YL5 Week 4 @ASMPH: The Week of 3 Exams + Prudent Prognosis

 The 4th Week of 3 Exams (Prudent Prognosis)

Late posting this week but for good reason. We had a week of exams on the cell module. Again, it likely isn't any different from any other medical school though I'm not sure if the 4th week having 3 exams (2 of which were split into two exams) is standard. By the way, did you know that 4th type of Ehlers Danlos-syndrome is a mistake in type 3 collagen? Well now you know.  Either way, it was a turning point for me in terms of thinking about priorities. I'm the kind of person who really only studies when he enjoys studying. Studying medicine is like a full time job, it is true. So I always try to work on motivation and long term learning rather than grades. Though I am grade conscious insofar as it is a kind of test on whether or not I am actually meeting the learning goals. There are so many things to learn and so little time. I don't think I'll have a separate spiritual reflection and will just weave it in this time.

Honestly, it seems kind of a blur writing this at this moment. This is probably why I shouldn't write on Sundays, where I take a non-negotiable break until 4 pm. But being there for a friend is more important than writing a blog post. Not that writing and reflecting is unimportant either. 

Nevertheless, the MD/MBA life seem like segmented alter egos of myself. On the one hand, I was assigned to watch the Netflix movie the Founder for discussion at the Principle of Management class that runs all semester, watching with my TG and ended up ordering McDonalds (low key regretting it when we got to the middle part because plot). That was Monday. Then there was Thursday MBA me who had to write a paper on decision making process in an organization of my choice. I interviewed my best friend about his company. I submitted the paper a minute too close to the deadline so I had to email the paper because I was procrastinating watching to CGP grey videos. And that was that, we have another two things– a paper and reflection next week, and potentially a mid-term. But that's for next week's MBA me.

Then there was MD me, who had to juggle decisions between studying more in depth things that clearly aren't going to be tested but are very interesting that's also applicable to medicine or studying the "high yield" material to get good grades, trying to find out what the upper year groups said and trying to guess questions. Clearly there are pros and cons to be made and trying to find the "mean" between the two extremes. Going too much into stuff not tested will yield to failure and not being allowed to continue in the program. Then there's going too much into high yield which can be a road of chronic stress and second guessing if one has studied enough. This is the struggle of the MD and your preference for specialty or freedom clearly favors the latter– you can get in better specialties when you perform at the top of your class (especially surgery) and it won't be frowned upon if you pursue something not as competitive anyway. 

And yet it's not just about the virtue of the "mean" but a specific virtue, specifically prudence. In Catholic lingo, it involves the practical decision making between two good choices, finding the right one in the context that demands it. Here I think it applies. Two sub-decisions as well: spend your limited amount of time discerning if it's a good idea or just making a decision already and stick to it. The former takes time but with practice, one can make a prudent prognosis. Prognosis because it is really a "best guess" of the available decision that doesn't mean it's going to happen. Prognosis is also important in medicine, albeit less and less emphasized in favor of diagnosis. But we must retrieve prognosis, even in medical school, coming from a medical student. Because the future can definitely always change but it is important to make peace with one's decision and to take it as it is– a best guess. 

Only the Lord closer to us than we are to ourselves can see our hearts in its, without a distinction of the past me, present me or the future me. We are loved entirely and God, who is love itself (1 Jn 4:16). Yan ang tunay ng pag-ibig na ang talagang dapat na katotohanan ng aming buhay. To study medicine, if one is privileged to be called to this humble profession, is to love love by knowing love in the abstract via studies of collective evidence (science) and loving in nature through sacrifice as it pertains to the lived reality of those who take on the role of the one who suffers (patient). In essence, everyone suffers. To suffer is human. That is precisely why God, whose essence as love is by loving, so loved the world that He sent His only Son to become a human precisely to suffer with (com-passion) and for us– that whoever believes in Him may not perish, but have eternal life (John 3:16 paraphrased). 

Medicine is at the heart of suffering because it deals really with, even if implicitly, what sickness makes manifest– the finitude of our lives. This sickness unto death is truly the prethematic given fact of our lives. We are going to die at some point. There is no proper story without an end, and we only understand life hermeneutically– that is in stories that are interpreted over time and the interpretation influences our future interpretations and so on (the so called "hermeneutic circle"). 

Similarly, Jesus, the divine physician, does not heal us from death, but heals us so we can have a proper orientation to death. He makes us more human because God made Himself human for us, seeing what it is that ails us, which sometimes can be a form of physical ailments– the body and soul are inseparable after all: we are created body and soul– which is where we, as future doctors, can participate in Jesus' healing ministry from the beginning– growing "in wisdom and stature, and in favour with God and man" (Lk 2:52) in our own silent years before we begin our own public ministry of healing. From this, we can sew hope, as the end is also the beginning of eternal life– to know in its entirety just as we are known. "For now I know in part, then I shall know fully; even as I have been fully known" (1 Cor 13:12)

So one should prognosticate herself honestly. There is prognosis if things keep going the way it is and prognosis if one changes one thing (or many things). But do so in prudence and in prayer, and I think it will all be all okay in Love.