REFLECTIONS
REFLECTIONS : INNOCENTS ABROAD AUTHOR Teresita Bacani-Oropilla , MD
During the past 65 years , the science , teaching and practice of medicine has progressed so much that one would surmise it ’ s the Middle Ages being referenced , not the lessons of our youth . We however , the fortunate remnants of that era , can summon our reminiscences and long-held memories with a familiar picture , a tune , a review of a report or attending a conference on Zoom .
In those days , circa 1955 , medical graduates from most of the then modern world could apply for medical residencies in the US . Armed with their diplomas and whatever medical expertise they had , they fanned out across the country to medical school affiliated institutions to work and learn the “ latest .”
Although very eager and willing , this cultural sea change was disconcerting to new arrivals . Devoid of the knowledge of the “ do it yourself ” culture in the US vs . the “ be guided by your superiors ” ethic where they ’ d come from , they were taken aback by the “ everyone is equal ” stance . You could call your attending by their first name without their title and similarly , refer to much older persons and superiors without an honorific such as Uncle , Aunt , Sir or Ma ’ am .
26 LOUISVILLE MEDICINE
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A young “ princeling ” from India , proudly sent off by his father ’ s thousand or so village workers , arrived at a US children ’ s hospital and asks the desk person to please call the bellboy to bring his luggage and direct him to his room . Surprise !! There is no such person ! He is given a room number and a key .
Two young women , newly graduated MDs from the Philippines , jet lagged , are assigned to a room to share in the nursing dormitory and told they are “ on call ” the next day . What is this “ CALL ?” Where ? To whom to report ? What uniforms ? Where to eat ?
The new arrivals eventually meet a hodge-podge of residents from China , Korea , the Middle East , England and Mexico , in different stages of training and in different fields of medicine . There are fellows in neurosurgery , general surgery , pediatric infections and oncology and there are rotating interns assigned for two or three months at a time in different specialties . Eventually the newbies master the order of the day - and the call nights too .
When on call , you are lucky to get a second-year resident who helps , instead of saying “ Figure it out yourself .” You have to do your own labs . Emergency ( ER ) calls last for one month at a time , 12 hours of either day or night . Count on seeing the day only if on night call , and the night only if on day call .
Meal tickets are free : four slots per day , three for meals and one extra for midnight if on call . Pay is $ 60 per month . Lodging is free , assigned and underlies the origin of the term “ housestaff .”
Find your own books to read in the library . There were no cell phones then to guide you . Present your patients every morning at attending rounds / Morning Report . Fridays mean Grand Rounds in the newly built amphitheater in the basement ( this later became security guard quarters ).
Want help with interpreting X-rays ? A very knowledgeable professor of radiology was willing , able and thorough with instruction in the X-ray department . MRIs are still in the future .
Consider , one stormy night , a somewhat new rotating intern , assigned to obstetrics call , delivered four babies in a row while more pregnant women were being rolled in . She calls the formidable Chief of Nursing ( a no-no in those days ) to have someone tag the babies before they got mixed up . Amid the thunderstorm , the intern delivered 11 babies in 12 hours . She survived and so did the mothers and babies . Those were the days the interns had to be very attentive on their first call ! It was a “ See one , do one , teach one ” time !
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All this happened 60 years ago . Those hodge-podge residents , thrust into all kinds of acute and chronic conditions , learned enough to go back to their respective countries to impart or practice the new knowledge and techniques they had acquired . Some stayed to practice in the US .
In this electronic age , progress in medicine has grown by leaps and bounds . Looking back , as I was one of those residents , we did our best with what tools we had .
Isn ’ t that what we raise our right hands for and pledged our oath as physicians ?
“ I solemnly pledge to dedicate my life to the service of Humanity .”
Carry on , younger colleagues ! The future is yours . Dr . Bacani-Oropilla is a retired pediatrician and child psychiatrist .