Monday, April 21, 2008

Graduation Banquet

The other day, I attended the school of graduate medical education's graduation banquet. A night to honor those of us who will be graduating from training, from the 'mothership' this coming June.
Being in that hall and looking at the crowds of colleagues and consultants, I couldn't help but to reflect. It has been a long journey which is now only coming to an end, with another chapter to begin very soon. After all, I began medical school in early 1996. If someone had told me I'd be training for the next 12 years, I'd probably have told him to go straight to hell and packed up my bags and gone into school for something else.
Even now, when I lecture to the starry-eyed medical students in IMU, I wonder if they have any idea what's in store for them. I know I didn't.
But now, 12 years later, when I'm not so young anymore, when I'm a PGY-6 (in many's opinion, that's considered really senior. A career trainee), knowing what I know now, what would I have told myself, if I could travel back in time? What pearls of wisdom might I impart?

It's going to be a sacrifice
Thinking back, I've worked insane numbers of hours, missed out on so much in life, left behind loved ones, been so far away from my dear family, studied hundreds and hundreds if not thousands of hours. To this day, I feel guilty if I don't spend a few hours reading something medical. Nothing great comes without a price- only that person can decide if it's going to be worth it. But you have to know going in, that you're going to let go of a lot of things, even parts that make you more human.

It's okay to be weak
To have moments when one has to cry. I know I've done it. Numerous times as an overworked, exhausted intern, when my patients die, or when I make a mistake on rounds, or when I get dressed down. To survive, I've used the 'hide in the bathroom/phonebooth and cry' trick. Me, a 25 (then) year old. But, with every tear, one learns to be stronger.

Have faith
That the Lord will provide. I don't consider myself overly religious. But I do believe in a Higher power. And I do believe He took me, a homesick, shy kid from a tiny country in Asia, and put me here, for a reason. When you're on the verge of exhaustion and have been on your feet for 32 hours, have faith that you'll find the strength to go on. One of my favourite quotes:
"When you come to the edge of all you know, you must believe in one of two things. There will be earth upon which to stand, or you will be given wings to fly".
I've leapt off so many edges I've lost count. And yet, somehow I'm still here.

Only you can sell yourself
One handicap I've always faced was, coming from Malaysia I tend to be more reserved than my counterparts here. And often, you meet people who speak a lot, and loudly, without actually saying much in substance. You realize that it's sometimes sadly not what you say or do, but really how you sell it. In a competitive world such as this, there is a fine balance between humility and losing out.

Never forget your roots
Though I've been away for so long, and will likely settle down here, I never forget when I came from. Undoubtedly, neither my grades nor luck put me here; my family did.

It's alright to make mistakes
After all, doctors are human too. And it's hard realizing mistakes often involve people, and can result in harm and lawsuits. But as much as I hate to admit it, we do make mistakes. And we need to forgive ourselves, and learn from it.

Never regret, never ponder
Never look back and wonder about lost loves, family and career opportunities left behind. There was a time I tortured myself with this. But I finally learnt: it's hardly relevant. You picked a path, you stick with it until you complete the journey. No point wondering about 'what ifs'.

Your patients will hate you. Your patients will love you
As with all relationships, some patients you can never please. Some patient will always complain and be dissatisfied, and you can't let that get to you. Instead, remember the gratitude and friendship from those who genuinely appreciate your help and use that energy to sustain you.

Give back
As you learn from patients, give some back. Volunteer; you get back so much more than you give, really. My most memorable and fulfilling experiences have been related to volunteering.

Patients die
No matter what. Whether it's of old age, or of that acute pulmonary embolism that caused a cardiac arrest that made your resuscitation efforts futile. Such is the circle of life. And yet, death isn't always a failure, and even in death, you often can provide comfort and care as a physician.

Officially, I close this chapter June 27th. 2 more months as a fellow. Unofficially, we're all board-certified endocrinologists and have already signed up with our respective employers. The next chapter will be an interesting one.


Anonymous Anonymous said...

Young man:

Very aptly put. I wish more young people these days have the wisdom, humility and values like you. You still have a long journey in life to track. Walk wisely, walk faithfully and you will be ok. The karma will take care of the rest. Take care and all the best in life.

2:25 AM  
Anonymous Alvin said...

woop!12years yae?meaning that i still hv..1,2,3,4,5...uh oh 12-3=8 more freaking years to go!!Anyway,thanks for those kind words!They really reminded me again why am I in it!

9:53 AM  
Blogger CHARIS said...

Good reflections. I'm glad you took a breather out of your busy schedule to pause and ponder. Congratulations!

10:33 AM  
Blogger Mei said...

Hey TK, congrats~!! Can't say how much I appreciate your true empathy and care towards, not only your parents, but everyone around you... **I still have ur card, and the fake Godiva's you sent me when I was having my difficult moments**

I always tell myself that I'm only human too, and I think that makes me a better doctor. Well, at least I know my patients appreciate it too :D

Well, bottom line... you never fail to inspire :) Will tune back soon for more.

4:28 PM  
Blogger nyrac said...

thank you doc. gives us med students insight, and maybe courage, to face what's ahead. thanks, once again. i loved this post.

12:38 AM  
Anonymous Anonymous said...

Very well put. I'm sure you have touched countless lives over the years and will continue to do so. You are a true, compassionate doctor who shows empathy and wisdom. Keep up the amazing work.

5:45 AM  
Blogger yawen said...

thanks for your advice dr. vagus. you really inspire me! :)

9:05 AM  
Blogger adriene said...

this was very profound. thank you for sharing.

11:25 AM  
Anonymous wendy said...

This post comes right in time. I believe most, if not ALL medic student have doubts as you mentioned above every now and then. And for you, someone who has been there, done that, and still doing it to take the fuss and pen it all down, I can't thank you enough. Because it shook me awake. Thanks again

3:12 PM  
Blogger pavlova said...

hey you've got braces!
sorry, occupational hazard of dentists to look at one's teeth first in photos, real person.. etc

as said, good post indeed.
but one thing i've learned fm the medics is that medics are able to let it go much easier than dentists. if we make mistakes, we screw up the tooth (plus enduring some nasty remarks fm patients and threatening to sue/ complain), we get so stressed up. in fact, some get so suicidal, hence contributing to the high suicide rate among dentists.
in the grand scheme of things, it's nothing compared to if a patient died on you..
a matter of perspective...

6:43 AM  
Anonymous so-p said...

hi =)
I was one of those wide-eyed IMU kids you spoke to last year.
it's so amazing to have discovered your blog.
wished i had the same fortune as you in the states, unfortunately, there seems to have other plans for me.

congratulations! on the engagement by the way! so happy to hear =)

God bless!

10:14 AM  
Anonymous so-p said...

'there seems to be =)'

10:19 AM  
Anonymous Anonymous said...

hye. i'm just a 18 year old girl, struggling to complete a preparation programme and competing for a place in medical school in australia. i adore your wisdom and most importantly your spirit to sail through the journey in medical world. thanks a lot for those inspiring thoughts of yours =)

12:10 PM  
Anonymous Anonymous said...

It's amazing that you spent 12 years chasing down a dream that's about to become your reality. Your story and reflections are very practical. Many Malaysians studying and working abroad can relate to your experience, especially those studying and practicing medicine. I am one of them, it's my 9th year in Taiwan, spent 3 years trying to fight my way into med school and now t-minus 1 month to internship. When I graduate, I'll be here for 10 years. Is it worth it? It seems the further you go down the rabbit hole, you'll find that no one can come up with a definite answer except the guy who took the path less traveled. Getting into medicine was about making a difference in the world, for me, my family and for people in need (mostly just children ><). Even though it's not that simple anymore, I am not sure I would have chosen any other path in life.

3:07 PM  

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