Welcome to the Emerald City

Sometimes, when we run after the things we want, the more elusive they can be. But when we stop and stay still for moment, a tornado may sweep us off our feet and bring us to the yellow brick road to our dreams.

I tried to get matched to the DOH-Philippine Centers for Specialized Health Care twice. During the first matching, I went all Legally Blonde and did not have a second choice. But the during the second matching, I listed down my two other hospitals of choice -- our base hospital, Quirino Memorial Medical Center and the other hospital in close proximity, AFP General Hospital. I got matched to QMMC. And from the minute I found out that I was matched, I accepted it and tried to forget my dreams of being a DOH intern.

QMMC, after all, is not a bad choice. It is actually a very close second choice, yung tipong hindi ko lang magustuhan ang isang bagay sa DOH, tatakbo na ako pabalik ng QMMC. QMMC has been my home since 3rd year medical school. I know every twist and turn in its halls. I know almost all the hacks a Junior Intern must know to make life easier. Most of all, a lot of my dear friends chose QMMC, too.

So the wires in my head went all berserk when one of my friends, whose dad can work wonders in East Avenue Medical Center, told me that he is backing up my application in the internship program. Then my cousin, who is a former DOH intern, told me to go ahead and try my chances during the third matching. But I am backing out of DOH, I thought to myself. I have given up. I am going to QMMC and that's that.

But who was I kidding, this was the internship I have been pining for. So, cancelling all my plans for Maundy Thursday, I braved the scorching heat of the summer sun to try and pass the third matching exam and interview, hoping to maybe get in without having to call my friend's dad or my cousin.

Wore my red shoes to the interview to pay homage to Dorothy and her visit to the Emerald City. My red bag is Toto. 

They told us to wait for the results of the 3rd matching after the weekend. And wait I did. It was excruciating to wait. Until I got the message I have been waiting for. I got in. With all the people who supported me and my panel said that my interview went very well, I was thankful that I finally have an official slot.

The girls of Group G. Or at least half of us. 

Fast forward to a week later, after all the uniform-fitting and teambuilding, I found myself in a new group of 15 individuals who braved the challenge of DOH, and fitted into my new subgroup of four -- subgroup G4.

When I saw those two letters, I knew my name will never be the same again. To top it off, it sits above that much coveted DOH - PCSHC logo. 

Labor day 2014 marked the beginning of my year in my Emerald City. I have high hopes for this year, much like my year in QMMC previously. And who knows, after my 365 days here, I might choose to stay or click my ruby red slippers together to find my way back home.

Matched

Since I started med school, I only had eyes on one internship program: the DOH-PCSC program based in East Avenue. But when they said that they'll only be taking in top 20 students from medical schools across the country, I knew my chances were slim.

I did my research on how to get in despite not being in the top 20. "They" said I should walk in, "they" said I should try and get matched during the 3rd matching. But duties during clerkship wore me down that I was too tired to be competitive. I found myself matched to another hospital during the 2nd matching.

I gave up all hope until my cousin called me and asked if I really wanted a slot. I said yes. He gave me specific instructions on what to do next, and when.

After endless pep talks (kaya mo yan, Noah!!), a car that won't start, and exam made in the depths of hell somehow I nailed that final interview. Now here we are. It's official.

QMMC, I love you. Someday, I might find myself back in your embrace. But for now, I will have to go with my "other" hospital. 

Here's to new adventures, new friends, new environment. Here's to my Emerald City. Let's go, Toto. It's time to meet the wizard.

JIship in Retrospect

In the first three years of medical school, you don't feel like you're training to be a doctor. It feels more like an extension of high school, not college -- high school.

You belong in one big class, divided into sections. You go to school at eight in the morning, leave by five -- at least that was how it is in my medical school. People get to shallow fights over notes and who sits where in class. We are scared of recitations and pop quizzes really pop everywhere. And yes, there are those little classroom romances and "issues", just like high school. But then once you get promoted to fourth year, things change drastically. 

For starters, no summer vacation. Immediately after promotion, you start the crash courses on doing procedures, basic life support, advanced cardiac life support. And then just like that, you are brought to the hospital. No ceremonies, no anything. 

I was "lucky" enough to have OB-Gyne as my first rotation. Yes. I was sarcastic. 

OB-Gyne is known as the most "toxic" of all rotations. During the first couple of weeks, I actually considered skipping duty more than once. Primarily because it was tiring. But mostly because I was scared. I was scared to poke patients, I was scared of the residents, I was scared of blood. And well, OB is like bloodbath everyday. 

My OBGyne groupmates and first year residents, Doc Mich and Doc Rhaizza.

 But then eventually, I got the hang of it. The don't mind the smell of lochia on my hair anymore or the fact that sometimes I fall asleep in the cab after a long night in the labor room or operating room. Until one day, I realized that I was already shifting rotations. After that, I can't say that it was a walk in the park, but it was pretty much downhill.

In Junior Internship, I got to meet many kinds of people. I got to know my fellow Junior Interns better. They say that people actually change during JIship. I beg to disagree. I think its more of we finally get to know people better. In med school, we go home at five. In JIship, we go home the next day. And overnight, a lot of things can happen that would bring out the best and the worst in each other. 

Subgroup C4: Shakes, me, Oliver and Ian.

Growing up, I experienced attending a private school and a public school. I was exposed to people from different economic backgrounds. I have classmates who arrive in big, chauffeured cars and I have classmates who walk n kilometers to school in battered rubbershoes two sizes too big. I thought I already saw the stratification in social classes, then I rotated in a government hospital, it took my consciousness to a whole new level. 

My family is lucky enough to be able to afford to go the big hospitals when we have to. Personally, I have a pulmonologist for my asthma, a cardiologist for my arrythmia, a dermatologist for my skin. But the patients I met in my rotations, they come in, their illnesses fullblown, uncontrolled. They come in because they finally have the money for transportation. Since that's the only money they have, laboratories and other ancillary tests will have to wait for an indefinite time. Diagnoses are hit and miss sometimes. Interventions are delayed. Sometimes -- most of the times -- we have to shell out our own money just so the simple procedures like drawing blood or putting an IV line can be done. 

My partner since day 1, Oliver. 

There were times during the 11 months of JIship that I was too tired, too jittery, too giddy, too sleepy to function well. There was a time when I was crying while driving home because the consultants kick my butt in conference. There was a time when I left my car in the middle of the parking lot just so I can sign in on time. There was a time when I was the patient in the ER because duty + makeup duty hours started to take its toll.

Block C San Beda College of Medicine Class of 2014.

The night before graduation, as I forced myself to sleep -- I couldn't, out of sheer excitement -- instead of counting sheep, I counted my patients. 

The first one, who I monitored in the Surgucal ICU because of asthma in acute exacerbation, at 22 weeks AOG, not in labor. 

The next one, postpartum bleeding. Stayed in the SICU for weeks, succumbed to sepsis.

Then there's the girl we admitted in the Pedia ER, transferred straight to Pedia ICU due to Dengue Fever Grade III. I didn't know what happened to her afterwards.

Then there's my patient in Psych, who got so drunk he ran around his town many times.

Then there's the MDR-TB patient in Silang, Cavite, who we have to transfer to DSLU for continuity of care. 

Th list went on and on. Some of them, I can only remember faces, some last names, some only the diagnosis, most were just a blur. 

Then just as soon as it started, it came to an end. The last two weeks of JIship was an emotional rollercoaster for me. The prospect of breaking up with the subgroup I have known and love so dearly was enough to drive me into tears everytime (that was a secret).  And the thought of venturing into the unknown -- PGIship -- was great enough to scare me enough to want to crawl back to med school.  This time, a JI would ask me how to do things, why things are, and I don't know if I would know the answer to that. 

I am now less than two weeks away from PGIship (Post-Graduate Intern), still with no concrete plans of what hospital to go to. 

Am I scared? 

Yes. 

Am I excited? 

Definitely. 

Am I ready for it? 

In our profession, there's no such thing as "ready". Just do, the rest will follow. 

The PGI Bucket List

I've done and/or assisted numerous procedures during my Junior Internship year. This upcoming PGI year, I wish to do more, and possibly every item on this list.

[   ] Intubate an adult.

[   ] Intubate a newborn.

[   ] Lumbar tap an adult.

[   ] Hold the drill in an Orthopedic surgery.

[   ] Spinal tap during Anes rotation.

[   ] Episiorrhaphy -- 4th degree laceration.

[   ] Close the skin, C-section.

[   ] Close the skin, open cholecystectomy.

[   ] Assist in CABG.

[   ] Assist in kidney transplant.

[   ] Appendectomy, surgeon.

[   ] Deliver a frank breech via NSD.

My magic 12. Make it happen Universe! List me down for DOH-PCSC!

Here's to Us!

I wasn't given the chance at a privilege speech during my graduation. That honor is reserved for the brightest in class. I am not. I never was the "--est" in my class even before coming to medical school. But I feel that some form of gratitude speech/post is in order, especially for the people who helped me reach my second pitstop.

1. My parents -- Noel and Angie Pagdanganan.

Before attending college, people assumed that I would follow my mother's footsteps as a nurse. But surprisingly, my mom was against it. I am not that good in math so becoming an engineer like my dad was out of the question, too. So I decided to level-up my mom's profession, I went into the health sciences and eventually medicine. I am now the 8th doctor in the family. The 7th in my generation. The 10th, including the laterals.

So it is fitting that the first in my list are my parents, who never gave up on their daughter, despite lots of mischiefs she managed to get into. Seeing your proud smiles during the graduation erased all the exhaustion I felt especially during the last few weeks of junior internship.

2. Ninang Allyn and Tito Mon.

My mom's older sister and her husband who serves as my second parents. I didn't have to invite them to my graduation, it is given that the two extra seats are for them, no questions asked. Ninang has been my second mom ever since I can remember even until after she got married and had a kid of her own. Thank you for always praying for me, the guidance during the times when I was confused as to what I really want to be. Sorry for missing many important family gatherings, but I know that you understand the demands of the profession I want to belong to.

3. My Oca Cousins -- Erjohn, Anna and Feliz.

There's only four of us, and being your super ate, sorry if at times I cannot be with you. But this is for you, too. We have a relatively small family and all we have is each other. Always keep that in mind. Ate is always here for you, no matter how busy or crazy her schedule becomes.

4. My Pagdanganan Cousins -- Kuya Almer MD, Ate Lisette MD, Ate Ivy JD, Ate Chela MD, Arni MD, Jhec MD and Hester MD.

I finally feel that I belong. Thank you for the kind words and encouragement during the times that I want to just quit and go into research seclusion. Thank you for making me realize that even though a PhD is just as rewarding, an MD will suit me better. And you were right.

5. The DVMI Sisters -- Sr Bren, Sr Julien, Sr Cristina, Sr Eloisa and Sr Adelie.

Thank you for always including me in your Vespers and Lauds. For always telling me to not give up when med school was slowly dragging my hopes down. For giving me the spiritual integrity to fight every battle with a clean heart, that despite being soaked in science, I would never fail to marvel at the work of God and to know where my abilities as a healer would end and to let God do the rest.

6. Fr. Anthony.

You were my Parish Priest when I decided to go to medical school. You wanted to send me to World Youth Day 2008 in Sydney, Australia but unfortunately, I had to say no because of my classes. You supported me throughout my tenure as President and eventually Coordinator of the Parish Youth Ministry. A few months into medical school, I started losing grip of the Ministry but you never lost your faith in me. Thank you for the prayers, for the spiritual support and for being a good friend throughout my med school years.

7. Fr. Rico.

Since you came to our Parish more than a year ago, you never failed to show support to PYM. And even though I had my share of shortcomings especially in the last few months, you stood by me as the Coordinator. I am almost ready to turn over the position I have been holding since 2006 to someone equally capable of handling the youth soon.

8. The Parish Youth Ministry.

These kids were my lifesavers. They gave me back my self-confidence and self-worth when I was going through one of the most painful heartbreaks one can imagine. You gave me back my life when I thought things would not get better.

9. My first med school barkada -- Nikki, Jilly, Apple, Tres, Gary and Ron.

It's kinda sad that we didn't get to the finish line at the same time. But here we are, one more year and almost all of us are MDs. Thank you for a very colorful first 2 years in medical school. Maybe we can get together again sometime soon?

10. C3 and C4 -- EA (kahit iniwan mo kami), Czi, Lei, Makoi, Shakers, Ian and Oliver

I actually enjoyed the year with you. You guys helped me make my JI year bearable and happy. The thought of going back to the duties without you there breaks my heart. I miss you all already. And to my subgroup C4 -- for making me you "baby", for always reminding me to not to fight with intoxicated patients, for saving my ass when I can't get a procedure done. I miss you already.

11. Rochie Cuevas PhD -- the Bestfriend

Remember when we were in 1st grade, we said that we'll attend HS in UPRHS, college in UPLB then go to med school. So I didn't go to UPRHS, I didn't make the cut or UPLB because I took my chances in UPD instead. But you didn't go to med school so that makes us even.

Seriously, thank you for being my breath of fresh air year after year. Whether I got promoted or retained, you always show up in the Orange House, either to congratulate me or cheer me up. Twenty-four years of friendship can never go wrong!

12. The DLRC Kids

Hey you. Thank you for always being "happy". You always spread happiness when you're around. Sorry for the missed birthdays and gatherings when I'm on duty or have a big exam. We'll have SS again this year, yes? Yes!

Did I miss anyone? Yes, I did. I deliberately did. You know who you are. No thank you for you just yet, we still have a long way to go.