Saturday, May 31, 2008

Time is a funny thing

In fairness mama gaya (who is in most likelihood, as well, to be one of the very few people who will read this post) I've already had 4 posts for May.

Anyway, I write this in the middle of probably one of the scarier times I'll ever face in my life, preparing for the medical board exams. I can hear the "Gee, didn't you get enough of it the first time?" I'm 6 years removed from the time I took and passed the PT Board Exams and still I remember it to be really really tense.

Time really is a funny thing.

I say that because, med school was for the lack of a better word, an experience.

We had the boob model incident and hanging people out to dry (which Gaya loves to bring up every now and then), our basketball team competition and championship collapse(meant that we compete with ourselves rather than with the other team), the progress notes fiasco, the palpable but nonexistent Velez vs non Velez personalities, and coming together to put up one of the more successful Students' Night in recent memory "bleached" but who can forget all the stuff that happened behind the scenes with the dance and choir practices, organizing committee bickerings and the divisive Bass Amp Debacle.

Then internship came along and brought out, for most, the worst in us. We were under pressure, papers, procrastination, plasticky interactions, people angry at you for reasons that escape you and more (I ran out of P Mnemonics). I had my own personal issues with people in my group, leadership issues, work issues, personality issues, respect issues, ugghh you name it. We had it.

It has been a full year since our internship and all that stuff in med school. Blame it my reviewing pathology right now, but like an infarct that forms in the cardiac tissue after a prolonged ischemic episode, so does time slowly patches up those experiences you'd rather not have had.

Patches up, but never the same. An infarct will not make up for the normal cardiac tissue. But definitely better than damaged.

As I look up from my BRS Patho Reviewer, I see the other guys talking and catching up, planning and imagining lives beyond the board exams, I join in sometimes, smiling, tension palpable, but washed away by laughter, then comes back again. I see some of my co-PGI's now and then, as rattled as I am because our classmates have already made headway into their reviews.

Things have changed in the one year apart. All for the better, I think.

I get up, close my book and I'll probably turn in for the night. Tonett brushes her hair and gets her back and we walk through the mez, giving nods to Domeng, Dodong, Tam, April, share a laugh or two with Lugie and Chatie, and wave goodbyes to Neil and Cla-Cla.

I think we're gonna be fine from here.

P.S. Keep us in your prayers.

Wednesday, May 14, 2008


I can finally see the end to all the paperworks. Hopefully. It's been frustrating to not be able to get a signature to clear me from the Records Section of SUMC. I'm going through everybody else's charts to find if they've been hoarding my files. And once I'm done, I'm going through all the files they've returned, this way they would have no other excuses to put that scribble over the records section on that quadruple-copy clearance form.

I want to start studying already. I am starting to get scared facing the board exams so unprepared. But I'm relying on the fact that experience tells me, one can never be truly prepared for an exam of that magnitude.

So some parting words as I bid you until we meet again.


I have no doubt that Pediatrics is not my strongest suit. Yet, when I rotated at Silliman Pediatrics, well, it seemed so easy. Despite my pedestrian scores in the final exams, I think I learned much and had fun at the same time during my rotation, after all, how can you not like working with kids?

The Residents

I'll remember Dr. Ang's brooding and penetrating gaze, teachy, firm, and fair at the same time. Oh and he smiles, jokes, and laughs way way way often that the first time I was under him at his former training hospital; Dr. Bonghanoy's smile, laughter, jokes, lessons and an IV helping hand; Dr. Sinda's IV misadventures, "'matic" pose, and how to report heart rates x 4; Dr. Calumpang's laughter and coaching as well as sharing my annoyance at nonsensical late night to early morning consults; Dr. Bondad's TMZ moments at the library and advice; Dr. Singco's food and laughter; Dr. Alo's wisdom, telegraphy and, late night rounds throughout the whole hospital.

The Consultants

I can't possibly write a post that long to include all of them but I will remember revalidas and computing feeding for preterms with the institution that is Dr EBOracion; "keeping my distance" and answering 4 am queries from Dr GFGAscano; assignments from Dr BYPFlores; marvelling at the patience of Dr GNNuico; endorsements and lessons with Dr RTOngkingko, among others, all of whom added to my knowledge of pediatrics.

The 4th Floor

Thank you for all the help and trust you gave me. I will remember how you gave me the benefit of the doubt when I ordered Diazepam per rectum in a seizing patient, I had to say it twice to clearly-puzzled faces but you trusted me nonetheless. I will also easily recall the way the milk for feeding was always ready everytime "Gatas" was mentioned. I will defer from mentioning all your names 'cause I might leave somebody out, hehe. Thanks for co-managing IV's and telling me.


I grew to love IM here. I was intent on pursuing my dream field of Neurosurgery before I came to rotate at IM-SMC. Thanks to all of you, I am officially at a loss of where to go next. I loved the late night rounds, the collection of people during codes, and ultimately, I guess the challenge of diagnosing, and treating patients here appealed to the nerd in me. Haha. Me and my challenges.

The Residents

I'll remember Dr. Sat Paciencia's nosebleed ECG interpretations and slashes to the basket, but I'll let him take that 3 point shot any day; Dr. Ryan Cruz's rendition of September and videoke nights, and outings; Dr Gayle Opada's census; Dr. Charo Amasula's laughter, respect, and easy-to-get-along, we're-learning-together attitude, Dr. Dehuel Cuyacot's one-liners, impressions, petroleum jelly and of course, a venerable source of wisdom and enlightenment, Dr Jasmin Lubguban's work ethic, commander-in-chief attitude, rolled cotton and lessons; Dr Joel Borromeo's busy nights, trusting me in the ward, and learning at the ER; and last but not the least, my elder "sister" 'Nang Dr Venus Saceda, having known her before, I look to her as a model and listen to her advice, and I'll remember her for the kindness she showed all of us, work ethic and her green blue book and bright notebook.

The Consultants

Again, too many of you to mention but I thoroughly enjoyed having had a peak into the genius of Dr EGHMoleta and Dr MFUdarbe, who also happens to share a passion for sports like I do; I'll remember the suave Dr JGMagbanua, the cool Dr BGSy, the intimidating and imposing figure of Dr KTCoo, the dazzling beauty and brains of Dr SORosario and SODenura, the fanning of slides with Dr MDUy, the sharp mind of Dr JCCredo, the wisdom of Dr GBRosario, the cool Dr GNGarcia, among others whose contributions made IM fun for me.

The 3rd floor

Believe me, chaos was a mild way to put it. But yet, we made it work. Charts everywhere, sheets of paper anywhere, phones ringing off the hook, medications to be given and hallway admissions are a norm. Yet we made it work. Thank you for those who didn't get my charts when I laid them out in order, or those who got them and returned them so that I wouldn't know.


OB-Gyne here wasn't as stressful as in my previous life as an intern, and I thoroughly enjoyed it. Surgery was great as I often found myself being entrusted with suturing, incisions, assessing trauma patients which I loved doing.

The Residents

I will remember Dr. Bernadas' late night quizzes, rounds and fast OR times; Dr Sibul's patented chika endorsements, taray tirades and a really cute AJ, and Dr Badon's motherly and friendly companionship and especially deciding on dinner. For Surgery, Dr Sanico's last duty and my first, as the busiest it could possibly get with me alone outside with an anisocoric admission while he was in the OR; Dr Rebaya's captain-of-the-ship personality with questions, quizzes, and battlefriends; Dr. Jabines' laid-back personality, entrusting me with responsibility at the ER and amazing me with how sturdy a Nissan Sentra can be; Dr Guinto's do-it-all attitude and quick trigger to answering questions; Dr. Casamayor, the new guy on the block, well I got to know him before, and he has no air about him and carries his weight as a young aspiring surgeon.

The Consultants

Still too many, yet the mastery and the brains of Dr LSSerillo will not be forgotten and his revalidas during morning endorsements will be treasured; the institution that is Dr RVJandoc, steady, true, still in his "prime;" the orthopod encyclopedia and my PT anatomy teacher, Dr EPKatada; the smooth Dr MSBaviera; the brains and humor of Dr MTOzoa; the megaphone and the man in charge Dr CBRana; the fast hands of Dr MASingco; the sports enthusiasm and encouragement of Dr KLGubantes; the cool Dr STFlores; the prince of the province Dr PPAbsin, and the petite yet all-around Dr MCVera Cruz, and the bachelor Dr JAOccena. I will also not forget the never-rattled, always smiling, calm Dr VTreyes, the cool Dr GCAustria, the frantic pace and fast hands of Dr CDUy, the institution that is Dr MSKho, the young smiling Dr FPVasquez, among others.

The 2nd Floor

Dressing and late night food trips. Things were made easier in the 2nd floor from dressing to rushing to the DR and OR calls, thanks to all the nurses, aides and staff.


The Residents

I will not forget the advice, the head-bobbing, the late-night talks, the understanding, the making-children-cry, the signature of Dr Mona Ducay-Alota, Doc thank you. The voice, the gentle smile, and slow to anger, owner of the LTB Bar Dr Teng, the helpful Drs Mana and Sadjail, who has two really cute kids; the fiesty take-no-prisoners Dr Tulang, and a former resident, her coolness herself Dr Abam(b)onga.

The Consultants

Who can forget marathon rounds with sphygmomanometer in tow with Dr LTBandoy? The simple, quiet, effective Dr ELJuan; the voice of reason, and driven Dr MLUrsos, and the friendly, jolly, suave Dr RSArco.

The ER

Codes. Admissions. Toxic patients. Truly one of the best learning places in the entire hospital. I know I had my male aide moments but I thoroughly enjoyed the ER experience.

The Interns

Lost is putting it mildly. Piece of advice, listen to your superiors, know your place and check your attitude at the entrance. We may have come from different styles of training, but there is no place where you can teach humility, hard work, discipline but within yourself.

The People

From the admin, to the HR, to the dietary, to the Surebright, to the laundry, I cannot express enough how thankful I am with how great this year has turned out to be.

Until we all meet again we hope we all have your prayers.

Thank You.

I'm off to study now.

Monday, May 12, 2008

Relearning What I've Learned

I have had great teachers in my life, some more mentors, some tormentors, and some just as clueless as I was.

But med school was a different story.

You see, I am a product of a new breed of educational style, the problem-based learning method of teaching medicine.

There are different opinions regarding the system -- the conservative and old school doctors have spelled doom for it, the flexible have embraced it, though the majority probably stand in the middle and don't know what to make of it. The last group includes me, those who had no choice but to go through it.

Yes, I admit that, going into my first year of med school, I did not want to leave the safe confines of the old traditional way of teaching. But as the four years went by, I realized (not having a choice of system, aside of course) I realize, it's not without flaws but it works.

Here, the entire class is broken down into small groups and we take on a module, raise learning issues about it, read up on them, dissect the management and talk about them with our fellow classmates. In short, we sort of, teach ourselves. You're asking where the teachers are in this set-up? Well, our teachers are quietly sitting behind us, grading us with how we share, how much we delve into the subject matter, and if needed, provide often-needed insight into the problem.

In our discussions, I was fond of saying, "If I'm not mistaken..." or "If I remember correctly...", and our group preceptor (what we called our teachers) called me on it. She said, "You should have more confidence in what you know and what you've read," and "It's either you know, or you don't. You get mostly right answers to the problems but being so defensive takes away from knowing you are right."

I made it a point to never be so defensive again.

There were some forgettable experiences as well. Like the time when I was part of a group reprimanded for touching a model of the female breast that we never knew we were not supposed to handle in the first place. After all, we thought it being our surgery module, what was a supposed breast model for, aside from practicing the breast examination? Some were having a little bit of fun with it, but there were some who were practicing in earnest.

I recently finished my post-graduate internship this past April 2008 and I'm hoping to be one of those who have learned enough to pass the August board exams, and for the past year, there have been no shortage of mentors and I thank them all.

I remember, towards the end of our internship year we had an orientation into the different specialties available for aspiring physicians like us and what one general surgeon said struck me and its a philosophy I've tried to live by as I go on my path of learning: Our greatest teachers as doctors, are our patients. What you learn from one patient, absorb it, milk it for all the learning you can get, because what you learn from your patient, no one else and can take from you. It is yours and yours alone."

It was in that context that I remember one particular "teacher", way back when I was a Physical Therapy intern. I was assigned to this incomplete spinal cord injury patient for a whole month. It took painstaking PT sessions to even get him to use whatever motor function he had left, preserve it and improve on it. I had grown used to calling me "Doc" though I told him countless times I wasn't. At the end of my time at that center, we had accomplished so much that he regained standing balance and begun his gait training. When he took that step, however, unstable it was even with the gait belt in my hand and a co-intern locking his knee, there was no mistaking the happiness in his eyes. His mother came to me after and thanked me, and that she wanted to continue her son's treatment with me. I told her that he would be in good hands even in those who will follow me. I certainly hope I was not mistaken.

It was one of those pure moments in my life where I realized I made an impact in someone's life.

In retrospect, I learned then that being in the service of people, being a physician, and making an impact in other people's lives is how I want my "job" to be.

Call me naive or young, but we all once felt this way, I think. I guess, we just have to relearn from our "teachers."

Tuesday, May 6, 2008

Some Good Things

There have been too many goodbyes in my life.

As our PGI year comes to a close with mostly trying to clear ourselves from the hospital for more time for reviewing, finishing up paperwork and making discharge summaries, and packing stuff up from Abby or, in my case, from home, I find myself saying goodbye yet again.

For the record, I don't like saying goodbyes.

But slowly, surely, we have to. Arlyn has gone home to her son and family for a break before resuming her extensions, (though she would have preferred to take the boards this August), Emma is off having her own little vacation, Ligaya is saying goodbye to us tonight, as she is heading home and off to her Phuket vacation with Ria, and she most likely won't review with us (she's perfectly capable of passing without reviewing especially with that freakish brain of hers). All the rest of us left behind are left to fill up their spaces which are obviously hard to fill.

I lay in bed, feeling... well, "weak, small, and alone."

It feels like pieces of this nice year I've had are slowly being broken off into little pieces.

Removed from all other people in this life, I realized, we're simply alone. Single. Individual.

As I lay in my bed at 1:26 am, it hit me, this is ending. Should it have to? Can't it wait? Can't it go on? It was fun wasn't it? It was all about learning and helping and medicine? No answers to some questions. Uggghh, couldn't even think of something original. I had to borrow from all the other's bylines.

I slept.

I woke up.

I decided. It won't have to end. I will love my home for as long as I'll live. I'll remember SUMC and hope to come back again. I will take all those pieces and hold them dear to my heart. As they will be part of me.

It won't end, we'll see each other again guys, along life's trodden and not-so-beaten paths. I love you for being part of all this.

Though we are alone in this world, we gather strength in being together.

Some good things may never last, but sometimes, you just have to pick up where they left off.

No regrets.

Monday, May 5, 2008

Introductions please...

A while back, before all the hullaballoo of the graduation started, Dr Ducay pulled Ligaya, Tonette, and I separately aside and attempted to extract an introduction for each the other candidates for the honor of being the Most Outstanding Intern but we didn't fall for it, but we made them anyway. Hehe.

I was assigned to make one for Tonette, one that was as unbiased as I could possibly make, (haha, and I did), and I made one for Ligaya, just in case Tonette couldn't make one, knowing that she was cutting it close to the deadline, but knowing full well she'd come through as well. Dr Ducay promised to post them but still hadn't done so probably because she's off on her uhm honeymoon? Haha, I've heard Gaya's introduction for me and flattering as it sounded, it was refreshing to see me through someone else's eyes. Though I could never be as eloquent as her, here is how I see them.

Ligaya Solera

Ligaya is the complete package.

She was always smart, as she had excellent grades since probably infancy getting scholarships and finishing her pre-med degree in BS Psychology at UP Cebu. She is the eldest of two sisters and loving daughter who has never been this far away from home as now. She graduated among the top in her class at Cebu Insitute of Medicine in 2007 and came to Silliman Medical Center to explore places beyond Cebu as she has a penchant for travel and adventure, and on the oft-made comment of “wala pa juy nagmahay nga nag-PGI sa Silliman.”

She is intelligent beyond her years and is inquisitive and interested in learning even more. She is easily one of the calmest of our batch and often carries out her tasks efficiently and without much fanfare. She has the most receptive demeanor and she often quietly greets you with her trademark smile and soft-spoken with her words.

Not only is she great at her medicine but if ever there was a Renaissance woman, Ligaya would be one. She writes beautifully (those of you who want to see her work can visit her blog), and is also able to, secretly, perform songs and dance moves. She is as adventurous as they come and loves travelling so don’t be surprised if you see her in most of our outing pictures.

Ligaya Solera is a great doctor, a great friend and an even better person. She listens to her patients, does her work efficiently and effortlessly, diagnoses her patients, smartly asks and answers questions, has one of the highest marks in exams and admittedly “wa siya gamahay nga ni anhi siya sa Silliman nag-PGI.” This is why, among other things, why she is our batch’s most outstanding intern.

Marie Antonette Huyo-a

Tonette always knew that she would be a doctor.

As the eldest of three siblings, she was the only one to take interest in the field and would have an early start, having physicians as parents. Growing up she would watch her father’s procedures, an orthopedic surgeon, and her mother’s deliveries and surgeries, an obstetrics-gynecologist, and early on had her influence in choosing this field of life. She grew up in and out of the Philippines but eventually came back to study medicine at Cebu Institute of Medicine graduating last year 2007. She came to Silliman Medical Center to further her knowledge and training, and exploring new places beyond the safe confines of her home in Cebu.

Talking to her, you would know that medicine comes naturally to this petite smart woman with a clipboard of histories and often rattling off patient’s progress in the wards off the top of her head.

She usually comes off soft-spoken and shy to people who do not know her, but for us who have had the pleasure of working and simply being with her, we have come to admire her for her quiet brilliance.

One might say that confidence is an issue, and that may be the case. However, her theory is sound as she often gets good marks in exams, knows what to look for in the laboratories, alert to emergencies and answers the occasional revalida question during rounds.

Asking the personnel and staff to remember her in the wards of this institution would be a bit difficult because, in all the years that I’ve been blessed to know her, she has always been content to work behind the scenes, working quietly, effectively. Most likely, she was the doctor you referred your RBS to that you got the order to give insulin from or the doctor who inserted the IV line on the most difficult of patients. She was the intern you trusted to accompany a consultant laden with patients because you were also with another doctor making patient rounds or the intern you trusted while you took a few minutes of sleep during the duty. Most likely, she was that PGI who ably followed up your orders, referred you the results, and carried out those measures you ordered in the chart.

She is not without faults, of course, but they are few compared to her strengths, and her tireless work ethic, great attitude, and overall quiet brilliance make her our batch’s most outstanding intern.

Tonette got the nod for the top honor, but Gaya had her own awards as well with Best in IM and Pediatrics.

And I truly believe they will even be better as doctors.