Thursday, October 8, 2009

Certain Reminders on Patient Care

One of my non-medical friends who used to join me and my doctor-friends in our travels once remarked that our life in this profession is extraordinary - deserving of a sitcom in primetime television. Not only do we live horrible schedules and gravely inhuman work hours, we also subsist on a totally absurd and unjust paycheck, inversely proportional to the extent of our labor and psychosocial and emotional burden. What he found most amusing, however, was the fact that we never run out of intellectual conversations. According to him, ordinary conversations in the outside world where he came from usually revolve on the mundane, the casual, and the superficial. Doctors, on the other hand, talk about life - what they try to save, and what they miss in the process.

This good friend, who is still, by far and without a doubt, the most amazing and profound person I've ever had the good fortune of running into, had the habit of listening to us while we rant and whine about our work and our patients, once in a while giving his trademark laconic comments or a wordless mocking grin. After being exposed to us for several instances, however, he concluded that doctors all over the world, no matter how diverse and strange, will always find something to talk about - their patients.

But while doctors occasionally consider their patients' cases gossip fodder for casual conversations, I realized patients also talk about their doctors a lot more than I expected them to. During yesterday's out-patient clinic, I overheard a bunch of patients talking about their own doctors, reminiscent of those Tito, Vic, and Joey sessions in Eat Bulaga's Bulagaan.

Patient A: Aba yung duktor ko, mabait yun! Laging nakangiti. Nagsalita pa lang sya, parang gumagaling na ako.
Patient B: Mas mabait yung duktor ko! Lagi akong binibigyan ng sample ng gamot! Eto may mga abstract at referral letter pa. Kaya nakakalapit ako agad sa mga senador.
Patient C: Pinakamagaling yata yung duktor ko! Mukha pa syang artista! Mabait na, maganda pa.
Patient A: Talaga? Anong pangalan ng duktor mo?
Patient C: (blurts out a gravely mispronounced name of someone familiar) Basta yung maputi na parang model. Tawag ko nga dun si Dra. KC. (probably referring to KC Concepcion)
Patient B: Yung akin, di ko matandaan. Basta yung mataba na malaki ang tyan! Kamukha ni Arnold Clavio. Nakakatuwa ngang kausap e.
Patient D: Yung duktor ko, yung kalbo na Inglesero. Ang sungit. Di ko maintindihan ang salita minsan. Dumudugo nga ang ilong ko lagi.
Patient E: May mga duktor dito na ang papangit ang ugali! Akala ang gaganda at ang yayaman, mukha naman silang mga katulong!

I was wishing Patient C was talking about me, though that would be highly unlikely. I'm probably more of Patient A's doctor. Ehem, ehem.

Few days ago, I received a text message I still didn't have the slightest gumption of deleting. It was from my greatest doctor-idol and mentor - the Great Dr. D himself! In my phone, I have created a folder made especially for inspiring messages from Dr. D - messages I go back to again and again, during those PMS-moments when I absolutely hate my profession and whenever i bemoan my pathetic white-coat state.

Anyway, it said, "Thanks for caring for my patients last month jean... etc. etc. BTW, you have great bedside manners. Don't ever lose that." Waaahh!! That's a compliment from the Compassion Guru himself! I was floating and high when I got it. Somehow it reminded me, that even during my most toxic moments, even when I'm most tired and ugly, I have to keep my manners. Empathy is the name of this game. First, do no harm. To cure, sometimes. To alleviate, often. But always, to comfort.

Anyway, going back to my topic. While I was busy scribbling in my charts yesterday, I overheard another OPD conversation.

Nurse: Nanay, sino po ang duktor nyo?
Patient: Hmmm, basta yung mabait po.
Nurse: Nanay naman, mabait naman lahat dito.
Patient: (To her companion) Sino nga ba yung duktorang yun? Ah, naalala ko na! Si Dra. Alcobar! Yung mabait! Malaking babae na mabait. Oo nga, si Dra. Alcobar - yung matangkad na mataba!

Ahhh, WTF! The grossly mispronounced surname, I can forgive. But mataba??? Somebody just burst my bubble.

Me (thinking): Nanay, di ako mabait! Masungit ako! At hindi ako mataba!!!

But of course, my patient was right. There's no way I can ever deny my hideous, giant, amorphous state. Ugh! Rub it in. Go ahead.

I stared at my poor patient, like I'm going to pounce on her and give her a defibrillatory dose of shock waves - all 360 joules of it. And then suddenly, her face lit up. "Duktora Alcobar, Duktora Alcobar!!"

I couldn't help but smile at her. And the old woman, using all her post-stroke effort, shuffled up to me, and gave me a hug. Sigh... Too much for my being big again.

On second thought, I wouldn't really mind being remembered as "matangkad"or "malaki", not even as "mataba". For as long as once in a while an old woman will smile at me that way, or a blind old man will claim with unblinking but blind certainty, "Duktora, ang ganda ganda mo", I guess I'll be all right.

Perhaps I'm doing fine, after all.


will said...

parang kilala ko ang doktor ni patient D.

AngelMD-No-More said...

hahaha dra alcobar!!! funny how you narrated those patient anecdotes...these stuffs happen i guess from luzon, visayas to mindanao since ive experienced it myself back in my just wondering why our patients cannot remember our names instead could remember our every feature...and the descriptions they make? aside from very generic,they sometimes make us hate them.haha

Pats said...

@ Will: Ako rin bigla. :)

Gosh Duktora Alcobar, my [big] tummy was aching after reading this!!! :D On a more serious note, you're right... Patience+composure is the name of the game. Plus the fact (which people always remind us of) that our patients been waiting a looooong time for us to arrive. :) We're supposed to treat our patients like how maitre'd's treat restaurant patrons... In this case, even just a smile can go a long, long way. :)

Walking on Water said...

Go PGH!!!
i wonder why they're called "patients". They teach their doctors patience?

AngelMD-No-More said...

parang kilala k ang doctor ni patient B...if he's a cardio fellow too and a senior of yours. i heard the same description of a patient way back years ago to that person im referring to when I was his junior. mataba na malaki ang poloyapoy ba yan?hahaha ooops dont post this comment...he sometimes bloghops.hahaha