My Thank You to You, PSH

Went through my 9th graduation yesterday! Haha, looking forward to next one, hopefully.

Happy to have had one of my highly held mentors feel like he was a pufferfish, bursting with pride at the sight of all the graduates in the chapel at 3A.

I thank the CME for giving me the honor of thanking everybody on behalf of the graduates so when they called my name, I stepped to the podium, adjusted the microphone, looked up, smiled and said:

Ladies and gentlemen, good afternoon.

Just lately, I’ve come to realize how amusing it is for people to think, that after achieving a milestone in life, things get a lot easier -- you get to catch a lot more breaks here and there, or things might even get handed to you on a better-looking platter. Conversations in the coming days will go like, “O, musta na ka?” (Oh, how are you) or “Asa naman ka ron?” (Where are you based now?) and you’ll gamely reply with a smile, “Bag-o pa graduate.” (I've just graduated) or “Magsugod pa tawon.” (I'll still be starting out), and the response will be, “Aw, pero hayahay na na.” (But, it's gonna be easier now) or “Aw, basta kay humana na ka.” (Well, at least you're done!)

Come to think of it, after every personal milestone in my life, which has included eight prior graduations, that has always been the case with the all the questions, but the answers were never really the right.

Has it ever really been any easier? For every step, there has been more responsibility and more at stake. Consequently, every step has been way harder than the previous and every year a bit more challenging than the year before.

Who can remember their first days of residency – the wide eyes, the nerves, the first calls to consultants, the first reprimands, the first deaths, their first operations, their first codes, their first deliveries? As the days became weeks, weeks became months, and months became years, in came seniority, more responsibility, more disagreements and more conflicts.

So no, it has never gotten any easier. It never does and it never will.

Actually, it gets harder from here on out.

And so, what do we have to thank for after 3 or 4 years in PSH?

We thank everybody for the training.

We came here to train, learn and be more confident in treating our patients in our chosen specialties, and, personally, I can truly say that I am coming out of this institution a better doctor than when I first came in. The knowledge taken from conferences, lectures, rounds, and even mistakes, is what my mother has always said about education when I was a kid – something that cannot be truly taken away from me. So the training, the medicine, and the education we will cherish and be grateful for wherever we go from here.

But more importantly, we thank PSH for the company in this stage of our careers and this stage of our lives.

It was one of the constants we had for the past 3 or 4 years in our lives. Here, we have made our shares of irreplaceable friendships and maybe some forgettable ones. Each of the individual graduates here have shared their lives in one way or another to our second home – some fell in love here, others found their freedoms, some gave birth, some got married here and some found somewhere else to be aside from being anywhere else. And we can’t deny that all the laughter, the tears, the pains and joys, the sleepless nights turning into endless dawns, the endless holidays spent away from our families to tend to our work and the company we kept here in PSH have helped us along our way to become better persons and helped us grow.

In the past few days, I’ve had a couple of people ask me, “Is your speech ready?” or even to the extent of a friend from another hospital, jokingly asking for a copy of what I was going to say in front of you today, I’ve continuously replied with a mixture of earnest questioning and surprise. I will never have enough paper to say how I feel about having been here the past 3 years. To truly grasp that idea, one would have to be here, train here, experience it and live it here.

So to PSH, we all thank you for everything.

To our mentors, and tormentors, to our consultants, and insultants, to the staff, from the nurses to the guards that watch our cars in the parking lot, our parents, families and significant others, our utmost and immeasurable gratitude.

We all yearn to be remembered.

From a few weeks to a smattering of years from now, some of you that will be fortunate to still be here will recall an anecdote, a blooper, a desirable and undesirable quality from each of us here that you might use to make a point to some goo-goo eyed first year resident. That is our imprint on the whole PSH experience.

But rest assured, we will remember your imprint on our lives and we will be forever grateful.

From the bottom of my heart, thank you and good afternoon.

Much was said about it -- funny, facetious, nice, quaint -- but I tell you it is three things, honest, heartfelt, real.

Thank you PSH

Flood

When I was in elementary, our grade school principal usually referred to Dumaguete as a "city spoiled by God." It was a tropically beautiful city, relatively peaceful and always with the right balance of great weather.

That is why the first thing that came to my mind, when I found out that Dumaguete was one of the cities that did not fare well during Sendong's two-day havoc, I really didn't believe it at first. Then I found out on Facebook and the news and, the more important question came to mind, "What did you guys do to upset Him?"

Seriously, there has never been damage like this from a storm in Dumaguete in all my 31 years of existence. I saw a couple of houses float down Banica River when Ruping struck but that was it.

Here is a video montage I found on Youtube on the damage in my hometown.

Thankfully, my home and my family were safe and dry.

But not for others. Two of the people that help my mother in the market each lost their houses to the raging Banica river, along with everything they owned. Several bridges cracked while some collapsed. Lives were lost. Floods that carried disease increased hospital admissions. People stranded -- some missing, some worrying the people they cared about because there were no means of communication and transport.

I was finally able to come home and I saw some of the damage done by the storm -- trees uprooted, houses collapsed, and a shoreline full of debris and receding water levels in the Banica and Ocoy rivers.
There are still a lot of places in the province where there is no water and electricity available.

But, slowly, life goes on.

Some grieved for the lives they lost, some are still figuring out how to bounce back from losses of home and property, while for most, moving on begrudgingly because life doesn't stop for floods.

What is heartbreaking is that, when asked, where the families will go now that the water levels of the nearby rivers are receding, most replied that they will be returning there to start again. Not for the lack of options, but because they can't afford to be anywhere else.

The outpouring of love and compassion from other people remind us that we are capable of wondrous things when faced with adversity, but maybe if we can manage to continue the goodwill beyond these times -- beyond Christmas, beyond calamities -- we can truly say that we are making the changes that we want to see in this world.

Updates for those who call Dumaguete City home:
- Tejeros and Forest Camp are run over by boulders, mud and river water
- Shorelines are still a bit muddy but regaining the deep blue color that lace our province
- More property losses than actual lives lost, but even the lesser deaths (as compared to those in Cagayan De Oro and Iligan) still count, considering there has never been anything like this in this city
- Valencia is still struggling to get water to drink (fire trucks are making their rounds in the city)
- The spillway near Foundation University still cannot be accessed at this time, as it is still overrun by the river.

The spillway

How high do you think the water went?

That infamous stranded boat is getting a once over in the still sea.

The Rat Race? I Don't Think So.

I recently ran into an old high school friend of mine along the walkways of IT Park, Cebu while going through the motions of ending another routine study day. We didn't expect to see each other but, meetings with old friends are always nice surprises.

So we took seats outside, a local fastfood chain while I waited for my wife's chicken jambalaya and she was waiting for her work shift to start. She had just moved to Cebu and was starting a new job there after leaving her former work in Dumaguete City with her husband. It was all about advancement and such and how it hadn't provided enough growth for her and her family.

We counted that it was fourteen years since high school ended and all of our ways had to part. We shared most of what were small disappointments and mostly happy memories.

But we all had to go -- grow up, choose careers, go to college, get jobs, live.

She has been happily married for eight years, with one son. She shared that in conversations with her husband, she found it tedious to have had to start again in a new career, when at 30 they were supposed to be slowing down and enjoying the fruits of their labors and seeing their kids grow up.

I smiled, nodded, not really in agreement but mostly sympathetic and supportive.

30? Slowing down and retiring? Hmm. No.

It must be a new age thing.

I've been married, as of this writing, 1 year and almost 2 months. Kids? God-willing in the near future. Job? Physician, and just starting out, including the prospects of getting fellowships. Travel? A few places, here and there. Car? Whatever my family loans me, for now.

Happy? Definitely.

I've maintained the stand, all this time, that this life isn't a race. I've politely smiled to everybody that has remarked and commented that I'm getting too old to enjoy and see what my kids will be doing when they enter high school themselves. I know some people mean it encouragingly, when they say start a family now, build a house, because all the people around you are, but hey, which begs the questions why and why not?

Happiness is relative. So just as politely as I nod and keep silent my disagreement and project my support, do the same.

Its happiness when I see that the woman who wakes me up in the middle of the night for me to drive her to the hospital for an emergency C-Section, is the same woman who I want to wake up every Sunday morning with for the rest of my life, and hopefully, with kids knocking on the door saying it's time for church already.

Its elation when you have a job that allows you the challenge of figuring out what ails a person and actually have that same person thank you when he leaves your clinic, and I intend to do it until the day I no longer exist.

Its satisfaction when you just take time to smell the roses, be able to sit in your own little corner of the world and drink a large caramel coffee ice-blended frappuccino while rattling away emotions on some obscure blog.

Just enjoying walking slowly in the race of life.

Nerdification

I started watching downloaded episodes of The Big Bang Theory on my laptop a few months ago and it didn't take me long to realize, I had so much in common with these guys.

The realization that I was a nerd.

But what makes a nerd? Is it just wanting to be Lion-o of the Thundercats or be a member of the Silverhawks, or knowing that Patrick Stewart was Jean Luc Picard in Star Trek: The Next Generation (a series which I absolutely adored? Wanting to be MacGyver?

At times, I find myself laughing so hard at what Sheldon, Leonard, Howard and Raj talk about on the hit series and I find myself relating to everything they're doing. My wife apparently, who has come to grips with marrying one, laughs along as well.


The all knowing Wikipedia defines it as "a derogatory slang term for an intelligent but socially awkward and obsessive person who spends time on unpopular or obscure pursuits, to the exclusion of more mainstream activities." They are "stereotypically intelligent and but socially and physically awkward."

Hmmm. Hold up.  Wait a minute.

If it means growing up intellectually inclined, I guess, yes, I'm a nerd.

But I'd like to think I didn't grow up as a social outcast. I'm not saying I was a jock, given how most of my life I've made it a dream to win big on Jeopardy! but I had more than my fair share of stage time, lettered in almost every sport I could think of, dabbled in writing for the school paper and some, so pretty much a non-social outcast life.

But still, whose fault is it, (aside from myself) that has me thinking I'm more a nerd than most people I meet?

As I read on its origins, I realize that society at large is to blame. Popular culture makes this so. The norm established by "normal" people setting trends refer to social status and inclusion by referring to people of lesser stature in terms of social interaction -- the outsiders, the "nerds" -- for them to stand out.

Well, in those terms, I'm glad I'm a nerd. Seeing it through my eyes, they're the ones not on my social radar. They are outsiders to me and I'm pretty happy with how I've turned out. Even if it means knowing who Brent Spiner is.

As Charles Sykes said, "Be nice to nerds. Chances are you'll end up working for one."

Stepping Out The Door

On a bright sunny Tuesday morning, November 1, 2011, I glanced at the office's clock's second hand make its final turn. It was 7:30 am.

Flashback to the time when I first came in to this office 3 whole years ago. I arrived second that day, second to Mush, who would eventually become my competition for earliest to log in during that first year, and with whom I will proudly say, most of the time, haha, that we stuck through this residency gig and survived. It was November 1, 2008. 6:30 am. (Yes, I came in that early). A freshly minted and licensed physician armed with his stethoscope, sphygmomanometer and pen as weapons, and a trusty wooden clipboard as a shield, I went on duty.

I smiled as I sat in my usual place at the far end of the office table near the AC and the window. The early morning sunlight started peeking through the 3-year old curtains and the paging system crackled to life. I took a deep breath and lay back to stare at the ceiling. Mixed emotions washed over me as I took a mental picture of what would be the last view of this office as a medical resident at the same time, knowing I was a far cry from the physician I was when I first came here to train.

I reflected for a bit, standing up to put my things in order. I thought of the people that have come and gone -- patients who have gone home or have moved on to a better place, staff and personnel who have left for greener pastures or simply moved on to other fields, friends and colleagues who have come and gone as well -- and thought wow, it has been a great ride. The signs had been there the past few weeks -- new faces , new systems being put in place, new technology -- kind of heralding the culmination of a particular time in my life, and the beginning of another.

I finished endorsing every little thing I could think of to Pie, who is taking over my job, the night before. I checked in on the critical patient in 2A who was in severe congestive heart failure and I went on my last hospital rounds. I made sure to check the charts and the patients in each station before moving on to the next. I said my goodbyes to the hospital staff who were still on duty when I first took my first station (2C) and so with the personnel. Haha, most of them were happy to see me go, I think, for all the good and bad reasons, but hopefully mostly for the former.

I thought selfishly for a moment. I knew way before today, before I even first set foot in Perpetual Succour Hospital, what it would take to finish residency.

 Just give a damn.

Yes, if you actually care and feel the need to improve, you will find a way to do so. If you give a damn that your patient receive the best physician-care possible, you will actually give more than what is asked for. The drive of actually wanting to do a good job, will, most likely, make you do so. It will make you walk faster, get labs faster, think quicker, run, jump through hoops, prove people wrong and ultimately get the result you want. It definitely got me through the three great yet bone-tired years. It made me learn to operate the CT scan machine, just in case the technician wasn't there to do it. It made me push stretchers and ICU beds without transport personnel just so I could get imaging within the prescribed time limits. It made me brave enough to stand up to anybody, and I mean anybody, and say, all that I was doing was in the best interest of saving a life of another human being.

Apparently, the powers that be thought I was doing a good job, because they dumped a whole departmentload of responsibility on me in my senior year. Teaching the new residents, administrative, defense, representative -- all in stride, done and finished. To the open minds, I've shared most of what I knew. I've defended even those that were not worth the time for others, hoping that the promise of something better came along. And well, I felt like I did a pretty bang up job of everything.

But there's always a critic, a dissenting opinion, another point of view.

I was finishing putting my laptop in and took a sip from my gray cup of water. I glanced at the white board, the tables, the files and thought of the tears that were shed in this office, the arguments, the scolding and reprimands given, the countless questions rattled off in many a morning report or ICU rounds and the countless blank stares. But for all those things were overshadowed by the comebacks, the smart replies and right answers, the laughter and joys and the growth that stemmed from taking every little comment constructively. But most of all, their was strength and joy in sharing with people who actually gave a damn. Some more than others, but who cared nonetheless, to improve themselves for others.


My bags were packed and my office cubicle emptied. I slowly peeled off the taped name under my space. I turned the knob and halfway out the door, looked back inside for anything I might have left behind.

Clear.

Just a whole load of wonderful memories and a immeasurable gratitude.

See you on the flipside, PSH.

The Blur of Residency

Three years.

Almost.

As long as that as has been, I can still remember how I was during that day -- nervous but quietly confident they'll pick this newly minted physician from Dumaguete City, who knew nothing but hard work, who was naive enough to think he was going to make a difference in the world, and bullish enough to think he could do it.

It's during these times where things are kind of winding down that, it's always nice to take that proverbial time to smell the roses.

My first day: November 1, 2008. Floors assigned were 1A, 2A and 2B. I remember the mad rush for labs, the fear that my patients die at my hand, and the relief that washed over me when I turned my floors back over to the on-duty residents the next day. It was a skeletal duty day, and for those who aren't medically inclined, only those that were necessary to make the hospital function were on duty as it was, after all, All Soul's Day.

Wanting to be the upstart resident that impressed on the first day, I religiously went through all the rooms in my wards (as it should always be, wink) and did every S-O-A-P method I could think of. I had an ICU Set-up patient at floor 2B that I really really did not want to be the one to kill, so I did a more than meticulous PE. I was in there for a good couple of minutes, inhaled all the cold, musty hospital air, and then read the label on the chart.

All the precautions in place. Meningitis. Oh, crap. I was so sure I felt my neck stiffen once or twice during the whole 24 hour duty.

When that patient had episodes of dyspnea while on his ventilator, I did my best to do the troubleshooting of the settings. When I decided I needed help, I called my immediate senior, and I got the first revalida and grilling of my young residency. No worries, I learned. First, never call without actually having some idea of what I needed to refer. Nevertheless, I didn't kill my patient, and I grew to respect my senior as he would become a source of infinite learning to my batchmates and I as we went through the muck of residency together.

My first mistake: One can never get through training without falling down once, or twice along the way. I had my share. I made the mistake of sending a text message to one of my attendings about a patient who had gone into acute atrial fibrillation, became hypotensive, among other things. It turned out he was on his way to the patient, but his reply throught text reached me first -- ALL CAPS, telling me that I should call if I needed to update critical patients. That I was not being trained by his INBOX -- I laugh now, but the first time I saw that message, I thought my spirit left my body and I was looking at my pale, drained face from the next floor. Imagine my surprise when he, just as suddenly, appeared at the patient's door. I tossed him the chart and ran -- kidding, I actually survived and he was a bit more forgiving in person.

The next time he reprimanded me was for waking him up so early for an update.

He became one of my ninongs at my wedding.

I had other mess-ups, some my fault, some not entirely mine. But, like any good resident and any good friend, you take it all on the chin, put your head down then barrel your way through.

My first code: I was first year. I informed my immediate senior but after a really busy night, she was out like a light. She answered my call, said she would be down, but never got around to doing it -- where cases like the mind is willing but the body is too weak proves to be exceedingly true.

She was a Breast Cancer Stage IV with metastases to the liver and lungs. After several attempts at appraising the family on the patient's condition, they decided they still wanted the CPR even with the odds against them. The patient arrested and I quickly did a flawless intubation and manned my first code. I was the captain of the ship. Code Captain.

The only problem was that it was just me and three nurses. One nurse did the bagging, one to give the medications, and one to get everything we needed. I was left to do the chest compressions by myself and man the code at the same time. I was rattling out orders while doing CPR all by my lonesome for a good 1 1/2 hours. I didn't even notice that one of the patient's relatives was actually taking pictures and videos of the whole thing. After we saw her, I was quick to send her out. It wasn't that we were doing anything wrong, it was just plain weird.

Time of death: 4:30 am.

My small victories: There are so many among which are making admitting orders for a patient in congestive heart failure with an array of arrhythmias where all the cardiology fellow on duty could order on the chart was "attach copy of ECG tracing at chart," being able to actually win a bet against a consultant/fellow that the patient was having digitalis toxicity rather than just plain hypokalemia, and going through a whole month in the ICU with just 3 mortalities out of 61 admissions (granted, some of those transferred out per request and passed away peacefully in the ward with DNR directives.

One cannot truly count the small victories, all that matters is that you make them count.

My band of brothers/sisters: I will forever hold dear the times spent in the trenches with my batchmates. Things happen for certain reasons, people come, people go, and I could not have asked for things to turn out any better than they have, because despite our differences, we work like the best of machines do.

To these people, I will always be indebted.

For all his patented "bowl of lies" and "snail-faced" ways, Mush was there with me from the beginning. Albeit, with two attempts at quitting under his belt, and a two-month extension coming up, I salute the guy for braving two straight years without vacation leaves, and a whole slew of controversies. He has always been a steady friend, sometimes wavering, has really-hard-to-understand principles, but I couldn't ask for maximum effort.

Christie came in December. She is, as I fondly refer to, but she vehemently rejects, is the glue. She compliments all our personalities. She holds us together with her incessant tact/naivete, and laughs at nearly everything, but is quick to shed tears for the most corniest of movies. She is one of the more honest people I have met, and sometimes to a fault, but one thing is for certain, she will always give her best. And you really could not expect anything less.

Mercurial is just one of the many adjectives for Gladys. She can become moody and snappy one minute and rolling over, crying with laughter in the next. Dependable, she zones in and simply gets the job done, her way. She will keep you in line with a sharp retort but is quick to help you when you need a hand.

Jeffrey has always been quick to lend a hand, and reliably strong against the criticisms and trash thrown at us. Aside from being an infinite supply of food, Toblerone and Lay's, he provides a level head at viewing certain subjects/problems. You don't need to tell him what to do, he just goes out and does it. His dancing and singing skills are, no doubt, valuable in presentations, though it takes quite push to get him to show his talents, he will stand there, with skinny jeans and a tight fitting shirt, grin bear it, and finishes what he starts.

Ian is the elder statesman. Haha, no doubt about it, he provides that certain maturity -- a dose of reality + dry wit + sarcasm and humor = actually good advice. Thought he has a certain code of rules that he lives by, his laid-back (literally) personality, is a welcome change to our group. But when it comes to getting stuff done, he never fails to find a way to actually make things happen.

Ours will probably go down in PSH-IM history as one of the chilled-out, hatred-free senior years of residency, and I would have it no other way.

My quiet prayers and deepest thanks go out to the people along the way. The friends I've made, the enemies who hated my guts (thank for building me up to feel that someday, with just the right amount of work, I will be better than you), for the mentors and tormentors, and for all that made a jolly rockin' great time of a residency.

I'll see you all again -- who knows, more sooner than you think, or a bit later than what you expect.

Official time-out will be October 31, 2011. 7 am.

In A Better Place

I was never really around her very long. Even on those days when she would come to visit us in Dumaguete -- on certain Christmases, on a few of her physician check-ups, or just to come see us -- I was not as close to her as grandkids to grandparents were. Maybe it was because of the distance between San Carlos City and my hometown, or maybe it was the time spent away from each other, I can't really put a finger on it but I was never really with her for very long.

Those times however few, were beautiful moments in themselves. I did not know her favorite color, her love story with my paternal grandfather, her favorite activities to pass the time away, yet I loved her with all my heart.

She passed away quietly last Saturday afternoon.

I knew she loved me too. I was the first grandson on my father's side and I knew she held me in a special light when she came all the way from San Carlos to attend my college graduation. I vaguely remember summer vacations where she would be concerned over my throwing up on the bus on arriving in San Carlos, getting us sheets for the beds I and my siblings would be sleeping in and asking my younger cousins to play with us and make us feel at home.

For that, Lola, and so much more, thank you.

I knew she loved me too, whenever I looked into her eyes from greeting her and seeing that familiar twinkle, matched with a smile that made you feel like you were the best grandson in the world. She looked every bit the wise and compassionate grandmother that I could always run to when times I needed advice.

For that, Lola, and so much more, thank you.

She was a teacher. And from the people that I know who knew her, she was a good one. She was just as great as a mother raising my dad and his brothers.

I wish she could have seen me during my wedding, one of the happiest days of my life, but she texted that she would be here in spirit, being that she was not feeling too good and probably would have been too tired from the travel and I thanked her. She was already diagnosed with Chronic Kidney Disease with all its complications, anemia, a fast-rising creatinine, hypertension, and deep inside I knew that it was a battle that could not be won. She had had several hospitalizations in hospitals near San Carlos and I kept in touch with my cousins all throughout these last few years trying to help in her treatments.

She lost that battle last Saturday, and is now in a far better place than where I am.

My Dad mentioned that an aunt said that even though I never got to see her during this last few years and despite our consults being short text messages through my cousins, Lola always considered me as one of her doctors.

I am 'la. And always will be.

You will be remembered. We love you. Rest in peace.

My Take

 ONE OF US

Someone I know is currently in the process of applying for Filipino citizenship. Yes, you read right the first time around. Somebody still actually wants to become one of us. That's what happens when, say, you're from China and you have been in the country for the better part of your life, long enough to finish medical school here, and now you're stuck with taking the Philippine Medical Licensure Examinations, one requirement of which is a Filipino citizenship.

He was in a bind because he had to have "show money" in the bank, let's say, half a million pesos, and processing, paperwork, fees, and a host of other red tape amounting to another half a million pesos.

I was shocked that if you wanted to become a Filipino these days, you'd have to shell out a million pesos for what? Poor healthcare coverage, a government system that's shot, a corrupt military that can't even defend itself, become part of the jaded, crabmentalized brown race?

Then again, we have to control the population somewhat, so I'm sure levying stupendous and exorbitant fees for immigrants is the way to go.

SUMMER MOVIES

Well, it's been disappointing so far.

The sequels are there:

Kung Fu Panda 2  - It isn't going to sneak up on you on how cool a panda looks performing Ip Man/Bruce Lee moves like how it did during the first movie. Sure the Jack Black one-liners are there and some scenes merit a few guffaws and snickers, but you get the feeling that the awesomeness is being stretched more than it should have. Maybe the 1st movie was perfect the way it ended, but then again, a buck is a buck in Hollywood.

Pirates of the Carribean Umpteenth Time - Milking the series for what its worth. And more probably coming. Honestly, I haven't seen it yet and I will, eventually, on a bootleg copy most likely. After the first few movies, you can honestly get excited to see Captain Jack Sparrow prance around for only a couple of more times before he gets annoying.

Thor - I was honestly excited to see how the Hollywood bigwigs would portray the superhero but, disappointing again. Maybe I was expecting too much? Some people I know liked it but it was dry to me. Lacking in personality and engaging conflicts, I walked out of the movie a bit dejected. I think it should be retitled Mjolnir. It was pretty much the hammer doing all the damage.

Super 8 - Well, it was okay. A homage by JJ Abrams to Steven Spielberg and it showed. The evident references to ET and Batteries Not Included and Cocoon was there. Perhaps, a more heartwarming touch would have done it, but otherwise the best storytelling of the summer so far. Great kid performers and Elle Fanning is legit.

Priest - I didn't expect to be entertained by this unheralded movie, but I was pleasantly surprised. It won't win any filmmaking awards but it engaged me from the start. Paul Bettany will always be a favorite of mine and the idea of the priests of the Roman Catholic Church as vampire-killing zen, kung fu master machines wielding weapons is a pretty fun thought.

There is still hope for summer -- I'm going to get myself a copy of Hangover 2, but it's hard to get excited about a bunch of guys getting dead drunk and forgetting what they did when I go out with my friends to do that. I end up remembering everything but they don't. There's of course, Green Lantern, Larry Crowne, Transformers, and Harry Potter.

I may rant and rave all I want, but I'm still going to watch them. In the end, Hollywood works. Hehe

THE BASKETBALL IS ROUND

I have been a Detroit Piston Fan all my life. And always will be.

But these NBA Finals have been the best in a while. The best since the Detroit Pistons shocked the Los Angeles Lakers in a 5-game sweep in 2004.

It was the talents of South Beach versus the boys from Dallas.

After what Lebron and Chris Bosh did this offseason, everybody outside of Florida hated the Miami Heat. Nobody in earnest could cheer for them save for those who were used to cheering for winners and bandwagon basketball fans. With their trio, they were going to win games and anything less than a championship would be failure.

Fail they did.

And oh the joy.

You see, I am one of those who despised James for doing what he did (leaving Cleveland, the team that will forever be associated with him since the Heat will forever be Dwyane Wade's team) and how he did it (playing around with teams, and announcing his decision on "The Decision" all over prime time TV).

I could go on and  on about how the Heat classlessly handled themselves in this Finals like how they made fun of Dirk Diggler's wheezing, fever and sinus infection and foolishly enough did it on camera, Dwyane Wade's dig at Dirk after the 2006 championships, and celebrating like they won it all after game 1, but I won't.

Instead, let's dwell on the things that will make us smile:
1. The veterans finally get rings: Jason Kidd (after 17 years, and 2 tries with the Nets - I didn't like him then cause they went through the Pistons to get to 2 Finals but lost), Dirk Nowitzki (one of the truly great shooters to play the game), Peja Stojakovic, Shawn Marion, Brian Cardinal.
2. Rick Carlisle: He was once Pistons red, white, and blue. Congratulations to him for finally getting over the hump.
3. Mark Cuban: After trying so hard, he finally shut up and actually let his players play their games. Dallas is probably the only team in the NBA where the players tell the owner to shut up, and that's actually a nice problem to have.

And the best reason to be happy about these Finals?

The catchphrases, jokes, and gimmicks! Cavs for Mavs shirts are fast sellers in Ohio, the Loss of the Rings is pretty catchy, the Heatles versus the Last Roundup, you name it.

All in all, it was one of the best Finals in recent years. Let's hope that lockout doesn't happen, because I'm up for the NBA Draft and getting ready for next season.

Now....back to work!

Room Clutter

The pharmaceutical and medical fields are inseparable.

Which is why, I find it hard to not smile in return at a medical representative despite my heavy ward workload or even when I'm in a hurry to get off work and go home, and a rep stands in front of my car to get my signature.

But what to do with all the room clutter that's left when all the dust settles, is kind of becoming a problem. All these giveaways -- large bags with their brand name logos plastered all over the front and back, large paper bags, folders with product endorsements and prices, cotton containers, soap, boxes of tissue paper both dry and wet wipes, pens, bookmarks, prescription and lab pads, clocks, you name it -- are taking up a chunk of space in our small, err, cozy room.

I love freebies as much as the next MD, but I don't go out of my way to collect them. Because more often than not, these thingamajigs all become room clutter -- space occupying lesions if you will.

Well if they're still giving them for free, I'm just gonna smile and bear it. After all, these are free. And freeloaders can't really be choosers (I wouldn't go so far as to say beggars, but let's not seem all too eager to line up sometimes?). But I wish I had space to put them where I'd actually keep our room immaculately clean.

But then again, that just wouldn't be our room, won't it?

So I'll still take the bags and give them to my mom and wife, give away the pens as nurse bribes to carry out my orders first (we get weak-a$$ pens anyway, and I have this thing about using my own pens that can actually spit out a thick black line of ink instead of gray), the prescription pads go to whoever wants them, the folders and envelopes to the office, and the sample meds to my charity patients.

All's well that ends well. The dust settles, the clutter is gone.

That is, until the next coverage day.

23rd of May

I imagine I'm graying and old as I step out onto the veranda of my humble two-story home and marvel at the way the vines cling to the once-white trellis, adding a much needed green to the fading specks of white.

Every year on the 23rd of May, I sit here, look out onto the lawn and occasionally see my grandchildren running around with reckless abandon, laughing, playing tag, the wind blowing and picking up the freshly cut grass, and maybe go through the latest book I've bought, or like what I'm doing now --write.

It is during these pensive times that I think of the life that I have lived. My parents taught me early in life to live content with what I had and not really spend beyond what I could earn. Thankfully, the hard work of medicine paid off with a fari number of patients, and eventually, good friends.

I looked up from the glow of my laptop and the silent world of my thoughts to see the reason I couldn't really ask for anything more -- just to catch a glimpse of her smile everyday, hear her thoughts and exchange an intellectual conversation -- and I never let a day pass without telling her how much she means to me.

"Hey." she says "Writing again?"

"Yup." I reply, relishing the warmth of her touch as she cupped my head in her hands and kissed me.

"Okay, don't be too long, dinner will be served in a while." She said, in her half-ment, half-kidding tone.

"Yup, I'll be right down."

I sat back to right down my thoughts to the unknowing audience of Scrubbed Out. If I had more time and more money, what would I do with it? The question was posed on the week's Blog Rounds, and I couldn't help but smile as I remember Gaya asked the same question on the relaunching of TBR, back when they added Voice of the Filipino Doctor as a byline.

I typed in simply: I'm happy, and I could not ask for anything more.

I thought about it. I wasn't Trump-rich, but the money that I had were spent on
- the majestic grand piano now standing in my music room which I proudly say I've made
- 2 self-produced albums of piano instrumentals and a 12 track CD of original songs
- the decked entertainment room complete with the latest movies and classics and a TV with 4D capability, and your choice of video games, interactive of course.
- minority stock shares in the Detroit Pistons franchise
- a beachfront house with pristine deep blue waters off Zamboanguita, a few meters walk from our family beach home
- a small ultralight plane I can fly anytime

During the first few years of our marriage, I whisked my wife off to
- travel to the places where I've always dreamed of going -- swimming in the Maldives, rocking the samba in Rio, treasure hunting in the tombs of Egypt, marveling at the ancient heads of Easter Island, walk among the mysteries of Machu Picchu, chilling in Hawaii, and standing in awe of the beautiful Northern Lights of the Arctic circle.

Well, I did spread the wealth around
- The sports center in the middle of my hometown is a delight
- My educational fund together with a couple of friends from medical school has put 50 scholars through high school and college
- A small farm on a stretch of mountain land away from the city.

Well it took a lot -- A LOT of hard work, indeed.

The sumptuous smells wafted from the downstairs dining room, as well as the sounds of scurrying feet stopped my train of thought.

Well, this should be enough for the day. One can never keep the family waiting for food, I chuckled, and I could be facing a whole slew of stern faces if I was late for dinner.

I shut down my laptop and thought about time.

Opening the door, I saw my kids gather around at the foot of the stairs and waiting expectantly, "Coming. Coming."  They had come to celebrate -- a gathering of families, and moreover to give thanks for so many blessings throughout the years.

I reached the lowermost step and was greeted with mano po's and good evening's

"Lola, eat na ta!" squealed the eldest of my grandkids.

"Wait, your lolo's still coming pa." She sat them down and looked up at me, smiling.

I smiled back, beaming back and realizing a most important thing about what to do with more time --
that time stands still in her eyes, so I plan to spend all of my spare time looking into them.

i Blog because i am

I blog because I write.

I still blog because I still write (despite the schedule making me do the contrary).

I blog because I run little commentaries about the things that happen in my life while I'm living it but sometimes too lazy to put it on a pen and paper.

I blog because I am (sorry Descartes).

I still blog because I still am.

I blog to voice out, rant, shout out and say to the unknown audience what I think about the things I write about and the world we live in.

I agree that writing has become an art with dwindling ardent practitioners, and the blog, a once nice avenue for writers has slowly given way to the shout outs on Facebook, the tweets on Twitter and what have you. Some people have resigned their infinite thoughts and compressed them into the perfect tweet or the shortest FB post.

I blog to write.

I blog to write my thoughts while thinking about what defense I think about while preparing for the mortality and morbidity conference in the next week.

I write for the Blog Rounds and the fun I have reading and writing again.

I blog because I write.

I write because I think.

I think therefore I am.

I blog = I am.

A Place I Still Call Home

The big yellow Ceres bus I was on lumbered towards the city I called home for the greater part of my life -- Dumaguete City, and which I still do.

I was coming home for the first time in three long years. To some, three years may not seem that long, but I can't even remember the last time I lingered in my hometown for more than a day. So, it was good to come home.

I had expected everything to stay the same. I got my usual attack of my allergies -- rhinitis, colds, runny nose, the works -- which has happened every time I came home ever since I left for medical school. But the changes were tangible as we rolled past the Sibulan airport with a Cebu Pacific jet taxiing down the runway, the heat was pelting the roof of the bus and the cement road endlessly.

As I passed by the buildings, I made a mental note of the changes but lost count by the time I reached the boulevard and got up to get my bags in the overhead compartments. The St Paul's First Gate lawn seemed a bit more crowded with more signs and oversized plaques, the infrastructure fronting the Provincial Hospital has seen so much growth that I don't even know half the stores in the area, heck even the bypass road now has a name and a really big hole right smack in the middle.

Some things still remained the same though. The tricycles and motorcycles still dominated the roads with bad Dumaguete City driving (every person who comes from somewhere else endlessly complains of Dumaguete drivers zipping in and out of traffic coming from out of nowhere). The pillars of the city were still standing -- Silliman University, Lee Plaza, NORSU, not to mention the Public Market, the churches and parks -- but somewhat grayed and older.

I marveled at the changes that have happened since the last time I was here. So much has changed. Stores have moved. A huge Robinson's mall now stands tall a stone's throw away from our house, with all the trimmings of big city life -- the KFC's, Crocs, iStore and an entertainment section. I'm sure the Dumaguete people are quite thankful for the decent cinemas we can go to for the latest movies.

But so much has been taken away from what I remember Dumaguete City to be. I zipped easily on that warm afternoon as sunlight was slowly creeping away, I noticed even my favorite place to buy Pan De Sal during early mornings when went to Silliman Beach when I was a kid was now closed, Gold Label Real street was gone, food places weren't where I expected them to be like Negros, Scooby's Silliman is back but on the other side, and even National Bookstore Portal Building has packed up and moved out to Robinson's.

One thing I religiously do every time I come home is go to Taster's Delight to eat what I know to be THE BEST burgers in the WORLD! But sadly, those days are gone (hopefully just temporary) because Taster's has closed down and orders can be placed at Howyang, but those burgers don't taste the same as those freshly cooked Taster's burgers wrapped in the yellow and orange plastic (mouth watering) and when you take that first bite...the best, indeed. Bring it back please.

My leave was coming to an end and work beckons.

But changes have also happened to me in the past three years -- first I'm seven months married to a wonderful woman who keeps me laughing, and strong, I'm in training in a profession I love despite the stress and hours without sleep, and new friends on top of the old.

I guess the people have changed so much as well.

Dumaguete City, despite all the changes, is still home to me. Nothing can keep from family. My parents are still there keeping busy, my brother is doing his thing, my sister is married with her husband and newborn son, Lucas (sorry ma, Lucas sounds more uhm sophisticated, i.e. sa ebanghelyo ni San Lucas).

And I'd still be coming back.

See you the next time Dumaguete.

3 am

With the deafening silence of the dawn all around me, I sit alone in the office, with a blank computer screen, phones lying quietly at the side, and the overwhelming compulsion to write something for this blog which has been quite dormant the last few weeks.

I glance at the clock, it's 3:16 am, there is a pile of yellow and orange envelopes in front of me, piling evaluation forms to one side, and the books that need to be read on the other. I look at the 20 or so admissions written in a barely legible scrawl on the white board, reminding me of the census and logbooks that need to be completed before the end of this year.

The monster that is residency has been on my back for a full 2 and a half years now and it hasn't gotten any lighter and fellowship is right around the proverbial corner. A corner which consists of specialty board exams, oral exams, among other unique challenges.

In the meantime,  I'll get started on the mountains of paperwork, the books that are laid out in front of me, these evaluations that need filling up, and the unenviable task of steering this ship.

Music and Lyrics

The video speaks for itself...

In the spirit of the month of hearts, this one's for you -- a vacation from my numerous rants on this blog. Let's turn up the mush from time to time.

Just because it's Monday.

;)

Caritas

This is not a post about health insurance, haha.

I've recently, uhm, "leveled up" and now have the unenviable task of handling charity patients. In residency training, these are the supposed learning cases where the residents can apply their knowledge of medicine and practice their own brand of healing.

Guinea pigs? Nope, I don't think so. Not when there are 2 or 3 consultants hovering over your management and questioning you. And let's not even mention the audit, somebody might get ideas. Haha.

For our training, charity means handling those out-of-funds patients who most likely have difficult cases being they've already exhausted their money.

For me, it's trial by fire.

For my patients, it's a chance at a really big discount for his care.

I've had the fortune of having had 4 charities so far, and it's a different feeling each time seeing patients go home a little bit better than how they came in because of my orders in their charts.

The feeling of holding that chart with your name on it, seeing the patient and talking with their families each time you go on rounds, and expecting them on follow-ups -- it's very doctor-y. Haha. It's a mixture of the anxiety of messing up, the fear of failure, the elation of getting something right and the power of healing another human being.

It probably isn't the most reasonable thing to hope that all my patients end up walking home through the hospital doors, but I'd like to keep that streak up as long as I can possibly can.

A Little Bit of Something Each Day

I can't believe I've been away from writing this long. Well, I had more than a couple of things going on and I simply couldn't get away to write up a post here and there. But with the new year comes a new resolve to write more, sing more, live more, not to mention work more, but all in stride. After all, it's always the little things each day that makes up those moments that take your breath away.

SOMETHING SAD

I've written about so many things on this blog, and the seeming nearness of death to us all has always been an easy topic to expound on. With 2 full years of residency under my belt, the losses still matter to me. Most especially when some losses are closer to home. When we lose young patients with so much more to live for, and recently, a friend's mom passed away under our care (my condolences, Ver), I feel, more than anything, the fragile state of our mortality, and that sense makes each morning a better one than yesterday's.

SOMETHING TO LOOK FORWARD TO

I've done 2 years of my residency in Internal Medicine and going into the final stretch. It's going to be a heck of a year with seniorship, teaching juniors (that is if I have anything to impart, haha), and conferences and presentations, and hopefully, graduation.

SOMETHING SCARY

In line with the stuff to look forward to, there are exams, oral and written coming up and which I have yet to prepare for.

SOMETHING MUSICAL

I've finished a close friend's wedding song, but I never got to record it or present it at their wedding. Maybe I'll get up and do it once I'm done with all this residency stuff. And, that Christmas love song for you, you've heard. Haha

SOMETHING LOVE-LY

I'm married! Haha

With all these things, come the promise of a new year -- more blogs, more unforgettable moments, more music, less pain, more joy -- and the wish that it's gonna be a whole lot better from here on out.

HAPPY NEW YEAR!