differentials

It was getting dark and I was walking aimlessly along Faura… As I crossed the intersection, somebody shouted “Doktora!”. I looked around and saw a familiar woman, probably in her 30s, smiling at me and waving in surprise from the end of a jeepney. I was thinking of whether I saw her in OPD continuity, or ER, or WARDS, or the PAY floors. I was quite sure though that she is one of those smart and responsible bantays. She probably quickly noticed that I was thinking hard and recalling who the patient was and what the patient had. She told me as the jeepney she was riding was moving, “Patay na po si tatay”. I still couldn’t think who the patient was. She said, shouting as the jeepney zoomed away, “Si Jimmy po.” I absentmindedly had the urge to run and hop on the jeepney to ask further… then I heard a man shouting at me and another jeepney from my back was blowing his horn. I was blocking the way.

“Sino si Jimmy?” I was asking myself as I walked home. Somebody with a chronic disease? Somebody with terminal cancer? By the way his daughter remembered me and how she seemed happy and open enough to update me, I knew he was one of the patients I did touch the life of. It reminded me there and then that these are lives of people we touch as doctors and it is indeed a great responsibility. Every little encounter might have an impact to the patient and their family. I have always been very slow in seeing patients wherever I am. One reason is because I couldn’t resist having to always appraise and explain to the relatives and the patient. If patients need empathy, I’d give them. I think that I’ve been a good doctor in that way. I am happy that med school starting from subjects like Introduction to Patient Care has taught me that–to always go beyond just the biomedical aspects, but also see the psychosocial, economic, and cultural issues surrounding the patient’s disease.

Today, however, I just felt guilty because I have been a very bad doctor. I had bitterness. I had bad sleep. I’ve also been having nausea and troubling polyuria and polypdipsia. I was very grumpy and I scolded 3 of them unnecessarily.It was indeed a horrible day. In the middle of OPD continuity, I just sighed to myself. “F*ck. Ayoko na.” I remember, I said to one of them:
“Ano po? Hindi ninyo matandaan ang gamot na iniinom ninyo!? Ano po?! Kaninang umaga lang ang huling inom ninyo, hindi nyo ba po agad matandaan!? At iisa pa lang po yon. Isang gamot. E madali po pala kayong lasunin e, hindi nyo alam kung ano ang iniinom ninyo.” Then I realized I was too harsh. What if he had bigger problems that day? What if he was just really forgetful? I had to ask him why he didn’t remember. He said he’s just forgetful. I had to explain the importance of knowing his meds and offering an alternative by asking him to list down his meds and always keep in his pocket. He thanked me at the end of the visit. And I had to joke him because of my guilt, “Salamat po saan? Sa pagpapagalit ko sa inyo? wala pong anuman.” He laughed and promised me that he will remember all his meds from now on.

I just wonder how many Mang Jimmy’s out there would remember me for the comfort I gave them and there family? How many Mang Jimmy’s out there would loathe me for my bad days when I scold them. It is indeed a challenge to be a doctor–to put oneself behind, however one feels bad, and put the patient at the center. Or maybe, the greater challenge is for the doctor, to appreciate life more, and live a life of well being and happiness so that every patient encounter is filled with a projection of the beauty of this sacred life.

RIP Mang Jimmy.
To doctors out there, let’s celebrate life and our power to share that celebration with our patients and their families.