I was diagnosed with atypical varicella zoster (a.k.a a not-so-usual presentation of your supposedly childhood chicken pox) which gave me a few crops of typical lesions with no other associated symptoms...
Owing to the fact that I was busy and felt otherwise fine, it took almost a week for me to see a dermatologist and got a delay in the diagnosis...
Still, I was made to stay in quarantine at home for another week... What was this usually busy radiologist to do, cooped up at home?
Looking back in the week, I actually had several things going on:
- preparing in advanced talks I will be giving
- readings of Porta Fidei and the accompanying Note with Pastoral Recommendations on the Year of the Faith
- a bit of spring cleaning
- going over old pictures in CD's to pick the ones for a slide show
- working at home with a provided portable viewbox a.k.a. negatoscope and x-ray films brought in for twice a day reading
- more time in prayer
I guess I was busy afterall...  
;-)

The recent past has held its share of painful memories. Yet I owe it to myself to transcend it. Sometimes, it amazes me how people believe that I have yet to move on and continue to misinterpret even comments on my own Facebook page.

Oh yet more things to offer up for love of God!

And I do know that I am only accountable to God in the end, not anyone else.

I'm in for another long holiday from most internet activity (except for email) in order to study for two sets of diplomate exams in January. Pray for me and wish me luck.

By a twist of fate, I will be asked to cover for the ultrasonologists at the hospital where I am working even before I have passed all my diplomate exams. It just so happens that both will be out of town for the duration of two whole days with no one available to cover for them. Who wouldn't be apprehensive in such circumstances?
I guess I shall have to rise up to the occasion...

Will be staying off blogging for the rest of the month until after the Philippine Board of Radiology Examination Part I on June 18th... Hope to be back and joining TBR after the exams. :)

I thought is was the beginning of another lazy Sunday duty, the only highlight of which would be installing the newer printer to the older computer in the panoramic x-ray room (which also serves as the resident's makeshift office/quarters), when we got the call:

A busload of mostly Iranian nationals headed towards Balamban had fallen off a ravine.



I braced myself for the busiest duty of my residency so far while the non-duty senior clerks, PGI's and residents were being called back to the hospital. The minor OR was opened for the patients to be accommodated. I also heard that they opened the hospital boardroom for the use of the Iranian ambassador.

The junior resident on duty with me chose to stay in general radiography, while I took on the task of generally giving preliminary readings at the CT-scan. (Our MRI is closed on Sundays, and the attending physicians decided to do CT's in the meantime because of the time element).

There were several fractures, a few suspected spine traumas, but no major brain injuries.

There was the toddler who was with a senior clerk the whole time as the mother had died, the father was still being transported and nobody could tell us the little girl's birthday (the techs decided to just estimate the age since they could not log the patient).

The surgical service thought a now unresponsive young woman had a brain injury, but with an unremarkable CT-scan of the brain as well as the visible abdomen, the diagnosis was changed to hyperventilation/hysteria vs. an electrolyte imbalance.

We heard the story of how one ophthalmology resident in another hospital had the presence of mind to remove himself from the vehicle and climb up the ravine by grabbing on to a few shrubs to finally reach the highway. He was the first patient airlifted and transported to the hospital.

We had to call the radiology resident on duty at another hospital to clarify findings on the CT-scan of a just-transferred patient (their institution and our institution now print on thermal paper which is insufficient for diagnostic purposes) as well as exchange news about the cases here and the badly injured radiology resident who was still at their institution.

The thing that struck me the most was that not a few of the people injured or dead and the relatives and friends around them were those I see from time to time in the hospital as they were also in the medical field.

Total death toll (as relayed by the surgical residents): 22 (mostly those seated at the front of the bus), including 1 who just finished residency in orthopedics at the local government hospital, 1 doing residency in nuclear medicine at our hospital, 1 doing residency in pathology at our hospital and 2 doing residency in radiology at our hospital and other sister institutions.

One of the radiology residents who died was rotating with me in the ultrasound section for this month.

As one of the orthopedic surgeons said, "It becomes an entirely different story when those involved in an accident, injured or dead are people you have work with or know." The week before, he had been assisted in the OR by one of the fatalities who had just finished his training in orthopedics at the government hospital. A few consultants were at the hospital looking for the whereabouts of their Iranian residents.

The department received the last patient for imaging at around 1am. By early morning though, we still had to endorse some clarifications regarding imaging for one patient to the incoming radiology resident on duty. There is a plan to transfer all of the injured patients to our institution and have them occupy a single wing of the hospital.

In the end, I never did get to install the newer printer to the older computer... I will have to do that during my next weekend duty.

Life does have unexpected twists. We just have to be ready for any eventualities that come our way, including the end of the road at the next turn.

* In memory of the deceased, and in solidarity with those injured or in mourning.

After chancing upon the on-duty radologic technologists leaving their area in order to have a meal together for the umpteenth time, the chief radiologic technologist had decided to feed his beloved staff some pieces of unleavened bread. These happened to be discards from the host-making process, given to the techs in the hope that they would be "transformed into angels" (roughly translated from-> "ma-anghelan unta"). This lead to a widespread, inevitable attack of the munchies for all the department staff (radtech interns, medical interns and radiology residents included). Variations included dipping the fine morsels in peanut butter. Discussions on the virtue of picking out the smaller melt-in-your-mouth pieces to the wider slabs worth a couple of mouthsful and the merits of some heavenly sprinkling of barbecue or cheese-flavored powder ensued. Needless, to say, the unblessed host seems to have no significant effect on the staff as demonstrated in the following photographs: There was half a plastic bag-full of stale left-over pieces left during my last hospital duty which I promptly took home for my mother to make some bread pudding from.

We now officially have a pre-resident who will start middle of the year, and by default, since I am the most senior resident still going on 35 hour duty, she is going on duty with me. It's an adjustment as I have been used to doing things by myself, and now I have to do my duties while teaching someone else to do my work. It takes twice the time working in a pair as opposed to working on your own. Then, there is calculating how much I should demand vis-a-vis knowing the limits of skills and knowledge I should expect of her. It helps though that I have known her personally for the past 13 years and we have been casual friends since then. No more surprises, I guess... Then again, the line between friendship and being one's senior in residency training also has to be drawn somewhere...

It's been a hectic week (finally about to end this Saturday!) since I went on double duty then had to forgo the usual every-three-day rotation to be assigned to the MRI during office hours while the MRI consultant is out-of-the-country for a conference.

It's hilariously exhausting to:

- Have the DCC (Disaster Coordinating Council) a.k.a. tandem of J.M. and K.L., the most junior MRI-techs giggle hilariously over one mis-scan (mistakes while scanning and or filming) after another.

-Almost freeze to death everytime R.B. arrives from travelling 2-3 hours from his hometown and turning up the central air conditioning again.

- Deal with patients demanding results when results cannot be promised at the usual 24-hours after sccanning release time (pending if Doctora is not exhausted enough to open the sent images and type them.

-Re-edit the results and signing for them (and also wasting a lot of yellow sheets --- try editing something techinical when you just had been woken up a couple of times at dawn!).

-Listen to the racket (some MRI-techs love their noisy music --or is it noise masquerading as music?).

-Snack without fear of being found out...

-Have the MRI-techs almost caught by the hospital medical director playing NBA via bluetooth sharing on PSP while on hospital duty.

-Make the call on sequences to be taken (and decide if contrast administration is necessary-- yikes!)

I enjoyed it, though... Unfortunately, I haven't found the time to complete my study goals for the next in-service exams because of this.

I thought about this post when the currently rotating senior clerk/intern in our department said to me: "Doc, I don't think you would ever grow old rotating here with such funny people to work with." And it's true... The radiologic technologists (radtechs for short) can be crazy... Majority of them (I'm beginning to think it's a requirement before you get hired at our institution) can make a gay impersonation close enough to fool any consultant radiologist (the sonologist actually got tricked into thinking this, when currently none of the radtechs are male homosexuals). The CT-scan techs did do Tuesday Vargas' ditty which went "Hindi ako bakla..." complete with costume for last year's Christmas party celebration. I also had this intern last month who would don two-three lead gowns the entire time he was assigned to the ct-scan.... No wonder his next 15 days of rotation was spent at the psychiatry department of the local government hospital. In the MRI, we usually hide the food in the drawers or in the dressind room, but i think the consultant knows that we eat in the control room when she's out. At lull periods, they are quick to hide their PSP's when she drops in at the control room, and everybody then pretends to be busy. We have also been hiding the water dispenser from the administrator in the IR dressing room for almost a year or so (water deliveries done only after office hours). Then, there's the free for all internet access from one of the network computers (the provider knows that we use it for the access because of some sort of team-sharing and the fact that the radtechs have shown not a few websites and message boards to the engineer while he was visiting). Crazy.... But this is where I work... ;)

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 1^st 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 6^th 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 3^rd in the board exams), and our youngest sister is about to start her 4^th 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 3^rd in excellence with 1^st honors (equivalent to 1^st 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 1^st 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

Lantaw

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

Prophecy

Encounters of the "Dean" Kind

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

At times you end up doing what you don't like to do...

I have made it no secret since junior clerkship that I have absolutely no liking for doing anything remotely surgical... from suturing to performing a minor operation to looking into someone's insides... well, you name it... Mind you, I'm not the squeamish type, but while doing a surgical rotation way back in the internship (a.k.a. senior clerkship), one resident once remarked to my groupmate: "Dili lagi na siya ganahan ug O.R., noh? (She doesn't like the O.R., does she?)"

A few years later, I find myself doing my first month of interventional radiology rotation in my second year of residency. Like I said, it is no secret to the entire department that I don't like being first assist on the biopsies, the stenting, the cyst aspiratuions, the angiograms, and finally, today, assisting for the first time in coil embolization of an aneurysm. I have already made it clear to the hospital's lone intervetionist that I have no plans whatsoever of following in his footsteps.

I never intend this blog to go into the scientific nitty-gritty details of the procedure. So, i will just expound on the experience in laymens' terms.

Initially it would begin with an angiogram, but we had already done that for the same patient a few days earlier. The neurosurgeon had to abandon clipping the aneurysm on opening up thus patient was referred back for the procedure.

Patient was placed under general anesthesia. A small incision is made into the femoral artery where the catheters and guide wires are passed throught the larger arteries of the body into the blood supply of the brain. Everything is checked using real-time fluoroscopy and digital subtraction angiography with the introduction of radio-opaque contrast material. The guide wire with the platinum coil is then introduced and gently eased into the aneurysm.

Some of the guide wires had to be softened with a specialized steamer. Before introduction into the patient, the coil is first checked in a small basin of water. After precision placement, the coil is released from its guide using an electric charge and the guides are withdrawn.

Without complications or other confounding circumstances, everything is done in about two hours, as in the case I assisted today. Only two coils were put in place.

It's a pretty amazing and relatively safe procedure done to save a life.

Then again, I have no intention of ever doing it myself in the near future. I have never felt at ease in the OR.

(Note: Above image was taken from the internet and not of the patient refered to above.

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.

Here are some more pics of Cherrylyn, that little girl born blind from Sitio Ibo with the volunteers.

A short account of the Rural Service Project I joined back in 2005.

*** *** *** *** *** *** *** *** ***

Set in Barangay Tingo on Olanggo Island, 11 souls braved the constant threat of possible bird flu contamination considering the start of bird migration season. As expected, and to our dismay, the bird sanctuary was off limits to us for any excursion purposes.

And so we set out doing home visits, teaching catechism to primary grades and intermediate grades, giving a leadership seminar at the local high school, cleaning up the chapel and keeping house (doing all the chores!) in a place called home for one week which had only one bathroom. And all that with time to spare for prayers and get-togethers!

I left them yesterday in their beach excursion and pondered the coming events of today: the medical-dental mission and the health and nutrition seminars.

The memories of those memorable days spent with unforgettable people: Mirzi, Bea, Grace V., Angelie, Lucille, EJ, Celeste, Bulai, Ivi, and Narsheen will forever be etched in my mind. And now I look forward to my next Rural Service Project, whenever it may be.