Graduation Speech

 “Every good and perfect gift is from above, coming down from the Father of the heavenly lights, who does not change like shifting shadows.” (James 1:17)

 

This is the Word from God that I kept in my heart when five years ago, I was offered the opportunity to study Medicine and pursue becoming a doctor. I was already working as a nurse then, and have started on my post-graduate studies, contented with my calling but with the desire to be the best nurse I can be. In my heart, I have always desired to do more in the healing profession; but to be a doctor, at that stage in my life, seemed like a big, burdensome, almost impossible dream that I never even considered it. The opportunity came as a surprising gift. I had no doubt it was good, but I had to test if it was perfect. 

 

Five years of God’s faithfulness later, I have no doubt that the calling, this gift, is from God, and it is indeed good and perfect. I can only look back in awe at how He provided for me, guided me, sustained me, and enabled me to achieve great things beyond my imagination – from getting a good score in the NMAT, leading me to FEU-NRMF, giving me a scholarship that allowed me to study Medicine for free, to enabling me to do my best and excel not just to maintain the scholarship but also to train me to become the best doctor I can be. I can still remember that night, when I was crying in frustration while reviewing for our first Gross Anatomy prelim exam because I felt that I could not remember things even after reading them multiple times. I took a moment to pray and cried my heart out to God in surrender, then kept on reading anyway. That exam was my turning point, as I found myself knowing the answer to most of the questions, to my surprise. I knew it was God’s favor, and from then on, I just pressed on and did my best. I never thought it would get me here. All glory and praise to God alone!  

 

He has also blessed me with a wonderful family, and I would like to take this opportunity to honor my parents - Mama Susie and Mama Josie for the values you’ve taught us when we were young, I know you’re watching over us from heaven. Papa, thank you for supporting my decision even if it meant delaying your retirement. The journey could have been difficult and lonely, but I’ve always felt you, Ate Angel and Micah walking with me, making sure that I can focus on my studies 100%. 

 

Beyond my family, it took a village to send this medical student to school, and our whole family is grateful to you Maam, for being my benefactor in secret, for believing in me and asking for nothing in return except that I do my best. Thank you Tito Jorge for your constant support, which, to me, has become a symbol of our Mamas’ support of my dream. I also thank my relatives both in the Paglicawan and Aguilar clan, for all your prayers, encouragement, and support in all forms. I give my utmost gratitude to FEU-NRMF School of Medicine for the generous academic scholarship, and to the FEU-DNRSM Alumni Foundation thru Dr. Hernani Tansuche, particularly Class 1960, for accepting yours truly as a scholar and for believing in my dream. The foundation not only sustained my medical education but even generously allowed me to gain global elective experience. I treasure all these in my heart, and I hope to pay it forward one day when I am able.

 

 I also share this achievement with our mentors at the FEU-NRMF School of Medicine, including the consultants and residents, who have made training young aspiring doctors their calling, patiently sharing their knowledge to us and helping us not only to understand, but also to develop the discipline and desire for continuous learning. You did not make it easy for us, but we know that the constant challenge was meant to instill in us a greater appreciation of what it means and takes to become a physician.

 

We can look back and focus on what this journey took from us – time, energy, resources, at times our own health; but perhaps, everyone would agree that we have gained so much more and high above in the list are our friends, classmates and batchmates who shared not only notes, ‘transes’, and ‘samplexes’, but also bonded with us in our worries, tears, struggles and victories, both big and small. Let me take this opportunity to thank my classmates in 1D, 2F, 3F and Prime I, especially my inner and consistent circle then and now, Kirs foremost, then Ags. I may not be able to name each one but I am very grateful to you all for accepting me and showing me kindness. I cannot imagine getting this achievement without all the help you have extended to me, Ate Kat. To the transmakers of the batch, thank you for your generosity and hard work that have allowed most, if not all of us, to prepare for every exam more efficiently. 

 

I also would like to recognize those who have made my past four years more colorful and fruitful: my quiz bee and CPC teammates under the guidance of Dr. Vila and Dr Tagayuna respectively – doctors and educators at heart who have taught us lessons beyond the four walls of the classroom;  and my LUKEMD family led by our advisers, Dr. Viterbo and Dr. Ravelo, who helped us appreciate the greater purpose of who we are and what we do in God’s bigger plan.

 

I still hold on to that greater purpose, that while we, RCCO Class 2020, will forever go down in history as the batch who missed their graduation ceremony because of the COVID-19 pandemic, and who is now faced with a greater uncertainty of what lies ahead, we have victoriously finished the first step, and our journey, as aspiring doctors, continues. The current situation revealed to the world that the path we have chosen is dangerous and difficult, yet the need and the call is urgent and immensely significant. Years from now, we may find each other in different fields, but I pray that we may find each other serving nonetheless, always doing our best, for God, our patients, ourselves, our family, and our country. 

 

Congratulations Class 2020 and may our good Lord bless us all! 

My Yes to God Led Me Here

I'm still on a high...we all are...with the release of the list of FEU-NRMF School of Medicine Class 2020 graduates last night. I was so sure I would graduate..haha..even learned of the award I will be receiving a few days prior because they asked me to write something for the yearbook (will keep a copy of that here too!), yet to be able to celebrate it with the people who went through the highs and lows of med school with me is an entirely different experience. 

Friends are asking why I'm not posting on Facebook..haha. They've been used to it by now but this one's different, they say. It crossed my mind too, as I want to give back all the glory to God and let the people in my past and present world know of His goodness and faithfulness in my life. But privacy won and I opted to share in the celebration of our batch via IG where I have fewer friends, mostly from med school. I also sent a private message to the people I'd like to thank instead, for journeying with me, supporting me and helping me achieve this dream of becoming a doctor, one step at a time.

People have been congratulating me, and despite missing our graduation ceremony because of the pandemic, it still is a great victory, and I can only stand in awe of how the Lord directed me to this path, provided for everything I needed and more, and sustained me not only to make it through each day, but also to excel. There are many things that I do not deserve in this life, and the bigger the gift or the achievement, the more overwhelmed I become of God's favor in my life and my family then until now. My only contribution to all these is my whole-hearted response to the call. By giving me the desire to pursue becoming a doctor and exchange my well-laid plans with an uncertain future, the Lord invited me four years ago to give up control, throw away my timeline, not think about what others would think or say, and just TRUST HIM. Making that decision, to truly entrust my future to Him, was the most liberating and life-changing decision for me so far, after accepting Jesus as my Lord and Savior.

And it wasn't without a struggle. I took my time deciding Lord, didn't I?..haha..You know I am hardly spontaneous (you wired me this way..haha) and that I've learned to protect myself from unnecessary disappointments by rejecting entitlement as much as I can, not letting myself dream of things that seem impossible, or whose fulfillment would involve other people beyond myself. I equated security with contentment, and I refrained from asking for things that I want, and focused on things that I could work hard for. The pain of rejection from way back when I was young ran deep, and my healing came with focusing on what I could give over what I could get or wanted. It didn't help that I am uncomfortable with drastic changes..haha..and You know me so well - that even though I dreamed in my heart to become a doctor, I would never go as far as inquire about it or even consider the possibility, because I knew it would change not only my life, but also that of my family. 

So that dream was shelved in the deepest confines of my heart, only to be forced out unexpectedly by using a generous sponsor who offered to pay for my tuition fees in med school, no matter how expensive they were. I was excited, but I kept myself from being too excited to protect my heart from disappointment. I asked, "What about my plans? My income? My contribution to the family finances? My chances of getting married? My obstetric clock? (this one's funny, coming from someone who never had a boyfriend..haha) Isn't it too late? Am I not too old for this?"; but all these were minor because in my heart the real questions were..."Will my family support me? Will it mean putting their lives on hold too to support my dream? Will I be a burden to them?" because although my tuition is covered, I knew that the expenses would go beyond the already very expensive school fees - for allowance, books, projects, etc. Just the thought of not earning my own money and be totally dependent on others scared me. It scared Papa too, but my sisters were braver, and their full support gave me hope to give it a try and at least take the first steps towards an NMAT and an application. My prayer as I was going through the process was, "Don't lead me too far Lord if this is not your will for me."

But the Lord was probably scratching his head saying, "Can't you see that it is? But I am patient, I'll let you see..." He did, and I never looked back. He changed my Papa's heart...He blessed my sisters' work tremendously and I have never once felt that I was a burden to them...He led me to FEU-NRMF and introduced me to a scholarship opportunity during the orientation, that could provide me with more than enough funds for my books, school materials (a laptop, a tablet), daily needs and more...He gave me the courage to apply and the favor to be accepted...He showed me grace and favor in every class, every exam, every project, and enabled me to meet the requirements to maintain the scholarship...He led me to people who've become my family in this journey...He increased my influence and expanded my territory...and He enabled me to finish, not just strong, but strongest. There were a lot of trials and disappointments too along the way, but not being in control did not scare me. It made me braver, and motivated me to continue, comforted by the knowledge that the One in charge and the One who put me here, is (as the song goes) a Waymaker, Miracle Worker, and a Promise-keeper. 

We still have a long way to go Lord, but despite not knowing what's in store especially with the pandemic,  I am not worried 😊. My role in this partnership is to obey and respond. I do not need to know what your plans for me are exactly. Your unchanging character, your might, and your love for me assures me that it will be awesome! My prayer now, is no longer that you won't lead me too far, but only that You would lead me and help me stay on track (cue You Make Me Brave by Bethel Music). 

All glory to you Lord! Thank you for this victory! 🙏

Love, 

Katrina A. Paglicawan, RN

Doctor of Medicine, Class 2020

Magna Cum Laude 

My Australian Adventure

March 2020 is electives month and I had the wonderful privilege to take up Renal Medicine under UNSW Prince of Wales Clinical School. Who would have thought?..haha. Yet, nothing is impossible in the Lord:) This is also a welcome retreat from our very tiring clerkship rotation (still part of it, but one I was looking forward to..haha), but one that is full of learning, so it's win-win for me.

When I began writing this, I had already been living in Sydney for 2 weeks and was halfway through the month-long elective. My thoughts then were...

        The COVID-19 situation is making things complicated, and I don't know what will happen next week. Back home in the Philippines, community quarantine and curfews have already been implemented in Metro Manila. But I'm taking it one day at a time, grateful for each morning I get to wake up, assured of God's favor and protection. If I may be honest, I'm also a bit worried, but I thank the Lord for whispering peace to my heart each time I feel anxious. It doesn't mean I have the license to be careless though, He made me enter medicine after all for a purpose, so I make sure to practice frequent hand hygiene and I try to stay away from very crowded places.

My Airbnb host says I shouldn't let the virus stop me from making the most of my trip. But I'd rather be careful and come back another time, than enjoy now and expose myself, potentially exposing the people I deal with as well, including my family when I return to the Philippines. But it doesn't mean I haven't been enjoying my stay..haha..Australia is very beautiful (even the cemetery looked breathtaking to me..haha) and I'm very grateful to be here, not just for the learning, but also for the experience.  

This is also my first trip abroad alone, one month long at that, so it was very daunting at first and I got homesick during the first few days I was here. But I adjusted soon enough and I want to keep a record of my experiences as detailed as I can so I can always go back to this amazing experience:)

Day 1
I arrived safely (thank you Lord!) with only one casualty. I lost one bluetooth earphone because it fell and I could no longer find it on the floor inside the plane..huhu..luckily I still have one.
I immediately got a SIM for Wifi and an Opal card.
I thank the Lord for Loi and Kelvin, who fetched me from the airport and treated me to lunch.
Once I got settled in my booked Airbnb, I went to the grocery to get some supplies, then slept early.

It was an 8 hour travel..and I got a window seat:)

First meal with Loi and Kelvin...fresh from the flight! (in all haggardness..hehe)

I wasn't able to take pictures of my room but it was very clean and organized, and Hanny and her husband were very kind hosts. I made good use of the kitchen, and I was also provided a space for my food supplies in the cabinet and in the refrigerator. Lodging is a bit expensive in Australia but Hanny's place is less pricey compared with the others - https://www.airbnb.com/rooms/23717562?s=67&sharer_id=48720447&unique_share_id=7e19ad62-4798-44bd-a80d-3c6dd2f771d7

The neighborhood in Eastlakes was also very apt for me. All the essentials were within walking distance from our place (grocery, pharmacy, bakery, even restaurants and cafes) and I can always spend some time at the Eastlakes Reserve if if didn't feel like going home yet. 

I pass by the park (Eastlakes Reserve) on my way to and from the bus stop daily 

luto-luto din

Day 2 - First Day
I woke up early, had breakfast then prepared to go early.
I arrived before 8am, and took my time looking for the building I was supposed to go to..haha
Today's a very tiring day because aside from joining the rounds, I had to go back and forth from the hospital to the university (a bit far) in heels
Hospital Activities:
-Toured around the renal units
-Joined the doctors' rounds
-Attended the weekly teaching conference (Topic: Advanced Care Planning for CKD patients)
-Attended the Radiology Conference which I appreciated and which I hope we could also have at home

I met Gibson, Zhi and Phoebe (medical students from UNSW); Julian (intern); and Daniel (registrar). I'll be joining the general nephrology team for 2 weeks, then I'll transfer to the transplant team for the final 2 weeks.

Mishaps for the day:
- I left my glasses at The Nucleus. I left it at the table where I put it down as I was having my ID picture taken..I didn't realize it until the staff sent me an email to inform me. I got it back thank you Lord
-I lost my OPAL card..I don't know how..but because Loi told me to register it online I was able to block it and transfer all the balance to my new card..huhu..

Thank you Lord for always having my back.

I was only able to sustain logging every activity for 2 days..haha. As the days went by, I was somehow able to develop a routine:
-Wake up at 5:30am and thank God for another day (2:30am Manila time)
- Take a bath
- Have breakfast
- Walk for 10 minutes to the bus stop and try to catch Bus 357 scheduled at around 7:40am
- Arrive at the POW hospital at around 8am
- Do some reading at the hospital canteen before I go to the ward or the clinic at around 8:30am
- Go around and be a tourist if we were sent home early
- Drop by the grocery near my place before going home to check for sale on chocolates..haha

mandatory early morning selfie at the hospital for my family (part of daily updates..hehe)

       Depending on the activities scheduled for the day, I would usually leave the hospital at 3 or 4pm except on days with conferences (usually Mondays) and scheduled lectures later in the afternoon. I enjoyed the rounds and the clinics, and learned a lot from them. I especially had a great time each time I joined Dr. Fernando in the clinics. She was patient in teaching but she also challenged me with her questions and helped with my physical examination skills as well. I got to see classic signs in patients with rare diseases, that I have only seen in pictures and books. The patients were also very kind in allowing us to sit in, observe, and apply our examination skills. Their participation made a huge difference; because unlike some of the patients I had back home who weren't very keen in allowing us to attend to them because they felt that we were practicing on them, the patients that I have encountered in the wards and in the clinics thought that we have to start somewhere to become good doctors in the future, so they offered their full participation. Through my exposure, I developed a stronger appreciation of renal medicine, and healthcare in general, as I saw the impact it had to people because it was made accessible. I saw long-time lupus patients who did not look like they had it because they were managed well. I also encountered patients with Wegener's granulomatosis, sarcoidosis, and atypical HUS who developed renal complications, on top of the other more common causes such as Hypertension and Diabetes Mellitus. There were a lot of AKI cases in the wards, patients who have undergone multiple kidney transplants, and there were also patients who refused renal replacement therapy and were given best supportive care. As with all healthcare systems, there are challenges in diagnosis and management, but since they have less limitations on tests (there were many tests that I heard for the first time..haha) and resources, the only undiagnosed cases are really the challenging ones.

Also from my experience, I realized that I really have so much to work on in terms of my knowledge and physical examination skills. I will never forget that life lesson from Dr. Fernando...she said that just because we come from a developing country doesn't mean that we should limit our knowledge on the cases that we usually see. We should still know everything, so that wherever we go, we will not have a hard time adjusting. She also emphasized that a good doctor should see, note and observe things that other people usually miss. Mastery comes with practice, but not just mere practice. I should always strive to be best at what I do if I want to be a good doctor in the future. I also appreciated the conferences and the lectures for students, as well as the coordination with the multidisciplinary health care team. Doctors cared about not only the physical health of the patient, but also considered how they will fare at home, referring them to the social worker, OT or PT as needed.

I also got to see snippets of how medical education and training  in Australia are being done. We no longer had the chance to switch teams, but I learned a lot from joining Daniel and Julian, and appreciated the tutorials from Victoria (intern). We also had the chance to observe Nas (registrar) perform renal biopsy at bedside; and all the consultants were very kind and accommodating of this foreign medical student from the Philippines on electives...hehe. I got close to Zhi, a Malaysian UNSW medical student who somehow took me under her wing and toured me around the uni, allowed me to tag along and join their lectures. Their setup is very different with ours, and matches the big difference in our healthcare systems. I hope to go back for training and fellowship in the future, as the Lord wills it.

a small portion of UNSW..haha

POW Clinical School - where med students can study, eat, and access the library

As for my day to day challenge of living well in a far place alone, eventually I had less mishaps..haha..and also became better in figuring out Google maps for directions for public transport.  I truly felt the Lord's hand protecting me and saving me from the consequences of my mistakes..haha. There was one time that I did not realize that I dropped my wallet because I was so amazed of the sea creatures I saw up close at the Sea Life Aquarium, but praise God for the kind lady who called my attention..haha. I also had a problem with my GERD probably because of too much coffee (their flat white is the best!), and also because I wasn't conscious about eating proper meals on time in the first week, and He saved me by leading me to our local pharmacy (very near my place) that sold not only PPIs but also my trusted Bragg apple cider vinegar. It also wasn't all study as I got the chance to tour around the usual spots, museums, malls and markets. I even did the Coogee to Bondi walk straight from morning rounds at the hospital when we were sent home early..hehe. I also went to Taronga Zoo in office attire, in heels..haha. I preferred visiting tourist spots on weekdays, to also lessen exposure with many people, so I tried to squeeze in random visits whenever we had free time at the hospital.

when I was still figuring out how to take a selfie..hehe

About the food, the coffee, cakes and fresh fruits were my favorites! I enjoyed the steak, fish and chips and avocado toast, but eventually missed the Asian cuisines..haha. I visited the usual tourist spots and eventually learned how to take a selfie (was so poor at it at first..huhu), but my most visited place of all time would have to be Woolworths..haha. It was a short walk from where I stayed, and I practically went there everyday. On my 3rd week people started hoarding essentials because of the COVID-19 situation, but I kept coming for the chocolates...haha. I went frequently to check whether the chocolates and snacks I intended to buy were on sale and I got the best deals!!!! I also did some shopping for my sisters and myself at DFO :)

Daily grocery visit..hehe

It was truly an experience of a lifetime. It also was a test of faith because I was still there when they declared that the entire Luzon will be under enhanced community quarantine. My original flight schedule was canceled. It got rescheduled twice but all those also got cancelled. My family was worried about me as well and I thank the Lord for the wisdom and provision of resources to book the last flight home from Sydney to Manila on March 24th. I also praise him for His favor, and for allowing me to settle my requirements, with all of my supervisors expressing support and understanding of the situation. I was still able to participate in the remaining lectures via online access. My original flight booking is still for refund, but what's important is I got home safely. I spent a loooot for excess baggage, because they suddenly decided to weigh the carry on luggage, but it still won't compare to the blessing of being able to catch the last flight. I am grateful for my family especially Ate who arranged the flight for me, my classmates and friends for their prayers, and also for Ate Mary who fetched me from the airport and brought me home. I remember how much I cried that day when all was settled, overwhelmed with the experience of God's sovereignty, His control of the situation, and His love for me :)

Excited to go home! (was there 2 hours before the airport opened..haha)

I remember the flight back and I wasn't worried at all. I was careful - I kept my mask on despite the discomfort it placed on my breathing and I also performed hand hygiene frequently, but all in all I was just so grateful to be on my way home :) The amenities and service of PAL certainly helped me relax as well...so sige na nga keri na yung excess baggage fee, makauwi lang..haha..I missed my family so much and although I enjoyed the sights and all the new experiences I had, I always thought about how it would have been if I was there with them. When I arrived home, I did self-quarantine for 2 weeks just to be sure, and nowadays I'm the designated errand girl for groceries and supplies, which I am happy to do.

one of the events I physically missed - Alfie's birthday!

Thank you Lord for this experience! Thank you as well for my benefactors from the Alumni Foundation who supported this medical student's dream. I never thought it would be possible, but You provided the resources through people I do not know personally, but who believed and supported my desire to see more and maximize my elective learning experience. It made me develop a greater understanding and appreciation of Renal Medicine. I still don't know if this is the path for me because nothing is really certain, but I hope to bring with me everything I've learned as I press on towards becoming the best doctor I can be, all for your glory!

Thank you Lord! You are indeed the giver of perfect gifts! I don't deserve all these but knowing how much you love me, makes me brave to ask for these amazing blessings, trusting that you have the best in store for me, beyond what I could ever ask or imagine:)