Monday, December 9, 2019

Milan and museums

I realize it's only 4:56 pm as I begin writing this. I had just finished showering—this, after more than 24 hours of air travel, walking, getting lost, and saying "grazie," one of the very few Italian words I know. When delivered with my faux Milano inflection and my genuine Filipino smile, "grazie" can do wonders. The Italians are a charming and gracious people who respond well to thanksgiving.

I am now about to sleep and skip dinner—most restaurants are closed on Sundays anyway, and I don't want to return to Duomo, in the city center, just for a meal. When I barged in a neighborhood trattoria, the beautiful lady bid me come, only to tell me that they were closed for the day. Sunday is extraordinarily quiet in Milan.

I realize that even for my standards, 4 pm is quite early. It is typical of Italian winters to have long nights and short days, apparently—a foreign concept to someone like me who has spent 99.9% of his life in the tropics where these things generally don't matter.

I flew a few days earlier to make good use of my weekend. The main reason for this European foray is to attend an immuno-oncology conference in Geneva, where Harold and I will be sharing the results of our study on pancreatic cancer. I will be meeting Harold in Switzerland on Tuesday where, he told me, it is already snowing. I'm grateful to have worked with him on a number of research projects, and I'm proud of him as a colleague and friend.

This morning I went to Duomo. It was beautiful the way Gothic cathedrals can impress with their intricate patterns and ambitious motives.


I went to museums. This was Leonardo da Vinci's sketch at the Biblioteca Ambrosiana.


This was Rafael's cartoon, The School of Athens.



I also visited Filippino Lippi's L'Annunciazone exhibit.


The museum tour was in Italian, but I was surprised at myself that I could understand what was going on.


I dropped by Galeria D'Italia along Piazza Scala to look at the Thorvaldsen sculptures and other artworks.


I had an overload of artworks and paintings, so it amused me to hear Mariah Carey's "All I Want For Christmas Is You" in the background.


Praise God for His goodness in bringing me to Italy this weekend!

Thursday, December 5, 2019



The Farewell, directed by Lulu Wang, tells the story of a Chinese family that decides to withhold the diagnosis of lung cancer stage IV to their matriarch, the grandmother Nai Nai. They spare her the troubles of dealing with terminal illness, dismissing her complaints of cough as prolonged infection, and going out of their way to create fake X-ray results. I must say that I enjoyed the film immensely, as it deals with the question of how to best approach the family's decision against disclosure versus the patient's need to be informed of the illness.

This issue resonates with my daily experiences, but I've come to realize that patients know a whole a lot more about their illness than we give them credit for. How do I deal with this issue? It's still on a case-to-case basis. I tell the family it's hard to conceal a cancer diagnosis if we plan to give palliative chemotherapy or some other treatments with concerning side effects. Disclosure is a complicated issue for which no pat solutions can be offered. Here lies the art of medicine—something I keep working to be good at so that one day it becomes second-nature to me.

Wednesday, December 4, 2019


Blogs are here to stay

Blogs are here to stay. Tim Challies makes strong arguments of why that is the case.

"... We are seeing the shortcomings of other forms of social media. When blogs began, they were social media. They were an early form of online social connection between people who shared similar interests, whether that was politics, hobbies, Reformed theology, or anything else. But it did not take long for other forms of social media to develop—Twitter was at first considered “microblogging” and Facebook was a kind of “friend and family blogging.” Yet as much as each of these has displaced blogging in certain ways, none has quite replaced it. Twitter causes as many problems as it solves by its immediacy and by the nature of its character limit; Facebook emphasizes the most urgent information while older updates or articles almost immediately disappear into the void. These forms of social media speak to the present, but don’t adequately archive information. They allow people to speak quickly, but don’t value thoughtfulness. Though they have strengths, they also have weaknesses—weaknesses that blogs address well.

Now that we're in the subject of blogs, here are the top five blogs I subscribe to. While I miss Google Reader, The Old Reader does the tricks of an effective blog aggregator—perhaps even better!
Faithful to God's word, Tim has written daily for 5,877 consecutive days as of the time of writing. I love his insights on the kind of Christianity that's lived out daily. I love his devotion to God's Word, his recommendations of links and Kindle deals, and his tips on productivity. I've had the privilege of meeting him in person when he spoke at the Live It Well conference in Quezon City, a conference which our church hosted.
One of the coolest people in the internet, Jason Kottke is my go-to source for the best links in the web. I love his writing: simple and honest sentences, and quite sincere, too—like listening to a friend talk about the things he likes.

Paradox Uganda
Missionary doctors Scott and Jennifer Mhyre write about their work in Africa. They run a school and a hospital, and juggle many responsibilities in between. I love looking at the photographs of their family—their children are all grown up now. Their writing is a balm to the soul; the insights are otherworldly, transcendent, emanating from souls that commune with our gracious Redeemer.

Pinoy Penman
This is the personal blog of Dr. Buch Dalisay—college professor, writer, novelist, and fountain pen collector. What I love most is when he writes about fountain pens, his collection of antiquated materials, and his reflections on life. He takes great photos, too!

Austin Kleon
I love his Blackout Poetry collection, photographs of his notebooks, and insights into an artist's life.

Update: Evhead is back to blogging. I'm encouraged to read statements like this:

That’s why I’m getting back on the mat — i.e., making an effort to blog/write on a regular basis (in public) again. Partially for fun. Partially to see what comes out of my brain. And mostly to understand from the individual creator perspective how our tools need to evolve for this point in the internet’s evolution.

Sunday, December 1, 2019

Pen-abling the oncologists

There is a thrill when I pen-able friends—that is, coax them in a way that will change their behavior positively towards trying a new pen, or getting a fresh bottle of ink, or writing on a smoother Japanese paper.

This is what Fred and I did to Rich, who has taken a liking to his Pilot Metropolitan—the "gateway drug," said Berbi, who was among the first to pen-able me. I give credit, above all, to Mervyn, for telling me to try out fountain pens a few years ago. My life has never been the same again, although, to be honest, the Pilot V5 still occupies a special place in my heart; it was my pen of choice for most of residency. I still miss it, and I'm happy whenever I see my friend, and now hematologist-in-training, Jeremiah, who remains a devoted fan.

Image credit: The Well-Appointed Desk

We brought Rich to Overjoyed, along Handy Road in Singapore, and here he was, trying the TWSBI Eco—a beautiful entry-level Taiwan-made pen with a huge ink capacity, perfect for whole-day out-patient clinics.


Fred couldn't resist the thrill of the Midori Traveler's Notebook, passport size, and got himself the brown one. I like to think this was partly due to my influence, although I may be exaggerating at this point. Our dear friend, Karen, has also taken a liking to fountain pens and notebooks—the most surprising revelation of all because she seemed like someone who could never change her mind towards her ballpoints.

I'm happy to share this fascination with them. The great thing about pen-abling friends is that when I realize I'm running short of ink, someone will tell me, "May blue-black ako, Lance. Kuha ka langnasa drawer ko."

Saturday, November 30, 2019


When we bid our goodbyes yesterday on our final class for the semester, I felt a tinge of separation anxiety which, I confessed to a friend, was so unlike me. But that class was the penultimate master’s class meeting for my degree (Master in Clinical Medicine, if you’re curious). While it looked like an ordinary Friday afternoon—with Fred and I nodding to each other so we could rush to the LRT to avoid the paralyzing Metro Manila rush hour—it was, forgive the cliché, the beginning of the end.

I like to think that I’ve had a good run in Medical Oncology training. I’ve been blessed beyond measure. The Lord has proven Himself faithful and true to His word. He has given me so much more that I deserve. I consider the past two years the hardest moments of my life, but these were also the most fruitful.

I suppose I shouldn’t brush away these healthy feelings of gradual loss. It is painful to let go of things dear to one’s heart, especially to my constant company of rowdy, supportive, humble, inspiring, and brilliant colleagues-turned-friends.

*  *  *

I'm sharing some photos of us, taken by Raj.

Freddie, Kmomsh, Rech, myself, and Raj during lunch breaks at the European Society of Medical Oncology preceptorships. Freddie, Kmosh, and Rech attended the Gastrointestinal Preceptorship, while Raj and I were in the Immuno-Oncology session.

Photos taken by Roger

We helped one another set up our posters at ESMO Asia—a constant theme of our existence. Helping out one another, seeking the good of the other, even at one's inconvenience or expense. Raj would later win the award as Best Poster in the lung cancer category.

Photos taken by Roger

Our natural facial oils and Singapore's Gardens By the Bay. Raj insisted on a selfie.

Photos taken by Roger

Besties Raj and Freddie, reconnecting under the fake tree.

Photos taken by Roger


Photos taken by Roger

Ni hao, Rech!


Freddie delivering an excellent presentation of his team's randomized controlled trial.


Tuesday, November 26, 2019

Sweaty inside the Bangkok temples

We arrived a day earlier. Despite the tropical heat and humidity, Mervyn Leones and I determined to visit the temples, if only to marvel at the architecture and culture that Bangkok offered. It was a charming city, one that Manila could have been, if only we had been better at governing ourselves, or at choosing the people who governed us. We shouldn't compare places—each has its own peculiarities—but comparison was inevitable in this case because there was a time in history when Thailand and the Philippines were similar in status as emerging economies in Southeast Asia. Now Manila has been left behind. It is frustrating to write that. But she is struggling, and the struggle continues.

There is a place in human experience where one needs to have one's photo taken beside a famous statue or icon, but I have long since overcome that urge. I'd much rather take photos of people taking photos of themselves (how meta!), or to take random snapshots of humans maximizing their short opportunities at getting their snapshots before their tourist buses leave. It's amazing what people will do—poses that often border on humiliation, which they will soon regret, happily, years thereafter, when someone resurrects them with innocent likes—for a chance to amuse their Facebook friends temporarily.

So here we were.

An iconic photo of a largely unnoticed pond. The doctor in me thought of Aedis aegypti.

Lotus pond, Thailand

Masyadong ginalingan.

Posing, Thailand

The looking-far away pose, which reminds me of creative graduation photos of people where I train.

Tourists in Temple, Bangkok, Thailand

And my favorite—this kid, tired from all the walking, in the process of hydrating himself.

Thirsty, Thailand


When I learned that my good friend and colleague Rich King also liked gardening, I knew I wasn't alone. After doing chemotherapy, Rich would lull himself to sleep by watching YouTube videos of plants and herbs (see the channel, Garden Answer—thanks, Rich!). This seems to agree with him—a quiet, peaceful hobby, perfect for introversion. I told him that I like watching Monty Don's Big Dreams, Small Spaces in Netflix, a show where ordinary people transform what little patch of land they have into the garden of their dreams. The gardens don't always turn out well—an episode showed the creation of a pond that looked like a toilet bowl—but one appreciates the effort and drama.

Gardening and plants. This botanical fascination creeps on us as move into our thirties, when we are more stable, perhaps more certain of our place under the sun. As a kid, I took a liking to botany. Having learned about monocots and dicots, I carved out a special place in our backyard and planted corn (monocot) and munggo (dicot). I tried out fertilizers, decomposed dried leaves, and was mostly impatient that things would speed up.

Recently, my good friend Kuya Imay, also the best insurance adviser in the world, sent me photos of his vegetable garden in Nabunturan, Compostela Valley. I asked permission to share these here. What a relaxing sight, indeed!

Kuya Imay's vegetable garden

Kuya Imay's vegetable garden

Kuya Imay's vegetable garden

Kuya Imay's vegetable garden

Saturday, November 16, 2019

Down under

Last week my brother Ralph and I had the opportunity to visit friends from Down Under. These were friends from way back—those who knew me from when I sported the crew cut and looked emaciated. We stayed in a university dorm together, enjoyed sweet Christian fellowship, labored in prayer for "acads" (how we termed our university requirements and exams, which we hoped to pass to get us closer to our baccalaureate degrees) and our spiritual walk with the Lord, and went to dinner in our favorite staple, Lola Lita's and its killer tofu, already burned down to the ground because of a massive fire a few years ago. They have remained friends and have become—no, really—family. My eyes water and my heart overflows with thanksgiving when I think of the tapestry of my life in my twenties, carefully handcrafted by God who included them.

After the delayed release of our visas, we booked a cheap flight to Sydney. Friends in Manila asked me what I was going to do there. My reply was that I did not know. The plan was to just coast along, follow the itinerary set in the WhatsApp group called "Catedrals in Sydney," and have fun.



So have fun we did. Kuya John hosted us in his beautiful place in Burwood. He would cook lunch and dinner—steak and Australian wine and that luscious salad. He would join us for coffee and snacks during his breaks. He would tour me around Newtown and bring me to his favorite bookstore, where I saw a vintage copy of The Pilgrims Progress.


Mike Tan treated us to dinner at The Rocks. He would be our tour guide in The Blue Mountains, and would ask us to pose for the camera, something I rarely do these days. But Mike was always insistent: "Naglakat pa kamo diri kung hindi lang kamo magpapiktyur!" Ah, Mike! It makes me laugh every time I recall our walks along the eucalyptus trees and our views of the vast New South Wales landscape, marred with the occasional bush fires and chilly winds. He also took us around the charming Katoomba and Leura towns, which looked like the New England setting of The Good Witch, a feel-good Netflix series I'm watching.




Kuya Arbie and the lovely Ate Vinz prepared dinner for us in their apartment just a few blocks away from the Sydney Olympic Park. Their daughter Louise knew how rally a crowd, with her small violin and her ABCs, which she would sing to Kuya Arbie in the morning, like a natural alarm. I hope she does not get Kuya Arbie's musical ability when she grows up.

All of us, save for Ate Vinz and Louise, went for a drive to Port Stephens, did a not-too-exhausting hike, dipped out feet in the beach, ate pizza at a public park in sleepy Newcastle, dipped our feet again in the sand dunes where I saw camels for the first time, visited a small zoo with wombats and kangaroos, and drove home.



In between these trips, we caught up with each other, talked about our other friends, about how God has been at work in our lives, and planned our next trip back to Australia.

Sunday, November 10, 2019

Three ways to "stay Christian" when discussing politics

I have friends whose political views run contrary to mine. This article by Jared Wilson is particularly instructive on how I should relate to them. In summary, the three ways are:

1. Turn some things off.
2. Remember your political opposites are sacred image-bearers of God.
3. Take your cues from Your Christ, not Your candidates.

I feel just the same way, and, at some point, have been guilty of this:

I cringe every time I see a friend or family member share some derogatory or dehumanizing comment or meme about politicians they don’t like. Sadly, objectifying our opponents has frequently been the way American [Philippine] political debate works, simply because it’s the way the world works. But Christians are not to act and look like the world. The stakes in our political rivalries may be high, but they are not so high that we must abandon the biblical truths that our real war is not waged against flesh and blood. They are not so high that we must deny the dignity of our political opponents, harping on their mistakes and flubs, scorning them with the hatred none of us owes to fellow human beings made in the image of God.

Saturday, November 9, 2019


Sydney 2019 — Day 1

Sydney 2019 — Day 1

Sydney 2019 — Day 1

First, cityscapes and suburbia; then beaches, pubs, and cafés. And then the mountains and rocks and chilly winds that nearly overthrew us over the cliff. Today: we return to the shores and 20-minute hikes. Ah, to celebrate the goodness of the Lord through friends!
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