Monday, August 28, 2017


L’Avenir (translated, “Things to Come”)

2016, directed by Mia Hansen-Løve

A philosophy professor divorces her husband, re-acquaints with her favorite student, and starts a new life during these transitions.

The French fascinate me in that they can be so detached and emotional at the same time, like the scene when Nathalie Chazeaux (Isabelle Huppert) learns of her husband’s infidelity. “I thought you’ve loved me forever,” Nathalie says to him, then she gets back to her classroom as if nothing had happened. No caterwauling, no slapping of the face—the suffering is subdued, hidden, and repressed. She takes time off to join her former student, now a courageous political writer, in the countryside. She sends her bipolar mother to a nursing home, as if to emphasize that the old has gone, the new has come. She brings her charming cat, Pandora, with her.

One can wish for better life for her as she starts anew.

Rating: 3.25/5


2016, directed by Paul Verhoeven

I don’t know what to make of the film exactly: a successful video game designer/entrepreneur (Isabelle Huppert—yes, yes, I’m a fan) gets raped by a man in mask. She learns that the rapist is her neighbor, and that the rape is a sexual acting out of sorts. Is it about women empowerment? Is it about sexual abuse? I honestly don’t know.

The film is much too graphic to recommend, but it serves as a reminder that beneath the mask of decent jobs and successful lives lies many dark secrets, many desires pent up, seeking escape.

Rating: 3/5

Les Femmes du 6ème étage (translated, “The Women on the 6th Floor”)

2010, directed by Philippe Le Guay

How I enjoyed this film! Monsieur Joubert (Fabrice Luchini), a successful stockbroker, lives on the 5th floor of an old but charming Paris apartment. On the 6th floor live the Spanish maids—rambunctious, guitar-playing middle-aged women, each with emotional and financial baggage of their own. Their living conditions couldn’t be more different. (They’re a lot like the Filipino domestic helpers in Hong Kong, off to another country to earn more so they can support their family.)

When Monsieur Joubert’s old maid resigns, Maria (Natalia Verbeke) is hired. She gets the job because she’s able to prepare the perfect eggs for breakfast—something that can make or break Monsieur Joubert’s day. Maria introduces her boss to the Spanish contingent upstairs. He learns that they don’t have washbasins, their rooms are too small, the plumbing is atrocious. Monsieur Joubert becomes their advocate, offering them his telephone so they can contact their family in Spain, joining them during Mass (a fact that the made-up French ladies find amusing), and bringing them to the countryside for an outing.

A story of love, family, and friendship, this film really made me happy.

Rating: 4.2/5

L'Arnacœur (translated, “Heartbreaker)

2010, directed by Pascal Chaumeil

Funny, but I can’t get over the diastema of the leading lady.

Rating: 2.75/5

My writing of these mema-reviews of French films has been inspired by Nico Pajes and Pao Cerrado, internists who double as fine cineastes. They should start their own blogs.

Mema is the truncated form of "May masabi lang."


Sunday, August 27, 2017

My brother's culinary pursuits


My brother has gotten into cooking, and I'm just happy to tag along with and encourage his culinary pursuits. How cutting up vegetables or waiting for the water to boil relaxes him escapes me. My participation is in the eating and washing of dishes. For dinner he prepared a salad, sprinkled with lemon, slices of kesong puti and fresh avocado. The highlight was the salmon—so properly cooked, moist in the inside, a bit crispy on the edges, with the meat oozing with flavor in every bite. "It's also low salt," he told me as he poured me a half glass of Chilean merlot. He has read the review article on healthy diets I had emailed him.

On some days he cooks me lassoir laswa, an Ilonggo dish of assorted boiled vegetables that reminds me of home. When it rains he cooks me pochero. We have the occasional fried meat, but this is more the exception than the rule—we eat it when we eat out. During breakfast he leaves me food in the fridge to microwave, knowing I am clueless and therefore useless in the kitchen.

After work or during the weekends, he takes me with him to the grocery, where he picks the meat, onions, kangkong, or whatever it is he imagines the dishes will be. The perishable goods section has become our new hangout place, the starting point for my Manong's unpretentious cooking.

Sticking our necks out

It's a little less than a week before I bid farewell to the wards. I've rotated at the charity wards for three straight months (Ward in June, Medical ICU in July, and Ward again this August). No third year rotation has given me more fulfillment than being a Gen Med senior

This month has been extra-special because I was mentored by our service consultant, Dr. Ester Penserga, whom I've looked up to—even as a medical student—for her wisdom, intellectual rigor, compassion, and the fact that, whenever she asks us questions and we can't answer her properly, she gives us negative million points, effectively rendering us bankrupt in her mental account of disappointments if these were tallied.

But Ma'am Pen carries on with grace (and it's not such a coincidence that her daughter, my friend and colleague in IM, is named Grace), patiently reminding us to act as internists first of all and not as subspecialists, ensuring that we don't miss out on nutrition, that we compute for the ideal body weight and BMI, that we measure the abdominal girth in centimeters, that we do the math for the fluid requirements of a patient to the very last drop (25 mL/kg of ideal body weight in 24 hours, as a starting point)—things often forgotten or ignored by the busy medical resident but things that impact medical care. Her attention to detail keeps us all in check. She refuses to "frame" a patient based on the presence of co-morbidities and reminds us to keep an open mind and not be "swayed" by the obvious—we could be dealing with another disease entity entirely. She is not impressed with sheer eloquence, piercing through the veneer of pretensions and rushed endorsements, but she pauses, like a metronome, and probes deeply into the details, reminding us, "History! History! History!" because the patient's story is key to his cure. Her motherly queries usually worded as "Sure ka, ha?" makes us question our memory. Her presence in the room gives us a healthy kind of insecurity.
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Saturday, August 26, 2017

Hello, too!

I'm honored to have worked with these brilliant, wise, and young colleagues during my rotation as General Medicine senior. Thanks for this, Greco, Nico, Josh, and Inah. (Harold is missing.) Greco taught me compassion, Nico speed and focus, Josh humility, Harold determination, and Inah fortitude. To me, they're no longer kids but respected colleagues who, in a few years, will make fine internists, saving lives one patient at a time.

Friday, August 25, 2017

His eye is on the sparrow

I derive much encouragement from John Calvin.

For this reason, Christ, after having asserted that not the meanest sparrow falls to the ground without the will of the Father, immediately makes the following application—that the more we exceed the value of sparrows, the greater care we should consider God as exercising over us; and he carries this to such an extent, that we may be confident that the hairs of our head are numbered. What more can we desire for ourselves, if not a single hair can fall from our head, but according to his will? I speak not exclusively of the human race; but since God has chosen the Church for his habitation, there is no doubt but he particularly displays his paternal care in the government of it.—Chapter XVII, The Intitutes of the Christian Religion, Volume I. 

Tuesday, August 22, 2017





Friday, August 18, 2017

Paradox Uganda

Once in a while I visit old blogs to catch up on my favorite online writers and personalities, many of them I haven't met but whose works have made me glad or deepened my passion for the things I do or should do—a habit I haven't gotten over, what with the fact that blogging is probably dead, or so most people think. (It's not.) One of these websites is Paradox Uganda, written by missionary doctors Scott and Jennifer Mhyre, whose love for the Lord has brought them to the unreached places in the world.

Here's a story that hits close to home, something I experience regularly: dealing with a patient who requires surgery for an infection that's hard to treat. Years before, we had to shell out our own money to get the much-needed antibiotics (yes, including meropenem, as in the story) immediately so that the patient didn't succumb to septic shock.

At Naivasha District Hospital, we don’t have the benefit of microbiologic cultures, so we could not culture any of the fluids or pus. We had no way of knowing what bacteria was causing this infection or which antibiotic would best fight the infection. But shortly before this event, Jennifer had sent a baby to Kijabe Hospital who was critically ill and beyond our capacity. They did blood cultures which grew a bacteria (Klebsiella) resistant to all but two antibiotics. Based on that culture result, we began to wonder if Mary could have been infected with this resistant Klebsiella (there is a lot of traffic between the Post-Op Ward and the Newborn Unit). At this point, I began to doubt whether Mary might survive. She was critically ill. She should have been in an ICU, but that was beyond our capacity and her financial resources. And our hospital didn’t even have either of the ideal antibiotics to fight the Klebsiella. So, I decided to go to an outside pharmacy and purchased the Meropenem out of our own pocket. That pocket is not really my own. We live and work in Kenya as the hands and feet of many generous churches and donors. From their generous support, I was able to buy a full ten days’ worth of Meropenem at a cost of about $500 (which is about 9 months’ salary for the average person in our area).

I love how the narrative ends. What a truly Christian response! Let's support and pray for the Mhyres and the wonderful work that they do!

It’s a tale of prayer and perseverance. I don’t think we can necessarily step up with these resources in every complicated case, but God put Mary in my path and seemed to call us to action. So thankful today for her great smile and her life.

Soli Deo Gloria.


Tuesday, August 15, 2017

To kill . . . never!

Credo of Oncology

Roger Velasco, you can be our graduation speaker!

Needless to say, it should've read, "To Cure Sometimes, to Relieve Often, to Comfort Always."

Harrison's Principles of Internal Medicine, 19th Ed, Chapter 99, says, "A credo for oncology could be to cure sometimes, to extend life often, and to comfort always."

Monday, August 14, 2017

We always have time

From Dr. Al Mohler:

David McCullough once told of Teddy Roosevelt during his time in the Dakota Territory and before his arrival on the world scene. Two thieves who had been on something of a crime spree in the territory had stolen Roosevelt’s rowboat, and he was determined to chase them down and arrest them. He chased the thieves for 40 miles of rough landscape, through deep snow and in constant danger of attack, and indeed brought them to justice. McCullough then tells the reader: “But what makes it especially memorable is that during that time, he managed to read all of Anna Karenina. I often think of that when I hear people say they haven’t time to read.”


Sunday, August 13, 2017

Internal change

Inspired by Austin Kleon's Newspaper Blackout Poems, taken from the chapter on Iron Deficiency and Other Hypoproliferative Anemias of Harrison's Principles of Internal Medicine, 19th ed.

This is inspired by Austin Kleon's Newspaper Blackout Poems. The page is taken from the chapter on Iron Deficiency and Other Hypoproliferative Anemias of Harrison's Principles of Internal Medicine, 19th ed. I do love his work.

Saturday, August 12, 2017

John Ames

John Ames

My Kindle Paperwhite, has arrived.

I don’t fancy liturgy, but with my books and reading devices I take a peculiar distinction. What books do I upload in the Kindle cloud and sync with my device? What books should I read first?

I decided on the following:

— Marilynne Robinson’s Gilead, a letter of a 70-year old pastor from a small town in rural America, to his seven-year old son. I always treat Ms. Robinson’s works—Homecoming, Gilead, Lila—with a kind of sacrosanct awe. Her prose is topnotch. Relevant things happen that remain unwritten, a bit hidden from the narrative, which makes the imagination run wild. There’s a certain kind of peace and stillness to her fiction, as well, as if one can hear cicadas in the background as Reverend John Ames, after whom I’ve named my Kindle, settles himself in his chair to relieve his anginal pains. This is the second time I’ve read Gilead, but my appreciation for it has more than doubled. Maturity, or so I hope, gives a person a wider, deeper understanding of things—like grace, hope, kindness, and forgiveness.

— John Calvin’s The Institutes of the Christian Religion Volume I, a masterpiece of theological writing, penned by one of the forerunners of the Reformation, whose 500th anniversary we’re celebrating this year. Calvin was an exceptionally gifted, intelligent man; he was only around my age when he had written the Institutes—a voluminous work that reflects his lofty view of the Word of God and his passion for the Lord’s glory.

— Lauren Collins’s When In French, an American woman’s journey into the study and application of French, an inevitable chore she needed to do partly out of duty (she and her French-speaking husband Olivier have moved to Geneva, Switzerland) and out of love, in a sense, so she could understand and get to know her husband more. I’m self-studying French myself, just for the fun of it, to kill time, as if I have any to butcher.

— Tim Challies’s Do More Better, a guide to productivity, centered on the goal of glorifying God by doing good in whatever we do. Published by Cruciform Press, it’s a short book that will benefit anyone who struggles with procrastination, busyness, and unproductivity. I look to Tim Challies for his efficiency and wisdom. I visit his blog daily and have taken many of his recommendations on which apps to use (Ulysses, for distraction-free writing; Kindle, for reading; Evernote, for note-taking; and many more).

— Life Stories: Profiles from The New Yorker, edited by David Remnick, a collection of the best profiles published in one of the world’s best magazines written in English.

What I Talk About When I Talk About Running by Haruki Murakami. I haven’t taken on running yet, but the title seems so interesting. Many colleagues from the hospital run along Roxas Boulevard—why they do this, apart from the cardiovascular benefits derived from physical activity, remains a mystery to me.

I carry John Ames anywhere now. Its battery lasts for four to six weeks without charging. It’s lighter than my phone. I adore the screen, whether I read it in broad daylight or in between my sheets at night, because it does not have the glare of my iPad but feels a bit like paper itself. I’ve become more active in Goodreads, which is a friendly community for readers, to which I’ve linked the Kindle account so I can keep track of my reading habits.

I showed it to friends from work.

“Where’s Harrisons*?”

“It’s not here,” I said, partly because the Kindle is not optimized for reading PDFs, partly because I want John Ames to be my repository of non-academic reading.

*Harrison’s Principles of Internal Medicine—our textbook in residency.

Many thanks to Hannah for getting this for me!


Monday, August 7, 2017

In a sea of surgeons

I was in Hong Kong for four days to present a paper at an Asia-Pacific Urology conference, making me and Jay Magbojos the only internists in a sea of surgeons. We took some time off to explore Hong Kong, this trip being my second time—never mind the fact that I still can't figure out the locals' English accent, if they care to speak English at all.

Vintage posters of Mao and other Chinese ladies line the streets near the Sheung Wan MTR. We figured this out because my friend and elementary-college schoolmate Trisha Moustafa, now based in Hong Kong, took us around her favorite city spots on our last day.

Mao and other Chinese ladies

Colorful murals make the buildings look Instagrammable.

Sheung Wan

The trip won't be complete without trips to the night markets, this one near the Jordan MTR. I don't enjoy shopping, but I like sampling street food in the area. I'm a huge fan of sugarcane juice, usually sold here for 30 HK dollars.

Yau Tsim Mong, near Jordan MTR

We also visited the Hong Kong Museum of History, where we visited the exhibition, "The Hong Kong Story."

Chinese opera

I'm quite tired from the trip, but I was refreshed, what with the extremely efficient public transportation system, the first world comforts of working elevators, the Chinese efficiency often mistaken for rudeness. More photos to come.

Also read Hong Kong 2016.

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