2008 had its ups and down for me. I had to give up, give in, bear it, take it as it is, do more, be better. I've been involved, missed out, loved a lot, been excluded, lived my dreams and drifted back with nostalgia. Now, the new year is here, and i'm this close to turning the big 3-0!

What's in store for me then?

Stay tuned!

A few days ago, I became both the daughter and the sister of board exam topnotchers. My brother found out that he got 4th place in the recent ECE board exams. He somehow bettered the 9th palce finish of our own father in the Chemical Engineering booard exams several decades ago.

Just as the results were about to be released, our phone lines and internet access died. We had to rely on text messages from an aunt for news.

My youngest sister (forever at odds with the brother, the place I held before I "matured" and stopped quarreling him myself ) couldn't care less. She couldn't understand our concern about not being able to get to the news first. We were all going to find out about the news the following day anyway.

A little past midnight, my mother woke me up with the news that my brother had passed the exams and was in the top ten placers. He learned about it from the text messages of classmates. One of his classmates also gave him a call which woke him up. The rest of the family was already awake and celebrating: Mama, Papa, my brother and my other younger sister.

We decided to let the youngest in the family sleep it out in the couch.

The next day, when I asked if she had congratulated her brother, she said nothing.

I still owe my brother a tub of ice cream though.

Congratz, Joven!

Tomorrow, I will be celebrating my 28th birthday. Since, I will be the radiology-resident-on-duty at the hospital tomorrow, I'm writing my birthday post on the eve of the day itself. I'll be cooking for the staff of the department (yes, those guys I have been occasionally ranting about who have appetites of epic proportions!) and my co-residents for breakfast tomorrow. They are planning a mañanita (dawn serenade) which I am strongly opposed to! I don't know yet if they will really carry out their plan...

Anyway, I used to celebrate my birthday by writing a poem with the exact number of lines as my age when I was in college. I think it is about time to revive this custom...

~@ ~ @ ~ @ ~ @ ~ @ ~ @ ~ @ ~ @ ~ @ ~

Twenty-Eight Verses

With the night at end

Ane the day begun

The sunlight glides

To break the dawn

And allow the rain

To pause and think

Of puddles that muddy

The path one takes

Or rainbows to usher

The day's delight

And I pause to wonder

Of the things to come

Be they lights or shadows

Joys or adversities

And see that the difference

That lies beneath

Depends on one's perspective

Of what is at hand

Thus, I resolve to wear

Those rose-colored glasses

That I may see

The world anew

From the optimistic perspective

Despite the hurts

Or the ills that come

The darkness shall fade

And the light shall come

With the rising sun

-jara-

(c.2008)

To Doctors and Nurses

Likewise we hold in the highest esteem those doctors and members of the nursing profession who, in the exercise of their calling, endeavor to fulfill the demands of their Christian vocation before any merely human interest. Let them therefore continue constant in their resolution always to support those lines of action which accord with faith and with right reason. And let them strive to win agreement and support for these policies among their professional colleagues. Moreover, they should regard it as an essential part of their skill to make themselves fully proficient in this difficult field of medical knowledge. For then, when married couples ask for their advice, they may be in a position to give them right counsel and to point them in the proper direction. Married couples have a right to expect this much from them.

I'm taking this breather from a hectic, tension filled day after having been on duty.... I'm doing some template tweaking as you have noticed (now my multiply, friendster and blogspot are all butterfly themed...) It's just in time for my 28th birthday as well. I will be posting my 100th post here at blogger as well... Watch out for it! In the meantime, I leave you the link to the general get-together with St. Josemaria's current successor during his recent visit: Opus Dei Prelate's Pastoral Visit to the Philippines

A mouse once found its way into a rat hole. Oblivious to the animosity of the rats that lived there (perhaps thinking that they are so much like him, since they essentially looked similar to him), he decided to partake of a small nibble of cheese from a pile in the corner. The rats just stared at the little mouse as he ate a little.

He thought he was indeed welcome in this company of other rodents thus he decided to ask, “Is it possible for me to taka a little to my children at home?”

“Take as much as you wish,” they obliged him.

As he was about to leave the entrance of the rat hole though, he heard them whisper to each other, “Who does he think he is, this lost mouse taking his fill amongst a company of rats?”

It was only then that he realized that he was never welcomed in the first place.

Moral of the story: Tongues only wag when the unwelcomed guest leaves.

Sometimes, the only way for you to find out how people really think about you is to be away for awhile. For sure, you will be the one talked about. That’s why at times, one is tempted to be the last one to leave the party so one hears all the grisly details about those who left first.

Maybe, there was another reason for me to have been given the chance to have that one-day-away break from the hospital. I finally found out the very same thing I had been long suspecting the whole time. There are people who loathe me. And now, I try to remember one of the last things the Father (Bishop Javier Echevarria, the Prelate of Opus Dei) told us before he left the get-together yesterday,”… not to keep grudges or resentments.” It’s hard and I will be lying if I say that I am not holding back my tears, but I will have to give it a try, with a sincere smile on my lips.

I never knew I would be writing about her for this edition of the blog rounds, but I guess she deserves it because of giving me another chance...

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It was almost 11 years ago when this high school freshmen did the unthinkable by literally kicking the shin of one irritating classmate. Naturally, she was shocked, and so were the 50 or so other classmates who saw it all happen while they were lining up for the next class. The consequences of that one act of passion redounded to many things, including possible expulsion.

Her homeroom adviser asked to speak to her. She was naturally nonchalant as they spoke about what happened, maybe she was still seething in anger at what the classmate had commented on in the first place which led to the incident. In the end, the adviser decided to issue no sanctions at all, not even a censure as the mildest warning.

Past forward to a few months later, when this high school student found herself sitting in the school auditorium and about to line up onstage to receive an award as an honor student. Suddenly, she found her homeroom adviser sitting behind her. She whispered, "You know, I fought for you to be here. They wanted to ban you from the honor roll this year for that incident, but I begged them to give you a second chance." The student didn't know what to say, but just nodded in agreement.

For the next three years, this student found herself in the high school auditorium, lining up on stage to be in the honor roll. Eventually, she graduated 3rd in a batch of 200-something.

On getting her credentials for college, she found no mention of that long-ago incident in her freshman year, even in recommendation letters for good conduct. Somehow, her homeroom adviser then had managed to convince everyone else to give her that clean slate, a real second chance.

She graduated Magna Cum Laude from her college course in biology, finished medical school and is currently doing her residency training in radiology.

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Mrs. P isn't my favorite high school teacher. In fact, I think she is a little over the top at times... Over-acting is the word we often use to describe her. But on returning to my high school for our 10th year reunion last year, I wanted to see her, to formally thank her for that second chance a long time ago. I wanted to show her how things turned out afterwards for this once-upon-a-time short tempered teenager. Unfortunately, she was not around at that time. I guess this blog entry will serve as my tribute to her and a reminder to give erring individuals a second chance.

Lantaw na lang sa

Hunas na baybayon

Samtang wala pa

Nibalik ang dagat

Na mo-anod sa

Imong kagul-anan

-jara-

(c. 2008)

The subtitle of this post happens to be one of my less irritating current pet-peeves. A certain radtech has started calling me "Dra." (Yes, you do pronouce it in the way you spell it... Not "doktora", but "dra") and everybody else in the department is joining the bandwagon... Of course, it means "doktora", but alternate meanings are as follows: "drama queen", "dramatics", "hydra"... Oh, the list could go on with a lot of smart-alecky staff around you (although, the last one actually came to me in a conversation with the radtechs... ). I guess that's precisely what you get if you're the only female resident in the department training for a male-dominated specialty...

I studied elementary and high school at an exclusive girls school. I took biology as a preparatory undergraduate course for medical school in a female dominated class. In medical school, approximately 70% of our class consisted of female students. My senior clerkship group (in my part of the country, we usually refer to it as internship), consisted of five females and only three males. When I did my internship (in my part of the country, we refer to it as post-graduate internship or pgi), my first group was all-female. In my second group (I did PGI mid-year) I had only two male groupmates (and one of them is an outed homosexual, the other one, people had been speculating on for a time, though he now has a girlfriend). I have more female friends than male friends. I also lend a hand to a foundation that specifically caters to female youth. I was definitely in for a culture shock of sorts...

I actually applied for residency at two hospitals, and at both hospitals, they asked me whether or not i was married, or had plans to get married, musing on the possibility that I might get pregnant while doing my training (the other residents will have to cover for a pregnant radiology resident doing and supervising radiographic procedures due to fetal risks). Then, at the other hospital I applied to (not the one I am currently working in), one of the interviewers specifically stated that in a span of two or so years, they had two residents resign, and both of them happend to be female. At the back of my mind, I was already thinking that they won't accept me (which was a blessing in disguise since I was more keen on doing residency where I currently am now). That was exactly what happened although I think my gender was not the main reason (I think they were more keen on accepting the other two applicants who had their PGI in the same hospital).

When I did begin residency, I had to adjust to a predominantly male work environment. There is only one female radtech in general radiology (the rest of them are in the women's imaging center), and only one female interventional radiology nurse. I answer to only one female radiology consultant. The receptionist and secretaries though are all female. At our monthly meetings with radiology residents training in our city, I found out that only two of us are female, and she is already about to end her training while I am just starting mine. Hopefully, more females will take up radiology in our place in the years to come. Otherwise, I will have to contend with the fact that I'll be the only female radiology resident in the years to come.

I still detest having to listen to my seniors and other staff comment on the way certain females look/dress/etc. Sometimes, they start talkig about their night out at some lewd place (Do they sometimes forget there is actually a female working nearby or is it just to irritate me?) I still put my foot down on any joke or conversation in any shade of green (Totally inappropriate in any working environment, or any environment for that matter even if to some, the mere fact we are in the medical field, anything goes in that direction...).

The equipment are actually more tailored to be handled by male staff. The fluoroscopy machine's image internsifier is bulky, heavy and a little difficult to manipulate, more so if it gets stuck in one place ever so often. The lead gowns are heavy. The cassettes are also heavy. Giving an intravenous push of contrast also requires some degree of force. Preventing a hematoma after taking out a femoral catheter also requires some force (Perhaps that's why the interventional radiologist has not yet asked me to remove a femoral catheter from any of his post-coil embolization patients?) In the first few months, our chief resident has occasionally joked that I consider working out to build some upper body strength.

Not having had a female radiology resident for the past three years has sort of confused the nursing staff. Just one of the many cases to point:

Department Receptionist: Doktora, telephone call.

Me: Hello, Ma'am?

Nurse: Who's this? I'm looking for the radiology resident.

Me: Ma'am, this is Dr. J.A., the radiology resident.

Nurse: Hello, Ma'am, we have a referral for Dr. --- at room --- for ultrasound-guided liver biopsy.

Me: Who's the primary atttending physician?

Nurse: Dr. ***

Me: Ok, I'll inform, Dr. ---.

Nurse: Who's this again, Ma'am? Are you going to tell the radiology resident?

Me(now a little bit irritated): Ma'am, this is Dr. J.A., the radiology resident.

Nurse: (Pause) Ah, ok, Doctor.

Some female patients undergoing more delicate special radiographic procedures (i.e. a hysterosalpingogram) do appreciate that the resident around is female. At one time, a patient did request for a female resident. It was a good thing that it was also my assigned day for special radiographic procedures. I have no qualms about doing a urethrogram on an adult male patient though. It is part of my job, and anyway, more likely that not, the staff around are also male. At one time though, while supervising a voiding cystourethrogram, I decided to leave the room while the radtech was doing overhead films as I thought that the young boy might have inhibitions on urinating while an unrelated female was around.

I still get a little irked when some patients still refer to me as "Miss" or "Ma'am" while I am wearing a doctor's coat. I guess the average Filipino mentality still thinks females in white at a hospital are nurses while males in white at a hospital are doctors.

I am relatively young in the world of the medical profession, having just received my license to practice a little over a year ago. And with that came automatic membership into the local medical society under the Philippine Medical Association. Until now, I actually have no idea what their activities for doctors is, although I recently heard about some symposium in our place, which I'm not sure any of the other young doctors were able to attend. For most of us residents, the next time you usually here talk about the PMA is when someone is about to take the specialty board exams (i.e. the chief resident in our department) and finds out he/she needs to pay the requisite membership fees for the past 3-5 years which he/she was not faithfully remitting to the society. After that , probably you won't hear much about the PMA... you'll hear more from the specialty societies...

I'm sorry that I still have to figure out for myself exactly what they are doing for us and what we are doing for the Philippine Medical Association in turn. Honestly I'm clueless... So, I really can't say anything more based on personal experiece.

I hate to say it but the fact that a lot of the doctors in their mid-30's to early 40's are taking up nursing to seek greener pastures seems to say volumes about the state of the profession. Maybe they don't feel their family will be secure with them staying and practicing their first profession in the country?

Fewer students are deciding to take the additional 4 years of medicine plus one year internship to get that M.D., and of these, probably 3/4 (I'm stating this as a reality in terms of my own class- CIM 2005) will be aiming for the USMLE and other foreign board examinations with the intention of settling elsewhere for good.

The few of us left doing our residency training are probably also thinking of doing further studies abroad (that's one option I'm personally inclined to) and probably settling somewhere else in the near future (Personally, I'm not inclined to the option of permanently renouncing my citezenship, but it's not something I'm totally ruling out either).

So, what's the value being put on us? Maybe it isn't that much. I know residents in the capital are paid a paltry. In our part of the country, most of us are paid a little higher (can't complain about my own salary as I get to save since I work pretty near where I live with my family and can save on some expenses) yet there is still a general dissatisfaction about the income that pervade (i.e. a co-resident of mine having plans to get married next year is taking up a side-line job just to afford to pay for the wedding expenses). When you go into sub-specialty training locally, you still get paid a paltry sum... Then, when you start your practice, it's another story... A friend and college classmate of mine, also planning to go into residency training in radiology stated it plainly when she told me: "You know, we will probably have to set-up a diagnostic center together..."

So... Maybe I am a bit worried with regards to the financial side of this profession. Still, I think it is a pretty noble endeavor, although reaping the rewards of the time, effort and finances you have sacrificed are a long time in coming or won't come at all. Afterall, we touch on something basic in a person - health. Sometimes, it is not just the physical side of the person that you touch but also one's mental, emotional and spiritual well-being. Still it is a way for one to earn a living so one has to be able to determine the pros and cons of determining the right professional fee for one's services, or maybe decide to charge nothing at all.

Somehow, I have always sort of counselled most of my younger friends not to enter medical school by presenting the hardships that are in the way. My advice though is seldom heeded as just this school year, I happen to have two good friends who are not about to heed my advice by beginning their freshmen year of medical studies.

I'm keeping my fingers crossed that my youngest sister (about to start 3rd year high school) won't follow the footsteps of this eldest sister... I still don't want anyone else in my immediate family to go through everything that I did to become a doctor and whatever difficulties I have yet to undergo to establish myself in my chosen profession.

I think it is about time I stop ranting and raving about the difficulties now that I am about to end my first six months of residency training... So here's a short list of why I am lucky to be doing my residency training where I am now surrounded by the people around me now in my work place.

1. I have only 4 consultants to whom I am answerable to and I already know their quirks and personalities.... I get along with all of them for the most part, and know that I can relax around them. If I make a mistake, I know for sure I will never be yelled at... mistakes will be pointed out to me as calm as possible.

2. I can vouch that my three male seniors care for me in their own way although they will try to get on my nerves at certain times. They sort of look out for me and advise me at all times.

3. As I am in-charge of the interns a.k.a. senior clerks rotating every fifteen days at our department, I also get to look out for two or three persons and help them to understand the intricacies of the different imaging modalities, though I don't entirely understand things myself either. I have always wanted to influence people in a positive way,a nd this is it.

4. By sometime next month, I may get an assignment to lecture before the second year and third year medical students of the affiliate university of the hospital where I work. It reminds me of my first career choice which I wrote down way back in second grade- to be a teacher, like my mother (who used to teach grade school before she chose to be a housewife). My father, an engineer by profession also used to teach mathematics part time to business and accountancy students of the university I went to in college. It sort of continues the tradition -> now I'll be teaching medical students, and for the first time, they will get to listen to someone who has gone through the entire process of problem based learning (PBL) give them a lecture. As one of our consultants just mentioned today, it's a practice for when you'll be "lecturing" the examiners when taking the oral examination for the specialty board.

5. Even if the mostly male staff (from the chief radiologic technologist of the hospital down to their probees... well even the rad tech interns occasionally...) will tease me to no end, I guess that somewhere beneath everything, I have already sort of gained their trust in my ability to take care of the work done... I'm starting to believe that everything they say is only part of their..."pag-lambing". And today marks the first time (I still can't believe it has happened though!) that none of them had made a teasing comment at all!

6. The secretaries and receptionists will talk... Then again, what else will they talk about now that I have told them point blank the real reason why I have no intentions of getting married (sigh!). As usual, people can't seem to grasp the concept of someone not being a nun , not living in a convent or wearing a habit and still not getting married for loftier reasons.... Maybe I still have a lot more explaining to do through my actions as well, which is a lot harder since the staff can get on my nerves.

7. Mama still packs me a great lunch everyday. I do need it. And so I am grateful.

8. I still get some occasional lull time wherein I can relax at my workplace.

9. I am at the coolest department in the entire hospital.... It has somewhat calmed me when I am particularly busy and moody at times.

10. The Blessed Sacrament is reserved 24/7 at our hospital's chapel... I can always go there to seek solace, or if I cannot do so at once, I can "fly" there in my mind's eye.

I guess, there is no more reason for me to be ill at ease, to be frazzled, annoyed and worried if I always keep in mind these 10 thing.s

I started blogging when I read an article in the Philippine Daily Inquirer all about it. It was my in-between period after passing the board exams and beginning residency training then. And, so, I got hooked. I have been blogging more or less regularly for a little over a year now and nearing my 100th post.

I have always loved to write ever since I was a kid->stories, poems,essays, even some short novels, mostly unpublished. I became literary editor of our school paper in my senior year of high school. I also kept a diary more or less daily from high school until early college days. I now edit the semi-annual newsletter of Banilad Study Center. Though I never thought I would make it a career, writing was always my hobby, something I would have pursued if I didn't want to become a doctor in the first place.

The switch to the realm of the blog came natural for me who have long mastered the intricacies of doing things over the internet and emailing back when I was in college.

When Dr. Clairebear extended the invitation to "The Blog Rounds", I naturally gave it a try and came out with my first entry in its 5th edition, giving in more of my contributions and eventually hosting the 11th edition.

I like the idea of the blog rounds, writing on a theme and making it your own, setting your own boundaries. Somehow though, I find the once weekly schedule a little tight (even if one may or may not choose to blog on the weeks's topic anyway). Maybe a bi-monthly schedule for us doctors is more feasible?

I also like to read up on other people's thoughts on the different topics as it is a great way to find out more about someone you may not have yet met in person. You get a lot about his/her personality from the things he/she writes about and more or less find out more about the persons values and way of life.

I hope the blog rounds continue their discussions indefinitely into the near future with the hope that more doctor-bloggers will join our rounds.

It's kind of odd that I only got to met her then husband-to-be in person (he's based in the UK where they plan to settle down eventually) when they were already sending out the wedding invitations. But judging from all I heard about him, I already had an inkling that the first guy to catch my choosy friend's heart would be the last one as well.

I would have had a chance to be at the wedding to (one of my seniors said that he would cover for me...), but I decided to finish the last special radiographic procedure for the day and miss the 3 o'clock wedding. If I had been there, I swear I would be crying my heart out.

She already knew I would be late for the reception, (my early Friday evenings are fixed for activities at Banilad unless I'm on duty...) but it didn't matter since I came to the wedding reception eventually.

Seeing her in that gown really tempted me to comment on its style (I had already warned her to wear a bolero at the church-she ditched that at the reception, though... but forgot to warn her about showing more skin elsewhere... ), but I decided to hold my tongue until later...

I then started to reminisce on how a friendship developed some 11 years ago when this other four-eyed girl in loose jeans and a shirt (just like myself) started hanging around my arm (literally!) and sniffing my hair (literally as well!).

On one jeepney ride in between classes (and campuses) I learned the telenovela of her family life, quite different from the normal humdrum one that I had. I was amazed that amidst it all, this was a girl who was determined to rise above her family's past.

We officially quarrelled for the first (I think, it was also the last time) from the stress of working on our baby thesis together for Ecology in 3rd year college. We patched up almost immediately.

I wrote several poems for her, but I still wonder if she was able to keep them all.

We started attending activities at Banilad together. She was one of the few people who new I was about to become an associate and let me go my own way. I'm sure she did not understand my decision entirely (eight years ago, I'm sure she'll agree how immature she was then....).

In medical school, she made more new friends, had different interests while I focused on my studies and slowly adjusting to my vocation. Somehow, we drifted apart, but still a certain connection was there whenever we start up a conversation again, just like we just talked yesterday.

I'm going to miss her when she moves to join her husband definitely, but right now, I savor the times we still text with each other now that we are doing residency training in different cities.

I guess, Angie, I'll always remember you as that four-eyed girl attached to my arm and sniffing my hair over my shoulder...

It’s just about time for us to cut the chitchat short, say grace and dig in! This banquet is officially about to commence!

FAMILY TRADITIONS:

MerryCherry, MD gives us a glimpse of how Kapampangans do their cooking in “Mangan Tamu”

DINING OUT:

Joey MD gives us a glimpse of her food choices in “Around Robinson’s Place Manila in 5 Days”

Noel gives us a sampling of international cuisine in his entry “Recent Acquaintances: Pastitsio, Kulfi & Cherry Garcia”

APPETIZERS:

Dr. clairebear takes us down memory lane with this oh-so-familiar street food in “Fishball Memories”

MAIN COURSES:

Kittymama shares how Lasagna became her comfort food of choice in “Garfield’s (Kitty)Mama”

Dr. Tes glorifies the quintessential Pinoy fiesta favorite and mainstay in “Lechon of my Life”

SWEETS AND DESSERTS:

Got meloinks shows us his sweet side as he savors the sweetness of muscovado in “The Case of the Skin-Rejuvenating Chicharong Bulaklak and the Evil ‘Kamay’, which turned out to be Muscovado”

Ness teaches us the intricacies of cooking this native kakanin the old-fashioned way in “How to Cook Palitaw”

REFRESHMENTS:

Your host, J.A. presents you with her favorite drink, on the house in “Ice Tea Girl”

I don't drink coffee. For some strange reason, this medical doctor doesn't even like the smell of this brew which has aided generations of medical practitioners in their quest to be awake while serving 35 or so hours in one shift. In other words, I abhor the drink. What kept me partially awake the whole time (and still does today, although I am an unusually light sleeper when on duty...) is iced tea.

I'm not exactly an iced tea addict, more like a connoisseur of sorts. I don't take it everyday. I don't crave it all the time. I do fully enjoy a little sip or a long slurp every time.

When eating out with family, friends or colleagues, its my usual drink of choice.

At home, I'm the one you see mixing up a pitcherful of any instant iced tea flavored mix for household consumption. Occasionally, there's some lemonsito (Philippine lemon) in the mix as well. It could also be half an iced tea mix and half another fruit flavored mix. It depends on my creativity (or the supply in our refrigerator).

Sometimes, I take my tea hot as well, or brew it hot then place it in the freezer. Occasionally, I'd brew some tea, then add powdered milk or some powdered fruit juice into my hot beverage, take it as is or chill it as well.

Now that I seldom have the luxury of time to mix things up, one usually finds me with a bottle of C2, Lipton or Sola with my afternoon snack, bought from the hospital's pharmacy/convenience store.

I'm almost midway to my 1st year of residency training, and it seems like I just started yesterday... I have already begun to adjust to the work schedule (which can range from doing nothing the whole day to being so busy that you get out only at 6pm when your previous or not have a single wink of sleep the entire night you're on duty...) and, maybe a little bit to the teasings of the male staff, which I have begun to adjust too (I still put my foot down on their "green conversation" and so-way-back-in-high-school types of comments and teasings...) But in the midst of it all, I am happy, serene, and I love my work. I'm still looking into the possibilities of giving a little extra to the people I work around with... whether it's a smile, a greeting, a word of advise, or maybe just listening and praying for what the other person needs. I'm grateful that I have found fulfillment in what I do, even this early in further studies in my chosen profession... I hope that everyone else does so as well.

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To all the MOTHERS out there: HAPPY MOTHER'S DAY!

[Taken from the Frindster site of CIM with the original captions: Recognize the white figure inside the library? ]

Our newly retired Dean, Dr. Josefina L Poblete has been a defining icon of sorts for all of us graduates of the Cebu Institute of Medicine ever since she has been at the helm of our medical education. She's one of those persons who leave an impression on you. I think it can be summed up by this one thing comment I remember in a conversation with her daughter, Dr. Poblete-Chan, who was then my Problem-Based Learning (PBL) group preceptor when she asked me, "Are you (referring to me and my groupmates) uncomfortable with me just because I'm the daughter of your dean?" I have never felt uncomfortable around Dr. Poblete-Chan, but her mother makes you uncomfortable when she's around just because you know that she is dead serious that she wants you to become THE "Physician With a Heart"

I remember a panel interview with her and the deans of the other local medical schools as part of the application for the regionalization program of the UP College of Medicine (I never pushed through with applying there due to non-compliance with a requirement though). She was the only panelist I remember who rarely ventured a smile throughout the interview.

Everyone was always careful when she was around. Maybe it's because she has the tendency of spotting something awry with one's uniform (i.e. too short skirts for females, wearing earrings for males). She would tell it exactly to your face when you did something wrong/inappropriate/not to her liking. She also makes you want to be somewhere else when she was around. Interns (senior clerks in local parlance), PGI's (post-graduate interns), and residents literally disappear from the OPD's hallway when they spot her coming through the door from a mile away.

One time, at our stay-in community rotation, she caught one of my co-interns walking around sans uniform in the primary care center. She saw him running into the male quarters to hide, so she went right up there to talk to him, ask him why he was running and to give him a piece about being properly dressed when assigned to the center and not to loiter there when not on duty.

Another time, at the same community rotation, she noticed that I buttoned my smock. She really came up to me and told me to unbutton the smock as it is more becoming to look at us in uniform that way. I was quite taken aback. I am until now still uncomfortable with buttoning my now long-sleeved resident's white coat.

For an entire two weeks, in my internal medicine rotation, our sub-group was on our toes when she was house consultant and would annouce house rounds almost daily, and even a surprise ward rounds on a Sunday morning which caught even the house resident by surprise.

Charity cases were presented to her on a one-on-one basis directly by the interns for her approval. You never know whether she would focus on the socio-economic background of the patient in question or the intricacies of the treatment modalities the patient would be subjected to. I had the misfortune to once present to her the only charity case which to my knowledge was unapproved (mostly through the lack of foresight of the admitting resident, and the lot just falling onto me to present the case). I felt like dying on the spot when she said the words, "..., and that's why I'm not going to approve this case!"

One thing that I do appreciate is her effort to help us learn to practice medicine in an ethical manner through lectures, though I guess it has sometimes fallen into deaf ears. I also appreciate her emphasis on modesty and dressing in a manner in which people would regard you with more respect, which a lot of my peers have tended to disregard.

There are people you won't forget your entire life. Dean Poblete is exactly on one of these people in my life.

Physical Education has never been my favorite subject. Ever since early in grade school, this klutzy nerd has had a hard time coping up with the intricacies of a modern dance routine or playing any ball game. Later on, sometime after having had swimming lessons, I developed a distaste for dipping my self into any large body of water (i.e. swimming pool, sea, river, waterfalls) because of a certain incident which I would rather not mention... I then became adverse to any form of regular physical activity with the exception of a nature hike or long walk. Unfortunately, I seldom have the opportunity or the time to indulge in this activity nowadays.

In short, I don't exercise regularly. As a medical doctor, it's something I'm a little reluctant to actually admit. I have never set foot in a gym, and neither do I plan to in the future. I am already living such a tight schedule in my first year of residency and attending to other family and social obligations that this has been at the end of my set of priorities. Frankly, it's the only thing in the healthy lifestyle list that I am unable to do (aside from the usual lesser number of hours of sleep all doctors are subjected to in the course of their training and profession).

I still wonder when I will ever incorporate a regular routine of physical activity into my schedule...

I was probably in second grade when one of our projects was a needlecraft sampler with the Phlippine flag stitched on it and the words "I love God and my country". Somehow, this childhood memory resurfaced in my mind when the topic for this week's TBR came up.

I can't deny the reality that our homeland has its share of problems, yet I can't imagine living and working anywhere else. Sure, in the future, I may have the chance to train further in my field somewhere else, but ever since, I knew deep in my heart that I would still go back and practice here, nevermind that probably half my med school classmates are setting their sights elsewhere around the world with a mind on permanently living there for good.

There is no where in the world where you find people who find humor in the most serious of situations and who would venture a smile at a camera or a friendly wave even if they are waiting to be rescued on a rooftop from rushing floodwaters brought by a raging typhoon. There's a different kind of optimism and faith there.

We have so many places of interest, both typical and atypical from beaches to waterfalls to trekking sites to caves. The natural wonders these islands have to order are amazing. There's a wide variety of food choices as well wherever you go.

I have spent most of my life in this country, and I'm sure that if I go away again, I will long be back with all my heart.

Dorothy is right: "There's no place like home." Even if it is this grey, dreary one called the Philippines.

You'll get the point of my subtitle once you read through this post.

A funny, odd thing happened to me while doing one of the most common special radiographic procedure: a barium enema. This consists of introducing a liquid contrast through the rectum to visualize the large intestine upto at least the cecum and appendix, at most to the terminal ileum (the distal small intestine). We usually have the contrast up in a bucket with a rubber tubing at the bottom hanging from an IV stand. I already moved the IV stand a little behind me and was through with introducing the contrast, but was still visualizing the large bowel using fluoroscopy. Suddenly, I heard a clang, and the next thing I knew, the IV stand fell to the floor spilling the bucket of barium. I guess my hairstick (I usually get my curly locks out of the way when doing a special procedure with this, a clip or scrunchie) hit the bucket and sent the whole set-up crashing to the floor. The radiologic technologist thought I was soaking wet, but thankfully, the contrast only slightly splashed the sandals I was wearing and my exposed toes. Neither my patient, the fluoroscopy machine, the monitor nor I were hit by the contraption consisting of an IV stand and a bucket full of barium contrast. I had a laugh and got back to work after the housekeeper cleaned up.

Upon mentioning it to a friend, she commented that my guardian angel must have been at work. I believe that she's right. The whole thing could have crashed anywhere but the floor and yet to the floor it went. Nobody was hurt and no equipment was damaged. And the thing was, I didn't need anymore barium at that time because I was through with infusing contrast. Lesson learned though: No hairsticks for my curls at my next scheduled barium enema.

Thank you, Guardian Angel for keeping me, and those around me safe...Again!

"Angel of God,

My Guardian Dear

To Whom His Love

Commits me here

Ever this day

Beat my side

To light and guard

To rule and guide

Amen."

TBR 6, Here I come!

~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *

It was my rotation at the local regional government hospital, and the first time I had a patient under my care die right before my eyes.

CC, single mom, early 20's, was one of the patients I inherited from the previous group of rotators at the department of medicine. Her mother, probably in her mid-forties, was quite frantic, not knowing where to get money for the labs and medications... To make a long story short, we called a code a few minutes before her case was presented by my resident for weekly ward rounds and then revived her. After the presentation, we called another code and the patient expired. A little girl lost her mother...a mother lost her daughter.

I felt awful afterwards as I talked to friends about it. But what could I do? And then I started to ask... Who's to Blame?

We can always say that it is the system, but behind the system, it all goes back persons. Graft and corruption is so rampant, one feels no need to raise eybrows when another anomaly comes to light. Values seem to get askewed along the way when millions of pesos are at stake.

Health is often times not a priority to people as well and since the cost of health care from trained professionals is astronomical to the everyday Filipino, people go to the oftentimes well-meaning local "mananambal" (translated-> healer) who can sometimes just complicate the matter before the case is finally brought before the doctor.

Then, there are the health care professionals who become so anesthesized to the human suffering around them... Overworked and underpayed, what incentives do they get to provide the best care to those entrusted to them? The call of greener pastures then comes and off they go to find more appreciation and fortune in foreign shores.

I could go on and on and on and on about all the other things that come into play.... In the end though, it starts with each one of us in the health care profession to find even small ways of bringing health care closer to everyone.