by Work the World

Medical, The Philippines Iloilo, Guest articles


My second week in the hospital began in shockingly unprofessional circumstances as I had failed to set my alarm and turned up an hour-and-a-half late, straight into a departmental meeting, where I was to meet with a number of the Internal Medicine consultants for the first time.

In my defence I think holiday mode had started to kick in; we had had a very pleasant, relaxing three-day weekend (due to there being a national election on the Monday) which had involved having a night out in Smallville (the centre for nightlife, just a short stroll along the riverside away from the Work the World house) on the Saturday, being invited to a housewarming on the Sunday and just hanging out on the roof terrace on the Monday, and I think I had finally managed to switch my head off from the exam crazy. However, meeting our head of department was a bit of a wake-up call as I realised he was a guy I had met at the housewarming, and talked to at great length about all manner of things, yet completely failed to ask what he actually did for a living...

By lunchtime the consultants had departed and I was wound up supremely effectively by the residents about coming in so tardily, and I think a combination of guilt and a sugar-high from a ridiculously chocolatey cake that I had been eating led me to foolishly commit to doing a 37 hour shift the next day. This is something that all residents have to do one day in every four (and this is when there is a full staff complement; at particular times of year they may have to do these once every three and sometimes once every two days!) and something they had been badgering me to get involved with since day one. There were hoots of laughter upon my announcement, but I knew there was going to be no getting out of it now.

the slyly-shot video was up on Facebook and nurses from the other side of the hospital were coming over to the ER to congratulate me

So the next day I came in at 8am, in the knowledge that the next time I would be leaving the hospital grounds would be 3pm the next day. This would involve two full day shifts covering the Infectious ward that I had been assigned to, as well as night shift on the Emergency Room. As darkness fell I began to feel a strange sense of trepidation washing over me. Despite my medical school’s best efforts, I had still never done a night shift, in fact I think the only time I have ever been on a placement past about seven in the evening is when I got lost in the new Royal London Hospital and couldn’t find my way out.

And pretty soon it all started to kick off in the ER as a patient in cardiac arrest came in, followed by another with a number of stab wounds. After we tried unsuccessfully to resuscitate the first patient I went in to watch the team at work on the second. I found it really fascinating to see how they went about it, apparently as calmly as anything – one guy was singing as he successfully decompressed a tension pneumothorax in the left lung, and the others were sticking gloved fingers into the guy’s abdomen, trying to assess whether the knife had penetrated the cavity. This was going on whilst the patient himself – only a relatively young guy – watched on with an expression perfectly appropriate to a recent stab victim who was now watching one man put a finger in his belly whilst another sang “Toxic” by Brittany Spears.

And then they got me to eat balut. Now this is a “dish” which I have seen in a number of countries, but most memorably from this part of the world. It is essentially an egg, but one which has been fertilised, and so contains not only yolk and egg white but also amniotic fluid and a small, dead chicken foetus. Or a duck foetus in my case, as my Chief Resident was at pains to inform me. Again they got me to commit to this in a moment of weakness: at 2am when my brain was starting to retire for the evening, and we were in the office having our late dinner/early breakfast. Even as I cracked the egg open I still had absolutely no intention of eating the wretched thing, but I think it was the fact that the smallest and – up until this point – kindest member of the team was eating her own egg and giving me reassurance that it was “delicious” and “a Filipino delicacy”, that spurred me on. To be absolutely honest I can’t remember it tasting completely bad, but I don’t think that is really that relevant when you are eating a dead duck-baby.

However – immense tiredness and stomach-churnicity aside – I really think that I broke through some sort of social barrier by facing both the 24 hour duty (ok so they let me off the remaining 13 hours...) and the balut-eating, and coming out the other side. Sure everyone had been lovely to me up to this point, but I felt now that I had actually become considered “part of the team” (or something equally cringeworthy). Plus, I had completely underestimated the power of social-networking over here in the Philippines; within a few minutes of the balut incident the slyly-shot video was up on Facebook and nurses from the other side of the hospital were coming over to the ER to congratulate me.

On Thursday night we had another Work the World barbeque on the rooftops. This time Gerry and co served up possibly the largest quantity of oysters I have ever seen. It turns out they are ridiculously cheap over here and generally served steamed, which makes so much more sense to me than the horrendous snot-in-a-cup raw oysters I have previously been disgusted by in restaurants in the UK. And that wasn’t the only thing I learnt at that barbeque – I also learnt that it is a very bad idea to try to explain, after a couple of bottles of local beer and to a guy who doesn’t have a very good grasp of the English language, that the food you are eating is widely considered an aphrodisiac in your country...A fair while after the resulting confused silence had been broken I went out to meet a group of doctors and nurses from the hospital for a night of karaoke over in Smallville.

My second week has been very different from the first, but equally as good. As I mentioned above, I now feel that I have become part of the team, and this has been reflected in the incredibly busy social life I seem to be having out here; I’m not a particularly outgoing person and generally prefer a night in tutting at the experiences of people depicted on my television than actually going out and having my own. So it is something of a surprise to me that the people out here always seem keen to go out and do something, even if they have just come off a 37-hour certainly makes you feel very welcome.

Rob is a 5th year medical student from Barts & The London, Queen Mary's School of Medicine & Dentistry.

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