Reflections of a Third World Surgeon in a First World Nation, Part 5, by Dr. Joben Abraham
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It was another busy day during my fellowship at UC Irvine, filled with trips to the operating room, research work and conference meetings. We were particularly busy that day because of several deadlines. We had multi-talented personnel who seemed to be inexhaustible in their efforts, working day and night. The enthusiasm that we shared as members of the minimally invasive urology program stemmed mainly from the leadership of our chairman RVC, who is both an innovator and inventor—the perfect example of the modern “surgeon scientist.”
Recently our team submitted various abstracts to the upcoming congress of the Society of Laparoendoscopic Surgeons, the unified society of various specialties who perform minimally invasive surgical procedures. I have been tasked to analyze and compare our experience with robotic and laparoscopic-assisted radical cystectomy for the treatment of bladder cancer. This was a huge project, being the first to prospectively study the differences between two minimally invasive approaches to bladder cancer.

Doc Joben (second from right) and colleagues during the 2007 conference of the Society of Laparoscopic Surgeons, held in San Francisco, CA.
I devoted a lot of time to this project and looked at several aspects of the study population, making certain all the details were accurate and up to date, beginning with patient demographics and treatment outcome. My mentors supervised these submissions as well, overseeing the design and content. Abstracts submitted to these scientific meeting were reviewed extensively by several experts prior to acceptance and could therefore be denied presentation if they were considered irrelevant or flawed in design. For this reason, one has to be critical with one’s work before actual submission.
It was on this one busy day that I received an email from the SLS stating that my abstract entitled “Comparative Analysis of Robotic and Laparoscopic-Assisted Radical Cystectomy with Ileal Conduit for Bladder Cancer” had been chosen the “Best Urology Scientific Paper” of the Conference. It was a great day! My mentors were very proud.
I could not contain my joy and immediately informed my family members and friends back home. My parents were extremely overjoyed and traveled to the United States to attend the conference in San Francisco, where I received this award. I think they were the happiest parents on that day. My Filipino colleagues also extended their greetings and expressed their immense delight.

Doc Joben and family during the conference.
Indeed I was very happy to represent UC Irvine during this conference but more so, I also felt the pride of being able to represent the Philippines. I knew we have many talented people all over the world in the medical field that bring honor to our country. I was so glad for having contributed to that in a small way, knowing fully well that I am not alone in this venture and that many of our Filipino friends are jubilant with my “success.”
When Pacquiao won against Hatton recently and became the undisputed pound-for-pound king in world boxing, the entire Filipino people rejoiced. This was because we were able to identify with his success and felt the joy of being able to conquer a part of the world, lifting our self-esteem and respect.
These are the things that continue to inspire me as I continue my fellowship training abroad: the incessant call to live up to the demands of the medical profession, rising up to the occasion and being proactive in the pursuit of excellence.

Dr. Paterno Dizon Jr. practices Interventional Cardiology and has contributed an article to RxPinoy Net’s efforts towards educating Filipinos about important health issues. Dr. Dizon is an RxPinoy member. Click 
Back home in the Philippines, a physician would not always readily order a CT when confronted with a patient of a similar symptom. Instead, he would rely more on his “clinical” ability to diagnose a patient, such as a detailed history and physical examination in order to make an intelligent guess. While an astute physician may lead to a correct diagnosis, an inexperienced one may linger on an erroneous one.
The goals of this fellowship focused mainly on learning minimally invasive urological techniques, which included familiarity with video-endoscopes, both rigid and flexible types, and adjunctive devices that may be used to access and treat various urinary tract diseases, whether retrogradely through the bladder, or percutaneously through the kidney (via the flank), or laparoscopically (through the abdomen).
In fact one day she remarked, “Anak, I know that you have a very active clinical practice, but what have you been doing for the poor?”

