On internship and wearing the white coat

Hi, world! It’s been two months since my last post and this is a sign that this blog and its author are still alive!

What’s up with life lately? Well, post-graduate internship has started! I’m an intern now, meaning I am in my fifth (and last!) year on the road to becoming a licensed doctor.


All of us were really excited to wear our coats (lakas maka-aura!) but the tropical climate proves to be a challenge. For my group, first stop was two months in OB-GYN, which is already coming to an end in about a week.

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On scholarships, graduations, and finally getting a medical degree

 

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When I decided to take that long and winding road to becoming a doctor, I had no idea about how much money and tears it would cost me (mostly tears for me) and my family.

First and foremost, I have always been my Lola’s (grandmother) scholar. She sent me, along with my brother and cousins to private schools in elementary and high school (except for me). I attended a public high school (with an outstanding science program) but she still supported all of us financially. Note that she was more than 70 years old at that time, but she still worked to help us achieve our goals. I was not pressured to study hard by anyone. Maybe I did my best to at least return the favor to my hard-working Lola and parents.

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Meet the best lola in the world, my wonder woman, Lola Dim
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Elementary graduation — yes, I am that chubby girl at the center (read about how I lost weight here). I was the Class Valedictorian.

During college in University of the Philippines Manila, I had a scholarship grant from the Department of Science and Technology (DOST) so I did not pay for tuition fees throughout those four years of education. I was lucky that my high school encouraged us students to apply for this particular scholarship because it really helped me. My Lola still supported us financially.

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During the UP Manila graduation (left) and College of Arts and Sciences recognition day (right) – I graduated with honors (cum laude). I can’t seem to find a high school graduation photo but I am proud to say that I was the Class Salutatorian.

Going into med school was a different story. After not being accepted by UP-PGH, I had to choose between University of the East Ramon Magsaysay Memorial Medical Center Inc. (UERMMMCI) and Pamantasan ng Lungsod ng Maynia (PLM). The former is a private school while the latter is government-subsidized. Going into PLM would mean less fees to pay for by my family but I just knew I would be happier in UERM. I was really selfish but I do not really regret this decision.

I was a University Entrance Scholar in UERM, meaning I did not have to pay for the tuition and miscellaneous fees for my freshman year. We literally saved about 250,000 pesos that year. The problem was that I overestimated my capabilities and underestimated the study of medicine. The effort I exerted during freshman year was so much more than how I studied from first grade to college combined. I did not understand why I just could not have an average of 88 (1.75 GPA) after all the late-night studying, missed day out with friends, and missed celebrations at home in the province. I would often call my parents in the middle of the night or past midnight just to cry and tell them how I was having a hard time meeting the required grade. If I won’t get a 1.75 GPA (1 being the highest), I would lose my full scholarship. To make things worse, we were having a financial crisis that year.

One night, I called my parents crying and my mom asked, “Gusto mo bang tumigil muna?” I know she only wanted what was best for me and the whole family but it really broke my heart. The thought of not being able to reach my dream despite all my hard work was killing me. I never thought poverty or not having too much money could actually hinder me from becoming a doctor. I felt hopeless; I thought that was the end for me. “Sana mayaman na lang kami,” I said to myself. There were so many questions in my head like, “Akala ko ba kapag masipag ka, walang imposible?”

Just when I thought everything was over, I had a call from my parents telling me that everything was going to be alright. During second year, I was a partial academic scholar (my average was 1.78 for first year, sayang talaga). It means I got a 50% discount on tuition fee. On top of that, the UERM Scholarship Committee gave me an additional grant which further decreased the amount we had to pay for. Lola Dim still supported me financially, and some of my aunts and uncles also helped. The same thing happened for my third year. That’s when I learned not to be hard on myself. I knew I did the best that I could and a partial academic scholarship was still a great help. I am very thankful for the financial and moral support I have received.

The transition from third year to fourth year was the hardest. I was really nervous because third year was the most difficult. I was not able to get an academic scholarship for the following year. But the transition was so hard to bear because Lola Dim passed away during my last month in third year. She was 89 years old. I always dreamed of the day she would see me graduate. I was devastated to hear the news that she would not be able to witness the fruit of all her hard work and selflessness.

Not having an academic scholarship was a great obstacle. But you know, there were a lot of people who were willing to help and give overflowing encouragements — the doctors from the scholarship committee, my sisters from the Sigma Beta Sorority, my brothers from the Beta Sigma Fraternity, friends, and of course, my parents, my family.

Today, I am writing this as Rachelle Carmona Ramilo, MD. I will forever be grateful to the institutions that helped me, and the people who have always believed in me. From saying “Sana mayaman na lang kami,” I now say “Sana makatulong rin ako sa iba sa hinaharap.

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I really wish Lola Dim was there with me, Tatay, and Mami on the stage when I got my diploma (our diploma). I hope I made you proud, Lola. Maraming maraming salamat po.

Rachelle

Things I Learned From My Patients

Hello, world! I am no longer a slave! JUST KIDDING. Clerkship (4th year of medical school) has been a year full of learning and extraordinary experiences. I gained a lot of practical knowledge and I can’t wait for the next chapter of this career that I chose.

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But before I completely move forward, I want to share with you what some of my patients taught me. Akala ko drama lang yung sinasabi nila na you learn from your patients pero totoo pala. You can learn about tuberculosis more effectively by actually seeing a patient with this disease and then reading about it on your textbook or journal articles. The patients won’t tell you about the technicality of their disease, obviously, but what I learned from them are lessons that are deeper than the things you could read in a medical book.

So, these are the things I learned from my patients, in chronological order of my rotation as a clinical clerk.

Surgery

During our rotation in Amang Rodriguez Hospital (Marikina), a woman stabbed by her husband was brought to the ER. I definitely learned to stitch the scalp (yes, she was stabbed on the head!!!). But most importantly, I will always keep in mind to marry a keeper. Girls, stay away from criminals, and criminals in the making. Katakot!

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Trying to make sense of the CT scan plates…
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This was taken in UERM Hospital during a surgical procedure.
Medicine

I had a very lovable elderly patient who was obese, with heart failure and chronic obstructive pulmonary disease (COPD). Whenever I see him, I couldn’t help but associate him with Santa Claus! If only he stopped smoking a long time ago, started living a healthy lifestyle, and became proactive in taking good care of himself, he may have been living a comfortable life without fear of whether or not he would be hospitalized again in the near future.

Psychiatry

Patients in a mental ward are still human beings, with emotions and an innate kindness in them. One time, we taught them how to make pastilles during one of their occupational therapies. They were so sweet, they even gave us some of their finished products.

Ophthalmology

My mom had a cataract operation in UERM (thanks to Dr Felarca and the whole department!). I’ll never forget how happy she was to be able to see the smallest details again, for example, a tiny dirt on my dress. Let’s appreciate the small things in life. How lucky are we that we can send text messages, appreciate Instagram photos, and read wonderful novels?

Otorhinolaryngology & Head and Neck Surgery

There are bad people everywhere. Some may even break into your house at night and stab you in the face if you try to stop them. Keep your house and neighborhood safer. Again, katakot!

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Equipped to look inside your ears. There was one patient with a cockroach stuck inside his ear. I KNOW.

Pediatrics

Looking back, I actually learned the most in this rotation. The most unforgettable is the five-year old boy who had Cerebral Palsy, a neurologic disorder. While he was still in the womb, his mother was advised that it was likely for the child to have a disorder (based on the ultrasound). She still chose to continue with the pregnancy and to give birth to him even if she had the chance to terminate it (at that stage it was still an option). I would say this kind of love is definitely unconditional. The mother was doing everything she can to provide the child with a comfortable life.

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Cute babies make work so much easier! (Photo taken and posted with permission from the mother)
Obstetrics and Gynecology

For me, the most memorable part of this rotation is when I was coaching mothers during labor. I’ll never forget this line we kept on telling them — “Hingang malalim, pigil, and push!” It must be really hard and painful for mothers to give birth. Dugo, pawis, at marami pa ang pinuhunan nila. Thanks, Mami, for pushing me out of your uterus, to be a part of this amazing planet.

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Delivery room — where babies are born (East Avenue Medical Center)
Dermatology

We had the option to choose two elective programs for one week each and I chose Dermatology twice. You may think this specialty is shallow and easy but it’s the complete opposite. Skin lesions usually look the same and you have to read a lot (and see a lot of patients) to be able to distinguish one disease from another. I interviewed one patient who had Psoriasis, and his whole body was covered in thick crusts. He was a hard-working man but his condition was preventing him from going to work (kasi nakakahiya raw). Diseases affecting the skin not only affect productivity but the mental health as well. Everybody deserves to be confident in his or her own skin (I swear this is not a sponsored post, haha).

Neurology

During my first day in the ward, there was this one patient who was always grumpy. I’ve never seen her smile the entire day. But then, she was diagnosed with a brain tumor so I completely understood. The following day, she was visited by friends and family. She was smiling the whole time they were there, even long after they were gone. She had a brain tumor and nobody in the entire hospital (or the entire world) was sure of what would exactly happen to her after her operation; but she seemed happy and hopeful. So, what are the key ingredients for a happy life? I guess family, friends, and optimism.

Community Medicine

While teaching barangay health workers in a health center in Rizal, one of them asked if drinking pineapple juice can decrease blood pressure. You see, most people in the province believe that if one is having symptoms due to increased blood pressure, he only needs a can of Del Monte pineapple juice to alleviate the symptoms and normalize his BP. There are so many misconceptions about health and medicine that hinder us from preventing common diseases. I think kids should be taught in school about the important things they should know about healthcare. Let’s debunk the myths at their level.

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Our group with the receptive barangay health workers

This would be longer if I’ll continue to talk about the changes I would like to be implemented in our healthcare and education systems so I’ll stop right here. I’m not an expert and I know  the people in charge are doing their best (well, hopefully).

And no, drinking pineapple juice is not enough to decrease one’s blood pressure. A healthy, active lifestyle can, with the aid of medications (depending on the individual).

There you have it, a preview of 12 months worth of education. Thank you, dear patients! In a few months, I will be starting with my post-graduate internship which for sure, would be another year full of learning and meaningful stories.

Take good care of your health because I don’t want to see you in the hospital!

Rachelle

On nearing the quarter life, and the joy of doing what you love

You may not know this, but I just turned 24 a few days ago. I used to associate this age to being old but now, ironically, I feel young. Although I have to admit, I fear turning 25 next year. I think by then there would be more pressure to act like a real adult. But you know what, before I even turn 25, I think I already experienced that quarter life crisis. Or maybe there’s another inner struggle about to happen in the future? Oh, God.

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Life in the Time of Diarrhea: Why I Got a Health Insurance

Hello, guys! Are you still there? Well, I’m still here, back from an unexpected hiatus from blogging. I became suddenly drawn to hospital work and group exercises at Gold’s gym, and realized how medical clerkship (4th year in med school) can be actually fun and enjoyable. Why am I suddenly going to talk about health insurance, you may ask? I have “diarrhea” to thank for this blog entry, actually!

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