I remember having been taught in medical school that as a doctor, one should never look at children as tiny people or smaller beings. That they should be appreciated as individuals who may need smaller doses of medicine, slower rates of dextrose solution, or lesser food, but must receive no different care than our adult patients. In most cases, they may even require more meticulous computations of dosage, more rigorous calculations of intravenous fluid rates, and more exact provisions of daily caloric requirements.

I have also learned in the short time that I practiced pediatric surgery in this city that the field necessitates that one loves children. That he should be patient with their tantrums, and should always be on the look out for their "pains". Most children do not know how to communicate their complaints, or communicate them properly, such that the doctor needs not only a so-called high index of suspicion, but the acumen to discern them adequately and clearly, to institute the proper care. I do not intend in the very least, to pass myself off as a veteran of the art, as I have been trying to grasp its wisdom and appreciate its beauty only within a few years of seven. But the challenge so far had been considerable, that I would like to look to the future with more confidence and skills required to deal with this interesting field of medicine and of surgery.

A doctor normally goes through four years of preparatory medicine in college, another four years of medical school proper, and a year of internship, before he can take the national board examination for his license. To be a pediatric surgeon, one needs to add another four years of general surgery where he learns the basics of operations (mostly on adults), before he can proceed to another two years of pediatric surgical fellowship training where he operates ONLY on children. That is a total of fifteen years. In other words, he has to learn how to operate on adults first before he can operate solely on children. This does not include his eventual taking of examinations to make him a diplomate of the field, and ultimately a fellow of his subspecialty society and the college of surgeons. The rigors that one doctor has to go through to be able to practice pediatric surgery with credentials is, therefore, at the very least, contained within some eighteen years of sustained enthusiasm and struggles, at the end of which, one wonders if it was worth all the lofty dreaming. Or why ambitions have to be scaled so high one forgets that he has himself to take care of. In short, if my child in the future asks me if I want him to become a surgeon, i would say no, much less to specialize in something like pediatric surgery.

Why all this bitterness has been ensconced in my mind, I still cannot explain. Probably it is just a sum total of the protracted struggles that an impatient soul like me cannot yet see the value of. Given time, perhaps, I will be able to look at everything without dark glasses.

Pediatric Surgery is also known as a subspecialty of, and for, the poor. Unfortunate as it may seem, congenital anomalies appear to be the exclusive properties of the lower stratum of society. Medical literature, of course, blames this on poor nutritional status of the mother, poor prenatal follow-ups and supplements, not to mention poor personal hygiene of families in the lower income bracket of society, making them more prone to virulent microorganisms that cause infections. And woe to the baby that becomes a product of a pregnancy hounded by such infections. An attempt to abort is also identified as a culprit, but guilty parents will always deny they inflicted any such evil deed on the child they now see deformed right before their eyes. Whatever the reason,or reasons, it is just a wicked twist of fate that the surgical monstrosities that I have so far encountered in my practice are from families with little or no financial resources. Perhaps, then, that's the long and short of the bitterness that I am feeling. It can be very disappointing that one cannot do much for less, for these dusts of life, whose only crime was being born.

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