Ahmad Sampang ibnu Hajiri, MD

A Personal blog by a Tausug medical student (now a doctor!) from Sulu and the stories that inspired him.
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This is an auto-publish post. I orignally wrote this letter last July 2015. 

Six months since I wrote this letter, I wonder what have changed?

Assalamu Alaykum wa rahmatullah!

Hey dude, it’s me, your pre-clinical clerkship self a.k.a. the self that you had (hopefully will still have) before you started your death-defying ordeal called “Clerkship”. I know this is crazy, but hey, since when did we ever consider things “not crazy” huh?
Perhaps, right now you’re about to begin your most challenging year in Med School. And the anxiety is killing you already—you don’t know what to expect, you feel like you know nothing at all! Don’t worry, that is exactly what you are supposed to feel. Just give it a few days and you will get used to the feeling, the pressure and slowly you will find yourself adapting to the new environment you have. 
Or maybe you are already in the middle of your clerkship year: Now far more confident that you were the past years. Getting your way with all those days that you feel worthless and useless at all. Maybe you are already on your way to another 36-hour duty, another long day huh? Or maybe you are having another endless night working on paperworks and case reports for your presentations the next day—how many times did I tell you not to cram!? Or maybe you are just sitting on a corner in one of the halls of the ER trying to steal some naps, or maybe just sleeping lifelessly in your bed at the callroom after duty. Or maybe you are on your rounds checking your patients. Or God knows, you are being grilled by your consultants about your morbidities right at this very moment! (Good luck bro! Buy a whole pizza for yourself later, okay?) Wherever you are right now, I just want you to read this once in a while. I hope you do my friend, I hope you do.
Anyway, I am here writing this letter perhaps to remind you—yes, the me in the future—about who you are before clerkship. Hoping that you wouldn’t change after all those things that you have been into. Hoping as well that I could shake some senses into you when you suddenly changed and became a monster without you noticing it. So please remind yourself always and never forget these things I am about to tell you.

1.       Bismillah. Begin everything with Bismillah: In the glorified name of Allah. He is the beginning of all good things, and He will surely make things far easier and better if you remind yourself why you are doing all this horrible things to yourself: To please Him, to Worship Him alone.

2.       Never, ever forget to pray. This is your source of inner peace. This is your direct “landline” to Him. This is your only rope to keep you holding on when things become too out of control. In good times and in bad, never forget to pray.

3.       Read the Qur’an. I know you will be too busy to even look at your phone leave alone your books in Internal Medicine and Pediatrics. Still, find time to read at least a verse or two of the Qur’an or a hadith. This will remind you of your purpose in life. You already know that right? Indeed, you are so blessed to be a Muslim, share that blessing as well.

4.       Read. Read. Read. Do not ever lose that sense of curiosity to know more. Keep that responsibility of being knowledgeable about the conditions your patients have. What is worse than a doctor who doesn’t know what his patients’ conditions are? Of course you cannot possibly know everything, but at least do take some extra effort to learn on your own. After all, this is one of your greatest responsibility to your patients as well. You owe them that, at least.

5.       Do remember where you came from and who you really are. You are Ahmad, a son of a teacher, coming from a family with humble beginnings. You started as someone down below. Keep your dreams high without raising your voice to others. Keep yourself on the ground, be humble, for you are nothing but a piece of dust. And dust you shall become one day as well.

6.       Remember, always remember your family. Your dear mother who sacrificed everything and suffered all her life for you. Remember her smiles, her warm embrace. Remember to keep her proud by doing your best here. Call her once in a while. Tell her how much you love her. Tell her you miss her, talk with her about anything. I know your time is now limited considering your schedules in between rounds and duties. But please, try to squeeze in a few minutes for her.

Also Remember your late father, the few remaining memories you have of him and the dream that you will see him once again someday in Jannah, ameen. Remember your dear sisters who are supporting you right now. Remember your siblings and your relatives who have high hopes for you. Remember, you are the FIRST Doctor in the clan if ever. Do not ever fail them.

7.       Treat everyone with respect and kindness, especially your patients. You may be too exhausted with everything and your body is yearning to get a few minute of rest. You are on your verge of breaking down, and then your patient failed to do what you asked them to, what you expected him or her to do. No, DO NOT BE ANGRY. DO NOT ever raise your voice. Breathe in, slowly count to five, and then explain everything again to your patient. Make him understand how important these things are for him to be treated. Be kind, always keep yourself on their shoes before doing anything unnecessary. Think before you talk.

8.       You are human. You are not perfect. You can commit mistakes once in a while. Just don’t make it much a habit to do so. If you fall down, remember that these are just part of your training, not just in the hospitals to become a better physician, but in life as a whole—to become a better individual. Learn from those mistakes and commit in improving yourself to avoid making those mistakes again.

9.       In everything that you do, just do your best—that’s how Islam taught us right? Do your best—and put your trust to Allah alone. Remember He knows best what is good for you.


10.   Work with your team with greater dedication and responsibility as well. Make the most of what you have to keep the team working. Do not hesitate to volunteer and help out. Remember that you may be different people altogether but you are all in this together. You either work as one or you all fall as one as well.

11.   Do strive to accomplish your tasks way ahead of time. Yes, I am reminding you again about this! Do not ever wait for the deadlines to come for you to work on your required tasks. Remember how to prioritize things and do what is necessary. You have done this before, surely you can do it again, right?

12.   Don’t waste your time on worthless things. Manage your time wisely. Time is such an irreplaceable thing that was borrowed to us. And whatever you do with every second of it will be recorded forever. And they will never ever come back. This is the only life you got, yes you only live once and you die only once as well. Make the most of it with greater purpose.

13.   Treat yourself once in a while. Surely you deserve something that will make you happy somehow. Go watch a movie with friends, enjoy a long trek, or go buy a cone of ice cream. Don’t be too hard on yourself but don’t be too lax as well. Just strike a balance with everything that you do.

14.   Believe in yourself. Yes, believe that you can always do better than yourself. Stop those pessimistic thoughts you always have about yourself. You are here for a reason, and because you can do better as well.

15.   Remember why you are here in the first place. Remember all the people behind you that pushed you up here. Remember the people of Sulu whom you still owe a lot. They need you back here in Sulu. You have to prepare yourself to be of better service to them. Keep them in your heart, they are your inspiration; your shield and your weapon when this war goes from bad to worst.

16.   And lastly of course, with all these things in mind, do not forget about your health as well. You have a responsibility as well with that body of yours to take care of it while you are still alive. Follow the advices that you doctors give to your patients. Live a healthy lifestyle because that is the best way for you to do better things in life.


Hope you are reading this while in good condition :) See you by the end of clerkship, Ahmad. Congratulations, you are half way there!


Yeah, yeah, I know this is going too long already. SO I will stop here. I will send this letter again to you after a month, then after 6 months then after a year just to remind you of these things once in a while. Hope you won't get to used to reading this and just ignore it. haha.

With love,

Ahmad from May 30, 2015
"Bantay" or "watchers" are those who come and stay in the hospital to accompany the patient. Mostly, they are the patient's parents (notably, mothers), grandparents, siblings or even cousins. Sometimes, they are just a close relative, a friend, a neighbor or even at times, just a stranger, a passer-by. We see them everyday. We interact with them almost at all times. Although we often neglect their mere presence, we cannot deny that they are among those who play an important role in the management of our patients' health and well-being. 

This is just a portrayal of how a day of a "bantay" begins as they enter the hospital for the first time through the Emergency Room....

*I used the Tagalog language in this post as I found it the most relevant and appropriate in this setting. 
==== 

“Kayo po ba ang bantay ng pasyente?”

“Opo. Ako po.”

“Ah, OK po. Eto po yung mga kailangang gawin. Kailangan po namin siya kunan ng dugo para po sa laboratories niya tulad ng CBC, Blood type, atbp.”

“Ah, sige po.”

“Pero kailangan po natin ng mga gamit tulad ng syringe panturok, yung mga lalagyan ng mga dugo pati na rin po yung mga ‘dextrose’ na gagamitin natin... Eto po yung reseta, nakalista na po dito ang mga bibilhin ninyo. Mabibili niyo po yan sa mga malapit na pharmacy dyan sa labas.”

“San po to banda?”

“Dun po sa labas. Labas po kayo ng ER, tapos kaliwa po kayo, dire-diretso hanggang makita niyo yung parking lot? Yung may mga kahoy? May mga guards po dun, magtanong na lang po kayo. Marami po sa labas.”

“Sige po. Pwede po bang mamaya na, kasi… wala po kaming nadalang pera eh. Biglaan po kasi to…”

“May matatawagan po ba kayong kasama niyo? May mga gamit po kami dito pero kailangan po kasing palitan para sa mga susunod po naming mga pasyente. Kung may makakatulong po sa inyo, pabili niyo na po agad para mapalitan natin.”

“Sige po, ganun na lang. Pasensya na po. Salamat.”
Kumuha na ng mga dugo ang mga medical students, na parating napagkakamalang “nars”.

“Ginagawa na po namin yung mga labs. Mamaya iakyat niyo po to sa laboratories, wala na pong bayad yan kasi ER Charity po tayo.”

“San po banda yung…”

“Sa may second floor po. (tinuro ang pasukan) yan po nakikita niyo yung pasukan sa loob? Diretso po kayo dyan, tapos kanan po, tapos pasok ulit kumaliwa kayo. May makikita kayong daanan na may hagdan na paikot pa taas. Sa bandang kaliwa niyo. Yun po yung laboratories. May mga guard po dun, magtanong na lang po kayo pag di niyo makita.”

(tahimik) “Okay po.”

“May bluecard na po ba kayo?”

“Blue card? Wala pa.”

“Naku Tay, kailangan po natin ng bluecard para maasikaso to lahat. Di po ba kayo nainterbiyu sa harap?”

“Na-intirbiyu po, pero walang binigay na blue card, diretso na daw po kasi kami dito at…

“Kailangan po natin yun tay.”

“San po ba ako…”

“Dun po sa ER din po sa may Triage area. Kung saan po kayo unang ininterbiw? balik po kayo dun, i-fill up niyo po yung ‘Kaalaman’ form, tapos pagawa niyo po yung bluecard. Pagkatapos po nun balik po kayo dito ha?”

“Ah sige po.” (umalis papuntang triage, makalipas ang ilang sandal, bumalik si tatay na may Bluecard) Kinuha ng medstudent ang bluecard at sinulat ang hospital number ng pasyente.

“Eto na po yung ibibigay niyo sa laboratories. Daanan niyo na rin poi tong isa, blood typing, sa blood bank. Magkatabi lang po sila.”

“Ah, san po ulit yung laboratory?”

“Sa second floor po. Diretso dun, kanan, pasok, kaliwa, may hagdan sa kaiwa, paakyat, laboratories.”

“Sige po salamat.”
(umalis ang bantay papuntang laboratory. Dumaan ang duktor.)

“Oh, asan ang bantay nito? Bat iniwan ang pasyente?”

Pagdating ng bantay, papagalitan ng konte kasi iniwan ang pasyente. Wala kasing ibang kasama.

Kawawa naman ang bantay. 

====





“Tell me about yourself.” Our professor asked us before beginning our case discussions. My group mates started by telling their names and then their future careers (future Neurologist, Surgeon, Medical Oncologist, etc.) until it reached my turn. I was still unsure what “specialty” I will go into, so I just answered the question with what I can think of best:

“I am Ahmad from Sulu. I love to travel and do photography. My dream one day is to publish my novels.”

“Oh, I have been to Sulu a lot of times,” said our professor who is a practicing surgical oncologist in PGH, “my last trip there though was in 1996.”

“Ma sha Allah, really sir? That’s nice sir! What did you do there, sir?”

“We stayed and volunteered in IPHO-Sulu. Did a lot of charity services doing surgeries for free.” H mentioned names of some Tausug surgeons back then, some I knew by name some I don’t. I was somehow elated to find out that another great physician have visited my dear homeland before.

“It was a nice place. Until all those horrible things happened. There was this doctor who had his son kidnapped? What’s his name?”

Yeah, the kidnappings. Indeed a horrible thing perpetrated by horrible people lurking in the dark side of my dearest homeland. I was not disheartened by this remark. I was in fact unaffected at all. It was as if I was already expecting to hear it. As if it was something normal to hear when referring to Sulu. (Now I realize how horrible that was: being unaffected about it.)

I didn’t know the name of the doctor who had his son kidnapped, perhaps I was still too young back then.

“It was too bad since then, we were never able to go back” he remarked

And I shared his feelings of disappointment. Frustration. Despondency.

“Another thing that I noticed when we were there… Say some patient came in due to a vehicular accident, they would just patch him up, clean his wounds, suture them, then leave him be.”

“Huh? But why sir?” his students, including me, asked in unified shock hearing this horrible situation.

“I don’t know. There was this notion that if you actually did something—say a definitive management of operating on a patient—and things went bad, say the patient died, all the blame will be pointed to you, the doctor. Especially if you came from the localities as well, it’s easier to blame you. No, we were not among those they applied that ‘belief’ as we were ‘visitors’, ‘foreigners’ they claimed.

I am sorry to say this, Ahmad, but it really happened. There is just a lot of things needed to be done in your place.”

I intently agreed with him.

“I know sir,” I told him, “There is just too much mess right now. Too much that maybe the only solution is to do an ‘overhaul of the whole Tausug mind-set, of the way how we think’ about things like this.” And I ended this statement with a big sigh.

“Ahmad for Governor of Sulu!” A group mate jokingly remarked.
“I hate politics, dude!” I said
“For revolution!” Another said
“I don’t like revolts as well.” I laughingly remarked “And I know I won’t be able to do it, to change Sulu? That’s too ambitious. Perhaps someone out there can. And I will just support them.”

“Will you go back to Sulu, Ahmad?” our professor asked.

“Definitely sir. In sha Allah (God willing). I cannot see myself in the future somewhere else than Sulu.”

“Very good. I am happy to hear that.
And I am looking forward to reading your novels.”

“Ahaha but I haven’t finished them yet sir. I can give you a copy once I am done with one.”

“Yes, please, even the draft, give me a copy. I really want to read them.”

I thanked him. I was both humbled and embarrassed for in reality, I haven’t really done much with those ‘novels’ I am blabbering about. In due time perhaps. In due time, in sha Allah. And after one last member to be introduced, we were back to our case discussions.

====
[I recorded this conversation because it brought in some thoughts about the Tausug situation and mind-set. That what needs to be done in Sulu is far more than just socio-economic nor politico-militaristic approach. It’s an OVERHAUL! Redirecting our mind-sets, of how we think! But how in the world are we going to do that? Education? Maybe. I don’t know as of now. Perhaps someday I will find out. Or someone will enlighten me how. *Sigh*]


Written December 4, 2015 9:50AM

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just saying. -Dr. Ahmad