LEADER DR. MA. LOURDES G. LAGUNILLA REFLECTION PAPER #3 What is your passion (what is it that you love doing? How is it reflected in you work, daily life, and life's journey.

LEADER DR. MA. LOURDES G. LAGUNILLA
REFLECTION PAPER #3
What is your passion (what is it that you love doing? How is it reflected in you work, daily life, and life's journey.
MY PASSION and ADVOCACY in Life : My life and love for children

As a child I was sickly. Coming from a family with history of allergy, I had asthma, allergic rhinitis and skin allergy. This conditions are recurrent hence my mother will always bring me to a pediatrician the late Dr. Ramon Lao. I can still remember my mother pays for the pink medicines in brown bottles which did not taste good, but I should take without choice. It was these several consultations when I dreamt to become a doctor. I should learn to treat myself and I know I will be the best doctor for myself because I can feel what it is to be patient in need of treatment . A dream I never thought will come true.
Given the chance to study with a GI Bill of rights scholarship I thought then I must enroll in the most expensive and highly coveted profession. That was my chance to become a doctor .
My interest in science, my passion for lifelong learning, and my need to incorporate benevolence within my profession is why it was a natural progression to combine two passions of mine, my affection for children and medicine, into my chosen specialty of Pediatrics. Working with children is often funny and challenging; you never know how they will react or what they will say. I learned that children thrive on attention and require a significant amount of patience while generously sharing their great capacity to love and zest for life. Children are innocent and they only tell the truth. These experiences generated my desire to pursue a vocation working with children.

Experiences throughout my clerkship have solidified my aspiration to become a pediatrician. One of my first shifts in the pediatric rotation was the Delivery room where I witness the birth of a premature baby, so fragile and helpless. Every baby born is a miracle, a blessing from GOD. The father is worried for the baby and the mother. It made me think me that I must learn to bring an environment in my practice where children can live in a nurturing world.

If I become a pediatrician, I must make a difference. There are times when children cannot voice their concerns or speak for themselves, and I will become their advocate. I will keep my focus on how my young patient's health or circumstances are going to affect him or her. I believe that working with the team and the parents is in the best interests of the child and is an important part of being a pediatrician. This was particularly evident in intensive care rounds during my pediatric neonatology. Every member of the team has an important role in the patient's care. I work together with a team to ensure proper nutrition, adequate cardiopulmonary care, proper dosing for the numerous drugs each patient required and adequate social support. Meeting the child's medical needs, while doing my best to give the child and parents a normal life, was a big challenge that could only be managed by working together. In pediatrics, the wide variety of age groups, interesting congenital syndromes and neonatal issues will provide me with unique challenges. From my previous experience, I know how to approach children of varying ages and I am comfortable working with them.

Working in the NICU brings to the forefront decisions about commencing and terminating treatment. These difficult decisions are controversial and much debated. Completing research in jaundice in babies and a rotation at the neonatal intensive care has given me insight into neonatal issues. It has stimulated my thinking about how far medicine can offer.

Completing my community service in pediatrics provided exposure to a wide variety of clinical childhood diseases. They provided insight into sub-specialty practice and also trained me to treat many common pediatric conditions. I also worked with children who were very sick, on dialysis or in the ICU. These experiences not only taught me how to deal with complex cases, but they provided an opportunity to hone my skills to diffuse difficult and emotionally charged situations.

Being a pediatrician I have the opportunity to build relationships with children and their parents while helping them live healthier lives.
I interact with both kids and their parents. Pediatricians need especially strong interpersonal skills. "You need to bond not only with the child but also with the child's family," "This is challenging because when a child is sick, the family is under a lot of stress."
Very fulfilling moments are when the parents are so excited to have their children perform their talents like to singing , dancing or telling their stories at your clinic.

Playfulness and imagination help pediatricians establish rapport with wary or frightened young children. But pediatrics is far from being all fun and games. From a clinical standpoint, the field is as intellectually demanding as internal medicine. Since infants and young toddlers cannot describe their symptoms, diagnosing childhood illnesses can be particularly challenging.

What sets pediatrics apart from other specialties, however, is the huge education and advocacy role pediatricians play. On the front lines of preventive medicine, pediatricians champion immunizations, healthful eating and exercise, as well as safety precautions, such as wearing a helmet while bike riding and knowing what to do in a house fire. This often means asking difficult questions that may seem intrusive to parents.

I love the age spectrum; from the newborn period helping moms with breastfeeding and other common newborn issues, to the fun yet trying toddler years, to our adolescents where I feel we as pediatricians can have such a positive impact during one of the most challenging times of their lives. It's a journey and I feel blessed to be a part of it."

While pediatricians do commonly care for adolescents even up to 18 , some specialize in infants, babies and toddlers. During routine well-child visits throughout the first few years of a baby's life, the pediatrician gets to know the personality and character of her patients. Assuming the baby is in reasonably good health, this can be a very endearing part of the job. I get to share in the development and growth of the baby from first cries to the memorable moments of their lives, when they learn to walk, talk and develop their full potentials as future leaders.
I especially enjoy being able to be a part of the lives of so many children and families. Whether it's a warm hug or a picture drawn for me by a patient, I treasure the moments I spend helping them in their time of illness and celebrating their accomplishments in times of wellness.




Being a pediatrician requires dedication and a passion to provide the best medical treatments for babies, infants, children, teenagers and adult patients. Due to the devoted time it requires to take care of young patients Being a pediatrician is the kind of job not a lot of people are willing to do. The sacrifices, the long hours, less time for family activities, and not being able live a regular life as everybody else, might be the reasons why few want to be pediatricians. Even though pediatricians do have to make sacrifices, the profession is very fulfilling as I become very much part of the family. From the time the baby is born, and I hear the first cry.. This is music to my ears. I am very sure that baby has life. If for some reasons, the baby does not cry , I should intervene immediately so as not to lose the golden period of oxygenation to the brain and prevent immediate and future complications. As the child grows till adulthood, the family have always good memories of you taking care of their child. Though immunization, their monthly injections had always been horrifying moments.. children eventually overcome these fears with kind words, warm touch or a lollipop . Parents are so proud to tell me their children have grown up well especially those who were seriously ill at one time and now are already nurses, engineers and some have their own family and they bring their own children to the clinic.

I have to be child like. I listen to kids without contempt or ridicule, understanding that children think and speak at a different level than we do."

I have to be meticulous because medication doses must be calculated so carefully. As a pediatrician, you need great patience and great humility. If you have to start an IV on a very sick child , you will be sweating a lot s because it's so hard to find a vein, especially in the presence of scrutinizing parents.

Pediatricians also need the courage to confront parents who exhibit poor judgment, such as not feeding their children well or letting them watch too much television. " I give parents guidance and try to increase their confidence," . "And I can't be afraid to challenge a mother and father when their parenting skills are not adequate. Many times they don't realize that what they're doing is not best for the child."
When dealing with young patients, who are often afraid of doctors, hospitals, shots, pain, etc., you have to have a rapport and connection to them - they have to feel that you care. So if you don't love kids, I think it would be very hard to be a pediatrician.

I would think another reason is that, when giving medical care and treatment to kids, you are helping an entire family. Their world comes apart (especially the mother's, right?) when their child is hurt or sick, and a pediatrician can restore that world in some cases. As opposed to a geriatric doctor who deals with the elderly. It's a tragedy to lose one's parents in their old age, but we all expect it and it is inevitable. Anyone who loses a child would tell you it's an extra level of tragedy, because so much life was yet to be lived. I can help in some of those cases, more so than in other medical professions perhaps. As a pediatrician I work with preventive medicine - the nutrition and health of children is very important for the length and quality of their life later on, and I have an immense amount of potential to affect that.

As a pediatrician I will be able to use my expertise to advocate for the children and provide holistic care to the families , and teach and mentor the medical students who are the next generation of pediatricians preparing to serve tomorrow's children.
The first and greatest essential of pursuing is a love for children. I am passionate about caring for children, and advocating for their needs. I have qualities required which include compassion, patience, tolerance, a love of science and medicine, the ability to multi-task and tolerate long hours, be disciplined, committed, and great communicators – because the children and their parents are counting on it.

As Pediatricians we are in charge of the infant from the time of birth whenever given the opportunity to attend their delivery.
The first cry of the baby signifies life which must be sustained. Every second counts. I must be able to intervene for signs that threatens the life of this innocent baby.... whenever the baby is not breathing , whenever the baby is ... not crying.
We take good care not only any physical deformity or future complications but also do preventive measures for some diseases which may not be symptomatic immediately at birth. My advocacy is to prevent disabilities or complications in children using screening test for metabolic diseases, hearing and vision screening.
Initial data from 201 participating hospitals for NEWBORN SCREENING ( NBS ) reported in September 2001 confirmed 48 cases of congenital hypothyroidism, 21 cases of congenital adrenal hyperplasia, 2 cases of galactosemia, 4 cases of phenylketonuria and 1,495 cases of glucose-6-phosphate dehydrogenase deficiency. These metabolic diseases bring mental retardation or death if not diagnosed and treated soonest. The Department of Health has recognized the significance of the initial data and efforts were undertaken to ensure the nationwide implementation of newborn screening. I am very priveleged to be a part of the successful Newborn screening which started in 1996 which eventually gave birth to the Newborn screening in Central Luzon.The NBS project continued through the years until the Senate passed Republic Act No. 9288 the COMPREHENSIVE POLICY and a NATIONAL SYSTEM FOR ENSURING NEWBORN SCREENING in April 07, 2004 . This institutionalized the National Newborn screening system that ensures that every baby born in the Philippines is offered the opportunity to undergo newborn screening. NBS saves 34,000 babies a year from mental retardation and death. This is more than enough reason to screen babies.
I should take upon myself the initiative as a concerned citizen and pediatrician to adapt screening procedures even before needed legislation are passed.
The prevalence/ incidence of deafness in the Philippines is 2-3 per 1000 . Hearing screen would assist in learning if the baby has congenital hearing loss that may be caused by maternal diseases or genetics. Recognizing the impact of hearing loss, I took the initiative and instituted hearing screening at AUFMC . I brought the Oto Acoustic Emission OAE equipment for screening in 2007. It was only in August 12, 2009 Republic Act No. 9709 , an ACT establishing a UNIVERSAL NEWBORN HEARING SCREENING PROGRAM FOR THE PREVENTION, EARLY DIAGNOSIS AND INTERVENTION OF HEARING LOSS was passed.
One out of ten school age children would have eye problems, 25% of which would have amblyopia while the rest mainly have Errors of Refraction (EOR). Based on the National Survey of Blindness 2004 and PERI-DOH Philippine Eye Research Institute (PERI) Department of Health Vision Screening Preliminary Data 2014, the prevalence of amblyopia is from 1-3%, while EOR ranges from 3-15%. This bring concerns to my practice in caring for children. An ACT establishing a COMPREHENSIVE INFORMATION CAMPAIGN ON AMBLYOPIA and requiring the mandatory inclusion of visual screening on amblyopia in the NATIONAL NEWBORN SCREENING COVERAGE, amending for the purpose REPUBLIC ACT NO. 9288, otherwise known as the NEWBORN SCREENING ACT OF 2004" and for other purposes was sponsored by Senator Lapid . This ACT was titled as the "MAINSTREAMING AMBLYOPIA ACT of 2009." To this date there are no implementing guidelines yet.
Again the I must take efforts to initiate steps for the welfare of patients. It takes a longer time before very important legislation are implemented nationwide.
In October 2014, with the cooperation and collaboration of my partner in life and medical practice, Dr. Ferdinand Lagunilla, an EENT specialist and I took the opportunity for babies to have vision screening we named " BRIGHT EYES BRIGHT FUTURE" project ..... because I care for the babies, I care for the children.... the future LEADERS of this nation.
This is my life a LEADER, a PEDIATRICIAN a MOTHER of my own children and all children , who is very much part of their life ..... from the first cry to their future... we shall live in them... . the LEADERS of TOMORROW.
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