Bottled ※ Brain

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. 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.

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 investment

IT'S A LONG holiday. After the revelries, you're probably stuck at home with a computer. If you have all the time in the world (or you think that you do), give these links a try. On Russian tatttoos—great article from The Siberian Times.

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.

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.

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.

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 bo

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 faci

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. * * * 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

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.

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.

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.

CHRISTMAS is upon us, even at the hospital where I work. Here's the makeshift tree at the sixth floor. It's made of empty piperacillin-tazobactam boxes. How very medical. Just so you know, my brothers and I never grew up with a Christmas tree in December. Our mother felt it a chore to put one up, always postponing, always "next year na lang ." When she did decide to finally have one, we were already grown up, out of the house, in Manila or Davao, studying and working. Now she tells us that her tree looks wonderful. "Yes, Mother, it probably is," we reassure her, as good kids do.

My friends convinced me to watch A Second Chance, the movie sequel to the highly successful One More Chance (which I didn't watch completely—I saw parts of it, but couldn't stand it). I'm not too big on romance, and I don't understand it when people, even my close friends, sing their praises for John Lloyd Cruz and Bea Alonzo. Their chemistry on-screen is supposedly perfect, like they're meant for each other. I said I'd give this movie a try; I had nothing else to do but read the chapter on Disorders on Rhythm in Harrison's to lull me to sleep. We watched it last night, after dinner. The crowd was less than I had expected, but the movie house was still full, save for a few rows of empty seats in front.  I can't give an unbiased review, but the movie wasn't bad. I had a problem with its wordiness, though—it was as if Popoy (Cruz) and Basha (Alonzo) had to recite essays to each other every single time they quarreled. And they quarreled every 1

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.

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.

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.

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.

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 (kottke.org), 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-blogg

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.

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.

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.

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.

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.

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.

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.

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.

I. 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, 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.

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.

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.

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

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

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

Garden in front on Ward 3, taken on a lazy Sunday morning. NOTHING reminds me more of The End of First Year Residency than the prospect of seeing new faces applying for one of the 21 coveted slots in our training program. This limbo, called the “pre-residency,” is the worst of two worlds—the newly-inducted physician doesn't quite know whether he should celebrate his recent victory in the Boards or whether he should study again (as if studying ever ends in our line of work) to prepare. I do not want to go through it all over again. I will call a masochist anyone who claims otherwise. There is a reason why pre-residency is proverbially called The Hunger Games.

I WOKE UP this morning with this view from my hotel room––a huge one, and all to myself. I was picked as one of the participants to the 8th National Writing Workshop and 1st Writeshop for Young Researchers at Sofitel, Manila.

AS A CHILD I only knew of Singapore through its flag (there was a time when I memorized all the flags of the world—the era, for instance, when Czekoslovakia was still an entity) and through the hanging of Flor Contemplacion, then the highlight of national news. Since then I’ve had friends who’d visit the city-state occasionally, just for a few days, and never longer than that, to shop and dine and attend conferences, convenient excuses for free travel. For the last three to five years I’ve had friends, too, some very dear to me, like Kuya John, who have relocated there for work. The pay is better, the living conditions much more humane, and it’s only a three-hour plane ride from Manila. I decided to visit Singapore on my week-long leave out on a whim, thanks to my brother Ralph who encouraged it. “What about Singapore? Let’s visit John,” he said. That night, without fanfare, and with the sole request that I must escape the country, lest I lose my mind; our tickets were booked—never

After a hearty breakfast of kaya toast, soft-boiled eggs, and sweet hot tea with cream at a nearby hawker center at Sembawan Hills, I leafed through the final chapters of Elena Ferrante's The Story of a New Name, the second in her phenomenal Neapolitan series. Lina Cerullo and Elena Greco's friendship is complex, set in Naples and occasionally Pisa and Milan, all of which which make for an interesting story. They seem to idolize, and outdo, each other. Elena, having just finished a university degree, visits Lina at the sausage factory, while avoiding and antagonizing the other workers' sexual innuendos. Elena writes this passage, a beautiful and appropriate description of their unusual friendship. I understood that I had arrived there full of pride and realized that—in good faith, certainly, with affection—I had made that whole journey mainly to show her what she had lost and what I had won. But she had known from the moment I appeared, and now, risking tensions with h

WHAT surprises me the most is the strange, unbelievable chasm of time between my waking up and my leaving the room. Light years away, that void, unappreciated by most, except the very few who hardly have time for anything else other than the painful, occasionally dreadful, sometimes joyful, reality of work. The curtains are drawn, and my little bed is filled with sunshine. Everything is aglow. The house, in its stillness, beckons to be looked at, studied—its nook and cranny, the little specks of dust that have settled on the jalousies—just because I can. I have all the time in the world. There is time for contemplation, for prayer, for smelling the freshly brewed coffee as little drops of it falls from the machine. The phone is quiet, and I am not needed.  So this is how it feels like. My heart sings, leaps, and dances at this strange, new, free world that has opened up.

THE PLAN was to spend the afternoon to study somewhere else. Madame Julie, my January Gen Med senior who has long since become a dear friend, offered to bring us, Racquel and I, to Tagaytay. She did not bother to tell us it was her first time to bring her car to the area, lest we back down. Because she had GPS, we did not get lost. The voice of a lady, possibly Siri's older sister, entertained us throughout the ride. "Turn right. This is an accident prone area." We were thrilled.

BLOCKMATES are forever, they say.

Yesterday afternoon, as I was checking my phone while lying on bed inside my dorm room, still wearing the same clothes I had when I did rounds that day, my roommate barged in, as if in a hurry. I felt spent, with all of me, hands and heart, feeling the heavy burden of the month that was. “You’re not going home?” Tom asked—home being Quezon City, where my brother lives. “Maybe later, when the traffic dies down,” I said.  I watched him pack a few clothes and stuff them into his red backpack. He arranged some of his clothes in the closet before closing it with a sense of finality. “When are you going on duty?” I asked. “August 10 pa. Leave ko na kasi.”  “Wow!” was all that I could muster, until I had gained the courage to ask him where he was spending it. I knew I would falter somehow—my envy would make itself manifest. He told me, and I kept a straight face. “Oh, the whale sharks,” I said, to make steady conversation. Then I desperately wished for a chance to leave the hospital, too, eve

While convalescing from a bad case of flu (upper respiratory tract infection, probably viral, if I should document that in my chart), I headed to my optometrist to get an eye exam and a new pair of glasses. It has been a while since my last visit—three years ago, when I was still a medical student. Now with long, black-brown hair but still brimming with a hippie vibe, she remembered me fondly, telling me, while checking her index cards, that she started seeing me in 2005. I was around 17 then, majoring in molecular biology, when I could still see my feet clearly sans the spectacles. These days, you could strip yourself naked right before me, and I wouldn’t recognize a thing.

I'VE BEEN stationed at the Charity Wards since July. I'm sharing and annotating some photos taken randomly during my stay there. Interns from Services 3 (where I've been assigned since, believe it or not, clerkship) and 6. They look fresh in this photo despite monitoring our patients nonstop.

We rarely get patients with Down’s syndrome. This month I’ve been taking care of a patient with such condition; he is already 35 years old. His mother, in her early seventies, still looks after him. She cleans after him, changes his diaper, doesn’t mind that his feces has soiled the sheets, and makes sure he doesn’t fall off the bed. He has gotten better since his admission, and we plan to send him home in a day or two, God-willing.

The nurse at the Out-Patient Clinic alerted me that I had a long list of patients to see. My pile was extraordinarily tall. Some charts were as thick as my books, brimming with paper made fragile and yellow by time. I was running late. I should have started seeing patients at 1 PM—it was already 10 minutes past two. I was also attending to one of my admitted patients whose course was getting complicated by the day. I couldn’t be at two places all at once, so there I was: sweaty and hungry and ready to save lives, one patient at a time.

THE LEGALIZATION of same-sex marriage in all of the United States is the biggest news these days. It didn't come as a surprise that it happened at all—that the Supreme Court would issue a decision so final about an issue so divisive—but when I saw the news, my heart was filled with sadness. So this is what our world has become.

Photo by Jill Krementz, published in the NYT . JAMES SALTER has died. He was 90. Considered a writer's writer and the " greatest writer you've never read, " he has written novels, short stories, and essays that have brought me delight and inspiration. Not a lot of people, even avid readers, know about him. His books are a rarity in bookstores. I only find them in thrift or second-hand shops.

WE CELEBRATED Sean's birthday yesterday at our favorite ramen place.

Luther and Mau. Photo by Mike Tan, not the UP Diliman chancellor.  TWO MONTHS ago I hurriedly finished my rounds to catch a quick bus ride to Tagaytay. My dear friends, Luther Caranguian and Maureen Estacio, were getting married in a few hours, and I couldn't afford to be late. I was part of the entourage as one of the groom's men, which explained why I was in a white polo barong, carrying a well-made wedding invitation with the couple's caricature in the cover. If you had sat beside me on the bus, you would have noticed that I intermittently looked at the address, complete with the exact latitude and longitude (Luther's suggestion, I'm sure), lest I get lost. I knew it was going to be held at Sonya's Garden, a beautiful events place that serves flowers for salad. The dressing, I would later discover, would be heavenly.The wedding was to start after lunch. It was almost 11:30 AM. My friends, especially the ones who brought their cars, were already there.

THE SNAPPER, Roddy Doyle's second novel in the Barrytown trilogy, is about a middle-class family in Dublin trying to cope with an unexpected pregnancy of the 23-year old daughter, Sharon. Living up to his title as the virtuoso of casual, conversational dialogue; Doyle spins a masterful tale about the noisy Rabbitte family. They almost sound like the typical Filipino family—so bonded together that someone's business becomes everyone else's.

I WAKE up to a cloudy morning—a little cold but not hot, like most mornings the past months. It rained last night. The soil has been dry, the air extremely humid, and the people irritable—we needed the rain. The room is dark and quiet, save for the clickety-clack I make on my keyboard. I haven't drawn my curtains yet. In a few minutes I will head to the bathroom, don my stethoscope, and make rounds. I have a few ECGs to read, too, so I mustn't forget that.

ON MY BEDSIDE (and study) table are books that keep me company at night. When I have reached my daily quota for human interaction for the day, I retire to my bedroom and read my books, one of the few moments when I'm quiet.

MY ARTICLE on Sagip Buhay Medical Foundation is featured in the June  May issue of Health and Lifestyle magazine. Many thanks to Abi Roxas for giving me the chance to write for Sagip, a go-to place for us, internists, when we're faced with patients who have absolutely nothing inside their pockets. Grab a copy, and learn how you can help our patients at the Philippine General Hospital.

THIS PESTO-FLAVORED ramen is proof that weird food combinations work, like tomato ketchup + soy sauce, or banana + peanut butter. Never mind that it looks like vomitus; it's a work of gastronomical art. I will keep coming back.

HERE'S the first personal investment for I had for my career: the new edition of Harrison's, the ultimate textbook in Internal Medicine, the source of most of our monthly exam questions, the reason why I am now Php 5,700 poorer.

I REMEMBER the morning when I did rounds earlier than usual. I am a morning person, and I like the peace and quiet of the wards at 6 am, still devoid of the usual crowd of fellows and residents looking for the same charts. I saw one of my clerks pushing our patient's stretcher. I learned that he came in at 5 am to make sure the patient didn't miss the cranial CT scan schedule. I was so moved by his dedication, realizing I wasn't like that at all when I was a medical student.

WHILE CATCHING my breath after two flights of stairs, I looked out the window from the 7th Floor and saw the Central Block Atrium from a distance. I have come to terms with the fact that my life will never be the same as everyone else's. Whereas the rest of humanity sleeps and dreams around this time, I wander along the dimly lit corridors of the Philippine General Hospital, shooing away the angel of death by making sure the patients are all chest pain-free, able to breathe optimally, their hearts still beating, ready to face the new day. The life of a doctor is almost poetic.

I HAD THE privilege of finally dining at Uno, a small, quiet restaurant in Tomas Morato. It looked like one of the hang out places I saw in Amsterdam: intimate, dimly lit and inviting, devoid of noisy crowds fresh from the office or school.