August 1, 2002

     A hero doesn't always come in a red cape, or a nerd in a spider suit, or an anatomically perfect female specimen with a whip.

     A hero doesn't always come as a physically-gifted athlete with immense talent (basketball's Michael Jordan or Kobe Bryant), or a physically-gifted athlete with absolutely no talent (tennis's Anna Kournikova).

     And just because Enrique Iglesias sings to you, "I can be your hero, baby...", you shriek and scream back, "You're my hero, Enreequeeee...!"

     In fact, the real heroes are ordinary people you meet everyday - your teacher, a neighbor, or your favorite surgical consultant, who has hypnotized you with his skills, you were made to believe he is able to perform surgery blindfolded, wearing an oven mitt while climbing Mt. Everest at the same time.

     You, you can be a hero, too. To your little boy or girl who thinks you are a genius just because you can answer all the questions on 'Game Ka Na Ba?'. Of course, you don't tell them the truth that the questions are so easy, you only need to finish Grade 4 to answer them.

     In my book (that's just a figure of speech, don't e-mail me that you could not find it at Amazon.com), heroes are those who do things most people are capable of doing but chose not to. Heroes are those who sacrifice personal glory for the greater good. Heroes are those who disregard monetary compensation to perform a personal commitment with one thing in mind - "if I won't do this, who will?"

"The position of Dean in the College of Medicine continues to suffer the stigma of being a 'position of sacrifice', a 'very difficult' if not an 'unattractive position'."

     I am probably creating a lot of heroes with that definition, but so what? If there are a million heroes out there, so be it. If somebody changed your tire today because you are too 'clean' to touch something that your dog probably 'peed' on, then, by all means, you may call that somebody a hero. I don't think that's undermining other people's heroic deeds like getting assassinated in an airport tarmac, or donating a kidney.

     I read Dr. Noel Binayas's (Class '79) article and Dr. Victoria Villareal's acceptance speech and I am proud to add two new heroes to my list.

     I very well remember Dr. Pearl Palacios-Pedroso having graduated just a year ahead of her class. She who chose to do the things that most doctors could do but chose not to. She who ignored the people who probably felt sorry for her when she decided to stay in a medically-underserved community as a rural physician instead of an air-conditioned clinic.

     Then again, why should we feel sorry for her in the first place? If indeed there is a reason to feel sorry, it is because no matter how Dr. Palacios-Pedroso sets herself up as an example, she will eventually find out that few will follow her lead. In an on-going study as mentioned in Dr. Binayas's article, only 5% of WVSU College of Medicine graduates from 1979 to 1998 pursued "alternative" routes of medical practice, such as community medicine and research. Feel sorry for her because she will probably never see that number change.

     I admire her commitment and her conviction. To come to a conclusion that she is here to answer a need "and this need is best answered if they ventured out into the community" is admirable. Few parents would have tolerated that. Consider what happened to four of her friends who were very much willing to go with her but they did not come up with a signed parents' consent. You just wonder what were those parents thinking. You probably heard the same thing from your parents. And by the way, since when did we require parents' consents for 25-year-olds?

     I remember Dr. Palacios-Pedroso always has a ready smile for everyone. She probably has one of the 'cheapest' smiles and I mean that in a very good way. I said that because I have this classmate who never smiled (at least for the 4 years that we've seen her), and there was nothing wrong with her facial muscles, we called her "the lady with a million-dollar smile". This simply shows Dr. Palacios-Pedroso's love and affection for people. "I want their lives in their hands as much as they are in mine," she told Dr. Binayas. "In my profession, I don’t always have that choice. So I would like to work towards having less of that situation and having more options where the people’s health is in their hands."

     The new College of Medicine Dean, Dr. Victoria Villareal, refused the position at first, but the overwhelming support of the College of Medicine community prevailed upon her. According to a position paper released by the Alumni Association 2 years ago, "the position of Dean in the College of Medicine continues to suffer the stigma of being a 'position of sacrifice', a 'very difficult' if not an 'unattractive position'." Many doctors with successful private practices who may be qualified to be Dean, look at it as if it's a dead rat or something that's covered in leeches.

     That is why choosing a Dean for the College of Medicine was never easy. You and I know our turbulent history. The end of a Dean's term and the start of another were always recipes for trouble. Bitterness, animosities and the disruption of stability in our academic atmosphere everytime there's a change in the Dean's office were normal occurrences. They were always considered threats to the continued well-being of the College of Medicine. To see the College survive after all the trouble is a testament to how far our mentors will go to save our revered institution.

     The root of the trouble is easy to explain - the people who are interested (usually supported by the administration) are not qualified while the people who are qualified are not interested (or the qualifications being ignored by the administration). The administration's choice usually wins in the end (no competition?). Naturally, the faculty and students resist. What happens next is as predictable as Dr. Marte's jokes.

     The faculty sees the qualification of a candidate should be at the top of its list for Deanship, and rightly so. We are talking about the College of Medicine here, not the Philippine Senate. Does the University's administration (and the Board of Regents) care about qualifications? Your guess is as good as mine.

     I was invited to an Alumni Association's meeting in September, 2000 in the heat of the discussion on who will be the next Dean. Then-Dean Dr. Myrna Abello's term was about to expire. (Dr. Abello, by the way, is already in my "Hall of Fame". She never practiced Medicine to be an educator and to make sure the College of Medicine stayed afloat. She ate lunch, probably dinner too, at her Roxas Hall office. I can attest to this. I visited her once at her office and she had Jollibee Chicken Joy.) The University's bet, of course, was somebody the faculty and Alumni Association did not like. So they asked for a temporary extension of Dr. Abello's term while a search for a worthy candidate is going on. Needless to say, the faculty's bet refused the post. The Alumni Association was concerned about 2 things - (1) any "controversy" that arises everytime a new Dean in the College of Medicine is selected, and (2) over the perception that Deanship in the College of Medicine is "unattractive". The website got a copy of the Alumni Association's position paper at that time. I have no idea what happened after that.

     It was not a surprise that Dr. Villareal refused the position at first. She has an excellent practice. Being a Dean would mean she'll probably lose half of it. At the urging of the faculty who as she said, "put the dare to me as no one and nothing ever had before", Dr. Villareal finally accepted the post and "with firm resolve, wholeheartedly accepted the responsibility of Dean."

     You don't need half your brain to realize that this is an ultimate sacrifice. Being a Dean is a thankless job that pays peanuts. But it's not the pay, it's not the prestige, Dr. Villareal has enough of that. She "loves the College" and for the next few years we know that the College of Medicine is in good hands. The College of Medicine will survive.

     We hope that by the time Dr. Villareal's term ends, another hero comes along. With the strength to carry on. And you cast your fears aside. And you know you can survive...

     With apologies to Mariah Carey.

Re: PBL - Path to Better Learning?

     From Dr. Dan Garganera, 1994 - "I have experienced PBL first hand years ago and I think it is great. However, it needs a firm foundation of direct, didactic teaching (and reading) before any intelligent case discussions can be undertaken. I have witnessed how they teach Med students in Rush and Loyola in Chicago, and a huge chunk of the teaching is similar to PBL, partly in high tech fashion (Powerpoint, computer graphics). But still, much time is spent on the textbook, lectures, cadavers and journal articles related to the topic. Then, direct hands-on patient care by third year. I think PBL should continue without neglect to teaching. And whip their asses that they should still do that reading to the wee hours of the morning as we all did in the past (at least I did). Trying out your medical knowledge and skill on theoretical cases can save many lives and lawsuits in the future. "

     From Dr. Art del Rosario, 1980 - "I have my personal reservation and concern about PBL which I expressed to Dr. Noel Binayas. I was under the impression that the "old" system worked just fine. So why mess it up and introduce a "radical" change? (Or maybe, it is not "radical" at all). All along the way I learned medicine and managed patients was problem based (or I thought it was). On reading Dr. Villareal's speech, she asked for a "cease fire". Dr. Victoria Villareal is one of our excellent mentors in Pediatrics (Of course, I do remember Drs. Casenas, Posecion, and Carmona as my excellent mentors during my time). I knew her as a low profile and humble person. Shy and quiet. But, "silent rivers run deep"!. She's one mentor who speaks english very, very well. As a gesture of great respect for her wisdom, let's all observe the "ceasefire". Let's all give her our wholehearted support. Let's give "PBL" a chance."

     From a reader - "The PBL has just been recently introduced into some of the medical schools in the Philippines, perhaps one of the ways to assess whether it is effective or not would be after the first batch of medical students who took medicine based on PBL would pass the medical board exams which, sad to say, is still based on the usual type of questions best learned from didactics and what you called as Plain Boring Lectures. Until then, I will stick to the way I was taught on how to become a doctor. "

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

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