Most people have a “Eureka!” moment or a life-changing anecdote about the moment the Universe revealed to them their Calling. I didn’t have that. Very recently (as in a few minutes before writing this paragraph down), a medical student asked me when I realized I wanted to be a Pediatrician. My answer was, “I’ve always known.” Which was the less dramatic, more straightforward version of:
“It was a desire planted deep in my heart. And my Heart has always known where it was meant to go. I merely followed it.”
Looking back, I realized that all my past experiences are minute revelations leading up to the pursuit of this Dream. As if I was being prepared for a journey I had no idea I was already taking.
Like when I was a kid and Mama would take me to my Pediatrician. I would always begin our consults by saying, “I have tonsillitis because my throat aches especially when I swallow. I also have fever. I will take antibiotics for 7 days.”
May assessment na, may management pa!
In high school, being part of the Light Cavalry Leadership Community allowed me to spend hours after class visiting various institutions – Home for the Aged, Boys Town, House of Hope, DSWD for Kids, etc. Every visit had been insightful, but even then, I gravitated towards the children especially.
In Med School, my blockmates would always “refer” to me the Pedia cases we would encounter. Mostly because I had the EQ to play with them while also dealing with their parents.
It was when I did my Pediatrics Rotation as a Clinical Clerk, the penultimate year of medical school, that I knew there was no turning back.
As Uncool as it is to admit, I was Pedia’s biggest fan. And my reasons were simple: I saw how our seniors took a moment to teach students during rounds. We were empowered to endorse as if we were residents. We were part of the team that managed patients – and we claimed and owned that responsibility. We would eat post-duty breakfast with our residents, and even hang out with them! As an outsider looking in, what I saw was a loving, nurturing family that called each other “mumsht” and “beshie cakes”. A family I wanted to be part of. I was so privileged in my experience as a medical student rotating in Pedia, the only promise I asked of myself is to make sure I continue that tradition of camaraderie. That the same patience that led one Pedia resident to teach an about-to-cry clerky Marianne how to read an ABG will be passed along to the next generations of future doctors rotating with us. God, I wish I was able to do just that in my 3 years of Residency.
Because I also know that I wasn’t always patient and kind. That there were days (many of them) when the exhaustion, frustration, and disillusion merged into a pit that consumed my Humanity. How I wish I could take back those moments. But maybe even then I wouldn’t. Because the rock bottom taught me lessons that helped me become the person that I am today. And while this version of Marianne is far from Perfect, this is a version of Marianne I am learning to love.
And so, with all the gratitude in my heart, it is with great humility that I share this love letter to myself. A processing of the 3-year Residency experience. Because I am overwhelmed with this feeling of Indebtedness – for everything and everyone that allowed for my Growth. Writing, my Great Panacea, is a source of immense personal catharsis. To be able to share it with others (even when 99% of my being tells me not to) allows for a Vulnerability rooted in Courage – the Bravery of Self-giving.
So here are the 3 Great Lessons the Past 3 years taught me.
1.) Lesson Number One: Forgive Thyself, Ad Libitum
In my piece, “Progress Notes” (read here), I wrote about my overwhelming insecurity the entire first year of Residency (and beyond!) In fact, when we were asked
“If you know you couldn’t fail, what is it that you would do?“
The response I never said out loud was:
“I would do Residency….less afraid. Less afraid of disappointing people I look up to. Less afraid of falling short of everyone’s expectations.”
First year Marianne made a lot of mistakes. I was too slow. I handled complicated cases I didn’t fully understand. I lacked skills I believe would have helped optimize patient management. It was endlessly frustrating!
You see, as a Type A, Enneagram One, Virgo rolled in one, I put premium in Perfectionism. I expected myself to give 100% at all times – nothing less. I was dealing with people’s lives, there is no room for error.
I remember one morning, I was on my way to the hospital when I passed by a coffee shop. I saw the barista inside, and how I envied them! If they made a mistake with the customer’s order, they can simply make another cup of coffee. My profession, on the other hand, is not as forgiving.
But the thing about Training, I learned eventually, is that you’re in it because you don’t know everything! Of course you will make mistakes! A lot of the skills that prove important in your practice will be acquired as you go along.
So while I continued to make mistakes throughout training, I also made sure that I learned from them, but more importantly, that I forgave myself every time I committed them. I would make sure not to repeat them, and identify factors I could employ in the future to prevent their recurrence.
I learned to offer myself Grace whenever I feel undeserving of it, especially when I feel undeserving of it.
And this Process will continue even after Residency. So while we strive to do our best, in moments when we do fail, let us find within us the Courage to forgive ourselves – over and over again.
2.) Lesson Number Two: Do small things, with Great Love
Residency Training is filled with BIG things, momentous occasions. Your first intubation. First department-wide presentation. Grand audits. Examinations. There are a variety of ways devised to evaluate how we are doing. And most of the time, we find ourselves preoccupied by them: we have to pass this test, perfect this procedure, accomplish this task, etc. And it has become so easy to lose ourselves in the big things.
But Love, I discovered, is in the little things that do not concern themselves with being announced.
It is love when we wash our hands before and after patient interactions to minimize the chances of them getting new-onset infections. It is love when we insist on calling patients by their nicknames rather than their last names or bed number! It is love when we spend a few moments to strike a conversation with guardians and parents even if it takes away precious time for charting and accomplishing to do’s.
The small things very often do not get rewarded with prestigious awards. They do not pad CVs nor boost credentials. But these are the things that show our patients and their loved ones that they are deserving of the best version of care we can possibly afford.
So continue to memorize their birthdays, remember their Kpop bias, give away stickers. The smile you see on their faces will remind you why you chose to be here in the first place. No earthly reward will ever match that.
3.) Lesson Number Three: Manatiling Bukas
It was around two years ago when I shared an exquisite conversation with a senior, mentor, and friend I look up to. In that dialogue, she imparted an important piece of advice I held on to:
“Manatiling Bukas”
Only when we open ourselves do we allow it to meet our soul, over and over, in the different People we are fortunate to have our paths cross with.
As tempting as it is to put up defensive walls to minimize potential pain, our openness ensures our ultimate experience of life. In this case, of residency.
Manatiling bukas sa sakit, sa tuwa, sa pagkamangha, sa bago, sa hindi tiyak.
At this point, I acknowledge how privileged I am to have had the chance to meet all the people that I did in Residency.
I finally got to be a part of the family that called each other “mumsht” and “beshiecakes”.
I am grateful for our consultants and the wisdom they unselfishly shared. For all the rounds, the lectures, and the conversations with them where I learned a lot from. 7 years ago, I wrote about standing in front of the bulletin board with our Consultants’ names telling myself that one day I want to be like them. I still do!
I am also thankful for our fellows who had been amazing since day one! They recognized when I was feeling down, and would cheer me up. They would send words of encouragement when they sense that I am on the verge of crying. They let me side refer cases to them. They would take a moment to teach me. All their “Kaya mo na yan, Marianne” boosted my confidence in moments I didn’t believe in myself. We looked at lab flow sheets together when I couldn’t pinpoint the cause of my patient’s hyponatremia. They taught me the basics of doing a 2Decho and a cranial ultrasound. They made me join their rounds and listen to different murmurs because I always joke that my special power is that I couldn’t hear murmurs. They would tease me about how toxic I am yet again (cue: “Sayo na naman Marianne?” whenever there is a difficult case). They would volunteer to review my presentation and provide helpful inputs just before I present them to the Department – even if they aren’t required to do so!
If you find yourself training in an institution with seniors as cool as the fellows I had the chance to work with, you would know you are in the right place to be!
Beyond the hospital, I found myself sharing ‘one bot’ sessions with some of them! Over hotpot and Korean chicken, they would be teaching me life lessons. Some are constant source of Netflix series recommendations up until now!
I don’t know how I got so lucky, but I highly appreciate our fellows!
I am also lucky to have worked with our nurses, secretarial staff, nursing aides, manongs – the real MVPs! One time, while receiving endorsements as an APOD, I almost fainted from hypoglycemia. I was managed swiftly by our nurses, but I also got a well-deserved pagalit! “Anak, wag magpapalipas ng gutom.”
They also saw me cry throughout the years, would hear me say “Ayoko na” And in every episode, they never failed to reassure me, “Mabilis lang yan, Doc. Kaya mo yan” There was something about the Certainty in their tone that made me believe that maybe I really can do it.
Of course, I am so lucky to be part of this amazing, amazing batch! Our graduation was termed “Tahanan” because in each other, we have found our way Home. We shared all the ups and downs of the past 3 years. We cried together, laughed together. And ultimately survived the three years together.
We are also grateful for our patients – our greatest teachers! Thank you for trusting us to take care of you, and in so doing, for allowing us to learn.
I am also indebted to so many other people – the Village that continues to ensure my Growth. My family, my friends, my mentors. The support system that never tired to sit down with me patiently as I figure out my life.
Towards the end of residency, I had to make an important decision that impacted the trajectory of my career for the coming year. This was when I recognized how lucky I am to be surrounded with the best set of People I can ever ask for. I knew that no matter what I chose, I will have their support.
I was never dictated to choose this or that, I was merely told to follow my heart.
And when I did, I found that the greatest gift I gave myself this year is the chance to Heal.
I needed to realize that this is what I wanted in order for me to eventually recognize that this is also what I needed.
Regardless of what others had to say.
It wasn’t an easy choice to make.
A lifetime of conditioning made me prioritize what others have to say. If it pleases other people then maybe that’s what I had to do.
If my choice disappointed others then maybe that’s not what I should choose.
But this time, I chose to take a step back and rest for a while.
Since I started schooling at the age of 2 (haha yes!), I never really stopped training in a structured environment.
I only knew to take in work and chase after the next accolade, the next promotion. It was second nature because I mistakenly believe it had to be that way.
People, especially those close to me would often describe me as passionate. I am.
But fires of passion do burn out. It took me a while to accept that I was burning out.
I poured and poured and noticed too late that I barely had anything left.
So I had to take a great pause because how else could I pour when the cup has already been emptied?
Nicola Jane Hobbs put it exquisitely,
Instead of asking, “Have I worked hard enough to deserve to rest?” I’ve started asking, “Have I rested enough to do my most loving and meaningful work?”
Because I love what I do, I had to make sure that I am able to offer my best version. And if that means taking a break, then I must honor that.
So while I do get pressured whenever people casually ask me of my plans (I have none!), I am slowly making Peace with the version of Marianne that now needs to rest. In order for her to be able to do her most loving and meaningful work.
So that was the past 3 years of Learning, and Unlearning – and all the lessons in between. I forgave myself, fell in love, and allowed for a vulnerable openness that led to my Growth – as a Pediatrician, but also as a Human!
I still have no idea what comes next and this Uncertainty is oftentimes frightening, but I take comfort in the fact that my Story is written by the same Hand that commands the sun to rise and set each day in perfect timing.
How can I fear when the Artist sees in me a Masterpiece?
medschool panacea 