My student Hannah weaves her Tnalak into a white coat

Teaching is my happy job. The classroom is a balancing mechanism for an otherwise tedious clinical practice in cancer care. (The heaviness in oncologic practice emanates from an almost daily proximity to death and dying. There are days when meeting five patients in a day feels like a lot. Some of my friends will agree with this.)

Interspersed in my otherwise packed Google Calendar are lectures, seminars, and meetings. Behind them are the quiet tasks I often do after clinic hours: preparing my lectures, crafting my evaluations, grading my students' research protocols. These academic routines activate another part of me that is separate, but somehow still related, to my day job. In a sense, clinic work is my vocation; teaching my avocation.

I've been teaching since the launch of the College of Medicine (COM—as in "see-oh-em") of the Mindanao State University - General Santos, a fact that gives me much pride and joy. I find it a privilege to interact with bright students who would otherwise not have the opportunities to become doctors if not for government support. Half of our student population are from underprivileged Muslim and indigenous communities, many of them from Mindanao. COM is my happy place: the faculty members I work with, the college's support staff, even the canteen owners who give me an extra helping of pastil. 

A number of our students are scholars of the CHED Medical Scholarship and Return Service (MSRS) program, part of the provisions of the Doktor Para sa Bayan law (RA 11509). One of them is Hannah Joy Bento-Billones, one of my mentees! Dr. Popoy de Vera features her in his Philippine Star Column, Edukampyon. The article is entitled, "Weaving her T’nalak into a white coat," which you can read in full. 

Here are some excerpts. Dr. de Vera writes this about Hannah:

I met Hannah Joy Bento-Billones, a bright, articulate and self-effacing medical student. A T’boli from Lake Sebu, South Cotabato, she is the first in her community to study medicine and become a doctor. I told myself her story had to be told.

He continues:

Like the T’nalak, medicine was once a distant, impossible dream. When I first told my family I wanted to pursue medicine, my father grew quiet. I sensed both fear and disappointment – not in me, but in himself, for not being able to support his daughter’s dream. His line was, “Kaya ng utak, pero hindi kaya ng bulsa.” It was beyond what we could afford. For a time, I convinced myself that maybe medicine was not meant for me – maybe it’s for my children to fulfill someday.

When MSU GenSan opened its College of Medicine, it gave me a chance to revisit a dream I had once buried. I carry the reality of being a first-generation doctor in the making – the first pure Lumad in our family to pursue this path. My education has always been supported by scholarships, from high school through college. Still, there were moments when even that was not enough. At one point, my family had to sell a portion of our land just to sustain my studies.

I am also a product of a learning environment that prioritized inclusivity. At MSU-GSC COM, opportunities were never withheld because of ethnicity, social background or life circumstances. This support, together with the MSRS program, made it possible for me to continue even in seasons when continuing felt hardest. Tey bong slamat! Thank you very much!

Today, I am one step closer to becoming a physician. I will graduate this June. This milestone is not mine alone. It reflects the impact of programs like MSRS that invest in students who are willing to return and serve. It is shared with my tribe, the T’boli, and with every Indigenous community striving to be seen and heard.

We're so proud of you and your class, Hannah! 

—

In 2012, during a day trip to Lake Sebu with classmates, I took several photos and stitched them in an imperfect panorama.

Realizations while teaching Research

I'm pleased with the mid-year student evaluation for Research 2, the clinical and community research class I teach weekly in medical school. It's the most important feedback a teacher can possibly get: what, in the end, do the learners think of the course? 

My students rated the course as excellent, including the non-traditional teaching-learning activities. One particular activity, the peer-review, gives me satisfaction more than the others. I pair one group of students with another and instruct them to carefully study and critique the work assigned to them. In class, I listen to my students offering generous, well thought out, and considerate critiques. I learn a great deal from this exercise, too, and it frees me up from the task of doing the reviews all by myself. 

As the third quarter is unfolding, I have some realizations, especially as regards to my Research 2 class: 

Expect great things from, and think highly of, students. They live up to expectations, or will attempt to achieve lofty things. 

Allow creativity to flourish. This means creating certain allowances for unusual ideas and allowing them to explore unconventional research questions. 

Give them time to think. Setting aside dedicated study time, where they can work and meet with their groups, helps. Academic load in second year medical school is heavy and burdensome; their minds need space to think. 

Start with the capsule proposal before the full-length version. Capsule proposals are brief, concise, easy to read and critique, and force the students to distill the intricacies of methods and statistical analysis without being overwhelmed by length. Only when the capsule proposal is finalized can they expand it to create the final version. 

Use Google Documents! I can keep track of the evolving versions of the proposal, and my inbox is less cluttered.

Sir Mike

… The promise of closure fleeing what remains
Of this extravagant, fatal, blinking life.
— Maya C. Popa, Fireflies


We all felt the same thing when we heard the news: first the blow, unexpected and jolting, then the sorrow. Sir Mike’s passing was announced in our gadgets as a brief note interrupting the otherwise uneventful chats about birthdays and the upcoming annual convention this October. The message was clear and somber: Sir Mike, our dear mentor and big brother in medical oncology, has died. He was in his forties.


I confirmed the news with batch mates and friends, and they confirmed the news with me: is this true? His passing remains difficult to believe—and harder still to understand. He was perfectly fit, was in great spirits, had a good support community. Nobody that night had real answers, merely clues that would be confirmed by a poster asking for prayers and an announcement of a funeral mass. The background was white. The JPEG showed a photo of Sir Mike smiling. He had a mischievous grin. I remember that he had a funny sense of humor, laughing at and with us, more like a big brother than a stern consultant. But he could be dead serious when he dissected cases, and always earnest and kind when he shared his experience as an early-career medical oncologist. Beside his photo were the dates of his birth and death— bookends to a life well-lived.


Writing about Sir Mike in the past tense is painful because it feels . . . wrong. Gone too soon, leaving this mortal coil prematurely. Why do the good people leave us behind? We are all in shock and in grief.


The best we can do for our departed loves ones is to keep them alive in our memories by speaking and writing about them. It’s my great honor to have been taught and mentored by a great man whose legacy—his compassionate care for his patients, his kindness, humility, and faith—will last many lifetimes.

Tears

Some people are surprised when I tell them I have a class to catch, and could I see them on my next clinic day perhaps?

“Class”? You’re still in school? What are you studying? is the usual reply.

I say I’m a teacher, which doesn’t quite get the message across. Then I clarify that I’m a pro-fe-ssor, which elicits responses akin to admiration. “Professor Catedral” has a nice ring to it, like a smart, fancy, and profound human being. But nobody calls me that, unfortunately. In reality, though, much of academic life is answering emails, meeting with wayward students whose absences warrant me to be creative with their make-up tasks, and attending committee meetings that often start late and could have been just as productive as emails. But these in-person meetings are almost always moments of human connection, with the warmest and kindest of teachers, and with generous servings of crispy turon for snacks—so why not?

And I’m an assistant professor (some meetings), not a full professor (many meetings, I imagine).

The job of teaching does get easier with repeated practice. I like to think I’m a better teacher now than I was last year. Unless I find a valid reason to prepare them all over again, I rehash most of my lectures, repurposing and improving them to fit the moment for a specific batch of students in a specific point in history. My teaching-learning strategy is a hybrid of synchronous and asynchronous activities. On these last two weeks I shared my video recordings of lectures to my students. The topics are technical—better read than listened to. My students would doze off if I gave hour-long lectures in class. While they wash their dishes or prepare for sleep, they can listen to my spirited discussion about the hallmarks of cancer, the principles of cancer treatment, and the side effects of systemic oncologic treatment. They’re adult learners (I hope) and should have the internal motivation to learn things at their own pace. After some time, I meet them in person, expecting they’ve done their homework.

Last Thursday afternoon, I gave my last lecture for the oncology module of the (Internal) Medicine course this academic year. What I had originally outlined as a 40-minute summary lecture extended well into the afternoon, with my students asking me deeply profound and smart questions, both personal and technical, that they could all be topics of an essay collection.

For that afternoon, I intentionally shared stories about my patients to give the personal side to otherwise technical concepts.

I illustrated Weinberg and Hanahan’s Hallmarks of cancer through a story about my young patient with ALK-positive lung cancer. That allowed me to to talk about targeted treatments, crippling the process of oncogenesis, especially invasion and metastasis. This man had superior vena cava syndrome and was at the brink of respiratory failure because the lung mass was obstructing his airway. When he took alectinib his symptoms disappeared; he is now back at work.

When I spoke about honoring the patient’s wishes, I told them the story of one of my first patients in the city: a university professor, a single mother, who had stage IV rectal cancer. I shared to my students my mental picture of her: always well put-together, with her flowing dress and lipstick, and her remark: Hindi halata ang colostomy bag, Dok, no? She chose not to see me for a year; she felt great after all the treatments and decided it was the best course of action to resume her life. The cancer was quiet for all those months, but she came back, jaundiced, in pain. She told me: I’m ready to get treatments again. I want to live long enough to see my son graduate.

Her sister would return to the clinic and would tell me how the senior high school graduation went: the patient was inside the car, looking out the window, seeing her son get his diploma. She would die the day after, her prayers answered: she had set her son up for success. And all was well. 

I delivered the lecture in the fourth floor auditorium with tiered, theater-style seating, and I could see my students’ faces. Many were in tears..

I went on and on—getting through my slide set and remembering my patients, forcing myself to hear the sound of their voices and laughter—until I was done. Any questions? I asked. 

Several students raised their hands, but not all at once. They asked me things I still ask myself. How do I deal with so much pain and suffering? How do I react to patients who do not have the funds for their treatment? Do I ever get sad and frustrated?

There was some personal confessions, too. The students opened up their hearts, becoming vulnerable, understanding that ours was a safe, sacred space. A student told me I was her grandfather’s doctor and she thanked me. Her Lolo had passed away. One student said his mother died when he was 16 years old. I asked him, You must miss her, don’t you? She must be your reason for taking up medicine. She must be so proud of you.

I was asked: Do you cry?

I said, I schedule my moments of drama.

History in the making: first graduates of the College of Medicine of Mindanao State University General Santos

Here’s my weekly newsletter, the second for July. I forget how fast time flies, like an airplane hovering above ground, undetected—that is, until an internal alarm tells me a blog entry is due. This is probably what it feels like to write a column for a newspaper, my wild dream since childhood but which never materialized. I became a doctor. To be an opinion columnist is to have a good-enough supply of intelligent opinions, which I don't have a lot of. (I don’t know about you, but I miss reading Inquirer columns printed on paper. My father bought them for me as a treat. Conrado de Quiros was my favorite. His turn of phrases thrilled me, even if I didn’t understand half of what he wrote.)

*  

I attended two graduation ceremonies this week, arguably one of the best ones I’ve ever been part of, largely because my 12 students at the College of Medicine of the Mindanao State University – General Santos were at the center of attention. My heart swelled with joy and pride at seeing them in their elegant graduation regalia. I could hear sniffles from my side of the auditorium. Dr. Dar Guiomala, one of the kindest and most generous teachers, even showed me a detached portion of her faux eyelashes after a deluge of happy, grateful tears. I may have teared up a bit.

The ceremony was extremely formal and liturgical, which surprised me, having known rowdy, warmhearted UP graduations for most of my life where interruptions by protesters and activists were so common they hardly ever surprised anyone. But MSU graduations are apparently cultural celebrations, too: there were elegant cultural dances with vibrant colors that celebrate traditions. Simply a thing of beauty. 

I remembered my own graduation and how fast time flies. When I marched to get my diploma, Tatay was still alive. My parents were as proud as any parents could be. I felt, on that front-row VIP seat reserved for Medicine faculty, a sense of longing and emptiness, but also of sheer gratefulness at seeing these young doctors make history as the first graduates of the College. 

Teaching is an arduous, often thankless job that involves quiet study and concentrated dedication. But since 2021, we’ve been doing the hard work, the time-consuming labor of designing the curriculum, crafting and grading exams, and innovating teaching-learning activities to teach good, compassionate doctors who will soon serve their communities. One reward of teaching is being in the presence of excellent, gracious, and kind faculty members who, like me, are juggling clinical work with teaching. We find that both vocations complement each other. Being with the young also make us feel young. 

But the pre-commencement exercises last Monday was truly a gift. It was the first time for many things: the first time we had Doctor of Medicine graduates, the first time we would use the smashing College of Medicine auditorium built by taxpayers’ money, the first time we would don the yellow academic regalia. 

Congratulations to our students, faculty, and staff!

*

Here are highlights of the ceremony, shared in the College of Medicine's Facebook page. 

* 

Here are some pictures I took. The photos may not be displayed correctly. I'm not sure why. If that's the case, please click on the links that should take you to the Flickr page. 

Faculty members assembled for the processional. We were instructed to walk slowly.

But we couldn't waste the moment. On ordinary days, we wouldn't normally bump into each other. The ceremony was a reunion of sorts.

My first time to see the auditorium, which just got its occupancy permit. 

Walking behind Dr. Jean Alcover-Banal, who used to be the fellow coordinator for cardiology when I was a second year student at UP College of Medicine. 

The costumes of the ushers and dancers were dazzling. 

An elegant, cultural moment. 

I had a front-row seat!

Sir Noel Sug-ang, who helped supervise the ceremony.

The proud parents and family. 

Photographers and videographers on stand-by. 

Ushers danced, while the crowd stood, waiting for the processional to conclude. 

University officials standing on stage, with Sir Charlie Mina making sure everything was running smoothly. The MSU chorale sang a beautiful rendition of The Lord's Prayer. 

Now: the graduates.

Dr. Joey Maravillas, class valedictorian, cum laude. 

Dr. Ikha Estrella, cum laude. 

Dr. Charleskin Daig, cum laude.

Dr. Kathleen Demegillo



Dr. Julieen Ca-at



Dr. Psyryst Allado



Dr. Alberto Evangelista, Jr



Dr. Jay-R Malayag



Dr. Eleonor Olaybal



Dr. Rose Ann Paalisbo



Dr. Florence Jay "FJ" Salcedo



Dr. Earl Uy



So much pageantry was on display.

University officials and their academic regalia. 

Medicine faculty members were moved and inspired. 

Joey's valedictory speech on behalf of the graduates was impressive. He said something about being "doktor para sa bayan," and his class returning to their communities to serve their people. 

Ikha, on behalf of the class, honored their families for supporting them through their medical journey. 

It was, I believe, Dean Ed Alconcel's idea to have a slideshow, which turned on the waterworks. 

The graduates performed a beautiful song they composed!

The lyrics pasted on manila paper, in true 90's fashion. 

I got a rose!


Everyone did!

 

Our amazing College of Medicine support and office staff! Such great blessing to have them!

Some of our students watched, too. Soon, it will be their turn. 

On the way to the lunch banquet!

Faculty members, waiting for the lunch to begin. 

Our support staff, looking like senators!

But first: another photo op. At the Medicine atrium this time. 

Our Dean, Dr. Ed Alconcel, and the stellar and shining Junjun Yabon, coordinator of Physical Diagnosis. 

Getting ready for the group shot. 

Here it is. 

*

 

And the second graduation? I almost forgot all about the university graduation last Wednesday, if not for Dr. Jo Frial who reminded me an hour before the start of the processional.  What I wore was not acceptable for such a formal event: a shirt that should probably transition to the pambahay category and a pair of Levi's jeans, faded from repeated use. So I headed straight to the mall, bought an undershirt, white long-sleeves, trousers, and black socks. I borrowed a colleague's regalia. I braved through Calumpang traffic, which wasn't so bad at 2 pm, and found a nice parking spot at the Y Building. I marched as if I'd been preparing for the occasion, sweltering in the magnificent, dehydrating General Santos heat.