June 13, 2002

     I just couldn't resist it.

     It is hard to start an article about St. Joseph's Hospital in the town of Manapla, Negros Occidental without telling a Dr. JP story.

     To JP's classmates, to those who know him and to those who have worked with him, you know that these stories are not a knock on JP at all. Or I am just making up things at his expense. Not at all. JP is a natural-born comedian, and it's not a mere coincidence that sometimes he finds himself in a funny situation or creating one himself. In fact, he told most of the stories. For sure, he would love to tell you these stories himself.

     To those who don't have the slightest idea who JP is, it doesn't really matter if you know him or not. Just think of him as a very likeable person who once started his grand conference in OB-Gyne with this - "Our country at this time is beset with all sorts of problems..(pause)..In the wards (pause) we have H. mole....". That brought the house, or at least the conference room, down.

     I can tell you right now that JP is actually comedian Joe Piscopo, and it won't make any difference. Although I don't think Joe Piscopo is a College of Medicine alumnus.

"Working under the setup of Victorias Milling Company where every aspect of the company including the hospital was controlled by executives, the accreditation of the residency program was doomed from the start."

     You've heard a lot of bizarre Operating Room stories but I think this one takes the cake.

     JP was at that time the only surgical resident in this 250++ bed hospital ran by Victorias Milling Company. There were 2 surgical consultants. It was a very busy O.R. day inasmuch as at the end of the last elective operation, the O.R. had ran out of scrub suits.

     JP was about to call it a day when an emergency case was wheeled in. Of course, he had no choice but to assist in this one, he was the only surgical resident, remember? But wait. Did I mention the O.R. ran out of scrub suits?

     The O.R. staff was able to produce a scrub suit for the consultant, while JP came down in history as the only one who scrubbed with only his briefs on.

     And to add insult to injury, the O.R. gown that JP wore was very old, worn out and very short, sort of 'above-the-knee'. The circulating nurses were having a heyday 'looking' at the situation.

     The patient lived. And to think JP had to expose his legs for the patient's sake. He was a hero that day. And you really thought I was being funny?

     In early 1994, the management of St. Joseph's Hospital started adding more residents to major departments after entering into a consortium with a private hospital in Bacolod (the hospital's name escapes me now but it's not Riverside or Bacolod San). The idea was both hospitals will apply for accreditation of their residency training in Surgery, Internal Medicine, OB-Gyne and Pediatrics. Residents were supposed to rotate in both hospitals every 3 months or so. Apparently, one hospital alone could not meet the criteria for accreditation considering it could not come up with the minimum number of beds, patients and consultants who are fellows of their respective field.

     Bless the mind of whoever came out with this brilliant idea. As brilliant as it was then, it went nowhere. It was like a marriage that was never consummated and ended up in a bitter divorce.

     I was one of about 3 or 4 doctors from Iloilo who heard about this. We immediately went to Bacolod City and inquired with the private Bacolod hospital. There were no immediate residency openings in Iloilo at that time and we felt it was a good opportunity to pass the time while earning a little cash.

     Expectedly, the Bacolod slots were quickly filled by Bacolod-based doctors. We were interviewed and were told to pack up for Manapla.

     Each one of us went with whatever department with a slot available. I ended up with Internal Medicine (IM), a department I never thought I would go into even in my worst of nightmares. If jumping into a den full of hungry lions was a choice, I would have chosen it over IM. Surgery was quickly filled and so was Pediatrics. OB-Gyne? I may be desperate at that time but not THAT desperate.

     Consultants were brought in (recruited or enticed as the case may be) from Iloilo City. Dr. Fred Guillergan for Internal Medicine and Dr. Gilda Espanta for Pediatrics, both College of Medicine alumni (Class 1981). Dr. Galileo Pabalinas, a surgical fellow left a promising career at Western Visayas Medical Center to be at St. Joseph's Hospital. I was told Doc Pabs (as we call him) was a cinch at that time for Directorship of WVMC until politics got in the way. Manapla was a perfect alternative considering Doc Pabs' family lives in Bacolod City.

     All three are board-certified and fellows of their respective fields, a credential necessary for accreditation purposes. I'm not sure about the original consultants of the hospital who have worked in the hospital for at least 15 years, if they're fellows too or just our fellow human beings.

     There were 3 residents per department rotating every 3 days. Residents received an initial salary of 8,000 pesos per month increasing a thousand pesos every year. Lodging was free. Good enough for a single startup doctor trying to make lunch money. But here's the better part - the salaries for 3 residents were paid even if there's only 1 or 2 residents. If there's only two of you in a department, you partake the salary intended for the third one, increasing your monthly take to 12,000 pesos. It was not surprising for new residents to get paranoid, they could get stabbed in the back.

     Before our group came to St. Joseph, JP was the only surgical resident and on his third year. Basically, he was receiving 30,000 pesos per month, the salary for 3 residents. No wonder he was willing to scrub in his underwear.

     Heck, at that time, I probably would've scrubbed naked for that money.

     For consultants, however, that amount was just loose change. Upon signing a contract, they received 200,000 pesos towards a car. They stayed in a house provided by the company complete with major appliances. Utilities, including electricity and water were free. Their children went to private schools for free.

     They maintained clinics within the hospital and charged standard professional fees for both out-patient and admissions in addition to a flat monthly salary. Since there was no nightlife in this town other than telling stories by the moonlight with a beer in hand, the value of money seemed higher. I don't have to remind you that drug companies took care of occasional 'night-outs' in the city and the almost regular scientific eatings, er, meetings. Life was good.

     Personally, I learned to love the place, the hospital, the people, and surprise, Internal Medicine. I lasted a year and a half at St. Joseph, learned a lot of things from Dr. Fred Guillergan. While attending the Philippine Heart Association's convention in Manila, he took me to a place called Metallica along Timog Ave. in Quezon City. You won't believe what we've learned there. And it's not learning how to read ECG tracings.

     And of course, there were the usual irritants - the nurses. And I'm not talking about all nurses, in general. Because of fringe benefits, most of the nurses at St. Joseph were 20-or-more-year veterans. They didn't dream of going to the U.S. or care for dollars anymore. Because of this, they usually had a comment on what you tried to do. I'm not saying I did not learn from them, because I did, but mostly they were aggravating. Comments like "Doc, nga-a amo gid nang ihatag mo, di' bala mahal na'?" or "Doc, nga-a ma-ECG ka pa kay mapatay man lang na' siya.". To which I usually replied, "Linti', pabay-i lang ko bala!" There's silence after that.

     Patients could be irritating at times too but you always try to understand them. If a patient insists that he or she be admitted for a simple headache, there's really nothing you can do, you can throw your admission criteria out the window. The company pays for their hospitalization and the workers/patients feel they always have the right to that benefit, even for a simple headache, caused most probably by vehemently protesting to be admitted. Hospital food, I guess, is better than home-cooking. And it's free.

     When Victorias Milling Company went under, St. Joseph's Hospital had to go. Quotes from news reports stated that the company borrowed a lot of money through loans which it could hardly pay back. To satisfy its creditors, the company had to close or spin off most of their diversification projects, and fire most of their employees. Since the hospital did not generate revenues for the company, everybody saw it coming.

     I was told Dr. Guillergan is currently finishing a Masteral Course and plans to go back to Iloilo to join the College of Medicine faculty. Dr. Espanta went back to Iloilo and resumed her practice. I don't know the whereabouts of Dr. Pabalinas but I'll definitely find out. I miss the guy.

     Working under the setup of Victorias Milling Company where every aspect of the company including the hospital was controlled by executives, the accreditation of the residency program was doomed from the start. With all due respect to them, and they may be graduates of Asian Institute of Management, the hospital is a totally different arena.

     You could tell how much control they had when they once required most hospital employees, including all doctors, to join the 'dancing troops' they were sending to Bacolod to join the Masskara Festival as representatives of the hospital.

     We declined at the risk of losing our jobs. We were not fired but we definitely got their ire.

     I show no disrespect to Billy Ray Cyrus, but you have to kill me first before you can get me to dance to Achy Brachy Heart on the streets of Bacolod.

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     The author's e-mail address is at drgarcia@wvsumedaa.com

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