Coming from a public science high school, I was recruited by Pathways to Higher Education to attend its advanced classes every summer break and self-enhancement workshops year-round, in preparation for the next chapter before adulthood – the university life. I then graduated from the Ateneo de Manila University with a very generous scholarship from the same university, through Pathways. Never had I imagined that Pathways would still guide and support me as I chose to endeavor on a different path from other students, even if this meant delaying all the gratification of fulfilling my potentials from years of studies and eventually earning for myself and my family. I trusted my faith and took a big leap towards my childhood dream. I entered one of the top and most competitive medical schools in the country, the University of the Philippines (UP). Studying medicine was definitely not a walk in the park. Slacking off was never an option, at least for me. I took my studies seriously; I believed that being a doctor is not a privilege (unlike what others might think), but a vocation coupled with moral and social responsibilities – which I have chosen to embrace.
During my last year of medical school as an intern at the Philippine General Hospital (PGH), I was given the opportunity to go to Switzerland for a short internship. That would not have been possible without Aiducation International. It was my first time in Europe, and the experience was unforgettable. I marveled at the sceneries the moment I landed in Switzerland. It was the Europe I used to dream about and see on postcards. I gained not only knowledge and memories, but also new-found friends from Florian, Matthias, Monica, Nora, and Franka, who warmly toured me in their cities, and even welcomed me into their homes.
Medical internship in a tertiary government hospital like PGH is like a baptism of fire for soon-to-be doctors. Patients flock the emergency room, flood the wards, and pile up in the outpatient clinics, pushing the hospital beyond its limits, infrastructure- and manpower-wise. Rare cases continue to perplex the students, trainees, and even medical experts; some are almost only seen in textbooks. But the most distressing and unfortunate fact is that many of these patients present to our hospital late in the course of their diseases, for reasons attributable to poverty, lack of education, and a flawed health system. For many Filipinos, PGH is their only hope for definitive treatment; they believe that the hospital has the facilities and specialists for their illnesses.
My internship in PGH, even my education in UP and Ateneo, had helped open my eyes to this painful reality. Hence, as soon as I became a licensed doctor in 2017 on the same year I graduated, I applied for a specialty training program in Internal Medicine (IM) at this very institution that honed not just my clinical skills, but also my socio-political awareness.
Fast-forward to 2020, no one would have predicted that a pandemic would make the world stood still by the turn of a new decade. The year that should have been for mastery and fine-tuning, and for relishing the final year with my batchmates in IM, turned into a year of anxieties and uncertainties. PGH became a COVID center, living up to its name as a national general hospital. Since COVID is a disease managed mainly by IM practitioners, I then found myself in the frontlines. I have never imagined this vocation’s greatest challenge and responsibility – serving in a pandemic – would happen in my lifetime. It was as if we were called to engage in a battle with the unknown, unseen by the naked eye. We immediately learned to gear up to protect ourselves from the virus. Despite all my cautious efforts to evade the virus, I became mildly infected last June 2020. I am still thankful that I recovered immediately, and was able to serve again in the hospital
Caption: The new normal attire when doing rounds in non-COVID patients: N-95 mask and protective goggles, on full scrubs suits, without a white coat and fancy accessories other than a stethoscope.
Pre-pandemic, manning the medical wards and intensive care units (ICUs) full of patients with mind-boggling complicated cases was the difficult reality any IM doctor-in-training had to face every day. But because of COVID, the weight of this already daunting task undoubtedly tripled or so. Wearing the suit, mask, goggles, and gloves for the entire 8-hour shift, with no bathroom nor water breaks, was a test of physical and psychological strength. Imagine the sweat and grease (and the calories burned) after attending to around 20-25 ward patients or 8 ICU patients. Particularly in the COVID ICU, where our batch was assigned, almost all 8 patients were hooked to mechanical ventilators most of the time. I remember resuscitating (giving chest compressions) to an intubated patient as soon as I entered the ICU at 6 AM. That patient did not make it. A few hours later, another patient had to be closely monitored for a potentially limb-saving surgery (COVID increases the risk of forming blood clots, and that blood clot lodged into one of the patient’s blood vessels in the leg). Another patient had to be started on medication to increase the blood pressure (otherwise, the patient might go into cardiac arrest). Only one doctor is designated to attend to those kinds of situations in the COVID ICU. On top of that, s/he has to make very comprehensive electronic entries per patient (handwritten during the first three months of the pandemic), update and inform the relatives of their patient’s improving or worsening situation, and join rounds of other subspecialty doctors just to name a few. However, the most draining task was calling the relatives to ask whether to continue resuscitative efforts or not on their dying patients. There were times when I found my voice was already cracking, and my eyes were welling up with tears. But hearing them wailing while bidding goodbyes to their patient via video call was a million times more painful. I probably would not be able to get over that.
Caption: The COVID attire, taken after doing rounds on all my COVID ICU patients. Wearing this suit was exhausting and draining.
Caption: Trying to find the silver lining despite the pandemic. I (on the left) took this photo with two of my batchmates in IM residency training during our last day of COVID ward rotation for July 2020.
Caption: We took this photo in the medical ICU after doing various procedures during our rounds. I (second from right) was with the medical ICU team composed of doctors, nurses, and nursing aides.
Despite all the chaos and misfortunes of 2020, I am still very grateful to have graduated from my specialty training program this December. Though my duties to the patients of PGH might have ended for now, I vow to continue to attend to my responsibilities as a physician of this country.
Marie Gene D. Cruz, MD - AiduTalent, Philippines