Kandle

WE FOUND a new after-morning Sunday worship service spot—Kandle Café, along Mother Ignacia Street, Quezon City, a five-minute walk away from church. It opens at 11 am. We were the first customers, and the place was devoid of hipsters, noisy teenagers, or Filipino families with noisy, crying children—crowds one would do well to avoid if one desires peace, quiet, and a short nap. It goes without saying that I only had three hours of shut-eye last night. I understand the place gets jam-packed on the weekdays, so we had come at the perfect time.

After-church coffee

The internet is reliable, there are sockets all over, the tables are at about the right height: tell-tale signs that this will become a popular spot for people studying for board exams or periodical exams. Coffee shops, even restaurants, have become modern-day libraries.

Press on

We in Pilgrim Men, the cell group I'm with in church, had our Christmas Party today at a restaurant in Quezon City. Kuya Jayrus, our guest speaker, spoke on Philippians 3:12-14. What a blessing to be part of this group: such godly, wise, Christ-exalting men!

Christmas Party!
Click on image to view panoramic photo in full.

Kuya Bobby and Kuya Ferdie share a light moment.

Kuyas Bobby and Ferdie

Jason, Kuya Dean, Kuya Moncie, and Kuya Ferdie look on. This was the traditional Christmas gift giving portion.

Jason, Dean, Moncie, Ferdie

Manong Ralph with his new glasses.

Manong Ralph

Ken and Jason, among the youngest in the group.

Ken and Jason

Kuya Vance, our cell group leader, gives away his stash of Biblical literature. I have been blessed to have been taught by him. His passion for the Word, his love and concern for us, his excellent punchlines—we thank God for you, Kuya!

Kuya Vance and his stash of books for giveaway

Uncertainties and challenges: my penultimate POD month

As I was wrapping up my 24-hour shift this morning, I was also ending my penultimate POD (Physician-on-Duty) month, my foray as one of Internal Medicine's ER physicians this October. And with it was the thought that in a few weeks I'll be taking on seniorship, leading one of six charity services to sound dispositions, standing at the forefront of administrative battles that happen on a daily basis.

Are we ever ready for the tasks ahead of us? I had the same dilemma when I finished my first year of residency training, knowing that the ER would be daunting. Daunting it had eventually proved to be; and at some point it almost became impossible, what with the stronger reinforcement of the admit-all policy, something that has always been there, apparently, but whose effects became more palpable this year. The hardships that came with the doubling of our usual patient load have allowed for my personal growth: my clinical eye, I like to believe, was developed; and the same could be said about my patience.

Our experiences are never enough, I suppose, to make us ready. And the feeling of self-sufficiency—that we think we can do all, that we are ready—might be a marker of immaturity and eventual unpreparedness. It is, in a sense, healthy to feel inadequate.

At the Observational Unit, while I was waiting for General Medicine (GenMed) service to finish the disposition, I had a chat with the interns. How I have loved working with a responsible, cheerful, and rowdy block! Few things can be as refreshing as reminiscing at 6 AM. I thanked them for the great work they've done. They've surely made my life easier—by facilitating the labs, by monitoring our critical patients, by even suggesting management strategies.

"Magiging masungit po ba kayo sa Guazon kapag senior na kayo?" they asked, to which I replied that terrorizing students has never been my style. On this point, I'm not too sure, because my colleagues tell me I may have gained quite a reputation among the students—they always "prioritize" Dr. Catedral's orders, considering all my orders stat until proven otherwise.

I apologized, with all my heart, for my occasional impatience at the slow return of lab results. I have been guilty of insisting that chest X-rays be done as soon as possible, and that blood cultures be followed up without fail. I have always believed that students must learn the urgency of why we do things—a negative culture might mean an earlier discharge date for a patient, and therefore, lesser chances of getting nosocomial infections.

We were all laughing that morning, the kind that emanates from knowing that another day has ended, and there was rest waiting for all of us. More challenges will be waiting for us—for them, a new rotation, the upcoming Physician Licensure Exams, their respective residency applications; for me, the month of November, and the prospect of seniorship.

But my fears and uncertainties are calmed down by the fact God will strengthen me, all of us (Philippians 4:13). What grace, indeed!

By becoming a carpenter, Jesus has redeemed the value of work

DR. JOHN MACARTHUR made this observation: that “Jesus was a preacher for three years of His life and a carpenter for probably at least twenty.”

I paused and considered this. I imagined that Jesus must have been extremely skillful at carpentry. He must have woken up early so he could work on his deliverables. He must have been a joyful worker: pounding on his hammer, sawing a heavy lumber, and assembling blocks of wood to form a table. He must have been gracious with his customers, too. What was it like to work with him in the shop? Did he also make jokes or was he serious all the time? It fascinates me—this picture of Jesus doing manual labor. What a humble God we worship indeed. He didn’t come as a big-time scholar, or a lawyer, or a physician. He was a carpenter.

This image cuts deep into my heart.

No apraxia

A FEW days ago, I took care of a patient admitted for a four-day history of generalized weakness—at least, that was what the watcher beside him had told me. I wasn’t convinced. I spoke with another watcher, one of the extremely worried relatives, who said she only noted the weakness a day ago. Was this acute stroke? I performed a neurologic physical exam. I asked him to show me how he brushed his teeth; he slowly lifted his right hand where the IV line was inserted, and did an up-and down, back-and-forth, and circular motion, his hands clasping an imagined toothbrush. It was a good sign. I then asked him to demonstrate how he combed his hair. He refused to do it, saying, “Kalbo po ako ako. Bakit ako magsusuklay?”

May point siya.

Elect

I choose you

Dr. John MacArthur's preaching on the doctrine of election and predestination is a worthwhile read. It is a difficult concept to grasp: God choosing his elect even before the world had begun. Why do we, for instance, need to share the gospel when God has predetermined whom He will save? Why do we need to bother with evangelism, at all, if that were the case? And isn't it unfair of Him to not give us a chance, for him to say we will go to heaven or hell, before we have lived our time on earth? Difficult questions, indeed—I grappled with them when I was a young believer. Yet the Bible is clear about this.

Pastor John ends the preaching with this beautiful prayer. I hope it ministers to you, as it has to me:

Father, we are thrilled with this glorious truth, thrilled, stunned really that you’ve chosen us and we ask the question “why us?” Why us? We thank you, O God, for your gracious salvation and we thank you that that salvation, even though we can’t comprehend it, is open to anyone who looks to Christ and believes in him. Whosoever will may come. How you harmonize that with your sovereign election is for you to understand and not for us.

But we know Jesus weeps over those who will not come. We thank you on the one hand, for those who have not embraced Christ, may you awaken their dead souls, give sight to their blind eyes, may they see Christ irresistibly before them and run to him for salvation. We pray in his name. Amen.

The proverbial Outside

MILES away from Manila, and hardly having slept for the past 24 hours, Poring Porlas, Jerê Vallente, and I take an hour-long drive in search of the Outside World. It was providence that only brought some 15 patients to be decked to Internal Medicine at the Emergency Room last night, a far cry from the usual number of patients we attend to—about twice or thrice that number. Maybe because it was a Sunday, or maybe it was raining hard, what with typhoon Karen entering the country’s area of responsibility, forcing the ill to stay at home and wait for the sun to shine.

The coffee shop where we sit, all of us half-groggy from all the walking and window-shopping, is quiet. I’ve missed afternoons like these, when I could finish reading a book in silence, only to be surprised by the fact of the sun’s setting.

As we eat kaya toast and half-cooked eggs (“Don’t worry about Salmonella,” I tell them) in a corner, Poring makes fun of the way I assign our interns their tasks; he mimics my serious, stern, tone and wonders why, of all of us, our interns follow my orders first before theirs.

Wedding in Cebu

Cebu Mactan Bridge

I FLEW to Cebu last Saturday to attend Leeca—Lee-ann to many—Caro’s wedding. She finally married Matt Chang, her internship block mate who left her heart defenseless against romantic love. I didn’t stay too long—maybe just five or seven hours, some of it at the airport—but I was, and still am, glad that my friend (who occasionally reads this blog) is now happily married. May God grant them a fulfilling, lasting, and fruitful marriage.

Longer—yes, change has come

I HAD never seen Kuya Vio, my barber of seven years, so excited. From the glass pane, I saw him about to doze off on his barber chair. The shop was extraordinarily quiet, and save for the Indian man getting a massage, there weren’t any other customers. It was a rainy Saturday afternoon, the kind that made one think of pajamas and dark rooms and hot coco and study lamps and good books and feet curled up in bed.

“Bagay na bagay ang buhok mo sa ‘yo, Dok,” he said, literally jumping out of his chair when I had opened the door, my arrival signaled by the obtrusive jingling of metallic rods hanging over me.

“So okay nga ang mahaba sa akin,” I said.

“Oo naman! Mas bagay ‘yan dun sa semikal.”

“Talaga lang ah.”

“Mas mukha kang doktor,” he said proudly.

I had seen only him four weeks ago, then many weeks before that. It was only months ago when I had decided, after my friends’ prodding, to finally grow my hair. I was convinced that it was probably time I’d change something. My brothers have outgrown the semikal hairstyle since many years ago—Manong Ralph, when he had gone to college in 2002; Sean, when he got to high school at about the same time. I was what you would call stuck.

When we were growing up in Koronadal, Tatay would bring me and my brothers together—a so-called haircutting day that happened monthly—and we’d go to wherever Pastor Ray would be working. During those years, he’d transfer from one shop to another. He has seen us grow up and old, and since we have moved to Manila to study and eventually work, he would ask Tatay about our whereabouts. He was, as far as I knew, pastoring a local church in another town but had to support himself and his growing family financially. A clean cut was what my father was gunning for—he didn’t want his sons looking like “addicts.” Eventually, my father did grow his hair—it made him look younger—leaving me with the shortest haircut in the family.

During the transition from semikal to what it is now—a barbers cut with a straight hairline, my hair combed to my right—I had to get used to the fact that whenever I scratched my head, I had to arrange my hair back to what it had looked like. I had to learn new things, as well: combing my hair in the morning before I’d leave for work, even using hair products to keep my strands in place; or getting used to looking at the mirror to check if I look harassed; or learning the value of holding on to my head whenever the wind blew. The term, “bad hair day,” had now taken a new meaning.

Friends always exclaim with surprise at how different I now look and how well the new hairstyle fits me. I have difficulty reacting to those statements—until now, my hair hasn’t gotten any attention, save for some classmates who used to rub my head with their palms during lectures.

I’m writing this to tell you: change has come. I just hope that like my hair, my faith in and love for the Lord, too, would grow.

What’s a good shampoo? And how much conditioner do I need to apply?

New hair

What I should've written in my residency admissions essay

DAVID Remnick's profile of the writer-singer Leonard Cohen is an enjoyable read. Cohen said he had wanted to be a writer:

“raincoated, battered hat pulled low above intense eyes, a history of injustice in his heart, a face too noble for revenge, walking the night along some wet boulevard, followed by the sympathy of countless audiences . . . loved by two or three beautiful women who could never have him.”

Read the rest of the article here.

With trembling voices

THREE pre-residents1 came to the call room yesterday. They introduced themselves with trembling voices. One used to be our intern. The other two were from other prominent schools. They were to go on duty with my team. They seemed intimidated, as pre-residents usually are, considering that they find themselves in a rather precarious, awkward position—halfway between being an intern and an actual resident physician. I don’t blame them.

About a year and a half ago, I remember waking up at 2 AM every morning to catch an early cab ride, so I could arrive at 3 AM and finish charting all my assigned ward patients before my residents even saw the light of day. The goal of pre-residency was to impress, to show off, to demonstrate that I was better than the rest of them—and therefore I could survive residency. It was extremely competitive. Those were never my goals, however. I felt, at the time, that I just needed to be myself: if they didn’t like me enough, then it was probably for my own good that I shouldn’t get into the prestigious UP-PGH Internal Medicine training program.

First time: MICU Senior

I was the Medical Intensive Care Unit senior last night. No biggie for those who’ve been there, done that. But there's something exciting and frightening about experiencing New Things or Things Never Tried Before. Last night wasn’t quite the exception. It’s the idea that things always change—for better or worse—that prevents us from stagnating. The attitude we employ must be that of welcoming the changes and learning from them. I got a few hours of shut-eye last night. My phone was beside me all the time, and I was waiting for it to ring, for a nurse or panicking intern tell me, “Sir, may code po.” Praise be to God for guiding me through the number of referrals I’ve seen. I realize, as I write this, that I’m more than halfway through residency training in this bright, beautiful, sometimes depressing, world of Internal Medicine. I’m grateful that I am where I am, and that I’m doing what I love.

Another post about C. S. Lewis

Photo Credit: http://www.nytimes.com/2016/09/25/opinion/sunday/the-political-magic-of-cs-lewis.html?_r=0

PHOTOS of old people make me really happy. They fascinate me, like babies do. Maybe even more than babies. I like keeping old friends in my life. It's not a secret I want to look like C. S. Lewis when I grow old: that hearty chuckle, gentleness, and faith. And maybe that double-chin, too—give or take.

I found this charming collage in The New York Times Opinion page, in an article written by Peter Wehner.

C. S. Lewis was a great thinker—his Christian worldview is pervasive in church circles, even to this day. He spoke about many things but hardly meddled with politics and government. And understandably so. He believed in the separation of church and state. He believed, in a sense, that the goal of Christianity is not to reform government but to proclaim Christ and Him crucified.

Compelled

For the love of Christ compels us, because we are convinced that one died for all, and therefore all died.—2 Corinthians 5:14

IN THE WEE hours of the morning, as soon as I wake up, I launch into a philosophical exploration of sorts. Why do I do what I do? Am I where I should be? Is it the Lord’s will for me to be a doctor? It’s amusing: I’ve had my PRC license for a year and half now, but I still wonder if I should be a physician at all. Do you find yourself asking these questions, too?1

But I am where I am and where I should be. And I trust in the comfort of God’s promises that all things work out for my good and His glory (Romans 8:28). I am thankful for the calling—this vocation of saving lives—that He has led me to.