When doctors cry

A physician once told me, “Learn to detach yourself from patients.” He said these words while I was crying my heart out for a 64/M Juan dela Cruz from Nueva Ecija diagnosed with Stage IV laryngeal cancer. The old man was at our college tambayan asking (through a letter) for financial assistance. He came there alone, with a plastic bag of junk food and a bottle of water. All who read his letter cried. I was a second-year medical student then, with no actual patient encounter in the clinics or the wards.

Two years later I was a medical clerk who went on duty every three days, sometimes every two. I have since then seen countless cases ranging from the most benign fever to a bulky tumor, from chronic kidney disease in need of repeated dialysis to a comatose patient with family members unwilling to let go.

Most times, as a clerk or intern staying at bedside, you get the unfortunate privilege of being asked by relatives about the patient’s status. For improving cases, it’s effortless to explain the patient’s condition. But for the deteriorating ones, breaking the bad news is never easy. You have to be prepared for any reaction. There are some who accept the fate of their loved ones; there are those who blame medical professionals for the perceived incompetency that resulted in the patient’s worsening status. At these times, you bite your tongue and try desperately to understand. There is nothing easy about death.

Through the years I’ve lost count of the patients I did chest compressions on and manually ventilated with an ambu bag. I’ve debriefed relatives and held the consent form while the wife signed a DNR (do not resuscitate) form. All these I did with a poker face. There is nothing easy in having to watch someone die.

I began my residency in pediatrics last January, knowing fully well that I can never escape a mortality. But I was never prepared that in some cases, a patient’s death will scar me for life. The first time I got teary-eyed was when I had to convince the parents, a teenage couple, of a premature baby to come back to the wards and bid their son a proper farewell. The sight of the mother sitting on the cold stone floor of the Philippine General Hospital, hair unkempt and eyes wet with tears, is forever seared in my mind.

The second time I was moved to tears was when one of our chronic patients—he had been confined for more than 40 days—suddenly passed away. I remember the exact words the mother kept saying to her beloved child, “Sorry, anak. Alam mo namang ginawa namin ang lahat. Kahit sa huli, hindi ka namin iniwan.” (You know we did everything. Until the end we never left you.)

I have handled other “toxic” patients. They have touched my life in more ways than I expected. I do understand that as doctors, we need to set up a barrier to constantly remind ourselves of our professional relationship with patients. But then, it doesn’t make you less of a medical professional when you let a tear drop sometimes.

Surely I will still cry for every memorable patient encounter I will have, good or bad. More important than being a doctor, I am human and capable of emotions, of sadness, of happiness, of anger.

Speaking of which, may I use this piece as a means to vent my frustration about how the Bureau of Internal Revenue has mistreated the medical community.

I am a newly inducted doctor working in a government hospital. I still do not have a salary and I still depend financially on my parents. Most of my patients belong to Class C-D-E of society, and often I use my allowance to pay for their lab tests, medicines and mechanical ventilators. The way the BIR has portrayed the medical profession is somehow disappointing to young doctors like me who have but one goal (other than surviving residency): to be of service to the Filipino people.

And like the way I write daily to the PGH foundations, pleading for financial aid for my patients, may I say: Sir/ma’am, respectfully requesting your good office in behalf of the countless government doctors who are overworked, underpaid, and now misrepresented and misinterpreted, to please give us the respect that any member of the noble profession of medicine deserves. Hoping for your positive response.

Odessa Joy P. Taganas, 26, is a first year resident at the UP-PGH Department of Pediatrics.