At the End of the Day

At the End of the Day
by Michael Hussin B. Muin, M.D.

(taken from htt://pinoy.md)

Doctors are leaving. We’ve read the bitter reviews, the harsh editorials and the sensational news. Filipino doctors are packing their bags and taking the next flight out of the country. It doesn’t matter where or as what. The bottom line is that they're out of here—and Philippine society is angry.

It’s easy to lump individuals into professional categories: doctors, specialists, general practitioners. When headlines shout “Doctors are leaving”, it conjures an image of a crowd in a cinema running and fighting their way to the exit as if a fire just occurred. In this instance, it doesn’t matter where you end up as long as you don’t end up dead. Anywhere but here, as an old saying goes.

Is this far from the truth? I honestly don’t know. I only know that there are familiar faces in the crowd: classmates, friends, teachers and mentors. And they are not running. They are sitting silently in the corner, deep in thought but ready to make their next move.

My friend told me a story once. He was in a Florida club with a white female friend. This was just after he passed the local boards. A white dude came up to him and insulted him with racist remarks. His female companion defended him, saying he was a Filipino doctor. The dude just had one thing to say to my friend, “So, what does that make you HERE?” My friend replied, “Nothing. That makes me nothing at all.”

It is a true story. Sad, but true. It also drives the point that some doctors, when they leave for other countries, may also be leaving their hard-earned degrees. Ten years of sleepless nights, stressful days and neck-breaking hours in between—all down the drain.

Only a few understand the rigors of medical training. The prized M.D. degree consumes almost 10 years of a person’s life. If you add residency training, by the time the new specialists graduate, they’d have spent half of their lives going after a goal—to be a doctor.

But beyond the time and the labor, fewer people understand the support behind every medical student or resident physician. For many, medicine is not an individual goal; it is a collective dream—nourished by fathers and mothers way before medical school. Nobody survives medical school or residency training without moral and financial support.

We know the stories: an OFW in Saudi cannot go home until his daughter becomes a doctor; a caregiver in Canada continually sends half her income to pay tuition for her brother in med school; a government employee foregoes retirement to fund materials and equipment for her son in residency training. There is no dearth of stories, as each will have his own. Behind one doctor’s dream is a collection of family sacrifices—family sacrifices that may have to be paid in full.

It’s not surprising new physicians or specialist are running up and about, ready to put all their training to use. They need to earn. Let me repeat that, they need to earn. With a certificate in one hand and some idealism in the other, they stand at a crossroads.

Doctors practice their trade wherever and whenever they can. Some go home to their provinces, while some try their luck in urban centers. Some take up additional training, while some set up small clinics. Some apply for admitting privileges in hospitals, while some get affiliations from HMOs. Working hours may start as early as 5 am and may end as late as midnight.

But at the end of the day, in the confines of their own homes, they hang up their stethoscopes and tuck away their degrees. They watch the news and eat stale dinners like everyone else. They play with their kids and put them to sleep like everyone else. They go to bed tired and weary like everyone else. Because at the end of the day, these doctors are not doctors. They are fathers and mothers, sons and daughters, husband and wives. And much like everyone else, they worry about their future and their family’s future.

As the exodus continues, Philippine society will see doctors leaving careers and patients behind. But in the confines of homes in different parts of the country, we see fathers and mothers leaving families behind, sons and daughters saying goodbyes, and husbands and wives praying for a bright future. At the end of the day, we are not losing doctors, we are losing loved ones.

Almost a year ago, my good friend told me he was leaving for Trinidad and Tobago as a UN Volunteer Doctor. I didn’t ask about his career, his degree or his plans. The only question I asked was “Paano anak mo, asawa mo?” And with a long sigh and a short smile, he answered, “Para sa kanila naman ito.”

And that is where many doctors find themselves at. With a plane ticket in one hand and a good dose of reality in the other, they stand at a new crossroads—where paths lead to faraway places and foreign countries, where the only things they can bring are what they can fit in their hearts, and possibly some pictures in their wallet.

I may soon find myself standing at that crossroads—falling in line and holding that crisp boarding pass in my hand. But I don’t dread the day some white dude would walk up to me and say, “So, what does that make you HERE?”.It makes me a father. At the end of the day, in the confines of my rented space in a foreign land, my son is more important to me than a piece of paper hanging on a wall.
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Michael Hussin B. Muin, M.D. is the Founder and Editor-in-Chief of Pinoy.MD - The Website for Filipino Doctors. He is a professor of Clinical Anatomy and Medical Informatics in Pangasinan.