The future of medical consultations

I’m going to do a bit of a personal medical narrative here, a fancy term for stories about health and illnesses. We use a lot of that in medical anthropology and process the narratives to advise physicians, nurses, and health professionals about patients’ perceptions and experiences around health and illness.

My focus is on what COVID-19’s impact has been on getting sick, and how it is reshaping the future of medical consultations.

Shortly after our lockdown began in March, my personal physician Dr. Yul Quanico warned me not to get sick, because this was a bad time to be in the hospital. Take your maintenance medicines, he advised, adding zinc for the immune system, eating right, exercising.

Yul is a urologist and was my father’s physician for benign prostatic hyperplasia (BPH), which also became part of my inheritance. Sigh. My father was quite old when diagnosed, so surgery was not advisable especially because with such patients, they tend to die before prostate cancer develops.

In my case, Yul said it’s better to have surgery since I’m still relatively young (yes!). We had planned on the prostate intervention after I finished my chancellorship, but then the lockdown came.

I was a good patient, following all of Yul’s admonitions, but in June, I came down with an unexpected problem, which I am certain was triggered partly because I was caught up moving out of the Balay Tsanselor in UP Diliman. Since the household staff did not report during the lockdown, I did much of the packing, which included carrying around the hundreds of books, many heavy, that I had accumulated.

Then one day it happened—a feeling of discomfort, then a throbbing “pop” feeling on the lower right abdomen. I looked with horror at a lump in the area, like a tiny alien trying to break through.

I knew what it was right away: an inguinal hernia. It’s not “luslos,” and when I tell people it’s not a “ball” problem, women go, “parang buwa,” which means a uterine prolapse, a fairly common problem after child delivery. I laugh and say in Filipino, yes, it’s like buwa except it’s the bituka (intestines) and not the uterus, which, last time I checked, I don’t have.

I knew right away it was an inguinal hernia because again, my father had it. (“Ibang klaseng pamana,” I joke, a different inheritance of BPH and a weak abdominal wall that causes hernia.)

My father’s inguinal hernia came when he was already 90, and we had to operate because the doctors were worried. He tended to get constipated like many elderly people, and his bearing down (pag-iire) could cause a strangulated intestine. Sinakal na alien, I thought for my own condition. (I’m being humorous here… I do that with my health problems, and it helps.)

So I called Yul for help and he said, much as he preferred I didn’t have to get to the clinic at the Urology Center, it was best for him to look at it and combine it with a check on my prostate.

I went early, but was aghast to see a long line of patients waiting. As things turned out, it was like checking in for a flight. Department of Health guidelines now require many procedures and forms to screen even outpatients. No tests required for procedures like laboratory tests and physical examination—the staff, of course, were all in PPE (personal protective equipment) and there was plastic everywhere to prevent unnecessary direct contact between people.

I knew all the hassle was needed to protect both the hospital staff and patients, but be forewarned, all that will be part of life in COVID-19 times.

Yul said the hernia could wait, like the prostate, and we discussed the possibility of a 2-in-1, considering that for surgery, you’ll need the PCR test for COVID-19, which everyone now knows as a swab test.

A day later, he sent my laboratory results through email, something that will happen more often now, to prevent unnecessary trips to the hospital.

Next week, I’ll tell you what dental care is going to be like, based again on my personal experience.

mtan@inquirer.com.ph