Mornings

End of the road
End of the road at Pierce Point, Singapore, taken during an early morning walk.


There’s no virtue in it for me—I wake up early. It was never a struggle.

I’m a morning person. I’m usually awake by 5 AM—6 AM if it’s a holiday or if I had stayed up late in the night, which rarely happens. My brothers seem to follow the same circadian rhythm. As children, our parents woke up before us. They’d have coffee in the porch or in the garden at 5:45 AM, then we’d be up by 6 AM, at which point my mother would dish out her instructions for home work—literally, chores to be done at home. My father wanted us out of the house to enjoy the early rays of sunshine. He’d take us walking or jogging to as far as Rizal Park near the SMRAA complex, occasionally with Rocky, our spitz, by the side. We’d be done by 10 AM. We’d take our morning showers after having tended to mother’s plants or having made sure the windows were sparkling, only to be drowned to sleep by ABS-CBN Tagalized cartoons. I still get my best sleep at 10 in the morning—I attribute that to how I’d been brought up.

New look

I'VE DONE away with the two-column template with the drop cap—I will miss it, of course, but it limited what I can do with the photographs. I want the photos big. So I've shifted to a single-column minimalist design, adapted from Wordpress's Twenty and One classic theme. I've missed having a side-bar. Not that anyone cares; tweaking with the code has brought me back to the days when I'd kill time by learning html and CSS. I remain an amateur in that respect. I've decided to settle with a text instead of an image header. Minimalism, yo.

Meanwhile, below is a photo of what I call The Hanging Gardens of the Burn Unit at PGH. Not the most beautiful garden there is, but people in these parts do what they can.

20160209_140855

Also, here are my pabebe brothers, both with bulging flanks—yet another proof that one can't escape genetics. The Catedral body phenotype: bulging at the poles, flattened at the equator. You should look at my father. And may I add—as I hope it applies to how we construct our sentences—short and sweet?

Brothers humoring me during Sunday after-preaching coffee.

The Chinese New Year

THE CLOSEST thing I’ve come to being Chinese is to have been mistaken by rowdy Filipino OFWs as Chinese; this, while buying fruit juice at Schipol, on my way back to Manila to catch my Nephrology exam. They were taunting a guy named Noy, who kept a mistress in Surigao, unbeknownst to his wife in Iloilo. I understood a joke I no longer remember, chuckled in amusement, at which point they looked at me and said, “Pinoy ka pala.” The gang, who I later learned were seamen working for a Norweigan vessel company, forced Noy to share his chocolates with me. “Huwag kang madamot. Bigyan mo naman si Doc!”

Yesterday, despite the lack of immediate Chinese heritage in my blood, I celebrated the Chinese New Year. I did away with wearing red, inasmuch as I’ve done away with many things I don’t believe in, but I enjoyed the pleasures it entailed: more time away from the hospital.

Handshakes

I don’t remember the last funeral I had attended. My experience with death is largely limited to the hospital: me, attending to a code, defibrillating, doing chest compressions. As soon as the death certificates are signed and the bodies brought to the morgue, I don’t know what happens next. There must be mourning and crying and staying up late over multiple tables of mahjong and cards, entertaining guests with crispy crackers and hot cups of coffee.

Tough month

Another month has ended. These days, I only force myself to blog whenever the month ends, if only to place bookends to chapters of personal experiences inside and outside the hospital for the past 30 or so days. For sure, I have many stories to tell, but I no longer have the drive to write about them every time they happen. In college, I used to write almost twice a week—those entries can be accessed to this day. Admittedly, many of the posts embarrass me if you read them to me aloud. Really—I wrote about my Biology exam that way?

Books and movies

1. Finished Karl Ove Knausgaard's My Struggle, Book Two: A Man In Love. I don't understand why I'm drawn to reading his memoir even if it's all just about himself, but the writing is captivating. We end the volume with three kids in his household. I like reading about his best friend Geir or his morning coffee or when he bursts into tears.

2. I'm down to the last three episodes of Breaking Bad. I'm saving up the last episodes for better days, when I can watch them without much distraction. That scene that showed a group of hired mobsters shoot Hank was too heavy to bear. Hank, second to Mister White, is my favorite, and seeing him lifeless in that desolate New Mexico desert broke my heart.

3. Friday Night Lights, a series about the life of a high school football coach in the fictional town of Dillon, Texas, is my new pastime. Just the right kind of drama, it's made up of characters that all bear noticing. Coach Taylor is a moral, loving, kind man who cares for his players' welfare. He wins many matches, too.

Dog bites

YOU know I got bitten by a dog when I was young. What you probably don’t know is that it happened thrice. I still remember, quite painfully, the dogs’ names by heart—and not just their names, mind you, but their fierce growls as their sharp incisors dug deep into my feet: Pluto, Rocky, and Rocky II. (My brother, Sean, named the dogs in my house; when I took over the naming, I called one dog “Benjamin” and another "David").

[Read this and this.]

It’s funny then that you’ll be seeing me at the Anti-Rabies Unit (ARU), manning the clinic on Mondays, Thursdays, and Fridays. I totally get what my patients are going through. At some point, when my mother dragged me to the hospital to have my shots—I never had them; the doctors said they were unnecessary given my minimal injuries—I thought I was going to die.

Welcoming 2016—Happy New Year!

Turning a new leaf -- last day of the year

I spent the New Year’s Eve the way I have spent it in previous years—asleep, alone, oblivious to the sound of firecrackers. December 31st found me inside my room, catching up on sleep, reading random websites, trying if I could finish a Faulkner story ("The Fire and The Hearth" in “Go Down, Moses”), and changing my bed sheets. Outside was balmy, the skies dark, and I got the feeling that it would rain any time. It was the perfect weather for sleep and meditation. The only bad thing was that I had to cancel my tennis appointment. A soaked clay court is no good for bouncing tennis balls.

I loved the solitude inside my dorm room. My roommate was away with his family, so I had all the space to myself and all the silence I needed to think things through. In a way, I am introverted this way—a fact that will amuse even my closest friends. I’m actually quiet when I’m left alone. It was so silent, by the way, that I could hear my stomach grumble, an observation that led me to snack at a nearby convenience store—one of the very few times when I went out.

Night out with my lunch buddies

FINALLY, we have proof that Casti Castillo is alive. Thanks to Carlo de Guzman who organized the meet up, I've reunited with some of my lunch pals during med school. How this group was formed is a mystery to me as well: perhaps it started one day in 2009 when, disinterested as we were in joining fraternities, we decided to eat lunch together, gathering at the BSLR Lobby to go to Chicken Charlie or Wham Burger at Robinsons. They were voracious eaters, fun to be with, and such great people that it did not take long for me to call them friends.

To CBC or not to CBC?
Lunch at Midtown Diner (ca. 2013), where Bon, Casti, and Brazy were discussing whether requesting a CBC was appropriate. We seemed to have all the time in the world then.

On Honor Thy Father

Honor Thy Father takes us to the northern city of Baguio, the country's summer capital, where people wear sweaters because of the cold. The scenes mostly depict pine trees, mountains covered in deciduous vegetation, houses on steep slopes—not the usual Philippine setting for films, yet they are familiar, reminding us of childhood vacations, of Burnham Park, and of strawberry jams.



Many controversies hound this Eric Matti film, but I had only learned about them about an hour before I went inside the cinema. Although still qualified to join the Metro Manila Film Festival, Honor Thy Father has been disqualified from the Best Picture category because the producers allegedly failed to disclose to the screening committee that it had been entered into a different film festival early this year.

We learn the story of a once-struggling family who are finally making it big in business, that which involves collecting money from local people, promising that the money go to big investments.  Edgar and Kaye attribute their success, their rise to financial freedom (and excess), to this business. They had once hit rock bottom when Kaye lost her second child and Edgar was penniless, but Yeshua answered their prayers through this money-making scheme based in Pampanga, operated by Kaye's father. Their testimony is unimpeachable; as such, Edgar (John Lloyd Cruz) and Kaye (Meryll Soriano) excel at what they do. In the first few minutes of the film we see them organizing a birthday party, which later turns into a conference of sorts. People are wary of the consequences: is the offer not too good to be true? Where will the money go? That scene felt real.

Manila is empty on Christmas morning: a documentation of our post-duty walking tour

AFTER NOT BEING able to sleep last night—there were few admissions, but they were difficult, complicated cases—my friend Jeremiah Vallente and I hurriedly rushed out of the hospital after the morning endorsements.

"So what do we do now?" we asked ourselves after we deposited our bags in our rooms.

"Let's find a good place to eat eggs," Jere said. Eggs are his favorite.

"I just need a good cup of coffee," I said.

Christmas at the ER

Christmas
Philippine General Hospital, Central Block—not the ER.


I'M ON 24-hour shift at the Emergency Room Department today, stationed here as the Physician-on-Duty. It also happens to be Christmas Day (in the Philippines, it has been Christmas season since September). This is the third year that I've spent it away from home. It's okay; we don't have established Christmas family traditions anyway: usually just a special dinner at 7 PM, with my mother's fruit salad as the dessert, something she has perfected in the past 10 years or so—salads, because she can't cook. The rest we order. We then sleep the night off, occasionally interrupted by worried calls from Auntie Elsie Dizon or Auntie Norma Cobrador, our neighbors, where they invite us over to their Noche Buena and karaoke sessions.

Stethoscopes

MY FIRST stethoscope was a Caribbean blue Littmann Classic II (3M), bought in 2009 at a sale of a local sorority. That special day in 2009 was a milestone: me, a would-be doctor, donning my first stethoscope on my way to the Neurology Ward, where I was to have my first preceptorial with Dr. Leonor Cabral-Lim. With bated breaths, my classmates and I waited for her to arrive; save for what we had read in DeMyer, we hadn’t had any idea what to expect. We were to demonstrate what we learned on the art and science of the physical examination. Yet we carried our steths—as we liked to call them—proudly, like a thick necklace. I remember trying mine out with my seatmates, the Catangui twins. I asked them to breathe deeply—ah, bronchovesicular sounds, no crackles, no wheezing. They, in turn, listened to my heart beat, alternating between a bell and a diaphragm to make sense of the S1 and S2.

My Reading Year 2015

Unlike my brother Ralph who finishes at least one book a week—at most three, he tells me—I didn’t even reach the 20 book count mark this year. Residency happened, you see; and since the start I’ve resolved to read more academic and medical books, less of fiction. But fiction keeps me sane and grounded. I undertook long reading projects, many of them remain unfinished, and chose short story collections to pass the time.

2015 has been a great year for reading, nevertheless.

1. My Struggle* by Karl Ove Knausgaard. I discovered the Norwegian journalist and writer through The New Yorker, where he was interviewed by Deborah Treisman, the magazine’s fiction editor. His work reads like a long, extremely well-written blog. Critics say that it’s funny to read the thoughts of a Scandinavian, an otherwise laconic, introverted people-group. I don’t know if that’s true. He takes us through his childhood, his drunk father, his friends, his discovery of writing. Why we keep on reading when the book is really all about the mundane—the author’s daily life—is a mystery, but they key is the great writing. I’m more than halfway through Book Two: A Man In Love. It deals with his relationships—his first and second (the current) marriages. I love the scenes when he meets with his writer-friend Geir, and they talk about philosophy and about other people. Knausgaard still cries a lot—in the vernacular, “mababaw ang luha.” The fourth volume has already been translated into English, released for distribution. I still have a long way to go, and many volumes to look forward to.

2. My Brilliant Friend by Elena Ferrante. This year I was introduced to the Naples-based Ferrante, whose real identity we don’t know. What we know is that she’s female, has been divorced, and is intent on keeping her anonymity. Let the books speak for themselves,the author is unnecessary, she seems to say. This book is the first in the Neapolitan novels, which star Elena and Lina—two characters who both hate and love each other. They consider each other best friends. They grow up in a small, provincial town. Elena is the studious student; Lina the deviant, but, to Elena’s mind, even more brilliant. They seem to idolize and despise each other all the same. I love how Italian this book is—when Lina’s father gets mad at her, he throws her out of the window.

Signing out of the wards

MY BATCH, fondly called the iMax for reasons that still escape us, just had a party at our callroom. In the spirit of togetherness, the party planning committee opted to hold it inside the hospital so that the people who were on 24-hour shifts could participate as well. It was a Christmas and Year-end gathering of sorts, and the theme was, “First Years Noon, Second Years Na Later.” After all, tomorrow will see us assuming new posts, new lives in a way—out of the wards, into the colorful, often dreadful world called the Emergency Room.

Second year residency is supposed to be easier, with more opportunities for leisure and rest. The duties are tiring, but they end almost as soon as they begin, and one goes home without the weight of the patient’s fate on his shoulders. This is what makes first year residency overwhelming—the idea that it is a marathon instead of a sprint. At the ER level, it’s enough to work on a reasonable diagnosis, to make sure that the emergent labs have been facilitated, and to find vacancies at the wards. Once the patient is admitted, say, to Ward 1, it is the first year resident who will polish the diagnosis, search for other contributing problems, ensure that the medications are being given, and plan for discharge, which, in some cases, never happens in this life.

A new look + a godly perspective

This site has a new look. The letters and photos are smaller. The posts are shown in two columns. Each post starts with a drop cap—one of my favorite features of this template. I was having trouble creating an archive page, though. The tutorial by blogger Sarah (adapted mostly from jhwilson's script) was particularly helpful.

Thanks for dropping by.

Afternoon meals

* * *

I'M sharing Charles Spurgeon's meditation on Psalm 16.8, "I have set the Lord always before me: because he is at my right hand, I shall not be moved."

This is the way to live. With God always before us, we shall have the noblest companionship, the holiest example, the sweetest consolation, and the mightiest influence. This must be a resolute act of the mind. "I have set," and it must be maintained as a set and settled thing. Always to have an eye to the Lord's eye and an ear for the Lord's voice—this is the right state for the godly man. His God is near him, filling the horizon of his vision, leading the way of his life, and furnishing the theme of his meditation. What vanities we should avoid, what sins we should overcome, what virtues we should exhibit, what joys we should experience if we did indeed set the Lord always before us! Why not?

This is the way to be safe. The Lord being ever in our minds, we come to feel safety and certainty because of His being so near. He is at our right hand to guide and aid us; and hence we are not moved by fear, nor force, nor fraud, nor fickleness. When God stands at a man's right hand, that man is himself sure to stand. Come on, then, ye foemen of the truth! Rush against me like a furious tempest, if ye will. God upholds me. God abides with me. Whom shall I fear?
A great week ahead!

Random scenes from Antipolo

HAVING just arrived from a two-day team building activity, I'm exhausted from the gut-twisting laughing spells (a phrase I've adapted from Racquel Bruno), the non-stop games and meals, and the clean and healthy fun that comes with the company of my colleagues—people I meet day to day, and those whom I now regard, after one year of living and breathing the hospital air, as family.

The place was Punta de Fabian in Antipolo, Rizal. It was overlooking Laguna de Bay.

Teambuilding

Congratulations!

Graduation IM

TODAY my seniors in Medicine are graduating. This day will be filled with celebration, thanksgiving, and remembering. I get emotional with endings, as graduations are often thought out to be, because these wonderful people have taught me and affected me in ways that go beyond making clinical decisions, diagnoses, and treatment. This means I will not be seeing any of them at the OPD anymore, will not be chatting with them randomly for a few minutes to pass time, will not hang with with them over food and videoke as often as before.

December 1

Christmas décors at the hospital

IT IS A minute past midnight. My intern shows me her proposed correction for some deranged electrolytes. She tells me one patient's serum sodium levels are going up. I ask her to compute for the total body water deficit. She scrambles hard for the answer but eventually gets it. I ask the nurses to carry out her orders. She'll make a good internist one day.