Mind and Heart

Essay by Marc Gregory Y. Yu Posted online 4:50 PM 25 January 2018

BEDSIDE ROUNDS with Dr. Ramon Abarquez with medical student at the Philippine General Hospital. (Photo taken by Dr. Jean Alcover-Banal)

“NO WAY,” I thought to myself in utter disbelief. I was a lowly clinical clerk fresh into my Medicine rotation, learning the ropes of the grueling workload, when a colleague suddenly strode into the callroom bearing somewhat exuberant news: One particular consultant can apparently diagnose cholecystitis just by looking at the ECG alone.

That consultant, he stressed, was no ordinary cardiologist but a cardiologist among all cardiologists, seated aloft on an ivory pantheon reserved for the greatest of the heart gods.

Not a small feat, all right, but my skeptic self was hard-pressed to believe his story. Even imaging studies, the gold standard, do not possess 100% sensitivity in detecting cholecystitis, so perhaps the man harbored some sort of zany supernatural faculties? Later on, we’d joke among ourselves that he might be able to identify a dog merely by ECG, too, but even such a statement may end up with some truth to it. That was how I came to know Dr. Ramon Abarquez, and that was how I came to respect and admire him as an eminent clinician, teacher, and scientist.

My initial impression of Dr. Abarquez was that of a fragile-looking old man, always groomed to the nines with slick hair, a smart shirt, and starched pants. Afflicted with Parkinson’s disease, he traversed the narrow PGH corridors with a slow, shuffling gait and a characteristic hand tremor, but even these physical limitations were no match for the tenacity of a mind that cut through the most difficult cases, and the magnanimity of a heart that has always put Filipino welfare above everything else.

Rounds with Service 1, his beloved home base, was a revered tradition that unfolded every Tuesday at 8:00 A.M. “Don’t forget to reserve the small room at the back of the conference hall,” the senior resident chirped, her voice tickled with a gleeful nervousness that lent itself only in the presence of sheer genius. Then, of course, the necessary reminders. “He hates beta blockers,” chimed one junior resident. “Make sure the patient is on Digoxin,” added another. And finally, the ultimate reminder: Be ready with your patients’ ejection fractions – computed without fail using an ECG-based formula that Dr. Abarquez effortlessly derived on his own.

I was never fortunate enough to have been part of Service 1 from my clinical clerk days down to my senior resident year, but Dr. Abarquez’s rare dedication to the department was a palpable sight despite his advancing age and declining functional status. In his later years, he continued to make rounds while being pushed in a wheelchair – body somewhat frail, but mind still sharp as ever. Such mental astuteness gave rise to moments of awe-inspiring epiphany during conferences and audits. On one occasion, the cardiology fellow casually flipped through a slide showing a somewhat unremarkable ECG. “Wait, you missed aortic regurgitation,” he quickly pointed out, with nary a bat of an eyelash. Sure enough, the finding was confirmed by a definitive pathology report a few minutes after – to a wave of deservedly thunderous applause.

My first direct, albeit humorous, encounter with Dr. Abarquez was when he served as an examiner during my first-year residency oral examination. “Always remember left ventricular hypertrophy,” he emphasized, even as I rattled on with what I hoped was a sufficiently exhaustive list of pertinent cardiac differentials. ”Nah, age is just a number,” he quipped, when it was mentioned as a risk factor for hypertension. And when I proceeded to discuss dietary measures, he quietly muttered, “Just so you know, I love my porkchop.” I was left astounded, however, when he then nonchalantly excused himself and headed for the restroom – leisurely steps and all – while I fidgeted in my seat and fervently prayed for the 15-minute time limit to stretch on forever, at least until his glorious return.

Several years after, he was in the audience when I presented my case report during a competition. As I wrapped up at the podium, he asked for the mic, threw a few clarifying questions, and then gave me what must have been one of my most defining moments to this day: “That, folks, is how you present a case.” I felt the heat rise up to my cheeks when the moderator approached me right after and whispered, “With a comment like that, you might as well feel like a winner.”

I found out that even during his last days in the hospital, Dr. Abarquez dutifully carried on with writing health articles for a lay magazine and keeping abreast with the latest journal issues, a testament to his legacy of scientific pursuit and extending its reach to the masses. When news of his passing broke out like wildfire among members of the medical community, many colleagues took to their blogs and social media accounts in fond reminiscence of an extraordinary man, filled with erstwhile encounters, stirring tributes, and gushing gratitude. As for me, I’ll always see him as the embodiment of a five-star physician with a life lived to the hilt, the unalloyed union of mind and heart, body and soul.

About the Author

Dr. Marc Gregory Y. Yu graduated from the UP College of Medicine and finished both Internal Medicine residency and Endocrinology fellowship at the Philippine General Hospital. His fiction hasbeen published in the Philippines Free Press, the Philippines Graphic, Philippine Speculative Fiction 9, and Lauriat: An Anthology of Filipino-Chinese Speculative Fiction; while his nonfiction has been published in the Philippine Daily Inquirer, Tulay Fortnightly Magazine, the Canadian Medical Association Journal, Likhaan 9: The Journal of Contemporary Filipino Literature, and From The Eyes of A Healer: An Anthology of Medical Anecdotes. He received a Palanca Award for the Kabataan Essay in 2004 and a Philippines Graphic-Nick Joaquin Literary Award for Fiction in 2010.