Showing posts from December, 2018

Miniso unlined notebooks and fountain pen knobs

I recommend this unlined journal from Miniso—great paper for notes and doodles! It costs less than 300 pesos and is widely available. Jessica Zafra, a rabid note-taker, recommends this, too, having broken up with Moleskines because the company no longer distributes unlined notebooks in the country. I don't mind lined notebooks, as long as the paper is good. My kid brother, Sean, after sensing that a knob on my fountain pen was loose, decided to fix it on the spot. "Do you need to apply grease?" I asked. "No, it looks fine. It just needs a little tightening." He has always been good with his hands—he is, after all, a dentist—so I wasn't surprised that he did a better job at fixing my TWSBI Diamond 480 1.1 mm stubbed-fountain pen than me. "I read online that you shouldn't tighten the knob too much when you suction the ink," he said, warning me that there could be problems if I did so. I asked for some ink; I didn't bring a


via Instagram

Birds and bees at home


Happy birthday, Roger and Fred!

From left: Roger, Fred, Karen, myself, and Rich. They're my colleagues and friends from Oncology.

My Reading Year 2018

This has been a good year for reading. I wish I had read more books, but in between chemotherapy, academic reading (which I don't count as reading, in the way that I define it here, i.e., reading for pleasure), I could only squeeze in a few. Which is not to say, of course, that reading DeVita isn't pleasurable—it can be. Nevertheless, here are my most memorable reads for 2018. [ Before I launch into my list, I asked some friends and family to list their favorite reads, so I can convince non-readers to try out the habit. You can read Kuya John's top seven , Manong Ralph's top ten , and Ate Liw's many recommendations , including those that had lasting effects on her. In a sense, you are what you read. Surely, you don't want to be defined by the fact that you only read—that, too, is mildly entertaining, but there are greater joys to be had.] 1. Institutes of the Christian Religion by Jean Calvin After a year, I finished reading volumes 1-3 of Joh

Christmas celebration 2018

With the Espinos, Fernandos, and Gesilvas With Ate Milaine and Kuya Vance, among my dearest friends from church Just when I've gotten used to spending Christmas alone, having been away from home for medical training, I got invited to a family gathering for the second time. There was food—Ate Milaine is a marvelous cook whose recipes pose a challenge to my self-imposed diet! There was music—cello and piano played by a wonderful home-based live band that played the songs I knew. I couldn't leave the party without a song rendition of sorts. I sang "On the Street Where You Live," among other standards, which unleashed the old soul within me—and in all of us, when I think about it now, because everyone chimed in during the chorus. There was conversation about cancer, fountain pens, and Christianity, where I learned various things about these brothers and sisters in Christ, all of whom left me with the feeling of being in heavenly company. Thank you, Espinos, Fernando

Liw's Reading Year 2018

Ate Liw, human rights lawyer and advocate, certified world peregrinator , once an English major and a dear friend, shares the most memorable reads she has had for 2018. Her global humanitarian work inspires me, but so does her travels, her book choices, and love for Jesus. She's one of the coolest, bravest, most elegant people I know, taking the road less traveled to champion the rights of the oppressed. She has has been a blessing to me and our family. Three books with lasting effects on me 1. An American Marriage, Tayari Jones My work allows me to witness the humanitarian consequences of overcrowded jails on persons deprived of liberty while on trial so I immediately connected with this novel. The way the story unfolds shows how each one of us can easily get caught up in a flawed justice system and how incarceration dehumanises. It is life changing to those incarcerated and alters their relationships with those outside, often in tragic ways. This novel should force us t

The role of novels in society

Héctor Abad, a Colombian novelist, answers this way when asked what literature can play in forming his country's historical memory: I believe that novels are condensing machines for stories. In a farm, the history of a country can be reflected, because history passes through its terrain and leaves traces. The war leaves traces. In Gabriel García Márquez, one massacre stands for all the massacres. In Evelio Rosero, armies without a name can be the guerrillas, the paramilitaries or the regular army. In Juan Gabriel Vásquez, German Jews are treated like Nazis during the second world war. In Santiago Gamboa, sex is the substitute for many other frustrations. In my novel Oblivion , a good man murdered becomes the symbol of many innocent victims killed unjustly. Novels help us understand and understand each other. I love Latin American novelists—they write a lot like Filipino novelists. We are related in more ways than we can imagine, having been colonized by Spain for many years an

Manong Ralph's Reading Year 2018

My brother, Manong Ralph, a human rights lawyer based in Manila, reads more voraciously than I do. In college he majored in English Studies, perhaps his best excuse to go the library and get lost in the world of stories and ideas. Analyzing stories of James Joyce wasn't a chore but a delight, which is why I wasn't surprised that he graduated top of his class. A lot of book ideas I gain from him. He introduced me to Michael Chabon, who appears in this list, and to many more authors who have made our lives and imaginations richer and grander.  At the beginning of the year, I decided to read Marcel Proust’s tome, In Search for Lost Time , beginning with Swann’s Way . A quarter into the book, 2018 is already about to end! I did manage to squeeze in a few books, having read them while stuck in traffic, waiting in court, or before bedtime. Here’s the top ten books I’ve read this year, in no particular order: 1. Lincoln in the Bardo by George Saunders At the heart of this novel

Kuya John's Reading Year 2018

My friend, Kuya John Dasmariñas, based in Singapore, has spent a great deal of 2018 reading. I'm sharing his favorite reads. This was originally posted on his Instagram, but I'm sharing it now, with his permission. My Top 7 books based purely on how I felt after reading them; because while details escape you, feelings linger. 7. The Corrections by Jonathan Franzen - A comedy on relationships with our family, money, our ambitions and the cruelty of the world we all need to live with. Only an avant-garde writer can curate a plot that resonates with our very own musings we all are embarassed to tell even ourselves or our closest friends. 6. Smaller and Smaller Circles by FH Batacan - Apologies for the cheap analogy, but it's a page turner like Crazy Rich Asians. This first Filipino crime novel in English should be mandatory reading for all secondary students in the Philippines. 5. Nocturnes by Kazuo Ishiguro - The short stories brought to life my introvert predi


Today was extraordinarily gloomy, with overcast skies and the occasional drizzle—my favorite version of God-ordained weather, as I do not care much for the sun, given that I live in the tropics, and discomfort from too much heat is a daily reality. Today was extraordinarily relaxing, too, because I had no errands and therefore had the entire day off. I chose to spend it on intermittent naps, books (hardbound and electronic), and Netflix (currently on Silvana Sin Lana, whose Spanish-speaking characters have Filipino emotions and proclivities—highly recommended by mother, so how could I say no?). I came across this passage from T.H. White's The Once and Future King, where Arthur, called Wart, asks Merlyn the magician to turn him into a bird. Before Merlyn answers, T.H. White launches into a beautiful description of the landscape, the kind that makes me long for pure, black-and-white classic stories like the one I'm reading now, where good always prevails, and the trees are love

A year since finishing residency

I was so glad to meet up with some friends from my batch in PGH-Internal Medicine—as if, of course, we need catching up, this despite the fact that we bump into each other at the hospital on a weekly basis. Jay is pursuing further studies in Maryland, USA. Roland is in Pulmonology. Everly will pursue further studies abroad next year, having just finished her colorful stint as the department's Chief Resident (congratulations, Chevs!). Bea is in Endocrinology. Carla is in Pulmonology. Racquel is in Endocrinology. Rich is in Medical Oncology. Jeremiah is in Hematology. Roger is in Medical Oncology, too. This was snapped during Kuya Dane and Jo's wedding last Sunday. I just wanted to memorialize this photo here to remind myself that a year has passed since we finished residency. We're in different fields now, busy with various careers, but inside, trappings and degrees aside, we're still the same noisy, sleep- and food-loving people who care for accurate diagnoses and pro

Where King Arthur is called Wart

I won some cash at yesterday's Christmas party and, before going home, I took some time reading my new copy of T.H. White's The Once and Future King , in a special hardbound edition by Penguin, at a café inside Robinson's. It opens with a foreword by Neil Gaiman who talks about science fiction/speculative fiction; he enumerates his favorite works, some of which I have already read, including Left Hand of Darkness by Ursula Le Guin and Dune by Frank Herbert. Seated across from me was a Japanese man copying sentences from an English newspaper using pencil and paper, reciting the words in a whisper as soon as he had written them—yet another proof that it's never too late to learn a new language.

Some say apples are better than coffee

via Instagram ... in keeping one awake—I say, why not have both? This was snapped after my leisurely morning rounds which rarely happens these days.

You're All To Us

Let the glory of Your name be the passion of the Church Let the righteousness of God be a holy flame that burns Let the saving love of Christ be the measure of our lives We believe You're all to us

Congratulations, Mr. and Mrs. Sacdalan!

I'm grateful for the friendship I share with Kuya Dane Sacdalan and Jo Lucero who are now, as of today, husband and wife. I've known Kuya Dane since our undergraduate days in Molecular Biology at UP Diliman. He was—and still is—one of the kindest people I know, and talking to him always uplifts me, like breathing fresh air after being stuck inside a stuffy room. I was glad to meet him again in med school; he graduated earlier and pretty much took up the same career choices as I did: three years of Internal Medicine (UP–PGH) and another two in clinical fellowship in Medical Oncology (UP-PGH). He was my senior at the Medical ICU and remains a lifetime member of the OPD Team B (a badge that I, too, proudly carry). Whenever opportunity presented itself, I would ask him for advice. I sometimes send him emails the old-fashioned way, to which he would write heartfelt responses. On the occasion of my father's death, Kuya Dane wrote to me: Life is a sacrament of waiting—waiti

Just in case you're wondering what to give me for Christmas

Here are some ideas. — fountain pen with a 1.1 mm stub nib (notify me first so I can direct your attention on which brands I prefer) — fountain pen ink (preferably Parker Quink blue-black, Pilot Irishuzoku of any color, and Noodler's black ink) — an unlined pocket notebook (not Moleskine, which isn't ideal for fountain pens) — any book by Marilynne Robinson, Kazuo Ishiguro, Ian McEwan, James Salter, and Jonathan Franzen — The Institutes of the Christian Religion by John Calvin — Systematic Theology by Wayne Grudem — shoe leather conditioner More importantly: — four 50 mg vials of oxaliplatin — three 80 mg vials of paclitaxel — one box of sorafenib, regorafenib, or lenvatinib — six vials of trastuzumab 600 mg — one free whole body FDG-PET CT scan And then there's always world peace. Or a round-trip ticket to New Zealand.

The innocence of childhood friendships

I’m rereading Elena Ferrante’s My Brilliant Friend , the first book of the Neapolitan novels, and it has given me enormous pleasure once again. I read this in 2015: my mother and her best friend, Auntie Cecil, went to the Lucky Chinatown Mall in Binondo, Manila to buy things. Meanwhile I preferred to stay at a Mary Grace café and read on my iPod. Here's a passage that appears on pages 106-107 that shows the unique dynamics between Elena and Lina: We were twelve years old, but we walked along the hot streets of the neighborhood, amind the dust and flies and the occasional old trucks stirred up as they passed, like two old ladies taking the measure of lives of disappointment, clinging tightly to each other. No one understood us, only we two—I thought—understood one another…There was something unbearable in the things, in the people, in the buildings, in the streets that, only if you reinvented it all, as in a game, became acceptable. The essential, however, was to know how to pl

A nature changed

This nature is changed in every believer; for it is impossible a man should stand bent to Christ with his old nature predominant in him, any more than a pebble can be attracted by a lodestone, till it put on the nature of steel. An unrighteous man cannot act righteously, it must therefore be God, who is above nature, that can clothe the soul with a new nature, and incline it to God and goodness in its operations. Now to see a lump of vice become a model of virtue; for one that drank in iniquity like water, to change that sinful thirst for another for righteousness; to crucify his darling flesh; to be weary of the poison he loved for the purity he hated; to embrace the gospel terms, which not his passion but his nature abhorred; to change his hating of duty to a free-will of offering of it; to make him cease from loathing the obligations of the law, to a longing to come up to the exactness of it; to count it a burden to have the thoughts at a distance from God, when before it was a bur

Neapolitana novels -- complete!

My stack of fiction reading.  Today was especially tiring, so I treated myself to printed books, Europa editions, of Elena Ferrante's Neapolitana series of novels. I've read the first two in my Kindle, but I'd love to read them, and the last two, in print. These will keep me company throughout the holidays. My brother, thrilled to see them on the dining table, made a very good point, "And where do you plan to display these?" As with most of my books, they find their ultimate home in our St. Gabriel house, where Nanay will likely complain that she doesn't have enough shelves to have these on display.

After the closing song

Almost every Sunday service, after the closing song is sung and the crowd starts to move out of the sanctuary, I am asked about a medical problem before I descend the stairs—from a stomach ache from too much coffee, to an anterior mediastinal mass that screams malignancy. I love talking to these brothers and sisters who call me “Doc” despite my protestations (“Just call me Lance”), but I’ve long since realized that this is their way of showing their endearment, their filial pride. It warms my heart that they think I can enlighten them as to what bodily issues they have, if they have cause to be worried, or if their own physicians are doing the right thing. I feel that these random consults are, in a sense, an extension of the clinic. Indeed, illnesses know no boundaries, and people close to us, even those with whom we share the same faith and theology, can suffer the humbling truth that bodies disintegrate, organs fail, and cells malfunction. Such is the bittersweet reminder that our

Second years na!

I had a great time moderating the PGH-sponsored PSMO Round Table Discussion on AIDS-related Malignancies. Our case was that of a 29-year old male with Kaposi sarcoma, presenting with cutaneous lesions as well as with internal organ involvement, i.e., lungs and liver. Rich King and Fred Ting discussed the details of the case and principles of management. Because I moderated the program, I had the chance to mine the clinical experience and expertise of our guests in the panel discussion. We were so grateful to have learned a great deal from Dr. Franscisca Roa (Dermatology), Dr. Dessi Roman (Infectious Disease), and Dr. Gracieux Fernando (Medical Oncology). Our colleagues from the seven other training institutions—St. Luke's, Makati Med, Veterans, Jose Reyes, Medical City, UST, and NKTI—were wonderful, answering spot-on the questions we threw at them, and sharing their institutional experience regarding the case. Here are photos taken by Norman Cabaya. Update (as of November 8, 2


I will be moderating the PGH-sponsored Philippine Society of Medical Oncology Round Table Discussion on AIDS-Related Malignancies tomorrow night. My friends and colleagues, Dr. Rich King and Fred Ting—rhyming, I know—will discuss an interesting case and some nitty-gritty details in the new approaches to these diseases. It will be followed by a panel discussion with the following experts: Dr. Francisca Roa (Dermatology), Dr. Dessi Roman (Infectious Disease), and Dr. Gracieaux Fernando (Medical Oncology). Some residents and fellows from Dermatology and IDS—and Hematology, I learned—will also be joining us. This is exciting news—having these great minds around—because management of these cases is largely multidisciplinary.

Christian theology is not too big on self-esteem

Christian theology goes against the grain of modern psychology, such as in the issue of self-esteem. Whereas we are taught that we are all good and should feel good (consider, for instance, the many Dove commercials, with self-esteem as the battle cry), Stephen Charnock , an English Puritan clergyman, wrote this about man as he pondered on the doctrine of regeneration. In ourselves we are nothing, we have nothing, can bring forth nothing spiritually good and acceptable to God; a mere composition of enmity to good and propensity to evil, of weakness and wickedness, of hell and death; a farden of impotence and conceitedness, perversity and inability, every way miserable unless infinite compassion relieve us We have no more freedom than a chained galley slave till Christ redeem us; no more strength than a putrefied carcass till Christ raise us, an unlamented hardness, an unregarded obstinacy, an insensible palsy spread over every part, a dreadful cannot and will not triumphing in the w

In defense of light reading (and watching Netflix)

With the breakdown of the internet connection this weekend came more than sufficient time to take on leisure reading. During residency I resolved not have any internet connection at home to give myself time to study and rest. It proved a wise decision, as it helped settle my mind to rest, shielding me from unnecessary distractions. A distracted person is a bad physician. Since I moved in with my brother, I've had steady internet connection. It sometimes proved a distraction, but only during certain days. It has been useful for academic reading; anybody involved in oncology knows how fast things change in the field. But work generally exhausts me, and I treat myself to a few episodes of Netflix shows (the latest: The Kominsky Method, which my family loves) or some light reading before I go to bed, usually between 7:30 to 8 PM. How geriatric, I know.  Being able to relax and unwind makes me a better physician--this I have long since realized. By light reading, I mean the enj

Poster at 7/F elevator proves existence of hospital grammar police.

via Instagram

Internet frustrations

Just when I thought I had a hold over my impatience, the wifi connection at home broke down. For months I’ve dealt with patchy internet connection—this, given the fact that my brother and I are subscribed to PLDT Fibr , arguably the fastest connection available. It isn’t news that internet is more expensive in the Philippines than in most of the world; the internet service in this country has much to improve on. But for the past three days the connection had died. I called the PLDT customer service, but I only received platitudes, excuses, and an assurance that a report is being written, which will be forwarded to the technical service crew. A lineman arrived at home yesterday. His diagnosis was that the PLDT connection was fine; the problem is with the conduit connecting the modem and the TTC. The wire needed to be changed, he said, and it was left to me to contact an engineer who can replace the wires. In a few hours I was able to get hold of an engineer. This morning, the cat. 5 i

Where can I get one?

This reminds me of college. (Photo credit: Michael Dorado via Twitter )