A+ to F

The funny thing about evaluations is that they often are not reflective of the body of work that you put out every single day in the ward and yet they label us for the rest of our residency lives.

It really isn't fair sometimes. I go on a 36-hour duty shift, minus stealing a few minutes to hours of some shut-eye time, weather another 24+ hours of actual work time and if I screw up for a few seconds during that time, those few seconds will become my evaluation.

Nobody really cares about the 24+ or so hours you did stuff right.

By whose standards are we graded?

I've always had standards for myself and I'm harder on myself than anybody else. Most of the time, I don't let the opinions of other people ruin my work which I know I did wholeheartedly. But yes, I do make mistakes, and it's a hard pill to swallow when those mistakes are made the sole basis of my grades. Nobody ever mentions the times you were right and shouldn't those count more than the mistakes?

Well, it should.

I've realized these past few days that in medicine, and life in general, one should:
a) evaluate oneself
b) if one is happy, content, and making the people around you better, treating them right, then you're bound to be doing something right despite all the claims otherwise.
c) realize that there are people who dwell on the wrongs than on the things done right, and that these are the people you can never ever please, (their opinions don't matter)
d) make a mental note that you only answer to the Almighty, to yourself, and to your patients.
e) come to grips that you cannot please everybody.

We are but reflections, parts and parcel of the teaching and handiwork of those that have come before us -- our seniors, our teachers, our consultants.

So if you've done a good job, we'll turn out okay. If you've done otherwise, then we might not be so good.

We are your evaluations.

August Rush

RANT ALERT!(Don't say I didn't warn you)

Another month down.

At this point in any residency training, 2 months before I hopefully enter my third year in Internal Medicine, you come to the dog days -- days when you're dead tired, getting snide remarks about your work from people who do their best work from a distance, and you sometimes, do not feel the need to go on.

These are times when you feel that quitting is an option.

Believe me, these days come.

Often.

But I have come to realize that quitting isn't an option. It is a mirage. It looks like it's there but it really isn't. It's tempting, but it won't do you any good. Sometimes you get lucky and you find a casbah and a big pool of fresh water, but if only we can all be so lucky.

I wish an 80 hour work-week was in effect in our country but it isn't. We tally a total 100+ hours by my count (my brain isn't processing numbers at this time, so I could be wrong).

I've been working with people who say that I've been extra sensitive and touchy about how I work with my patients. And these are people who aren't even doctors and do not, in the first place, have any idea what is going through the mind of one.

So to them I say, BLESS YOU!

It's the only way I know how to work. I was raised by a mother who wakes up at 5 am to go to the market and sell meat, rush home, gets into her uniform to go to the bank and comes back at night to talk to us and help us with homework; a father who goes to the bank every morning and is dedicated to his organizations.

I take pride in my work and I will rant and rave in anger at any attempt to discredit it. You can break me down, tell me I'm ugly (I hope at least I'm average-looking), fat (I do need to lose weight), dumb (now wouldn't you want me as a doctor?) and other really bad adjectives you can think of, you don't get a free pass when you talk about my work.

I give you everything I have, everyday.

He who matters (pointing up) knows I do.

And His opinion is the one that matters.

The rush of August has come and gone.

Happy August

There have been several things that have brought a smile or two to my stress-laden face these past few days. I’m not talking about the crappy one-liners that crack you up, but rather it’s all about those times that come up and surprise you – that box of chocolates, those life-affirming purpose-filling experiences and those moments that bring joyful memories and images that you just can’t help but radiate happiness.

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I’ve made it no secret that I fell in love with this line of work during my post-graduate internship. The endless diagnostic puzzles and the countless thanks we get when we see a patient walk out the hospital doors floor me now as much as it did then. And for every intern that has come through our hospital (two batches) I’ve always tried to impart that sense of awe, respect, and interest in the diagnosis and treatment of patients. One way of doing that is having them man the triage and outpatient consults (as we did then). After they see the patients and take their histories, they come to us, residents, with a plan for diagnosis and treatment. I have always given them a little free hand to do and get what they want as long as it is in line with the diagnostic possibilities.

A week ago, we were saddled with a patient with abdominal pain, mainly in the epigastric area with radiation into the back, noted after eating a meal of squid. There was epigastric tenderness and vomiting. My intern mentioned all the differential diagnoses and was hedging on Gastroesophageal Reflux Disease and Pancreatitis, ruling out of course an acute coronary syndrome with a negative ECG. I was already happy with the way she handled the patient. In the background of a previous history of GERD, it was highly likely just GERD, but she wanted to rule out Acute Pancreatitis.

I said, “Convince me to allow you to take a serum amylase.” She went into the doctors call room and brought out our text books and began to read from the symptomatology of Acute Pancreatitis. I laughed and conceded. Who couldn’t say no to that?

Serum amylase was negative. Endoscopy eventually still showed GERD.

She came up to me after the results came out and said, “Doc, I’m kind of disappointed and happy at the same time. Happy that my patient doesn’t have pancreatitis, but disappointed that I didn’t get it right.”

For someone to try that hard, to figure out a patient, and bounce back after getting it wrong is a lesson learned in itself.

That became a life-affirming moment for me. I love teaching whatever I can to those who listen and when you see it come together like that, it’s a wonderful thing.
I told her, “You can’t get all your patients right, you can hope to try, but you just can’t. It’s the thinking process that counts. And you are well on your way.”
She stood up, flashed a smile and went on to the next patient.

Small victories.

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I don't have any fangled camera DSLR's and whatnot, but I have my hearing and I've rediscovered my love for music -- thus, thanks to my mother (ever-supportive, she was the one who had us take lessons way back in kindergarten), I've been reconnecting with my love for music through a new keyboard. (thank you ma.)

As Gaya says, it's chasing giants that make this life worth living. Hahaha, if I didn't know better, I would have sworn those were lyrics. But that's just me.

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Broken

It's been too long.

It feels like it's been too long.

I spent a whole 5 years on my pre-med course, a whole 4 years on studying medicine, a year of post-graduate internship and a nerve-wracking board exam. I got through it then moved onward to practice medicine.

I'm two years into residency -- seeing patients, greeting them, diagnosing and treating them, knowing some secrets, building relationships -- and it feels like it has been forever.

We get patients, walking, talking, breathing human beings in our ER and sometimes, it would just feel good to be able to say that "You're gonna get out of here in one piece," or "it's gonna be alright," but we don't. It's not that we don't want to say it.

It's because we can't.

We don't know what's lying around that corner. Some unforeseen complication, some undiscovered comorbidity that just lurks in there and takes you away from us.

Or sometimes, we do everything we can, yet it still falls short.

I spent the better half of the past 3 weeks pondering what I could have done more at that ER table while writing down the orders for my patients to change the outcomes of the certificates I had to sign. I asked people who knew more than I did, who had seen more than I did, yet they just smiled, comforted me with words like, "it wasn't your fault," and moved on.

You see, here in impoverished Philippines and I assume in the better part of Third World Asia, we get sick patients who most of the time, do not even have the opportunities for a cure. We get a patients who don't even get a chance to swing for that home run, or that open three-point shot to tie the game. Instead, we get patients and their crying families, and we have to look them in their eyes and give them the options, surgery, a thousand-peso antibiotic to be given for two weeks, an ICU stay, eight units of blood, and what have you, but all we get in return are more tears. Then they wipe them away and all that's left are faces with clenched jaws, and flushed skin, and the realization that this is the end for a loved one. The hand is dealt and they've lost.

It's hard to be the one on that other side.

I spent a week trying to convince a patient with a manageable cerebellar stroke to undergo a needed decompression -- wall, no money.

I started two large bore IV's and got blood without delay for a patient with an upper gastrointestinal bleed and stabilized her in the ER before sending her up, but she exsanguinated and bled out 3 days later on her rebleeding probably due to massive peptic ulcer -- she was awake the whole time until the last minute, where I stood from a distance knowing full well the Do Not Resuscitate form was signed.

I did my first child intubation two weeks ago, mainly because I was at my ER post when they came. He was blue, unresponsive, and severely dehydrated. Somewhere from the first hospital they went to until they reached us, that poor kid was lost to his mother and family, and the screaming, bawling was enough to remind us of how much pain we try to prevent each single day.

I lost another patient to a puzzling diagnosis that really can't matter now because his daughters have brought him back home for his funeral rites.

We've had so many losses.

And everything goes slow each time we do that I look around and I feel that it goes on too long.

The grief, the sadness, the pain...

Sure we are not your family, we are not your friends and we are strangers but that doesn't mean we don't care.

Walk one day in my shoes as you go through the wards and the hospital rooms and see how many people we try to bring back to health. See us as we break the news to more than one family. We feel the pain too, two, three times over.

And I do.

I hurt when I lose a patient.

Each time I walk out there to talk to someone about what treatment someone's wife, or someone's mother, someone's brother, or someone's boyfriend needs, it is from the deepest, most well-intentioned part of my heart, that they heed my advice. And if by some way fate deals us something that we can't overcome, well, I am not going to pretend that choosing or making a decision is easy, but I'll be there, and I'll listen, because I do feel pain. It might not be the same as their pain, but pain and hurt nonetheless.

Like the faults that people easily notice, losses seem to count more than gains.

Reflecting, I realize I admit as few as 10 to as much as 20 people in a span of a 12 hour duty and 1 out of those 20 might die, 2or 3 might need an ICU stay, and some fraction could refuse treatment, but nobody sees the 15 or so that I help cure.

I realize that.

People can say that at times doctors are heartless and cold because we move on so quickly from a death to the next patient that walks in our doorway, but the truth is, the losses do hurt, but more people are out there who need our help, and the only way to make it hurt less, is to make the losses matter.

If the time comes when losing patients doesn't hurt anymore, it would be the time to hang up the white coat and stethoscope and stop because to what end are we working for?

For Mrs C, Mr. P, it will matter. It will count.

I'm scared every time I take that ER floor. But it is easier to accept that I am there determined to have you smiling walking out the doors, handing in your discharge papers and knowing your free of pain and sickness.

And a faint fleeting flicker of memory flashes at the back of my mind, and I remember the losses and how I should make them matter, how I should count more the gains, and move on to the next patient because I am a doctor, and that's what doctors do.

realizations

i realize that no matter how great one wants to be, and no matter how great you become, one would still be small in the grand scheme of things.↲

in residency, i have come to realize that my teachers are my patients, my books are my consultants, and how i learn is all entirely up to me and my desire to be a better doctor, nothing else.↲

i've come to realize you can serve two masters at the same time, but should these masters go on rounds at the same time, you might as well go into the emergency craniectomy and do cardiac monitoring.↲

i realize that we as a nation should have our heads straight, if all we could muster as an internet headline is that a local fastfood chain on Glee, then i should think we have either a) we do not have our priorities straight or b) we have nothing else going for us.↲

gasp, i just realized that in the above realization, it could be both.↲

i read, in a national newspaper that voters have become wiser because most senators elected in the last elections were pro-RH bill supporters. I hate to put us down, but seriously, whose leg are you trying to pull? Are you really that convinced that the first thing that came to the voters' minds was the candidates' stand on the RH Bill? Should that have been the case, in my opinion, we'd have a better cast of senators. But, i realize, that's just me.

Thanks For All That Matter

My birthday came and went like any other day.

And I realized all my birthdays had a lot of things in common. One, it is always sunny. I don't think I've ever had a birthday with rain before. I think it's probably because it's right smack in the last quarter of May but I'd like to think that I've been blessed that way -- blue skies n gentle summer breezes included.

I woke up late, and went to work. The mood I was in was just like all my other birthdays -- reflective, subdued, pensive. There's something about another year of life that gets recorded in the books that gets one thinking, well about almost everything. I look at how lucky I am to have lived this long because I've had patients younger than I, who had the misfortune of losing their lives to disease.↲

I've never made a fuss about the day itself. If I'd meet you in the hospital hallways or text me a birthday greeting, I'd be equally touched and happy that you took time to remember, but I usually don't go shouting it out to the world.

I say a prayer of thanks to Him who has blessed me with all I need in this life -- the grace of love, the safety of family, the company of great friends, the luxury of talent, the challenge of work, and all that matters. Some people search lifetimes for most of the things going for me, and I'm eternally thankful to Him for letting me get some glimpses of heaven here. Sure, I know there still will be tougher times up ahead, but like they say, these never last, tough people do.

Who Wants To Be A President?

Who do we choose as our next leader?

That question comes to the forefront of everybody's minds as they march to cast their votes at the polling precincts today here in the Philippines.

Sure we know all the candidates' platforms because these have often been recycled over the many elections I've had the fortune of taking part in during my lifetime -- create more jobs (how exactly they don't say), improve the economy (sure, sure), eliminate poverty (ugghh, how many times have I heard that). Do they really think they can do all these things and run a government of malcontents and selfish politicians only looking out for themselves? Or maybe they just want to think that.

But they are out there, asking for your votes and mine.

So we have the power to actually put someone in the driver's seat who steals and cheats the least.

So here's how I judge the candidates, not basing on their stands and platforms (because we all know that's crap) and not basing on achievements (topping a nationwide exam and passing or not passing a bill that doesn't make sense does not really count), but rather basing on the concrete things we know about our candidates.

Like:

COLOR: Primary colors are always a big hit in elections, in my opinion. They catch the attention of even the most dimwitted voter and perhaps sway them into thinking that because your giveaway (insert color here) shirts and wristbands match my (insert chosen apparel here), they'd be more likely to vote for you.

But the colors are important as often they symbolize some unattainable goal like, hmmm green for money, err, prosperity, or some save-the-environment cause, yellow for fear, err, freedom, democracy, red for bloodshed, err, power, and orange, well, I'm not sure what orange really stands for. How about a large-sized orange jumpsuit after your conviction?

3rd place: Orange, simply because it's weird and it would do well to serve as a warning to really be careful and not get caught so as to avoid having to dance Thriller and becoming the next Youtube sensation

2nd place: Yellow. Who doesn't like the bright and cheery yellow? Everybody seems so happy, and pretty and gay.

1st place: Green. It's the coolest looking color. It also provides the easiest defense for a color to the associated candidate -- environment, money and economy, development, and it makes a great looking wristband than a yellow one.

Point: Gibo

PARTNER: I don't mean the vice-presidency, because the Prexy and the VP relationship isn't what we would find in the dictionary right next to rock-solid. Ask De Castro. I mean the candidates' wives and girlfriends. It would help if you would have someone to draw the public's attention away from your receding hairline or your latest gaffe with a stunning and camera-worthy first lady/first GF.

The lineup would show:

3rd place, all the other first ladies-in-waiting.

2nd place goes to Councilor Shalani Soledad. Linked fo course to Mr Yellow Ribbon himself. Heck if she was running for VP, I'd bump Yellow Boy all the way to Numero Uno.

1st place to Rep Nikki Teodoro, who is fetching as the partner of Mr Green Himself. Not only is she a wife of the possible future president but a representative as well. Neputism all the way!

BEST SLOGAN: Catch phrases, rhymes, and really unrealistic claims plastered all over campaign posters hanging from our venerable electric posts and picturesque electric wires.

3rd place: Erap para sa mahirap. It brought him to power once, can it do it again? And that really is not a comforting thought.

2nd place: It's a tie! Toss-up between "Kung walang corrupt, walang mahirap" (True, true, are you?) and "Galing at Talino" (a lot of help if you don't want to get caught right?)

1st place: The Transformers. What can I say? You can't help but smile, stifle a laugh and imagine good old Mr Subic transforming into a bright yellow Camaro/Volskwagen and tweeting like Bumblebee. I'm thinking more Volkswagen for Gordon in Transformers 3 though.

THEME SONG: I'm a music guy so this one is a bit on the serious side so, let's go to the votes.

3rd Place: Rivermaya and Gibo with "Lipad"



2nd Place: If only for probably the only campaign song known to every kid in the Philippines, Manny Villar's Commercial comes in a close second. Now if only it had the slightest chance of coming true, I'd truly love this down to earth song and not treat it like another soon-to-be unfulfilled campaign promise. But when it comes down to it, I think the kids are singing for themselves and not for a particular candidate so, thank you Mr Orange Peel.



1st Place: I think the least heard campaign song is the best, and old Dick's supporters put this doozy of a song/jingle for Mr Subic. Enough to make me want to vote for the guy, who, realistically doesn't have a chance of winning (though a lot of people like him, they aren't voting for him, funny huh?)



So.....

All in all, we march to the polls today.

These criteria are shot. They really don't count. But it tells us that sometimes all that we have an idea about are the tastes of our candidates and what they're rolling out with to entice us to vote for them.

We know all those promises and platforms and programs aren't all going to come to fruition (hoping some of them do see the light of day), yet we hold on to hope and faith that somehow, someday, some President is going on that seat of power and realize that the Filipino people mean a lot more than just petty vote-buying and power-hunger, but people of a truly great nation.

Me? I'm voting for that guy named Wisely.

My Two Cents...

Aaah, it's April. Another month, another post.

I could not make up my mind on what to rave and rant about so I just took a couple of random snippets from the eternal sunshine of my spotless mind.

RANT: I genuinely harbor a growing dislike for expats. I guess that's too much of a generalization. Let's narrow it down to expats who think that just because they've gone to work in a foreign country, make them authorities on how to best treat their sick family members.

One incident in the recent weeks was a nurse who worked in a 1st World country (as opposed to our country's glowing ranking in the world), came to tend to his sister who had a hemorrhage in her brain due to an aneurysm. She was awake with no motor problems whatsoever. She had an elevated white blood cell count and a slight fever. To placate him, one of the attendings had an infectious disease consult immediately, and even started antibiotics for prophylaxis, but we all knew that, given the paucity of other symptoms linking to a likely infection, her fever and white blood cell count was reactive in origin.

I went on duty at the ICU and he went on about blood cultures, and how it was standard in the country he worked in to get them before starting on antibiotics, the necessity of a sputum exam, among other things that we did or did not do that apparently was common practice in his country.

Feeling a wee bit insulted, annoyed, and concerned all at the same time, I got up, spoke in perfect and straight English as I could, and proceeded to go through how a cerebral hemorrhage can cause fever complete with pathophysiology of the breakdown of red blood cells and how it can cause irritation and further inflammation, how a blood culture though useful is actually a poor yield for isolates (but you can't dispute it if you have a growth).

He looked at me in disbelief, and even gave me a grin/sneer/smile that made me even more furious and said,"That's new to me. Really?" he chuckled and added,"You'll get killed if you mention that in the NCLEX."

I smiled, and calmly said, "Oh sir, I don't need to take the NCLEX, I'm a doctor."

I gave him a pat on the back and tended to the other patients.

Welcome home.

RAVE: This season of American Idol has not been as great as seasons past. I'm glad that my preperformance favorite Crystal has quietly emerged as the frontrunner (though I usually like the underdogs, so mixed emotions about that). And that her peformance of Midnight Train To Georgia was beautiful (what can I say, I'm partial to the piano).

There were only 3 voices I liked hearing this season -- Crystal, Casey James and Alex Lambert -- since then, Lambert is gone, James has been reduced to strumming his guitar and heartthrob status, so that just leaves Bowersox for me.

My two cents worth on AI:

Michael Lynche is somehow good because there isn't anybody else who is doing the whole R and B, Hip Hop thing, he sings too much on the consonants and not the vowels, there is something that annoys me about his voice and his antics, and I don't trust a performer when it looks like anytime he could break his guitar by just cradling it.

Siobhan Magnus is serial-killer, artsy chick, Bjork weirdo singer. Sometimes I like her (Rolling Stones week), and sometimes I don't (the rest of the other weeks). I've grown to hate inappropriate screaming and she's bordering on Adam Lambert Status.

Tim Urban should be gone. Aaron Kelly and his "aw-shucks" routine is getting on my nerves. Seriously, I really wouldn't want to listen to a whole album of his songs. Lee Dewyze and Andrew Garcia are redundant. Katie Stevens (despite her sometimes look-a-like to Lei, a close friend) remind me of a beauty pageant queen / evil mastermind at the same time. And she just doesn't know what to sing.

Aaargghhh, who cares right? I'm just one vote.

RANT: My Pistons....Oh the pain.

Looking forward to the draft. This season is over for me. I could not care less who wins the championship but they better look out, next season we're coming for you.

RAVE: Hooray for the Holy Holidays and skeletal duties. Nothing like a good day's rest to get you ready for the weeks ahead. It just rejuvenates the tired soul. With that being said, I expect it's going to be a really busy busy busy week.

Happy Easter everyone.

State of the Nation

I have a bone to pick with this administration.

Why do all of you, when placed in a position of power (though how little power it is) seemingly change into pretentious, authoritarian know-it-alls who think so little of their constituents.

Why do you, madame leader, choose to point out all our flaws, and refuse to acknowledge that we are even assets to what we, the members of this coordinated effort towards success, are working for.

Followers are but reflections of the leaders who guide them.

Though it seems convenient to just cut your losses and choose the next best thing, you just can't go around firing people right?

You are supposed to lead not lynch, guide not gobble up.

But yet, there is that fine line between authority and leadership.

Some are gifted with the authority, use it, abuse it, bully people around with it.

But some are in positions of leadership where you actually give and get respect. And actually respecting the people who actually look to your position is the key to getting respect in return.

Turning your people on each other is not the way to go. Lynching your very own is definitely not a good thing.

Do not destroy the people you meet on the way to the top, because you very well might meet them when you are on your way down.

The National Elections are fast approaching and we are in dire straits. We act like everything is okay, but it is not. Leadership and authority can go together, believe me.

To our fearless head of state, do recognize that your leadership hinges on the very chains that hold this motley of people together. Do not break down each weak link but rather, strengthen it.

These are random thoughts running through my sleep-deprived mind right now. Too much politics everywhere, but when you get down to the nitty-gritty of everything, it's always about doing what's right. And you get that chance to make that difference that everybody is talking about.

Until then, we all are content to follow, endure, and pretend like it does not affect us. But there was once a time when the strength of many toppled a wise dictator, and we aren't as dumb as you think we are.

A Funny Thing

When you're me, and you've been going on duty at the medical ICU for the past four weeks, you get to see front row seats to fate's gala performances.

Stuff just happens.

And it's crazy when it happens to you.

Just when you go off duty, the weirdest things happen -- arrhythmias (really bad rhythms of the heart that believe me, you don't want to be facing alone), spontaneous pneumothorax in a patient with a chest tube, an arrest.

Just when you're done updating an attending on how unremarkable the night went for his or her patient, she crashes and you get to call them again on how you had to stick a tube down their patient's throat to help them breathe.

Just when you say the pupils are equal, the consultant comes by 30 minutes after and orders a CT scan because the pupils are not reactive to the light shone in her eyes.

When these crazy things happen, you just want to smack yourself on the side of your head.

You can only do so much to not look like an incompetent fool and worse a liar, but that's how it plays out sometimes.

Stuff happens.

Like inserting a line a really swollen, twice-my-leg-sized arm after a gazillion attempts by trained IV therapists.

You make the right call in diagnosing the patient and you silently beam, puff your chest out a little, when the attending tries to find something to chastise you about.

You don't give a crap about critics' opinion of your progress notes when you know all the patients admitted are stable because you know their cases in and out.

Times that you actually order ahead for something the consultant thinks of two days after.

That's just how it is.

Stuff happens.

Just simple random stuff.

Fate is truly a funny wicked thing.

The Soundtrack

In my previous post, I wrote about someone very very close to me is getting married to someone she really really loves (wink). (Aw c'mon, just play along, haha). And for that happy event, it's mainly her preparations and she runs stuff by me every now and then but she assigned one special thing to me -- the music.

So it's my job to come up with the bestest wedding soundtrack that says who they truly are and one or the other, these songs are going to be in.

TRAIN - Hey, Soul Sister



BOYS LIKE GIRLS - Two Is Better Than One




And one of their favorites


LOS LONELY BOYS - More Than Love

Embedding disabled for this one so click the link:

More Than Love

But here's live slower version with Ronny Millsap




No "Hopelessly Devoted To You" at this wedding. (Nothing against it though, haha, I happen to think it's a beautiful song, but not at this wedding.)

This is the music they share together and now shared with you.

You and Me

Kudos to the Dave Matthews Band for this great number at the 2010 Grammy Awards



Got me singing and thinking music all over again...

The Proposal

How do guys actually come to decide that the girl he leads out of the crowded moviehouse is the one woman he spends the rest of his life with?

How does a man realize that he guides the girl of his dreams by the small of her back to enter a restaurant and share dinner and a conversation?

What does a man feel when he is standing along that center aisle and watch the angel that is the reason for his existence glide to meet him with a radiant smile that reminds him he is the luckiest guy in the world.

Close friends have shared their memories with me, and more people dear to my heart are getting married and to me, these people, realized all these with a question they ask ... the proposal. And here's how one went...

There was a cool wind that picked up as they got out of the church attending the first afternoon mass and headed out to their car parked among the throngs of vehicles slowly filing out of the church grounds.

"Where to now?" He said with a wry smile, knowing full well it was her turn to decide the night's activities.

She let out a small laugh and said, "Hmmm, there's still some light out, do you want to check out the chateau?"

"Fine with me." He agreed opening the car door, "We don't have anything better to do anyway, and we could still use the light to check out the grounds."

Half of his consciousness was making conversation while the other half went back to when they first met and how happy everything was when he was with her. They had countless conversations of finally getting married and a proposal was just a formality. But what she did not know was that he had already gone out and bought a ring -- not just any ring, but THE ring.

He carried it in his pocket wherever he went just like he did now, waiting for an opportunity to come up where he could ask THE question. Sure, knowledge and familiarity laid things out as they were already set, but, he thought, at least the proposal would be something to remember.

A few months back, he consulted a few friends and suggestions came up from the conventional to the death-defying categories -- from a simple dinner with friends, to proposing while going down the zipline, to his own plans of go-fetch around town -- but none felt good enough for him, so he waited.

"Where is the chateau exactly?" he asked.

"Haha, I don't know uhm, exactly where it is, but I have vague idea." She laughed, which he always found irresistible.

"Gee that's a relief." He said in mock disdain, then laughed, "We'll still be able to get home right? I have to be at work early."

She punched him lightly on the arm, "Of course, we turn left at the fork in the road up ahead and it's straight on ahead. It's somewhere on the left I think, with a really big sign that we can't miss."

The last vestiges of day retreated behind the mountains on our side and the glimmer of the evening crept in. They were about to turn back when they drove up to a sign that said they were there at their chateau.

They exchanged a short smile and stepped out of the car. The same cool breeze swept through the hill and gave that all Christmas-y air.

Just before heading up, he turned around and to check the glove compartment, and took the ring and placed it in his pocket.

"She is beautiful tonight." He silently thought. "Just like any other night, and come to think of it, all the nights of the past few years we've been together."

He jogged up to her as she was already at the foot of the quaint bricklayed chateau and took her hand.

The view was breathtaking -- the city lights sparkled in the distance dotting the evening landscape, the wedding in the garden below them was wrapping up with lights hanging down from the trees like frozen yellow raindrops, and the faint hush of a man-made waterfall nearby.

She had inquired inside on the rates and was hurrying back to his side just as he was taking it all in.

"It's nice here." he said.

"Yeah, it's nice." she replied.

"You like it here?" he asked.

"I'd be okay if we have the reception here." she smiled.

They went around and went up the staircase to check the alternative venue on top of the house just in case it rained and found it to be suitable to their tastes. He felt around in his pocket and felt the ring there.

He realized that it is just not how you do ask, or when you ask, or even the years that have gone by with you together, but to paraphrase a popular movie, what matters
are "the moments that take your breath away."

And this was it.

At that viewdeck, on that chateau, on that night, he turned and said," Hon, I've tried so hard to come up with ways to ask you this -- from the weird, to the expensive, to the traditional -- trying to come up with some grand gesture to show you I love you and I want to spend the rest of my life with you, but none of them would have been me. So as we stand here, I realized that there is no need for grand gestures, because all that matters is the two of us. And there is nothing grander than that."

He reached into his pocket and took out the ring and placed it on her finger, "I've been carrying this around for a couple of months now and I've come to ask you this. Will you marry me?"

Tears had welled up in her eyes but still couldn't hide that bright twinkle as she managed to say, "I will."

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They will be married this October 23, 2010.

We shared a laugh, because the blooming bride-to-be says she couldn't remember anything said that night apart from the visit, the ring, the tears then the happy ride home. So this is to refresh her memory.

Well, I realized, it really isn't always kneeling down on one knee, or some elaborate plan to propose in the middle of the day at the mall. Others realize it on the ferris wheel or some may do it on the front porch (right gay?, congratulations their wedding will be sometime october as well).

It's simply about two people knowing what matters most to them -- each other.