Saturday, March 21, 2015

The other end

IT IS already 9 PM. I admit a patient for an elective coronary angiogram procedure, a short diagnostic test that maps the vessels supplying the heart and identifies where the clogs are. I phone the Cath Lab to inform the anesthesiologist that the patient is now ready for preoperative evaluation.

"Good evening, this is Dr. Catedral."

"Good evening po," says a shy sounding woman at the other end.

"Yes, we are referring patient Neriza Marzo*. She is at Ward 1. Her scheduled angiogram is tomorrow, 7 AM."

"Ano po ang procedure?"

"Coronary angiogram po—at 7 AM. I already informed Cardiology of this admission. I understand that this schedule has been confirmed made weeks ago pa." I use my CNN reporter ultra-serious, no-nonsense voice, which usually works when I do referrals.

"Ah, ganoon po ba . . . Pwede po ba akong lumabas?"

"May I know who I am speaking to? This is Doctor . . . ?"

"Ah, si Norma po ito. Sa sixth floor. Pasyente po."

And it occurs to me: I dialed the wrong number. So Nineties.

Ah, the Nineties: when phones were not mobile, and phonebooks were still made of paper.

* * *

Not her real name.

Friday, March 20, 2015

Catching up

I'm more than halfway through my second stint at the Charity Ward. Time goes by very fast, especially when one has a lot of things in mind. It is, I suppose, better the second time around, though the transition from the Medical ICU to the Ward (which is really an extension if the ICU, if you think about it) wasn't as smooth as I'd expected.

But enough about residency.

Friday, February 27, 2015

Moving in (and out)

I'M MOVING to a new place again, somewhere much nearer, literally a stone's throw away from the hospital entrance. Moving out (and in) is stressful for me. My upper body strength is so weak, such that carrying two volumes of Harrison's inevitably brings about pain the next day. My friend Jef, who penned my college yearbook write up, referred to my arms as “wispy.”

Sunday, February 22, 2015

Best lunch I've had in a while

WHENEVER I overhear someone say he “enjoys” residency—as if it were as easy as window shopping or reading Danielle Steele—a part of me doubts him. Either he's exaggerating the ease of his transition into residency life, or he's not doing what he's supposed to do. Medical training is hard work—more so during the first year.

Thursday, February 19, 2015

Late entry for Valentine's

ON MY WAY out of the Medical ICU to catch a quick breakfast before I did my rounds, I was greeted by unusually giddy nurses, “Happy Valentine's Day, Doc.” I would've told them that Valentine's Day is a non-entity for me—and not in a romantically bitter way, for those emotions escape me—but I replied, in the interest of time, something like, “Happy Valentine's Day, too.”

No man is an island

ONE OF the greatest joys of my week, assuming I'm not on a 24-hour shift, is the Bible study (or cell) group I've been attending for months now. It's called Pilgrims, composed mostly of married, basketball-loving, middle-aged men. In terms of age, I'm in the minority—at 27, I'm among the youngest. We meet Thursday nights in church.

Saturday, February 7, 2015

Libro

HANDFUL of quotes from materials, mostly books, I'm currently reading.

On the art of seeing and managing too many patients all at once.

To a medical student who requires 2 hours to collect a patient's history and perform a physical examination and several additional hours to organize that information into a coherent presentation, an experienced clinician's ability to decide on a diagnosis and management plan in a fraction of the time seems extraordinary.—DB Mark and JB Wong, In: Decision-Making in Clinical Medicine, Harrison's Principles of Internal Medicine, 18th Ed., Vol. 1

Tuesday, February 3, 2015

Part of the narrative

MY FIRST foray at the Wards as first year resident was made up of a whirlwind of experiences—a combination of frustration and fulfillment (mostly the former). I suppose my month-long stay there was an initiation to the tough, challenging world of residency training in Internal Medicine at the Philippine General Hospital.

Thursday, January 29, 2015

Recap: first month

Service 6
Service Six. From right: myself, Racquel Bruno, Josh Abejero (back), Julie Gabat, Raymond Lozada (back), Amy Lopez, Jing Lagrada, Bea Eusebio (back), and Mia Licyayo.

TWO DAYS left, and I'm done with my first stint at the Charity Ward as resident. It's where much of the action happens. The first year's roller-coaster life—victories and failures, recoveries and morbidities—essentially revolves around Wards 1 and 3.

Monday, January 26, 2015

Baffled

I HAD the immense privilege of helping Rich King, our batch head, compose the speech for the welcome ceremony for incoming first years in the Department of Medicine last week. His delivery gave this short message a more serious, determined tone; and he spoke like a seasoned orator. Here it is, in full.

Internal Medicine - Philippine General Hospital
Credit: Dr. Nemo Trinidad

It still baffles us: the fact we made it to residency in Internal Medicine at the Philippine General Hospital. When we look back at the rigorous pre-residency process just a few months ago, we had no way of knowing whether we were going to get in at all. There were so many applicants, many at the top of our own classes, all oozing with brilliance and compassion, so much so that in the end, we felt it was anybody's game. We wouldn't feel cheated if we didn't get in and they did. And yet, by God's grace, by a beautifully orchestrated miracle, we received the call one fateful afternoon. Some of us were still curled up in bed, or watching a movie over our laptop, and when we heard the resounding, “Congratulations! You made it!”, many of us couldn't believe our ears. Our lives finally took a new direction for the next three years.

Sunday, January 11, 2015

How do you measure a year?

LAST THURSDAY night, during my time with the Pilgrim Men—the Bible study (or cell) group I've had the privilege of attending in church—we shared what made our year memorable. The question was, in effect, like this: what criteria do we employ to say that our year has been a success?

Saturday, January 10, 2015

Basement boys at the Ward

MORNING always has us scrambling for charts—not an easy task at all, but one that requires the visual acuity of an eagle, the extraordinary flexibility of a snake, and the father's forbearance in the Parable of the Prodigal Son.

Friday, January 2, 2015

New Year's Eve, PGH, and 2015

I WELCOMED the new year in the hospital. I was on 24-hour shift at the Pay Ward, intermittently called up by nurses for referrals that ranged from possibly fatal complaints (difficulty breathing or chest pain) to electrolyte abnormalities easily corrected by telling the patient to eat a piece of banana. I had brief moments of rest, perhaps the longest ones I've had since I had begun residency two weeks ago. From the call room window I could see fireworks decorating the expanse above Manila Bay. I imagined that, if I were home on New Year's Eve, my street at St. Gabriel would be noisy too. I could see our dog, Benjamin, cowering in fear whenever our neighbors lighted fireworks. The Dizons, who live just right across us, would call us up and invite us to their home; I wonder if their family computer, which we always fantasized about, is still working. My parents would probably be asleep, especially my mother, who cannot tolerate staying up late lest she incur a migraine the next day. But Tatay would wake me and my brothers up sometimes—that much I can remember when I was in elementary school. He would give us firework sticks and light all three of them at the tips with a single matchstick, assuring us that our hands wouldn't need to be amputated because that hardly ever happens if one is careful. I was particularly paranoid; I liked my hands very much.

Monday, December 29, 2014

My Reading Year 2014

HERE'S a list (probably incomplete, and not in any particular order) of books I've read this year. I'm not sure which ones I like best; the top ten should include the works of Marilynne Robinson, William Faulkner, and, well, of pretty much everyone else in this roster. Jhumpa Lahiri was a surprising discovery for me; her simple prose evokes so many complex emotions. I read The Interpreter of Maladies once in a while, and I get a different insight from it every time. Roddy Doyle, the Irish writer, famous for The Barrytown Trilogy of which The Commitments is the first, is a happy addition to the Funniest Writers list I'm compiling—a list that already includes David Sedaris and PG Wodehouse. Also included in my 2014 reading diet are essay and short story collections, like Chabon's Manhood for Amateurs and Faulkner's Go Down, Moses. The New Yorker anthology, Secret Ingredients, features the best magazine articles about food; I enjoyed that immensely, too. Spiritually, I've benefited from Jon Bloom's Not by Sight—great retelling of Biblical stories Christians have come to love. Overall, a great year for reading.

Saturday, December 27, 2014

Fellowship

ONE of the greatest blessings—and joys—of the Christian life is having a church family. Having been literally rooted out of our home in Mindanao to pursue further studies in Manila, my brother and I didn't have any immediate family members to go to, homes to spend the weekends in, aunts or uncles to visit. Yet the Lord, in His sovereignty, brought us to a small, faithful church where everybody knew each other. Over the course of many years we have developed meaningful relationships with many of the members who have always prayed for us and wished us well. Our local church is the closest thing we have to a family in Metro Manila.

Sunday, December 14, 2014

About to begin

RESIDENCY begins on the 16th of December. Last week, I was handed my schedule for the entire year. I'll be at the Pay Wards on December, the Charity Wards on January, and the Medical Intensive Care Unit, hereon referred to as the MICU, on February—that's all I can remember for now. I will have my out-patient clinics every Tuesday morning and Thursday afternoon. I will have 24-hour shifts every three days. Except for the seven-day “leave” (yes, it's in quotation marks because it doesn't really exist) on the third week of August next year, I will be doing rounds every single day of the year 2015, regardless of holidays, floods, or supertyphoons.

Saturday, November 22, 2014

Lila by Marilynne Robinson: a story of grace



YOU READ a book, expecting to have fun, the kind that your brother Sean, who hardly reads anything at all, save for his textbooks, won't ever understand. You begin with the first few paragraphs. Amazed at the craftsmanship of the sentences, you keep at it—the pleasures of reading, they call it. Then you lose grip of time; your head is up in the clouds of the story—a made-up world that, for a moment, seems more real than reality.

You wonder at how words—letters pieced together, their meanings defined by spaces or lack thereof—can have such an effect on your emotions. Apathy turned into concern, rage into sorrow, discontent into delight. Or maybe a combination of them, because a person, indeed, has the capacity to handle, though not completely explain, a wide range of feelings, like the spectral colors of the rainbow in the afternoons of childhood.

Monday, November 17, 2014

Soaring like the eagle in the light of the eternal sun

AS A SUPPLEMENT to my daily devotions, I'm reading "What Happens When I Pray?," a condensed version of the works of two not-so-famous classic Christian writers, Thomas Goodwin and Benjamin Palmer. My copy is published by Grace Publications Trust (London, England), and is a rewritten and abridged version prepared by Dr. N. R. Needham, in order to cater to a modern-day readership.

Thursday, November 13, 2014

Karl Ove Knausgaard on brothers

KARL Ove Knausgaard is a Norwegian writer whose monumental book, Min Kamp (My Struggle: Book One), is what I'm currently reading. Critics call the 3500-page autobiography monumental; I can see why. There's nothing so special about the subject--his life--but he writes in such a way that keeps the reader, any reader, hooked. Compelling: that's the word for it. He keeps us interested, finding meaning in the minutiae of life: his breakfast, his band, his first pseudo-sexual experience, his father's death. One of my favorite book critics, James Wood of The New Yorker, said that "even when [he] was bored, [he] was interested."

Wednesday, November 12, 2014

Laughing at politics

AS I WAS INUNDATED with news of the Senate Blue Ribbon Committee crucifying Vice President Binay for his alleged involvement in an overpriced parking space or airconditioned chicken farms, I discovered the HBO original production called Veep. Having resolved not to get too involved with national politics, I considered Veep a welcome diversion.