To Serve is to Die: A Touching Doctors’ Legacy

Introduction

Every time I visit my cardiologist for a regular check-up, I cannot help but get mesmerized by her tranquility, which somehow enables me to stay calm despite my unpleasant laboratory result. During my cholecystectomy, the surgeon made me feel relaxed with her amicable approach, giving some pieces of advice, coupled with words of encouragement. Also, during the coronavirus disease 2019 (COVID-19) pandemic, having a consultation with my pulmonologist through telemedicine assured me that I would soon recover and do not need to overthink after having been infected with the virus for three times. These unforgettable experiences with my different doctors enabled me to reflect on the precious value of these health professionals in our lives. I can definitely feel the sense of empathy which enables me to be courageous enough in facing whatever pain and discomfort I have. When empathy is grounded in concern, it can promote an altruistic or helping behavior with what people are going through (van Dijke et al., 2022). Thus, let me highlight the heroic stories of three doctors who are exemplars of empathetic and unconditional service in the Philippines. They are included among the 21 doctors who died as frontliners during the early surge of the COVID-19 pandemic in 2020. Through a reflective reminiscing of their virtues, we can appreciate more their crucial role in society, and be reminded over and over again of the importance of sacrifice, service, and trust, in every doctor-patient relationship. Maintaining a harmonious relationship and partnership with them is a vital key to keep them more motivated in their chosen vocation, and makes the healthcare service delivery more successful and effective.

Sacrifice Up to the End

This was the last text message of Dr. Romeo Gregorio Macasaet III to his godson, Aboy Paraiso, that went viral online before his passing. Dr. Macasaet was one of the many healthcare professionals who died in the line of duty during the initial surge (March 2020) of COVID-19 in the Philippines. To what extent can a doctor sacrifice himself for the sake of their patients? Sacrifice is commonly described as giving up of something with such value to the agent, that foregoing it would be deprivation or a hardship, for the sake of something or someone that one values, other than oneself or one's interests (Raz, 2017). These doctors and many other health professionals who died during the pandemic made the ultimate sacrifice of losing their lives for an end that they vowed to keep — being faithful to the Hippocratic oath and their other medical declarations. Their goal is undeniably clear — to preserve and save their patients’ lives to the best of their ability, no matter how it takes.

Being part of the medical profession has always involved shouldering the burden of clinical risk and an implicit acceptance of personal sacrifice; both can challenge a personal sense of comfort. A sense of security characterizes comfort zones due to familiarity, but medical practice has always had the potential to take clinicians out of them (Simons & Vaughan, 2020). During emergencies, a doctor is on call or working round the clock. They sometimes even sacrifice their personal and family time and celebrations when their patients poorly need them. Their time and strength are shared with their patients, even during the unholy hours of the day. Aside from losing their lives, this is a great sense of sacrifice.

Service for Humanity's Sake

Dr. Marcelo Jaochico was another heartbreaking example of a heroic service to his fellow Filipinos. Residents of the Pampanga province mourned the passing of their provincial health chief, one of the pioneers in the Doctor to the Barrios program. The first quote is a social media post from Cielo, Dr. Jaochico's daughter, while the second are some remarks from a local official and other co-workers.

Dr. Jaochico's exemplifies the true spirit of service. Before the pandemic, he was one of the few doctors who go to far-flung areas in the province to render various health and medical services to the inhabitants. The concept of service in the realm of Medicine has four essential elements: to secure the health of people and the institutions that sustain it; to provide health care equally and nonjudgmentally and to treat people as ends, never as means; to assure the integrity of medical knowledge; and to do this all with benevolent intent (Reiser, 2012). These elements are indeed embodied in the humanity of Dr. Jaochico, and all the other doctors who are continuously dedicating themselves to serving their respective countries at all costs. I am amazed at how some local and foreign doctors volunteer themselves for medical missions in different far-flung provinces in the country. They have to walk for 2–3 h to reach the sites. Upon arrival, they face various challenges, such as food shortage, inadequate clean water supply, and sometimes, intermittent to no electricity supply. What is more unfortunate is that sometimes, the doctors themselves are inflicted with the disease and lose their lives.

Trust and Cooperation: A Doctor's Plea

This plea was the last Facebook post of another physician, Dr. Nicko Bautista, who died in a plane crash. He was accompanying a COVID-19 patient on a medical evacuation mission to Japan. This post was a tribute to a fallen doctor who died after being exposed to a “lying” patient. He then urged patients to disclose their health status and travel history, as not doing so may endanger the lives of the healthcare workers. His post ended with a prayer for peace as a tribute to the fallen doctor, promising that remaining frontliners like him will continue the fight.

Doctors are undeniably known to be men/women of great sacrifice and service-oriented. Despite their enormous tasks of preserving our health, they sometimes feel disappointed due to trust issues and the uncooperative behavior of their patients. Trust refers to the willingness of a party to be vulnerable to the actions of another party based on the expectation that the other will perform a particular action important to the trustor, irrespective of the ability to monitor or control that other party (Mayer et al., 1995). The doctor-patient relationship is considered as the heart of health care, and the trust of the patient is an essential aspect of that relationship. It is crucial when patients do not disclose their real condition to their doctors, it will be difficult to prescribe the right medicine, advise the corresponding treatment, or perform the required medical procedure. Doctors rely on the information provided by their patients. With this, it is also important for doctors to establish a rapport with their patients from the beginning. In relation to this, another Filipino physician, Dr. Israel Bactol lost his life on March 21, 2020 due to COVID-19 after an exposure to an elderly patient, who lied about his recent travel to China. The patient, who only disclosed about his trip three days after getting admitted, has also passed on (Sun, 2020).

Doctors play an important role in taking care of our health, thus, preserving our lives. We can witness in them some of the essential virtues that are manifested in the performance of their duties and responsibilities. Through sacrifice, they vowed to keep what they have promised in their medical declarations in doing everything for their patient's sake, no matter how difficult and dangerous the situation is. Through service, they provide unconditional healthcare even in remote places with benevolent intent. However, they also have struggles that patients should understand. They are pleading for trust and cooperation from their patients to execute an effective treatment and care management. This appropriate behavior from patients motivates them more and ignites their heart to continuously offer their service and life to everyone in need.