Wednesday, March 21, 2018


The biography of cancer

The Emperor of Maladies: A Biography of Cancer is written by Dr. Siddhartha Mukherjee, an oncologist, researcher, and writer. The title refers to this work as "a biography"--of cancer as a disease, its mechanisms, its evolutionary strategies to evade any form of cure. It is also a biography of scientists, physicians, and politicians whose efforts have led to its greater understanding; of its victims and survivors, both patients and their families alike.

The book rekindled my love for medical history; it is as fascinating and intriguing as our present-day politics. Many issues tackled in this work--including, for example, the discovery of cigarettes as a leading cause of preventable cancers and the powerful, multi-million dollar efforts of tobacco companies to stifle public health efforts aimed against it--remain relevant today.

It is a narrative that illustrates the value of the scientific process, and how basic sciences--molecular biology, chemistry, and physics--form the backbone of medicine's understanding of this disease. The book excels in outlining the doubts and worries of the scientific community, a reminder that uncertainties lead to scientific questions; and with the questions come the answers--not as an inevitability but as a possibility. In a situation where death is impending, any possibility spells the hope of relief, if not an actual cure.

Dr. Mukherjee distills the central dogma of molecular biology and explains it in terms people can understand. He shows that the study and treatment of cancer is never static, always full of hopes and disappointments, but that the effort to fight it is well worth the time. He rejoices with the world upon the discovery of the genome; for the first time in history, we now have a centralized mechanism of carcinogenesis. A new age of oncology has dawned.

He writes about his experiences as an oncology fellow, drawing lessons from patients, exposing his frustrations, and telling us about his dreams: that someday, perhaps, we will be able to find a cure; and in this search, the patient--the human being with the disease--must remain central.

Weeks away from the start of my clinical fellowship in Oncology, I'm blessed to have read this work; it reaffirms my conviction that this is the field where I want (and need) to be. I will reread this to draw inspiration and hope.

Books change their readers for the better. This is one of those books.


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JI Packer on weakness

Weakness is the Way by J. I. Packer from Crossway on Vimeo.

JI Packer, who wrote the book, "Knowing God," talks about weakness in the Christian life. Christianity is an amazing movement in that it runs counter to many of the world's beliefs: salvation to non-Jews, salvation by grace alone through faith alone, respect and equality for women, love for others as love for self. Here, JI Packer argues for the different definition of strength in the Christian life and the acknowledgment that that true strength can never be had without an acknowledgment of one's weakness.

I like listening to old, godly men, especially if they happen to write with typewriters, as is the case here.

Tuesday, March 20, 2018


The apostle Paul got married at some point?

The apostle Paul is major figure in the New Testament. He argues that being married is not superior to being single. Theologian Denny Burk writes that at some point Paul was actually married.

I think this interpretation [of 1 Corinthians 7:8-9] is mistaken. It may be that Paul’s words have implications for all who are unmarried, but I think Paul’s reference to the unmarried refers to widowers specifically. There are a number of reasons for this. Not the least of which is the fact that the Greek word for “widower” was rarely used in ancient Greek and was never used in the Koine period (Fee).

For some reason, first century speakers did not use the word “widower.” My hunch is that they didn’t use it because of the negative social connotation attached to the term. In the first century, a widow was not only bereft of her husband, she was also often destitute. It was a patriarchal culture, and to be without a husband was to be in an extremely vulnerable position. That vulnerability is why the “widows” and “orphans” are often paired together in the Bible (e.g. James 1:27). In a patriarchal culture where there’s no social security safety net, widows and orphans are extremely socially disadvantaged.

(HT: Tim Challies)

Monday, March 19, 2018


Follow Mike at Walk and Eat

If you like eating out in Metro Manila, I invite you to follow Mike at Walk and Eat. He visits restaurants almost every day and writes about food, interior design, and service. As far as I know, his job allows him some flexibility to roam around town, and maybe this is why his blog is called such. How he chooses the restaurants amazes me. A self-confessed obsessive-compulsive and completist, he follows a list of best restaurants for this year or the other year and ticks off the place once he has visited it. He also chooses randomly. Some of his best pieces are those when he stumbles upon a hole-in-the-wall restaurant and finds out that the food is amazing. Unlike many professional food critics, he writes simply, devoid of any pretensions. If he likes the food, he writes that he'll be back. Otherwise, he just says that burger, for example, is bad without sounding condescending. It has become a habit to scroll through his archives, or do a quick search in his site, so I'd have an idea where to dine in. I visited Assad Café in Paco because Mike recommended it highly.

Sunday, March 18, 2018

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Yellow is the color of the tennis ball

week 28 (UP Medicine Tennis Court)

What color is a tennis ball? My answer is yellow. I learned recently that this is quite a divisive question.

The seemingly trivial question tore apart our usually congenial group. Lines were quickly and fiercely drawn, team green against team yellow, as my colleagues debated the very definition of color itself. Swords were brandished in the form of links to HTML color codes or the paint selection at Sherwin-Williams. Attempts to broker a cease-fire, to consider that maybe tennis balls are actually yellow-green—or green-yellow, or chartreuse—were brushed aside. At one point, I lashed out at a colleague who then reminded me we were on the same side.

The article offers a theory on color perception.

When we’re looking at a given object in different types of light, our brains make substantial color corrections that allow us to see the object in a stable color over most lighting conditions. Conway’s theory is that some people discount cool colors in their perception, while others discount warm colors, in order to view objects consistently as the light changes around them.

It goes even further: one's perception of the tennis ball color may shed light into one's lifestyle.

When we’re looking at a given object in different types of light, our brains make substantial color corrections that allow us to see the object in a stable color over most lighting conditions. Conway’s theory is that some people discount cool colors in their perception, while others discount warm colors, in order to view objects consistently as the light changes around them.

In my second year of residency in IM (sometime in mid-2016), I enrolled in a tennis class. The court was a few steps away from my dorm room. Never mind that the interns saw me sweat it all out.  Weng, my young instructor, said at one point that I had a good backhand. The last I heard about Weng was that he got married and moved to the province.

Saturday, March 17, 2018



I was moved by this: former President Obama surprises Vice President Joe Biden with the Medal of Freedom, a spectacular display of generosity of spirit and a humble heart.

From the NPR:

The two have enjoyed an unusually close working relationship over the past eight years, and Obama himself even joked at the outset of the ceremony that "this also gives the Internet one last chance to talk about our 'bromance.' "

Throughout the ceremony it was evident not just how close the two men were but how close their families and staffs had become, and Obama said his "family is honored to call ourselves honorary Bidens."

You don't have to be friends with the people you work with. But if you are friends with them—well, that makes the work easier, the hardships more bearable.

Friday, March 16, 2018

Coffee impacts biodiversity

Another good news for coffee drinkers and environmentalists:

The impact of coffee on biodiversity has been intensively studied, particularly in Latin America. The conclusion of most, but not all, of those studies is that biodiversity impacts increase as more intense farming techniques are used. Truly rustic coffee, where coffee plants are grown interspersed with forest trees and understory, has the least impact on vegetation and birds. Shade-grown monoculture is a slightly more intensive technique, farming larger densities of coffee plants underneath the forest canopy. This impacts biodiversity more than rustic coffee, but still far less than sun coffee, which involves clearing the forest like a traditional farm, removing epiphytic plants from the coffee plants, and applying chemical fertilizers.

Thursday, March 15, 2018


The patients' narrative

As I prepare for my clinical fellowship in Oncology, I'm reading Siddharta Mukherjee's masterpiece, The Emperor of Maladies: A Biography of Cancer. As with any medical discipline, the patients remain central.

But the story of leukemia—the story of cancer—isn't the story of doctors who struggle and survive, moving from one institution to another. It is the story of the patients who struggle and survive, moving from one embankment of illness to another. Resilience, inventiveness, and survivorship—qualities often ascribed to great physicians—are reflected qualities, emanating first from those who struggle with illness and only then mirrored by those who treat them.

This book excites, challenges, and inspires me.



Dr. Jun Jorge, chair of the Department of Medicine at PGH, called me up at 9 PM, March 14. I passed the diplomate exam of the Philippine College of Physicians. I'm now a board-certified internist. I will remember this day with Sir Jun's sonorous tone as background. He was perhaps holding back his excitement that everyone in my batch made it, some with the highest scores.

My heart is bursting with joy at the past and the present and the future, all of my life bearing the indelible mark of God's faithfulness. If doubts assail me in the future, I will look back to this moment. This is yet another milestone in my life, a testimony of God's goodness and love.

Whenever I celebrate victories, King David's calming and humble prayer gives me the right perspective.

Not to us, O LORD, not to us, But to Your name give glory Because of Your lovingkindness, because of Your truth. — Psalm 115:1, New American Standard Bible


After the end of residency in December 2017, I spent the next two months at home in Marbel. My grandmother died, but I was able to squeeze in a few moments to read Harrison's, scribble a few notes, and manufacture mnemonics—the kind that I forgot after three days of having concocted them. People call that short-term memory loss, and I've been guilty of forgetfulness many times over. Interspersed with the flurry of activities, Netflix series, downloaded books in Kindle, and coffee sessions with high school classmates—many of them already married and with house-and-lots—I was able to work part-time as a physician in a coastal town in Sarangani and a company hospital where my parents had first met.

My family wasn't all that helpful. My father would drag me with him to the mall for his afternoon coffee or the farm for his morning appointment. My mother would volunteer my services to many of our close family friends. My brothers would question the validity of my studying: was I really remembering things when all I did was watch films and blog?


My go-to café was The Brew Project along Judge Alba Street. I almost always had the shop's excellent single-shot espresso which kicked my dwindling afternoon consciousness to activity. I took photos during some of these study sessions, yet another proof that cafés are the new libraries.

January 5. The baristas, who saw me enter the store between 2 to 3 PM, remembered what I always ordered.

January 21. My TWSBI Eco and Valiant columnar notebook.

January 22. Infectious Disease was the longest topic.

January 23. This reminded me of the Viennese kaffeehaus.

January 24. My kid brother Sean would join me.

February 2. I interrupted my break with a short visit to Manila, where I took an online exam. I was able to catch up with Carlos, Racquel, and Abby, all diplomates in IM now, too. Congratulations, guys.

February 10. At Bo's Cafe, SM General Santos. I later spilled the creamer.

February 22. Austin Kleon's calendar served as my short-term planner.

February 23. Another day at the cafe.


Thank you for all your prayers and words of encouragement. I haven't told my parents yet.
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