NEW YORK — The hospital lobby is a blur of surgical scrubs as a shift-change approaches. But when Elmer Jacinto slips in early in pressed whites and sneakers, he draws barely a glance from the guard behind the security desk.

It's 2:15 p.m. and soon he'll begin preparing IV drips and checking temperatures, tasks assigned to an entry-level nurse. Except for the fact that he's one of only two male nurses on the floor at St. Vincent's Midtown Hospital, he's just one of the girls.

Well, here anyway.

But in his native Philippines, Jacinto is at the center of a controversy — a sellout to his critics, a paragon of hard work and admirable ambition to supporters.

Once, he was his nation's most promising young doctor. But doctors there are not well paid, and so he came to America to make more money as a nurse.

It hasn't worked out as he expected. Life in New York is exhausting and full of unforeseen pitfalls. Back home, many of his countrymen still find his choice difficult to accept, because the parable of Elmer Jacinto raises grim doubts about their future.

"Jacinto encapsulates perfectly the country's fundamental question today," one Filipino newspaper columnist opined. "Namely, why should anyone want to stay in it?"

On the Filipino island of Basilan, electricity is a sometimes event. Telephone lines deposit calls at dead-ends. Both are blamed on the Abu Sayyaf, a Muslim extremist group with an outsized reputation for violence.

So when Jacinto graduated high school there, eight years ago, he and his father set aside talk of dreams to examine reality.

"There is money in nursing," the older man counseled.

Jacinto graduated first in his nursing class, and found work at the local hospital before leaving for a better-paying job in the city. Not long after, Abu Sayyaf guerrillas stormed the hospital, taking nurses as hostages. One of Jacinto's former co-workers was killed during a shootout with Filipino soldiers.

TOPS MEDICAL EXAM

But in Manila, Jacinto pushed ahead. He enrolled in medical school, rose to the top of his class, then joined 1,800 other aspiring doctors to take the national medical exam.

When the scores were released, Jacinto was the No. 1 young doctor in the nation.

Jacinto, though, was already making other plans — to set aside his goal of becoming a neurologist to work as a nurse in America for far greater pay.

His choice should not have been a surprise. Nearly a million Filipinos take jobs abroad each year. But now the Philippines was bleeding doctors.

"Before, we just branded it as a brain drain. But I label it now as a brain hemorrhage," says Dr. Jaime Galvez Tan, a former minister of health.

He estimates that in the past five years, 9,000 Filipino doctors — out of about 56,000 — have retrained as nurses, and 5,000 have gone abroad. Some rural hospitals have few, if any, doctors and nurses, and care suffers.

Money is a major factor. A nurse in the Philippines makes $150 to $250 a month; doctors make $300 to $800. But the average registered nurse in the U.S. earns $4,000 a month.

The decision, though, remains intensely personal, and as an issue, it had generated limited attention — that is, until Jacinto set out to explain himself to a nation of 84 million people.

In early 2004, Jacinto quietly began telling others of his plans.

"Even before he announced his decision, we already felt it was coming," says Reynaldo Olazo, dean of medicine at Fatima. "It was I who brought it up because I could see his embarrassed smile."

But Jacinto's decision drew little notice until a friend suggested he talk with a reporter at one of the country's largest newspapers.

Jacinto, now 31, seems an unlikely candidate to stir controversy. With a toothy grin and somewhat large head, he has a boyish air. In conversation, he is reluctant to tout himself.

"Mister is fine," he replies to how he prefers to be addressed. "Here I am not a doctor."

Jacinto says the newspaper made him the face of an issue — the "doctor-topnotcher" who ignored the nation's interests for his own.

But he acknowledges wanting to draw attention to the shaky economic status of healthcare workers as an issue policymakers had too long ignored.

"Patriotism is a two-way process," he recalls thinking. "It's not only you as a citizen. It's also about the government that should also give you work, or something for yourself, to be able to live a dignified life."

His decision struck a nerve — and it was raw.

Jacinto's story "was like a slap in the face," Tan says. "Even ordinary people that I would meet, it was like, 'Hey, what has happened to our country?'"

"Deplorable ambition," one newspaper proclaimed.

"We cannot begrudge you, but only appeal to you to stay," a leading politician, Sen. Aquilino Pimentel Jr., said in a speech to Jacinto and nearly 950 other new doctors.

A fellow doctor, Willie Ong, wrote a "doctor's covenant," then persuaded 1,800 physicians to sign it, pledging to remain in the country for three years.

But another 2,200 turned him down.

So last year, Ong started the Movement of Idealistic and Nationalistic Doctors, or MIND, campaigning at medical schools to persuade doctors to stay even before they become doctors.

Filipino lawmakers, too, found their way to the issue. They've proposed requiring all new nurses to serve in the Philippines for two to three years before being allowed to work overseas.

The question now is whether U.S. lawmakers will speed the exodus.

When the Senate approved an immigration overhaul last summer, it included a measure allowing an unlimited number of foreign nurses to enter the country. If that becomes law, "the Philippine healthcare system will bleed to death," Tan says.

By the time U.S. lawmakers had taken up the issue, though, Jacinto had already arrived.

NEWLY MINTED RECRUITS

On a Friday night in November 2005, a China Airlines jet touched down at New York's John F. Kennedy International Airport. Twenty newly minted nurses walked down the gangway, and a recruiter stepped forward to meet them.

Jacinto and seven others were sent to Avalon Gardens, a nursing home in Smithtown, N.Y., about 50 miles from Manhattan.

For Jacinto, this new world was exciting, but alien.

The air was sharp, the ground was brittle. He and his roommates were the only people who seemed to walk anywhere in a land where most everyone moved by car.

But the jarring adjustment was minor compared with problems that over time became increasingly troubling, he and other nurses allege. Their account is strongly disputed by the nursing home operator and its sister recruitment agency.

The new employer, which had promised two months free housing, assigned eight nurses to a small, dingy home — a tight fit with three bedrooms and a single bathroom that did not always work. Jacinto and another man slept on pullout couches in the living room.

The home — a one-story bungalow large enough for a small family — still houses newly arrived nurses and their families.

On a recent visit by a reporter, it housed eight people, including three children, after two nurses had moved out. The kitchen sink was clogged shut and was draining out the window. Lights in the kitchen did not work. A rat scurried across the driveway.

After a few weeks of doing clerical work, Jacinto and the other nurses say they were assigned to nursing duties but paid less than promised. Some say they were shortchanged in other ways, not being paid for night work or given promised insurance.

By spring, they'd had enough. Their employer, who contends they were always treated fairly, says many walked out without notice, endangering patients requiring constant care.

What's clear is that on April 7, Jacinto and 10 others quit. In all, 26 nurses left, including five trained as doctors.

Not even five months had passed since Jacinto, briefly the most famous doctor in the Philippines, had arrived in the United States. Now he was anonymous — and out of a job.

REVISED MORALITY TALE

Last fall, Jacinto's face returned to front pages at home, the central character in a revised morality tale about a trap set by naive expectations.

Jacinto and the other nurses are out of work and running out of money, Filipino newspaper readers were told. Worse, they are living in abandoned, leaking houses, at the end of dark city alleys, stories said.

"They have found out for themselves that the honeyed words they had relied upon were laced with large doses of bitter circumstances when they disembarked on the shores of the promised land," Pimentel said in a speech before the Filipino Senate.

But Jacinto, himself, is missing from the discussion, grown weary of explaining himself.

On a recent afternoon, he leads the way through New York's Elmhurst neighborhood to a table at the Fay Dah Chinese bakery.

"I feel I belong here," he says. "Look, Asians. Lots of Asians."

It took just weeks for the nurses to find work, thanks to an insatiable healthcare labor market. He and three others have settled into a spare, but spotless walk-up apartment.

Once a month, he walks to the bakery and wires $500 to his parents back in Basilan.

The past year has been so tiring, he talks of remaining a nurse rather than trying to become a doctor in the United States.

Still, Jacinto says he is finding a place for himself — and a sense of peace.

He knows some in his homeland still judge him.

Well, he says, let them talk.