Monday, May 30, 2011

A Valedictory Address

The following speech was delivered by Dr. Marc Gregory Y. Yu, valedictorian and the only magna cum laude honoree of the University of the Philippines College of Medicine Class of 2011, during the 102nd UPCM Commencement Exercises, SMX Convention Center, Manila, May 22, 2011.  

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UP President Dr. Alfredo Pascual; our Chancellor Dr. Ramon Arcadio; PGH Director Dr. Jose Gonzales; our beloved Dean Dr. Alberto Roxas; members of the faculty, staff and administration of UP-PGH; distinguished doctors, parents, fellow graduates, and friends. Good afternoon.

Not too long ago, I was just another regular guy from the province, pleasantly thrilled to be in the metropolis for my medical education. I couldn’t call a code to save my life, and if someone came up to me and mentioned words like “spondyloarthropathy”, “calciphylaxis”, and “tardive dyskinesia”, they would have sounded like magic spells straight from the pages of a bestselling Harry Potter book.

It never occurred to me that several years after, I would go on to present an award-winning pilot study on “spondyloarthropathy”. “Calciphylaxis” became a crucial question that cost us the winning point in a quiz show; and somewhere in one of the whitewashed rooms of the OPD, I encountered my very first patient with “tardive dyskinesia.”

That patient, I would like to believe, had been my second most memorable patient. My most memorable patient was a forty-year old woman who approached me one day and said: “Doc, kamukha niyo talaga si Aga Muhlach!” To which her very observant companion replied, ““Mali ka! Si Dingdong Dantes ang kamukha niya!”

So what’s the moral lesson? In these difficult times, ditch med school. Watch out for the next Starstruck auditions!

But perhaps when we were younger, there was a time when we thought being a doctor was what we really wanted. Years ago, some of us showed up in Calderon Hall believing they could make a difference. Others have been drawn by the allure of such a prestigious profession; while still others, fearing expulsion from their homes, reluctantly exchanged business suits and ballet shoes for scrubs and surgical tools. As for me, I became a doctor simply because all I ever wanted to do as a child was to play with a stethoscope all day. Of course, that quickly became the least of my concerns.

Looking back, however, what matters is not why we became doctors, but that we chose to become doctors. And today is a fitting celebration of that choice.

So congratulations to everyone. We are not only graduates in the academic sense but also graduates from being called Hijo, Kuya, Ate, Ineng, ang lalakeng nakasalamin, ang babaeng maputi, ang bakulaw na singkit.  We have finally earned the enviable right to be called Doctors of Medicine.
Being a doctor is a rare power, and a vast privilege. Not only are we dealing with a constantly evolving array of drugs and diseases, but we actually possess the dynamic capacity to heal, to cure, and to care (also, to be sued for malpractice and sexual harassment.) As products of the country’s premier university and trained at the foremost national referral hospital, we have been part of a time-honored tradition of excellence, having studied with the best professors, mingled with the best students, and taken part in crafting some of the best ideas.

Five years – seven years for us Intarkids – have made us duly realize that this power is nothing short of tremendous. In the words of a balikbayan patient: “I came here to be treated because I believe in the ability of the UP doctor. I came home because I believe in what we have.”
Every day, hundreds of patients trudge to the gates of PGH, each bearing a tiny flicker of hope for recovery and redemption. We’ve met those who were easily content, and those who might have complained to their heart’s content. Those who were actually happy enough to have a rusty stretcher bed to lie on, and those who would be more than happy if the ER also served complimentary espresso. Some were extremely glad to have undergone a timely leg amputation, while others fiercely demanded a cure for metastatic disease. Time and again, we have been firsthand witnesses to these patients, who represent the staggering microcosm of life and its harsh realities. This incredible richness of experience has been our power, and to a certain extent, our responsibility as well.

Here in our country, the ironic wonderland that is amazingly resource-rich and resource-poor at the same time, the young Filipino doctor has to grapple with long, horrendous hours of work, little pay, limited social life, and boundless exposure to dangerous communicable diseases. Our commitment has been tested by the minute, and our creativity stretched to the utmost. How many times have we performed CPR on the floor? Juggled two, even three, newborn babies in a single bassinet? Utilized Jollibee cups for ABG purposes?

Some people would call it the very essence of “community-oriented education directed to the underserved.” Others would brush it off as merely OA: overused anecdote. While still others would declare, it is something that needs OA: optimistic attitude.

Dr. Tony Dans, one of the most passionate doctors I’ve seen, has always emphasized: “We never have to work a single day in our lives as doctors if all of us had passion” (which may include passion in bed, as exemplified by a familiar doctor with his now infamous videos.) An attitude of passion and commitment allows us to emerge from 24 hour duties with enormous eye bags and splattered with blood, sweat, urine, and amniotic fluid all at the same time, and people would think we’re flaunting the newest fashion craze in town.

But let me tell you something else.

Last year, without benefit of a medical degree or a license, I received an unexpected surprise from a patient whom we pulled out of uremia: a box of cookies and a bottle of Coke. Not long after, it was a one dollar bill from an OFW. Cinnamon rolls from a grateful mother who was so relieved that her son didn’t have dengue. A pat on the arm from an elderly patient who commented that she finally understood her disease, for the first time in all these years. A year before that, I had been blessed with the most beautiful sunrise while on duty at the SOJR.

Maybe we’ve all had similar experiences, or come across similar patients. These are the things that continually renew our passion, the things that keep us waking up each day and raring to go, the things that often remind us why we turned to medicine in the first place, when we could be out there writing novels, selling shares in the stock market, or simply enjoying the perks of being a Starstruck grand champion.

The only words I could say right now are “thank you.” Thank you to our esteemed doctors, who have incessantly served as our lecturers, preceptors, mentors, and tormentors (just kidding.) No amount of scientific brilliance would comprehend how much you have influenced and inspired us, not only in refining our clinical eye and management skills but more so in the conduct of ethics and effective doctor-patient relationships.

Thank you to our patients, who have been our most indispensable bedside teachers. I will never forget how an enthusiastic mother lectured me on her newfound knowledge of epilepsy, or how a particularly persistent bantay taught me the value of sheer resourcefulness. And when I was about to perform my first ever gynecologic examination as an ICC, the young woman on the examining table gave me a knowing look, chuckled, and said, “First time mo no?”

Thank you to our families, who have provided unconditional love and support despite enduring an eternity of missed dinners, birthdays, anniversaries, weddings, baptisms and reunions. Finally, we can confidently answer your queries regarding X-rays and ECGs – with matching journal articles to boot.

Thank you to the staff and administration of UP-PGH – the nurses, NAs, manongs and technicians who have offered invaluable assistance and made life in the wards, OPD, OR, ER, and ICU so much more worthwhile.

Most of all, we give thanks to the one Great Healer, who has wisely utilized us as His fitting instruments.

Med school had truly been, in the words of Charles Dickens, “the best of times, and the worst of times.” We salute our co-interns, block mates, poker pals and karaoke buddies – the people who have walked with us for better or for worse, on days when we only had oversized anatomy textbooks for breakfast, lunch, and dinner; got grilled for two hours in front of a poker-faced audience; fell in and out of love; flunked exams and barely passed others; studied hard and partied even harder – which turned out to be an excellent decision because in the end, we can’t even remember half of what we studied. Of course, even if we failed to study, we were assured that we can always have a “good time”.

Hovering between student life and the start of real medical practice, our minds may be riddled with questions: What do I do? Where do I go? What will happen to me when I’m bald, fifty, and still a bachelor? (I’m not referring to Mr. President.) And most importantly, how do I change the world?

Let me rephrase that: How do 150 UP students – and 260 PGH interns – change the world?

Our working knowledge of malignancies and chronic diseases tells us that obviously, it won’t be overnight. We won’t wake up to suddenly find an automated, fully air-conditioned ER, an expanded labor room that will comfortably fit a hundred pregnant women (the key word being “comfortably”) or all ICU beds equipped with the latest, most powerful mechanical ventilators.

But then maybe, just maybe, we will wake up to know that a patient survived a hypotensive episode, thanks to our diligent monitoring efforts. That another patient escaped a potentially fatal arrhythmia, because we stayed on to retrieve labs and aptly discovered a potassium level of 7. That a patient in sepsis finally became afebrile, because we ensured a sufficient supply of antibiotics. My most uplifting moments in medicine have been these little everyday things, simply because these are the meaningful things that count, the tiny changes that triggered an earthshaking world of difference.

Change will forever mark the bountiful frontiers of medicine. Soon, we will be diagnosing TB with just two sputum smears, more and more molecular agents will target cancer cells, and the rise of novel endoscopic interventions may eventually obviate the need for more invasive surgeries. Soon, more terms will crop up, terms even more peculiar and more bizarre-sounding than “spondyloarthropathy”, “calciphylaxis”, and “tardive dyskinesia”.

This is how our stay in the UP College of Medicine has changed us. We have been granted the collective power to think and to imagine, the ennobling responsibility to accept challenges with open arms, the steadfast commitment to drive all our undertakings, and the burning passion to keep our efforts aflame. History will fondly remember us for our unbeatable record in the TRP Chorale Competition, and for our perpetually perfect attendance in the BSLR Tuesday Conferences that so impressed our beloved Dean.

Before I lose credibility as a patient-certified Aga Muhlach and Dingdong Dantes lookalike, allow me to do away with overpriced TV commercials and instead echo the words of renowned physician and UPCM alumna Dr. Fe Del Mundo, who is exactly 76 years older and wiser than I am: “Give to the world the best you have, and the best will just come back to you.”

My fellow Swabes, as we emerge from this hall today, let us give to the world nothing less than the best we have, and nothing less than the best that there is to offer. Who knows? It may not be too late for Starstruck auditions, after all.

Thank you and good day!

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