Well, actually not a babble. This is my reflection paper after my two-week rotation in community medicine during my third year in med school. When the community medicine rotation is nearing its end, I thought to myself that it ought to be longer. The amount of learning and realization that one acquires as he or she goes through the rotation is huge, and just indispensable. What I like about community medicine, particularly the immersion in the community is the fact that it brings us closer to the people, allowing us to look at them closely and having the chance to recognize details and facts that we tend to overlook or just plainly do not see when we are in the hospital or in the university. It has the capacity to revive or magnify the human in us, medical students. It magnifies our innate ability to empathize and to relate to people, to understand them and where they are coming from.
In almost all of our other courses, we tend to have this sense of fulfillment once we are able to diagnose a certain condition that we see in the out-patient department. We get even more satisfied with ourselves once we know how to manage that certain condition. But here, I realized that fulfillment should not come from the ability to diagnose and the theoretical knowledge on how to manage a patient. What we should be asking ourselves once we get down to the diagnosis and management is this: does this patient have the capacity to go through the kind of work-up that I have in mind for him? That is the larger question. We may know from the heart the stepwise approach in the management of conditions, but the reality dictates that there is a high possibility that the patient may not be able to go through it, curtailed by numerous factors that do not allow him to do so.
The thing about community medicine is that it gives you the chance to see through the lens that would enable you to consider other factors in people’s lives that are silently shouting to your face during patient encounters in the hospital. It gives you the chance to understand patients more deeply and significantly. When we see through this lens, we are prevented from making judgments and accusations toward our patient when they come to the clinic too late, or when they do not take medications according to how they were instructed. There are just too many things that are happening on the sidelines that we do not see, or refuse to see when we encounter patients in the clinics. And I am hoping that what we realized and saw during this rotation stay with us for much longer, because they enable us to be more human. The moment I entered medical school, the thing that I was afraid of is the power of dehumanization and desensitization. Through repeated exposures to the dire conditions of people in the hospital, I was afraid that everything will become all-too-common and familiar that they will eventually just cease to affect me as they should. I was afraid that the sheer size and magnitude of hardships and suffering of patients will numb me down just to be able to continue on. And I am really thankful that we have these kinds of reminders, constantly pulling us back as we dangerously stand on the precipice of insensitivity.
Community medicine also hints you that there are just too many things out there that we haven’t seen yet, that in certain parts of the country, people are suffering from other forms of suffering that we are not yet acquainted to. This way, it indirectly urges us to take bigger leaps in striving to become people that may be able to affect change. It urges us to not box ourselves in just becoming medical doctors, but people who would really bring about change. We are exposed to the many realities of the world so we would know them, and so we should be encouraged to do something about them. And it will not be easy. But the first step is the acknowledgement of their existence and then the knowledge that we have this potential to change them if we have the right and enough will and commitment.
During the rotation, when we are in the community, we are faced with numerous obstacles which made our endeavor more difficult. Community profiling and organizing is not easy, and the theoretical knowledge of it that we were taught in the classroom would not be enough to make us realize the kind of challenge that awaits us when we are out there in the field. The mere act of gathering people to make them listen to what you have to say takes effort; the simple act of interviewing carries with it the possibility of being rejected and ignored. These are things that we learn when we are already doing things. But I would also say that everything was worth it. I am happy with just the fact that we were able to experience what we have experienced in the community, and that we were able to go through the things that we have gone through.
I am just hoping though that things should not end when we left, and that there will be continuity of what we have done. The bulk of our efforts were put into profiling the senior citizens of our assigned barangay, and since we were able to identify problems in the course of our profiling, I hope continuity ensues so we should be able to have greater impact in the community. What we did is just the beginning, and there is still a lot to be done.
I am really thankful that this rotation gave us the opportunity to learn and realize a lot of things, because after all, experience is the greatest educator.
