Bottled ※ Brain

In the final chapter, The Train to Tibet , Paul Theroux writes:  An early European explorer to Tibet burst into tears when he saw one lovely mountain covered with snow. When I saw the landscape of Tibet that did not seem to be an odd reaction. The setting is more than touching—it is a bewitchment: the light, the air, the emptiness, the plains and peaks . . . It is a safe and reassuring remoteness, with the prettiest meadows and moors buttressed by mountains. It was, somehow, a mountain landscape with a few valleys—a blue and white plateau of tinkling yak bells, and bright glaciers and tiny wild flowers. Who wouldn't burst into tears? This is one of the best books I've read, and I will likely get back to this piece of art and history soon enough.  It goes without saying that this chapter, too, resonates deeply with me. My hometown, a piece of paradise inhabited by proud, happy, and smiling people, may disappear soon. A huge mining project in a nearby town has been approved. That

As I return to Paul Theroux's Riding the Iron Rooster on this cool Saturday morning, the feeling of calm-after-the-storm descends upon me. After a tiring week of my kind and gracious grandmother's passing away, I can go about my day without anything urgent floating in the air. I want to tell you more about Lola Ugól, of course. I can start with the story of why nobody—not even her children—knows why she was called Ugól when her real name was Trinidad Zamora Garcenila. But not today. Of course, there are patients to see and faculty work to be done, but those can wait until 10 am.  For now, I want to savor this moment: the possibilities of a weekend. A quiet morning in the porch, the vanilla-smell of old book pages, the exquisite gray strokes of my Blackwing Palomino, the minimalistic design and engineering of my MacBook Air. These small things and habits allow me to both dwell on and forget about grief. The running joke in the family is that May is a particularly harrowing time

It's too bad that, as a canine, he is perpetually disenfranchised from participating in democratic exercises.

Driving at 6 AM along the Gensan-Polomolok border, I see a tricycle on the outer line. It is jam-packed with five people, excluding the driver. As I inch closer, I notice that a motorcycle, propped up vertically on one wheel, is strapped on the tricycle's metal sidecar. Yellow ropes keep the motorcycle from falling off the road. The men reinforce the motorcycle to the tricycle with their arms. In their late twenties, wearing shirts and denims, they grin, smile, and laugh. Are they bringing home this brand new vehicle at home? If that's the plan, why don't they ride on it? Perhaps I'll never know. In the meantime, an olive-green Vios, which I'm presently trailing, slows down. A window opens. A teenager, her hair tossed by the wind, emerges with a camera phone. Realizing they are being recorded, the men wave in the light, intermittent rain. They are having a great time. As soon as I arrive at home, in time for the Sunday service, I receive a text message that M has di

My high school classmate and friend S dropped by my clinic to have her blood pressure checked. Told her she was a newly diagnosed hypertensive. It runs in her blood. These past months, she could only count the nights when she's had a good night's sleep. How could she if, at any given moment, one of her daughters would cry? Her maternal instinct does not allow indifference; her reflex reaction is to land on her two feet to be with her children. Mothers are amazing. I thought of S when I read this passage from  Glory in the Ordinary by Myra Dempsey: Even in life’s mundane tasks, God is shaping us into a people who beautifully reflect his glory to the world. Left to our own devices, we will never naturally drift toward holiness. We rely totally and completely on God to rewire us and re-mold us, making us more like his son, thereby making us more and more holy. Because he loves us so perfectly and immensely, there isn’t a moment of our existence that he won’t use to accomplish jus

From a blog I've just subscribed to, La Vie Graphite : an eloquent  meditation on pandemic life : Enduring these months is a learning experience of what to eliminate or change. There are shortages and there are pinched resources. Less money, in the face of inflation and reduced pay, but less to buy. Three full tanks of gas in my car, in six months. Having less causes a discipline of needing less. As the workplace began requiring a weekly on-site workday, I’ve simply treated my department like a quarantine: A straight-out eight-hour day, with granola bars and thermos of coffee. There are no places to go for lunch, anyway. Then it’s become two days on-site. More granola bars for the perpetual motion. I just want to get the work accomplished, plain and simple. Perhaps it’s an imposed austerity, but the workplace is the place to get work done; there is no more socializing, and it’s hard to tell how much longer the situation will last. I’ve noticed myself working faster and more strateg

A teacher from high school dropped by the clinic yesterday, just as I was about to close shop. She was surprised that turned out to be a medical oncologist.  "I thought you took up neurology," she said. "But why 'Bottled Brain' then?" Ma'am T said she visited my blog daily until her phone was stolen. She couldn't access it anymore.  I'll help her bookmark this page the next time she visits.  The Hiligaynon word for the day is ma'éstra . It means "teacher or instructor."

I often get asked how I deal with patients who cry in the clinic. There are no easy answers. But I assume that most of my patients and their families know more than what they'd be given credit for. They might not know the nitty-gritty details of treatment and prognosis, but they carry with them a vague, often accurate, idea that what they have is "not good." When they enter the consultation room, I don't immediately get into the details. I warm them up with questions of where they're from and what they do. I establish a connection. Where I practice, that involves asking if they know a common person. It helps that I speak the vernacular for a more nuanced, intimate back-and-forth. They hardly get surprised when I break the news: that they have cancer. But my speaking to them confirms the fact of their disease. They cry, usually quietly, grappling for a handkerchief or tissue paper. I have a stack of napkins on my desk that I offer to them in a few minutes of silenc