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.

Sharp shooter

"I hate blood extraction," says Lennie as she enters the cramped Surgery call room where we all await the dreaded phone call from the OR. "I'm not a sharp shooter. I don't know how some people do it so effortlessly."

On her face are beads of sweat—her post-procedural facies, I call it, because she looks wet whenever she does something stressful in the wards. She tells me her patient had huge, superficial veins which, after a couple of attempts, were useless, forcing her to use the other edematous arm whose veins were hardly visible. She was successful on that last attempt—one of life's many ironies.

"In my case . . . I guess I'm getting the hang of it," I say, explaining to her that the more I convince myself that I won't get it the first time, the more I feel confident that I will. "But inserting IV lines is still a big hurdle for me."

One step at a time

Yesterday was Day One of our clinical clerkship in PGH. My block's first rotation is Surgery. Everyone was on a first day high, armed with new bags, newly purchased stash collections, and overflowing reserves of enthusiasm—pretty much like the first day of school.

Block Three, wheee!

Our initial impressions:

1. The hospital's referral system is so intricate it's harder to remember than the steps in the Krebs cycle. We panic every time we read new orders in the charts, mostly because we're clueless how to go about them.

No, sir, not this time

Now that clerkship is two days away, my classmates and I are resorting to what I would call panic-buying behavior, only that we don't hoard on grocery items but last-minute happy memories.

Someone flew to Bohol for a last-minute vacation; she'll be starting off with the notoriously difficult six-week Internal Medicine rotation. A couple of classmates are still in Europe. Some went home to spend what may well be their last weekend for the next couple of months. I watched Prometheus yesterday with my roommate Ian; this evening, it will be Snow White and the Huntsman with my brother.

Won't bacteria die when you clap your hands or rub them together?

I'm in the habit of pestering my seatmates when I'm on the verge of sleepiness. Yesterday the lecture was on preventing hospital acquired infections. As the discussion veered towards the superiority of clorhexidine over povidone iodine as an antiseptic, I asked Marvyn Chan, "Do you kill germs when you clap or rub your hands together?"

"Seriously, Lance?" He looked at me with insulting, condescending dagger eyes. I was amused. Perhaps he expected too much from me because I have a molecular biology degree and I don't know squat.

"I'm serious."

"Why would you ask that?"

"Won't bacteria die when you clap your hands or rub them together?" I explained my hypothesis: that the trauma generated by clapping may be—for all I know—sufficient to induce mechanical destruction and therefore death.

He ignored me and went back to sleep.

In transit

The taxi driver told me his wife is Manny Pacquiao's cousin. Manny is a big name in the country, but he is worshiped in Gen San, even regarded as a living saint in Sarangani. I don't really care much for boxing which I have come to associate with Parkinson's Disease, even if there isn't much evidence for it. (See Lolekha et al, Mov Disord. 2010 Sep 15;25(12):1895-901.)

I got to the airport two hours before departure, a rule my parents insisted that I obey to the letter. I was the first one to check in. No, I did not do a Claudine.

On Cormac McCarthy's Blood Meridian

I just got back from the nearby café to spend the afternoon. I finished Cormac McCarthy's novel Blood Meridian or the Evening Redness in the West. I did not feel happy afterwards.

Not that the book is badly written—far from it. This may well be the best novel I will probably read this year. It's just that the world McCarthy has painted is so dark, depressing, and hopeless that any reader will end up with their spirits dampened somehow.

I've been to paradise, and I've been to me

I'd been to a number of places this summer, done some life-threatening things I didn't imagine I'd ever do, but there was a part of me that wanted to explore my own place, too. It felt wrong if I didn't. How does that Charlene song go again? "I've been to paradise, but I've never been to me."

South Cotabato is blessed with natural resources, many with the potential to become major ecotourism attractions. Presently these spots remain unheard of.1

When my high school classmate Charlen Suedad—we fondly call her Tita—invited me and some of our classmates to her home in Lake Sebu, I knew it was my chance to do that local adventure. I only had a couple of days left. I wanted to make the most out of it.

The town of Lake Sebu is about 1.5 hours from Koronadal City. At its heart are three lakes: Lake Sebu (from which it is named), Lake Lahit, and Lake Siluton. The areas around these lakes are considered ancestral domains, bursting with history and culture.

IMG_8491

The story of the phone that was lost and now found, Part Three

I hope this is the last time you'll be hearing something like this from me, but here I go again: I lost my phone this morning. 

Faithful readers of this blog will recall that losing phones has been a regular phenomenon for me. I wrote all about them in my little space on the web. To refresh you:

— In 2006 a thief slashed my pocket while I was inside the UP-Philcoa jeep. My phone was lost forever.

— In 2010 my phone decided to jump out of my pocket while I was dozing off inside a Taft-Fairview FX. I got an email from a kind man who picked my phone from that vehicle. I learned that his name was Jonell,  then a graduating Mass Comm student from UP Diliman. We met up at Robinson's Mall. He's now working for a local newspaper in Panay.