Wednesday, December 28, 2016

Good films

The Metro Manila Film Festival selection this year has been a pleasant surprise. For the judges to have done away with awful romantic, formulaic films, to have finally gotten rid of the recurring Filipino-Chinese family-problem themes (after, what, six or seven sequels?), to have censored supposedly funny superhero films whose only redeeming quality had been the large, gaudy entourage during the Parade—they have finally realized (or they’ve done so long ago, but only had the guts to do something about it now) that Filipinos, too, take pride and joy in watching sense and intelligence and good humor. Id est, good films worthy of our 200-plus-pesos tickets and a little less than two hours of our time.

I pleasantly whiled away time at the local cinemas and didn’t mind the long queues—I had, after all, a book, which temporarily removes any need for human company. This is how I prefer to watch movies: alone, lest I disturb the people around me. I have coffee or tea in between movie breaks, so I’m able to watch the next film in line without so much as a yawn.

I haven’t really favored the dichotomy between “indie” and “commercial”—they’re all films, and if they’re good, they’re good, regardless of who had produced them. There are awful indie films and commercial films; there are pretty good ones, too.

Die Beautiful
was hilarious and depressing at the same time. The crowd in the cinema howled in laughter. The man beside me, a college student in shorts, couldn’t restrain himself—I surmise that popcorn must’ve exploded from his nostrils. For a film that shows gay people in loud costumes, the movie surprisingly offers a sensitive approach to understanding the LGBT community: that they struggle with mockery and hatred; that they yearn for so-called love that society refuses them; that they are human beings, too, sinners like all of us—yet another testament to Pascal’s statement that there is a God-shaped vacuum in every man that only God can fill. They fill it with romantic love, ambition, and vices; only to realize that these cannot give them lasting joy. We Christians will benefit in watching the film, if only to realize that there is an entire community before us that needs the gospel. There are expletives, references to homosexual sex, but overall, these have been included in the script with restraint and care.

Saving Sally was a delight to the eyes. Ten years in the making, the animated film is worth the wait. The conversations are carried on in English—Filipino English, not the forced “Americanized” accent—that actually sounds normal. There’s not much to the story: a boy falls in love with a girl and saves her from her evil parents. But the novelty of seeing walking monsters, the house on top of a steep hill, the school whose façade resembles UP Diliman’s Quezon Hall, was fun.

Seklusyon was scary. Four would-be priests, a girl who spews what looked like abodong pusit paste and who performs miracles, a beautiful but indifferent nun beside her—all these in scenes shown in sepia tones—made for a startling experience. Of course, the doctor in me made me diagnose the illnesses of the sick (“Ah, acute symptomatic seizure, probably secondary to a primary seizure disorder, rule out metabolic causes” when a 20-year old man was brought to the albularyo girl). Watch this with friends who hate horror; they won’t be sleeping after. But I suppose no film, in my experience, has scared me more than Sadako.

Ang Babae Sa Septic Tank Part 2 was a riot. Eugene Domingo is one of my favorite actors: hey, I watched Kimmy Dora Part 1 thrice, in cinema! Oh, how that lady can act! She now has a Spanish assistant who fetches water for her and serenades her with his guitar. The humor is intelligent, which doesn’t diminish it at all. More, more movies please, Eugene! And that ending!

Go, watch. These are good films.

Saturday, December 24, 2016

Consigned to hell?

Tim Keller, who pastors Redeemer Presbyterian Church, is interviewed in The New Yorker York Times ("Pastor, Am I A Christian?"). He's asked:

What I admire most about Christianity is the amazing good work it inspires people to do around the world. But I’m troubled by the evangelical notion that people go to heaven only if they have a direct relationship with Jesus. Doesn’t that imply that billions of people — Buddhists, Jews, Muslims, Hindus — are consigned to hell because they grew up in non-Christian families around the world? That Gandhi is in hell?

Read his wise response here.

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Christmas in the hospital: an unexpected celebration

I GO ON 24-hour shift today, on this cloudy Christmas Eve, while the rest of the world celebrates with friends and families. It doesn't bother me. While riding the taxi this morning, surprised that traffic was going smoothly (Quezon City to Manila in less than 20 minutes!), I thanked God for Christmas: for coming to earth to become man to save me—all of us, sinners—from our sins.

John Bloom, one of my favorite bloggers, writes:

This Christmas, do not be surprised if you find yourself worshiping Jesus where you did not expect to find him.

He goes on to write that Jesus has always broken expectations. He ponders on the meaning of the celebration:

Jesus came into the world at a desperate time in a desperate way. It wasn’t the way people expected him to come. It wasn’t for the reasons they expected him to come. He did not come to meet their expectations but to love them in the ways they most desperately needed. 
For Christ, Christmas is not about tradition but salvation; it’s not about expectations but sanctification. Christmas is about love — earthy, gritty, sacrificial, even bloody love. When Jesus came, he did not come “to be served but to serve, and to give his life as a ransom for many” (Matthew 20:28). This was a love that no one expected — a love that exceeds all our expectations. 
And this is the way he comes to you this Christmas: to love you in the ways you most need. That may, in fact, be why some of your expectations are not met: they aren’t what you really need.

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Friday, December 23, 2016

Trip to Solidaridad, the store owned by F. Sionil José

Solidaridad

I DRAGGED my friends Karen Montevirgen-Mondragon and Jay Magbojos to Solidaridad, the quaint, quiet bookstore owned by the writer F. Sionil José. It's in the neighborhood, near the intersection of Bocobo and Padre Faura Streets, a private store that sells books, albeit more pricey compared to their counterparts at National Bookstore. But I always like the sweet smell of books, both old and new, and the classical music—mostly Bach and Mozart—that plays in the background, so I always visit when I have the opportunity.

Solidaridad Bookstore

One can find rare books in the store, even those published by NYRB, like this essay collection by Max Beerbohm, which I shall buy next.

Max Beerbohm

I must confess that I've never read any of Mr. José's books. I don't know why, but I should really find the time.
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Wednesday, December 21, 2016

Cruel but inevitable

As doctors we commit to decisions that mean life or death. I suppose, given the variety and severity of cases we—internists-in-training—see every day, this is inevitable. How must we wrestle with the daunting task of taking care of several critically ill patients and deal with the fact that we only have one or two vacancies in the Medical ICU? Who should we prioritize?

Dr. Flàvia R. Machado’s piece[1] illustrates this peculiar dilemma. It’s a worthwhile read.

We begin another day at 7:00 a.m., and once again we need to decide who will get an intensive care unit (ICU) bed after an elective surgical procedure. A 55-year-old grandmother with colon cancer? An elderly man with liver metastases? A young woman suffering from pain who needs an arthrodesis to keep working so she can continue to feed her family? Should we choose or deny patients because they have cancer? Should we choose on the basis of age? On patients’ previous quality of life? Or on social impact, if, for instance, one patient has four children to raise? Should we give the bed to a patient whom we’ve already had to refuse once? Or should we perhaps just stop playing God and give it to whoever asked first? 
Every day, all around the world, intensivists face such cruel choices. And deciding which patients will have elective surgery is not even our most hideous task; emergency admissions are far worse. Death is probably not imminent for a patient who is denied the chance to have a tumor removed, but some patients will die without immediate intensive care to sustain their lives. 
Poverty is shocking, but social inequality may be even worse. Social inequality is the hallmark of middle-income countries, which usually have two distinct health care systems, one public and one private. How can we advocate for equality in health care, treating all patients the same, if not everyone is starting from the same place?


[1] N Engl J Med 2016; 375:2420-2421

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Christmas Party 2016

PRAISE be to God for a great time during the seniors' Christmas Party. So much laughter, games, and food.

Seafood paella by Roland Angeles. Paella disarms me all the time.

Christmas Party IMax 2016

Roast chicken by Carlos Cuaño. So tender, juicy, flavorful—best served with a squeeze of lemon.

Christmas Party IMax 2016

And, hands down, one of the best pastas I've tasted: squid-ink noodles smothered with crab fat (alige) by Roland.

Christmas Party IMax 2016

Not in photo: crispy lechon.

After that: a series of crazy games (newspaper dance, trip to Jerusalem, bunong braso) that left us all tired, in a happy kind of way.

I went to residency to train and not to make friends. I guess it's an added bonus that I've made good friends along the way.

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Tuesday, December 20, 2016

The parking lot outside



WHEN I was drowned in Pay Floor referrals in 2015, I used to look out the window of the fifth floor MROD call room and watch all the cars in the nearby Robinsons Manila parking lot. There were people enjoying the mall, while I was stuck in the hospital. These memories come to me so easily as I go on duty tonight.

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Sunday, December 18, 2016

Typical Provenciano dinner

MY PARENTS crave Filipino food. It's not a proper meal, for instance, if there's no rice served. We can convince Tatay to try other cuisines; he has liked Korean, Japanese, and Thai thus far. He takes photos of the things he eats. If he had grown up in the time of Instagram, his feed would be busy.  Mother, on the other hand, can't be bothered—she loves her fish and steamed/boiled vegetables—and can't tolerate beef. The smell makes her nauseous.

I went home one day from the hospital to find that they hadn't prepared anything for dinner yet; they had just flown in from Mindanao to pay a visit to Mother's doctor. The default eat-out place is Provenciano along Maginhawa Street, now home to many restaurants, its popularity as a gimmick place (do people still use that word?) having grown these past years so much so that the traffic gets congested during pay days and weekends. Thankfully it's just a few blocks away from where we live.

December 2016

December 2016

We had the pansit molo (delicious!), pinakbet, and I couldn't recall much else. We love the seafood salad drenched in acidic vinegar.

We're regulars in the place; my father is now "friends" with the headwaiter, who gives us the best seats when we're around.

Site update: Roboto as the new font



YOU'LL notice that I've switched fonts again. I'm now using Roboto, designed by Christian Robertson, made freely available at Google Fonts. From the foundry:

While some grotesks distort their letterforms to force a rigid rhythm, Roboto doesn’t compromise, allowing letters to be settled into their natural width. This makes for a more natural reading rhythm more commonly found in humanist and serif types.

Saturday, December 17, 2016

First day, Third Year

On our last Physician-on-Duty (POD) duty, Racquel Bruno—Executive Officer of the Department for 2017—and I were bogged down. Many admissions for the night, many responsibilities awaiting us, and many meetings set for the next few weeks were running through our heads. We were going to be seniors when the clock struck 12.

First Day, Third Year

But we started our first day as seniors with a hearty breakfast with our interns JB Besa (whom I’ve been calling President; he heads their batch), Paolo Torres (who had ample time showering and changing clothes), and Gelo Tampus (who also took up Molecular Biology in undergrad). Overworked, never-paid; they helped us take care of our numerous, critically ill patients at the ER. This was the least Racquel and I could do for them.

First Day, Third Year


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Sunday, December 4, 2016

Kandle

WE FOUND a new after-morning Sunday worship service spot—Kandle Café, along Mother Ignacia Street, Quezon City, a five-minute walk away from church. It opens at 11 am. We were the first customers, and the place was devoid of hipsters, noisy teenagers, or Filipino families with noisy, crying children—crowds one would do well to avoid if one desires peace, quiet, and a short nap. It goes without saying that I only had three hours of shut-eye last night. I understand the place gets jam-packed on the weekdays, so we had come at the perfect time.

After-church coffee

The internet is reliable, there are sockets all over, the tables are at about the right height: tell-tale signs that this will become a popular spot for people studying for board exams or periodical exams. Coffee shops, even restaurants, have become modern-day libraries.
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Wednesday, November 30, 2016

Press on

We in Pilgrim Men, the cell group I'm with in church, had our Christmas Party today at a restaurant in Quezon City. Kuya Jayrus, our guest speaker, spoke on Philippians 3:12-14. What a blessing to be part of this group: such godly, wise, Christ-exalting men!

Christmas Party!
Click on image to view panoramic photo in full.

Kuya Bobby and Kuya Ferdie share a light moment.

Kuyas Bobby and Ferdie

Jason, Kuya Dean, Kuya Moncie, and Kuya Ferdie look on. This was the traditional Christmas gift giving portion.

Jason, Dean, Moncie, Ferdie

Manong Ralph with his new glasses.

Manong Ralph

Ken and Jason, among the youngest in the group.

Ken and Jason

Kuya Vance, our cell group leader, gives away his stash of Biblical literature. I have been blessed to have been taught by him. His passion for the Word, his love and concern for us, his excellent punchlines—we thank God for you, Kuya!

Kuya Vance and his stash of books for giveaway

Saturday, November 26, 2016

New glasses—again

Eyeglasses

I HAD a quick trip to UP–Diliman today: lunch with Manong Ralph at Chocolate Kiss, and a visit to Nella Sarabia's optical shop at the UP Shopping Center, still my favorite eyeglasses store of all time. We were glad to see it in operation on a weekend; we usually call to make sure.
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Friday, November 25, 2016

Heart failure

Cardiology

We won—Marvyn Chan, Ces Tuazon, and I—in the Heart Failure Quiz organized by the Heart Failure Society a few days ago. Praise be to God from Whom all blessings flow. Thanks for your prayers.

Thursday, November 17, 2016

Daily prayers

Haven’t written anything here recently, so here goes. November has proven to be a very busy month. But I relish—or must force myself to relish—deadlines; only then can I get anything done. I’ve been doing quite a lot of writing, too—mostly technical things I can’t publish here.
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Tuesday, November 1, 2016

Uncertainties and challenges: my penultimate POD month

As I was wrapping up my 24-hour shift this morning, I was also ending my penultimate POD (Physician-on-Duty) month, my foray as one of Internal Medicine's ER physicians this October. And with it was the thought that in a few weeks I'll be taking on seniorship, leading one of six charity services to sound dispositions, standing at the forefront of administrative battles that happen on a daily basis.

Are we ever ready for the tasks ahead of us? I had the same dilemma when I finished my first year of residency training, knowing that the ER would be daunting. Daunting it had eventually proved to be; and at some point it almost became impossible, what with the stronger reinforcement of the admit-all policy, something that has always been there, apparently, but whose effects became more palpable this year. The hardships that came with the doubling of our usual patient load have allowed for my personal growth: my clinical eye, I like to believe, was developed; and the same could be said about my patience.

Our experiences are never enough, I suppose, to make us ready. And the feeling of self-sufficiency—that we think we can do all, that we are ready—might be a marker of immaturity and eventual unpreparedness. It is, in a sense, healthy to feel inadequate.

At the Observational Unit, while I was waiting for General Medicine (GenMed) service to finish the disposition, I had a chat with the interns. How I have loved working with a responsible, cheerful, and rowdy block! Few things can be as refreshing as reminiscing at 6 AM. I thanked them for the great work they've done. They've surely made my life easier—by facilitating the labs, by monitoring our critical patients, by even suggesting management strategies.

"Magiging masungit po ba kayo sa Guazon kapag senior na kayo?" they asked, to which I replied that terrorizing students has never been my style. On this point, I'm not too sure, because my colleagues tell me I may have gained quite a reputation among the students—they always "prioritize" Dr. Catedral's orders, considering all my orders stat until proven otherwise.

I apologized, with all my heart, for my occasional impatience at the slow return of lab results. I have been guilty of insisting that chest X-rays be done as soon as possible, and that blood cultures be followed up without fail. I have always believed that students must learn the urgency of why we do things—a negative culture might mean an earlier discharge date for a patient, and therefore, lesser chances of getting nosocomial infections.

We were all laughing that morning, the kind that emanates from knowing that another day has ended, and there was rest waiting for all of us. More challenges will be waiting for us—for them, a new rotation, the upcoming Physician Licensure Exams, their respective residency applications; for me, the month of November, and the prospect of seniorship.

But my fears and uncertainties are calmed down by the fact God will strengthen me, all of us (Philippians 4:13). What grace, indeed!

Saturday, October 29, 2016

By becoming a carpenter, Jesus has redeemed the value of work

DR. JOHN MACARTHUR made this observation: that “Jesus was a preacher for three years of His life and a carpenter for probably at least twenty.”

I paused and considered this. I imagined that Jesus must have been extremely skillful at carpentry. He must have woken up early so he could work on his deliverables. He must have been a joyful worker: pounding on his hammer, sawing a heavy lumber, and assembling blocks of wood to form a table. He must have been gracious with his customers, too. What was it like to work with him in the shop? Did he also make jokes or was he serious all the time? It fascinates me—this picture of Jesus doing manual labor. What a humble God we worship indeed. He didn’t come as a big-time scholar, or a lawyer, or a physician. He was a carpenter.

This image cuts deep into my heart.

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Wednesday, October 26, 2016

Happy 65th birthday!

Happy 65th, Tatay!

Too bad Sean wasn't around to celebrate Tatay's 65th birthday. Before we launched on our gastronomic explorations tonight, Manong prayed that God grant Tatay more birthdays to come. We asked what our father's wish is; he said "more love for Christ, more years to celebrate." Happy birthday, Tatay!

Saturday, October 22, 2016

No apraxia

A FEW days ago, I took care of a patient admitted for a four-day history of generalized weakness—at least, that was what the watcher beside him had told me. I wasn’t convinced. I spoke with another watcher, one of the extremely worried relatives, who said she only noted the weakness a day ago. Was this acute stroke? I performed a neurologic physical exam. I asked him to show me how he brushed his teeth; he slowly lifted his right hand where the IV line was inserted, and did an up-and down, back-and-forth, and circular motion, his hands clasping an imagined toothbrush. It was a good sign. I then asked him to demonstrate how he combed his hair. He refused to do it, saying, “Kalbo po ako ako. Bakit ako magsusuklay?”

May point siya.

Thursday, October 20, 2016

Then Came the Morning by The Lone Bellow

THEN CAME the Morning, performed by The Lone Bellow, is my current LSS. The hope that a new day will dawn, that all the worries of the day will disappear, that all this suffering is momentary—maybe that's the message of the song, never mind if it's about romantic love. Enjoy.


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Wednesday, October 19, 2016

Elect

I choose you

Dr. John MacArthur's preaching on the doctrine of election and predestination is a worthwhile read. It is a difficult concept to grasp: God choosing his elect even before the world had begun. Why do we, for instance, need to share the gospel when God has predetermined whom He will save? Why do we need to bother with evangelism, at all, if that were the case? And isn't it unfair of Him to not give us a chance, for him to say we will go to heaven or hell, before we have lived our time on earth? Difficult questions, indeed—I grappled with them when I was a young believer. Yet the Bible is clear about this.

Pastor John ends the preaching with this beautiful prayer. I hope it ministers to you, as it has to me:

Father, we are thrilled with this glorious truth, thrilled, stunned really that you’ve chosen us and we ask the question “why us?” Why us? We thank you, O God, for your gracious salvation and we thank you that that salvation, even though we can’t comprehend it, is open to anyone who looks to Christ and believes in him. Whosoever will may come. How you harmonize that with your sovereign election is for you to understand and not for us.

But we know Jesus weeps over those who will not come. We thank you on the one hand, for those who have not embraced Christ, may you awaken their dead souls, give sight to their blind eyes, may they see Christ irresistibly before them and run to him for salvation. We pray in his name. Amen.

Monday, October 17, 2016

The proverbial Outside

MILES away from Manila, and hardly having slept for the past 24 hours, Poring Porlas, Jerê Vallente, and I take an hour-long drive in search of the Outside World. It was providence that only brought some 15 patients to be decked to Internal Medicine at the Emergency Room last night, a far cry from the usual number of patients we attend to—about twice or thrice that number. Maybe because it was a Sunday, or maybe it was raining hard, what with typhoon Karen entering the country’s area of responsibility, forcing the ill to stay at home and wait for the sun to shine.

The coffee shop where we sit, all of us half-groggy from all the walking and window-shopping, is quiet. I’ve missed afternoons like these, when I could finish reading a book in silence, only to be surprised by the fact of the sun’s setting.

As we eat kaya toast and half-cooked eggs (“Don’t worry about Salmonella,” I tell them) in a corner, Poring makes fun of the way I assign our interns their tasks; he mimics my serious, stern, tone and wonders why, of all of us, our interns follow my orders first before theirs.
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Sunday, October 16, 2016

Wedding in Cebu

Cebu Mactan Bridge

I FLEW to Cebu last Saturday to attend Leeca—Lee-ann to many—Caro’s wedding. She finally married Matt Chang, her internship block mate who left her heart defenseless against romantic love. I didn’t stay too long—maybe just five or seven hours, some of it at the airport—but I was, and still am, glad that my friend (who occasionally reads this blog) is now happily married. May God grant them a fulfilling, lasting, and fruitful marriage.

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Saturday, October 15, 2016

Longer—yes, change has come

I HAD never seen Kuya Vio, my barber of seven years, so excited. From the glass pane, I saw him about to doze off on his barber chair. The shop was extraordinarily quiet, and save for the Indian man getting a massage, there weren’t any other customers. It was a rainy Saturday afternoon, the kind that made one think of pajamas and dark rooms and hot coco and study lamps and good books and feet curled up in bed.

“Bagay na bagay ang buhok mo sa ‘yo, Dok,” he said, literally jumping out of his chair when I had opened the door, my arrival signaled by the obtrusive jingling of metallic rods hanging over me.

“So okay nga ang mahaba sa akin,” I said.

“Oo naman! Mas bagay ‘yan dun sa semikal.”

“Talaga lang ah.”

“Mas mukha kang doktor,” he said proudly.

I had seen only him four weeks ago, then many weeks before that. It was only months ago when I had decided, after my friends’ prodding, to finally grow my hair. I was convinced that it was probably time I’d change something. My brothers have outgrown the semikal hairstyle since many years ago—Manong Ralph, when he had gone to college in 2002; Sean, when he got to high school at about the same time. I was what you would call stuck.

When we were growing up in Koronadal, Tatay would bring me and my brothers together—a so-called haircutting day that happened monthly—and we’d go to wherever Pastor Ray would be working. During those years, he’d transfer from one shop to another. He has seen us grow up and old, and since we have moved to Manila to study and eventually work, he would ask Tatay about our whereabouts. He was, as far as I knew, pastoring a local church in another town but had to support himself and his growing family financially. A clean cut was what my father was gunning for—he didn’t want his sons looking like “addicts.” Eventually, my father did grow his hair—it made him look younger—leaving me with the shortest haircut in the family.

During the transition from semikal to what it is now—a barbers cut with a straight hairline, my hair combed to my right—I had to get used to the fact that whenever I scratched my head, I had to arrange my hair back to what it had looked like. I had to learn new things, as well: combing my hair in the morning before I’d leave for work, even using hair products to keep my strands in place; or getting used to looking at the mirror to check if I look harassed; or learning the value of holding on to my head whenever the wind blew. The term, “bad hair day,” had now taken a new meaning.

Friends always exclaim with surprise at how different I now look and how well the new hairstyle fits me. I have difficulty reacting to those statements—until now, my hair hasn’t gotten any attention, save for some classmates who used to rub my head with their palms during lectures.

I’m writing this to tell you: change has come. I just hope that like my hair, my faith in and love for the Lord, too, would grow.

What’s a good shampoo? And how much conditioner do I need to apply?

New hair

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Tuesday, October 11, 2016

What I should've written in my residency admissions essay

DAVID Remnick's profile of the writer-singer Leonard Cohen is an enjoyable read. Cohen said he had wanted to be a writer:

“raincoated, battered hat pulled low above intense eyes, a history of injustice in his heart, a face too noble for revenge, walking the night along some wet boulevard, followed by the sympathy of countless audiences . . . loved by two or three beautiful women who could never have him.”

Read the rest of the article here.

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Tuesday, October 4, 2016

With trembling voices

THREE pre-residents1 came to the call room yesterday. They introduced themselves with trembling voices. One used to be our intern. The other two were from other prominent schools. They were to go on duty with my team. They seemed intimidated, as pre-residents usually are, considering that they find themselves in a rather precarious, awkward position—halfway between being an intern and an actual resident physician. I don’t blame them.

About a year and a half ago, I remember waking up at 2 AM every morning to catch an early cab ride, so I could arrive at 3 AM and finish charting all my assigned ward patients before my residents even saw the light of day. The goal of pre-residency was to impress, to show off, to demonstrate that I was better than the rest of them—and therefore I could survive residency. It was extremely competitive. Those were never my goals, however. I felt, at the time, that I just needed to be myself: if they didn’t like me enough, then it was probably for my own good that I shouldn’t get into the prestigious UP-PGH Internal Medicine training program.
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Sunday, September 25, 2016

First time: MICU Senior

I was the Medical Intensive Care Unit senior last night. No biggie for those who’ve been there, done that. But there's something exciting and frightening about experiencing New Things or Things Never Tried Before. Last night wasn’t quite the exception. It’s the idea that things always change—for better or worse—that prevents us from stagnating. The attitude we employ must be that of welcoming the changes and learning from them. I got a few hours of shut-eye last night. My phone was beside me all the time, and I was waiting for it to ring, for a nurse or panicking intern tell me, “Sir, may code po.” Praise be to God for guiding me through the number of referrals I’ve seen. I realize, as I write this, that I’m more than halfway through residency training in this bright, beautiful, sometimes depressing, world of Internal Medicine. I’m grateful that I am where I am, and that I’m doing what I love.

Another post about C. S. Lewis

Photo Credit: http://www.nytimes.com/2016/09/25/opinion/sunday/the-political-magic-of-cs-lewis.html?_r=0

PHOTOS of old people make me really happy. They fascinate me, like babies do. Maybe even more than babies. I like keeping old friends in my life. It's not a secret I want to look like C. S. Lewis when I grow old: that hearty chuckle, gentleness, and faith. And maybe that double-chin, too—give or take.

I found this charming collage in The New York Times Opinion page, in an article written by Peter Wehner.

C. S. Lewis was a great thinker—his Christian worldview is pervasive in church circles, even to this day. He spoke about many things but hardly meddled with politics and government. And understandably so. He believed in the separation of church and state. He believed, in a sense, that the goal of Christianity is not to reform government but to proclaim Christ and Him crucified.
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Sunday, September 18, 2016

Books read in recent memory



Cathedral by Raymond Carver. Short, short stories about very American people and their problems. I admit to choosing this book because the title resembles my family name.
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Friday, September 16, 2016

Compelled

For the love of Christ compels us, because we are convinced that one died for all, and therefore all died.—2 Corinthians 5:14

IN THE WEE hours of the morning, as soon as I wake up, I launch into a philosophical exploration of sorts. Why do I do what I do? Am I where I should be? Is it the Lord’s will for me to be a doctor? It’s amusing: I’ve had my PRC license for a year and half now, but I still wonder if I should be a physician at all. Do you find yourself asking these questions, too?1

But I am where I am and where I should be. And I trust in the comfort of God’s promises that all things work out for my good and His glory (Romans 8:28). I am thankful for the calling—this vocation of saving lives—that He has led me to.
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Monday, September 12, 2016

Sweaty palms on bare metal

MY PALMAR HYPERHIDROSIS—sweaty palms, something I’ve had since kindergarten—has gotten worse. I’m not alone in this; apparently, I share this with more or less 2.9% of the US population1.

This afternoon I bought a transparent matte case for my laptop. The feel of sweaty palms on bare metal is too much for me to handle—too gritty, too uncomfortable. So goodbye to my well-loved, overused laptop sleeve for now. My palms are funny: if they’re not sweating, they’re peeling. Ah, they have lives of their own.



  1. Stratton et al. J Am Acad Dermatol. 2004;51(2):241. We don’t have local data on this condition. ↩︎

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Sunday, September 11, 2016

The professional food critic

Post-orals lunch at Café Ilang-Ilang, Manila Hotel

THE New Yorker’s profile of Pete Wells, The New York Times restaurant critic, is fascinating.

The front of the room was bare and bright, and filled with thirty-year-olds on backless stools at communal pale-wood tables—a picnic held in a cell-phone store. The noise level reminded me of Wells’s review of a Tex-Mex restaurant: “It always sounds as if somebody were telling a woman at the far end of the table that he had just found $1,000 under the menu, and the woman were shouting back that Ryan Gosling had just texted and he’s coming to the restaurant in, like, five minutes!” Wells is not peevish about discomfort. His columns make a subtle study of what counts as fun in middle age—loyalties divided between abandon and an early night. His expressions of enthusiasm often take the form of wariness swept away: Wells found joy in a conga line at Señor Frog’s, in Times Square. But after dining at Momofuku Nishi he returned to his home, in Brooklyn, and wrote in his notes about “a hurricane of noise.”

Being a restaurant critic is one of my dream jobs and is in the category of: “being a writer for The National Geographic” or “being a book critic for The New York Times” or “working in Shinya Yamakana’s stem cell laboratory.”
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Sunday, September 4, 2016

Under-shepherds

“For you remember, brothers, our labor and toil: we worked night and day, that we might not be a burden to any of you, while we proclaimed to you the gospel of God. You are witnesses, and God also, how holy and righteous and blameless was our conduct toward you believers. For you know how, like a father with his children, we exhorted each one of you and encouraged you and changed you to walk in a manner worthy of God, who calls you into his own kingdom and glory.”—1 Thessalonians 2:9–12

ON THIS SUNDAY morning, I thank my pastors and Bible study leaders in my local church, men who preach the gospel day in and out, in season and out of season, regardless of how many there are of us who listen. I thank these men who toil daily, searching and understanding scriptures to equip us to be God-fearing church members. Theirs is a difficult job and calling, and one that doesn’t start at 5 and end at 8. They labor to strengthen our souls, to lead us to maturity, and to leads us to see the beauty and majesty of Christ. Let's thank the Lord for them, and to pray that God strengthen them and their families, and provide for their needs.

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Saturday, September 3, 2016

Not pressured enough

JUST as I’m about to embark on a study spree—which includes hours of poring over my notes, occasional note-taking by hand, and intermittent sipping of brewed coffee—my father, a gracious man who’s turning 65 this October, drags me to the cinema.
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Thursday, August 25, 2016

The end of the day

Going home

THERE'S something about this photo that makes me sad and tired and comforted—a typical scene of Pedro Gil Street that one encounters after long, tiring moments at the hospital, a reminder that the day is almost over, and one can retire to one’s bed and read a good book or maybe have dinner with friends or go to church for Bible study. Every day ends, and regardless of how long it is, it comes to a full stop at some point.

Wednesday, August 24, 2016

Displaced: Outtakes from the AVR

THE SMELL of something burning brought us all out of the Second Year Call Room. I think it was a Thursday, and I was sleeping inside my dorm room when I got the text pass: vacate the call room now. It was later traced to a defective electrical wiring inside the bathroom. The Call Room has been declared a fire hazard.

Since the weekend we've been sleeping, rather comfortably, like refugees at the AVR Conference Room, where Mang Dan made a homey place for us to lounge around as we wait for the next referral.
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Sunday, August 21, 2016

The case of the missing C

Buti na lang, hindi "No Parcking."

Taken near the PGH ER Kiosk, home of the affordable and delicious artery-clogging bacon, the object of desire of many of our breakfasts. Best heated in the callroom microwave for 2-3 minutes.

It's a relief that the sign doesn't read "No Parcking."

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Jason in the house!

Jason in the house

JASON Enriquez, my college roommate in Kalayaan Hall, still looks the same after all these years—save for the fact that he now sports more subcutaneous fat, his hair peppered with white strands of hair, his orbits barricaded by metallic frames that look comfortable on his face.

“Nearsightedness,” he told me. “Laging nasa harap ng computer.”

His fourth finger now bears a minimalist silver ring.

“How does being married feel like?” I asked.

“Masaya,” he said in perfect Tagalog.

He has been married for at least two years now, a ceremony I had missed because I was in the hospital, attending to my patients—a tragedy I have repeatedly come to accept. It wasn’t the only time something like it had happened.

I met Jason two nights ago, at 9 PM—a time of the day that, after all these years, he still remembers as the beginning of my descent into sleepiness. It was the only common time we had for his brief foray in Manila: a business trip in between which he planned to squeeze meeting family and friends before he goes back to Kyoto with his wife.
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Wednesday, August 17, 2016

Rainy nights

The IM coffee shop lifestyle.

ON RAINY nights such as the ones we’ve had for the past days, I wish I were curled up in bed, reading a good book, the blues playing in the background1. But routines are meant to be disrupted, especially with well-meaning, insistent friends.

True enough. A few days ago, friends from work insisted that we study elsewhere. The weather was perfect for walking—the winds were just beginning to howl, the clouds were starting to pile up on top of Manila Bay, the way crowds in concerts do before any singing happens. I wasn’t too tired, so I gave in.
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Tuesday, August 16, 2016

Sample post from Ulysses

Hello there1. This seems like a vital issue that needs to be addressed immediately.
  1. What is your problem, anyway? ↩︎

Friday, August 12, 2016

Redesigned with Bitter(ness)

Bitter, font by Huerta Tipográfica

YOU'LL notice that I've switched fonts. From Helvetica Neue, which I have enjoyed immensely, given its neat, modernistic feel; I've moved on to Bitter, developed by Huerta Typogràfica, an Argentinian foundry. I discovered it through Google Fonts. The site bears a tutorial on embedding the code to one's CSS. The transition took me less than 15 minutes.

I like how reminiscent it is of Caecilia, the font used in Kindle. Bitter is a beautiful slab serif-typeface. It looks contemporary but also academic, and isn't distracting at all. I hope it adds pleasure to your online reading experience here, assuming you haven't realized that you may have wasted your time.

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A surplus of water

rain

WE HAVE too much water in this country—a fact I’ve come to terms with after three days of almost-incessant rain in Manila. It’s something we forget: we have easy access to water, unlike, say, our friends in Syria or Ethiopia for whom water is, literally, life-giving.

Israel has just opened a new desalination plant, “the largest reverse-osmosis desal[ination] facility in the world and we are staring at Israel’s salvation. Just a few years ago, in the depths of its worst drought in at least 900 years, Israel was running out of water. Now it has a surplus. That remarkable turnaround was accomplished through national campaigns to conserve and reuse Israel’s meager water resources, but the biggest impact came from a new wave of desalination plants.”
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Wednesday, August 10, 2016

Miracles

CS Lewis's Miracles is my bedside reading material.

MY BEDSIDE reading material is C. S. Lewis's Miracles, a short, albeit meaningful book about whether miracles are possible in the world. It's not a very easy, breezy book to read, but C. S. Lewis makes very strong arguments, dividing the world's thinkers into Naturalists and Supernaturalists. I admire his restraint and economy of words. I admire, too, the depth of his thinking, which, on the surface, seem simple but are actually profound. His analogies are funny, witty, and accessible.
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What I woke up to

OPD
View of the OPD Building.

Silver

I WOKE up to news of Hidilyn Diaz winning the country’s first silver Olympic medal after a 20-year drought. The sport is weightlifting, where she competed in the 53-kg division. She thanked God after her win. I had goosebumps. Onward, Hidilyn!

This is yet another proof that we need to focus our efforts on less popular sports, as opposed to basketball, our nation’s favorite past time. We’ve never really excelled in the sports arena—a combination of our natural physique that renders us at a disadvantage compared to our taller, bigger Caucasian counterparts; or our lack of resources for training because sports never gets the government funding it deserves; or perhaps we compete in the wrong sports events—but we’ve always been good at the arts and beauty pageants and Math quiz bees. I don’t know what my point is.
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Saturday, August 6, 2016

Broken down

Ambulance conduction

On the latter half of my Neurology rotation, all of the hospital's CT scan machines have broken down. They have all snapped after months of being overworked, their scheduled maintenance procedures interrupted by serious pleas of oily residents handling many patients at the brink of death: bleeding brains, complicated abdominal masses, and you know what. It couldn't have been more timely.

This breaking down of the machines could have been a metaphor for what I was going through at the time; I wasn't a machine, though, but I wondered how it would have felt to have a clone—there were so many things to be done. My rotation made me appreciate my friends who are training in Neurology: they must really love what they do to be able to do it excellently day in and out.
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Sunday, July 24, 2016

Yet another proof that I have a social life—ah, the gift of friends!

Sunset at Roxas Boulevard, Manila

I'M GLAD I have good friends where I work. While I generally prefer solitude after a long day, I do make time to meet up with them after, as if we need catching up at all.
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Saturday, July 16, 2016

The weekend

Studying

I


I bumped into an old friend at the hospital today. He reminded me I hadn’t posted anything here lately. I told Dalvie—a classmate now affiliated with the Doctors to the Barrios program of the Department of Health—that there are moments when I’m too physically exhausted to even open my computer.
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Saturday, June 25, 2016

Leave 2016: Southern Philippines

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PART OF ENJOYING one’s travels is retrospection, when one recounts the things that have happened, the places visited—a process made easier by the advent of camera phones and social media[1].

On this long weekend (yesterday was Araw ng Maynila—ah, Forward Ever, Backward Never![2]), I shall indulge myself in this exercise because I haven’t written much about the second half of my break, which I spent with family and friends in Koronadal, the place I still consider home.
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Friday, June 24, 2016

Why I no longer write as often

the thought

— THESE days I struggle with the lack of things to write about. Five years ago, I could turn the mundane into a decent blog post, complete with photos and quotes and links to random websites. Now that the world has changed, and the divide between the public and private has almost disintegrated, I tend to overthink. Will the things I write about merely contribute to the junk that’s already out there in the open? Do people really need to know this about me? While this is a private space, and only friends and a few strangers know of this website (the plan is to keep it this way), I still entertain the possibility that I might be wasting time—mine and those of my readers.
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ICC painters

AFTER MY MORNING coffee at my favorite diner, I spotted construction workers on my way back to the hospital. ICC painters! Must they be referred to Infectious Disease now?

ICC painter

The men spotted me taking a photo of them. I was, after all, in the middle of the street. They did awkward poses, while looking at my phone. “Pre, makikita na tayo sa YouTube nito.”

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Sunday, June 19, 2016

Fatherless

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Sean and Tatay share a light moment. 

I CAN write about my father all day.

He has been with me since the day I was born. He cooked me breakfasts and made me swallow everything on my plate—never mind the fact that I was full and already 10 minutes late for my first class. He reprimanded me for staying up late on Saturday evening and for taking so much time sleeping on Sunday morning. He has never been late for church. He is the most charming, humorous man I know. And I thank the Lord every day for him, my Tatay, whose body habitus I inherited.

But I know some friends didn't grow up with fathers. A few of them harbor hatred, indifference, or contempt for their fathers. Most of them miss their fathers even years after they had passed on.

Despite these, the Bible says we have a Father in heaven, Someone greater and better than the best fathers on earth.

"Behold what great love the Father has lavished on us, that we should be called children of God! And that is what we are! The reason the world does not know us is that it did not know him. Dear friends, now we are children of God, and what we will be has not yet been made known. But we know that when Christ appears,we shall be like him, for we shall see him as he is. All who have this hope in him purify themselves, just as he is pure," says 1 John 3:1–3.

Pastor Scotty Smith's prayer for Father's Day is worth reading.

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Thursday, June 16, 2016

Rest

fishing

That God has allowed me to enjoy the past two weeks is something I thank Him for. The theology of rest is that as God has rested on the seventh day of Creation, so should we—we of finite and limited strength and abilities. We can only go so far in our work if we do not give our bodies enough leeway to recuperate, our cells to regenerate, our sleep to take flight.

Yet there is a kind of rest that only God's children—His elect, His chosen ones—can enjoy. It is the rest of the soul after striving to earn its salvation and desperately failing to do so. It is, as Saint Augustine has written, the ultimate rest of the restless soul. After it has tasted this world and its promised rewards, the soul yearns for peace, healing, and assurance. Above all, the soul yearns for God Himself, whose very Person transcends yet embodies the very things He provides. For hasn't He promised that He will give rest to those who are heavily laden?

Have you experienced this rest?

Saturday, June 11, 2016

Dogs

I'M NOT the biggest fan of dogs, but I like watching them. There's a reason why they're called man's best friend.

— At Stanley Beach, where they were in a sort of courtship.

dog at stanley beach

— At the Stanley Market, where one dog looked too indifferent and tired—just the way I happen to like dogs best.

dog

— At the Po Lin Monastery, where they kept guard.

Standing on guard

I was surprised to know that Benjamin, our spitz, still recognizes me despite my two-year absence from home. He looks so grown up now, but is still extremely movable and hysterical.

Thursday, June 9, 2016

Hong Kong 2016

like in a film

AS WITH most of my trips before, my going to Hong Kong was largely unplanned. I originally wanted to go to Vietnam to get a feel of what I was reading (The Sympathizers by Vien Thanh Nguyen), a book set in the 1970s during the US war with the Viet Cong. It was a toss up between Hanoi and Ho Chi Minh. But three weeks before my scheduled leave, it was already too late to score cheap flights. My brother, always the optimistic planner when I felt I had nowhere else to go to, figured we could go to Hong Kong—it's not too far away, it's not expensive, and it's convenient.
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Friday, June 3, 2016

Case presentation—done

30 minutes before case presentation

FINALLY. I'm done with my case presentation. The Training Committee requires that each trainee present at least one case for an audit. I was never picked to present a medical audit, so I was given an option to present an interesting case of my own choosing in exchange. Originally slated in May this year, it has been bumped off from the Department's calendar many times already. I didn't mind that I had to go back to the hospital on the second day of my mandatory two-week vacation leave. I just wanted to get it over with.
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Monday, May 30, 2016

Nanay and Tatay, at 32

MY parents celebrate their 32nd year of marriage today. I can’t imagine growing up without them. I haven’t seen two people more in love.
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Sunday, May 29, 2016

Hello from the other side

AS ONE of the resident monitors for Learning Unit V (also known as med school's Third Year), I had the job of helping to oversee the OSCE—a battery of exams composed of eight or ten stations where students are expected to do physical exams for various organ systems, write clinical impressions, and do so with the flair of having practiced the routines for ten years. Each station was manned by a different department; Internal Medicine had two stations, which I took part in.
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Friday, May 27, 2016

Subic na Subic lumayo

IT WAS as if nobody cared. Nobody—except for a few people who had the patience to read the intermittent barrage of group SMS's—really knew where we were going. "Sa Batangas?"

"Hindi, sa Subic daw."

"Akala ko sa Bohol."

The date was sealed nevertheless—we were going out of town, somewhere far from the city, with the hope of being able to catch up on sleep as well as with each other. As if, given the daily hilarious lunchtime conversations we have at the callroom, we needed catching up at all.

But sleep we did. Inside the coaster, driven by an old, gracious man who was too careful that we should not figure into any accident, we were lulled to sleep. What were we dreaming of? Definitely not the last minute SAPOD referral for a fake emergency case, or the mechanically ventilated patient at the ICU whose diagnosis we weren't too sure of. Maybe we were thinking of the beach and the sand and what awaited us after the road trip.

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