Clerkship Update: Neurology, Medicine, the Retreat, Electives

Ok, now I'm really running out of time, so I'll be going really fast. Internship starts in roughly 3 days! I just fear that I won't be able to do justice to the rest of the services that I'm going to talk about, but what the hell..

NEUROLOGY

Ok, after spending about a full week in the loony bin, I had to move on to the organic causes of brain disease, the realm of mighty Neurology.. :D

Oh yeah, before I totally leave Psychiatry, I just wanna give a shout-out to Dr. Orestes Solis for making our Psych stay as bearable as possible. Thanks doc!

We made the swap with the outgoing Neuro clerks, them taking charge of the CC and us the Neuro ward. It was a really taxing job. You get all these critical patients, a majority of which require Neuroimaging immediately prior to beig brought up to the ward. And for some wweird reason, most CVAs tend to occur at night... Why the hell is that? :P Needless to say, me and Johnny were run ragged by the duty days we had in this service. In fairness to the Neuro department (who is also the Psych department), they were very forgiving when things couldn't get done as quickly as they would like, 'because they understand that the jobs are so many, but the clerks are so few... hehehe

The lectures we had in Neuro-Psych were very interesting. Listening to the great Dr. Poblete go about his thing makes Neurology seem so easy. I guess he's the prime example of someone who has a real gift for teaching.. I mean, I'm kinda biased towards Neuro as a subspecialty, given my condition and all, but hearing him make the subject matter palatable even to a lowly clerk kinda made me want to learn more and more... a rarity these days.. hehe

I have to note that this was the firat service wherein a patient expired while under my care.. WEll, not really, because I wasn't there when it happened, but the patient was decked under my name, so technically, that was my patient..

Also, life was a bit more bearable because we got along pretty well with our dutymate intern that time. Thanks Achi Margie!! ;) A shout-out is also due for Dr. Marc Molina, the hammer-twirling Neuro resident. Thanks boss! Hope to see you again in two years. :D

Then, before we knew it, Medicine already knocking at the door...

We had our orientation about two days before the start of the rotation.. Man, these Medicine peple really knew how to intimidate the hell out of you.. We had heard of the rumors but dismissed them as just ghost stories created by the other previous groups to keep the mystique of Medicine going.. But nay! Upon entry, the residents suddenly distributed test papers containg 50 items! This was stuff that, according to them, we needed to have known prior to starting the rotation!! Failure would mean a 7-day demerit even before we actually started!! No one could say a word...
After the exam, (which I obviously failed) they began a relentless orientation that haunts me to this day. The pressure placed on us was so great, tha tsome actually went home with migraines that night. They bombarded us with the various responsibilities we were to have, the numerous conferences we were to attend, the TONS of paperwork we were expected to accomplish, and a great many more.. We were dead scared...

We made our courtesy calls to different residents heading our various teams. I was in Team 4 (Go Team 4!!) with Kat LD, Janys, Christine, Justin, Haidee O., Nice, and Jacky. To add to our anxiety was the fact that our senior resident was the formidable Chief Resident Dr. Maureen Valentin! (ulp!) Our junior RIC (Resident in Charge) was Dr. Christine Untalan. ( I had seen her before on my undergraduate years when she was an intern, and I thought she looked tough..) They set down the rules and told us their expectations, during which we were able to breath a bit because they actually SEEMED nice! But still, I was on my guard, because you never know what the next day might bring..

The night before the big exchange, I was on duty at Neurology, which meant that I was FROM on the day we began!! Oh crap.. :S

I don't really recall the details of that 1st day, but I guess that was sort of a baptism for the entire group. No, we weren't handed demerit by the millions or anything of that sort. I guess being saddled with ACTUAL responsibilities provided a fresh change for us hardworking clerks, and I daresay we responded positively.

I could go on forever about that various day-to-day experiences I've had while rotating in Med, since most are firmly ingrained in my mind, but in the interest of tme, space, and practicality, I'll have to give a brief overview na lang.

Our first ever Team Intern was Gary. He was a walking Harrison's!!! He was very knowledgable and took time to teach us the nitty-gritty of stuff we had to do or needed to learn. He also willingly covered for us during those times we were absolutely shorthanded. Thanks Kuya Gary!!

During the middle of the 1st month, we had an intern swap, and new residents as well. This time our Team Intern was Mo (short for Moreen) who belonged to the beloved group of interns our group had grown to know so well. Our team residents were Dr. Emerson De Jesus and Dr. Romina Laguesma. And in the middle of our second month, we retained Dr. Emer as our senior, and got the slightly more OC Dr. Frederick Gabriel as our junior resident. And with that also came an intern swap. And lo and behold! We got Marge as our final Team Intern!!

The department wasn't as bad as adviertised. I now truly feel that Medicine as a clerkship rotation is seriously overrated. Fine, the workload is really a killer, but the Medical staff are SOOOO nice!! (at least, from my personal point of view) I guess it's really like that when you become "their" clerks. I recall during the OB days when people would argue over who makes the referrals to Medicine because they were really so scary...

I really learned A LOT from this rotation, mainly because this was probably the main "meat" of what being a doctor was about. (kaya nga tinawag na Medicine diba?). Also because we had good teachers in the ward (residents and interns) and my own personal interest in IM.

I have nothing but good words to say about the Medicine residents! They are so damn nice! They care about their clerks, have the drive and desire to teach, and (contrary to popular belief) aren't out to make our lives miserable! :D They were always there to answer our questions (but most of the time you'll also be asked a question yourself) :D.

Shoutouts go to the ENTIRE Medicine department, with particular thanks to the following:

Dr. Mossy Valentin
Dr. Emer De Jesus
Dr. Lyza Galia - current cheif res!! woohoo!
Dr. Bea Medrano
Dr. Hendra Nurjadin
Dr. Tin Untalan
Dr. Mina Laguesma
Dr. Eric Gabriel
Dr. Regina Yao
Dr. Julie Tapispisan
Dr. Isser Sugay

And to our beloved interns as well!

Thank you all!!! Medicine wouldn't have been the way it was without all of you!! :D

THE RETREAT

Now, in the middle of our second month in Medicine (just when I felt that I was about to totally burn out), we had the much-anticipated Clerks' Retreat at Angels' Hills in Tagaytay.. What followed was the three most relaxing days of Clerkship, EVER!! Nobody wanted to really do anything except sleep, eat, take pictures, and have a good laugh with friends.. I have nothing but fond memories of the place, and I do hope I'll be able to return someday... :D

ELECTIVES

Ok, after Medicine (yehey!), we were rewarded with the privelege of choosing our elective rotations for 1 month save for Radiology (the compulsory elective..). I opted to get 2 weeks of Medicine (under Dr. J. Go), 1 week of Neurology (yes, you read that one right), and the last week was for Radio.

The Medicine ("Dr. Go") elective was a hoot! We were finally free of the burden of having patients tied to our name and could now look at patients more objectively and "learn at the feet of the master". :P Dr. Go is a brillant man, no doubt about that, a trait only outdone by his generosity towards his clerks. We went on rounds with him at the CD ward and his Pay patients. He allowed us to sit in with his academic seesions for the residents. He brought us to the Christmas parties of the various medicine departments which had invited him. (It was nearing Christmas at that time, which worked pretty well for us, since we Electives people didn't have to do duties during the holidays. He fed our brains and kept our mouths stuffed with food. :P It all ended on a good note, and we were grateful to have been under him.

Next up was my Neurology elective. A lot of people thought I was pretty nuts to go and get myself involved in Neurology again, seeing as it's such a txic rotation that no one wants to put themselves through again. But I liked Neurology, and I'll go through it alone if I had to.. which I did.. :D It's a good thing the actual Neurology rotators at that time were all Medtechs. It made my stay there more enjoyable. Plus the fact that the interns there were also fun to be with. :) As an Elective rotator, I got to see what life was beyond all the q1 monitorings and the late-night runs to the CT scan. I went around with the senior resident to answer referrals. I got to hang out at the EEG room, I was regarded with respet by the Neurology resident staff and even got invited to have breakfast with them atMcDo. :D Of course, I still had to do 1 duty even though it was just an elective, and I helped out my Neuro friends by sharing their workload (except for monitoring of course!). After 7 interesting days, it was time to go to the final elective..

Radiology was cool, both literally and figuratively. We spent most of our time in air-conditioned rooms, doing light to minimal work, looking at impressive imaging devices and watching imaging-dependent procedures. The Radio staff was very kind as well. And i guess we got along fine with the Radio interns we had (Thanks Fritz! See you in Neuro!).

Well, I guess that's that for now. I'll wrap up the Sapang and Pedia rotations tomorrow.

Clerkship update: Psychiatry

The memories now grow dim, and I must act quickly..

PSYCHIATRY

After Dermatology, it was time to go to the loony bin of Psychiatry. The "psych ward" in UST-CD was actually called the Community Center. It was classified as Semi-Pay, so we didn't really have to do anything regarding actual patient care, and were just involved with the interviewing of new patients, the daily progress notes, and the discharge papers. The stay there was basically unremarkable, the most memorable thing there was the fact that I was able to get at least 6 hours of uninterrupted sleep during duty nights. =) It could've been more, but we had an arrangement with our friends at Neuro that we would go out and monitor their patients from 8 or 9pm up to 12mn so that they could get some much-needed shut-eye.

Life at the CC was pretty dull. We were cooped up all day at the Clerks room, which was locked to prevent the crazies roaming outside from getting in. It would've been a totally benign rotation had it not been for the Resident's night, wherein we were expecdted to help out. I won't dwell on this because my memories of the preparations are mainly of being really really tired and worn out.. But the residents' night itself was a real blast, and I had a huge kick out of watching my past, present, and soon-to-be residents perform onstage.

I also remember (with a grain of salt) that I was the most toxic clerk during Psych because of the endless paperwork I had to do.. It seemed as though I had a Midas touch of sorts, as every one of the patients I handled at the CC were discharged during my time.. It was at that point that I discovered how much easier life could be if only I had my own laptop that I could use..

Whoops, have to go! I'll follow up later with Neurology..

Bloody Monday

Just got back from the USTH-Blood Bank where I donated blood for a former patient of mine in Medicine who still owed the hospital 3 units of blood. This has been coming for a long time already, ever since I promised him that I would donate on his behalf when things got a little less toxic for me. Why the sudden burst of charitabilty one might ask.. Well, I guess it was because he and his family were real nice when they first came under my care. I admitted him twice during my 2 month stint in Medicine, and I would say that he was the best patient I ever had during clerkship. =) So today, I went and honored that promise.

Today we had our offficial interns' orientation at the MRI building of the Chinese General Hospital. As my luck would have it, my first rotation is Medicine, all FOUR months of it.. :=P It dosen't sound so bad, although the chief resident admitted that it was the most dreaded rotation of them all.

By the way things are shaping up, any my general feeling about all this, it seems as though we're gonna have ourselves a great year.. =) I hope I'll be able to do a good job and pull this one off without a hitch.

.. and the rest of the hospital stay was unremarkable..

Finally, I can once and for all hang up the blasted clerkship uniform, after a long tiring year filled with aches, pains, and new experiences. :)

Yes ladies and gentlemen, my clerkship is officially over (although it's about 4 days late because I still had to finish my Pedia OPD teaching with Dr. Rabago, which I did about two hours ago..)

I know it sounds cliché, but I never thought I'd see the day that I'd reach this point. And to tell you frankly, it feels GREAT!!!

It feels so good to be finally rid of the hospital once and for all.. well, maybe for the next couple of weeks.. But at least I'll be having my internship at another institution for a fresh change. :)

Some people frown on those "renegades" who opt to have their internship outside the safety of UST, but I say Phooey on them! I've gotten so saturated with the system that I need a breath of fresh air!

There are a lot of different reasons that influence one's choice of hospital for internship. For some, closeness to home is a big factor, as they might be fed up with being stuck in a dorm and miss the time that could be spent with family if they just came home everyday. For others, the relatively lighter load that some hospitals promise is a big come-on. These poor souls have probably been so drained during clerkship that it wouldn't hurt to get a little R&R before the boards. Still, others opt for a lot of action and "hands-on" experience, thus they go for those more toxic institutions like JRRMMC or UP-PGH. There are people who crave more "learning" or are just reluctant to leave UST, so they just stay. Then there are those whh want to just get away from UST with all the associated heartacjes and disappointments that happened throughout the year.

Looking back, can I say that it's been a good year?.. Well, I guess so.. Despite all the exhaustion and humbling experiences that go with being the lowest animal in the hospital, I was able to pick up a few things that would hopefully prepare me for what lies ahead...

I know I have so much backlog with respect to my clerkship stories, so I'll be finishing them up one by one shortly..