An Ordinary Journal

An Ordinary Journal

June 12, 2022

By Joaquin Arriola, UPCM Class of 2026

The following was originally posted on Facebook by Joaquin Arriola over the course of his first year of medical school, December 2021-June 2022. UPCM InSPIRE has been given permission to publish these.

Seatwork #1: Draw Your Future Self

Maybe one of the most important decisions we’d ever make is how we’d want to spend the rest of our lives. As a young adult, I find it frightening to simply entertain the idea. Luckily (or to my demise?), my 6-year-old self was confident and ambitious enough to answer for me.

It was 2006. I was still in Claret, class number 7 of my section, Prep-Maagap. Young, naive, and without an inkling of how the world worked, I decided, without a shadow of doubt, that I wanted to become a doctor.

It remains a mystery to me why I looked so sure of myself so early in life. What did I know of the fire and brimstone of the medical profession? Maybe it was that if I couldn’t shoot webs out of my wrists like my idol Spiderman, then the next best superheroes I could emulate would be my parents, clad in white coats, armed with stethoscopes. However, later on, Science would never become my strongest subject; I didn’t pass the Science High School admission exams nor make the cut for the INTARMED program. In college, my failed Bio exams, lack of higher Chem and Physics units, mocked my hopes of getting a good NMAT score.

Fifteen years since I made that drawing, I’ve somehow managed to survive my first 4 months in medical school. While I bet my 6-year-old self would be over the moon to see his drawing still on track to fulfill its prophecy, the question lingers.

How do we decide how we spend a journey that lasts a lifetime? I don’t know. I think that life is too unstable and unpredictable to map out a definite destination at the moment. But at the very least, all journeys have to start somewhere, and mine is no exception. “Always go back to your whys,” they say. Even then, I don’t have all my reasons fully laid out yet, and that’s okay.

We don’t have all the answers now, but perhaps the whole point of this journey is self-discovery and learning more and more about ourselves every day. And maybe as we go along, things will finally start to make sense.

First Exam, Failed

I waited my entire life for this – my first (virtual) step into the perilous path for the white coat. Eager, prideful, ambitious, I felt unstoppable. “The sky’s the limit for these next 5 months”…. or so I thought.

In just my first month into medical school, I failed my first exam (Biochemistry, of course). And before my first med school tear could even fall off my cheek, I was begrudgingly logging into my next class for the another set of lectures. With watery eyes, I took a shaky but determined breath as I rolled my sleeves up.

In my second month, I was helpless as we whisked through an entire dictionary of Latin words just to name skeletal muscles. One time, our lecturer called me on-the-spot to interpret MRI scans of the femur. Still mentally stuck on last week’s lecture, I wished the earth swallowed me whole then and there. But after a few hits and misses in my haphazard responses, I made it through. That night, I made the firm resolve to start waking up before dawn to carve extra hours into my study.

Three months in, I was dangerously calm. Our Head-and-Neck final exam was fast approaching and I wasn’t fully prepared, but I wasn’t fully afraid either. My laptop can attest to how much screen time I’ve devoted to reviewing. I knew my limits, and I was way beyond them already. If I fail, then I’ll sleep soundly knowing I fought until my last breath. Here, I learned to appreciate the value of the effort behind the outcome, more than the outcome itself.

Fourth and fifth. I learned from our neuroscience module that I knew nothing at all. Even as I share this story with you now, I’m still neck-deep in backlogs of brain lectures I’m excited to learn. “One day at a time,” ika nga. From this, I realized there’s beauty in accepting that I don’t know everything. For this is perhaps the admission through the gates of a plethora of knowledge and a lifetime of learning.

Med school hits you hard, and it hits you fast. Soon, I realized the most important thing for me this semester was not to get good grades. It was to develop a mindset that could endure “bad” ones.

After I failed my first Biochem exam, everyone in the batch submitted anonymous code names to go alongside our exam scores for all to see. When the list was released, beside my subpar score was the codename “Wax babawi next exam.” Not even a name. Hardly anonymous. It was a challenge.

By the grace of the stars above, I later passed the next 3 exams. Honestly, in the grander scheme of med school, this doesn’t mean much. But I celebrate the little victories as they come.

After all this, I still believe that sky’s the limit. So, tara, climb with me.

Lessons from Inside the Thorax

I thought it would take just 5 years to go through med school. I’m nearly through my freshman year, but why does it feel like I’ve aged 50?

Everything feels so cyclical. Every day is a new series of lectures we have to swallow. Every week, there’s a more sinister storm of small group discussions we have to brave. Every new module is a deeper, more treacherous ocean we have to cross. Is this the daily commute all med students take to arrive at that MD?

The most laborious travels of them all were, for me, pulmonology and cardiology. The experience was marred by grappling with arterial blood gases, cardiac electrophysiology, and hemodynamics, all inhaled in one go. I still have to run my fingers across my patient’s entire forearm to palpate the brachial pulse for a routine BP reading. I can’t auscultate the simplest heart sounds if I don’t first shut my eyes, furrow my eyebrows, and channel all the energy of the universe into the stethoscope. It frustrated me.

Madalas, nahihirapan ako. Nagagalit, nalulungkot, nawawalan ng gana, nagdadabog, sumasama ang loob, ginugustong sumigaw sa kawalan.

On days when my chest feels heaviest, I look back on one of our doctor’s parting words after her radiology lecture, “Will you understand all of this? Yes, but it will take time.” Other lecturers follow a similar tune, “Hang in there. This will all make sense when you go to the clinics.” My personal favorite: “Follow your heart. It will never fail you.”

My professors’ end-of-lecture wisdom guide me toward an attitude to stay unbowed in the face of adversity. In part, this means slowing down and seeing the bigger picture. There’s a reason it takes 5 years to go through medicine. As freshmen, still at the bottom rungs, we’re supposed to be works in progress. The clinical eyes and ears will follow; the patient skills are on their way. If right now, 1 year in school feels like 50, then we’ll proudly boast 250 years' worth of learning later on.

When I’m out of breath from the regular tolls of an online med school, these consoling words fill my lungs like a cool ocean breeze. From these, I learned to embrace faith and patience that, in the wake of tempests, calm seas emerge. A lot of things in life are unknown but there remain a few that are certain. For one, I believe in the certainty that the sun rises after every dark. And, with a faith of equal measure, I believe that my difficult days, too, shall pass.

To “inspire” means 2 separate things: (1) to motivate an action or belief, or (2) to breathe in air. But when slowing down, taking deep breaths is what pumps strength for us to keep moving forward, I learned that sometimes maybe to inspire means to do both at once.