first and third world medicine

I came to Toronto for training primarily because I wanted to learn and grow accustomed to the theoretically ideal ways of managing a sick baby, not just to read about it off a book. And what better hospital then Sick Kids? When Dr. Skidmore (my boss now) interviewed me for this fellowship one of the key things he did point out to me is that when I go back to Manila after this stint, will I not get frustrated? And of course, I boldly said, well, who knows, maybe when I make my comeback, the resources and technology in the first world will be available then. Big words. Did I say that health care here in Toronto is free for any legitimate resident? NO limits. Now that I am a third into my fellowship, I have gotten used to having anything humanly possible to support an ill baby. Money is not an issue. Quite a far cry to how I trained as a pediatric resident and even as a practicing pediatrician in the Philippines where resource allocation was a tricky thing to manage. I remember being a resident in charge of a baby with meningitis receiving costly antibiotics. The family was poor and there were five other mouths to feed. I took out a thousand pesos off my own pocket for the mother to buy medicine. When she came back, she brought four bags full of groceries. I had no words. And now with this memory, I fear that Dr. Skidmore's words may become prophetic.