Compassion fatigue

Working in a public hospital has its own set of pros and cons. The pro is that you get exposed to a huge bulk of patients. You have hands on cases and you get to practice and learn how to manage patients on your own.

I am grateful that I get to help patients and learn along the process. I am amazed with the medical profession overall but again, as someone who cares deeply about so many things, handling poverty-stricken patients still breaks my heart.

Patients who don’t have money to buy sutures for his wife’s cesarian section because the hospital doesn’t have enough supplies. Hypertensive disorders in pregnant women who chose not to seek prenatal care because they don’t have money. Women who keep on giving birth even if they obviously couldn’t afford another child anymore. Living in a country with backward laws for women. Needing the permission of the husband for tubal ligation consent. Grand multiparity patients who have chronic diseases but since they are not using any form of contraception, they keep on getting pregnant even to the risk of their own lives. Violence against women and children.

I am absorbing all these frustrating energy. I am having compassion fatigue. I feel like our country is just so far away from ideal. It hurts me that day in and day out it’s almost always like this.

Should I stop caring about things that I get upset about? Should I just be okay with how the system is. I know that in my own way, I am doing my part. I am helping by living a life of service. But until when will circumstances change?

The why

Yesterday, I had a meeting with event organizers composed of medical staff. I was tasked to host a lay forum and a fashion show, one was for menopause and the other was for pregnant women. I instantly said yes when I was offered to host the event. It’s one of the things that I do which I truly enjoy, and it’s also a change of pace from my usual routine of going on duty then going home.

As the meeting was about to conclude, the organizers asked if we have questions about the event. One thing dawned on me, I wasn’t aware why we have these events. For the menopause clinic, I believe that its a way of celebrating women’s month, but for the pregnant fashion show, I asked them, “Why did we have this event?”

People got silent for a few seconds, and they told me to think of a reason and just include it on the script. Oh my God, people have been preparing for this event for more than a month and yet they couldn’t answer me what the fashion show is for.

I figured out that the reason why people are so burnt out in our workplace is because they do not have a north star, a clear purpose. That is all that I was thinking about. These hardworking people do not know why they are organizing this event in the first place. I wasn’t surprised that they weren’t aware. I just got sad.

That meeting made me reflect on what I am doing. Amidst the burnout that is slowly creeping in my body, I still feel connected to my purpose. I know that I am training so that I will have the skills and competencies needed to practice as a medical doctor and to serve the community. I know that I want to help people have access to proper care and make them feel safe and supported despite them battling diseases. I know that if I study well, I could help provide answers and let them take charge of their health even if they don’t have money.

I see medical training as somehow like being an army. You have this rigorous training which is physically and mentally taxing, but at the end of it, you come out as a stronger and more equipped person. You know what to do and you are able to make quick decisions especially when the life of a person is literally on your hands. I see training that way.

If I am not clear with my why, I could have quit a long time ago.

I also see medical training as something like that of studying to be a priest. “It is a calling.” That’s what my friend who is studying to be a priest told me. Medical training is indeed a calling. It is a call for me to serve. How do I know this? There are tons of careers out there that I could have chosen and yet, I chose this torturous and bittersweet path. Why? Because I just couldn’t shake it off. I tried to get away from this itch, but I just couldn’t so I gave in. Now that I am seven months away from being a doctor, as hard as each day of training could be, my heart knows that it is in the right place.

So much thought came from that meeting. I remembered how a clear why changes the way you see and do things. I just hope that more people are clear with their why, maybe then this world will be filled with passionate and aligned people.

OB-Gyn thoughts

Becoming a medical doctor has been a dream of mine since I was in high school. I didn’t know what kind of specific doctor I wanted to be at that moment. This month, I began my OB-Gyn rotation. I remember this as my favorite rotation in clerkship. I just love the outcome of majority of cases. There are babies, and it reminds me of having a fresh start. Each baby that we deliver carries a lot of possibilities. Childbirth is a positive thing for me.

However, the work needed and the culture is not something that I want to subject myself to. To be honest I am surviving on, Omeprazole, pain meds and multivitamins.

I love the art of learning these information and all the skills that an OB-Gyn has but, the experience as a post-graduate intern has been draining for me. Maybe I changed? Maybe being a junior intern is just different with being a senior intern. The responsibilities are bigger and heavier.

I can’t actually believe that I am saying this, but I am on the process of discovering who I really am, and what I want my medical practice to be. I will just approach the succeeding weeks as part of my training to be a well-rounded physician and find ways to still be curious in the cases and gain skills. I will shift my focus to the patients. I will keep on studying and learning as much as I can for my future patients. They deserve a kind, smart, and competent doctor.

I will get through this. We will get through this.

Every single day is a new learning experience.

Let’s be better humans

Are we alone?

We can be surrounded by so many people and yet feel alone. Sometimes we advocate for something, and it’s just frustrating to see that not everyone operates on the same values as you. We all were raised in different environments after all. In whatever we do, I hope we make it a conscious effort to examine if what we’re doing is truly the real us, or if we’re are doing something just so we can please other people. I hope and pray that we all get better at being who we are. Personally, I do feel good. I sleep at night knowing that I contributed, that I gave the day my best shot, that I’ve been kind to my friends and that I did something that was true to myself. Although there are just moments when I still feel so alone, having a spiritual practice, such as writing makes me feel more aligned, and makes me evaluate the things that I do.

Love and belonging

Love and belonging are two things that is a necessity for us humans. We need to love and feel that we are loved, and we want to feel like we belong wherever we are. In my work, I do my best to exude that love and to be honest, I feel it reciprocated as well. Whenever I am rotating in a certain department and I sense negative energy, and too much gossip and doing work like it’s just another transaction, I get instantly turned off. There are departments though that I feel like I belong. It’s like my DNA knows that this is the right place for me. I still have time to think about what path I’ll choose, but so far I do feel that love and belonging in a specific department. They are the right combination of intellect, kindness, and warmth. The residents are nice to each other and they have weekends and holidays off so there’s no constant stress. No matter how enamored I am by other specialties such as OB-Gyn and Internal Medicine, I still see myself doing other things than being a hospitalist. I want time with family. I still want to go on nature trips, go the gym, play with my dogs, and travel. I still want to sing, dance, and write. All those things, I just couldn’t do while I was rotating on the other departments. I want to be in a place where there is love and belonging. I want to live again.

On rehumanizing and dehumanizing

Last May was a sad month for us kakampinks. I really wanted Leni Robredo to win the presidency. I just don’t understand how people could support someone who’s not even familiar with the Filipino’s suffering? Living in this world is just crazy. One of my friends even wrote an offensive comment on my facebook post. I have unfriended quite a number of people because of their political beliefs. However, I realized that we are all humans. We have to stop dehumanizing each other. My God, it is so difficult to do this. It is hard to understand when we can’t comprehend something, it makes it a lot harder to love.

I want to preserve my humanity and not engage, so I deactivated my social media accounts and decided to just stay still and be present in my life. No matter who is the president, no matter who the leaders are, I know that our lives will not drastically change in a snap. I am still a broke postgraduate intern living in a third world country, trying her best to survive and be of service. Aren’t we all just trying our best? No matter what we believe in, don’t we just all want to have a better life? Isn’t that something that’s common among us? I hope we treat each other as human beings again. I don’t want to base how I treat people according to their political beliefs. I want to be better at seeing everyone as a human being. Inhale. Exhale.

I’m not gonna do it perfectly.

As I was hosting a Christmas party last night, I remembered my first few hosting gigs way back twenty years ago, my goodness I started doing it at eight. I was very nervous. I even cried one time because one of my so called friends told me that I was just repeating what I was saying. When I was a kid, I was laughed at because I incorrectly delivered the closing spiel.

It’s funny because last night two surgeons told me that I was so good at this. Damn, that felt good. Looking back, I had epic fail performances, I’ve lost count of many embarrassing moments onstage but I learned how to laugh at it. Whenever anyone gives a negative comment, I just tell myself, “They can’t even do what I do. They don’t even have the courage to stand onstage, in front of so many people and make sure that everybody’s having a good time. Their opinions are valid when they can replace me and do what I do, better, onstage.” That was the trick. I rarely had panic attacks afterwards, and everything just felt natural. I was just being me. I am not perfect. I am not the best. But I am the only one who is absolutely good at being Kate. No one could ever out-best me at being me.

Even in my job as a doctor, I accept that I’m not gonna do it perfectly. But I sure as hell do my best to get better everyday so that I can deliver excellent work. Again, for those seniors who belittle us newbies in the medical field, “We’re not gonna do it perfectly.” Just watch us work and I swear we’ll keep on improving. I hope you see how we try so hard be good. I know for myself, that one day, I will be good, and this will all be just like breathing, it will be very natural and my patients will feel it.

On speaking out

This blog is my way of expressing my thoughts. It’s actually hard for me to type this but I am having an internal battle about the things that I see and experience in the hospital. Harassment is common in females. I don’t want to normalize it, and I am trying my best to put light into these issues. I get sad that I hear stories about female co-workers who get harassed in the hospital. I just get triggered when I think about it. I cannot and will never accept a world wherein men think like it’s okay for men to touch you without consent, and to comment on a woman’s body or anything that suggests sexual things. As an intern, I have personally experienced this and when you are in this situation, it sucks, because you can’t do anything, you just freeze. This person is your senior and as a powerless woman, how do you respond? Why can’t all men respect women? I am speaking out here because this is the only place that I can freely do this but, I just hate that almost all women have to go through this.

On important conversations

As hard as it is to talk about certain topics. I want to live in a world wherein we’re not afraid to have honest and vulnerable conversations especially about things that matter. Even if it is uncomfortable to talk about politics and abuse, I want us to talk about it. This is just a tiny effort on my part, but on my last breath, I know that I helped move the needle forward. Even if it’s a few inches, I want to know that I did something. I hope we don’t opt out, and that when we are in a position wherein our voice can be loudly heard, I hope we choose to engage in these conversations with utmost respect and curiosity.

On shame

Nobody wants to be shouted at, period. I wonder why this is normalized in some fields of medicine. As I am now choosing the next step in my career, my choice is based on values that I firmly believe in. I want to go to a field wherein seniors don’t shame their juniors for their mistakes. Being called stupid or dumb, is a big no for me. People who lash out instead of verbally articulating their needs is also a big no. Why is shaming juniors normalized? I understand that doctors have a high stress job, but it’s just not an excuse to be rude. So thank you to all the seniors who have treated us juniors like a human being, I will do my best to pass on what you have started. We are going to change medicine. We are not going to be monsters.

That ends my ramble. Hope we all live better.

The negativity bias

Hi there my dear readers, today I want to talk to you about negativity bias. Ding, ding, ding! We all have that and to be honest, I do experience that on a daily basis. Here in the Philippines, it is so easy to get inside that vortex. You just have to scroll and voila, you are in for a treat.

Anyway, how do we fight negativity bias? I have intentionally deactivated social media, because I found myself absorbing the energy that is just so rampant out there. I asked myself, who am I without all these influences, be it negative or positive? So far I felt a bit isolated, but the positive outcome of having spent more time being present than spending it scrolling, is, I am more mindful of my surroundings. I can bask in what is really happening in the immediate environment that I am in.

Negativity will always be there, and we have evolved to expect the worst because we used to be hunters, and there used to be all these wild animals that could eat us. But now, do we still need to be that way? Do we still have to protect ourselves the way our ancestors did?

For three nights, I have been panicking about so many things, PLE, my health, all the bad shits that could happen. Believe me when I say I have worked so hard to be in a good mental state but still there are times when, it just slips. I get anxious and scared, even if there is no literal threat that I am facing. So far, what helps me get out of this spiral are these:

1. Meditation.

2. Exercise

3. A solid morning routine

4. Talking to a friend for distraction.

5. Cuddling the dogs.

6. Spending time with my partner.

7. Writing.

8. Reassuring myself that everything will be okay.

9. Going for a walk.

10. Writing a gratitude list.

Ten years ago, I never would’ve thought that I will be working in a hospital because of how chaotic life was back then. There are times when I just can’t believe what’s happening. I can’t believe that it is possible to feel calm and at peace. I find myself waiting for the next shoe to drop, when there actually isn’t.

I made bold choices to have this kind of life and I worked hard and sacrificed, and toiled. I know that. Sometimes I wish I could erase all the trauma and scary things that I’ve been through just so that it doesn’t slip my mind and appear in my nightmares, but I guess I have to live with this. I have to accept the scary past and create happy memories, so that all the trauma would just occupy a small fraction of my brain.

Everything will be okay, Kate. You are doing what you can with what you have. You just finished another rotation in your post graduate internship, damn, you have finished medical school. You have the best support system, the best partner in life, good friends, and all that. I can’t ask for more. You can’t erase the past, but definitely you have created a beautiful present, and you can still keep on painting on this canvass.

I believe in you. You got this.

Of dreams coming true

I still don’t have a concrete reason as to why I chose this field. I just know deep in my heart that I am exactly where I am meant to be. To you, who’s reading this: Dreams do come true. As Oprah Winfrey once said, “Luck is when preparation meets opportunity.” I believe that every tiny step, bump on the road, curve ball and chaos that has happened in the past, has led to this moment.

A week ago, I just graduated medical school. Yes, finally, after four years of sleepless nights, unlimited exams, a global pandemic, here we are. Med school is now over and done. Hooray! I have been patting myself in the back for God knows how long because (if you have been following this blog since its early days) I really never thought that this day would be possible.

To be honest, I don’t know what to feel. I am happy, grateful and relieved. I am happy because, at least the bulk of studying is temporarily over. I am grateful because of all the people, who made this caveat possible. I am also relieved because, it is now less exhausting, at least senior internship will not require me to go on duty for 36 hours.

Junior internship was exhausting albeit life changing overall. If there is a word that is more extreme than that, please tell me because as far as I know, I reached my limit in terms of overall exhaustion. Medical school was hard. Medical school stole so much time that I could have spent with the important people in my life, but aah why is this still so fulfilling.

This brings me back to one of the toxic shifts in the medical ward wherein I had an epiphany. When I was still in my undergraduate days in UP, I used to love watching Marvel movies. I would download and watch every character’s movie, Iron Man, The Hulk, Thor, Captain America, etc. To be honest, I do not understand why I loved those movies, but for some unknown reason, I revel in watching Superheroes. 

Maybe because they give hope in impossible situations. They have principles that they try their best to live up to. They use their intelligence in thinking of the best strategies to combat the bad guy or to solve a problem that could lead to the annihilation of human race. I know it’s quite romanticized, but I hope you understand what I am trying to say. They try their best even if it means giving their lives in the pursuit of the greater good. I love those storylines. 

Is that related to me wanting to be a doctor? Is that why no matter how hard it gets, I’d still do this anyway? I am not a superhero with special powers. I know for a fact that I am just a simple human being who’s trying to help out sick people. I’m just a random human who loves Science, and gets a high in making strategies that solve health issues of people. As compared to those fictional superheroes, I am boring.

I still don’t have a concrete reason as to why I chose this field. I just know deep in my heart that I am exactly where I am meant to be. To you, who’s reading this: Dreams do come true. As Oprah Winfrey once said, “Luck is when preparation meets opportunity.” I believe that every tiny step, bump on the road, curve ball and chaos that has happened in the past, has led to this moment.

100 Things to Expect Before you Enter Medschool Pilipinas Edition

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PARA ALAM NIYO KUNG ANONG PINAPASOK NIYO.

It’s true what they say, taking the first step is easy but staying is the hardest part. Now I’m writing this because I know that there are people who are patient enough to read my long posts on dreams, tips, and tricks on this roller coaster that we all are trying to figure out. So yeah one year, a year of Guyton, Junqueirra, Lippincott, Gray’s, and etc. To the incoming first year medical student or anyone who’s thinking about becoming a medical doctor, here’s what to expect and a lot more:

1. You’ll realize that there’s just a lot to do. Five hours of sleep is gold. Goodluck!
2. You will learn the art of setting ten or more alarms or else you’re doomed.
3. You will probably sit on your bed after a long day and be surprised to find out that it’s already the next day. The nap turned into a full blast sleep.
4. You’ll develop your own way of coping with stress.
5. You will hit pause on some of your hobbies.
6. Your college textbooks will seem basic. Yup, you can now devour alien medical jargon better. Congratulations, you’re not as clueless.
7. You’ll thank yourself for having friends from higher years. They’re angels.
8. You’ll probably establish a routine.
9. Family will start asking you about medical concerns. They think you’re a doctor already. (No no no, sobrang layo pa po).
10. You will ask yourself why did you even think of punishing your 20s. Believe me it’s normal.
11. You will panic and end up studying anyway.
12. You will transform into a tita. Your bag will have tissues, katinko, ibuprofen, hair tie, sanitizer, crackers and all other stuff cause you just need ’em.
13. You will stain your white uniform once or twice.
14. You will switch to comfy although less stylish shoes.
15. You’ll have your go-to coffee that keeps you alert enough to understand everything. (Caramel Macchiato hello).
16. You will regret not doing your laundry or ironing on time.
17. Your room will turn into a jungle on exam week.
18. You’ll learn how to choose your battles when things don’t go your way. There are some things you let slide so you’ll have energy for what’s important.
19. You will learn how to run away from negativity. You just don’t need that.
20. Hopefully, you’ll have a stronger faith. (Sometimes nadadaan mo ang exam sa tiwala lang. 😂). Paano?
21. You’ll accept that your time is limited. There are birthdays you can’t come to and graduations you can’t attend. 😭
22. You will forget most of what you learned.
23. But hopefully remember what you need.
24. You’ll learn how to take on more responsibility than you could ever imagine.
25. You’ll feel guilt from time to time cause unlike your friends who are productive members of the society, you’re still studying.
26. Your family will be supportive and extremely proud. They will introduce you as the child or sibling na “nagdodoctor.” (At nakakapressure siya.)
27. You’ll be really grateful for your family. Without them you can’t face this.
28. You’ll have better leadership and management skills.
29. You’ll have better communication skills.
30. You’ll probably have better note-taking strategies.
31. You’ll learn how to extract blood (if you’re not a medtech).
32. You’ll learn how to take a blood pressure (if your premed is not clinical.)
33. You’ll learn how to take a patient history way better than when you entered medschool.
34. Your classmates will teach you a lot of medical stuff. This will be useful for nonmed premeds. 
35. You’ll have a destressing activity. (Roaming around bookstores. 😍).
36. You’ll have your favorite stress relief drink ( Biggs’ MANGO GRAHAM).
37. You’ll know where the best coffee shops are hiding.
38. You’ll know when your best study time is.
39. You are probably following a YouTube channel that teaches you tricks and helps keep you sane. (Med Insider, Aura Azarcon, Cathy Gonzaga).
40. You’ll have destressing buddies.
41. You’ll have study buddies.
42. You’ll have your favorite spot in school.
43. You will handle overwhelm better.
44. You’ll be more accepting about people’s shortcomings because you have a lot too.
45. You’ll learn how to work with a team.
46. You’ll learn how to be productive even in mini breaks.
47. You’ll learn how to adjust to abrupt schedule changes.
48. You’ll probably be more persistent than you used to be (because you don’t have a choice!).
49. You understand people more. Community immersion will teach you where people are coming from.
50. You will probably rant on Twitter .
51. Sometimes memes will be your only source of happiness.
52. You will look for motivation posts.
53. If you were previously working, you will miss earning money.
54. If you used to travel you will miss it, a lot. But treating this as a new adventure will do the trick.
55. You will doubt yourself 99% of the time but you’ll still push through anyway. Giving up is not an option.
56. You’ll feel like a badass when you can finally understand a concept by heart.
57. You’ll probably have a clue what specialties you MIGHT like.
58. Or might still not have a clue, and it’s okay.
59. You will feel like you gave your all but it still wasn’t enough.
60. You’ll be proud of yourself for trying.
61. You’ll thank God for the gift of friends who are always there during your breakdowns.
62. You’ll have great friends.
63. You’ll be a better teacher. 
64. You’ll give time for family even if it’s just a quick chat.
65. You will learn how to establish boundaries so that your safe space and sanity are still intact.
66. You will learn to celebrate your wins and work hard so that you won’t repeat your losses.
67. You’ll thank your past self for loving science. Because when you’re still curious, you’ll keep on wanting to learn.
68. You’ll learn that consistency is key, not motivation or inspiration.
69. You’ll meet amazing Doctors and ask yourself if you’ll ever be like them.
70. You will accept that medicine is your life and what’s worth having never comes easy.
71. You will still procrastinate even if you don’t want to.
72. You will know what kind of learner you are. (visual, auditory, kinesthetic, or mixed).
73. You won’t entertain toxic people because guess what, you don’t even have the time. Lol.
74. You will discover new friendships, and see how amazing your classmates are (even if you’ve seen each other’s toxic side haha). Because yeah we’re humans and that’s what we do. We try to be better.
75. You will need your best friend.
76. You will probably got the hang of how your school gives tests.
77. Sometimes your brain will shut down because it needs rest. Let it.
78. You’ll learn how to be kind to yourself especially when you are coming short of your goals.
79. You’ll know that you can’t study everything but at least you tried your best.
80. You will be humbled by how much you do not know.
81. You will be grateful for the chance to learn more.
82. You will learn how to maximize any opportunity for sleeping. (Yung tipong makadikit lang ulo mo sa pader, tulog ka na.)
83. You will thrive in some subjects and be astounded by how dumb you can be in other areas. 😂 But it’s okay.
84. You’ll learn the value of commitment. It’s hard to commit to this profession but if you love what you do nothing will stop you from hustling.
85. You will make a lot of mistakes. Sometimes you’ll feel like a walking mistake hahaha. But that’s how we learn, and you’ll learn to accept that.
86. You’ll get jealous. Because your friends are getting married and having babies. But, you’ll realize that everybody has their own story. And this is yours, it may be different but it is yours.
87. Discomfort will be your comfort.
88. Anxiety will always be there. But you’ll know that you are bigger than the negative whispers in your head.
89. You will say a lot of sorry’s for flaking out on appointments because you are just too tired to go out.
90. You will feel how much your friends love you because they will understand.
91. You will meet your idols. (Doc Gia and Doc Fortun yieee thank you Anatomy Teaching Learning and Academic Society!)
92. You will learn way more than you thought you ever could. What you study in undergrad for a semester, you’ll study for a week. Surprise!
93. Music will be your best friend.
94. You’ll have developed tricks to keep you awake when studying. Even something as weird as speaking in a British accent while memorizing cranial nerves.
95. You will attract people who are like you.
96. You will be braver and stronger than you ever thought. You’ll realize that medschool will not care about your personal problems, you will still take exams no matter how shitty you feel.
97. You will be extremely grateful for every person cheering you on.
98. Your cats and dogs will be your sanctuary. You will miss them a lot. Hays.
99. You will get sick but you’ll handle it aka superhuman ka. Haha.
100. Once you’re done with first year, it will probably be more clear for you if this is the life you want for yourself.

It is an eternity of studying. If you’re one of the fools, you know that it still is. ❤️

Feel free to add more in the comments so we can guide future MDs.😊