Wednesday, February 21, 2018


To post or not to post

Jon Bloom writes:

Christians should be the most careful speakers in the world. We ought to be characterized by two kinds of trembling when it comes to words: we should tremble at the words God speaks and we should tremble at the words we speak.

I'm rebuked by this:

There really is a time to keep silent. And that time comes more often than most of us are conditioned to think.

We live in an age of unceasing talk. Never in human history has the noise of human communication been so constant. Even when we are quiet we are not silent, as we receive and dispense talk through our digital media. Our culture does not believe that “a fool multiplies words” (Ecclesiastes 10:14).

Then, he strikes a balance.

But Christians must not always keep silence. There is a time to speak and there are things we must say. Our God is a speaking God and we know he most definitely wants us to speak (Matthew 24:14; 28:19–20).

But when God speaks, he speaks very intentionally and, considering his omniscience, he speaks with tremendous restraint. And that’s the way he wants us to speak, as his exceedingly non-omniscient children and ambassadors (2 Corinthians 5:20): intentionally and with restraint. He wants us to learn to speak like Jesus.

Read the rest here.

This blog may be older than many kids running around these days, but for me the struggle to choose which to post and not to post hasn't abated. Perpetual questions that (should) hover over my head: will this encourage others? Will this teach them something or make them smile or help them see the grace and sovereignty of God over their lives?

I'm thankful for this essay by Jon Bloom. If you haven't read his book, Not By Sight (read my thoughts on it here), then you may want to check it out.

Tuesday, February 20, 2018


On a mission for the Ekumen!

Valerie Stivers imagines the food described in The Left Hand of Darkness by Ursula K. Le Guin and concocts what looks like a cookbook. I'm fascinated: I loved the characters of Genly Ai, a human male, and Estraven, an ambisexual (male and female, alternating depending on the time), but I can't, for the love of me, cook anything more than instant pancit canton.

Here's a sampling.

Karhide Hot-Shop Soup with Mussels and Buddha Lemon

2 tbs olive oil
2 cloves garlic, chopped
2 cups chicken stock
1 lb potatoes, peeled and chopped
handful of green beans, chopped
2 lb bag of mussels, washed and debearded if need be
1/2 Buddha lemon, chopped (alternatively, 1/2 ordinary lemon, cut into wedges)
2 tbs fresh parsley, chopped

Monday, February 19, 2018


Doubly exposed

via Instagram

My new pastime: double exposures, inspired largely by British photographer Kevin Meredith who recommended the iOS free app, Dubble. There you can "collaborate" with other photographers—you contribute one photo, which will be superimposed on a photo (called a "single") taken by someone else. Here's my cookie photo superimposed on hkdonnie's building. My TWSBI Eco floats in the background.


If you want to generate double exposures using both your photos, use Studio MX. The free version doesn't let you save photos, but you can export or upload them to social media, notably Instagram. Here are some of mine.

Flowers along Diversion Road to General Santos City Airport + clouds over Sarangani Bay taken from a Cebu Pacific airplane.


Decrepit bahay kubo + wild grass, General Santos City.


Tatay at a flower farm in Tupi, South Cotabato + sunset in Maasim, Sarangani


Myself, swimming in Glan, Sarangani + shoreline


The final photo shows me floating just near the shore, when I'm so far from it.

Sunday, February 18, 2018

Let me know if you have a copy of America Is Not the Heart

I'd like to get a copy of Elaine Castillo's America Is Not the Heart, her first novel.

When Hero De Vera arrives in America–haunted by the political upheaval in the Philippines and disowned by her parents–she’s already on her third. Her uncle gives her a fresh start in the Bay Area, and he doesn’t ask about her past. His younger wife knows enough about the might and secrecy of the De Vera family to keep her head down. But their daughter–the first American-born daughter in the family–can’t resist asking Hero about her damaged hands.

An increasingly relevant story told with startling lucidity, humor, and an uncanny ear for the intimacies and shorthand of family ritual, America Is Not the Heart is a sprawling, soulful debut about three generations of women in one family struggling to balance the promise of the American dream and the unshakeable grip of history.

Eleanor Pritchett, writing for The Paris Review, smiled after reading it.

This is Castillo’s first novel, and it is masterful. It has drama and tragedy in spades, but it also has so much love of every kind spilling out of its pages that I closed it each night with a huge, warm smile. I might go home and read it again.

I think it was the writer Miguel Syjuco who said that we're not a reading nation—we don't have a reading culture. Novels and books don't figure into our every day, and they're not strong enough to be the subjects of conversation—a baffling phenomenon, considering this country has Jose Rizal's novels at the heart of her history. A chicken-and-egg problem, whose solution escapes us: writers are not writing enough because nobody's reading them; they're not being read because books by Filipinos are hard to come by.

This is why I'm on the lookout for things written by Filipinos. Castillo was born and raised in America, but her story seems like something that's closer to home, too.

Saturday, February 17, 2018

"On my own..."

Dr. Roni Baticulon writes about the challenges of being a first-generation doctor. If you're in the medical field, you should really bookmark his site.

Being a first-generation doctor, I had to start from scratch. My parents are not doctors. No one among my immediate maternal and paternal relatives is a doctor. My family cannot afford to buy shares of stocks in private hospitals. After finishing specialty and subspecialty training, I did not have a clinic to take over and neither did I have practice privileges waiting to be used. As to which course my neurosurgical career would take, whether things would pan out after I obtained my diplomate certificate at the end of last year, there was no way to be certain. Where to begin? How to begin? I was on my own.

Friday, February 16, 2018

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Cancer and art: a marriage

Cancer and art don't always go together, but a scientist has found a way to marry them.

By day, Dhruba Deb studies lung cancer. A postdoctoral researcher at the UT Southwestern Medical Center in Dallas, Deb puzzles over disease-causing genes and the scores of signaling pathways in which they act. Searching through this sea of data, he often has trouble deciding where to focus or how to push forward.

In the evenings, Deb leaves the microscope and pipettes and enters a different world—his home studio—where canvas and paint brushes await.

Thursday, February 15, 2018

Kottke on blogging

Jason Kottke's interview on The Nieman Journalism Lab makes me long for the internet of days past. As his site celebrates its 20th year, Jason talks about blogging, social media, and what has changed since then.

I don’t really think of myself as being a writer; I think that’s a label reserved for people who actually know how to write better than I do. How I think of my job is: I sit down and I’m lucky enough to read about interesting stuff all day, and to try and figure it out enough that I can tell other people about it. You can take that and do it in a number of different jobs: It’s what a teacher does, it’s what a journalist does, it’s widely applicable. When I talk about what I do with my kids, it’s in the context of that. I went to a small liberal arts college and I feel like I’m still kind of in college, in a way. I write about science, art, psychology, photography, and I can’t imagine a better way to spend my time.

Wednesday, February 14, 2018

Changed by reading

Ursula K. Le Guin on reading novels.

In reading a novel, any novel, we have to know perfectly well that the whole thing is nonsense, and then, while reading, believe every word of it. Finally, when we're done with it, we may find—if it's a good novel—that we're a bit different from what we were before we read it, that we have been changed a little, as if by having met a new face, crossed a street we never crossed before. But it's very hard just to say just what we learned, how we were changed.

From the Prologue of The Left Hand of Darkness.

Tuesday, February 13, 2018

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I’ll miss seeing patients here.

During my 24-hour shift at Howard Hubbard Hospital, just right across my grandmother's backyard in the quaint Polomolok town, I was able to reconnect with nurses who, when they met me, exclaimed, "Ay, ikaw na gali si Lance! Kadako-dako na gid sa imo. Ginakarga ka pa namon sang gamay ka." I even met a nurse who knew my parents' love story. My mother used to work as the hospital dentist, single, nearing her thirties. She would later marry my father, who was waiting for someone else in the hospital lobby. He had set his eyes on a physician but was eventually dissuaded from doing so when he met the petite dentist from Banga. My mother was in a hurry to get married. Tatay passed her stringent standards: he had clean fingernails. She married Tatay "by faith." Tatay claimed the marriage was out "of love." It's a boring story for what is clearly a match made in heaven.

The hospital packs so much personal history. Being one of the physicians working there, albeit temporarily, I felt the closing of a full circle. I enjoyed my time with the kind nurses, efficient staff, and the patients who wanted to get admitted for the most trivial of complaints—a three-hour history of cough, a lacerated pointing finger after manipulating heavy machinery, a snake bite from a cobra lurking in the pineapple plantation. We gave the anti-venom, and the lady was able to go home alive–that, after a brief stint at the ICU.

Monday, February 12, 2018

Sunday, February 11, 2018

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Mula sa puso.

I found this flyer in front of the house a couple of days ago.

Who watched the soap opera of the same name? I did. It starred Rico Yan (Gabriel) and Claudine Barretto (Via) and the villain Celina Matias (played by the excellent Princess Punzalan) who may have caused the death of some elderly people who died hating her.

Saturday, February 10, 2018

Defending the role of libraries in society

Alberto Manguel, the Director of the National Library of Argentina, unpacks his thoughts about books and libraries.

I would argue that public libraries, holding both virtual and material texts, are an essential instrument to counter loneliness. I would defend their place as society’s memory and experience. I would say that without public libraries, and without a conscious understanding of their role, a society of the written word is doomed to oblivion. I realize how petty, how egotistical it seems, this longing to own the books I borrow. I believe that theft is reprehensible, and yet countless times I’ve had to dredge up all the moral stamina I could find not to pocket a desired volume. Polonius echoed my thoughts precisely when he told his son, “Neither a borrower nor a lender be.” My own library carried this reminder clearly posted.

Friday, February 9, 2018

Swatting mosquitoes may fend them off for good, a new study reports

I’m the default prey of mosquitoes—this I realized as we were growing up. I’d end up the one with the most bites, and there seemed to be no escaping it. My mother complains that she goes through the same thing.

Which has made me wonder if mosquitoes bite preferentially. (This break has given me time to wonder about a lot of things!) I read somewhere, in a kids’ magazine that likely didn’t do aggressive fact-checking, that mosquitoes bite people who wear blue (I have a couple of blue shirts—too bad) and that they like children who haven’t showered (I took showering seriously when I was young—ok, not so seriously during summers when I didn’t have 7 am classes to catch!).

A study published in Current Biology, “Modulation of Host Leaning in Aedes aegypti Mosquitoes,” now shows evidence that mosquitoes don’t choose randomly. They, in fact, prefer some individuals in a host population over the others. The group of Dr. Clément Vinaguer showed that mosquitoes learn the scents of specific humans and odorants. They also avoid the scent of rats but not chickens.

Their experiments showed that mosquitoes perform “aversive learning.” They are able to associate the mechanical disturbance with the scent of the person who does the swatting and therefore avoid such a person.

By editing their genes, these scientists demonstrated that the gene that codes for a dopamine-1 receptor, suppressed this learning and therefore distorts the mosquitoes’ preferences. (See the illustration above).

The message is clear: keep swatting the mosquitoes away. If you don’t kill them, at least they’ll know you plan to do them harm and will find someone else to bug.

Image source

Thursday, February 8, 2018

The iPad has Parkinson's

I love my iPad Mini, but it has slowed down through the years—noticeably, after a few updates. Its Parkinsonian listlessness becomes more pronounced when I have a number of tabs open in Safari. I thought it was the hardware, but it's only been three years since my mother handed it to me. This happens all the time, apparently.

John Han ponders the slow death of his iPad.

My old iPad just turned five, and it’s starting to die. If it could wonder about such things, it might question this prognosis. Its memory, after all, still retrieves information as quickly as it ever did. Its face hasn’t aged a day, projecting as vividly as it did in 2012, when Apple called it “stunning” and “gorgeous.” It hasn’t suffered vision loss; the camera still works. The touch-screen works. Buttons work. Speaker, headphone jack, charging port: All still do what I ask of them. On examination, almost nothing about the device seems to have changed. And yet it’s starting to give up, and so am I.

Wednesday, February 7, 2018

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Resist these forces.

Even as a medical student, I've thought of Harrison's Principles of Internal Medicine as the best textbook we've had: well-written, organized, and funny. Have you read the Hematology chapters? A riot! I'm so glad Harrison's also main reference material for residency. I enjoyed reading much of it. There's no virtue in it from me (a phrase I'm adapting from Dr. Albert Mohler): I just like to read. I'm the type who learns a lot more from reading rather than doing or listening.

I was re-reading Oncology and stopped for a minute when I encountered the paragraph above—never have I encountered textbook medical writing so humane and emphatic.

Tuesday, February 6, 2018


What we can learn from Rachel Denhollander

Rachel Denhollander is a former member of the US gymnastics team who, when she was 15, was sexually abused by Larry Nassar. In her full victim impact statement, she delivers an out-of-this-world response: she shares the gospel of Jesus Christ, and she forgives her abuser!

In our early hearings. you brought your Bible into the courtroom and you have spoken of praying for forgiveness. And so it is on that basis that I appeal to you. If you have read the Bible you carry, you know the definition of sacrificial love portrayed is of God himself loving so sacrificially that he gave up everything to pay a penalty for the sin he did not commit. By his grace, I, too, choose to love this way.

You spoke of praying for forgiveness. But Larry, if you have read the Bible you carry, you know forgiveness does not come from doing good things, as if good deeds can erase what you have done. It comes from repentance which requires facing and acknowledging the truth about what you have done in all of its utter depravity and horror without mitigation, without excuse, without acting as if good deeds can erase what you have seen this courtroom today.

If the Bible you carry says it is better for a stone to be thrown around your neck and you throw into a lake than for you to make even one child stumble. And you have damaged hundreds.

The Bible you speak carries a final judgment where all of God's wrath and eternal terror is poured out on men like you. Should you ever reach the point of truly facing what you have done, the guilt will be crushing. And that is what makes the gospel of Christ so sweet. Because it extends grace and hope and mercy where none should be found. And it will be there for you.

I pray you experience the soul crushing weight of guilt so you may someday experience true repentance and true forgiveness from God, which you need far more than forgiveness from me -- though I extend that to you as well.

Here's her interview with Christianity Today where we can learn so much as a church in addressing these issues.

Monday, February 5, 2018



I noticed today that my Kindle has a tiny scratch on the screen—nothing too serious, as it’s barely visible in most angles, but it reveals itself in various places, in the toilet, for example, where the external light casts a vague shadow over the print. I’m uneasy with its presence, like dust stuck in my eye. For a few minutes I chided myself for not getting a leather cover or a screen protector; most times, you see, I just shove my Kindle inside the satchel and grab it when I feel like reading. I tell myself the scratch is a battle scar, a testament to its utility and purpose. Now and then, as I lose myself in reading, I hardly notice the tiny scratch anyway, and when I do, I feel a certain connection to it—this device is mine! It's scarred forever. Now, with its scratches, nobody will probably bother to steal it and resell it as secondhand goods on eBay. There’s so much to be thankful for in this life, that God has provided me with earthly comforts, such as this device, which I do not deserve (and likely don't need).

Sunday, February 4, 2018



By American artist and designer Ari Weinkle.

In my work, I look to break apart and re-appropriate different forms such as the human figure, geometric and organic shapes, and typography. Through the process of fragmenting different entities, I am continually searching for new and unique juxtapositions between shapes, colors, and patterns. My work is mostly experimental, often digital, and usually weird.

This piece resonates with me because instant noodles are among the very few things in my culinary repertoire.

Saturday, February 3, 2018

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On blogging almost every day

I've posted something almost every day since the second week of January, perhaps the most prolific of months since I decided to share a little of my life to this tiny, quiet, almost forgotten space in the web. Social media has been too noisy, angry, and alienating, but this spot here is just what it should be: a place that friends visit when they realize they haven’t dropped by for quite a while, or that strangers run into when Google answers their searches about med school, NMAT, and the UP College of Medicine. My inbox receives the occasional emails from hopeful students who want to become doctors, and I’m always happy to answer them when I have time. Which, in the past few weeks, I’ve had lots of.

Writing has always been therapeutic for me. I’ve resolved to not just blog more frequently, but to be more consistent in journaling. My ideas, dreams, and plans become clearer when they are laid out in words. I’ve found that writing my prayers as I pray them is beneficial to my soul, in that I am able to focus more on the glory and mercy of God and look back—days, weeks, or years later—at those prayers and realize that the God to whom I pray has answered all my cries, worries, and desires in the way He has deemed best.

January was over three days ago!

1SE January 2018

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Paradox Uganda is one of my favorite places in the web

The blog of Drs. Scott and Jennifer Mhyer is one of my happy places in the web—a paradox, in a sense, because not everything they write about are happy things. As Christian doctors, they've devoted their lives serving the underserved in Africa. They document their experiences in their website, Paradox Uganda.

They recently lost a patient to HIV. His name was A. They write about where the system failed and how A. could have been saved.

About halfway through the morning I walked into one of our isolation rooms and nearly stopped breathing. The 11 year-old boy I saw sitting there truly looked like a skeleton. His skin stretched taunt enough to see the shape of each bone. He greeted me in English and even smiled a little, and his mom said he'd had some mouth sores the last two weeks and lost a bit of weight because he wasn't eating, but now he was doing better. No one could look like that in two weeks. So over the next few days I learned his story.

More here.

Their lives are a source of encouragement to me. Let's pray for them and their ministry.

Friday, February 2, 2018

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Studying often works in a community.

I dropped by PGH briefly this morning for an exam. I was glad to catch up with my colleagues and friends, some of whom I had lunch with. We spent a few hours studying at a charming café along Adriatico Street called Café Esso. It was well ventilated, the chairs and tables were of the right height, and it had a distinctly Korean vibe, with the music and all.

A side note:

After three years, I finally took the time to retrieve my diploma from med school, the piece of paper that's framed and displayed inside one's clinic. Behind me in the queue was a lady whose son wanted to get into med school; the son was graduating senior high this year.

"Matagal-tagal pa po siyang matatapos," I said, explaining to her the number of years a person spends to study medicine—around ten years after high school, plus another three or five years, if he decides to go into a specialty. It can get overwhelming, I told her, unless her son really wants to pursue it. I wished her and her son well, and as I walked out of the lobby, I remembered I still haven't retrieved my undergrad diploma in Diliman!


Inching my way through Metro Manila traffic


Nothing quite reminds me that I’m back to the old grind—temporarily, I should say—as the claustrophobic, purgatorial feeling of being stuck in Metro Manila traffic. (No, I don't believe in purgatory.) After forty minutes of inching out of the airport complex, the taxi driver is munching steamed corn he bought from a street vendor during the standstill. He is apologetic, but I tell him hypoglycemia will only make his life miserable. Go ahead. Eat.

At the airport I spoke with two French tourists who are spending a night in Manila before they head to Palawan for a 15-day vacation. I almost feel bad for them—that they have to endure one night here. The rest of the Philippines est magnifique. C'est une vue à couper le souffle. (It's the height of pretentiousness when I mumble something in French, regardless of how bad mine is.) Certainly not Manila. Claims that Manila is historical, cultural, and therefore beautiful sound desperate—but there must be truth to them, only that the good is camouflaged by the soot, noise, cars, and terrible urban planning.

But hope springs eternal. Maybe someday the city will become livable. I write this inside the taxi, where I've spent the past two hours—and most of that hope is dying.

So, yes, I'm back in the city for a few days to settle some things for future work. It's bad—city life—but it still feels like home here, too.

Thursday, February 1, 2018

Valiant columnar notebook is my new study buddy

It helps me remember things I study if I write them down. I discovered that Valiant columnar notebook with four columns is a good notebook. The paper is of excellent quality, and the Lamy turquoise ink does not feather or bleed. (Dr. Butch Dalisay's writes about good paper.) The columns help when I create summary tables, and I trace the lines to keep them straight.

Any study tips you wish to share?

Wednesday, January 31, 2018

Leprosy in the Philippines

Dr. Belen Dofitas, my mentor during medical school and a woman I'm proud and honored to know, talks about leprosy in the Philippines. She is featured in this month's issue of MIMS.

Aside from a leprosy patient’s continuous battle with the disease, they also experience social isolation and emotional distress—all because of the many misconceptions about the disease.

For example, many Filipinos still think leprosy is highly contagious: “Around 95% of the population has good resistance against the leprosy bacteria and can clear it when it enters the body.”

Another false belief about leprosy is that it causes certain body parts (fingers, toes, etc.) to fall off, for which Dr Lardizabal-Dofitas explained: “Leprosy invades and damages the nerves that supply our limbs. When the nerve damage is great, the tissues of the fingers and toes cannot grow normally anymore and sort of wither and shrink, much like a tree’s branches when the roots are damaged. The fingers and toes most certainly do not rot and fall off.

Read about the amazing efforts of the Philippine Leprosy Mission and what you can do to help. At the Philippine General Hospital, patients with Hansen's disease (the more technical term for leprosy) are members of the Hansen's Club, where they meet regularly.

Ursula Le Guin’s “The Left Hand of Darkness.” She was brilliant.

I'm also reposting my Goodreads "Reading Progress" notes for the book. The entries are summarized in a timeline as soon as one is finished reading. It's a great feature, like a book diary. You should get a Goodreads account, if you haven't yet. I call it the Facebook for readers. Follow me there.

Giving birth in a Rohingya refugee camp

Rojinessa labored through the night and gave birth to a baby boy around dawn. Her mother delivered the baby. No doctors were present. No midwives. No beeping machines. Rojinessa became a mother in a tent with a bare concrete floor, a plastic sheet roof, and no running water. She is a Rohingya refugee, living in Ukhia, Bangladesh, with more than 650,000 other refugees who have fled the grotesque and incomprehensible genocide ravaging her people in Burma.

This was her third baby. She was accustomed to the harsh realities of motherhood in a life in poverty. But I wasn’t.

Firen Jones, a midwife from America, writes about the harsh realities of women giving birth in refugee camps.

In the Philippines, midwives constitute a major force in healthcare. Pregnant women who don't have access to a physician, let alone an obstetrician, are accorded medical care through the midwives. I can say this from experience because the midwives I've worked with in Maasim are great!

Tuesday, January 30, 2018


“Laban lang, Sir,” the barista told me.

“Laban lang, Sir,” the barista told me.

"Thanks," I said. When he handed me my espresso—which I always take in the afternoons when I resume my studying after a post-lunch nap—I checked my hair and realized I'd just gotten out of bed, and my hair looked like it could use some combing. I've grown my hair for more than two years, but I still keep forgetting all about it. I haven't spent this long in Koronadal for a very long time; I was hardly ever home when I started studying and training for Medicine. It's good to have comforts of home.

Monday, January 29, 2018

An objective way to measure adherence?

Adherence to medications is a hard but important thing to emphasize to patients. As an internist, I have patients with chronic illnesses that will likely be with them until their very last on earth. A valuable information I want, and need, is how adherent they've been as regards their medications and lifestyle.

A new development in medicine is the digital health feedback system (DHFS), a device "already being used in clinical trials to monitor adherence and will probably soon be combined with other chronic disease medications." For doctors, this means an objective way of knowing whether, say, a patient has been taking his/her antihypertensive medications daily. How DHFS ultimately affects adherence is still uncertain, but a small randomized controlled trial showed that patients with diabetes and hypertension in whom DHFS was used had better control of their conditions.

Read Swallowing a Spy — The Potential Uses of Digital Adherence Monitoring. An excerpt:

For those of us who struggle, the most effective adherence booster may be giving doctors and patients the time to explore the beliefs and attributions informing medication behaviors. These conversations can’t happen in a 15-minute visit. Given how little our health care system seems to value such interactions, it’s no wonder that skepticism often greets these new, unproven, and costly technologies. But though this skepticism may be warranted, it may also reflect a fear that the technology is intended to replace our efforts, rather than facilitate them. For technologies like digital adherence monitoring to do their jobs, we have to be willing to let them help us do ours.

The short of it is—sure, the device may be helpful, but let's not forget educating patients about their condition.

Sunday, January 28, 2018

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The beauty of short prayers


Here's a wonderful piece by David Mathis to encourage you this Sunday.

We are free to abandon our empty, evangelical stock-phrases, and free from needing many words, extending our requests to a certain length to impress, because in Christ, we already are known, loved, cherished, and secure. We are not unknown citizens approaching a distant dignitary, but children drawing near to “our Father.”

The collection of Puritan prayers by Arthur Bennett has been a blessing to me, too, and I turn to it when I don't feel like praying. An exerpt of "Worship":

Let me live wholly to my Saviour,
free from distractions,
from carking care,
from hindrances to the pursuit
of the narrow way.

I am pardoned through the blood of Jesus —
give me a new sense of it,
continue to pardon me by it,
may I come every day to the fountain,
and every day be washed anew,
that I may worship thee always
in spirit and truth.

Saturday, January 27, 2018


"Forest bathing" may help with stress

Shinrin-yoku means “taking in the forest atmosphere” or “forest bathing.” The term was coined by the Japanese Ministry of Agriculture, Forestry, and Fisheries in 1982.

Does “forest bathing” impact health and wellness?

Some Japanese scientists—curious people who ask all sorts of questions and conduct all sorts of fascinating studies—did various field experiments in 24 forests across the country to determine if environment, in fact, plays a role in health.

How this study was designed is interesting:

In each experiment, 12 [normal male university] subjects (280 total; ages 21.7 ± 1.5 year) walked in and viewed a forest or city area. On the first day, six subjects were sent to a forest area, and the others to a city area. On the second day, each group was sent to the other area as a cross-check. Salivary cortisol, blood pressure, pulse rate, and heart rate variability were used as indices.

I would’ve enrolled in that study, if I had the chance.

But back to the results. The findings show that:

…Forest environments promote lower concentrations of cortisol, lower pulse rate, lower blood pressure, greater parasympathetic nerve activity, and lower sympathetic nerve activity than do city environments.

The study has its limitations and flaws, of course. All studies do. One can argue that 12 subjects for each forest may not be sufficient. Or that only males with no co-morbidities were included—for females may have responded differently, and so on. One can argue, too, that while the decreases in cortisol and other objective parameters may be statistically significant, they remain surrogate markers for stress and do not directly measure it.

But the study interests me because of three things:

First, that it was done at all; second, that it points to the interplay between environment and health—something we already know based on observation (people in Manila are, for example, more prone to anger and exhaustion than those in Koronadal); and third, that I really like forests.

Yes, the forest more than the beach—and that's my segue to the next part of this post.

Japanese photographer Yoshinori Mizutani has made shinrin-yoku part of his daily life. He shares this calming, stress-relieving collection of photos in The New Yorker.

Throughout the series, Mizutani’s abstracted use of blur cushions his subjects, painting a simultaneously idyllic and voyeuristic scene. The viewer takes on the role of the forest itself, and of the creatures that live in it: we peer from behind, or from within, a bush as an oblivious couple strolls by, and we dip over a man’s shoulder as birds gather around his weathered palm.

A sampling:

One wonders where the nearest forest in Manila is—and if it's bathe-able.

Friday, January 26, 2018


Do you call your AI a "he," "she," or "it"?

I agree with Tim Carmody on this.

This is one reason why I am at least partly in favor of what I just did: avoiding gendered pronouns for the voice assistant altogether, and treating the device and the voice interface as an “it.”

He continues.

An Echo or an iPhone is not a friend, and it is not a pet. It is an alarm clock that plays video games. It has no sentience. It has no personality. It’s a string of canned phrases that can’t understand what I’m saying unless I’m talking to it like I’m typing on the command line. It’s not genuinely interactive or conversational. Its name isn’t really a name so much as an opening command phrase. You could call one of these virtual assistants “sudo” and it would make about as much sense.

Many drivers I met referred to Waze as "siya," a Filipino pronoun used to refer to human beings. Situations like that make me want to remind them that they're taking orders from a phone app. Of course I don't bother with the correction and just pretend that I'm sleeping. Driving alone in the horrible Metro Manila traffic must be lonely, and listening to the Waze lady is likely the closest thing they have to a conversation.

Thursday, January 25, 2018

Being alone is not painful at all

Haruki Murakami on solitude and introversion:

It might be a little silly for someone getting to be my age to put this into words, but I just want to make sure I get the facts down clearly: I'm the kind of person who likes to be by himself. To put the finer point on it, I'm the type of person who doesn't find it painful to be alone. I find sending an hour or two every day running alone, not speaking to anyone, as well as four or five hours alone at my desk, to be neither difficult nor boring.

From an excerpt from his book, What I Talk About When I Talk About Running. I sure can relate!*

Follow me on Goodreads. It's like Facebook for readers.

* It's not lost on me that friends refer to me (openly) as a "trying-hard introvert." My reply: "But I am!"

Social media is making us dumber

Jesse Singal writes about how social media twists our understanding of things. Case in point: Harvard professor and intellectual Steven Pinker who, in a clip, was shown to refer to “the often highly literate, highly intelligent people who gravitate to the alt-right” as “internet savvy” and “media savvy.”

But this wasn't actually the case. Singal argues:

The idea that Mr. Pinker, a liberal, Jewish psychology professor, is a fan of a racist, anti-Semitic online movement is absurd on its face, so it might be tempting to roll your eyes and dismiss this blowup as just another instance of social media doing what it does best: generating outrage.

He unpacks his observation:

But it’s actually a worthwhile episode to unpack, because it highlights a disturbing, worsening tendency in social media in which tribal allegiances are replacing shared empirical understandings of the world. Or maybe “subtribal” is the more precise, fitting term to use here. It’s one thing to say that left and right disagree on simple facts about the world — this sort of informational Balkanization has been going on for a while and long predates Twitter. What social media is doing is slicing the salami thinner and thinner, as it were, making it harder even for people who are otherwise in general ideological agreement to agree on basic facts about news events.

That’s because the pernicious social dynamics of these online spaces hammer home the idea that anyone who disagrees with you on any controversial subject, even a little bit, is incorrigibly dumb or evil or suspect. On a wide and expanding range of issues, there’s no such thing as good-faith disagreement.

This phenomenon isn't unique to America.

The last time I logged on to Facebook—something I do more often these days because it's the only way to get in touch with friends from high school (they've changed phone numbers since our graduation)—I saw angry posts about Mocha Uson receiving an award from a UST alumni body. The comments were degrading, the attacks personal. I read posts on the contrary, too—people cheering for Mocha but with the occasional deluge of hateful remarks about veteran journalist Karen Davila who had suggested that Mocha should consider giving the award back—a suggestion which, to me, sounded considerate, respectful, and in good faith.

Whatever happened to disagreeing agreeably?

A helpful rule a colleague told me was: don't write anything on social media what you can't say to another in his face. Philippians 4:8 is also instructive—just replace "think" with "post."

Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things.

Social media carries with it anonymity, the steroid that enables cowards to spread their hate and ignorance. When we're at the point where we can no longer distinguish the good from the bad, the truth from the lies, we must consider leaving.

Wednesday, January 24, 2018

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Waiting for my bus along the National Highway in Maasim, Sarangani

Maasim, Sarangani

After my shift at Maasim Municipal Hospital, where I attended to all sorts of patients and functioned as a community doctor—as an obstetrician, pediatrician, surgeon, and internist, all in one—it was time to go home. My patients were fishermen and farmers who lived in distant barrios. Most of them belonged to the indigenous people (IP) groups, and I had to have the nurses beside me to translate their complaints to Bisaya. My bus arrived an hour after this was taken, and I slept through the entire ride, tired and fulfilled.

The last time I'd been here was in 2014, a fresh graduate, and I had just finished my pre-residency in Internal Medicine. The hospital staff's reaction when I came back three years later: "Tambok na ka!" (You've gotten fat!). They said I looked better, too.

Ursula Le Guin has died at 88, and the meaning of refusing and receiving awards

Urusula K. Le Guin has died. She was 88. From the New York Times:

Ms. Le Guin’s fictions range from young-adult adventures to wry philosophical fables. They combine compelling stories, rigorous narrative logic and a lean but lyrical style to draw readers into what she called the “inner lands” of the imagination. Such writing, she believed, could be a moral force.

“If you cannot or will not imagine the results of your actions, there’s no way you can act morally or responsibly,” she told The Guardian in an interview in 2005.

One of these days, I'll reward myself by reading The Left Hand of Darkness (published in 1969).

Le Guin received many awards in her lifetime, but she wrote about refusing a prize once, which speaks a lot about her principles.

I refused a prize once . . . It was in the coldest, insanest days of the Cold War, when even the little planet Esseff was politically divided against itself. My novelette The Diary of the Rose was awarded the Nebula Award by the Science Fiction Writers of America. At about the same time, the same organization deprived the Polish novelist Stanislaw Lem of his honorary membership. There was a sizable contingent of Cold Warrior members who felt that a man who lived behind the iron curtain and was rude about American science fiction must be a Commie rat who had no business in the SFWA. They invoked a technicality to deprive him of his membership and insisted on applying it. Lem was a difficult, arrogant, sometimes insufferable man, but a courageous one and a first-rate author, writing with more independence of mind than would seem possible in Poland under the Soviet regime. I was very angry at the injustice of the crass and petty insult offered him by the SFWA. I dropped my membership and, feeling it would be shameless to accept an award for a story about political intolerance from a group that had just displayed political intolerance, took my entry out of the Nebula competition shortly before the winners were to be announced. The SFWA called me to plead with me not to withdraw it, since it had, in fact, won. I couldn’t do that.

Receiving and refusing awards—and handing them to someone—mean so much more than what meets the eye.

Julie Phillips's profile of Le Guin in The New Yorker October 2016 issue is wonderful.

I often find myself wallowing in regret whenever famous writers die before I even had the chance to read them. Sayang, di ko man lang siya nakilala. This happened with John Updike and so on. I know, I know, it's never too late, but still . . . .

Tuesday, January 23, 2018

I listen to this Wes Anderson playlist on Spotify as I review for the diplomate exam

Photo credit: IMDB

I'm always on the lookout for good music while I read or study. I like the songs subdued and not too distracting. Depending on my mood, I may prefer songs with or without words. There are days when I'd rather not listen to anything. These past days I've been listening to "From Bottle Rocket to The Grand Budapest Hotel," a Spotify playlist created by Michael Park . . .

bringing together 172 of the songs included in Anderson's eight features so far, coming to over nine and a half hours of immaculately curated, 20th century counterculture-rooted music, from not just the Stones and Bowie-via-Seu Jorge but Horace Silver, the Kinks, the Vince Guaraldi Trio, Elliott Smith, Yves Montand, Nick Drake, and the Velvet Underground. (via Open Culture)

You'll need to download and register for Spotify (and you should, if you haven't yet. The free account, which I have, dishes the occasional ads which don't bother me at all. In fact, they remind me that 30 minutes or so have passed, and I should hurry.)

I'm a huge fan of Wes Anderson and should make time to finish watching all his films. Ha! But first: this voluminous unit on infectious diseases!

Monday, January 22, 2018


Patronize locally grown coffee



I've been able to score good coffee in Soccsksargen. In Koronadal alone, where business is booming, cafés have opened, some of them owned by people from my childhood! In fact, a new coffee shop has opened near the house, and that's where I plan to spend most afternoons as I study for my diplomate exam. The espresso is good, the airconditioning is sufficient, and the place is quiet but gets a bit crowded in the evenings. I bring earphones just in case it gets noisy, and I plan to go home early anyway.


At home my kid brother Sean has a steady supply of Kulaman coffee. The flavors are rich, a little nutty, with hardly any acidity. He gets it from a person he knows at a discount, likely one of his patients.

Last week an aunt gave me Mt. Matutum coffee (Greentropics), which is slightly acidic, less nutty, and stimulating: it keeps my mind from getting headaches in the morning.

Greentropics is a local company that trades, processes and markets coffee sustainably harvested by the B’laan tribe, an indigenous peoples (IP) group living in the slopes of Mt. Matutum in South Cotabato.

More on Agricultural engineer Fred Fredeluces here, and the efforts he's put up to further the coffee industry in the region.

Clearly the coffee industry is growing in Mindanao.

Coffee is mainly grown in Mindanao with the island producing some 71 percent of the country’s total production volume. Sultan Kudarat is Mindanao’s number one source of coffee, having 15,500 hectares devoted to production of the crop.

Maybe it's just me, but as a coffee drinker I patronize local coffee shops more. I only order basic coffee: an espresso if I feel sleepy or an americano if I have the time for a leisurely sip. I like the bitterness. The prices are reasonable. It helps that I'm not the biggest fan of Starbucks, whose coffee tastes burnt. I still like the smell of a Starbucks store, which floods my memory with friends, good conversation, and reviewing for my board exams.

Sunday, January 21, 2018


Sunday mornings are for church

Sunday mornings are the busiest in the household. We wake up early to prepare for Sunday worship service. We're not allowed to stay up late on Saturday nights. We're reminded that our clothes should have been set aside the night before; our shoes should have been polished by then. (I've been guilty many times of not obeying these instructions.) My father reprimands us if we dilly-dally. Still sleeping at 7 am is almost unthinkable. At this time we should be taking a shower or eating breakfast already because the worship service begins at 9 am—and we shouldn't be late. My father used to remind us that we should give the Lord the best of our everything; if we arrive at our meetings for work on time, we should do the same—or even better—for when we meet with the Lord and His people.

I associate Sunday mornings with church. While I'm thankful for afternoon services (during residency, I had to report to work until 12 noon to do rounds on patients or had to stay for 24 hours if I was on duty—one of the most painful things I had to deal with during training), I still prefer going to church in the morning.

I hope you're up and about to prepare for church, too. Here's a beautiful Puritan prayer before going to church. An excerpt:

O Maker and Upholder of all things, 
Day and night are thine; they are also
mine from thee —
the night to rid me of the cares of the day,
to refresh my weary body,
to renew my natural strength;
the day to summon me to new activities,
to give me opportunity to glorify thee,
to serve my generation,
to acquire knowledge, holiness, eternal life.

But one day above all days is made especially
for thy honour and my improvement;
The sabbath reminds me
of thy rest from creation,
of the resurrection of my Saviour,
of his entering into repose.
Thy house is mine,
but I am unworthy to meet thee there,
and am unfit for spiritual service.

Saturday, January 20, 2018


Couchsurfers' stories

Gabriele Galimberti features 100 stories of couchsurfers he has met for two years.

CouchSurfing is the act of trading hospitality, practiced by the over 14 million members of the CouchSurfing network present in 230 countries worldwide.

He continues:

I traveled around the world with CouchSurfing for more than two years in order to discover this young, diverse, multicultural, multiracial global community. I have CouchSurfed on all the five continents and has hosted dozens of CouchSurfers in his house in Tuscany. I have slept on a bed worthy of a 5-star hotel in a fairytale villa in Texas and in a room ten square meters in Sichuan, which he shared with 3 generations of a Chinese farmer family. In Ukraine I was hosted by a couple that welcomed him naked, informing him they are “house nudists” and in Botswana by a young man training to become an evangelical pastor. 

Olena, 22 years old, is a committed naturist. "I don't like to wear masks or, when I can avoid it, clothing – especially not in my own home," she tells me. She and her boyfriend Igor often walk around the apartment – which consists of a living room (where I slept on a yoga mat during my stay), kitchen, bedroom and bathroom – naked. They do it so naturally that I quickly get used to it.

Lots of Filipinos are featured in this project, too. I haven't tried couchsurfing myself, but it sounds interesting.

Friday, January 19, 2018


Cimetière de Montmarte, a good place to think and rest while in Paris

Graveyards are peaceful places to visit.

I went to Cimetière de Montmartre the last time I visited Paris. I was tired from all the walking and decided to go to a quiet spot. Famous people buried there include the neurologist Jean-Martin Charcot, the founder of modern neurology who discovered Charcot-Marie-Tooth disease and Charcot disease; Dalida, the famous singer; Alexandre Dumas, the novelist and playwright; Jacques Offenbach, the composer; Émile Zola, the writer; Georges-Fernand-Isidor Widal, bacteriologist who invented the Widal test for typhoid; and François Roland Truffaut, the filmmaker who ushered in the French New Wave. [(Read my ruminations on Les Quatres Cinq Coups (translated The 400 Blows.)]











I wrote about graveyards because, by the time you read this, we will have buried Lola Gló. The cemetery is nowhere near as beautiful as this, of course—just a patch of land with green grass and a small tombstone—but Lola has gone home to be with the Lord, rejoicing and praising her Maker and Redeemer. Job 1:21 resonates with me:

He said, "Naked I came from my mother's womb, And naked I shall return there. The LORD gave and the LORD has taken away. Blessed be the name of the LORD."

Thanks for your prayers.
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