I entered medical school five years ago, and I am now a postgraduate medical intern in training. I have gone so far; I still have a long odyssey ahead of me. The local board exams loom, and to quote a popular 1990s anthem, “We are the ones who are next in line.”
We are next in line for carnage, we are fodder for raptors, and living prey for the predators of the real life ahead of us in this profession.
It feels like it has been a very long time since I was acquainted with medical physiology, the molecular basis of disease in biochemistry and the microscopic elements of histology, the cellular aberrations of pathology, reading anatomical descriptions, organic relationships, the insertion and origins of every known muscle to man, inspecting and labelling the deep crevices of an actual human brain and the neural pathways of neurology, dissecting unknown and unnamed corpses in gross anatomy, becoming tolerant to the smell of formaldehyde, understanding the disease causation of parasites and the application and correlations of these to the clinical sciences, and being exposed to real-life patients and treating actual diseases in the field and in clinics.
One thing I have learned in medicine is that you have to be at the bottom before you realize how to get to the top. The past five years have been partly heartbreak, partly crazy, most of the time sleepless, frustrating, demeaning and exhausting, but at the same time fulfilling. And I wouldn’t have it any other way.
I feel like I was thrown into a battlefield, underestimating the stories of my elders and coming out of the arena as a gladiator would, scarred and almost bleeding to death, arms raised in the air, alive but barely breathing, with a stethoscope swinging over a blazer once starched and pristine but stained now with blood and other bodily secretions.
Prior to entering med school, I didn’t think that the stress would be that terrible, or that the number of topics to study would be that overwhelming, and that the nights would be literally sleepless. When the reality set in and I found myself in the midst of this war for which I had voluntarily enlisted, each day I would ask myself if this was the life I wanted, if this was the reality that I desired for myself. There were many times when I wanted to quit, those times when I felt like my 100 percent was still not good enough, and no matter how prepared I perceived myself to be, the feeling of inadequacy still lingered in the back of my mind. There were numberless times when an hour or two of sleep, or even just a full meal, was considered a luxury.
There were times when I had to sacrifice all the important occasions and holidays because I had to conduct bedside monitoring, or study for a case discussion, or have a weekend date with my textbooks, hands stained by the ink from highlighters, accompanied only by very strong coffee, while my friends and the rest of the people I know were out partying or traveling—and all I could do was vicariously enjoy those moments on Facebook during “break times.” There were also times when I felt inept, daunted by my small knowledge and skills, wondering whether I was cut out to be like my attending physicians or my residents, or if I deserved to be in the company of the other doctors who came ahead of me.
Medicine is beyond the medical texts and the literature; it is beyond the stereotypical assumption that physicians play God, are power-hungry egotistical maniacs in white coats with superiority complexes (although I have met a handful who perfectly fit the very description). Medicine is more than the personal and physical pain you have to endure. It is sharing the actual visible pain and misery of a chronically or acutely ill or dying patient, and marshaling the best of your abilities to not only prolong life but also ensure that the quality of life is not compromised.
Those sleepless nights and those times away from our families and loved ones are all meant to prepare us for those few seconds when our decision is extremely vital, when life is reduced to a few waves on the cardiac monitor, when the imminence of death becomes a matter of how fast you think and respond.
Med school is an emotional and psychological experience comparable to nothing I have braved in my life. When I was conferred with the medical degree, and I had “MD” affixed to my name, I thought that the battle was over and the enemy defeated. But no. It was only the beginning of another set of challenges I have to face. “MD” is not a mere title we leave in the hospital premises when we go home, or an 8-to-5 duty we can let go of once we log out. The responsibility cannot be simply left at bedside when we leave our patients. We respond not only to the paging system when there is a “code” or to a phone call when there is a referral, but also whenever someone shouts in public if there is a doctor around.
Our patients trust that we will relieve them of grief, of their anxieties and fears, even if we have to set aside our own personal bereavement and pain to be able to think objectively. It is an experience only those who have gone through med school can understand (the rest can only observe, and barely brush the surface).
In the five years I spent in my young medical training, I learned that we can only learn so much from the formal lectures in classrooms or from reading our books. I learned that there is more to medicine than sustaining life and preventing death, that it is through our personal encounters with our patients that we will be able to understand and ponder on the complexity and brevity of being human, and how each day should be lived, as we resuscitate those who are gasping for breath and already living their last.
Regent Andre D. Piedad, MD, is 26 and a medical intern at De La Salle University Medical Center. He is a 2013 graduate of De La Salle Health Sciences Institute–College of Medicine.