Saturday, November 16, 2019

Down under

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

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



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


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




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

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



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

Sunday, November 10, 2019

Three ways to "stay Christian" when discussing politics

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

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

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

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

Saturday, November 9, 2019


Sydney 2019 — Day 1

Sydney 2019 — Day 1

Sydney 2019 — Day 1

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

Saturday, November 2, 2019

Still taking exams

Mid-term exams

I'm spending a good deal of my morning working on a take-home mid-term exam that's due next week. I love writing papers and taking exams, for some reason. There is no virtue in it for me—I just like punching the keyboard, reading my words come to life, and hoping they make sense to get me an acceptable grade.

Friday, November 1, 2019

More to life

More to Life

While cleaning my fountain pens, a private ritual I share with fountain pen-loving friends who do the same during long weekends, Spotify played Natalie Weiss's rendition of More to Life. Ain't that the truth? In this photo is a Parker Duofold Slimfold inked with a green ink (likely a Pilot Iroshizuku sampler gifted by Ate Milaine).

Thursday, October 31, 2019

Saturday, October 26, 2019


On my father's supposed 68th birthday, I find myself wishing he were here to congratulate me on my first prize wins for oncology research, or to tell me that I'm losing weight and should eat some more, or to listen to his hearty laughter that my brother and I remember him for. I miss you every day, Tay, and I look forward to the day when we meet again.

Wednesday, October 16, 2019

, ,

My morning anthem

Just when the day starts to overwhelm me, I am reminded by the fact that the Lord is in control, sovereign in all things. There is no cause or need for worry because if the birds of the air do not, why should I, whom the Father loves?

Each morning for the past weeks I've been playing Keith and Kristyn Getty's What Grace is Mine.

What grace is mine that He who dwells in endless light
Called through the night to find my distant soul
And from his scars poured mercy that would plead for me
That I might live and in his name be known

So I will go wherever He is calling me
I lose my life to find my life in Him
I give my all to gain the hope that never dies
I bow my heart, take up my cross and follow Him

What grace is mine to know His breath alive in me
Beneath his wings my wakened soul may soar
All fear can flee for death’s dark night is overcome
My Saviour lives and reigns forevermore

So I will go wherever He is calling me
I lose my life to find my life in Him
I give my all to gain the hope that never dies
I bow my heart, take up my cross and follow Him

To lose my life, to die to self, in order to find my life in Him—there is joy, peace, and strength in Him. Listen to the song here.

Tuesday, October 15, 2019

Sunday, October 13, 2019

Tuesday, October 8, 2019

No monopoly of greatness

Spot on, Kay Rivera, my med school batch mate and favorite Inquirer columnist! How long has it been since we took the UPCAT? How time flies. She ends her piece with this.

Clearly, UP is not homogeneous. It takes all kinds to make a university. For those who have made it past this weekend’s hurdle, my limited, unsolicited advice is simple: don’t romanticize the university, lest one be prone to complacency; don’t rest on your laurels or belittle the achievements of other universities; don’t buy into the thinking that it’s UP or nothing; and realize that what makes UP, even more than its staff and its professors, are the mettle, passion and moral compass of its students. The expectation shouldn’t be that UP ought to make or break you, but that your actions and choices can make or break a university which is held to a certain standard of freedom of expression, justice-seeking and political awareness. UP is only as good as the students it produces, and to respond to the needs of an ailing nation, you’ll have to be very good students indeed.

One thing I learned throughout the years: UP doesn't have the monopoly of greatness. This is both humbling and comforting.

Monday, October 7, 2019

Sunday, October 6, 2019


Aliwagwag Falls: my mother's adventure


To keep her busy, I've asked Mother to take pictures of her every day. This is a year-long project. I installed the Flickr app on her phone and configured it so that all photos are automatically uploaded to a private cloud. Because of this, I know that she has gone walking, or has met with high school classmates, or has attended yet another funeral—events she can't seem to get too much of, as she wants to encourage the grieving families with God's comfort, as she has been comforted when we lost my father.

She went on tour with our church family from Marbel Evangelical Fellowship to visit Aliwagwag Falls in Compostela Valley-Davao Oriental.




Here's Mother, with Auntie Cecil, her forever best friend who sticks closer to her than a sister (they've shared the same dental clinic for years, until her retirement) and practically a second mother to us.


Nanay takes good pictures, doesn't she? I tell her to take photos of clouds, flowers, moving things, and people. She listens to my advice occasionally.

Saturday, October 5, 2019

Quietly extraordinary

week 29 (waitress)

Over breakfast coffee, I talked to my colleagues and friends, Berbi and Marvin, about generation gaps in medicine, sentiments about fellowship training, funny experiences in the clinics, and life in general. I love these conversations. I liken them to well-written systematic reviews because they clarify the meaning of certain life events that have happened during the past week or month, amplify the important lessons in those time periods, and offer future directions.

We talked about our desire to live simple, quiet lives—doing God's work in our little corner of the world. "And maybe that's not such a bad thing," we concluded. Some people are destined to change the world and rally others to do the same. Others are called to carry on the good work quietly: a doctor in his clinic, a mechanic in his shop, a student in his class. It is a meaningful life.

And then I came across a beautiful tribute to a man who worked with medical missionaries in Bundibugyo. I don't know Drs. Scott and Jennifer Mhyers personally, but their blog has become one of my favorite go-to's in the internet. I am always refreshed, encouraged, and moved by their testimony. The man's name was Yosefu Mutabazi.

He was never in a hurry, never demanding, patiently deliberate, dedicated to Scripture and truth and mercy. Perhaps because he began as an outsider he was sympathetic to our neediness. After knowing him for more than two decades we found ourselves entrusting our newest missionaries into his care. I don't think any of us imagined Bundibugyo without him.

This brought to my memory the lesson we had this week in my Bible study and prayer group (Pilgrims) on arrogance (1 Corinthians 13:4–7).

Love is patient and kind; love does not envy or boast; it is not arrogant or rude. It does not insist on its own way; it is not irritable or resentful; it does not rejoice at wrongdoing, but rejoices with the truth. Love bears all things, believes all things, hopes all things, endures all things.

Yosefu Mutabazi, based on the Mhyers's account, wasn't full of himself, did not consider himself important, but cared for the needs of others. He lived a "quietly extraordinary" life, doing God's work in his little corner of the world.

* * *

Photo above was taken at Midtown Diner in 2011. It remains one of my favorite breakfast places in Manila.

Wednesday, October 2, 2019

Sunday, September 29, 2019

Thursday, September 26, 2019

What to do when the patient starts to cry

This is my every day: breaking the bad news, reminding people of their mortality, and reassuring them I'd do my best to care for them. Dr. Bishal Gyawali's essay reminds us to connect with our patients' humanity. And nothing confronts a person with his humanity as when he is faced with the reality of death and dying.

Dr. Gyawali offers a peculiar insight on the beautiful intricacies of cultural differences in how patients and physicians from Canada, Nepal, and Japan approach bad news.

In my brief medical career, I have worked in quite a few different countries. I went to medical school in Nepal, where I was born and raised. I then went to Japan in 2012 to train in medical oncology. Five years later, in 2017, I returned to Nepal to work as a medical oncologist before moving to Boston, Massachusetts, for a research fellowship in cancer policy in 2018. I now live and work in Kingston, Ontario, Canada, having moved here from Boston in early 2019.

He continues:

Although training does help, the most crucial elements of delivering bad news to patients—having empathy and being sensitive—cannot be trained. Knowledge can be obtained anywhere, but listening to and genuinely caring for a patient has to be built into an individual's character with inspiration from experienced mentors. Protocols and guidelines help, but the richness and diversity of the patients we serve are reminders that we need to be flexible, listen to our patients, and respect their values and the culture that created those values.

Thanks, Alfie Chua, for the heads up on this article.

Tuesday, September 24, 2019



When the going gets tough, I wear sneakers to work. I bought this pair almost at a whim after a long day of walking in Seoul. My feet hurt. I saw a nearby store that sold cheap shoes. They worked wonders.

Monday, September 23, 2019


Lord, have mercy

From Paradox Uganda, one of my favorite blogs, a continual source of encouragement for me:

In Bundibugyo, the Paeds ward is a centrifuge that applies a centripetal force upon all the misery of the world and distills it down into the bodies of dozens and dozens of small people.

This beautiful place, like all others on our planet, has a hidden brokenness. As we round the mountain curves to return home, I see the smooth amazing pavement which has replaced one of the most difficult roads in the world. I see the outlines of palms and the vibrant green of banana trees, testaments to rainfall and abundance. I see songbirds and sunsets, hear laughter, creativity, resilience, commitment.

But spin the globe a few times, and then enter the ward to see what settles out. Malaria, malaria, malaria, and the nurse tells me they lost one last night because the quick-acting and effective artesunate is out of stock. My first patient is a newly admitted 4-year-old, gathered on the floor on a mattress with her mother and little sister. I can see her skin is tortured with scabies (a mite) and her face puffy with marginal protein in her diet. Her baby sister's clothes, her mother's thin-ness . . . I am nearly certain that if we tell them to buy artesunate in a clinic, they won't be able to. We have a national medical store that supplies the district, but our population is large and growing, our malaria progress has stalled, the rain this year never stopped, and the vials of medicine run out too fast. We try giving her an oral dose which she immediately and dramatically vomits out. So I end up driving into the market and finding a private pharmacy where I can purchase 8 vials. 8 lives. $1.67 per life.

Dr. Myhre concludes thus:

Lord have mercy.
Give us wisdom and stamina.

Let's pray for their work and ministry.

Sunday, September 22, 2019


Fictional and technical

Reading fiction facilitates my technical writing—or so I like to delude myself. In this sense, I like to alternate between the two categories of material. I remember that the same method is employed by George Saunders, a fine short story writer who happens to be a geophysical engineer, too! After finishing more than half of the Elena Ferrante novel, I spend my Sunday evening writing the manuscript for a technical paper. It's not an easy process, but it's made easier by my remembrance of Elena and Lina.

Marginalia using broad nib, Pilot Custom 74, Diamine Chrome ink.

Weekend reading

The last time I stayed this long in bed—say, five to six hours, give or take—after waking up was, to be honest, a long time ago. So distant was the memory that I couldn't even remember. Yesterday, however, with the gloom and drizzle outside, and with the recent conclusion of the medical students' oncology module which I helped coordinate, I started my morning at 6 am with a fresh cup of brewed coffee, and, still in my pajamas, grabbed two books from my shameful but proud tsundoku pile. The first was The Science Fiction Hall of Fame Volume I (Avon Publishers, 1971), edited by Robert Silverberg, lent to me one of my mentors, Dr. Ding Fernando, a few months ago. The second was Those Who Leave and Those Who Stay by Elena Ferrante, book three of the Neapolitan novels, which I also bought many months ago. It was perhaps the closest I've ever gotten to an actual shopping spree—I bought all the Ferrantes at National Bookstore, fearing I may not see them in stock again.


As with most short story collections, I did not read the stories as they were arranged, but picked, without a predetermined plan, the stories at the spontaneous moment of actual reading. I treated myself to these tales after a handful of reading materials in medical oncology which, too, offered an excitement of a more technical kind. Helen O'Loy by Lester del Rey was about men who fell in love with robots. It was tragic but romantic in a way that left me uneasy. Theodore Sturgeon's Microcosmic God was about a scientist who shut himself away from the world and settled in an island, working on experiments made easy by highly adaptable and intelligent organisms he had invented. Isaac Asimov's Nightfall was about the coming eclipse that caused insanity to the entire humanity. Lewis Padgett's Mimsy Were the Borogroves was about toys from another dimension and the children who disappeared after they had played with them. The Nine Billion Names of God by Arthur C. Clarke was about monks who believed that the world would end after the nine billion names of God had been written down. The monks commissioned computer scientists to speed up this task. 


Those Who Leave and Those Who Stay was set in 2005, where Elena Greco was a writer and Lina Cerullo was a worker in a sausage company, already with a child of her own. Their friendship was complicated: they adored each other with a certain jealousy and contempt and fondness. Years have passed since I read the last Ferrante novel, but how this anonymous author weaves the stories, creates the characters' emotions, with interjections of humor, frustration, and anguish is beyond me: she is a master in her craft. To my mind, she is at par with Marilynne Robinson and Alice Munro—among my favorite contemporary authors. To understand Ferrante, and to see the city through my eyes, is the main reason why I want to visit Naples someday: so I can set an actual physical picture that will serve as a backdrop of my imagination when I return to her pages. In this sense, travel and reading are, in fact, complementary.


I interrupted this solitary reading confinement with quick walks to a restaurant that served Italian food, both for brunch and dinner. With all the Italian in my head and stomach, I may as well have gone to Napoli.

On my way home, I was almost hit by a tricycle as I crossed the street. It was a dark corner, and the lamppost was about to give up. It dawned on me then: I was, and still am, in Metro Manila.

Wednesday, September 18, 2019

Saturday, September 14, 2019

On my Twitter accounts

I'm presenting a paper at the ASCO Breakthrough in Bangkok next month. I was asked for my Twitter handle during registration—how cool was that? It will be printed on my badge. This goes to show that social media is here to stay, and it is best that clinicians and researchers make use of this platform. (In case you're interested in all things oncologic, you can follow me at @lanceoncology.)

I maintain two Twitter accounts—@bottledbrain, which is more personal and private, and @lanceoncology, which is technical, academic, and public. I use the first account to follow the news, engage with friends, and write miscellaneous realizations. In my younger days, I may have inserted a few rants. (Forgive the ignorance of my youth.) I use the latter to monitor the current developments in medical oncology, tweet key points of the the conferences I'm attending (it also helps keep sleepiness at bay), and follow researchers from all over the world whom I've met and admired. Establishing this dichotomy has redeemed the personal value of Twitter for me.

I'm glad I listened to Dr. Iris Isip-Tan who has written and spoken extensively about the use of social media to generate one's academic portfolio, to create one's personal learning network, and so much more. Her blog, The Endocrine Witch, is a thing of beauty. How she manages to update it, on top of the gazillion things that she has to do, is admirable! I suggest that you subscribe to it.

Wednesday, September 11, 2019

Favorite group portrait

As I count the months towards the end of clinical fellowship, allow me to share a favorite group portrait during our foray in Seoul where we shared our research findings at the Korean Cancer Association meeting. I’ve been blessed beyond measure to have worked with these men. @k.momdragon, our leading lady, wellspring of compassion, mother of the sweetest girl in Manila, our source of estrogen and testosterone, deserves a separate citation.

Tuesday, September 3, 2019


While watching Weathering With You (天気の子) in cinema, yet another film by Makoto Shinkai—whose masterpiece, Your Name (君の名は), I had just watched this weekend—it was raining outside. I once wrote that I used to love the rain until I lived in Metro Manila, where it translates to massive traffic jams and deadly cases of leptospirosis, but, when I think about it now, I still love the rainy weather. It reminds me of childhood when, trapped inside the house, I would play with my brothers and read the story book, "Who Made the Angels Cry?"—which was about a rabbit who stole a cookie from a jar.

Weathering With You is beautiful. I want to watch it again.

Wednesday, August 28, 2019


On Midori Traveler's Notebook (Passport) and my fascination for pens and paper

Never in my lifetime has my fascination for writing instruments reached this level, not even comparable to my childhood days when I would find any pen and paper to practice on my signature after I had read about John Hancock's curlicues or scribble whatever came to mind, even in the back pages of Childcraft encyclopedia, much to my aunts' dismay. As any fountain pen user would claim, the fascination begins with an entry-level pen—say, a Lamy Safari, still one of my favorite writing instruments—followed by a growing interest in inks and paper. Such is the natural history of this obsession.

A few days ago I ordered a Midori Traveler's Notebook (passport size) through Scribe's online store. After reading about it, I learned that there's a cult following of sorts—an entire community of creative individuals whose passion it is to take journaling to a whole new level. Search for "Midori Traveler's Notebook" or "MTN" in Instagram or Flickr to see what I'm talking about.





I keep mine simple—the passport size makes it convenient enough to bring it around, to scribble for when I need to remind myself of my to-do list, and to eventually use for my daily quiet times with the Lord. For now, I'm still using the old journals and notebooks I had acquired or received as gifts from friends.

Sunday, August 25, 2019

Life in the farm on a lazy weekend

I'm writing this using Sean's powerful desktop gaming computer. I'm in his room, with the air-conditioning at full blast. He's asleep, tired after seeing a patient in his dental clinic. The keyboard is a joy to tinker with: the keys are soft, pliant, and make a staccato-like clickety sound that resembles a typewriter's. In the kitchen, Manong Ralph is baking a cake. He saw the surplus of bananas nearing their expiration date; he figured he'd whip up something for dessert. The large oven at our St. Gabriel home , which sits in idleness for most days of the year, was acquired largely to facilitate his culinary pursuits and only comes to life when he is home for the holidays, as has been the case for the past three days.

Auntie Nanic (her real name is Nancy), my mother's younger cousin, lives with us and is presently assisting Manong as he prepares the batter for his banana bread, a recipe he has perfected. These days, her other two children, Lyzza and Dave, are staying at home, too. Their presence adds vibrance to the house, which is too quiet on most days, if not for mother's intermittent trips to the fridge, or her morning gardening. My clasmates who pass by our home say it's like nobody lives there anymore.

Yesterday we visited Auntie Cecil's property in Banga, about 30 to 40 minutes away from Koronadal. She is my mother's younger sister, a chemistry teacher in a public high school who enjoys hosting us during lazy weekends. It was the perfect timing because there was a scheduled brownout from 8 am to 5 pm. Going to the farm seemed like the best way to escape the city heat. Also gathered were my aunts and uncles and cousins from the Garcenila side. We are a family of farmers: my grandfather Mauro took his family from Antique to carve a better future for them in Mindanao. He didn't know much except for farming, and he was quite good at it. He was able to send all his children to college. Such is my family's humble history.

Rice fields

So we are connected to the farm in more ways that you can imagine. Our family conversations always involve fruits and trees and crops. For instance, my aunts and uncles were talking about what they'd do with all the durian and lansones that their fruit trees bore. Our calendars are marked by fruit seasons. During our phone calls, my mother would say something like, "Oh, it's rambutan season already; you should go home!"

It's a shame that I didn't get to learn more about farming as I should have. My brother and I grew up in a small city, and didn't get to play with carabaos or apply fertilizers to fruit trees, for example. And while my father did keep a farm, we only got to visit the property once in a while and only for a few minutes at a time. Farming is a worthwhile pursuit. If the Lord allows, I'd like to have a go at it someday.

Here are some photos.

My brothers, Sean and Ralph.
Brothers in the farm

Sean, in the rice field.
My kid brother, leading the way

Lilies in the pond.
Water lilies (Nymphae) in the pond

A cow feeding beside a tributary of the Banga River.
Cow and river

A beautiful vine growing in the backyard.
Purple flowers

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