No where to go but up!

in Blog Rounds/Medicine/Opportunities/Training by

(I wrote this article while savoring the brutality of starting a practice and endless whining of a slow start.)

My struggle has always been between filling up my empty stomach or satisfying my impoverished brain. To the millions of hungry Filipinos like me, this our “class struggle”-an unarmed, non-violent but similarly aggressive perspective of seeing past our choices of everyday life.

To a proletarian who have gone to the bottom lowest of the pits, the best assurance one can get whenever you start a career or something is an old adage that says “you can go nowhere but up” or something to that effect. Like a messianic prophecy, I fanatically held on to this belief since high school days . The capitalist notion of incentive-driven success vis a vis hard work is as ironic as it is baffling to everyone in this “stomach” struggle. Yet, I survived half of my lifetime living in such altruistic ironies that neither my myopic deconstruction of choices nor the risky jumps I made could explain the extraordinary luck I had ending up being a physician.

The dream of donning a white blazer and treating a patient is as fascinating as it is exciting. I am so entwined with that dream I forgot I have neither the financial capabilities nor the intellectual giftedness needed to attain such lofty dreams. I went into this profession simply because I wanted to prove to myself (and to my less encouraging social caste) what everyone in my bunghole has failed to do before me- don the white blazer with the least expense I can- financially and intellectually that is. Everyone think it was suicide in the making. I thought I have nothing to loose. I don’t have anything to loose anyway.


That dream however grew into a vision, thanks to my alma mater. I practically crawled and bled to finish top of the line education for a career not everyone in my caste will experience- not even in their dreams. Fifteen years of Hippocratic studying did wizen my outlook about this noble profession. But it also shattered some idyllic notions I once have about doctors’ blissful life. More importantly, it brought my bourgeois upbringing to its knees and gave me the awakening of my comfortable life. My mission is never confined to the personal and financial self gratification kind of success. Because if it is that myopic, I could have never gotten this far.

I have all the necessary ingredients for a successful medical practice. Ingredients that when “cooked” rightfully, would lead me into the much coveted goal in life that is termed success. Such “ingredients” are big words indeed, taught in bold letters, eaten in gastronomic amounts and digested in herculean way. It’s funny after that word found its way into the neurons of my brain, I have been deluded of a blissful life outside the academe, akin to the Renaissance Man. Little did I know about the truth that lay ahead in real medical life that is called “the Practice


Starting an upstream professional career is never an easy thing for the not so typical surgeon wannabe like me. I neither possess the inherited practice most other surgeons nor the coffers to buy a new one. Most people believe though, that having trained in one of the best medical schools in the country prepared me for one of the most formidable foe of the real life physician practice- an empty stomach.

Of course being out of the academe and starting your own practice has its exciting advantages. The thought of having to take control of one’s time and spend it according to what you want is exhilarating. I can spend more time with what I want most, or with my loved ones I neglected when I was still studying. Gone are the Sundays where you have to read and prepare for pre-ops instead of having to eat dinner with family. I see non emergency patients on a scheduled time I myself created. Most of all, I have time to take care of my body while taking care of patients as well. I can eat full meals in a day and exercise regularly to maintain a sound and fit body. It is ironic that while we take care of patients 24/7 in a hospital, I lost tract of my own health in the process.

I am into the practice of my profession for just barely two months, and it’s neither the blissful stride I once dreamed nor the catastrophic frustration I’m so afraid of before. Somewhere in between these extremes is the horrible spectrum of uncertainty where my minute practice existence resides. I wish my practice was as dramatic as the scenes in ER and Grey’s Anatomy or as wacky as unnerving as House’s one liner ass kicking. Nonetheless, the uncertainty gave me ample excuse to whine and be cynical about everything I get my hands on. Blame it on inexperience surgeon wannabe that is me. Everyone says that staring a career is shitty enough to make or break your soul. My soul has undergone so many breaks it neither can feel any shattering this practice has to offer nor enough time to recover form constant battery of changing lucks past choices.

I bet it’s easier to just look at it as the paradigms of opposites. The definitions of success (and failure) in ones’ professional practice defined by simplistic phrases like-great clinic practice, successful surgeries, acknowledged researches, magnanimous services to patients and yes, professional fees enough to buy what we need. In essence, the very opposite of such adjectives and superlatives defines failure . Of course almost everyone believes that such simple dichotomous definitions don’t exist in reality. The theory of relativity seems to apply even in the psychology of success.

So it seems. But that, I have yet to uncover.

(Photo credits: All photos were taken from Deviant ART, my favorite repository of artistic shots.)

Dr. Remo-tito Aguilar co-founded #HealthXPh. A board certified orthopedic surgeon, he is previously Chief of Clinics at St. Louis Hospital in Tacurong City and a consultant in Orthopedics at the Southern Philippines Medical Center in Davao City. Dr. Aguilar is a healthcare social media evangelist and writes his medical musings at The Cast & Curious (www.remomd.com).

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