Tuesday, August 17, 2010

The Sign

I wondered if she was "A Sign"...


This morning I was at the hospital I did my internship at to "collect" recommendation letters. It was late in the morning, and the doctors were deep into their clinic work. Since the attending I wanted to see still had a patient, I told the secretary that I was going to wait outside in the hallway (he had a full waiting room). 

I spied a quiet corner near the stairwell, so I leaned on the wall there, browsing through a book I had brought along to kill time with. 

A few minutes later, one of the attendings/consultants from my internship year called out to me. He had just come out of his clinic and probably noticed me ('cause I was loitering?) leaning on the wall, just flipping through the pocket text.

"Hey Michiko," he went, "What are you up to,  these days?"

I looked up from my book, and grinned. I told him the gist of what I was doing, and that I was interested in doing either Psychiatry or Neurology. He was the only one in the hospital who called me Michiko, perhaps either it was because my last name sounds Japanese, or that he totally thought that my name really was Michiko...either way, I didn't have the heart to correct him then. Well anyway, he wished me well, and was off to do rounds at the main building.

Presently, an elderly (OR slightly more middle-aged) lady came up to me, and said, "Are you really doing Psychiatry, Doc?" I replied, "I'm applying for it, Ma'am...but how it all fares, still remains to be seen." Her reply: "You'll be dealing with crazy * people, right? Right now, I am totally discouraging you..."

( * N.B. She used the dialect word buang to refer to people who were mentally ill.)

She was one of the secretaries there at the building. The surgeon she served under was still at the OR, and as such, there were no patients in her clinic. She was just coming out of the clinic when the attending (who called me Michiko)  talked to me. She probably overheard our conversation. 

She invited me to step inside so it would be cooler and more comfortable while waiting. Besides, the clinic was just parallel to the clinic of the consultant I wanted to see. I could easily see him if he comes out and not miss him.

She sat down at her secretary's table and started telling me about how she had once been a secretary to a psychiatrist who had practiced in that hospital. "Do you know Dr. So and So?" she asked. I didn't. So she went on to tell me that Psychiatry was going to be a bad idea because once people heard the word Psychiatrist, they immediately associated it with the "CRAZY". "Why, when Dr. XY ( a prominent obstetrician) referred patients to her, they wouldn't go to the clinic because they were afraid of being called buang." she said. "That's why, as early as now, I would suggest that you change your mind, and pick a different specialty, like IM (Internal Medicine) or OB-GYN..." she declared, matter-of-factly.

She was an older woman, with her hair cut short, in a pageboy dyed black brown.  She had a ready smile, and an air that bespoke of years and years as a secretary, having seen different tides and times in the hospital. She was in pink scrubs, with low-heeled leather sandals. When she talked, she had a way of speaking that, if it weren't in such a light, and amusing tone, would bring to mind something cautionary.

The doctor she worked for was a friend of hers, she said, and oftentimes (according to her), she would chide her boss that maybe it was wrong to take up psychiatry in the first place. Apparently, the doctor had to concede that maybe she WAS indeed in the wrong profession. Times were hard, according to her, and sometimes they'd go well into the night during consults. And they didn't charge much, she said, they made only Php 150 per consult, and that the biggest they had from a patient who gave 2500 a month. There were others too who didn't pay. They just gave cake (or a chicken. literally.). 

( She really was funny.)

She lamented about how her doctor was the only consultant in the hospital who still took the pedicab to go around the city, when all her other contemporaries were driving flashy cars. She really didn't make that much, she said. There was no money to be had in Psychiatry.

And so, this doctor moved to the States, where she had a thriving practice. Actually, the secretary told me other stuff, gossipy stuff, about that doctor. I pretty much dismissed that as irrelevant, but considered that she and I were nothing alike... and I therefore considered that maybe I wasn't going to be in the same situation she was going to be in, if ever I DID end up in Psychiatry.

From a secretary's perspective, she told me of "misadventures" of certain patients.  Since there was no official psych ward at the hospital I did my internship at, they admitted Psych patients into the top floor. One time, she said, there was this patient at the top floor, who spied someone building a fire (to burn leaves and stuff), she immediately got on the horn and called the fire department. And so, the fire fighters come rushing to the hospital, the alarm was sounded, which threw the whole hospital into a frenzy. 

It was a false alarm, of course. And, the patient was eventually discharged.

(I couldn't help but laugh aloud at this one inspite of myself. She was such an amusing storyteller.)

There was also a patient who, would come down from the top floor to flirt with the  attendings and the interns. She had been taking all sorts of psychotropic medications, had the side effect of lactation. She'd declare that she was pregnant (in English, too) and would go up to the males that she'd see and openly propose marriage.  

The secretary told me about the time when she had to chase around an agitated (or manic, who knows, she thinks they're all "crazy", anyway) patient who wasn't given a tranquilizing "cocktail"...

She had other stories, but it was cut short because the other doctor's secretary had told me that I could see that doctor now. I thanked her, and told her that I'd think about what she'd said to me.

For all it's worth,what she said got me thinking, which is why, at this hour, I'm taking time to write this one blog entry out.It's true, Psychiatrists don't make as much money as the surgeons, but it's a different story now (they earn a little bit more :-p), and if the Php 150.00 consultation fee was true in the late eighties, it surely wasn't the same case now.

Yet I believe it's not just about money...and, so far, from what I've gleaned, that psychiatrist she was telling me about was the only one who had second thoughts, because most of the mentors I've had from Medical School who were psychiatrists pretty much enjoyed their jobs, enough to say, "I love Psychiatry", so i don't think I can count this one doctor's experience as significantly valid.

:-) Although I was amused by the secretary's willingness to share, and maybe give me good advice, it was a bit of a, well, a turn-off to listen to her talk about clinic stuff and her boss' personal life to a perfect stranger (me.). She didn't really give details, but still, it was pretty personal, and if I had a secretary in the future, it'd be helpful if she had occasional Broca's aphasia. 


Was she a "sign", though? I mean, it's pretty uncanny to have someone just come to you and just say her piece like that. I mean, what are the chances of me being there, applying for psychiatry, and she being an experienced secretary of a lady psychiatrist, coming up to me to "warn" me. How often are things are coincidental as that?

Still, a secretary's perspective is not the same as the perspective of the psychiatrist in question. This secretary will always have her biases, I suppose.


I'm still scared of the unknown. 

Adventure coming up in a few days. I'll keep you posted. 

Ok, back to work for me. 




  1. Maybe you could track down the former boss and ask if she would make the same choice now.

  2. I guess it all boils down to what you really want to do. True that psychiatry is not a lucrative practice in the provinces, but some people still sure need your help still.

    I still am not comfortable with people giving unsolicited advice, especially from someone you barely know. but I guess that's just me. oh well.

    One thing that I always ask myself is, "Will I be happy doing this?" Another is, "will I be happy doing something that not many people close to me are happy about?" Then it's all priorities! :-)

    You can't live your life the way someone tells you to live it, you live your life how you want. :-)

  3. Haha, uhm, tep, before your week ends you will see and meet lots and lots of more "signs." There is no right or wrong choice, coz you won't know what it'll be like should you take the other direction at that fork in the proverbial career road.

    But it's simple. Really.

    What do you like (key word)?

    Do you think you can live a content (key word) and happy (key word) life with that choice?

    Are the Piston gonna beat the Lakers for the NBA Championship?

    Don't overthink it.

    Like one of the greatest slogans of our generation:


  4. nay it wasnt for me. just a bump in the road. steffy i just dont think you'll end up like his former boss. as youve said times have changed and you and her boss are two different entities and ages apart. im fascinated with psychiatry, its just so amazing how varied our human brains can get when they are cells fired up with dopamine, serotonin (and all the long list of neurotransmitters)... like how i was entertained with the idea that love is all about chemicals. how these chemicals produced charles manson, adolf hitler.. these famous psychotic people. and this is the only field exclusive for humans. we dont study how dogs can become manic or narcissistic or borderline.. do we? whhahaha. perhaps in the next millenia..

  5. bzzzzt, pwede ako na lang muna ang pasyente mo bago ka maghanap ng ibang "signs?" seriously.



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