Medicine’s own illness that needs curing

The Association of Philippine Medical Colleges-Student Network (APMC-SN) surprised everyone by publishing its most political stand in a while: upholding press freedom in the light of the ABS-CBN shutdown.

This might look just like another courageous act in the middle of a time when authorities have little hesitation in arresting ordinary citizens for posting criticisms of the government in their personal social media timelines. But for us, within this internal network of doctors and doctors-to-be, the APMC-SN statement is astounding in its bravery.

APMC-SN is mainly known as an organizer of competitions, particularly MedGroove and MedRhythmia, affectionately known as MGMR, and Palarong Med. These events are politically nonpartisan, a safe space amid the stresses of attaining that “M.D.” that medical students go through.

Medical students know that despite the haunting presence of “Ang Kuwento ni Rosario” in their subconscious since their first lecture in Community Medicine, the environment they get exposed to later on is sure to keep the story just there: dormant in the sidelines. Some might even consciously purge it, as the answer to the question at the end of Rosario’s story will not be found in any multiple-choice question they will encounter in the board exams.

Even if the essence of medicine is saving lives, it is not in the immediate interest of a medical student to dwell on social and systemic injustices that kill the poor. Google “Ang Kuwento ni Rosario” and you will see how stressful it is to really think of what killed her. Answering what is the drug of choice for ascariasis is still easier than answering why, in the first place, Rosario still got ascariasis in this day and age.

Then comes the hospital, where interns work as free labor, sometimes even being asked to pay an exorbitant fee despite clocking in more than 60 hours a week as paper-pushers. They endorse attendings and senior residents “to watch out for,” those that demand an entourage to accompany them on rounds, and those that utter sexist, racist drivel inside the OR. When someone attempts to speak out, they languish in being labeled as onion-skinned brats, “millennials” who cannot handle the pressure cooker that made their elders become who they are now.

The truth is some of them are indeed the most successful in their fields, great doctors that trainees have the honor to learn from. They are some of the most laudable examples of how to approach patients, how to build indestructible rapport, and how to elegantly manage diseases. Their contributions to Philippine medicine are undeniable.

Where are public health, preventive medicine, and family and community medicine in all these? Just there, kept in the sidelines. The lack of personal glory in these subjects may have created the myth of the “apolitical” medical student, someone who does not want to get into systems thinking because there is still the pathophysiology of a rare disease to memorize and recite the next time an attending gives an impromptu revalida. Medical training itself is an exercise in individualism. A private privilege.

So here’s the question: Is the push to further emphasize community medicine mutually exclusive with attaining individual excellence in the clinical sciences? No, it isn’t. Harboring great clinical knowledge should be based on moral and ethical principles formed by a deep understanding of our society’s pervasive problems.

What APMC-SN did in condemning the silencing of a free press is laudable against the backdrop of a culture that weaponizes professionalism as an excuse for repression. The pushback is a revelatory rebuke from a community afflicted with a disease that another doctor once wrote about more than a hundred years ago. A Filipino doctor who, because of his writings, was silenced with a bullet in Bagumbayan.

APMC-SN’s statement legitimizes what a great number of medical students and an even greater number of good doctors out there, quietly laboring and doing the good work, truly desires: to make a better world, not just for our own practice as doctors, but for our patients, the Filipino people.

I hope that for APMC-SN, this is only the beginning.

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JM Deblois was a “Scholars among scholars” awardee of St. Luke’s Medical Center-College of Medicine graduating batch of 2018, and is now a Family and Community Medicine resident.