Thursday, August 6, 2015

Reflection paper by 3 Leader Zel Catungal - My Passion

REFLECTION PAPER 3 LEADER ZEL CATUNGAL
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 life's journey is faced with not only one but of several passions. As defined, passion is a strong feeling of enthusiasm or excitement for something or about doing something[1], well, for the past several years, I have been enthusiastic and worked so hard for these things and they have molded me of what I am today.

            My passion to be a doctor, to be a healer started since I was 5 years old. I was a sickly child then and I was always either in the clinic or admitted for several reasons. Every time I am in the clinic of my pediatrician, I feel excited, not afraid, like most kids would feel. I looked up to my pediatrician as if she was a superstar! 
 At a very young age, I dreamt to be like her and this became my first passion, my journey. I knew since then that to be a doctor will not be easy. I had only one mission as a child. Every time someone would ask me what I would like to become when I grow up, I would only answer, and very quick, I want to be a doctor! I was immersed in my studies from preschool till I graduated from Medicine. I love studying. It became my next passion. Luckily I was gifted intellectually and excelled in class. Partly also because of my diligence to finish school. As I have mentioned before, my parents really worked hard to send us to school because they did not want us to be uneducated like them. Education was their greatest gift to us.


            When I was in elementary school, I joined an art club. I discovered that I could draw and paint from scratches and from still life. I started doing sketches on white drawing paper and my teacher noticed these. She told me to apply in UP Los Banos so that my talent for the arts will blossom if given the proper exposure. At first I was excited, but then I remembered my first passion, to be a doctor. I told my mother then, she somehow discouraged me first because it was too far from Pampanga and I was really young then to leave our home. My initial excitement to be exposed to arts soon was overshadowed by my desire to be a doctor. I declined the offer.

            Growing up, I would have signs that I would become what I wanted. I always play "doctor" during role-playing games. At home, when somebody has an ache, pain, I would look for a medicine or try to gently massage or comfort my siblings. I was a natural healer. I remember during the 1991 Baguio earthquake. I was only in my first year of Medicine. I was in Baguio then, after the horrible quake, me and my classmates rushed to the city. We were in a car and we were wearing our white uniforms. We saw a lot of casualties, horrible sights. We headed to group of people who volunteered to rescue. We told them that we are doctors (but not really, we still don't know anything about Medicine) and tried to help. But of course, we were not allowed since nobody believed we were real doctors with our uniforms.

            In med school, we were immersed in readings, laboratories, paper works and several reports. It was only during clerkship (4th year proper) that we were able to encounter real patients. I was excited to be in the hospital. It was not easy since, from books, we were faced with real cases. We experienced daily rounds, getting the vital signs, assisting in deliveries, surgeries and clinics. The first time I saw a patient died, I cried. It was a reality. Seeing life and death day in and day out was painful for me at first. There were times that I wished I could be like God and breath life to dying babies, children and parents.

            I wanted then to be a pediatrician. But sometimes fate will make a turn on you. My first love became my fear. This happened when I lost my first-born child. I had pre ecclampsia. It is a maternal condition presenting with hypertension during pregnancy, and usually would lead to premature babies. It was our first tragedy for my husband and me. I was terrified that I may not heal babies since my own baby died and I was a doctor! This experience almost got me abandon my passion. God really loved me since he gave me a husband who stood beside me during those times. I recovered from the depression and decided to move on. I then applied a teaching job for physical therapy students and moonlighting in a new hospital while waiting for the results of my board exam. I was enjoying teaching but I was not contented. I yearned for my passion, to be a healer. I applied for residency in Baguio. I actually applied in OB-Gyne. My mentor in the new hospital, Dr. George Pangwi, a cardiologist, who happened to be our "ninong sa kasal", got disappointed in me when I asked him for a recommendation letter for my application to apply in OB-GYN. He told me, go to Manila, apply in St. Luke's hospital. In his words, "Sayang ka, matalino ka, mag IM (Internal Medicine) ka". I succumbed to his advise and applied in St. Luke's Medical Center and luckily I was accepted and even graduated as the Chief resident.

            My decision to be a nephrologist did not come early. I wanted to be a cardiologist since Dr. Pangwi became my idol-mentor. But somehow, there were signs that I would become a nephrologist. Nephrology is one of the most difficult subspecialties and only few (that time) wanted to apply. Whenever I go on duty at the ICU and I would manage a kidney failure patient, I somehow enjoy it and what seemingly a difficult case would be swiftly easy with me. I remember a patient who was almost dying, with difficulty breathing who was easily revived and given second chance in life after he was subjected to dialysis. Wow! "Parang San Lazarus" ang effect. The patient practically "rose from the dead". I was ecstatic and I wanted to have that "San Lazarus" effect. The decision strengthened even more since Nephrology training was only 2 years compared to 3 years cardiology. During those times, I already have 2 children and only my husband was earning decently to support us with 2 helpers and an apartment to pay the rent. My decision to be a nephrologist became a reality. Looking back, I do not have any regrets.

Others would say that my specialty is very morbid. Yes it's true. Everyday, I see sick people, very sick. Many times I think the Lord has His hands on me and help in comforting these patients. There were several times that my patients will say to me " Una po ang Diyos, pangalawa po kayo Dra". So heartwarming, so thankful to have people think of me that way. So today my passion is all about healing. But as a doctor we can only do as much. So as the famous quote of Hippocrates, the father of Medicine " to CURE sometimes, TREAT often, and COMFORT always". This is my daily mantra. To bring comfort by being cordial, presentable, approachable, reassuring, and exuding positive attitude. This is the reason why I try to look good, beautiful and dress appropriately everyday. I want my patient to be comfortable seeing me. I want them to be excited when they see me. I want them to communicate with me with ease so that I can see deeper than the laboratory results they bring. My family name (Catungal) is not very easy to recall (especially during my start up years when nobody knew me) so many times patients would ask " San po ung doctora na matangkad na maganda?", the guards in the hospital would know without a doubt it is me they are looking for. It's like "branding". There are many conditions which are easily treated, example: pneumonia, UTI, peptic ulcers etc, so I try to TREAT often. But to offer CURE especially chronic kidney failure, diabetes, hypertension, hereditary diseases is most difficult. Many of these illnesses have concomitant complications and have resulted to end organ damage beyond repair, that is, beyond cure. The most difficult part of it is for the patient to accept his illness. For the past 12 years, I have somewhat mastered the art of guiding patients on their journey to their illness especially patients with chronic kidney disease about to undergo lifetime of dialysis. I have seen denials, suicidal ideations, isolation, fear, anger and dismay. Some would not even see me again and I would only see them again when they are in the emergency room or at the ICU needing emergent dialysis.

        I remember a patient who refused dialysis. He went to several hospitals for second opinion only to be told the same thing. His family told me he didn't want to see me again. And so be it. One day I was called at the ER. My patient was there, comatose. His relatives decided to go on with dialysis but I was adamant since I knew he did not like it. But his family insisted and signed the consent. I did dialysis. When he woke up, he said to me" Bakit ngayon mo lang sinabi na masarap pala ang naka dialysis, napahirapan pa ako". I was speechless. He is now on his 5th year on dialysis, always the first to come in the unit as early as 4 am. He had several complications like stroke, pneumonia, heart failure but he still survives and fighting.

            Many of my patients would forget the names of their relatives or even children but they cannot forget mine. Some elderly, hearing my voice, they know it. They look up to their doctor second to God. This is the feeling of being a HERO for my patients.

            Patients with chronic kidney disease especially on dialysis are the most patient, enduring, and faithful people I have encountered. Their disease is a long, painful, draining physically, mentally, spiritually and economically. Many of my patients are being sustained from donations from families, PCSO, NGO's and politicians (especially if near elections). I wanted to be of help, so early in my practice, I give special considerations to my dialysis patients. When they see me in my clinic, I do not charge them. Most, when admitted for complications and other illnesses related to their illness, I charge very minimal (P100 for tax purposes). It is my way of helping them. Many of them thank me and show their gratitude by giving me fruits, chocolates, kalamay etc. Many of course don't mind.
When I was a teenager, I memorized a quote I collected. " If your efforts are sometimes greeted with indifference, don't lose heart, the sun puts a wonderful show at daybreak yet most people in the audience go on sleeping- Anonymous". Helping or being generous is another passion. So I was not surprised that my Enneagram result showed type 2 or helper. I haven't done something big, yet. But I have been practicing it since childhood. Whenever I can, I help. Whatever I have, I share. If I don't need it and somebody ask for it, I give. During Christmas, I buy gifts for my patients, and for everybody. My dialysis patients receive gifts from me and this had been my practice ever since. It gives me joy whenever I see their faces and they receive something. During one of our family's Christmas gift giving to relatives of my husband in Baguio, my daughter asked me, how come I gave everybody a gift but nobody gave me a single gift. I told her, it is alright, because God blessed Mommy for the whole year so during Christmas, it's time for me to be a Santa Claus. Thus the saying, "Mas maganda na ang nagbibigay kesa sa ikaw ang humihingi o tumatanggap". I showed my children the value of sharing and not expecting something in return. I believe in doing good karma, it will come back to you in due time, but sometimes will not but it will be rewarded in heaven.
I haven't done something big-YET. It has been my dream to build a foundation for my kidney disease patients. I have seen their journey and I want to help. Our leadership class released this passion in me. This is now what I wanted to do. This what I wanted to leave as a legacy. I know it would be not easy but everything started from scratch, from a dream. Hopefully, soon.
Another passion is the love for my family. My parents sacrificed a lot to send us all to school. My father spent more than 30 years abroad, sacrificing his time to be with us and see us grow and mature. My mother did everything to augment the family's income by selling various merchandises. She also sacrificed precious time to be with us when she attends to her store. I valued their sacrifices. When I began to have a good practice, I told my father to retire from working abroad. He went home and just stayed home. Now I support them financially. It is my way of giving back. My father actually wanted to work but he is already 73 years old, but very healthy and fit. They are now enjoying their retirement years in the house they built through the years.
My own family is my first priority. From the day I was able to earn,  together with my husband, who continued to work hard for us, we invested in acquiring a decent home and were able to send our children to a very good school, the OB Montessori. This was actually owned by Mr. Max Solliven, a famous journalist  (deceased) who became my kidney transplant patient at St. Luke's Medical Center. He told me to enroll my kids at OB Montessori in Angeles Pampanga. It is an expensive school, and I was not able to afford it initially. I have three daughters, 18,14 and 11 years old. My eldest is now in her 3rd year HRIM Course at the College of St. Benilde of De la Salle University. In 2012, I was approached by my elderly patient. Her granddaughter, who was a widower, with 5 children, was pregnant and she wanted to give her son to me for adoption. I was shocked at first and at the same time excited. It was a dream for us to have a son, but because of my medical history (preeclampsia and hypertension) I was not able to bear another child. I prayed to God for guidance and to give me signs that this child will be our son. Again, God showed how much He loved us, our 4th child, our son, Luis Victor "Bitoy" was born October 29, 2012. We adopted him legally and probably, this is the good Karma I got in return. Our family's love for each other strengthened with the addition of Bitoy. A lot of people would ask why will I adopt a child, I have children already. I answer them, God loves me, He gave me a son, our love is unending for another member of the family.

So to answer the question " What do I love doing?"- I love my work as a healer, it is both a job and a passion. I enjoy seeing others happy by extending help. I live each day loving my family. And I am grateful to God who has loved me and my family for giving us continued blessings.
"Choose a job you love and you will never have to work a day in your life"
                                                                                    -Confucius  4
            "Love what you do and do what you love. Passion is the key that opens the door to joy and abundance"
                                                                                                -David Cuschieri



[1] http://www.merriam-webster.com/dictionary/passion

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