Waiting for the Cure 4/08/2009 06:36:00 PM

I just downed the last of the 28 Erythromicin tabs prescribed for the atypical pneumonia I got last week (superimposed on influenza), but I still have coryza (runny nose) and a cough from post-nasal drip...

I was strong enough to still go on duty like nothing happened. When I open my mouth though to say something, it's plain obvious I have a respiratory tract infection.

The interns (senior clerks) rotating at our department have yet to hear me talk in my normal tone of voice (the rad techs have had their field day ever since I started sounding sick and funny...) I hope to be back to normal by Easter Monday. I still have to go on duty this Good Friday though.

Have A Blessed Holy Week and Advanced Happy Easter Greetings!

rAdIoLoGy NoTeS 17: Anger Mismanagement 4/06/2009 04:23:00 PM

If ever this story would be picked up by the Cebuano tabloids, I think it would read:

Intern Nang-Head Butt ug PGI

That was precisely what happened.

In a fit of anger, one of our supposed-to-be-graduating senior clerks broke the nasal bone (it looked comminuted to me -> three fragments) of an intern at our hospital. This happened at nearby popular hang out when the said intern was with three other female interns and also in site of several other senior clerks.

From the information I got, it seems that he felt this particular intern had snitched on him (do you really need to snitch to the resident when you are around but the senior clerk isn't--> plain obvious that the senior clerk is out of post!) thus he got more extensions than he bargained for. Probably though, his ego was hurt when the PGI calmly explained to him why interns scrub in for appendectomies and PGI's don't (Hello--- haven't they seen their share of appendectomies when they were interns a year ago?)

Actually, he had all these extensions coming his way for his laziness (not wanting to assist in OR's as he had not been allowed to scrub out of one after wanting to eat) and absences (going back to the U.S. for holidays--whoever heard of an intern getting excused for going home for the holidays! That's 7 days for each day absent!). There's a rumor he was forgiven for falsification as well for timing in on a day that he was absent.

If I heard it right, the extensions all amounted to approximately 200 days (he got repeat rotations in the surgical rotations).

His only extension at our department though was half a day for playing at an alumni basketball game. But I keenly remember threatening to give him an extension for insubordination for making a subversive comment (I can't seem to exactly recall what it was as of the moment), the only intern thus far whom I addressed such a threat to.

Maybe it was the stress of his whole family coming to see him graduate on stage when he could not make the grade...

Instead, he threw four years out the door (the dean isn't about to give him a diploma after such a public display of anger) plus a criminal record as the intern (a simple guy who comes from a local political family and has relatives who are lawyers) shall be pressing charges.

I kind of feel sorry for him though because I was involved in similar circumstances when anger came to play many years ago.

Yet, I kind of wish that his intern (she actually just quit) girlfriend and senior clerk (his classmate) girlfirend (yes, they know of each other's existence and he's having them both at the same time) would both dump him.

Disclaimer: All information on this piece were taken from a reliable second-hand source a.k.a. a co-PGI of the agrieved party. I will attest though that I personally know both parties involved as they had rotated in our department while doing their senior clerkship.

A Not-So-Short Summary of Me, and then Some... 4/05/2009 11:51:00 AM

Once upon a time, way back in senior year of high school, we were each asked to write an autobiography for our Filipino class. I put myself to the task and that soft-bound copy of typewritten pages with pictures containing the 1st 16 years of my earthly existence is still in a place of honor at the third drawer of my old desk along with other stuff I had written in the past twenty-eight and a half years. Here, I shall present to you a summarized version of that plus the 12-odd years of the gap that needs to be filled.

I’m the eldest of four children of an eldest daughter and an eldest son. I attribute the success of us four to nature (my chemical engineer father graduated magna cum laude and landed 6th place in the board exams) and nurture (my elementary school teacher mother became a full-time housewife to see to it that no one leaves the house without breakfast, everyone keeps a study schedule, assignments and requirements are complied, and books for references are aplenty). I’m a doctor (radiology resident), the sister next to me is working on an MBA (she graduated cum laude), my brother an electronics and communications engineer (he graduated magna cum laude and landed 3rd in the board exams), and our youngest sister is about to start her 4th year at the local science high school. None of us siblings are married, and we still all live under the same roof that was built by our parents in 1986.

I was born in Cebu City and shortly after moved to Batangas where my father worked. When I was around two or three, my father got a job at the Jeddah Oil Refinery, so we moved to Saudi Arabia, where we spent the next 4 years. When I started school, we moved back to Cebu City and would visit him during the summers until he quit and put up our fully-furnished apartment business. I went to an exclusive girls’ grade school and high school, an environment I thrived in academically, but not socially. It didn’t help that I have glasses, thick, unruly hair, a severe case of acne, as well as palmar, axillary and plantar hyperhidrosis. The few close friends I made though are still my close friends until now. In senior year, I was literary editor of the school paper and class chairperson. I graduated 3rd in excellence with 1st honors (equivalent to 1st honorable mention) in a class of 206 girls.

I only discovered that I wanted to become a doctor in the last few months of high school, specifically a medical oncologist. I initially decided to take up Medical Technology, but then changed my mind and took up Biology at my parent’s college alma mater. A maternal aunt who used to serve as the department chairman’s secretary and knew several faculty members did a lot of convincing. It was one of the best decisions I had ever made in my entire life. I became a member of a class of Biology and Marine Biology students who are still emotionally close until now though we are now spread out all over the world. We even are familiar with the members of each other’s families. While in college, I discovered what I was meant to do for the rest of my life (as explained more thoroughly in this post). While studying at the university, I won several interschool quiz bowls, was a BPI Science Awardee (the same year blind mathematician Roselle Ambubuyog was also awarded), was nominated for most outstanding graduate, and graduated magna cum laude.

My one wish as I began medical school was to be just another one of the many ordinary students of my class, and stay out of the limelight. I got my wish since I did not even end up as among the top 20 students of our class. I managed to pass majority of my exams though.

Senior clerkship was one of the worst years of my life. The every other day duty at our teaching hospital was second to none, as well as the detailed discharges, histories and operative techniques you had to work on. In pediatrics rotation, I had to be absent after suffering from viral exanthems. In my batch, I had the distinction of having been the only one to present a CIM case to the legendary Dr. Josefina Poblete which was then subsequently rejected (my resident’s fault, though as the patient could have been worked up without being admitted to the hospital).

During senior clerkship, while doing my rotation in Internal Medicine at our teaching hospital, I discovered that I could not see myself doing the work of an IM resident. It was then a toss-up between radiology and pathology. I thought that my myopic eyes would hardly stand the strain pursuing a career involving microscopes. It was then that I decided that the field of radiology was the one for me to pursue.

My first mortality as a senior clerk (patient directly under my care when she died) was a very sick young woman in her early to mid-twenties admitted at the provincial hospital, who had multiple sexual partners and a toddler daughter born out of wedlock, probably suffering from sepsis. We couldn't actually figure out what was wrong with her (no money for further work-up) and she couldn't be treated either (no money, again, and a mother caring for her who was clueless on where to get help). I couldn't offer her any financial help either. She was my resident's case during the ward rounds. Shortly before he was about to present her case, she went into arrest, but was revived. Then my resident proceeded with the presentation of the case like nothing happened. We moved on to the patients of the other residents. She then went into arrest for a second time. My resident and I tried to revive her again, this time to no avail. She died before the IM ward rounds ended.

I decided to place as my hospitals of choice for internship those private hospitals in Cebu City which had training programs in radiology. I ended up being matched to the hospital where I am now doing my residency. I stopped for six months before doing my internship to attend to other things (to the consternation of my mother), but was allowed to observe for a few months at the radiology department where I now work. At that time, I got an overnight hospital stay for dengue fever. I then did my mid-year internship, no extensions but a few intrigues…

We were the 1st batch of students studying under the Problem Based Learning (PBL) curriculum. We knew all eyes would be on us as even then, the previous batches would look at as with envy as we studied at our own sweet time. My batch rose up to the challenge and set the bar high – three topnotchers and a near perfect batting average at the board exams (thus far, in the entire history of PBL at the Cebu Institute of Medicine, only one pure-PBL medical student had to re-take the exams, she passed it on the second try, and is now the only psychiatry resident in our batch that I know of).

I am now doing my second year of residency in radiology at a local private hospital. Aside , we also give lectures on radiology topics to the medical students at the school affiliated with the hospital as well as giving them exams. I have the usual night shift duties, but we can also go on call (just coordinate with the radiologic technologist on duty) if necessary. Since I live a short 8 min. walk away from the hospital (or a 3 min. jeepney ride) I usually get to go home for dinner when I am on duty for the night.

Back in high school, I had already made a choice not to become a writer for practical reasons, even if ever since early childhood, it has been one of my treasured hobbies. I loved being transported to a make-believe scenario and putting it in words. Writing short stories, essays and poetry is still my hobby, and with this new technology--- blogging as well.

I would have been a poet, a short-story writer or an essayist if I weren’t a radiology resident.

My former high school English teacher, Gilmin Royo-Kakilala (now based somewhere in the U.S.) is someone who influenced me in writing. She was a member of the WILA (Women in Literature Association) and gave all her students a love for literature through innovative ways of teaching. Once she asked to see me about a particularly poignant piece that I wrote for English class… out of embarrassment, I refused to approach her on that piece. The following year she moved to another teaching job at a local university. She was the one who then trained the applicants to staff positions in our high school paper the following year. I had applied for the literary section editor position specifically (a lot of guts on my part since I had never been involved in the school paper before), and she was one of those who decided that the position suited me just fine.

My reading consists of my favorite children’s classic novels which are also books that adults can learn from time and again, presented here in no particular order:

  1. The Wonderful Wizard of Oz by Frank L. Baum
  2. Little Women by Louisa May Alcott
  3. The Secret Garden by Frances Hodgson Burnett
  4. The Jungle Book by Rudyard Kipling
  5. The Lord of the Rings by J.R.R. Tolkien
  6. The Swiss Family Robinson by Johann David Wyss
  7. The Lion, The Witch and the Wardrobe by C.S. Lewis
  8. Heidi by Johanna Spyri
  9. Alice's Adventures in Wonderland by Lewis Caroll
  10. A Christmas Carol by Charles Dickens

The only other blogs I frequently visit are those of my friends on Multiply which are the following:

Enjoy Sherryl's World – What this budding wildlife biologist, former college classmate and close friend has to say about life.

Fair-inner glimpse - Teacher, business guru, and friend who has always something to say about everything.

stars got tangled in her hair whenever she played in the sky - Musings of my friend, my brother's high school classmate, Fair's soon-to-be-sister-in-law, and now in the midst of medical school.

These are links to my own top 7 blogposts, mostly my poetry:

Return to Waterfalls

Ballad of the Hermit Crab

Disco Without Dancing


28 Verses (Under the Post Entitled "Bisperas (The Day Before)")


Encounters of the "Dean" Kind

Note: This blog was made by answering all of Gaya's questions for this edition of TBR.

A Little Off, A Little Flu 4/03/2009 07:16:00 PM

I think I caught a strain of infuenza just this week, but since fever is controlled by paracetamol, and I'm now taking antibiotics because of signs of a superimposed bacterial infection, it hasn't stopped me from reporting for work. It's only obvious that I'm sick when I talk though... So I'm trying to keep my mouth shut! Hopefully I'll be better by next week and not have some people avoid me like the plague.

rAdIoLoGy NoTeS 16: The Worst That Could Happen... 4/03/2009 06:34:00 PM

This has been something only those working in our hospital had knowledge of last year, but not anymore. I can't seem to find a link to this story in English, but it did appear in today's SunStar Cebu after being reported in yesterday's Suberbalita as well as on FM radio. Sunstar Cebu's print version has the name of the doctors as well as the hospital... Incidentally, I share the same high school alma mater as the patient and one of the doctors charged. You may access the link in hardcore Cebuano here.

What the media has is just the start of the story of this poor woman though. After having her sigmoid colon nicked in the video-lap procedure to drain fluid from a fallopian tube. ad some complications, was brought to the CT-scan and found to have her ureter cut or nicked as well. She had another operation, then more complications, another CT-scan done showed her iliac artery was cut or nicked, so they opened her up again, a third time. She was really this close to death when I saw her at that time...

The last operation done was several months later when her ileostomy was closed. A few days prior, I had her as a patient for part of the work-up and it was only then I noted how pretty she was, now that she was in the pink of health and about to be made whole again. Her husband was with her the whole time, quite supportive.

Since several months had passed, nobody thought they would sue, until now.

In the course of medical treatment, you can never tell what could happen. A simple thing could have different risks, which you have to clearly explain to the patient. Sometimes, we could never know the extent of what could go wrong. Almost everything could go horribly wrong as in this case.

Observing things from the sidelines, I can only shake my head and silently pray such things don't ever happen to me or to any of the fellow doctors I know well, my classmates, friends, consultants.... But it already has, and it can always happen again.

In hindsight though, I guess none of these would have happened if they had decided to adopt a needy infant instead...

Angel on The Bus, With I-Pod 4/03/2009 05:28:00 PM

As stated in the previous post, I had to travel by myself to the retreat venue all the way from Cebu by myself. Now, getting to Manila by plane is the easy part but taking the bus to a town in Luzon by myself and getting to the venue I have never been to before was the tricky part. I can't ever remember traveling on a bus alone before. The whole thing made me nervous.

Later, I discovered I was given out-moded directions by friends. The only saving grace I thought I had is the ability to speak fluent Tagalog (my Tagalog friends often ask me why since I have lived most of my life in Cebu City) thanks to having BatangueƱos for playmates during my early childhood in Saudi Arabia. Incidentally, I was also headed for the province of Batangas.

Getting off the plane, I decided to take the metered airport taxi for safety reasons. The driver was pretty pleasant and helpful. He even guided me on which bus to actually board and not to allow anyone to act as porter for my baggage so I won't have to spend more by tipping.

It was almost lunch time when I seated myself in the almost empty bus. A mestiza lady with dark sunglasses, who seemed to be around my age took a seat to rows behind me. Then, for some unknown reason, she got up and asked if the seat beside me was taken. I offered it to her.

I asked her how long the trip would take to Lipa City,and then found out we were going in the same direction but she would get off first. She was surprised to find out that I was traveling by myself there from Cebu to attend a retreat, and that no one was out there to meet me.

She then proceeded to hum in tune to the music from her I-pod while I took my packed lunch as the bus finally got filled up.

My seatmate pointed out a few landmarks along the way for me as well as pointed out that the reason we were apparently delayed was that the bus went through the different towns, stopping each time instead of taking the SLEX.

We said our goodbyes as she got off at Lipa City Hall. I still had several meters to go before getting off at SM City Lipa to take a tricycle to Latag Study Camp. It was then that I realized that I had forgotten to even ask for her name, due to my tiredness (I was on hospital duty the night before) and nervousness about traveling alone.

My tricycle trip to my retreat venue was then uneventful.

It's funny how God kind of sends us people to help us along the way in such a natural, unobtrusive manner. I may not know her name, but I'm so glad she decided to sit beside me.