Monday, August 3, 2020

Sunday, August 2, 2020

ECQ is not yet over



Ate Lei sounds the alarm on increasing COVID-19 cases, reaffirms importance of physical distancing and wearing of masks, and empowers the public--"you are our first line of defense." The advice is firm and compassionate. Listen to her.

Dr Lei Camiling-Alfonso, technical specialist for the Philippine Society of Public Health Physicians, says the Philippines is far from return to normal. Camiling-Alfonso took part in the 'Frontliners for ECQ' online press conference on Saturday, August 1, 2020

Saturday, August 1, 2020

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The 14-day Quarantine, days 1-2

Day 2 of quarantine. Cloudy day. Rained all evening. Rooster’s cry woke me at 5 am. Could hear it over closed windows. Turned off the aircon. I get cold easily—an inconvenience in places with snow, but not a problem in Marbel, where it feels like an oven most days. Opened my email, wrote replies. Still dark outside. Before daybreak is the best time to get things done.

Last night, spoke with a couple from Dormitories Christian Fellowship over Zoom. DCF people are the best—bright minds, kind hearts from provinces meeting in the country’s best school. Or so we think. Among my dearest friends are DCFers. Call was a welcome distraction from the monotony of quarantine. Been itching to be productive all day. Getting the hang of online consults. With video, I could see facial reactions at least. So much of doctor-patient communication is nonverbal. Face-to-face consult, in the flesh, is still the best. Ended the call with my heart encouraged by their faith in the Lord. Miss talking to patients. Hoping to start a clinic here soon. Waiting for approval from a telemedicine provider. Doing remote clinics while locked in hotel room—why not?

Mavis Gallant—Tita Mavis, we call her—keeps me company. Paris Notebooks is delightful. They don’t print this anymore. Found a copy from Powell’s Books (Portland, OR). Delivered in post office last February but I picked it up few days ago. So worth the trip. Mother will reprimand me for risking exposure. Miss getting nagged. Tita Mavis writes she was neighbors with a med student. I love her more now.

Touchdown Marbel

Arrived in Mindanao last July 30. Flight was okay. Lady at NAIA checked my documents, stamped them. Remembered A Very Secret Service: “tamponner!” Man at PAL check-in counter asked, “You’ve been abroad, Sir?” He saw my Japan visa. Memory of cancelled trip. Will have to content myself with watching documentaries of Japanese old people. Might rewatch Kimi No Nawa. Throughout trip, wore N95 over surgical mask. Also: face shield. Felt like I had cataracts. Too much? Old med school roommate Bryan Jay wore complete PPE. Better safe than sorry.

Touchdown Marbel

Touchdown Marbel

Plane was 80 percent occupied. Fascinated by kids on board—they didn’t give a care to this world’s problems. Childlikeness, a virtue. Teared up as I remembered God’s goodness to me throughout all my years in Manila. Couldn’t wipe my tears lest I risk getting COVID. Tears dried on their own. Wala muta. Brothers tell me I’m a sosyal crier.

Touchdown Marbel

Nanay texted me, “Welcome home!” Auntie Net: “See you in 14 days!” Manong quite envious he was left behind. Sean asking if everything was okay, he’d bring me a coffee maker. I have the best, kindest, most generous brothers. Filled out some forms. Light snacks on designated seat in LGU bus. Driver started small talk, greeted everyone “good morning” in Hiligaynon. Sounded like one of my father’s friends. Felt like home, at last.

Touchdown Marbel

Touchdown Marbel

At Koronadal City Health Office, got tested. Old lady told me she remembered a speech I gave in high school. Someone from high school announced, “Amo ni ang valedictorian namon.” There went my wish for anonymity. Everyone calls me “Dok” now. Even the receptionist and the man who brings meals to my door. A small world.

Poignant scenes: six or seven-year old boy, before going to the rest room, asked if I could watch over their bags. Mother was away, interviewed by health care worker. The kid acted like an adult; he’ll reach places. In contrast to many kids these days—downright irresponsible, waiting for their overly doting mothers to feed them, while they play on their gadgets. Could be forgivable they had a book. But gadgets? Disastrous.

Another: old people asking the nurse, “Can we feed our dogs?” “Where can we hang our clothes?” “Can I walk around the garden? I have a fence and I live alone.” Nurse told us, “Be creative with your time.” Encouraged us to record Tiktok videos. So eloquent and heartwarming, with a reassuring voice that remind me of ninangs who sniff me during beso-beso.

Touchdown Marbel

Now settled in small hotel. Sean arranged for accommodation. Internet connection is good. Books keep me occupied—Thomas Watson, George Saunders, Tita Mavis, and maybe Hilary Mantel.

Friday, July 31, 2020

Thursday, July 30, 2020

Wednesday, July 29, 2020

Tuesday, July 28, 2020

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The upright man

I read Thomas Watson's The Character of an Upright Man. I love Thomas Watson and the Puritans in general. I turn to their writings if this world's air becomes too toxic. Their works offer a glimpse of heaven. There are some of my book highlights.

The upright man is no adorer of public opinion. (location 45)

This is the question the upright man propounds to himself, "Will this bring glory to God?" He labors still to bring in some revenues into the treasury of heaven. He prefers the glory of God before whatever comes in competition with, or stands in opposition against it. If life is laid in one balance, and God's glory in the other--the glory of God outweighs. (loc. 86)

An upright Christian, though he fails in every duty, yet he makes conscience of every duty. (loc. 110)

The upright Christian does not whirl about, or sinfully prostitute himself to the lusts and desires of men. (loc. 121)

True grace ennobles the heart, dilates the affections, and carries out a man beyond the sphere of his private concernments, making him mind the church's condition as his own. (loc. 175)

He also quotes Augustine when he writes that the upright man has peace with his conscience.

He has peace with his conscience. 1 John 5:10, "He who believes has the witness in himself." his end must needs be peace--who has a smiling God, and a smiling conscience. Augustine calls it, "the paradise of a good conscience." A godly man is in this paradise before he dies.

Monday, July 27, 2020

Adrian Tomine's Scenes from an Impending Marriage


I avoid weddings. I'd rather not go, if I can help it. If I must, I prefer to sit in the periphery where it's easier to leave after a few minutes of meeting and greeting. My friends, the newly married couple, understand me. Because they're too tired to bother anyway, they barely notice that I'm gone.

Adrian Tomine's Scenes from an Impending Marriage: Making Light of Nuptial Narcissism is a hilarious graphic novel that explores what couples have to go through to celebrate a wedding. I had fun reading this, especially the part where the man decides to exclude some friends to spare them the hassle of attending. I am one of those who like to be excluded. If you have problems with your wedding shortlist, feel free to remove me. You're doing me a huge favor. It's hard for me to understand why some people hold grudges against couples who don't invite them.

At the behest of his soon-to-be wife, Adrian Tomine set out to create a wedding favor for their guests that would be funnier and more personal than the typical chocolate bars and picture frames. What started out as a simple illustrated card soon grew into a full-fledged comic book: a collection of short strips chronicling the often absurd process of getting married. A loose, cartoony departure from Tomine’s previous work, Scenes from an Impending Marriage is a sweet-natured, laugh out-loud skewering of the modern marriage process, including hiring a DJ, location scouting, trips to the salon, suit fittings, dance lessons, registering for gifts, and managing familial demands. The most personal and autobiographical work of Tomine’s career, Scenes from an Impending Marriage is a charming, delightful token of love.

Delightful, indeed! I'm such a fan of Adrian Tomine. His New Yorker covers are beautiful. Shortcomings, one of his graphic novels, was engaging.

Sunday, July 26, 2020

Manong's lemon yogurt cake

Lemon yogurt cake

Afternoon merienda, baked by Manong. I don't know why, all of a sudden, both my brothers have taken interest in the kitchen–Sean with his flat bread, Manong with his cakes. I'm useless in that department. Sean jokes that I can't even turn the gas stove on properly (this is partly true, a fear kindled by my experience with a patient whose stove exploded, killing all his family members—surely the exception, rather than the rule). I compensate for it by having good taste in food. "This is too sweet," I would say, like a fake food critic. But this cake had the perfect sweetness. The lemon's tangy citrus flavor made me happy. It had a vibrant fluffiness, best served with Matutum coffee in French press. Kaon ta!

Saturday, July 25, 2020

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Folding at Home: in search for cures for cancer and other rare diseases

My friend Luther alerted me to Folding at Home. It's a global endeavor where you share a small portion of your device's unused computing power to enable calculations for scientists in search for cures for cancer and other diseases.

I installed the program two days ago in an old HP laptop that operates on Windows. Since then, I've been involved in a COVID-19 modeling study. Now I'm contributing (albeit passively) to Project 16447.

This project seeks to understand G protein inhibition in the treatment of uveal melanoma and other Gq-related diseases. The heterotrimeric G proteins are molecular switches regulate biological functions like sight, smell, and memory. This pivotal role makes G proteins essential players in physiology and pathophysiology. However, when G proteins mutate, they result in a variety of diseases from cancer to heart disease. For example, a single mutation in the Gq protein is known to cause uveal melanoma, a cancer in the iris of our eyes that remains largely untreatable short of removing the eye. This is due to an over-active Gq protein. Thus, targeting over-active Gq mutants presents a unique opportunity to treat disease.

Natural product chemistry offers the chance to identify treatments against these difficult to treat targets. A peptide found in Christmas berries, YM-254890 (YM) binds and inhibits Gq, preventing the over-active from resulting cancers. Previous results suggest that YM is even useful in cellular and animal models. However, both the mechanism of Gq inhibition as well as how to optimize YM further (for simplicity, potency, or specificity) remain unknown. This project simulates the heterotrimeric Gq protein bound to YM, to understand its mechanism. Project 16446 simulates the Gq protein by itself, which will help us understand its behavior in the cell.
Folding at Home

Uveal melanoma is rare, but I had the privilege of meeting a patient who had this disease. I did not meet her again. I wonder what happened to her.

Protein modeling studies are also close to my heart. In first year med school, my team and I, supervised by Dr. Frank Heralde from the College of Medicine's Department of Biochemistry and Molecular Biology, did protein modeling work on Influenza A(H1N1). We were able to present this work in a major conference in the Netherlands. We collaborated with a modeling program developed by French scientists. I remember that the program required fast computers, so we turned to Marvyn Chan, whose laptop did not lag.

Folding at Home is amusing and amazing, isn't it? If people ask me what I've been doing since the lockdown, I will say, "Finding cures for rare diseases." And I wouldn't be lying.

Friday, July 24, 2020

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Language of God: Notes No. 1

Language of God Chapter One

Language of God Chapter One

Language of God Chapter One

Language of God Chapter One


The handwritten notes above make up the initial draft of what should be a coherent essay/review, sort of a personal experiment that seeks to answer the question, "How do I sound if I don't edit myself?" The sentences bleed into each other. I envy people who can put their ideas together without so much as minor erasures.

This is a specimen of my lazy handwriting. I used Pilot Custom 823 (given by my friend Freddie) with Waterman Blank Ink (given by my mentor Dr. Strebel).  I must tell you that I write more legibly in medical charts and prescriptions.

I like to resurrect the old habit of writing using pen and paper as I make brief reflections on Dr. Francis Collins's book, "The Language of God."

Chapter One, "From Atheism to Belief," begins with the writer's childhood. He calls his early life "unconventional." He gew up in a farm, with loving yet unusual parents--"a happy mix of pastoral beauty, hard farm work, summer theater, and music, and thrived in it." Dr. Collins writes that "faith was not an important part" of his childhood. He was "vaguely aware" of the concept of God. But even as a child, he liked learning. I believe learning is optimal if the student enjoys the process. Dr. Collins eventually took chemistry as an undergraduate degree, something I can absolutely relate to. It was fascinating to learn that he did not care much for biology, thinking it only involveda lot of memorization.

I liked chemistry first. I can relate to these lines by Dr. Collins:


"Never mind that I knew relatively little about other sciences, this first puppy love seemed life-changing."

In the next paragraph, he begins:


"In contrast, my encounter with biology left me completely cold."

In high school, I didn't do as well in biology. In contrast, I enjoyed chemistry. My brother bought "Chemistry: The Central Science"*, a beautiful textbook that really changed my life.

After graduation, he [Dr. Collins] took a PhD program in physical chemistry at Yale. From being an agnostic, he became an atheist. He got married and, at 22, he went to medical school.

Dr. Collins writes about his encounter with patients.

"What struck me profoundly about my conversations with those North Carolina people was the spiritual aspect of what many of them were going through." In another paragraph he writes:


"My most awkward moment came when an older woman, suffering from severe unstable angina, asked me what I believed." Dr. Collins was not really sure.

In this intellectual and spiritual crisis, Dr. Francis Collins asked the help of a Methodist minister down the street. The pastor gave him a copy of C.S. Lewis's Mere Christianity.

Dr. Collins realized that inherent in every human being is a "Moral Law," a concept of right and wrong that is ingrained in human consciousness. Science could not adequately explain this.

Dr. Collins ends the chapter with:

"I had started this journey of intellectual exploration to confirm my atheism. That now lay in ruins as the argument from the Moral Law (and many other issues) forced me to admit the plausibility of the God hypothesis. Agnosticism, which seemed like a safe second-place haven, now loomed like the great cop-out it often is. Faith in God now seemed more rational that disbelief.

 *Newsprint edition, by Brown and Lemay.

Thursday, July 23, 2020

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The Language of God

This morning I got hold of a copy of Dr. Francis Collins's book, The Language of God: A Scientist Presents Evidence for Belief.  Dr. Collins led the Human Genome Project, an ambitious endeavor that sequenced the human DNA.

As an undergraduate student in molecular biology and a young Christian, I studied genetics and physiology of eukaryotic systems with a sense of awe and worship. I saw God as I attempted to molecular and cellular processes. This was the same God who saved me from my sins, who was involved in my daily affairs, who gave me the strength to wake up and the joy to live my life.

To read of this harmonious marriage between science and faith from Dr. Collins's perspective is what gets me excited. Not everyone can articulate this dynamic well. Dr.Collins writes in the introduction to the book:
... For me the experience of sequencing the human genome, and uncovering this most remarkable of texts, was both a stunning achievement and an occasion for worship.

Many will be puzzled by these statements, assuming that a rigorous scientist could not also be a serious believer in a transcendent God. This book aims to dispel that notion, by arguing that belief in God can be an entirely rational choice, and that the principles of faith are, in fact, complementary with the principles of science.

Dr. Collins believes there is no conflict between science and religion.

So here is the central question of this book: In this modern era of cosmology, evolution, and the human genome, is there still a possibility of a richly satisfying harmony between the scientific and spiritual worldviews? I answer with a resounding yes. In my view, there is no conflict in being a rigorous scientist and a person who believes in a God who takes a personal interest in each of us. Science's domain is to explore nature. God's domain is in the spiritual world, a realm not possible to explore with the tools and language of science. It must be examined with the heart, the mind, and the soul--and the mind must find a way to embrace both realms.

I will argue that these perspectives not only can coexist within one person, but can do so in a fashion that enriches and enlightens the human experience.

For the next few days (or weeks, depending on how long I can finish the book), I will write short reflections about the book in my blog.

Wednesday, July 22, 2020

One of my guilty pastimes is

Watching videos of Mandy Patinkin and his wife, Kathryn Grody. I'm a big fan of Mandy's Saul Berenson in Homeland, one of my favorite TV series of all time. Because Saul is a no-nonsense guy, always serious and calculating; I find the Twitter home videos of Mandy disconcerting. So this is who he is when he's out of character. Recorded in their vacation home, with a dog and lush greenery, Mandy and Kathryn interrupt each others sentences, making up answers to technology-related questions ("Is wifi different from the internet?"), while snacking and sipping water.

Vulture magazine published an interview by Rachel Handler. Here's an excerpt.

What’s the most profound thing you’ve each learned from each other?
KG: Oh gosh. Is this an overnight? For me, there is no way of feeling the depth of staying together for 40 years. You share it, you’ve created a common history. You see a lot of marriages you don’t want to be like, and you have the illusion you’ll never cause each other pain, and then you kill each other. But there’s something in getting through all that.

I remember Henry Fonda was watching him in Evita, and at the intermission, I happened to be sitting in front of him, and I heard him say, “This couldn’t be this Pad-inkin fellow’s first musical!”

And I went, “Excuse me, Mr. Fonda, it is.” And he turned and looked at me and said, “Oh, are you related?” And that’s when it really struck me. I said, “About to be.” We’re related. We’re kin and we made a family.

We talk a lot about being stunned about being older. Some days it’s really shocking. But even when it’s shocking, I see him as the person I first met. I see that person in him now. So I get more of him. I get the gorgeous young guy and the gorgeous old guy.

What about you, Mandy?
MP: I never experienced unconditional love until I met her. [He tears up.]

I love this conversation.
KG: I do, too.

Tuesday, July 21, 2020

Monday, July 20, 2020

Portraits for master's degree

Untitled
My classmates Freddie, Kmomsh, myself, Rich, and Raj.

My friends and I are graduating with a master's degree in clinical medicine (major in medical oncology) this year. Cramming assignments, figuring out solutions to problems in clinical statistics, rushing presentation slides a few minutes before class--we had fun! The graduation organizers asked us to send a sablay photo to be presented for the virtual graduation (I don't know when that will be). The last sablay photo I had was in 2009. I gained enough weight to create a stark difference from then and now. To comply with the requirement, I had my brother shoot my photo with an iPhone in the apartment. Congratulations, everyone!

Sunday, July 19, 2020

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Call for help for Dr. Karen Senen, neonatologist from PGH

Dr. Karen Abat-Senen—neonatologist, singer, and fountain pen enthusiast—has been readmitted.

The joy of a doctor who had recovered from COVID-19 was cut short after she again tested positive for the virus a few days after she left the hospital.

According to Ivan Mayrina's report on "24 Oras," Dr. Karen Abat-Senen could not hide her joy and even posted a video of her singing on July 3, the day she went home after a month of confinement at the Philippine General Hospital.

However, a few day later, the doctor experienced worse symptoms.



I took the liberty to re-post this from Dr. Hope Sagayaga's Facebook feed.


Please include our hospital Neonatologist in your prayers. Dr. Senen is a dedicated and passionate pediatrician with a heart of service for the Filipino babies. She is the wife of Dr Jerome Senen, (also a pediatrician) and mother of two. Both are UP College of Medicine alumni.

[Reposting] Help and prayers for Dra. Karen Abat-Senen.

This is a call for help. Dra. Karen's condition has gone from bad to worse. Her lungs cannot take in oxygen because of the inflammation caused by the infection. They placed her in prone position to help improve oxygen intake, however, her condition still regressed. She, right now, is in a very bad state. An option offered by the her physicians is to have her plugged to an ECMO machine. The problem is, UP PGH does not have an ECMO machine. They will try to make arrangements to borrow one for us to rent which comes at a steep price. Initial cashout needed is 750k Php and daily rate afterwards is 20k Php. Now, once she is placed in ECMO support, she would need lots of blood, O+ blood, not necessarily from COVID 19 survivors. For blood donations, they may walk-in at the Blood Donor Center at the back of Ward 3 or they can also call 0947-4882817 to coordinate. Please let the blood be earmarked for KATHLYNNE ANNE A. SENEN.


FOR BLOOD DONATIONS: Click on this link: http://tinyurl.com/pghscreen.

There's still so much we don't know about the virus.

My friends from the front lines tell me the situation is worsening. The ER and wards are full. Patients present with severe symptoms, and many die after 3 to 5 days, only to be followed by many new ones.

Saturday, July 18, 2020

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