Wednesday, December 24, 2008


Jeez, people.

It's Christmas Eve and it just so happens I am in one of those jobs who Bah-Humbug's all the major holidays of the year, simply because diseases do not have holidays.

Could that massive stroke wait 'til tomorrow please? Couldn't your asthma have waited just a few more hours? Or maybe you could have scheduled that family dinner next week so that your gastroenteritis wouldn't disrupt my family dinner?

Bah! Humbug!

So what if people are nicer during Decembers? So what if the cold weather makes you want to stay in bed in the mornings? So what if it's time to spend with people who are close to you?

Parties? Schedule disruptions.
Exchange gifts? Added costs.
Bonuses? Work during holidays.

And to boot, I'll be on duty on the 25th of December. At the ER. Uggghh.

Bah! Humbug!


Christmases at home when I was a kid were always a family thing. Yeah, yeah, I had my share of gifts. But the time spent for those Christmas Eve parties with my mom. dad, brother and sister with all the cousins and the whole clan, was a blast. I'd get excited as soon as Christmas vacation started and I'd get ready for the whole shebang. I knew there would be games, and trivia, and singing and dancing. And I wanted to win everything. And the food was good and there were plenty to go around.

Singing, drinking, and laughter filled the night as we waited for midnight to strike and wish each other a Merry Christmas. We'd go to midnight mass and the choir would sing like angels and we'd be right there singing right along with them.

Not only were the family parties a blast, but Santa would come along and drop by with some gifts as well! Who knew the guy actually existed?! My brother and I would get that Nintendo Family Computer or Playstation we wanted, my sister would get new dolls and other toys she liked, and our parents right there smiling with us.

And the next morning, we'd get to sleep in from the reverie the night before.

Now those were Christmases.


I have entered the whole new world of residency training. And in most hospitals, our work knows no holidays. Yeah sure we get skeletal duties (where those not on duty don't have to come to the hospital) but so often have I been the one on duty on those days that I've forgotten how it feels NOT to come to the hospital.

The parties are still there, but with new faces -- a new family, if I may. Surely they can't take the place of siblings and parents, but they are people who share with me the same special day -- people who, like me get to work on these days when the rest of the world is taking a break.

The gifts aren't as grand, but with more meaning. The singing isn't as orchestrated but more boisterous. The dancing is more zany than actual choreography. But the fun is still there.

Reunions and classmate gatherings goodbye. I just don't have the time. Christmas shopping? I hate it because I'd have to fight off two dozen people for a shirt and get in line for 2 hours to pay for a book I found in 15 minutes. The hassle is simply not worth it.

Yeah sure, admitted patients go home as much as possible around these days, but those that are left are those patients we really need to keep an eye on -- patients who could possibly die.

And that brings me back to reality.


I dream of a Christmas where family, friends, and happiness are all around me.

Yeah, Dickens had that morbid Christmas future where Scrooge gets buried without anybody going to his funeral, but this is MY Christmas Carol and not Dickens'.

Being with people you care about and love unconditionally is simply the best way to spend Christmas for me. Those days will come -- days where I will watch the smiles on my own kids' faces as they get their gifts from under that Christmas tree in the living room and run around with their new toys, getting hugs and smiles from my parents as they get their second serving of spaghetti, seeing my brother's and sister's families gather for gift-giving and sharing stories, and watch my wife's face glow as she puts on that simple but elegant necklace I got her -- days that will make Christmases worth waiting 11 months for.

Then we'd go to Christmas mass and sing with the choir, thanking Him whose birth we celebrate, for a day in the year where everybody are truly who they are meant to be -- people that care.


As the blog spirits of Christmas past, present and future have brought me back to this keyboard and cubicle in this small internet shop beneath CIM, I've realized I've had a lot of Christmases to be thankful for, as I'm thankful for the Christmas I have this year, and for all the Christmases to come.

I've gotten this much-needed skeletal duty day off from Santa and I'm sure he's probably halfway to Brazil by now, and I spent it sleeping in, walking around the mall, and seeing Tonett at work. Simply put, doing nothing and being a bum. Yup, that's what I asked for Christmas, a break -- a day to be a bum, haha.

I'll be going on duty tomorrow, and I don't know what it holds for me. Yup, I'll be scared as heck at that ER desk, but I'd be in the company of people who are less scared or just as scared, and in that it's a better thing than spending Christmas day alone.

And I ask myself, why can't people care like this all year long? Is it that difficult to be nice for 525,600 minutes?

We can try.

And until that time comes, I'll take that one time in the year when everything glows a little bit brighter, when people care a little bit more for others than themselves, when everything is about giving rather than receiving, and, in this sometimes Scrooged mind, everything is how it is really meant to be.

Merry Christmas to one and all!

Thursday, December 18, 2008

It's that time of the year

I know Christmas is coming but what I did not realize until a few hours ago is that it is just barely 6 days away. No, it is not my first Christmas away from home. In fact, I'm pretty much used to it now. But with this thing called residency training, I haven't really delved into the whole spirit of things.

How didn't I notice?!

People are nicer.

Exchange gifts.

Our seniors asking us less questions and offering more suggestions.

Lesser frowns on people I meet.

The cool breeze wafting through my curtains in the morning.

People talking about bundles of joy and bonuses.

How come I did see it until today?

I guess, I'm more preoccupied with adjusting to this whole residency thing. Following up laboratories, not killing people, getting ready for endorsements and actually learning as much as I can before I get another crack at the ER are what mostly occupies my mind during the waking hours.

It's just hospital-home-sleep and repeat-the-next-day for me right now.

Thankfully, an occasional movie and Tonett break that cycle but, as doctors, trainees, and residents, we all live life every three days.

As I'm nearing my second month of residency and being that time of the year, I'd like to offer some nuggets of wisdom for surviving two months in a residency program:

1) Make your seniors look good. Even if you end up looking ridiculously dumb. But if you are not ridiculously dumb, you'd find a way to make both of you look good.

2) Get a good history. There's just no substitute for a good clinical history and physical exam. Even if you don't know what the heck your patient is suffering from, I'm pretty sure you'd get killed in endorsements with a poor history and end up with something if you bring all your cards to the table.

3) Endorsements and morning reports are not easy things. Get ready for them and plan them in your mind.

4) Some allied medical professionals (nurses, PT's, OT's, etc) could be your best friends in the ward, helping you with patients and ward work. But a good portion of them can be the bane of your existence at times from reading too much into a simple order to not actually giving the medicines you needed to give or not referring nada to you at all.

5) Move fast. Sweat. Look toxic. Look busy.

6) Survive. Just take it an hour at a time. You'll be previous the next day, preduty after that, then repeat the cycle again.

7) Pray. Pray a lot. It helps if you have Him on your side.

As the day of Christmas draws near, I bid you all a Merry Christmas with trimmings of red, green and gold.

Somewhere in the middle of Cebu on the 25th of December, I will be on duty, at the ER, no less.

It's definitely that time of the year.

Merry Christmas.

Wednesday, December 3, 2008

In Sickness and in Health

Now that I'm a month into my residency torture err, training, there is a dearth of topics to blog about. But somehow, you always find something that will make you write and share.

There are two people whom I have come to admire these past few days and they aren't consultants, seniors nor doctors for that matter. They are ordinary, everyday, SO's (significant others) of patient's admitted here at the hospital.

They have given me a perspective of how "in sickness and in health" is supposed to work.

First, Mr. Tomas (not his real name, of course). His wife was diagnosed with Gastric CA since 2003 and underwent resection and chemotherapy. She was admitted for anorexia (loss of appetite) and body malaise.

She was everything you'd notice of a cancer patient -- bald, weak, pale. She had bruises all over that I could not explain because everything was normal save for the fact that she had cancer.

Yesterday, she suddenly started screaming at the roof, praying and was restless despite the sedatives I gave her. I've noticed that patients who suddenly start seeing stuff and screaming out Bible phrases have a tendency to start heading towards that proverbial white light at the end of the tunnel.

I thought it was brain mets. CT scan negative.

I thought it was encephalopathy. Nada. Nil. Zilch.

As I was going off duty, I walked by Mr Tomas outside their room. I stopped and talked to him for a few minutes and I talked to him about where we stood with treating his wife, and anybody could see the toll of taking care of his wife on his face. His hair was a bit mussed up, eyes bloodshot and teary, unshaven and worry crinkles on his brow. He was standing outside as his two sons tried to calm their mom down inside their room. He thanked me for whatever explanation or insight I could give, mustered a smile and I bid him good night.

Later that night, his wife was transferred to the ICU because of a probable seizure disorder probably with the cancer spreading to parts of the brain not easily visible on scans.

I can only imagine what he is feeling right now. Because as corny as it sounds, one could see how much he cared by looking into those teary, bloodshot eyes.

The other person is Mrs Cecilia (again not her name). I admitted her husband for the complaint of unresponsiveness and probable severe pneumonia and a stroke. They barely scraped by with money for admission, intubation and a CT scan, and let alone the mounting expenses for antibiotics, heart medicines and the ventilator to the point that she had approached me for a DNR.

Insensitive as I was at that time, I was quietly comforted knowing she would be signing that sheet of paper that would relieve everyone of us on duty that day, of any responsibility. I almost even groaned when the attending discouraged her from doing so.

But I'm thankful I realized I was wrong.

While I monitored everything about the patient that whole day -- his vitals, his sats, his weaning, his IV's -- she was always there beside him. I could tell she loved him even from the time she came up to me and tears trickled down her cheeks asking for that piece of paper.

I gave her a smile every time I came. She smiles back.

I was assigned to another ward at the start of the month, but still I see her from time to time walking in the hallways, bringing a bottle or two of IV fluid. I asked from my co-residents how her husband was doing only to find out they have not been procuring the IV antibiotics and some meds. Sometimes they have money, sometimes they don't.

But love, in sickness and in health, they have an abundance.

And to love like they do is how love is supposed to be.