My Writer's Journey
"The Spirit of truth will testify to me, says the Lord, and you also will testify."
- John 15:26b, 27a -
- John 15:26b, 27a -
It was late at night, and I could not sleep.
I got on my computer and typed like a mad woman until the wee hours of the morning.
I poured all my angst in this one piece and sent it to all my egroups and slept. The next day, I was shocked to see my inbox flooded with replies from that one email. This would persist for weeks, with comments coming from doctors I didn't even know. Had I been on Facebook, the post would have gone viral. Alas, the word at that time only signified negative connotation that was infectious in nature, whether to a human or machine.
My ranting and raving made it to the Pulse Monitor, the official publication of the Philippine Society of Anesthesiologists, Inc.
Is it serendipity that I picked up a copy of this newsletter today, 10 years after, from my plastic bin of binders and folders?
And that I, who wrote it 10 years ago should find myself in the exact situation that I only imagined and wrote about --- a U.S. immigrant?
I wrote The Sentiments of a Young Filipino MD at a time when many Filipino doctors were migrating abroad, leaving their successful practices behind.
That left me much puzzled.
This was in 2007.
The article that traveled far and wide
"If you have time to read some wandering thoughts... read along...
I have wondered so many times why a lot of successful doctors are leaving the country. Although I am still young in this profession and have not had that great desire to leave this country... not just yet... I feel worried that foregoing the opportunity to migrate abroad might turn out to be a decision that I will later on regret.
I'd often think, "What did these older doctors experience in their practices which made them decide to abandon it altogether?"
Just tonight, I caught a glimpse of the answer to my question. I thought it was just a search for a greener pasture, or a desire to give a better future for their children, or disgust for the present political climate in our country, but I think it is not that. It is something more basic. Something closer to the core of our being.
Tonight, as I was busy making plans for the coming Conferment Ceremony and surfed the web for photo and video packages, I remembered the stupendous amount that the movie stars charge for their services. I heard that for one young actor, a half day of photo shoots would amount to P80,000.
Then I remembered those times when we did operations on patients for the same duration, and I don't get half as much for professional fees. And I'm dealing with lives here! Precious lives.
Then I remembered how my husband would try to package professional fees to make it affordable for patients, and sometimes feels cheated when he sees that the cellphones of the patients' relatives cost 3x the professional fee that he is charging.
Now, looking at the packages for these photo and video coverages, which cost 3-4x our PFs, I begin to wonder, are we shortchanging ourselves as doctors?
I recalled that conversation I had with a businessman who said, "You doctors are in a very noble profession, that's why it's sometimes disheartening when other doctors charge so much for their professional fees."
For some reason, something inside me rebelled against that idea. Something inside me churned with anger. Here I am in front of a man, who charges quite a hefty sum for recreational activities and feels that it's justified since his customers have the money to spend on these hobbies and yet, points an accusing finger to us, doctors when we charge the same amount for taking care of their health. Of their lives!
Did it not even occur to him that just like him, we have families to feed? Just like him, we have children to send to school? Just like him, we have rents and amortizations to pay? Just like him, we need financial security which we can hope to depend on when we can no longer work?
But unlike him, we had to spend more than 20 years in school, dependent on our parents and not able to earn a decent income until we are in our late 30s or even 40s. We had to spend grueling hours trying to figure out the human body, and even have to push marriage and building a family much later in our lives.
We have sacrificed so much for this noble profession because deep in us, there is that desire to serve others.
Should this sacrifice be bled out of us?
It's a cliche --- one that used to make our classmates snicker: "I wanted to become a doctor to serve others." Yet, we know deep in us, at the core of our being, that IT IS a reason which we can never deny.
Of course, there are other much baser needs that crop up with this fundamental reason. Along the way, the much baser reasons become predominant, and then we become practical beings.
We come to realize that unlike those who join the religious congregations to serve others, we do not have a community who will support us. We have to support ourselves and our families.
The pressure of the material world sets in because we are mere mortals, who also have to satisfy our basic needs for food, clothing, and shelter. And on top of that, education, financial security, and retirement funds.
We come to realize that we have allowed ourselves to be burdened with so much pressure in our lives... with stress which is inherent in our profession because we deal with lives. That even as we go home, we still think of our patients or what's wrong with them. How come our interventions are not working? Have we made the wrong diagnosis?
Of course, if we could not figure out the problem, then the patients and their relatives will again burden us with their expectations, which sometimes prove to be too much. Because as I said, we are just mere mortals and not God.
If something goes wrong, the hungry media and some unscrupulous lawyers are just too eager to point a finger to the "erring" doctor.
On the other hand, when we do succeed in our mission of providing healing to their ailing bodies, and we charge them with our professional fees, we could not charge them too much because it would be unethical. Since we did something noble, we should not be paid too much, lest the nobleness fades.
However, for those doctors who feel justified in the amount that they charge --- thinking what can be more precious in a person's life but life itself --- they are confronted with patients who are not only shocked but resentful towards them.
How dare you, doctor, enrich yourself out of other people's sufferings!
Then flea market bargaining ensues, resembling that found in Divisoria which leaves the doctor feeling degraded and unappreciated.
That leads me back to my nostalgic thoughts on the professional fees of some movie stars who just needed to host an affair for one hour and gets paid P150,000. Not so for the cardiologist who took care of the patient for a week or the surgeon who operated for more than an hour or for the anesthesiologist who paralyzed and ventilated the patient so that the surgery can be performed safely --- which of course, is just "putting the patient to sleep." How difficult and complicated can that be?
No, we cannot charge as much as that movie star. If only we could, a lot of us would be millionaires by now.
Now, I no longer wonder why doctors leave the country.
There is just too much pressure placed on their shoulders, that at one point, in their successful but busy careers, they just wanted to be out. To breath some fresh air. To slow down. To be out of the rat race. To have that lifestyle with the promise of more quality in their lives.
Besides, there are no pension plans for doctors here. You can still find doctors way beyond their retirement years doing rounds, with their silver hairs, or worst, balding heads.
For some, it is a matter of survival. They stop working; they stop earning. They stop living the lifestyle that they got used to.
For others, retirement is simply not an option. They have been in the profession for too long. To be uprooted from this environment is like uprooting a plant and letting it die.
I have seen how some deteriorated and wilted like a plant after their retirement. They had their entire lives revolving in their noble profession that they felt useless without it.
Others are forced into retirement by some disabling disease like stroke, myocardial infarction, or Alzheimer's. Then depression sets in.
Perhaps this is the scenario that some doctors wanted to avoid in their future lives, that's why they are taking control of it while they still can.
For me, there is no judgment here. Because I think I now caught a glimpse of what's going on in these doctors' heads.
And perhaps even in my own head?
My apologies to those whose heads do not contain these thoughts.
Pardon me. I am merely venting.
Because seriously, I should just have joined the movie industry."
So yes, that was my piece seven years ago. I don't know if the situation has changed since then.
It's just funny that once more, I find myself typing on my computer... late at night... in a different part of the world.
But as I read this now. I can't help but be amused at my younger self. I have realized a lot of things since then. I have been on the other side of the fence --- to be the patient or the patient's relative. I've caught myself saying the very same thing the businessman said to me 10 years ago --- when I brought my daughter to the doctor and all he did was a physical exam and charged me $300. I could just have done that myself!
But that's something I have to contend with, having no license to practice as an MD here in the U.S.
As immigrants, we had to sacrifice a lot of things with the hope of a better life, a better future. It was a huge risk.
When we migrated to the U.S. in 2009, it was a decision borne out of discernment and prayer. We've been judged traitors or unpatriotic for abandoning the land of our birth.
But I think it was a very Christian move.
It was an experience not alien to Jesus, for he and his family migrated from Jerusalem to Egypt, to escape the tyranny of Herod. They sought a safer land where the family can thrive until it was safe to return.
He, too encouraged the disciples to "go out to all the world and tell the good news." (Mark 16:15)
And I'm glad He did.
Otherwise, Christianity would have been confined only to Nazareth and its surrounding regions.
So I believe, Jesus has a soft spot for immigrants and refugees because He once was.
That is a consoling thought.
In the end, we are mere pilgrims, just passing by. Whether we move a lot or not, go about from place to place, it should not matter.
We go where the glory of God leads us. And we welcome those He sends our way.
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