A doctor’s workday consists of a busy line of people looking for answers: How long does it take to heal? What treatment would you recommend? Would you please have a look at this X-ray? But across various tropes in popular culture and proclamations televised on screen, more often than not, the four walls of a hospital’s emergency room are glorified–even varnished to unrealistic effect–obscuring vulnerabilities, truths, and stories.
Glazed with TV glamour, drama and romantic interests, it’s easy to absorb hospital shows as truth, assured that no matter how the story plays out “no lives were harmed in the making of the production”. But the ER personnel who have it tough–not just physically and mentally, but very much so in the emotional aspect as well–work in one of the most grueling workplaces that function far less glamorously than how it appears to be. It becomes difficult to even begin to imagine the hardships that play out in the mind of an emergency medicine professional, but peeling off the covers of fiction, we unravel a side of the job that’s beyond prestige, title and the pristine white coat –a side of medicine that gets personal.
Humble origins
The tenacity in the face of high stakes, staying calm under extreme pressure, and working in unbelievably long hours–it’s an ambitious bid to keep going without the heavy weight of fatigue, but despite numerous encounters with the stories of illness, loss and death, nonetheless, persistent and passionate is what they remain to be.
Fernando Saul, a surgeon at St. Luke’s in Quezon City. Working in the ER for 8 years,he is one such professional who wants to tell the story of an ER doctor as to enlighten those who may not know about the nature of life there. “Life in the ER is tough,” he says, his eyes sullen, reflecting the sentiment. “In some ways, it’s a horrible job. It has very high stakes, and the room for error is extremely small. It can also get emotionally draining.”
It takes bravery to enter this line of work, and Saul says that he found this bravery through the example of his father. “My father was also an ER worker. He’s the reason why I chose to do the same thing.”
For Dr. Elis Maghirang, a professor of the Biology department and an ER physician, he begins that practicing it has been always been his lifelong dream. Although aware of the nuts and bolts, the highs and the lows of the profession–the long hours, the hard-earned money and the sacrifices it requires, he maintains his passionate view on the practice of medicine. “Being a doctor has nothing to do with being part of the high society. It has nothing to do with glamor, being rich or driving a good car,” he answers. Faced with tempting opportunities abroad, he makes the commitment to serve in the country because of passion and the fulfillment that follows it. “Kasi kaysa naman sa America, ‘pag uuwi ka ng mag-isa, ang ganda-ganda nga ng tinitirahan mo, ikaw lang naman nandun,” he imparts. ”Aanhin ko yung view ng Lake Michigan o anong ginagawa ng mga matatanaw ko dun, kung wala ka rin namang kasama na pamilya at mapagsasabihan?”
But despite the discouragements several factors pose, just like those who do choose to stay, he finds the reward–not in what he earns–but from the satisfaction that he gets from what he does. “‘Yung service atsaka fulfillment kasi na nakukuha mo, di mo naman palaging matatapatan ng dolyar. Wala namang kapalit ‘yun eh.“
Silver linings
“Working in the ER means that you know that there’s every chance your patient will die. And many times, if not every time, you’re what’s standing between them and death. But nothing can change the fact that man can only do so much,” Saul says with a heavy sigh, also recalling his father’s experiences on the job. “I remember that there would be times when he would come home, and cry in my mother’s arms because there was someone he tried so hard to save, but couldn’t.”
Through shifts that last for at least 12 hours,accomplishing piles of paperwork, and treating walk-in and critically-ill patients, Dr. Elis admits that even healthcare professionals are prone to suffer from fatigue, substance abuse, and PTSD. It’s a cost that’s attached to the practice of medicine, but also an issue that receives less attention than it deserves.
When Saul looks back on some of these tragic cases he has handled in the past, he mentions that he has quite a few memories to look back on. “I’ve lost quite a few people in my time working. I’ve lost mothers, children, many more,” he recounts. “I’ve had a patient once who was suffering from brain tumor and postoperative complications. I tried everything to save her, but after 8 months of bed-bound paralysis, she was unable to breathe one day at 3am. And in the end, the worst came to be. Her family, in tears, thanked me, saying things like, ‘At least you tried.’”
“There are countless moments like these in a single career. This will happen hundreds, even thousands of times,” he continues. “Of course, we do save people—we wouldn’t be very good at our job if we didn’t. But there’s no avoiding death. That’s a harsh reality we as ER personnel have to face. We are constantly being reminded of mortality in our work. And it’s really tough.”
Witness to several goodbyes and hours of long wait, one might ask: So how does one detach himself from the atmosphere of grief? And the thing is, there was never really a singular answer that resolve the question of how does one truly cope. As with their reasons why they began, each answer to the “why?” is what makes the narrative all the more compelling.
For Dr. Maghirang, his answer is found in the thoughtful and important details: “Kahit na someone comes back just to say thank you because you’re doing what ought to be done, it’s already the most rewarding feeling.”
How to save a life
There is a great wall of difference between passion and choice. And for doctors like Elis and Saul, practicing medicine is not simple a passive sway of wanting to do something–it’s a persistent desire that puts their passion into action, even though the odds are stacked high.
Despite all the tragedy in his line of work, there isn’t anything Saul would rather be doing. He says that he’s learned a lot from his time working, and that the lessons he’s learned are priceless to him. “The line of work I’m in reminds you of just how fragile life is. The pain of losing someone you’ve known and cared for, no matter how short, whether it be for two hours or two months, leaves a permanent scar. It reminds us of how precious life is, that we should make the most out of it while we can, and how we should never take it for granted.”
It’s much easier to spot the shadows than to appreciate the light, but among the things that keep Dr. Elis going are the moments of uplift and the silver linings.
He recalls an encounter with an 89-year old patient, accompanied at the hospital by her husband, more than 90 years of age. “Makikita mo siya, nakatabi, nagsasalita, hinahawakan yung kamay nung asawa niya. Naghihintay,” he refers to the husband of the patient. Dr. Elis remembers approaching him, unable to stop himself from asking the question: “Isn’t it painful to see her, na after all these years na magkasama kayo, mawawala siya?” Perhaps expecting to receive an entirely different answer, he is taken aback by what the man replied.
“Matagal na kaming nasa pre-departure area at bonus na lang lahat ng ito,” the old man says to him. “Nagkataon lang na ako ang maiiwan. Nagkataon na siya ang mauuna. Pero asahan mo Dok, siguro at most two years, ako naman. Magkikita rin kami ulit.” It’s the kind of story that novels and movies are made of, but also a real-life encounter that Dr. Elis holds dearly in memory.
There are different ways to answer why the call of medicine is one that’s worth pursuing, but the best reasons are found in the stories of passion, persistence, and dedication. In moments when he becomes witness, not simply to a love story, but to the lessons from unlikely characters who would leave an impact in his life, he is one to say with confidence: “That’s how I know I’m in the right place, doing the right thing.”
