Christmas meditations

DR. JOHN MACARTHUR puts it beautifully in his book, First Love: The Joy and Simplicity of Life in Christ:

The One who is the object of our love was born contrary to the laws of nature, reared in obscurity, lived in poverty, and only once crossed the boundary of the land in which He was born—and that in His childhood. He had no wealth or influence, and had neither tranining nor education in the world's schools. His relatives were inconspicious and inconsequential.

My Reading Year 2012

CLERKSHIP HAPPENED (is still happening, actually). Factor in the sleepless nights, the often backbreaking hospital work, and the pressures of getting as much sleep in one free night, and you'll find that these elements conspire against the habit of reading non-medical books regularly. I'm still thankful for the 30 books I got to read. Many of them were collections of essays or short stories—and understandably so. I didn't have the time to take on long novels, as they consumed more time and energy. I wish I could have read more books, of course, but there's always next year.

Benjamin

DAVID, our Japanese spitz, died this year. I've mentioned him in a couple of posts. I'm not crazy over dogs—I find them tiresome—but David was particularly sweet, barking at me the moment he saw my shadow at our gate, knowing my smell after months of parting. He was my favorite, in a sense, even if he gave the family overwhelming proof that he was The Stupidest Dog That Ever Lived. After he got rammed by that wretched tricycle at the highway some yards away from our house; my father, who considers dogs an integral part of our family's existence—to my mother's dismay because she hates seeing her furniture ruined by scratches—buried David in the vacant lot on St. Paul Street where we live.

Late dinner with Cesar Montano

THIS ONE'S too good to pass up.

I met up with old friends from my elementary days over a late dinner in Timog-Tomas Morato area. I hadn't seen some of them for the longest time. When we did meet, our previous encounters were always hurried—while lining up at the airport, queuing at the mall, so much so that I only knew bits and pieces about them, thanks to Facebook. We sat in the same classes for six years at Notre Dame of Marbel University - Elementary Training Department (now called the NDMU - Integrated Basic Education Department). They remained at Notre Dame for high school, while I transferred to Koronadal National Comprehensive High School after I qualified for its special science curriculum. I haven't been closely in touch with them since then (except for Katrina Magallanes who studied in UP)—primarily a fault of mine, the most irresponsible batch alumni president. To this day I have no plans of organizing any reunions.

Remembering my last duty day for the year

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I'D BEEN SLEEPING for more than three hours at the call room's upper bunk when the intern woke me up at 3:55 am, asking me if I could give the fluid boluses to the newly admitted newborn noted to have faint pulses and sudden onset pallor minutes ago.

"Sure," I said, squinting, yawning, and getting up all at the same time.

Week 48, 2012: Babies!

THE IDEA of handling kids used to frighten me. On my rotation in Pediatrics, I don't have any other choice but to deal with them—these little people.

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I don't just carry babies around, I get blood samples, insert IV lines, and make them cry in the process. In a way it's both harder and easier—harder because they have smaller vessels, so extracting blood is a  big challenge; easier because they can't complain much, and all they can manage to do is cry.

Dying thoughts

THE DEATH of an aunt very close to me has led me to think a lot about death and dying lately. The great equalizer, they call death, because everyone dies—the only question is when.

I talk about death to friends. I talk to them about the possibility of me dying early—not that I wish it, but that it can happen sooner than I think. This topic is received with two basic reactions: dismissal ("Stop talking about that!"), the more common reflex response; or excitement ("Ah, to see the Lord Jesus Christ and worship Him in heaven!"), usually from my Christian friends.



To live a full life on earth, one must realize that death, like a thief, can barge in any time. In the greater scheme of things, life is short, and man is but a vapor. "Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes" (James 4:14).

Multiply no more

TODAY is bottledbrain.multiply.com's last day before it's deleted forever.

As far as cramming could go, I spent a total of about six hours manually downloading photos, blog entries, audio and video recordings spanning six years. I felt nostalgic in the process. I looked eerily thin in the photos, and something in me had changed. The facial hair, perhaps, now that I shave on a weekly basis? The added weight, thanks to my daily intake of deadly cholesterol-laden material? Or the added life experience—of seeing actual people die, of witnessing the spectrum of human suffering head-on?

My blog entries were shorter, much more egoistic, and were ... shall we say, badly written. Reading old entries from way back when still make me cringe in embarrassment. What was I thinking? But hearing my younger self again can also be therapeutic. I now see how I've grown, thanks to God's unfailing grace, and how my passions have changed throughout these years. So there is that sense of me being relieved that I'm no longer the same person I was once years ago.

Even though I had an existing Blogger address in 2006, I opened a Multiply account to host my files. Because I took quite a number of photos with my digital camera, I wanted to store and share them online. Multiply offered the most user-friendly format. I liked how things were organized there. Unless otherwise specified, only approved contacts could access those folders. There were hardly any privacy issues.

Learning rock

MY FRIEND Carlos Cuano is a big snob when it comes to music, especially rock music. He hates pretentious bands and calls them copy cats. He despises revivals. He has a special hatred for Adam Lambert. But he has a list of bands he adores, and he knows the songs, the lyrics, the writers, and their life stories by heart. He recites the history of rock as if he did an academic dissertation on it.

"But 'rock' is too vague a term," I told him once. "How do you define it?"

He looked at me with serious eyes and said, pointing to his heart, "It's in here."

An era has ended

SOJR

THE ERA of the Two-Week Rotations has ended.

I didn't like Rehab Medicine that much, a fact compounded by my ignorance in all things anatomical.

I liked Orthopedics; the residents weren't just brawn. They had brains, too, but didn't have to brag about it. And they remembered our names, which made us feel human.

A. D. Miller's Snowdrops and my fascination with Russia

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RUSSIA IS ONE of the places I'd like to visit someday, if God allows it.1 I want to photograph the Kremlin, walk around The Red Square, smell the vodka on people's breaths, and freeze myself to death in the cold of winter.

Not knowing what it was about, I randomly picked A. D. Miller's novel, Snowdrops, from the list of unread books I have. Well, guess what: snowdrop is a Moscow slang for a corpse that lies buried or hidden in the winter snows, emerging only in the thaw.

An Englishman, Nick Platt, is narrating. He's an expat lawyer who has lived in Russia for four years. He's thirty-something, and he works for international banks that lend money to Russian businesses. The oil boom in the world's largest country is making a lot of people rich.

Nick is pretty much a single man. He has lots of money, which sustains his rather decadent lifestyle, but he's lonely. One day, on the train, he meets a young woman named Masha, "wearing tight, tight jeans tucked into knee-high brown leather books, and a white blouse with one more button undone than there needed to be." Even if she's only 23 years old, she becomes the love of his life—and I think, even with all the deception, betrayal, and hurt that came with her, Nick still loved her in the end.

Torpe

I HAD no idea.

I thought I had known what it meant, "torpe," a word I hear in every day parlance, in songs, on television, but I didn't take the effort to search for its actual meaning, the same way I didn't bother looking for the definition of "astig," "toma," or "chever" because, well, people just happen to know what they stand for. But my lexicographical laxity gave way to ignorance, and I had been mistaken all along. I still don't know a lot of things, apparently, and all these years I've misunderstood "torpe" entirely.

Losing sight

I TURN to Paul's letter to the Philippians during the hard times. Every time I read Paul's encouragement to the persecuted church at the time—"Rejoice in the Lord always. Again I will say rejoice!" (Philippians 4:4)—I'm reminded of my shortsightedness, of how little I think of God and what He can do to rescue me from my situation. That almost always brings me to my knees in asking Him for forgiveness.

I've not been feeling particularly well these past days. Many problems came up. I became anxious, worried, and helpless, so much so that I felt I was losing control of things. I became so caught up with my problems that I lost sleep and appetite. Has that ever happened to you?

Week 45, 2012: The continuing saga

SPENT THE PAST two weeks at the Otorhinolaryngology (ORL) Ward. Last week I had to insert a nasogastric tube to a patient who was recently operated on, and I had a hard time. I didn't want to risk introducing trauma to the neck which could potentially open the stitches up. Despite my failure, the patient's daughter, a sweet Ilongga woman, approached me and gave me my first professional fee: a Jollibee Yum Burger.

week 45, 2014

Losing temper

FROM WHERE I WAS SEATED I could hear a woman shouting. The customers, otherwise busy eating their hurried breakfasts, looked in her direction. Like me, they were wondering what the fuss was about. I came to my regular breakfast place, a fast food chain at the corner of Taft and UN Avenue, to have a quiet moment to myself, filling my stomach with something, reading the morning papers with a cup of hot coco; and here she was, adding drama to the scene. "Well, that's a neat way to start the day," I thought.

Italo Calvino's If On A Winter's Night A Traveler: the pleasures of disinterested reading

I FINISHED Italo Calvino's novel, If On A Winter's Night A Traveler, one of the best books I'll probably read this year, along the likes of McCarthy's Blood Meridian. To kill time I went to a coffee shop immediately after the Otorhinolaryngology Tumor Rounds where I had a cup of coffee and a pie, leafing through the book and wondering why it took me so long to finish it.

The book is about the art, pleasure, and adventures of reading. I'm sharing some of my favorite lines.

On which reading position to take on:

"Of course, the ideal position for reading is something you can never find."

On reading for sheer pleasure:
"How many years has it been since I could allow myself some disinterested reading? How many years has it been since I could abandon myself to a book written by another, with no relation to what I must write myself?"

Racism

I WATCHED American History X (1998), a film about racism, told from the viewpoints of the two Vinyard brothers, Derek (Edward Norton) and Danny (Edward Furlong). They're brilliant students, but you know how brilliance can be a good and a bad thing—you get high grades, sure, but on the other hand, you're exposed to various belief systems, and that if you're not careful enough, you can easily be swayed, overshadowed by the supposed complexity or sophistication.

Seclusion

I THOUGHT OF going out of town. The mere idea of hurriedly packing my bags, buying a random ticket for a bus trip that would take me somewhere far, quiet, and peaceful excited me. Chances were that I wouldn't be able to do any of these, anyway, with my packed and unpredictable schedule. So when I heard that I had a couple of days off, I asked my brother if he had plans for the extended weekend. I told him I wanted to see white sand; I hadn't been to the beach yet since the year had started. And the sand had to be white, or else it wouldn't look too good in the photos. 'We can arrange that,' he said. I felt giddy.

Pigging out

QUITE RECENTLY we've taken to exploring other places for dinner, our way of escaping the round-the-clock strain of being in the hospital. Nothing can parallel the impact of food in bringing us together. Some blocks like movies or parties or traveling—but throw us any food, and we're happy.

We're making the best of what little time we have, relishing each night when we don't have to stay awake for 24 hours. After all, hard as it may be to believe, the era of the short, relatively light rotations—that is, Ortho, Rehab, Ophtha, and ORL—is ending soon.

We encounter each other in the daily grind of hospital life, and we probably know a whole lot more about each other than we should—for instance, our bowel movements for the day, which remains a favorite topic of morning conversation.  But eating out in a relaxed restaurant does wonders. People talk openly, share their frustrations and, better yet, humiliations. They talk of past and present relationships, present and future plans, and they talk of themselves in ways I wouldn't have imagined they would be capable of. To see each other in jeans, colorful shirts, or skirts outside the context of PGH offers a welcome change of scenery. Ah, to finally not see those white uniforms.

Remembering



Happy birthday, TatayI REMEMBER when you took me to the barber and promised you'd be back after 30 minutes. You had to do the groceries. The barber razed through my hair, reducing its length to less than a centimeter, and I couldn't do anything about it. I had never felt so helpless. When you came back for me, I was mad. I hated my haircut. It was too short. I cried as we walked, but you laughed at me, which made me angrier. Eighteen years later, I still sport the same hairstyle.

I remember how you still call me Bon, a special nickname you gave me, which warms my heart every time I hear it.

I remember how hurt you were when I—then a melodramatic and verbose seven-year old—told you, "You have no right to do that to me!" because you ate the chocolate bar I was saving up in the fridge. I stormed out of the house, but minutes later, you came out and told me to get ready for lunch, as if nothing had happened.

I remember your excitement to take us, my brothers and me, to swimming lessons at the SMRAA every afternoon during the summer. From the stands, you stood proudly when we finished one lap at the Olympic-sized pool. You treated us to a hot, delicious arroz caldo at the nearest carinderia afterwards.

Memories of IM past

THREE WEEKS ago I wrote this piece. Here are some of the things I'll remember the most in Internal Medicine (not in any particular order):

1. The Guazon Hall endorsements. Every day, except Sundays, we'd troop to Guazon Hall for the morning endorsements.

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The two-hour session would start with a quick rundown of mortalities and mortalities of the previous 24-hours, followed by moments of silence as the senior residents, seated at the topmost row, picked one case to be discussed for the day. The ensuing tension was similar to the choosing of Katniss Everdeen's sister to represent District 12 in the Hunger Games, where one either lived or died.

The architecture itself was daunting: five or six rows of seats in ascending fashion, the lectern in the middle, and whoever was speaking was looked down on, quite literally, by the audience.

Week 42, 2012: Lunch at Seafood Market

PUMUNTA KAMI SA SEAFOOD MARKET para mananghalian. Hindi ko na maalala ang eksaktong pangalan ng restawran, pero isa 'yun sa hilera ng mga kainan na makikita mo kapag dadaan ka sa Macapagal Avenue papuntang Mall of Asia. Paboritong dayuhin ang lugar na ito ng mga magulang ko tuwing napapadpad sila ng Maynila, lalo na ng aking nanay na binabalik-balikan ang alimango na mabibili at makakain sa murang halaga.

Kasama ang aking mga blockmates, namalengke kami sa katabing bilihan.

Week  42, 2012: Team Clerk lunch out at one of those sea side restos along Macapagal Ave

Week 41, 2012: My week, what else?

WHILE WE WERE IN REHAB, breakfast was usually at Midtown Diner, one of our block's most favorite dining places along Padre Faura Street. The waitresses know us by name. Scratch the fact that the American breakfast meal—toasted bread, butter, bacon, and two eggs—is a bit pricey. The brewed coffee tastes and smells good, the couch feels comfortable, and there's that feeling of being in the 50's. We're loyal customers.

week 41, 2012: breakfast

A new academic word processor called LyX

BECAUSE I HAD CASE REPORTS to finish before the weekend, I learned a new program called LyX. It's halfway through LaTeX, which is more intricate, and Microsoft Word, which is so user-friendly computer ignoramuses can work with it. I took on the challenge of writing my reports with this program. I finished both papers early this morning; the thrill of tackling a new program was an encouragement to keep me on.

Unlike the usual word processors, LyX is a document processor that makes use of the WYSIWYM (what you see is what you mean) approach, which means it involves tweaking the structure rather than appearance of the text. This was how the screen looked like when I was writing the paper:


Binge-reading: Josh Bazell's Beat the Reaper, and David Sedaris' Naked

SO FAR, SO GOOD. Was able to finish two non-medical books in a row while I'm in Rehab. There's not much to do—and even if there is, I'm not yet in the mood.

I call this phenomenon binge-reading, which happens after prolonged abstinence from tackling—I like that word—non-medical literature. Doesn't help my eyes at all.

MY FRIEND Leeca Caro recommended Beat the Reaper by Josh Bazell. Two main reasons why I liked the book: (1) the author took BA English in college before going to med school in Columbia (pretty much like my story), and (2) the novel is about a doctor who was once affiliated with the mafia. I also highly value people's book suggestions. They fact that they take the extra mile to tell me something's worth reading means it has to be worthwhile.


When I was five

TODAY I FOUND this question in my email: When you were five, what did you want to be when you grew up? Did it happen?

My childhood memories aren't as poignant as, say, my brother's, who still probably remembers our grandmother's old house in Banga. But this I recall: that I was in preschool in 1992, seated beside classmates with runny noses (which I despised looking at), starting to learn my alphabet, and enjoying the drills on my DISTAR reading materials.

I remember a conversation I once had with my classmate John Michael Daraug during recess. I asked him what he wanted to be when he grew up. "A hold-upper," he said.

Intrigued, I asked him why.

Week 38, 2012: Wall stories

THREE MEDICAL STUDENTS visited our call room one afternoon at Ward 1 to shoot a video. They were doing an ad for a project that aimed to raise money for the renovation of both the clerks' and interns' call room in Internal Medicine—clearly an initiative that could potentially change the course of human history.

They asked me if I could say a few lines; I politely declined, of course. At that moment I realized something: that despite the intolerable heat and humidity, the assailing uremic smell of the bathroom with the broken doorknob, the clutter of empty mineral water bottles, and the non-functioning airconditioning system, I will miss the homey feel of our call room, a place Carlos Cuano appropriately called "our safe haven" (or something to that effect).

If only the walls could talk, they'd you tell how how we vented our frustration that some patients could barely afford a syringe or a red top vial, or how laughed at our cluelessness during the Guazon morning endorsements, or how we panicked because a new patient—potentially Guazon-able at that—had been decked to us 30 minutes before the cut-off.

week 38, 2012: huddle

Week 37, 2012: Endorsements

WHILE THE REST of my classmates were buried in piles upon piles of things-to-do for their patients at the wards, we in Service Three decided to have lunch elsewhere—that is, in the nearby mall. We only had three or four existing patients, most of them about to be discharged. What joy!

Our seniors treated us to pizza and pasta, which we devoured mercilessly, while some of us did 10-minute reports on chronic obstructive pulmonary disease, infective endocarditis, among other interesting  medical conditions. We had a quiz afterwards. I'm still amazed at the devotion our residents have shown in teaching, grilling, and advising us, something other clinical departments in PGH may want to emulate.

Here were Dr. Marc Gregory Yu, who's about the same age as I am and whose accent has a striking Ilonggo feel to it, and Dr. Gelza Zabat, our service senior, who also took molecular biology as an undergrad course.

week 37, 2012

Notes

MY PATIENT at the Medical ICU (MICU) liked writing notes. He was intubated when he came in, so I never really got to hear him speak. He relied mostly on hand gestures, but even those had their limitations. His wife had a brilliant idea: maybe he could write things down instead. Every time I dropped by his bed, I saw a notebook and a black marker pen beside him. I would ask him a question. Slowly he would jot the answer down.

Rfkill unblock wifi

I HAD TROUBLE connecting with the wifi when I got back home. I remember that while I was in PGH, I had turned off my laptop's wireless connection to save up on battery. When I tried to press the same button again to retrieve some files from the Net, the notification area on the upper right portion of my screen read, "wireless is disabled by hardware switch." If this were a hardware problem, I thought, then I must have my laptop fixed somehow. I simply didn't have the time.

Internalizing

I FOUND MYSELF updating my patients' online database at 7:30 PM on a pre-duty day, when I should've been home, reading a good book. My feet hurt from hours of making sure all blood pressures were stable in Ward 1. My face was soaked in sebaceous secretions, and I just wanted to get something to eat. The call room's air conditioning unit wasn't working, and the humidity was adding to the stress of having a growing checklist of things-to-do in my mind.

It's not a wonder why people start thinking of quitting med school on their Internal Medicine (IM) rotation: there are just so many things to do. My friends who are already done with IM already miss it, but I remember that while they were in my present state, trapped in Wards 1 and 3, they couldn't wait to get out. One never really figures out how precious something is until it's lost. I'm only on my third day, and it already feels like I've been here for weeks.

Philip Roth's Indignation is so depressing

Philip Roth, Indignation, at National Bookstore, for Php 99!

PHILIP ROTH'S INDIGNATION, a book I picked up on National Bookstore's month-long sale, is about the 19-year old Marcus Messner who decides to study elsewhere to get away from his father, a kosher butcher.

He grows up helping in his father's shop, eviscerating chickens or chopping cow hides, all the while maintaining his straight A record in school. His parents are proud when he becomes the first person in the family to land in college. He wants to be a lawyer, if not a high-ranking army official to be deployed in the Korean War.

Meanwhile Marcus' father becomes increasingly paranoid of his son getting killed or harmed. His father's prohibitions and warnings, many he (Marcus) considers irrational, force him to pursue his studies at Winesburg College in Ohio, hours away from his New Jersey home.

Anger

WHAT SOME PEOPLE may not know is that I can get extremely irritable. This afternoon, after a tiring day at the Medical ICU, I talked to my father over the phone while simultaneously turning my old, trusted Compaq Presario CQ40 on. I do it all the time—multitasking. Tatay was in the middle of asking me how I was doing when he heard me grumble about the pitiful state of my four-year old machine.

"Bon," he said, "you're getting angry again."

"My stupid laptop isn't working."

"Did you try to get it fixed? Maybe you have friends who can help you."

"No, it's a stupid laptop, and it's not being useful when I need it the most."

Week 34, 2012: Medical Intensive Care Unit, first week

IN THE MIDDLE of our first week at the Medical Intensive Care Unit, some of us were fielded to the newly-opened LICU. The L stands for Leptopsirosis, a disease caused by microorganisms transmitted through the urine of rats. Weeks after the massive flooding in Metro Manila, a deluge of severe lepto patients was imminent. Fortunately the unit wasn't officially opened yet; there needed to be about 25 consults a day for the LICU to be activated. Since there was hardly any patients, Lennie, Ching, Marv, and I went to the pantry to finish our breakfast, and we found this note—a perfect blend of good handwriting and sarcasm. Below was an empty box of BonChon takeout meal.

week 34, 2012

Old friends

IT WAS DR. SUSAN Punongbayan, a physician in Bukidnon, who gave me this important piece of advice last summer break: keep your non-medical friends close.

A month ago I met up with old friends from way back in first year college. Jaylord Tan celebrated his 25th birthday and invited us over to dinner. From experience I've learned not to commit to any social event, until I'm absolutely sure that I'm not on call at the hospital, so please forgive me if I don't reply to invitations immediately. I simply do not want to disappoint you.

I had first met most of them in Kalayaan Christian Fellowship. We had Bible studies every Tuesday (or was it Wednesday?). We bumped into each other at the Mess Hall where we shared meager servings of brown soup and unlimited supplies of rice—well, there was that. After I was done with homework, I would drop by their rooms at the Kalayaan Hall Basement, share to them how my day went, listen to them as they poured their hearts out, and ask them to solve academic problems I couldn't make sense of. They've been part of my closest circle of friends since then.

happy birthday, sir jaylord

On Sara Bareilles and drowning the world's noise with my earphones

SARA BAREILLES' album, Live from the Gravity Tour, has been on my playlist for weeks now.

The songs she performs—they have the right kind of melody to keep me awake, make me sing along without overly distracting me from finishing my patients' progress notes.

I discovered her about a year ago, when I chanced upon a live recording of King of Anything in YouTube. I liked her then, and I like her now: the clean and modest look, the magical voice, and the joie de vivre on-stage.

Two deaths

I WOKE UP to the news of my patients' deaths. Both expired early in the morning and were never revived successfully.

The first patient, a 30-something obese man, came to the Emergency Department three days ago with fixed dilated pupils. He was unresponsive even to pain stimulation and had high-grade fever. His neck was rigid. My superiors were entertaining a brain infection in its advanced stages. Unfortunately, because of the acuteness of his condition, I didn't see much of him.

The second patient, Mang Ronny, 65 years old, was close to me. I had been his student-in-charge since day one of my Neurology rotation. Because he had been confined for almost a month already, his chart was thick when it was first endorsed to me, packed with indecipherable notes from various services, laboratory results, antibiotic schedules, and nurses' narratives. I was overwhelmed when I wrote my incoming notes. It was the longest clinical abstract I had written.

A prayer to overcome my lack of faith

Though you have not seen him, you love him. Though you do not now see him, you believe in him and rejoice with joy that is inexpressible and filled with glory ... — 1 Peter 1:8
Dear Father, I tend to believe what I see and doubt that which I don't. Forgive me, Lord, for my lack of faith.

I woke up this morning on the wrong side of the bed, immediately turning my laptop on the moment my alarm clock had rung. I hardly uttered a prayer. Instead I went on grumbling, hoping the day would end before it had even started.

How short-sighted I was, Lord, and how irritable! I finished my report after an hour. I just wanted to get it done with. Was I thinking of doing it to glorify your Name, to display excellence so as to honor You? No, I wasn't. Exhausted, I headed straight back to bed, blaming the stresses of the hospital, my decision to sleep earlier the night before, the 24-hour duty scheme of my training institution—and the list could go on and on.

Erich Maria Remarque may have written about med school — by accident



WHILE SKIMMING through my dusty stack of books this evening, I got hold of Erich Maria Remarque's All Quiet on the Western Front, which I had read last year. The short novel is a searing and moving account of young German soldier Paul Bäumer in the trenches. Shortly after World War I began, he and his classmates are drafted for the battlefield.

And it hit me: Erich Maria Remarke may well have written about medical school—by accident.

The narratives of being in the trenches make great analogies of what to expect in, say, the emergency room on a Saturday night. There's also that danger of leaving one's things unattended:

The clearing station is very busy. It smells of carbolic, pus and sweat, just like it always does. You get used to a lot of things when you are in the barracks, but this can really turn your stomach. We keep on asking people until we find out where Kemmerich is; he is in a long ward, and welcomes us weakly, with a look that is part pleasure and part helpless agitation. While he was unconscious, somebody stole his watch. p.9

Miguel Syjuco's Ilustrado, and my wish for more contemporary novels written by Filipinos

THE WRITER Miguel Syjuco was unknown to me before he had won the 2008 Man Asia Literary Prize. Since then I've been hearing a lot about his book Ilustrado, having seen it many times displayed in local bookstores, its singular presence a reminder of how rare serious novelists are in the Philippines. Wasn't it the writer Butch Dalisay who said that Filipino writers can't be taken seriously in the international arena unless they publish novels?

Naturally I was curious as to what Ilustrado was all about. If you care to remember your Philippine history (and I still do, in a way, thanks to Mr. Mario Madrero, my high school history teacher), ilustrado was a term used during Spanish colonial times to refer to the enlightened; i.e., people from the society's upper middle class who were privileged enough to study in Europe. Our heroes José Rizal, Marcelo H. del Pilar at Mariano Ponce belonged to such a category.

Classes in Metro Manila suspended today

DURING MY TOUR of duty at the Emergency Department last weekend, I saw a number of patients consulting because of high grade fever, muscle pain, and jaundice. Their labs indicated that they had leptospirosis; all of them had waded in the flood, thanks to the rains that have left low-lying areas of Metro Manila looking like Water World.

Astonished by the Gospel

WHEN PRAYING BECOMES a tedious chore rather than a source of refreshment and delight, I often turn to Scott Smith's blog, Heavenward. There he posts daily personal and practical prayers, always beginning with a verse or two, with catchy, sometimes amusing, titles. His meditations are reminiscent of Augustine's Confessions or King David's Psalms, and I wonder if the blog is his way of forcing himself to commit to the daily spiritual discipline of quiet communion with the Lord. Heavenward has certainly been a treat for my tired and weary soul, especially during the quiet moments before my post-duty sleep commences.

The 10 best closing lines of books — and one of my own

ROBERT MCCRUM of the Observer has compiled his list of the ten best closing lines of books. The list includes:

The Great Gatsby by F Scott Fitzgerald:

“So we beat on, boats against the current, borne back ceaselessly into the past.”
Ulysses by James Joyce:
“I was a Flower of the mountain yes when I put the rose in my hair like the Andalusian girls used or shall I wear a red yes and how he kissed me under the Moorish wall and I thought well as well him as another… then he asked me would I yes to say yes my mountain flower and first I put my arms around him yes and drew him down to me so he could feel my breasts all perfume yes and his heart was going like mad and yes I said yes I will Yes.”

Yasunari Kawabata's The Snow Country: someday I wish I could see and feel snow, too


SNOW COUNTRY, arguably Yasunari Kawabata's masterpiece, is about a rich man from Tokyo who travels to an isolated town where the snow can be as high as four to five meters in depth during winter. This man, Shimamura, meets a young provincial geisha, Komako, and falls for her.

The town, which remains unnamed throughout the story, is famous for providing paid female companionship, a staple of the local economy. Men, both single and married, would often travel alone to far away places—in this case, a cold town—to get away from the busy and stressful life in the city and to avail themselves of such woman comforts.

The novel begins with a train ride. Shimamura sees a beautiful lady traveling with a sick man. He cannot keep his eyes off her reflection in the glass. Her name is Yoko. He keeps thinking of her.

During this vacation, the married Shimamura meets Komako. She is a rural geisha. Unlike their city counterparts, geishas in provincial places at the time were in the same social class as prostitutes. They meet in the famous hot springs. She visits him in his room. They walk around town together. 

Chico y Rita



I TREATED MYSELF to a full-length Spanish animated film after I got back from church. Chico y Rita (Chico and Rita) is directed by Fernando Trueba and designed by Javier Mariscal, a Spanish graphic artist.

The movie is set in Havana, Cuba and New York City in the 1940's and 50's. Latin jazz was the prevailing music of the time, and Cuban singers and composers, if they were good enough, were given the privilege of performing in the best clubs in the USA.

Chico is a handsome pianist who dreams of making it big one day. He meets Rita, a club singer whose voice captivates him all at once. It occurs to him that he should convince Rita to join him in a contest where a 500-peso prize and a profitable contract are at stake. They win the contest, and American producers discover them.

How I will remember my Anesthesiology rotation

Anesthesiology

1. ME, WAKING UP at 4 am every single day, when the rest of Manila was pretty much still in REM sleep.

2. Doing anesthetic pre-evaluations at 5 am, with the patients either sleepy, anxious, nervous, or overly conscious of their morning breaths when I asked them to open their mouths as fully as they could.

3. Praying that I'd get a good case, so I could perform the required number of procedures.

Week 28, 2012: The week that passed by

ON MY FIRST week in Anesthesia, I was mostly a tambay at the OR, hanging out beneath the curtains, looking at the ECG while the operation was going on, until the residents would ask me a question, and I would smile my smile that meant, "I honestly have no idea, Ma'am." I barely did tracheal intubations (inserting a tube inside the patient's trachea so he can breathe during surgery) or spinal blocks (puncturing through the layers of the patient's spine just enough to let the cerebrospinal fluid flow). 

week 28, 2012

On TV series and the first season of Suits

I'M ALWAYS ON THE LOOK-OUT for good TV series. By "good," I mean those shows with original plots, crazy characters, or funny punchlines. Depending on my mood, I enjoy both serious shows and sitcoms. Sometimes I want my shows to not require too much neuronal input; other times I want to get stressed watching them. The only requirement is that I should care for the characters and relate with them.

I don't particularly like drama, except for The Good Wife, and I have a special revulsion for shows with teenage lovers on them, like Gossip Girl, or anything to do with vampires, although I did get to watch some episodes of Vampire Diaries but was irritated by how the characters repeatedly mentioned "Elena" and "Katherine" like they were mantras. Among my favorite TV series thus far include (and this is in the order of how I love them): Breaking Bad, Generation Kill, The Good Wife, Gavin and Stacey, Modern Family, How I Met Your Mother, and Big Bang Theory. Of course I watch many other shows in between, but I couldn't, for the love of me, beat my brother in this area.

Kurt Vonnegut's Armageddon In Restrospect: don't use semicolons daw.

IF I AM to simulate, even by a long shot, the life I had just before clerkship, I must resume my usual reading habits. That means I must take a break from my medical books once in a while — if I ever do read them — although I must confess that Dripps/Eckenhoff/Vandam: Introduction to Anesthesia edited by David Longnecker has been a fun, engaging experience for me.

Kurt Vonnegut's Armageddon in Retrospect was my alternative reading material. I had read it intermittently, having started on parts of it while the eye of the storm momentarily passed through the Emergency Room, and continued on it while I waited for the Anesthesiology resident to allow me to do the spinal anesthesia block.

Published posthumously, the book is a collection of 12 essays and short stories, with themes ranging from the author's speech delivered in Indianapolis in 2007, to his World War One experiences, and the bombing of Dresden. Many of the stories remind me of Slaughterhouse-Five, probably Vonnegut's most famous work, which is about an ill-trained American soldier captured by the Germans.

For when I am weak, then I am strong

Manila Bay seen from SM Mall of Asia

MY EARLY MORNING devotions have taken me to 2 Corinthians 12:9-10:

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness. ” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong.
Almighty Father, remind me that I need you every day, as I am inclined to trust in my own devices, thinking I can make it through the day on my own. Show me how depraved and sinful I am, how large my need is for Your grace to win the battle against my godless desires and motives, that I may cling on to You, my joy and strength. Forgive me, Lord, if many times in the day, I wallow in my self-sufficiency. Glorify Yourself through my weaknesses, and humble me, however painful and slow the process may be. So very Amen, in Christ's precious and holy Name. 

Virgin Labfest 2012 at the CCP

I REMEMBER how surprised and daunted Renan Laruan was — one of my brother's housemates, also an old friend from our side of the country — when he learned that he qualified as a writing fellow for the Cultural Center of the Philippines' Virgin Labfest Writing Fellowship Program. The mentorship was to last for two weeks, to be facilitated by the playwright Glenn Mas to inspire budding writers to pursue theater.

I, on the other hand, felt like it was bound to happen somehow. Renan is the artsy-farsty kind of guy, having recently qualified into an art history program at the University College London, worked as an intern at a recent art fair in Hong Kong with a European company, and apprenticed at a Philippine art restoration project. He lives and breathes art. On his study table are old books on art, photography, and philosophy. Even the pieces of literature he reads are hard to understand — he introduced me to David Foster Wallace and Thomas Pynchon, and I would frequently see him reading books and essays that would otherwise lull me to sleep or leave me wondering, "Did I just not get that?"

Trauma

Trauma Ward, PGH

THE TRAUMA WARD, in all its blinding whiteness, resembles some scenes from shows I enjoyed watching in the past—namely, Downton Abbey where Lady Edith Crawley distributed letters among wounded soldiers, many of them with bandaged heads like Lazarus; and Atonement where the young nurse Briony Tallis changed the sheets and brushed the bed pans as the stern chief nurse, also a nun, looked on.


Now, you may laugh at me for saying this, but being in the midst of broken bones and lacerated bowels for a week made me feel like I was brought back to the World War One years, only that I did not care for dying soldiers who fought for their countrymen, but for patients who sustained multiple injuries due to reasons vastly different from heroism.

The Palma Hall that was

WHEN I WAS STUDYING at the University of the Philippines Diliman, I spent a lot of time at Palma Hall, or what we non-freshmen people called AS (short for Arts and Sciences; it used to be the home of the College of Arts and Sciences, if my memory serves me right). When I was a freshman, my brother had to force me to call it "AS" lest people think I was a newbie and trick me into rushing to the non-existent TBA building.


I took my English, Geography, Linguistics, Kasaysayan, Communications, Art Studies, among other General Education classes there. I invested a lot of happy memories in its halls, mostly of meeting random classmates in old, non-airconditioned classrooms; sitting on the cold, red floor to finish a good book while waiting for classes to begin; and buying blue books for Php 2 from a certain manong at the second floor.

Week 26, 2012: What's inside my bag

MY FRIENDS were in disbelief when they realized I had stopped borrowing things from them. I don't like carrying bags; I want both my hands free. I would go to class empty-handed if that were possible. And then clerkship came where I had to somehow invest in doctor-things lest I become a mere space-occupying lesion in PGH. Inspired by What's In Your Bag Flickr group, I'm sharing the contents of my bag. Whether they speak a lot about me is a matter of philosophical interest—the truth is, I just bring these things around because I need them.

Sampung payo

I COULD NOT RESIST not linking to Sir Bats' blog entry, Sampung Payo Para Sa Mga Bagong Medical Clerk (10 Pieces of Advice for the New Medical Clerks), because it applies to my everyday experiences. Dr. Baticulon, a neurosurgery resident in PGH, owns one of the most fascinating blogs about life in medical training. His archive has priceless entries on med school, tips on taking exams, and unforgettable patient encounters. My favorites are those written in Filipino. They're well-thought out, sincere, and heart-wrenching—and I can relate to a lot of them because I'm familiar with the third-world hospital context of his stories.

I may have bumped into him when we referred a patient with head injury to Neurosurgery this morning, but I was too shy to start any conversation that began with, "Hello, Sir, I read your blog." (I—or was it Franco?—was also busy assisting an intern make an improvised neck brace made of cardboard which, when fitted on the patient, made her look like Magneto.)

Week 25, 2012: Surgery call room

I like taking candid shots of people who don't realize they're being photographed. Having a portable gadget like the iPod, in my case, makes it easier to do. I still wish I have a proper camera, though: the big ones that weigh heavier than neonates recently pulled out from their mothers' wombs.

While killing time at our call room in Ward Four, I snapped these portraits of Casti, Marv, Bj, and Jegar. I guess my blockmates have come to accept the fact that their lives during clerkship will be documented properly. So those guys had better not mess with me, or their faces during the unholiest hours will be posted here for all the world to see.

week 25, 2012: Casti and Marv

Never giving up

I'm at the Observation Unit (OU) of the Emergency Room, monitoring some of the patients' vital signs. It's 11 pm. The air is humid, smelling of blood, sweat, vomit, antiseptics, all at the same time. All stretcher beds are occupied. Everyone on my team is busy with something—extracting blood, writing lab request forms, taking clinical histories, or stitching head lacerations of drunk motorcycle drivers from Cavite.

Near the OU entrance is a 40-something woman crying silently beside the intubated man on the steel stretcher. With an Ambu bag, she manually pumps air into a man's mouth. She has been doing so for two hours now. Her hands must be sore.