IMNMD 2B by Myrna L. Sajo

Anatomy Group 3 with Dra. Luz Surio

I am an MD-to-be. I live an unhealthy and sedentary lifestyle composed merely of sleeping to four hours a night (that is if you get lucky), sitting for long hours in the library. My exercise regimen is changing classrooms, standing for an hour or two during bedside discussions, and carrying thick-paged and hard-bound medical books. I am on the verge of caffeine addiction. All my energy has been drained from me. And the worst part is, I'm not just physically drained, I'm mentally and emotionally drained and socially stunted.

Anatomy of the Dorsum (R) Hand

Is this the price I have to pay to be a doctor, to have that right to attach to my name those two most important letters in the alphabet, MD? Being a med student is like being handed a free roundtrip ticket to hell. For me, at least, it feels like it. I'm not delusional. I'm not discouraging anybody to be a doctor. But, one must know and understand the realities—the truth that lies behind the typical life of a medical student. Before I entered medical school, I already had this preconceived notion that it would be really difficult. That was an understatement. First year was devoted to studying the "normal". The greatest bulk of my time was spent smelling formalin in the Anatomy laboratory with the cadavers. Since my pre-med was not Physical Therapy, I really had a hard time memorizing the origin, insertion, and actions of muscles which the doctors lovingly tie during practical examinations. Hello! Of course I know the commencement, termination, and tributaries of pudendal vein, but where the heck is it? I could not find it. I bet, even if they give me the whole hour to look for that vein, I'll never find it. Biochemistry? You need a trillion neurons to accommodate the litany of information you have to store. You'll need more than 36 ATP from glycolysis and Kreb's cycle to pass that subject. And more importantly, gluconeogenesis should also take place in your brain, not limited in your liver, because you'll really need a large amount of glucose to feed your ischemic brain.

Biochemistryland Map (Clinical Biochemistry MRS)

If you can live in Neuroanatomy, Histology, Anatomy, and Biochemistry memorizing without understanding, Physiology is a different story. Physiology is understanding without the need of memorizing which unfortunately, was even harder for me. Moving on from first year to second year was like transferring from the Sahara Desert to Siberia . Everything we studied was abnormal. We spent hours in Pathology looking under the microscope, helplessly racking every corner of our brains for the diagnosis of a small scraped tissue. How could you tell that the patient is having a heart failure, that she has cancer and that she only has five years to live just by examining a teeny-weeny bit of stained tissue, resembling more an abstract-surrealist painting which I can never appreciate?

Coping for Exam by doccartoon

The essence of being a doctor nowadays is to be able to give the patient a prescription (Right or wrong, most of the time it does not matter anymore. Patients get instantly healed when they get their prescriptions). And in our Pharmacology examinations, I usually don't get the right drug for prescription writing. Well, except for Paracetamol, but what the heck, I always computed for the wrong dosage. Internal Medicine tackled history and physical diagnosis. Here, you'll get a first-hand experience of interviewing a real patient. It's one small step closer to being a doctor.

I remembered how nervous I was approaching my first patient. I didn't know what to ask. My line of inquiry lacked coherence. I fumbled with the physical examination, wondering why I could not hear any heart sounds nor breath sounds, only to find out I wore my stethoscope the wrong way. I've just finished third year and I'm barely alive.

Third year was a totally different story. I had completely lost the idealism I had when I entered med school. I am beginning to ask myself why I'm spending the prime years of my life almost a breath away from cadavers, half alive-half dead myself. At 23, I should be earning already, and not be an immense burden to my parents. I have a high-maintenance lifestyle. My parents would spend close to a P100,000 a year only for my tuition. I still had to ask my mom money for my books and daily allowance. And I know that this setup will continue another four years or so. As my highschool friends are starting to save their earnings and beginning to build families of their own, I'm hardly out of med school, probably still stuck reading Harrison's Internal Medicine, cramming for a case presentation and helplessly being grilled by a consultant during bedside discussions.

Being a med student is nothing but sacrifice. First and foremost, you have to give up sleep. Sleep is the most precious gift any med student could ever receive. It seems that sleep does not exist in the vocabulary of our teachers. Sleep is taboo to medicine except when doctors advise it to their patients. It's totally ironic. Doctors know that human beings (medical students included), in order to function maximally the following day should at least get eight hours of sleep. Then why do they expect us to read everything, to pass all their difficult exams,actively participate in case discussions and to answer all their questions when you only get an average of four hours or less sleep per day? We're not different from human beings who need to eat three times a day, who breathe the same air, and who need to rest. It's not as if God had given us an extraordinary pineal gland and reticular system so that we have an extraordinary circadian rhythm and a long, long s tate of arousal. I just hope our doctors would understand that if a med student failed to read something, it's not because he was lazy. He was probably tired and had gone to a dreamless slumber because he spent the previous night like a psycho studying for three exams.

I have sacrificed time for my family, for my friends, and for myself. My whole life right now is devoted to Harrison, to Schwartz, to Nelson, to Adams, to Smith, to Green, to Kaplan, all authors of my medical books. I mean if these are the surnames of all the guys I go out with, seven times a week, geez! I would die a happy and fulfilled woman! Instead of accompanying my mom to the supermarket, I have to stay home because I have to study. My dad had already complained to me that I do not have time for him. My friends had stopped calling me because whenever they talked to me I either spoke in monosyllabic words, or they could not understand me because I spoke as if I drank tons of tequila. I talked like a drunk. Well, in fact, I was just in the middle of a dreamless sleep.

See? How can you choose this kind of lifestyle?It's not even a lucrative job anymore. You have to get rid of all the more experienced and old doctors to get even a handful of patients. So, if you want to be a millionaire, don't slave in the hospital because even if God had made one day 72 hours, instead of 24,or gave us 14 days instead of 7 in one week, you're still way off your one million mark before the age of 30.

Of course, I have witnessed a lot of people giving up med school. But never have I heard, not even an anecdote, of a rich businessman giving up his entire career, just to study medicine. Being a doctor is not something you have to decide overnight. It's not a result of your whim or a fulfillment of your parents' dream. Because if these would be your reasons, you're entering the wrong profession. Choosing to be a doctor means being committed to a lifelong journey of endless sacrifice. You have to be sure that this is the life you want to live—that you love to live—not something you'd tire of halfway. The ironic thing is I never wanted to be a doctor in the first place. I wanted to be a writer, a novelist, or even a journalist. I was just dragged by my mother to take up medicine but fortunately after seven years of schooling, I learned to love it. Of course I still have doubts that maybe I'm really not cut out to be a doctor, leading me to think if it's really worth it.

At this point, I don't know anymore. What inspires me to continue is that in the future, I know I'm going to save a man's life. And through it, I can honestly say to myself that I have made a difference in someone else's life. And I reckon, maybe that's what being a doctor is all about. It's not working in some fancy hospital,earning big bucks from your patients, changing your cars quarterly from BMW to an Alfa Romeo to a Jaguar, nor travelling around the world magnanimously sponsored by some big drug companies.

Neither is it the various letters attached at the end of your name. Being a true doctor is not treating the patient as some hypothetical case from a medical textbook. It is treating the patient as a human being, who possesses a heart that does not only pump blood but a heart that could feel, who doesn't have a brain that is visualized only as black and white in an MRI or CT scan but has a mind that could reason, who is not merely composed of cells, of tissues, of organs, and of different systems but a human being who has a soul.

Being a doctor is being able to look at every patient's eyes and seeing in their depths the hope that somehow you can make one father go home and enjoy dinner with his family, or you can make a grandmother attend her only grandchild's piano recital, or you can send a mother to be with her daughter as she enters into the complicated life of adolescence or you can transform an infant's cry to a frolicking laughter. Being a doctor means being a part of an unimaginable greatness that you can only understand if you surrender yourself to years of rigorous training and incessant pursuit of medical knowledge.

During all my interviews in different med schools, they asked me why I wanted to be a doctor. I always answered that I wanted to help and save humanity. I'm sure all my interviewers have heard that same line from countless fellow applicants. But I don't care because it's the truth. I don't know how I can do it but I know eventually I will, in my own small way.

Medicine is neither for the weak-minded nor the weak-hearted. My endurance has been tested. My strength has been staunchly fortified. Medicine has changed me completely. I have sacrificed a great deal and most of the times, I may feel I'm not compensated. Most of the time, I would want to give up but I know deep in the core of my heart, I won't. For after careful reflection, I realized that being a doctor actually gives me a different kind of happiness, a different kind of self-fulfillment, which I can never find in any profession. Well, I just hope my fellow aspiring doctors are fortunate enough to share the same sentiments.

                       -  Myrna L. Sajo