in her late thirties diagnosed with gastric cancer stage 4 ; always accompanied by her loving husband who always had questions for me. They were in the wards for a good two weeks when one day the husband told me, “Dok, uwi na lang po kami. Sa bahay na lang po siya magpapahinga,” It felt like a straight up sucker punch to see someone willing to do everything for his wife just a few days ago lose all hope in the world. I couldn’t offer him Hope that day, there wasn’t.
These are the human stories we lived as our reality in the past years. The all-too-familiar tale of a medical student, told and retold endlessly, a narrative not unlike the tragedy of Sisyphus: the whole effort of a body straining to raise a Rock, to roll it, and push it up a slope over and over again, ad infinitum.
Our version of this Myth: an image of a body straining to get out of bed, eyes that are bloodshot, ears that have not heard the voices of loved ones for a long time, stomachs that are empty until time permits them to be full again, souls that are weary from the weight of stories that intersected with ours for the briefest of time:
- My patient in Hospice, our Family Medicine rotation in clerkship. This family is endorsed from one SIC (Student in charge) to the next: “they don’t want to see you, they are in denial” Patient is an 8-year old female diagnosed with a brain tumor. She was the longest-staying patient in the wards, a solid 200-plus days. GCS 3. There was the usual defensive walls at first, the one-word replies, the quiet nods, but I went back again and again to check on them. Until eventually, they were showing me pictures of their daughter, who she was before her illness took over. An honor student. A loving daughter, responsible even in her young age. “Dok, alam ko naman po yung katotohanan. Pero bawal bang maniwala na may himala?” Her father asked. I didn’t offer my words, I didn’t have the right ones. I was just there, I listened. Somehow, it was enough. I found out that this patient passed away when I went back from Christmas vacation. I didn’t see her parents, I wasn’t able to say goodbye, or offer words of comfort. That night, I cried myself to sleep.
- My first ever FDU: fetal death in utero; the baby looked like all babies look before you wipe their faces, heads, and back, except this time there was no cry – only Silence, stretching itself in time and space, endless. The stethoscope made a mark on his chest as I pressed on willing his heart to beat. The moment you realize this baby is somebody’s someone – a mother’s son, a sister’s brother, a father’s child, the line between objective distance and the deeply personal starts to blur:
- In the middle of our duty, a patient went into sudden cardiac arrest. When we eventually terminated efforts to resuscitate, his mother went to him, and performed her own version of chest compression to her son. “Gagawin ko po ito hanggang tumibok ulit yung puso niya,” He was 15. My brother was also 15 when he passed away in his sleep. I wasn’t there. I was miles away, reading the Thyroid Chapter in Robbins because we had an upcoming exam that week. I wasn’t there when the medical staff at the ER were resuscitating him. But in that exact moment, in that ward, on that duty, I was. Years of medical education will teach you that you will not be able to save all the lives you are privileged to serve, but when you are there in place of a sister who couldn’t be, a loved one miles away, you try your best, you do all you can. Always.
- The first time we had to perform CPR on a baby who was delivered with an APGAR of 1: limp, cyanotic, bradycardic at 50s. After 20 minutes of CPR, intubation, a flurry of medical intervention – I auscultated for heart sounds once more, there it was – the magical beating of a fighting heart, faster, stronger, alive. His colors returned, and there was movement, the weakest of cries, but there it was nonetheless. We literally saved a life that day.
Such is the Sisyphean task of this profession – the unceasing attempt to reach the elusive; the striving towards a Perfection we are humble enough to admit we will never reach, but also Human enough to dare to aspire for. If we must fail attempting the impossible, we’ll be sure to attempt Grandly. Every single day is a Grand Attempt to provide the best version of human care to all of our patients because they deserve it. We owe this Grand Attempt, this asymptotic drive towards a Perfection we can only ever inch closer to, to the People that led us to this moment:
To our Patients, their relatives and bantay
To the PGH community, the nurses, the manongs, the rad techs, the NAs, really everyone that make up this resilient healthcare team
To our mentors: consultants, fellows, residents
To our loved ones and family
These medical students will not be sitting here today if not for all the People who believed in us when we couldn’t do that for ourselves. It is a grateful heart that now declares the most sincere “Thank You” we can ever hope to give. Thank you for giving us the opportunity to care for you, but also equally, thank you for caring for us.
Friends, if our myth is tragic, that is because it is only ever that – a myth.
Let today be a reminder that though it may often feel like so, we are not Sisyphus.
Our Rock is not a punishment. Our Happiness not imagined.
Once upon a time, in what feels like a lifetime and a half ago, we dared to dream an ambitious dream. We began our unending ascent uphill, pushed a heavy Rock up against a slope. Today feels like finally being able to reach the summit of an ever-expanding mountain.
But the most Beautiful part of this tale happens exactly right there, during the slightest of pauses. That infinitesimal moment between reaching the peak, and finding the Rock back to where it once was, seemingly unmoved – all the labor and toil, hopeless and futile.
It would be a lie if I say that this graduation is the end of our mountain, that we have prevailed over our Rock. There’s the Board Exams, Residency, Reality.
But if myths could have their moral, it’s probably this: It doesn’t take a god, a Titan, or a hero, to conquer Rocks and mountains. It takes a Human.
These stories we bring with us at the end of Medical School remind us that We Are – necessarily, unapologetically, and understandably Human.