Reaction on "Health and Human Values in the Basic and Clinical Sciences" which I delivered during the 3rd Centennial Colloquium of the UP College of Medicine last July 29, 2005. The speakers were Dr. Alberto Romualdez, Jr. and Dr. Antonio O. Periquet.
To our distinguished speakers, esteemed mentors, fellow medical students, guests, ladies and gentlemen - good morning.
First of all, I would like to thank the organizers of this activity and the Department of Rehabilitation Medicine for inviting me to be one of the reactors for this 3rd Centennial Colloquium of the UP College of Medicine Centennial Celebrations. I don’t know if this is just a coincidence because the department invited me last March 2005 to be a reactor on the bioethics topic of spiritual values in medicine. Now, I will be reacting on the topic of human values in medicine.
When I received the invitation for this colloquium, I was both hesitant and willing to accept the task of being a reactor. Hesitant because I will be reacting pro- or against the colloquy of two of the big names in the Department of Health – Dr. Alberto Romualdez, Jr. and Dr. Antonio Periquet. I was thinking, what can the experiences of a mere medical undergraduate, still on his first quarter of internship, compare to the wisdom and experiences of legends in the history of the college and the country? But then again, in times when the developments in the science of medicine has exponentially grown, I feel that the art of medicine – including human values – should still be emphasized, especially to us, the younger ones who aspire to follow the footsteps of our mentors. And so, thinking that this can be an avenue to stress this point, I accepted the invitation.
I would like to commend Dr. Alberto Romualdez, Jr. and Dr. Antonio Periquet for the extensive discussion of human values in the basic and clinical sciences, respectively. Never did I realize that the name Dr. Periquet, whom I usually hear over the radio when I was in Grade 5 or 6, or Dr. Romualdez, whom I saw on TV in 2001 during the height of President Estrada’s impeachment, be addressing us here today. Little did I know that I would be here now as a student of the UP College of Medicine because in 2001, I was just applying here at the college.
I believe that at the time of admission to the College of Medicine, each new student has already a set of values which he imbibed and developed for the past 20 years of his/her life. They may be good or bad. However, it is hard to instruct someone to change his/her values especially if they believe that they are intelligent would-be doctors as those students studying here now or the alumni practicing in the country or abroad.
At first, I thought that there are not much human values in the basic sciences, since there are less patient interactions when undergoing these subjects. At most, the things that I could recall are those lectures in bioethics by our Dean, Dr. Cecilia Tomas, during our 1st and 2nd years in medical school, wherein the values of beneficence, non-malefecence, autonomy, and justice were discussed. However, Dr. Romualdez showed us that in everything that we do in our basic sciences, there is a human value that is being developed. I did not realize until now that I was developing human values even in Anatomy or Biochemistry. Maybe it was just not evident because I am used to the usual learning by lectures or didactics. True enough, what is essential is invisible to the eye. And I thank Dr. Romualdez for influencing me to look at the deeper meaning of what we are doing while still young and while still in med school. Now, I could give meaning to the experiences and hardships I passed through in my four years of medical education.
On the other hand, reacting to the topic on “Health and Human Values in the Clinical Science” for me was easy – that’s what I thought at first. I said, maybe that’s why they invited a medical intern – among the students in the college, we are exposed more to the Clinical Sciences. However, when I saw the lecture of Dr. Periquet two days ago, I was a bit overwhelmed by some of the technical terms. I forgot that our distinguished speaker was a former Secretary of Health, and so, clinical practice for him was not only a single patient-doctor relationship, but as a doctor to the country. And so, health care system and health policies came into play. But upon further analysis of his lecture, the health care crisis that he mentions stems from the basic human values that are at often times neglected – equity, fairness and social justice. I believe that the UP College of Medicine has introduced her students to these values through its basic and clinical sciences, the Community-Oriented Medical Education (COME), and the Department of Family and Community Medicine. I appreciate this because not all medical schools are given this chance to have a heightened social responsibility not only to a particular community, but to the country as well. Maybe I need more experiences to be able to converse better on issues that are on a larger scale because as of now, the largest experience I’ve got is the Philippine General Hospital.
And so, let me concentrate my reaction on the experiences of a medical intern since we have in our audience medical students like me eager to become doctors. Let me share some of my experiences on human values that you might experience in the near future.
During the early parts of our medical education, YL III to V, we are often idealistic in our values. Get a good grasp of that because when you become clerks, interns, residents and even consultants, your values may be altered somehow. Like for example, in PGH, there is a practice called “Robinhood.” Because of the current health crisis wherein funds are not allocated to health, there is shortage of supplies for our charity patients. Therefore, we medical clerks and interns, are forced to prescribe more than enough medical supplies to one patient who can afford in order to use the excess supplies for other charity patients who do not have enough money to afford quality health care. We do this to give not quality care to the needy but simply just to care for them.
In PGH, we rotate at frontliner departments such as the Department of Emergency Medicine and Department of Obstetrics and Gynecology. It sometimes pains us to see that we have to turf patients away because we do not have enough facilities or beds to accommodate them.
In our early years, we hated interns or residents shouting at the patients but sometimes, we find ourselves and other co-interns doing the same because of the environment and toxicity we have in PGH. PGH brings out the worst in people.
Knowledge and skills are also important, as what Dr. Periquet has mentioned. When we were in 3rd year, if a resident tells us to request for blood chemistry for diagnostics, we would order the gamut of BUN, Crea, Na, K, Cl, etc. If you are equipped with the knowledge, you would only order what you need. If its only hemoglobin you want, you could order Hemoglobin & Hematocrit and not the entire complete blood count. This would minimize the expenses that our patients have to pay.
Finally, it saddens me that we get referrals from private hospitals sending patients to us because of financial constraints. People go to PGH because they think it is free but when they arrive, we have to send them to other government hospitals because we don’t have enough resources to cater to the entire country.
The challenge for us is that we always check if what we are doing is still aligned with the values we developed early on in life. Values taught to us by our parents, primary and secondary education and even medical education.
Before I end this reaction, may I just share a thought that came into my mind this morning while preparing for this reaction. I am one of those persons bothered by the increase in the number of UPCM graduates who go out of the country after graduation. I am not against this but sometimes I feel disheartened by the fact that there are more people needing the medical attention of UP doctors. Why go out? And then I realize what was mentioned before. Students enter the college of medicine with a set of values. We are indeed lucky if we get students who have the values of nationalism and service toward fellow countrymen. However, sometimes, we get students who value financial gain more, and they think that being a physician would help them attain that. I hope now they realize its not. And so, it is not a failure of the college if ever, our graduates go out. I believe that the medical education the UP College of Medicine has prepared for us in both the basic and clinical sciences has affected a lot… those present in this hall, those in the Philippine General Hospital, those working in the rural and even those practicing abroad. Sometimes, we realize our value of service and nationalism early on after graduation and choose to stay in the country… sometimes later on and help by donating to the college, like the UPMASA… but still, I salute the UP College of Medicine for making us human, socially aware, in the midst of the advances in the science of medicine. Now more than ever, I am proud to be part of this noble and time-honored institution. For it does not only prepare us to be good clinicians, but it also exposes us to the different values which will help us become the physician, caring and compassionate for the underserved. We are equipped with the values in life, but we are also given the freedom to choose which values to uphold. It is our choice. Thank you.
