My block just started our rotation under the Department of Pediatrics. To further enhance our learning and better our chances in understanding what a patient goes through, we were instructed to play the part of the bantays (people who accompany the sick patients at the out-patient clinic). For this activity, we gave our white uniforms a break and just wore what a usual PGH patient and their companions would wear. The goal was go undetected and unrecognized as a medical student in disguise and observe how a patient is interviewed, examined and treated in the out patient clinics.
After taking a very quick lunch, I was randomly assigned to a 9 month old boy with a three week history of fever of unknown origin. Despite treatment with a powerful antibiotic (cefixime), the fever has been on-and-off. It was an interesting case in itself, but unfortunately, I wasn’t there to do much medical stuff - I was simply there to play the part as a a concerned relative of the child and be one with the real bantays’ (his grandparents) frustrations and impatience as they eagerly await their turn at the clinics.
The anxiety of the patient’s bantay (the patient’s grandmother) is absolutely warranted. They arrived early in the morning to insure their slot in the clinics but they’ve already wasted four hours waiting for their names to be called. When you’re inside the examining rooms, it’s no big secret that the patient’s get to wait a long time so knowing about the waiting time is not really big news. But somehow, experiencing that unproductive lull is very trying to say the least.
That afternoon could have a day’s wages that was sacrificed so that one could have a hospital consult. Some parents could’ve left their children to a friend or relative so that they could take their sick baby to the clinics. The wait just aggravates the agony. The idleness that I experienced for a couple of hours had me wanting to just barge into the clinic to ask for our number to be called. But due to lack of man power, the consults ran at a snail’s pace.
When we finally had our chance to be called, my cover was immediately blown. The intern (a senior medical student who’s in his/her final year in school) knew me personally so the entire exercise of keeping our identity as a med student secret was moot at that point. To add to the drama of things, the little baby boy vomited suddenly missing the intern’s by mere inches. Being the nice and helpful person that I am - and to further play the part of a concerned relative— I rushed back to the waiting area to get new clean clothes from the grandfather. Upon returning, I gave the grandmother her grandchild’s unsoiled garments and let the intern continue the interview and examination.
 In an even more bizarre twist, the clinic’s nurse started tugging at my arm saying that I should look for newspapers to clean the mess up. Apparently, the nurse thought that I was the child’s father! Haha. It was really funny. The intern further blew my cover when she told the nurse that I was indeed playing a part and I was also a student in the college who would be commonly see examining patients in the same setting as hers.
Thanks to this exercise, the seemingly trivial struggles that a patient has to endure in the clinics have been further elucidated into a more tangible concern. If boredom has already set in for someone like me after a couple of hours, imagine the anguish that a patient from some far-flung province would feel if he’s made to wait for several hours.
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if you were on the md’s side however, i’m sure all you would see is how tired you are from seeing patients from who-knows-what-time. in a place like pgh, everybody gets tired and frustrated.
Tatay!
It’s nice to see that you have these kinds of immersion exercises. Quite different if you’re seeing things in the POV of the MD. But it’s sad that we don’t have any health care program to speak of and you have to sacrifice a lot just to get checked out.