By Benjamin Jose Celestino Quito, M.D.

During the last two months of my training in Adult Cardiology at the University of Santo Tomas Hospital, I had the dilemma whether I should start private practice or go into subspecialty training.  I reflected on my strengths and weaknesses as a fellow in training to determine what I really like and make the right decision.  I first contemplated on going into echocardiography, but my heart directed me to a different path.  My chairman and training officer directed encouraged me to venture in cardiac rehabilitation to strengthen the current practice and build a good program in our hospital.  After careful discernment, I decided to pursue training in cardiac rehabilitation, a field that was vague to me.

My first day at the Philippine Heart Center exposed me to the postoperative chapter in a patient after cardiac surgery.  I was able to talk to my patients one or two days after a bypass or a valve surgery.  Each patient had a distinct attitude towards recovery.  Some were optimistic and had the will power to recover, but a number were uncertain whether they would be able to go back to their daily activities.

As a clinical research fellow, my role was to encourage them to enroll in the program.  I was tasked to make exercise prescriptions based on their current condition.  During the Phase 1 or in-patient program, the primary objective was early ambulation.    With the help of our physical therapists, most of our patients were able to walk after the 3rd or 4th post-hospital day.  The simple arm and leg exercises were easily learned by the patients.  

The patients were asked to come back one week after discharge to start their Phase 2 or outpatient program.  Not all decided to pursue the outpatient program due to various reasons.  However, those who pursued the program showed dramatic improvements in exercise capacity and emotional well being after finishing the 12 sessions.  

Our program was designed to foster camaraderie.  The exercises were done together as a group.  A lot of friendships among our patients were built.  I was able interact with my patients through the lectures that I gave.  It was a challenge for me to lecture in layman’s terms so they would be able to understand and apply the different theories in real life.

In a nutshell, being a clinical research fellow in cardiac rehabilitation made me more humble.  It made me empathize with my patients, and put myself in their own shoes.  As a physician, I realized that patients should be seen as persons with a body, mind and a heart.  I made a good choice.    Not only did I become a better doctor, but a better person as well.  Now I can say that the road least travelled is worth pursuing.

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