Methodist Journal

FEATURED GUEST EDITOR

ISSUE INTRO

The Burgeoning Field of Cardio-Oncology

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RECOGNITIONS

Barry H. Trachtenberg Leads Issue on Cardio-Oncology

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REVIEW ARTICLES See More

Heart Failure in Relation to Anthracyclines and Other Chemotherapies

Heart Failure in Relation to Tumor-Targeted Therapies and Immunotherapies

The Role of Cardiovascular Imaging and Serum Biomarkers in Identifying Cardiotoxicity Related to Cancer Therapeutics

Prevention and Treatment of Chemotherapy-Induced Cardiotoxicity

Cardiovascular Toxicities of Radiation Therapy

Electrophysiologic Complications in Cancer Patients

Vascular Toxicity in Patients with Cancer: Is There a Recipe to Clarify Treatment?

Future Directions in Cardio-Oncology

CASE REPORTS See More

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

Anomalous Origin of the Right Coronary Artery from the Left Main Coronary Artery in the Setting of Critical Bicuspid Aortic Valve Stenosis

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Do Not Pass Flow: Microvascular Obstruction on Cardiac Magnetic Resonance After Reinfarction Following Primary Percutaneous Coronary Intervention

CLINICAL PERSPECTIVES See More

EXCERPTA

Cardio-Oncology, Then and Now: An Interview with Barry Trachtenberg

POINTS TO REMEMBER

Onconephrology: An Evolving Field

POINTS TO REMEMBER

Herbal Nephropathy

EXCERPTA

Rolling the Dice on Red Yeast Rice

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 8, Issue 3 (2012)

Humanities Full Text

ESSAY ON BEING A DOCTOR

With Actions, Not Just With Words

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Article Citation:

Rodolfo J. Oviedo. With Actions, Not Just With Words. Methodist DeBakey Cardiovascular Journal: July 2012, Vol. 8, No. 3, pp. 49-49.



Through the generosity of Charles R. Millikan, D. Min., vice president for Spiritual Care and Values Integration, an annual award competition was established at The Methodist Hospital among the resident staff. For the writing competition, residents submitted a poem or essay of 1,000 words or less for the topic, “On Being a Doctor.” A committee of 7 was selected from The Methodist Hospital Education Institute to judge the entries. Criteria for judging were established by this committee. This essay was written by the first place winner.

 

Dr. Xiomara Barrera was at the summit of her young career. International conferences where she represented the country’s obstetricians and gynecologists were not enough to distract her from her patients. Her mind could not stop thinking about Juanita, a 28-year-old woman who had been through four pregnancies that had culminated in miscarriages by the third trimester. Although an exhaustive workup had revealed no reason for her misfortune, Juanita was pregnant once again and feared the worst possible outcome. The doctor took this case as a personal problem and was determined to prevent Juanita’s baby from being claimed by death.

The most impressive prenatal care program ever implemented in the city’s hospital was dedicated to this patient. It included the latest technological advances, such as the use of ultrasound to perform measurements on Juanita’s baby girl. Dr. Barrera had recently returned from her fellowship in Paris, where she learned about that technology and others as part of her interest in highrisk pregnancies and infertility. Visit after visit, that mother’s heart would suffer from palpitations every time the doctor would describe the progress of her unnamed baby.

It was as though her mind was telling her not be excited but to anticipate the same outcome that everybody expected. Although Dr. Barrera was known to be a realistic doctor, with very honest assessments in times of possible fetal loss or risk for maternal death, her impression was different with Juanita’s baby girl. This baby had no particular reason to be lost in her mother’s uterus, no coagulability disorder that would predispose her mother to clot her blood vessels, and no medical condition that could be found in textbooks. It was all good news until the beginning of week 32. The baby’s heart rate was low for her gestational age, and the fetal monitor verified that, with every contraction, it slowed down instead of becoming more active. Moreover, she was not growing fast enough. Dr. Barrera decided to interrupt nature’s course and perform a Cesarean section to save the baby’s life. After she presented this difficult case to her colleagues, the consensus was in favor of her decision. Nothing like this had ever been done in that hospital, not for a woman with this history. Steroids were given to facilitate the development of the unnamed baby’s lungs in an effort to help her support her own life outside the mother’s protective core. To everybody’s surprise, an outstandingly loud cry was heard when the baby breathed for the first time and was delivered to the neonatologist in a sterile towel by Dr. Barrera. That little gift from heaven that weighed less than 3 pounds stayed in the ICU for a month and was sent home in great condition. Years later, Juanita introduced Dr. Barrera to her daughter, Xiomara de los Milagros, who was named after the doctor. Juanita had added “of the miracles” to acknowledge that the Lord had listened to her prayers and made the impossible possible, and huggable.

As a young teenager, I witnessed another scenario in which prayer was invoked. Dr. Guevara, a young internist from the teaching hospital in my city, became the victim of a brutal assault as he walked home one evening. He suffered from blunt trauma carried out by a baseball bat that struck his head and fractured his cranium, causing extensive intracranial hemorrhage that rendered him unconscious. The young doctor was taken to his own hospital’s ICU — only this time he was the one in critical condition, with a breathing tube connected to one of the only three ventilators available in the city.

Along came Dr. Oviedo. As the attending physician in charge of the unit, he stayed with Dr. Guevara all night, using every gram of knowledge he had acquired in the ICU during his fellowship in Paris. All the algorithms to assist the patient’s body in recovering seemed useless as he kept producing tremendous amounts of urine — his brain’s rebellion against such a crime. Even the best training in those Parisian hospitals from the masters of “reanimation,” a term describing the art and science of critical care and respiratory failure support, did not seem enough to save that life.

After numerous frustrated attempts to stop the inevitable, Dr. Oviedo listened to his heart and remembered that Dr. Guevara shared his same Christian faith. Both patient and physician believed in God’s healing power through prayer. Dr. Oviedo prayed at the bedside with his coworkers and students to ask God for the miracle of healing. And the Lord performed an amazing miracle that night. The young doctor’s body slowly returned to life, and by morning he was waking up against all prognoses. Dr. Oviedo learned a lesson that morning, a lesson of courage to express one’s faith if it serves a good purpose and if it goes along with the patient’s wishes.

These two stories are true. There are many more where these came from. Both protagonists happen to be my parents. I can humbly say that I have learned most of what it means to be a physician not through words found in textbooks or from speeches from endless rounds, but from the testimony expressed by two lives that continue to amaze me. I thank God for them because, in addition to being my wonderful parents, they are my source of inspiration when I don’t feel worthy of being called a doctor. I am a doctor, indeed, and may the Lord bless those who teach us with actions, not just with words.

Rodolfo J. Oviedo, M.D., was born in Chinandega, Nicaragua, on July 12, 1979. He was fortunate to learn about what it means to be a physician from the testimony of his parents, both doctors, in León, Nicaragua. He graduated from high school with honors in León, and at the age of 18, he and his family immigrated to the United States. He graduated summa cum laude in 2003 from The University of Saint Thomas, in Houston, with a Bachelor of Arts degree in chemistry, and he gave the commencement speech at graduation. The Doctor of Medicine degree was awarded to him by The University of Texas Health Science Center at San Antonio, where he graduated at the top of his class in 2007. Currently, he is the general surgery chief resident at The Methodist Hospital, Houston, for the 2012-13 academic year.