rAdIoLoGy NoTeS 30: Welcome to My Chiefdom! 1/02/2011 12:44:00 PM

Looks like there's no holding back... I'm officially the chief resident of our department...

This means:
1. Finishing my research (and I have been procrastinating...).
2. Studying for my exams (eeeeeekkkk!)
3. Finishing all my requirements (busy, busy, busy...)
4. No more 24 hr duty (Yipeee!!!!)
So, pardon me if I sort of hibernate from cyberworld... But not for long, I hope.
Wish me luck in this sort of busy year!

What you don't know about the goings-on in our public hospitals... 10/26/2010 12:21:00 AM

Let me add some of my impressions in the midst of the big issue on the RH Bill...
While I was a medical student five years ago, I rotated at the local regional government hospital for a total of 15 days. Though I was there for only a short period of time, I came to the conclusion that there is no need for any further legislation (i.e. the Reproductive Health Bill) regarding the use of contraception or sterilization. The mechanism is already in place right at this level. 
As soon as an indigent patient is brought to the delivery room,and subsequently advised to undergo a second caesarian section (or succeeding thereof), one is immediately advised to have a bilateral tubal ligation as well and then wife and husband are asked to sign a consent form. I observed this to be the standard operating procedure. No further explanations are made to help the patient in labor pains to come to an informed decision. I guess the few staff around were too busy attending to more patients coming in that giving said patient all the information she needs such as explanations of what to expect, pros and cons, including possible side effects (i.e. ectopic pregnancies in the blocked fallopian tube) would take too much of their time.
I was completely appalled when one mother about to have a third caesarian section was berated and bad-mouthed by resident physicians, nurses and midwives for deciding not to have a bilateral tubal ligation at the same time, what is known as C/S + BTL in medical parlance. The said patient was already crying (from the emotional barrage and the pains of labor) but firmly stuck to her decision. The husband was also unwilling to sign the consent. I decided to whisper to her to be strong and stick to her choice. The residents gave as reason that there are usually a lot of adhesions (Aren't there surgical SOP's done to prevent this from happening?) and when the the next caesarian section is done, the procedure becomes technically difficult. A good enough argument, yet are not doctors supposed to honor the patient's decision (without coercing her to change it by emotional abuse) and render their expertise with competence? If the uterus thus becomes so scarred after having been cut open several times as to render it diseased, hysterectomy thus may be performed without violating the bioethical principle of bodily integrity. I know of several persons who have had multiple caesarian sections (one had at least 7) and may have had difficult deliveries but mother and children come out fine, thanks to medical advances and the proficiency of attending OB-GYNE's.
My personal experience with conscientious objection to assisting the OB-GYNE resident in performing a bilateral tubal ligation after doing a caesarian section was met with rolling of eyeballs and snide remarks in the operating room. In other circumstances, it might also mean a few more days rotation within that department (serving an extension, as we call it) or other such sanctions. With the passage of this bill, I pity the young aspiring doctors who want to be consistent with their faith and ethics who would now be faced with large fines and/or imprisonment for such actions. 
At the out-patient services department, mothers who have at least two children are at once instructed on the different methods they can avail of during their first post-natal check-up. There is bias for artificial contraceptives, of course as all manufactured products have shelf lives and need to be disposed of as soon as possible (not a few of these contraceptive devices are surpluses from elsewhere). Anyway, in medical school there is little mention of natural family planning (NFP) which is always mentioned while dismissing it as "highly unreliable". I wish they also gave us time to learn how to teach these methods to couples as part of our medical curriculum, in the same manner that they teach us to write prescriptions for artificial chemical contraceptives or show us how to insert IUD's in medical school. In that way, there would be absolutely no bias for those wanting to go in this specialized field of medicine to just write down a prescription rather than take time to explain a method.
It also seems that government hospitals may also have a certain quota for sterilization procedures as one friend of mine noted that during an endorsement, the chairperson of the department of obstetrics and gynecology queried her residents regarding the fact that their census for said procedures had gone down for the month. They did not know that it was thanks to the way my friend tactfully and slowly explained to the mothers in the delivery room NFP and the value of openness to welcome another life even in the midst of poverty: Not another mouth to feed but two more hands to help.
As you may have well guessed, I am totally pro-life and uncompromising with regards to my Catholic Faith.

Wala Na ang Narra! 10/24/2010 02:50:00 PM

Ang karaan nga kahoy
Dinha sa among eskina
Kahugnu-on na
Mao nga
Gi-putol-putol na
Ang mga kara-ang sanga
Dili na mag-silbi
Nga padayung mag-tubo pa
Wala na ang narra.

-jara-
(c.2010)

Can I Reach You? 9/12/2010 05:45:00 PM

Can I reach you

Where you are

And remind you

Of the heart

That wants to care

For only you

I want you to come back

I want you to be here

Look me in the eye

Tell me you are fine

I promise we will talk

Recover what we have lost

Tomorrow will be much better

Than yesterday or today

Tomorrow will be much better

Than yesterday or today

-jara-

(c.2010)

Turning 30 9/04/2010 05:51:00 PM

Another
Milestone to remember
Another
Page in my book
Another
Turn of the road
One more
Event we can toast
One more
Reason to celebrate
Even if
Mistakes have been made
Even if
I have my ups and downs
I am
Looking forward to tomorrow
I bear much
Hope for things to come
Each day
Serves as a brand new start
I thank
The Highest Power
I thank
Those whom I love
I forgive
Those who have hurt me
I forget
All those past hurts
The day
That I turn 30
-jara-
(c.2010)

Damgo Ning Rosas 7/29/2010 01:23:00 PM

Ning

Katam-is

Sa

Katapusan nimong

Awit

Nagabilin nganhi kanamo

Ug

Malipayong pagpangalandom

Sa

Ni-aging panahon.

-jara-

(c.2010)