Posted March 21, 2002. You don't realize how much it flatters me when I receive an e-mail reacting to a recent column. Positive or negative, agreement or disagreement, anonymous or not, doesn't matter to me. It's like a weekly paycheck. It takes a lot of effort reading an article which gets longer every week, responding takes even more, that's why it is much appreciated. And if necessary, you can always use my columns as evidence in a sanity hearing in case you lose your mind reading them. Kidding aside, keep those e-mails coming.

     I do exercise extreme discretion whether I quote your e-mails or not. If it is quite interesting, it's unfair if I keep your thoughts to myself so I share them with other readers by way of small quotes or a whole article. Besides, think of how boring it would be if you read my line of thinking all the time. It's not only boring I guess, it's dangerous.

     Last week, I wrote about the interview we all had before we started our medical school days, our expectations then, and how it relates to what we do now. Most of the time, I just don't write what I feel or think about a certain situation. I call or e-mail friends who belong to different batches, not only mine, to get some kind of a cross-section of different views. I don't personally know all of you out there so your views may not be represented. Feel free to write, anonymous or otherwise. The Surgeon General has determined that keeping your opinion to yourself is very hazardous to your health.

"Doctors only get rich in 2 ways - 1) they are born of rich parents or 2) they have rich wives (or husbands)"

     Although the topic I had last week was about 'your first interview', some parts of the article touched on how do you start a practice or how was it when you started a practice. We will talk more about it with the help of a letter-writer who only goes by a nickname. She did her internship at Iloilo Doctors Hospital so I presume she belongs to an earlier batch, which is a good thing because she can relate to starting a practice many years ago while I, as well as others I know and talked to personally, can relate to starting a practice now.

     For the record, I don't practice Medicine right now. But I will admit that I still have delusions of having a practice someday. I am practicing to practice, if that's even realistic. If that doesn't make sense to you, don't bother. Sometimes I get annoyed by other people asking, how do you make use of your education? How I wish they would ask me other questions like 'how did you get so good-looking?' Anyway, I will answer both questions in future columns.

     Let's go back to our letter-writer who I'm personally grateful for taking time to write. "How did I answer my first interview? Why do I want to be a doctor?" she starts. "To be of service to humanity. To be able to provide medical care to the the underprivileged." I'm about to give her the Nobel Peace Prize at this point, but she quickly adds, "Baloney! That was not what I told them. My real answer was "there was no doctor in the family and my parents would be pleased if I become a doctor and go to America." So instead of the Peace Prize, I'm giving her the Nobel Prize for Honesty, if there is such a thing.

     Actually, the interviewers may actually appreciate your honesty rather than frown at it. Our letter-writer suggests that you may want to answer that "you only wanted to be rich". I am not discounting those who were quite rewarded monetary-wise by becoming a doctor and there's a lot of you out there, but this may not apply to everybody. Be careful what you wish for. Being a doctor in the Philippines does not necessarily equate to robbing a bank or winning a million dollars in "Who wants to be a Millionaire". My favorite professor in Surgery who loves to moonlight as a philosopher once said, "Doctors only get rich in 2 ways - 1) they are born of rich parents or 2) they have rich wives (or husbands)".

     "Starting a practice in Iloilo City is an uphill struggle", our letter-writer acknowledges, " but not to everybody who tried". "A number of my peers were destined to be successful in Iloilo city practice. Though they were not really categorized as smart students, they have other stuffs - pleasant personality, gentle aggressiveness, calculating, diplomatic, willing to kiss the senior consultants' 'you-know-what' (I say ass - RG) or at least rub their backs. You got to have some connection". She did not mention any specific connection but we can probably make it up ourselves.

     "After a few years of savoring success some of my peers developed 'hydrocephalus' (big-headed, bloated ego - I love her candidness, wouldn't you? - RG). But that's fine with me. The point is one can still start a practice in Iloilo City and be successful and rich."

     "Here's another pathway," she continues. "One of my peers got married to an 'overseas' guy. She opened a clinic/office and didn't really care if the business is slow at the onset. Anyway, she got some overseas' financial support. However, with a little patience and luck, words that 'she's really good' spread like wildfire, and the result? Success story."

     "It did not work for everyone, unfortunately. Some of my peers who are 'native' of Iloilo City practiced in the city for 2 or so years but were not lucky enough and had to relocate to Mindanao where the pasture is supposedly greener. It's tough to be uprooted from your home city. But that's life. You can't win 'em all. Iloilo City is a small city. Everyone knows each other (including each other's secrets)."

     Our letter-writer just keeps on rolling, "You may have noticed the game of monopoly being played by some senior attending consultants, i.e. being the ONLY specialist in the city in a particular field of medicine. When I was an Intern at Iloilo Doctor's Hospital, I knew of a smart senior resident in surgery who just finished his fellowship training in neurosurgery at UST. He wanted to practice in Iloilo City. I thought then that it was a good idea. This would break the monopoly game. The next thing I heard was he and his beautiful wife went to Mindanao. Years later, I heard that he became very successful there. Looking back, perhaps it was a very good idea after all, that he obeyed the wishes of the gods."

     Our letter-writer made good on what she told her interviewers and fulfilled her parents' wishes. She is currently living comfortably in the United States and says, 'she has no regrets'. She ends her letter with this message to the young doctors aspiring to start a successful practice in Iloilo City - "Good luck! Give it a try. Hey, you'll never know!"

     Well, what I can say. I just hope that our letter-writer maintains her internet connection so we can have more of her insightful and frank comments. She speaks from a slightly different era than I, so what's more of a cross-section of opinion could you ask for than that?

     A lot of you can easily relate to what our letter-writer said. Success doesn't come in a silver platter. More than that, there are varying degrees of success. Whatever amount of success you have now is a product of your own sacrifices. How I wish you'd tell me your own story, too. You won't find a better forum than this corner. A forum to reminisce and be reminded of our younger years. You won't get a full appreciation of your success now, unless you learn to look back at your failures (if ever you had one).

     I know a lot of friends who have difficulties during the first few years of their practices in the city. I'd like to think this is the rule rather than the exception. But through perseverance, referrals, and word of mouth, they have come through.

     I may never get to know the name of our letter-writer and her class but I know she speaks straight from the heart. You may disagree with the points she made and her experience may be altogether different from yours.

     But unless you write me, nobody would know.

University Medical Center

     It's official. The University Hospital is now known as the West Visayas State University Medical Center (WVSUMC). Dr. Joselito 'Bebong' Villaruz (1991) confirmed this in an e-mail recently. Due to the increase in the number of beds, the hospital met the criteria of a Medical Center with the approval of the University Board of Regents. Thank you for the information, sir. Looking forward to your stay here in May. Have a safe and happy trip.

Comments regarding this week's column are welcome. Please fill up the fields below and click Send to Author. Suggestions for future column topics are also encouraged.

     The author's e-mail address is at drgarcia@wvsumedaa.com

     All views expressed on this column and any other by-lined articles on this site are the authors' own and do not necessarily reflect the views of the organization or its members. For comments, please e-mail the author.