I am often mistaken as a Pediatrician by my colleagues in the medical field. They say that I have that “aura” of being a pediatrician, probably because of my demeanor, and looks. I always tell them I chose Internal Medicine as my subspecialty.
When I started medical school, I also enjoyed learning about Pediatrics and loved my rotations in Pedia. However, there are certain situations during my clerkship year that made me decide to pursue a different field.
Let’s me introduce you to Mark (not his real name), he is an active 12 year old who arrived in Manila few days prior from Bacolod City. He came to live with his grandmother in Cubao. He didn’t go to Manila for a vacation, he came to be admitted in one of the premier hospitals in the Metro for pediatric patients. He was diagnosed with osteosarcoma and was referred to this hospital for management. I was a medical clerk that time and got to know Mark from our daily rounds. He would especially talk to me since I speak Ilonggo and he was not comfortable speaking in Tagalog. He would talk about his life in the province, his classmates, his parents. He didn’t know what osteosarcoma is, he just knows that he has this “bukol” or mass on his left leg and that he has a limp when walking. After a few days he developed an infection that needed antibiotics to be given through intravenous route. The first two doses were given but his grandmother couldn’t afford buying it anymore. He would go for days until the next dose can be given, and he would also be in pain. One day we went on our usual rounds and when we passed by his bed, he was sobbing and was inconsolable. He wanted to go home but his grandmother can’t afford his medications, and was still looking for help from the different government agencies. Since I am a familiar face, he looked at me and talked to me with the saddest eyes, tears falling, and told me to please let him go home. I can’t help but stop the lump that was forming in my throat, and fight back tears that were threatening to fall. As an aspiring doctor at that time, we were told to be empathic but must keep check our emotions. I told him reassuringly that his grandmother is looking for ways to get him his medications so he can be managed well and go home. He continued to sob. We moved on to the next patient and I went on with the things that we needed to do that day, but my encounter with Mark haunted me when I went home and was able to reflect on the day’s happenings. My heart was broken because I got to know Mark and was rooting for him to get well but due to their financial situation, he could not be given the ideal management. I didn’t want my heart broken again and again. As an adult I know that I should be objective, but sometimes when situations involve these innocent children, I can’t help but be emotional. They should be playing, studying, and growing up but instead these sick kids are in the hospital. We were exposed to a lot of Pedia patients during our rotations and not all of them had a sad story, most got better. I admire my Pediatrician colleagues a lot.
Going through other rotations, I also enjoyed Internal Medicine more than the others, so I chose it for my residency and I am happy. How about you? Why did you choose the subspecialty you are in? For future doctors, what do you want to be? 💖