Being a doctor is exciting, manic, scary yet satisfying
I agree with what Lawrence Wright said: “I like the serendipitous surprises of reality.” Life’s surprises made me finish a degree in medicine.
While expectations are good to have, a doctor should not be bound by them since something better or worse could happen any time. In the practice of medicine, there is no roadmap that will reveal the future outcome of whatever procedure or treatment you are performing. All doctors can do is make informed choices based on our experiences, universal intelligence, scientific knowledge and awareness, and hope these will lay the foundations for what will unfold.
Case #1: Labor and birth
When I was still a medical intern at the University of the Philippines-Philippine General Hospital (UP-PGH), an unforgettable experience happened.
While I was on duty in my OB-Gyn rotation, I was assigned to monitor a pregnant lady, who was expected to give birth that night.
Monitoring is quite boring as it is repetitive and uninteresting. You need to take note of the contractions (when the muscles of your uterus tighten up and then relax to help push the baby out) and dilatation (opening of the cervix in preparation for the baby to pass through the birth canal), of each patient under your care. It was a routine already, until a patient’s water bag broke and I was assigned to deliver her baby.
Delivering a baby is exciting and scary. I was worried that the baby would slip from my hand and drop on the floor while doing it. I was excited and nervous at the same time. But to my surprise, I was delivering an anencephalic baby (one in every 4,600 babies).
Anencephaly is a serious birth defect in which a baby is born without parts of the brain and skull. It’s a fatal condition. Most babies don’t make it or die within a few hours, days, or weeks.
Even with a lot of experience, surprises will always be a part of a doctor’s job. And prayers should always be a part of every treatment decision and procedure of a physician.
Case #2: Tired and wormed out
I was assigned at the intensive care unit (ICU), which was fully booked at that time. It was quite a peaceful night and seemed to be an uneventful one. While doing my rounds, I noticed a long, pale, white-colored elongated worm coming out of a comatose patient’s nostril.
It was a live ascaris worm. I had no recourse but to pull it out gently. It was a foot long, perhaps trying to escape the soon-to-be unoxygenated body of its host to survive.
Case #3: Exciting but exhausting
It was New Year’s Eve and I was assigned at the emergency room (ER). Since I was still a rookie, I did not know what to expect. At 10:30 p.m., patients were arriving one after another, mostly with dangling fingers and flesh, burnt skin, and eye injuries (due to firecrackers).
As the night progressed, we attended to patients with serious injuries. I saw patients with their intestines partially coming out of the abdomen, gunshot wounds from irresponsible (gun) firing, and patients with multiple stab wounds. There were also patients who figured in vehicular accidents. It was exciting, but definitely exhausting.
Case #4: The dermatologist is in
My dermatology practice is not as exciting, but more of satisfying. I recently operated a cerebriform (like a tumor) at the back of a woman’s scalp. When you operate on the scalp, expect a bloody hell of an experience. Head injuries bleed a lot because of all the blood vessels there. Your brain requires a tremendous amount of oxygen to do its job. In fact, about 20 percent of the blood flowing from your heart goes up to your brain. Because of its extensive blood supply, even small lacerations to the head can lead to very large amounts of bleeding. And so the night before the operation, I asked my prayer warriors to pray for me as I performed this procedure.
As I cut through an almost non-existing peduncle, slowly and gently, bleeding ensued. My hemostatic intervention might not be enough so I prepared for sutures. Through diligence and patience, it worked.
The biopsy result came out. It was a giant pyogenic granuloma (PG), also known as granuloma telangiectaticum. It is a benign vascular tumor commonly seen in infants and children, but can also occur in adults, particularly in pregnant women. Although the exact cause is not known, possible inciting agents are trauma, chronic irritation, drugs, e.g., retinoid, mitozantrone, indinavir, and erythropoietin. It usually presents as a solitary, red, rapidly growing papule or a nodule. Giant PG variant is a rare condition.
Even with a lot of experience, surprises will always be a part of a doctor’s job. And prayers should always be a part of every treatment decision and procedure of a physician.
