Sunday, November 29, 2015

The day when I (almost) lost it

I THOUGHT I’d end first year residency without ever getting mad at a patient or a watcher. At the hospital where I work, the watcher—or the “bantay,” a Filipino term which means to watch over, to guard and to protect—plays a key role in the care of the patient. We don’t have much staff to drag the stretchers, do the bed turning for our intubated patients, procure the medications from the pharmacy, or facilitate application for financial assistance. Majority of these tasks are handled by the bantay—usually the patient’s family member or a close friend who stay at bedside—and my experience is that more efficient the watcher is, the more likely the patient will survive.

Saturday, November 21, 2015

Way past bedtime

Over dinner last night with Carlo and Glaiza de Guzman (not a married couple), and Patrick Abarquez; we spoke about the many crazy things we did in internship. Our conversations lasted way past 11—and to friends who know me too well, it was way past my bed time. It was definitely worth it, though: I missed the company. One can only laugh so much at the past.

Carlo is going on training for Radiation Oncology, which means he will be at the forefront of approving my requests for radiotherapy, usually for patients with superior vena cava syndrome. Glai is doing well in OB-Gyne, and has taken on a new fashion instinct—dresses, white coats, the works. Patrick will be taking up residency in IM.

So many things are happening all at once, and I'm thrilled to know that many of my friends are doing the things they're passionate about.

Thursday, November 19, 2015

Take outs

APEC afternoon

I SPENT the afternoon at a nearby coffee shop overlooking Manila Bay. In front of me, buying coffee, were members of the Japanese APEC delegation. They all got take-outs.

All smiles

I HOPE I’m not preempting anything, but when I visited my 70-year old patient—now with a tracheostomy tube, hooked to an oxygen mask instead of a mechanical ventilator—I saw a smile. He smiled back at me: he, my remarkable patient whom I had taken care of for a month or so. It’s nothing short of a miracle. I first handled him at the Medical ICU, where we treated him for a difficult-to-treat lung infection—the first he got before he had been admitted, the subsequent infections (the harder ones to treat) he later acquired during his stay at the hospital.

Saturday, November 14, 2015

1,540th—and more

photo (4)
Pagbilao, Quezon Province, taken in 2012

SINCE RESIDENCY has started, I haven't been as consistent in updating this space, my private space, in the Web. It was as if I got tired of writing on my charts—my patient's stories instead of mine—that I felt I had nothing else left to say at the end of the day. Even my private journal has suffered; I'm only halfway through filling up my pocked-sized Moleskine imitation notebook.

I must therefore make it a habit to write something here at least once a week, not simply keep this website alive, but to instil in me the practice of thinking and writing—the process, not the traffic, is the reward. I know fewer and fewer people have visited here since the advent of Facebook and Twitter, and that's okay. Maybe Jason Kottke, who owns one of my favorite websites (, is right: the blog is dead. My friends, who started their own blogs around the same time that I did, have decided to move on. People now turn to micro-blogging sites to be updated, having developed an evolutionary irritation at lengthy articles. 

But, 1539 articles since I had begun in in December 2014, I realize I've invested too much in this little site to let it all go to waste. I will still write, and keep on writing, as long as I can. 

Thanks for always being here. 

Thursday, November 12, 2015

Service 1 dinner

MOIZA is an unassuming Korean restaurant along Malvar corner Ma. Orosa Street in Malate, perhaps part of what still remains a busy, noisy, strip of bars and cafés. I almost got lost when  I looked for it last night. We had our mid-month "service dinner" there—a ritual consisting of eating out with the entire General Medicine service before the clerks and/or interns shift out.

Sunday, November 8, 2015

My Facebook sabbatical


THE NOVELIST Butch Dalisay writes, “For the umpteenth time, last week, another person asked me, with profound astonishment, why I wasn’t on Facebook. I told him that, in my seniorhood, I wanted to lead a quiet and peaceful life, and that Facebook was antithetical to that ambition.”

I’m on my third week of Facebook sabbatical; I want "a quiet and peaceful life," too. I made the decision when I realized that a lot of my idle time was spent checking for updates—a hobby facilitated by my ownership of a smartphone that can connect to the Web anytime, anywhere. At first I thought I could limit my Facebook immersion to once daily, but there was the itch to see what was happening in the world, to see the goings-on in the lives of my so-called friends, some of them I haven’t seen in years, some I haven’t even met at all. It got unhealthy. I would, in some days, prioritize checking Facebook over reading my Bible first thing in the morning. Something had to go.

Saturday, November 7, 2015

Second chapter of residency




A cat lounges in front of the Medicine Library on a rainy Saturday afternoon. It looks peaceful, nonchalant, oblivious to its surroundings. No, I have nothing else to say—just filling in the void because I haven't been blogging as often as I'd used to.

Sunday, October 25, 2015

Mervyn Leones's golden heart

Birthday boy, Mervyn Leones

MERVYN LEONES—pride of Legaspi City, distinguished alumnus of St. Agnes High School, internist-extraordinaire—celebrates his birthday today. I'm writing about him because he will be thrilled at the attention; he is very easy to please. In the photo above, we see him overseeing the consultant rounds at the Pay Wards (this was halfway through residency, I think, and he had mustered enough bravado to do just that). He looks intensely at us, making sure we all pay attention to the details—and we do, save for Roland Angeles, who looks at the camera anyway.

Saturday, October 24, 2015

Starbucks for the old (in) Manila

At Hizon's Bakeshop,  Ermita,  Manila

At HIZON'S Bakeshop—an old restaurant along Bocobo Street in Arquiza Ermita, Manila—I'm enjoying a cup of perfectly delicious coffee partnered with grilled ensaymada, the store's signature dessert. The place is empty, save for two gray-haired men who look like they've been retirees for a long while now. I realize I like spending a lot of time alone: my thoughts become louder, and I'm able to think things through. I should've brought my Bible, or a thick book, because reading requires much solitude, perhaps the only time when I'm actually silent. Hizon's may well be the Starbucks of the old, and I feel that I fit right in.

Hopeless romantics

NOT ENOUGH Filipinos are reading, but I hope that's changing. At National Bookstore today, I saw the following titles—catchy, thought-provoking, contemporary, perhaps funny. I haven't heard of the names of the authors before, but these books must have a place in our nation's literary diet, if there's one that exists.

Daily bread

PILGRIMS, my prayer and Bible study group, meets Thursday nights. You could say that since I've joined the cell, I've become very fond of and close to this funny, sporty, Scripture-loving group of middle-aged men in church. In our on-going series on the Lord's Prayer we discussed "Give us this day our daily bread."

"Bread" refers to our physical needs. "Daily" means we must ask God for these needs on a daily basis; He can flood us with blessings, but He wants that we depend on Him daily, the same way the Hebrews got manna every day. Praying for food, shelter, and clothing is necessary.

A key point in Kuya Vance's teaching is his emphasis on the fact that God does choose to provide us more than what we need at any given time. This fact rings true for many of us who don't have to labor 24/7 just to put food on the table. We have more than enough, when we think about it. Praise be to God for His manifold blessings.

Sunday, October 18, 2015


RAIN AND WIND are keeping people inside their homes. The typhoon is called Lando. No classes in Manila tomorrow, declares the local education department—a fact that leaves us, employees, salaried men and women of the Philippine workforce, wondering if we don't have to report to our offices as well. I spent the entire afternoon sleeping, relishing the bed-weather, hearing the howls of wind outside.

Watches, books, and tennis—a random update


I WENT with Mervyn Leones and Danes Guevarra—friends and colleagues in IM—to an unassuming store for watches in a mall in Manila. It was raining, traffic wasn’t as bad as we had expected, and the drive was uneventful.

Carlos Cuaño
Carlos, when I made him wear my spectacles.

With us was Carlos Cuaño whose new-found calling is making sure we get good deals. He knows a lot about rotors, automatics, and quartzes, and has done extensive research on the subject, so much so that he can write an entire dissertation on Japanese Watches And Why People Who Live There Are Always on Time. He, by the way, is almost always late.

Saturday, October 10, 2015

Nearing the end

2015-10-01 02.23.09 2
My view from Room 123, Gen Med Clinic, Out-Patient Department Building, UP–PGH.

THE END of first year residency is coming—this fact I had realized when Ma’am Lia met with my batch to ask us how were were. We seemed to be doing well, she said. She was pleased with the fact that we seemed to have adapted and adjusted to the culture of residency training at PGH–IM.

Saturday, September 26, 2015

Asking the right questions

IN THE DRUDGERY of an internist’s daily life, there are moments of surprises that come along the way. This happened to me two days ago. I checked on a fifty-something patient, someone my service and I were managing as a case of upper gastrointestinal bleeding secondary to a probable GI malignancy. I had told him during our first encounter that he should observe the color of his stool. It was to be his “assignment.” I wanted him to pay close attention as to whether it looks like asphalt or dinuguan—local descriptors of melena that I have found useful in my practice. Dark, tarry stools are a useful sign of acute or active bleeding anywhere in the GI tract.

Friday, September 18, 2015

Back to the basics

There's nothing new in Sana Dati. It is, for purposes of classification, a love story. A woman gets married to someone she doesn't quite know, just about a week after her fiancé—a respectable, intelligent, rich man—had proposed to her. She gets the jitters, complains of stomachache, but looks disinterested during the video shoot hours before her actual wedding. We later get the idea that something is wrong: she loves someone else; that person, however, is already dead. 

The narrative is ordinary, but there's something refreshing as to how it has been told. Maybe that's the difference. It does not use the usual Star Cinema romantic film formula. The characters speak naturally, as normal people in Metro Manila do. There are no obnoxious best friends, character-less entities usually fielded as dialogue fillers in other films. We don't feel kilig; we feel sad and supportive and hopeful that things will turn out well. The scenes are solemn and contemplative, all expertly shot—a great feat, given that the film only had a little less than three million to be produced. The music, too, does not invite giggles.

It is a simple movie told extraordinarily, certainly worth your while. 

Tuesday, September 8, 2015


TIM KREIDER’s essay, “The Summer That Never Was,” captures the longings of someone who had laid out his plans for a trip to Iceland, a to-do list that never materialized. (I want to go to Iceland, too, partly because the landscapes look like they're from another planet, partly because I want to learn how to pronounce the weird names of places.) There’s a familiar tone to it, I suppose: the fact that the possibilities for travel, leisure, and adventure are endless; yet I am limited by my career, which, in a sense, is of my own choosing. The essay speaks volumes to me, a doctor in training trapped—by choice—in the hospital, wanting to do so much more.

He writes,

"I’m not old but I’m not young anymore, either, and if you’re a procrastinator and a ditherer like me you can manage to sustain until well into midlife the delusion that you might yet get around to doing all the things you meant to do; making a movie, getting married, living in Paris. But at some point you start to suspect that you might not end up doing that stuff after all, and have to consider the possibility that the life you have right now might pretty much be it."

Saturday, September 5, 2015

The Journal of Travel Research

LAST NIGHT I lulled myself to sleep by browsing through PubMed, the largest, most comprehensive database of medical literature. I searched for random things, keyed in "funny" as a Boolean free-text search term, and found a case report about a patient, chronically diabetic, who presented with extreme funny-ness. There is a wealth of material there, but it can read like a phone book if one doesn't know what to look for, and how to look for the material desired.

Now, on to the subject of research. Publish or perish still remains the dogma in academic circles, and it's a shame that in our country, the culture of research is still too young, too immature, to even take flight. We must congratulate our local scientists and researchers for keeping at it, despite the lack of support, resources, and encouragement.

If I had the chance to be editor of a scientific paper, with all its perks and pains, I'd probably want to work here: The Journal of Travel Research, which I found at the Singapore National Library. Imagine all the traveling I will do, for the sake of "knowledge." But then again, why write for a scientific journal when one can always do feature articles of magazines? Or maybe work for National Geographic? One of my dream jobs, definitely.