LABIANO, ANA DELIA L.

May 12, 2022

CDUH 3rd YEAR IM RESIDENT

PCP IN THE NEW NORMAL

The Annual Congress, a large scale symposium for internists which occurred in a virtual
platform this year. A platform for us to be more informed and updated of the current
management guidelines. I admit that even though zoom meetings and online conferences have
become the mainstay during this pandemic for 2 years, I still find it difficult to focus since I’m
more of a visual learner than a listener. I don’t know if this rings true to others but I have a
tendency to listen initially then drifts off to another dimension 5 minutes into the lecture.
Therefore, the phone becomes a device that talks in the sidelines. It was hard to focus but the
desire to learn was stronger, thus this had been my motivation the whole time.

One of my favorite topics in the program was the updated chest pain guidelines by
AHA/ACC and ESC which provide us a comprehensive and easy to follow algorithm in the
management of acute chest pain for us to establish a rule-out protocol in our institutions.
Reminders given to us are the following: high-sensitivity troponin is preferred, no further
testing in low risk (<1% MACE), use clinical decision pathways and no more “atypical” but now
subclassified into Cardiac, Possible Cardiac OR Non-cardiac.

Another favorite topic in the program was SGLT-2 inhibitors and their role in CKD and
CVD. Empagliflozin, as the drug being discussed, has very good profile in regards to efficacy and
safety, and is a good addition to OHAs. The added bonus of having a role in slowing down
progression of CKD and CVD has put it at a top contender in choosing what OHAs to start
especially in patients with a lot of co-morbidities.

Ever since 1st year IM Residency, I knew what I wanted to subspecialize into. Even
though I’ve learned to love Nephrology and Pulmonology the following years, still my heart was
set into Endocrinology. The PCP Annual Congress also opens us up to the possible subspecialty
we want to pursue. We are surely, still, diamonds in the rough and the mentoring experience
backed by the PCP this year with the many updates from different experts in different fields,
catapult us into becoming the 5-star physician we are ought to be.

The start of the COVID-19 pandemic had devastated the world. A novel disease which
has consumed us, especially the healthcare workers, physically, emotionally and mentally. For
me personally, the 1st year of residency had been the toughest time of my life. My mom died of
COVID. We gave everything we could to save her but I guess this is how a novel disease
operates. Nobody really knew what’s the right thing to do or give. No bulletproof guidelines. No
experts but all are considered, just theories. I struggled to cope with residency and at the same
time, the death of my mother who had been my guiding light ever since I opened my eyes. I
also have to think about the other family members who were also coping. Everything was
falling apart and I almost decided to quit. Almost because I didn’t. Thank God for giving me a
sign when I asked for it. I realized that my mom wouldn’t have wanted me to quit. My mom was
admitted in the same training hospital, therefore, I wanted reciprocate what they have
provided and showed my mother. I continued my training, but my training lagged due to almost
2-months’ time of taking care of her then the mourning process. When I came back, I was
expected to perform like a senior and to recover instantly from the trauma. There was no
choice but to move on. The mom of another daughter might need me.

The trauma didn’t stop. COVID continues and we were running empty. My colleagues
were quarantined at an alarming rate, we were understaffed and overworked, it is not
surprising that it took a toll on our bodies. I reiterate, at the height of the surge I was terrified.
Being “young” did not exclude us from the worst of the disease. We were intubating patients in
their 30’s, some already with families at a fast rate. They would come in gasping and on high O2
requirement. Intubation and Code 99 were our breakfast, lunch and dinner. The surges, the
sudden stop in the academic environment in the training program, being in the frontline against
the disease all contributed to a slow learning curve.

With this mentoring program, I hope this would become much like a support group with
my mentees. I hope to learn more from each other as well. Learning never stops and so the
mentor might be able to give updates as well as our guide to ready us into the world outside
residency.