youngblood article

This one here, which was done by a medical clerk in UST, hit the spot. It's a very accurate description of what clerkship feels like. I'm just envious I didn't write it myself first =)



Zombies and Idiots?
by Lorraine Rojas, MD

I GREW UP in the company of doctors. My parents are doctors. My parents' friends are doctors. As I grew up, they were the people I saw every day. They were my family, my uncles and aunts, my playmates.

Since my parents had me when they were just starting out, a nanny wasn't in their budget. So everywhere they went, I went too: to the clinic or the hospital, on rounds or inside operating rooms, over hill and over dale. I don't think a 1st year resident can have more exposure than what I had at the age of 5.

Given this background, you could say it was a foregone conclusion where I would end up. I don't think there was really a moment when I had to tell my parents that I wanted to be a doctor. It was just a given. It's not that they didn't make sure that this is what I really wanted. I can remember them asking (as I was submitting my application for my pre-med course), with great seriousness, "Are you sure?" But that was about the extent of our discussion on the subject.

My parents definitely know how hard medical school can be. They know that they make it hard on purpose. They know that they beat you down, play with your emotions and drill you incessantly until you are a babbling shadow of your former self. So is it any wonder that they brag to anyone that their daughter is a doctor? No, excuse me, about to become a doctor?

See, that's what I am. I'm on the verge of becoming one basically. I am in medicine's no-man's land called "clerkship." Technically speaking, I'm in my fourth and (hopefully) final year of schooling. But as my father eloquently put it, "In the pecking order, the clerk is at the bottom. You are the lowest form of animal."

Yeah. See those insignificant things at the end of the line? That's us. We are the clerks. We are overworked and never paid. Heck, we're the ones who pay the hospital and the school a ridiculous amount of money to do this to us.

I wonder what all those people would think when they realize what exactly this (almost) doctor does every day -- or what all their doctors once did every day when they were clerks. We run around, doing everything for everyone else. We barely sleep and when we do, it's (1) on a bench, the floor, a chair or a mosquito-infested bunk bed; and (2) punctuated by periods when we are rudely awakened to monitor a patient, assist on an appendectomy, perform CPR or run some more. We walk around like zombies in the middle of the night, monitoring the blood pressure or temperature of patients. We push wheelchairs or stretchers for people three times our size. We suffer indignities as our patients mistake us for everyone else (nurse, nurse's aide, med tech, receptionist, random people dressed in white) except doctors. We are called "ate," kuya," "hija," "hijo," "'neng," "'toy" and, horror of horrors, "hoy." We measure the urine, we suction the secretions and, at the drop of a hat, we are expected to know everything.

I had one patient in the outpatient department, a college student. He watched as the consultant berated me over the physical exam I had given, my diagnosis and my proposed plan of treatment. As I turned to him with my last remaining shreds of self-respect, he whispered in awe, "Para pala kayong nag-dedefend ng thesis araw-araw." ["It's like we are defending a thesis every day."]

He got it. Every patient is a learning experience and every conversation is an exam.

There are those who say we have it pretty good now. It's worse when you're an intern, a resident, a consultant -- more responsibility, more work -- but as a clerk, you have camaraderie, blah, blah, blah. I know they have a hard time, maybe harder than we do, but when you're at the bottom of the heap, anywhere else sounds pretty good. It's hard to have perspective when you have to crane your head just to see where you're heading. I mean, when your boss has a boss who has a boss and that boss is part of a group of other bosses, how screwed can you get? While there are those who are genuinely nice, who understand and go out of their way to help, there are others who seem to have been put on this earth for the sole reason of making your life a living hell. If anyone else were in their position, they would be on the receiving end of a hissy fit. But no, these are our superiors. Unlike them, we still have something to prove. Whoever said that we should fight the Establishment was never a clerk.

My friends think I'm a little crazy, and more than a little bit sadistic. They can't understand why I can't make it to this party or that get-together on less than a month's notice. But even on one year's notice, there's very little you can do if you're on duty on that day or if at that exact moment, your patient decides that he wants to stop breathing. When you're so tired that you forget to eat, keeping your coffee date isn't exactly the top thing on your mind.

And when you do get together? It's hard to tell your friends about your day when they can't get what exactly you do in your day. There's also that little fact that while they all have careers, salaries and live independent lives, you're still relying on your parents for almost everything -- room, board, tuition and (sigh) allowance. Not to mention the fact that you're the only one still worrying about tomorrow's exams. Let's face it: This life is murder on relationships.

I suppose some people must be wondering, "Why are you killing yourself just to have two letters appended to your name? If you find it so damn hard, why are you still in the game?"

Granted, life might have been easier if I had wanted to be a kindergarten teacher, a housewife or a dancer. I wouldn't be constantly plagued with self-doubt, wondering if I can make it, if I'm good enough to be a doctor. I wouldn't dread the coming of every duty day. I wouldn't be scared shitless because some lives are literally in my hands. And I definitely wouldn't be still up at 1:30 in the morning writing this.

See, there are so many reasons for me to quit -- and only one thing, one measly thing holding me back: that despite the whining and the groaning that I do, I can't think of anywhere else I want to be. Simply put, I love it. It took me a while to figure out that even if my parents were trapeze artists or even if they had seriously tried to talk me out of it, I would still be here, right now. No matter how difficult or dangerous the game, it doesn't change the fact that I love the playing field. I cannot wait for the day when, more than just playing, I get to actually call the shots.

Some would think me a complete idiot to enter the field at a time when no one wants to be a doctor, least of all doctors. But hey, if being a doctor is being an idiot, I'll gladly be a complete and utter idiot for the rest of my life.