Anesthesia chief resident delivers a heartwarming response in the 2018 PGH Commencement Exercises

Dr. Mark Andrew B. Cruz, the chief resident of the department from

2017 to 2018, was chosen to deliver the response of the graduates in

the PGH Commencement Exercises last December 14, 2018.The

emotional speech was met with a standing ovation by an audience in

tears.  He was then greeted with a hug by the hospital administrators

and department officials after. 

This was the raw and honest speech delivered by Dr. Cruz in the


To our esteemed guest speaker, university officials, hospital

administrators, faculty members, distinguished guests,

fellow graduates and their parents, a pleasant morning to all of you. 

I am no valedictorian nor a topnotcher. I am standing in front of you

now, because in an era where there is a public outcry against bullying, I was bullied by my fellow chief residents to deliver this speech. Nevertheless, I am still honored for this opportunity, hopefully to share my PGH experience, inspire people and express my gratitude.

Perhaps people are wondering why I was chosen to speak on behalf of the graduates. What sets me apart from other chief residents is that I’ve been attending this ceremony for the past three consecutive years. The first year, as a graduating resident; the second year as a graduating chief resident, which by the way, is just ceremonial, as obviously, I am here again, as a graduating chief resident. Perhaps this is perplexing to some. Once I came across an intern who called me the Anesthesia lord. I was called the “strongest one”, “two-term chief”, the “forever chief,” and the “chief resident emeritus.” You name it, I was called all those flattering titles. Well, that’s because I was the brave one who accepted the prestigious, yet dreaded position, twice. 

People say that I am crazy when I accepted the position for the second time. In Anesthesia, chief residency is an extra year. So for me, that’s two extra years of my life. On my third year of residency, I used to tell my friend who is in General Surgery, “Pano ba ‘yan, mauuna na ako sa ‘yo grumaduate.” But then, I was promoted to chief resident the following year. On my last months during my first term as a chief resident, I told her again, “Matatapos na ako! Iiwan na kita.” But, I have to swallow my words again, as I extended for another year. But finally, this time, I can tell her, “totoo na ‘to” and “sabay na tayo gagraduate.”

With this, people may think that I am the best. The crème de la crème. Or what Beyonce says, Irreplaceable. But I never saw myself that way. I am just a person, in the right place but at a wrong time. It was a time when I was needed and I just felt the necessity to answer the call. A call, which made me put on hold all my other plans in life.

The call...
As doctors, the ringing of our mobile phones is one of the things that stress us the most. Most of the time, it’s a referral. A call to attend to a patient. A call to redeem a life. No matter what we are doing, be it eating a sumptuous meal after a day without a meal or catching a nap after a sleepless duty, we still drop everything to answer that call. How many times have you cancelled a planned vacation, missed celebrating birthdays and holidays or for some, lose the chance to hold a dear one’s hand before he/she passes away? I guess, countless of times. For in those moments, we choose to stay in the hospital to plan on how to manage our patients, to celebrate when our patients have recovered, or to sit beside our patients to hold their hand when they are dying. Remember the times you spent your salary to finance your patient’s mechanical ventilator, or the times when you fought with another resident for an OR slot because you believe that your patient really needs surgery. Perhaps until now, we still doubt if we are indeed selfless, for there were times, when we pampered ourselves and took the easy way out. However, I’m sure, that all of us here have an experience to share of how we once sacrificed our own comfort to answer a call. In a hospital whose thrust is to serve the poor and marginalized, we wouldn’t have gone this far if we hadn’t, even once in our stay here, learned the value of selflessness. 

Is it beautiful, or is it dangerous? To use it to drive yourself to serve is beautiful. But to let it overpower you is dangerous. 
Recently, there’s a viral theme online on how to be “extra”, meaning, how to be the best in anything. We PGH people are no strangers to this. We are extra in wisdom on what’s going on in our patients. We are extra in resourcefulness on how to deal with management limitations. We always go an extra mile not to be the best, but to see how we could change our patients’ lives. However, in our efforts to be that extra person, we forget about ourselves and once we become exhausted, we begin to question our decisions. Why do I need to cure a patient who doesn’t even know how to take care of his own life? I shouldn’t have cancelled my plans to assist a fellow resident who doesn’t know what he’s doing; and why should I help this people when I, myself can’t help myself?” But as for me, my question to myself was, “Why did I accept this position again when I should have moved on with my life?” 

On my second year as a chief resident, I was diagnosed with clinical depression, which I tried to hide at first. I was afraid of the stigma and of the thought of the strongest one becoming the weak one. Who will my residents look up to? Who will do all the work? But the more I hid it, the more I became weak until it became unbearable. 

There was a turning point when one day, I was looking out of my office window and was contemplating: “Is it high enough or maybe I should go to the eight floor?” I looked back on my desk where a framed picture of my batchmates and our past chief resident, Ma’am Annie, was standing. I suddenly remembered her advice during our endorsements, “No matter what happens, don’t forget about yourself.” Moments later, I picked up my phone and dialed numbers of psychiatric clinics. I admitted that I needed help.

“Don’t forget about yourself.”
Indeed, for us to look after others, we also have to look after ourselves. When was the last time you said to yourself, good job! When was the last time you reminded yourself where you’re good at? When was the last time you looked at the mirror and appreciated yourself? In the hustle and bustle of our daily lives, we drown ourselves with the problems of the system. We saturate ourselves with what others think about us, which further degrades our self-worth. But isn’t us who know ourselves better? We forget about our small victories and aim to win the big battles. When we drench ourselves with external pressures and push ourselves to the limits to meet expectations, sometimes, we end up being counterproductive. There are countless of times when we try to hide it when we don’t know what to do anymore; when we attempt to conceal our limitations and when we struggle to cover up our flaws. Pride...We are dubbed the premier tertiary government hospital. The university hospital of UP. Our programs are among the best in the country. We fought our way to be admitted in our respective training programs. For a person who wants to be extra, admitting that he/she has become weak is very difficult. But on contemplation, what I have realized is that the process of accepting your weakness is what makes you strong. Admitting that you need help is a way to not lose yourself. There is a huge amount of courage needed to overcome your pride, to acknowledge that we are no superhumans, and that we are bound with limitations. 

Is it what hinders us? Indeed. But if we try to acknowledge these limitations and try to go around it, then, they can propel us to actualization. Perhaps, there was a time in our stay here in PGH when, upon realization of these boundaries, we developed hate towards this institution. We see PGH as a chain that binds us from liberty and that graduation is the only way to freedom. During my battle with depression, this was my outlook. I told myself to just keep on moving forward and never look back to PGH. It was a dark moment, but as I recovered, I tried to find a light within a black tunnel. Dark as it is, but if you hold on and follow that thin strand of light, you will emerge from that tunnel. The light led me to a realization, that hadn’t I accepted the second year of chief residency; I could have went on with life without realizing my limitations; that I could have remained too drenched with career that I forget about the real joys of life. I realized that power, glory and prestige do not provide actual fulfilment. During my recovery, I once passed by a homeless father happily playing with his kid. I thought, “How could they be so happy, when I, who is seemingly blessed, can’t find joy with what I have?” And so, I rewrote my view and became forever grateful to PGH and its administration, to my chair, Dr. Pablo Lazatin III, his executive committee and faculty members, administrative staff, and my dear fellows and residents, who entrusted me the department twice and for this truly enriching experience. Undeniably, I grew up with wisdom which now, I can share to everyone

So, again, why am I the one standing here? Is it because I am the Anesthesia lord? Is it because I am special? Is it because I have a unique story to tell? I guess, all of you can relate to at least one of my stories; and that makes us no different. We have similar experiences, only written in different ways, because we existed together under one community. Coming this far, you are the Surgery lord, you are the IM lord, your are the OB lord, the Ortho lord, or the lord of your specialty. Each one is equally deserving to deliver this speech. We are all special because we have learned how to overcome our adversaries in this institution. We are connected through our PGH stories, the good ones and the bad ones. But no matter what it is, it is what molded us into what we are now.

Well, with that, I guess I’m just a graduating trainee, just like you, who was bullied to deliver this speech.

So this sums up my PGH story… What’s yours?

Copyright © 2019. UP-PGH Department of Anesthesiology. All Rights Reserved. Designed by: MAB Cruz, MD