What we chose to keep

Not everything in medicine is meant to last. Hospitals change. Systems evolve. People move on. But some things — values, friendships, the way we choose to work — are worth keeping.

When we began laying the groundwork for the Nephrology group at Makati Life Medical Center, I found myself in the rare and humbling position of working alongside doctors I had once trained. A few were former fellows. Others, I had mentored during the most formative years of their careers. Now, here they were — not as students, but as colleagues. As equals. Helping build something that felt familiar, even in a place we were only beginning to call home.

It wasn’t a planned reunion. There was no strategic campaign to assemble this group. It happened quietly, organically, and without any expectation. These doctors had practices elsewhere. They had choices. But they chose this — not because of a position or promise, but because they still believed in a certain way of practicing. They didn’t stay for a name or a structure. They stayed for something harder to define but easy to feel: shared purpose, trust, and a kind of medicine we had always tried to protect. And in a profession where movement is constant and loyalty can be fleeting, that decision meant more than they probably realized.

What we’ve created together isn’t a model that’s been rolled out hospital-wide. It’s not a policy or an institutional system. It’s just us — a small group of nephrologists who still happen to believe that collaboration works better than competition, that shared responsibility is better than isolation, and that generosity — of time, of effort, of spirit — is still possible in a field that’s become increasingly transactional.

Some days, that means sharing income through a pooled model, even if we’re seeing different volumes. Other days, it means showing up early on a Sunday because you’re on duty, no questions asked. It means trusting each other to handle patients with the same care and standards, even when no one else is watching. There’s no memo for that. No SOP. Just a mutual understanding that the work matters, and that the way we do it matters, too.

I’ve worked in hospitals where that kind of culture doesn’t exist anymore. Systems are fragmented. Relationships are surface-level. Everyone is focused on protecting their own patch. And to be honest, I understand why. The system doesn’t always reward trust. It doesn’t always make room for decency. But even so, we chose to do things differently — quietly, without fanfare, without waiting for someone to tell us it was okay. We remembered what it was like to train under people who led by example, who taught us that being a good doctor wasn’t just about knowledge or skill, but about how you treated people when no one was watching. And so, we tried to pass that on to each other. To keep it alive.

In the process, I’ve been reminded that mentorship is never a one-way street. I may have helped train some of them in the past, but today, I learn from them. I learn from their professionalism, their consistency, their patience with staff and families, and their refusal to cut corners. The work we’re doing isn’t dramatic or headline-grabbing. But it’s solid. Reliable. Sustainable. And in a world where so much feels rushed, that quiet steadiness is worth holding onto.

We joke sometimes that this is just a private club — a self-selected circle of doctors who happen to work well together and happen to share the same unspoken values. Maybe that’s true. But if it is, then I’m proud of that. Because in this little corner of our hospital, the culture still feels intact. The trust is real. And the work feels personal. Not perfect. But real.

People often talk about transformation and innovation as if they always come from the top down. But sometimes, the most meaningful change begins in small rooms, among people who simply choose to stay — not for power, not for recognition, but for each other. And maybe that’s the point. That in staying connected, in choosing to build something together again, we’ve found a way to quietly resist the more exhausting parts of modern medicine. We’ve made room for something slower, deeper and more human.

They didn’t have to stay — with me, with each other, with this kind of work. But they did. And because of that, this group—this little team that grew out of a decade of training, shared cases, and long conversations — is building something that doesn’t rely on policy or permission. It’s built on memory. On trust. On friendship.

In staying for each other, we held on to something rare. We didn’t

just stay.

We chose to keep what mattered. #RenalFamily. #CabralCountryClub.

A decade later — different setting, different name.

But the bond? Still exactly the same.