The ‘Master Teacher’ gives his final lecture

Manila, Philippines—Dr. Gregorio B. Patacsil Jr., a legendary icon in Philippine cardiology and medicine, was laid to rest this week. He was 74 years old.

Just as brave generals would die in the midst of the battlefield, Dr. Patacsil had his heart attack in the midst of a lecture before some 50 young heart specialists reviewing for the specialty exam that would qualify them to become diplomates in the field of Cardiology. Although he was just recently discharged from the hospital after more than a month’s confinement for progressive heart failure, he insisted to give the lecture to the young cardiologists with the usual passion and dedication he was noted for.

To the shock of the heart specialists listening to his lecture, he just stopped in the middle of a sentence, dropped his microphone and went into a seizure. And as if offering his own self as a human specimen for the young cardiologists to practice their know-how on cardiopulmonary resuscitation (CPR) without any modern medical equipment, he fell to the floor and was unconscious after the seizure.

The young cardiologists vigorously resuscitated him and was successful in doing it. He was immediately rushed to the nearby Medical City and at the emergency room he regained consciousness. He even joked that the ones who did the CPR pumped his chest so hard he might have broken a rib. In the next 24 hours, his heart stopped thrice more and not even the best of medical care could make it beat anymore after the third time.

‘Clinical eye’

Even after his retirement from the University of the Philippines College of Medicine, he continued to give lectures, imparting to medical students the art of physical examination or PE. His clinical acumen is well-known in the medical community, and all his students affectionately called him the Master Teacher in Cardiology.

Just by sheer PE, he could predict with reasonable accuracy what the findings would be when sophisticated tests are done on the patients. He impressed on his students and even fellow consultants that one should rely more on his or her “clinical eye,” rather than on expensive modern laboratory examinations. “You can arrive at a logical and accurate diagnosis 85 percent of the time just by mastering the art of medical history-taking and physical examination,” he would advise.

Although many believed that Dr. Patacsil had a God-given gift making his clinical eye keener than most physicians, he said that it’s a skill that could be learned and acquired by any physician who is willing to cut his umbilical cord-like dependency on sophisticated and most likely expensive laboratory procedures. “We should only request for these expensive procedures when it’s absolutely necessary,” he advised his various audiences who listened to his many lectures.

In an era when doctors are highly dependent on sophisticated laboratory equipment, just as the average individual is dependent on the cellular phone, Dr. Patacsil remained among the rapidly vanishing breed of practising clinicians who maximized their findings with the basic skills of clinical medicine—history-taking and thorough PE. “The best diagnostic tools that a doctor has are his senses,” he said emphasizing that optimizing one’s senses makes a doctor acquire a good clinical eye. He has authored several books and many articles on this subject.

Many lectures

Probably sensing that he had limited time left in the last 12 months, he volunteered to give as many lectures as his frail body could allow him to. “Marami pa akong gustong ituro sa inyong lahat (I still have a lot of things I want to teach you all),” he told Dr. Jean Alcover, senior Cardiology fellow at the University of the Philippines-Philippine General Hospital several months back. “Sana maibahagi kong lahat bago ako mamatay (I hope I could relay to you everything before I die),” he added.

When politely advised by Dr. Alcover that he had already done so much and should rest, he replied, “Kailangan kong ipasa ang alam ko (I have to pass on to others what I know).”

“I have thanked him many times, but I can never thank him enough for everything that he has done for me and the thousands of physicians he has selflessly taught,” Dr. Alcover said. “All I can give him is a promise—that I will teach as I had been taught. Sometimes, the only way we could ever pay someone back is to pay it forward.”

The Master Teacher is now gone. He will be dearly missed by his family, friends, colleagues and his countless patients all of whose lives he has generously touched, like the true healer that he was. Godspeed, Manong Greg.