Joey M.D.

Throughout my medical education, I had people who were my teachers, and there were people who tormented me. When the subject of Mentor-Tormentor came up, there was only one person I can think of. One person I would be eternally grateful to, because I believe it was under him that I learned the most and became the ophthalmologist that I would like myself to be. Even if training under him was very difficult.

To quote an old Chinese saying: “A teacher for a day is a father for life.” It just happened that my father is a strict one, but he is still a father to me, and I would forever be grateful for the lessons I’ve learned. And I would continue to think the world of him.

I went into my fellowship training with a lot of trepidation. My main preceptor would be a man who’s one of the most famous in his field, and one of the best. But he is feared by his junior consultants, fellows, residents and nurses.

When he’s operating, his OR has to be dark, the only light being the one from the operating microscope and the OR lights on the instrument tray handled by the scrub nurse. The background music has to be classical music. There has to be a certain way the hood is placed on the patient and the (specially made) pillows are arranged. His first (or only, if there’s only one) assistant should already anticipate what instrument to give him at the precise moment of that step. (That’s ok if it’s a routine surgery, but if there are some difficulties in the surgery, it’s sometimes not easy to anticipate what he would want to do — you gotta try to think like him!) His second (or still the only assist, if there’s only one), should irrigate the eye at regular intervals to keep the cornea from drying but should time the wetting well.

I remember an instance when the instrument nurse dropped one of his (tiny and very expensive) scissors with a loud clatter. The nurse promptly said that the culprit was the resident, who can’t even make any statement in his defense he was already subjected to that famous, angry glare and to the demand that he replace the now destroyed instrument. #@$% nurse! Poor resident! He had to cough up the money to buy the mentor a new pair of scissors of the same expensive brand and make. At that time, his measly resident’s allowance didn’t even cover for the cost of the scissors that he was not responsible for destroying. His only consolation is that the (broken) scissors were given to him and he was able to have it repaired eventually. Disclaimer: I was not the aforementioned resident, but someone close to me is.

Clinic time is also a source of a lot of stress for his nurses and especially his fellows. He usually uses 2-3 examination areas, so the nurses already position the patient at the slit lamp (with the correct height) with the required examination instruments, even before he comes into that area. Some of the nurses then proceed to prepare the next patient in the other areas.

When he’s in an examining area with the patient, the fellow has to report his history, PE, impression and suggestions for management. I usually do that while quaking in my shoes because a slight error would mean a dressing down (figuratively, that is) in front of the patient. And of course, as much as possible, the fellow should have seen all the patients already so that he can already report the findings. Now, if the patient comes in at just the right time (when the doctor and his fellow are in the OR), it’s virtually impossible for the fellow to see those patients beforehand, right? So the patient has to come in earlier. But the nurses would not do that, kasi naawa sila sa pasyente (they would pity the patient) who would be subject to long waiting hours. Truthfully, I could not blame them, because I feel the same way. So, guess who suffers a tongue lashing when none of the patients gets a preliminary examination by the fellow?

I also wish that I could just tell patients not to ask ME anything, and to just reserve their questions for him. Because I could never predict what will happen next. There was this time, when the daughter of a patient who had just been operated on for cataract (the day before) asked me why her mom’s vision was not 20/20 yet. Since she seemed a little agitated, I explained to her that it’s perfectly normal since her mom just get operated on the day before, here eyes have a little bit of post op inflammation (maga in Tagalog). Give it time to heal fully and it will be better soon, just be patient. I thought I had calmed them enough. Later, when my boss examined her, he proclaimed: “You’re doing very well.” That should have been the end of it, but the daughter suddenly said: “But she (pointing to me) said na may konting maga pa (there’s still a little bit of inflammation!”) I got banned from the OR for about a month because of that remark because he thought that I was criticizing him behind his back with his patient.

My boss is also a workaholic who starts work even before 7am until his last patient leaves, so sometimes that means as late as 10pm. Fellows (as well as his other support staff) have to wait until he’s done before we can ask him if it’s ok to leave. I am glad that I was still unmarried at that time because I would not have been able to keep the hours I did if I already were a mother at that time.

But being trained by one of the top honchos in the field has its lasting, positive effect on me. It’s like this. If you were to learn something for life, it’s best when you learn it from the best in the field. He is truly a very good doctor.

I learned to think like him, or at least I am able to predict how he would think in a certain situation. In my practice, whenever I am faced with a particularly difficult case, I would think: “What would Dr. ____ do in such a case?”

I learned techniques in surgery through observing how he does it. Maybe I still need a lot more years of practice to be as good as he is, but at least I have a good head start.

I was able to follow up patients who have been with him for a long time. I do not have enough experience to see a patient that is 10 years post surgery, but through his clinic, I was able to see what happens after such a period of time has passed.

I was able to learn the techniques of doing exams the right way by a person who has been doing it for a long time.

I was able to do significant research because he allowed me to dig through his database of case files. I do not like doing research but I discovered that I am actually quite good in it, if I put my mind to it.

Because we had a weekly journal conference and we spend time discussing and critiquing journals, I was able to do critical analysis of journal articles. I learned that you do not take every research printed with a grain of salt but you have to analyze everything first.

I learned to go back to the basics. I learned which books I need to refer to whenever I need to look something up. Not just any book or any website, but the authoritative books with credible and respected authors and editors.

I learned that it’s best to leave the money talks with the secretary (and to have a very reliable and trustworthy secretary). Patients often want to ask doctors about the fees for a particular procedure, and would try to haggle. We truly do not have the time to do that if we want to see a lot of patients, so it’s best to leave the bargaining and haggling to the secretary. That’s part of her duties.

I learned how important it is for patients to respect you. It does not matter if the patient will balk at the cost of a your fees, if he truly believes that you are good, he will still see you.

I learned that you should always do the best for your patient. You should always tell your patient what you think is the best option for him and do your best. But even with the best setting, the best equipment, the best conditions and the best person to do it, the result may not be as perfect as we want it to be.

Unwittingly, I learned that I do not want to put all my time into work. Maybe because I’m female and a mother? But I learned that although I love my work, I love my family more and would rather spend some of my time with them.

There are a lot more valuable lessons that I learned throughout my training. At the end of it, it felt as if I had passed through some kind of initiation. I feel some measure of pride for having entered and survived…and emerging better because of it.

I realize that I didn’t really describe him to be too scary. It’s because deep in my heart, I know that he is not the fearsome person that a lot of people think he is. He is misunderstood by a lot of people. Perhaps because the way he talks, the way he acts, the way he reacts — it’s really prone to be misunderstood. But I know that he is a good mentor despite of it, and I will always try to understand his point of view, even if sometimes it’s hard to. And even if sometimes people think it’s crazy for me to be always trying to understand him.