overseas call

Una: This morning I was on the phone with my mother who was only starting to tell me about their recent trip to Hawaii. She says she eventually played the role of the group’s tourist guide identifying trees and fruits that the kids in the group never saw before. “Oh, that’s a papaya.” “That one’s a mango.”

While in Hawaii they had visited a botanical garden. Unfortunately, my brother was not even remotely impressed with the plant life saying, “They’re all just like the plants I see in Lola’s garden.” Well, so much for the learning experience.

Pangalawa: On the phone with my 19-year old brother the first thing he asks is what we had for Christmas. I told him we had a whole lechon. As soon as I mentioned the lechon he dropped the phone and complained to my mother “See, they had a whole lechon. We don’t even have any food here.” Returning to talk to me he relays that he only had a bacon and egg sandwich for Christmas. Adding insult to injury I gloated, “Oh, that’s not all we had. We also had ox tongue in tomato sauce, jamonado and macaroni salad. For dessert we had tiramisu and fruit salad.” Poor kid, always hoping to come home to the Philippines for Christmas. He did regain his composure a little as he later boasted about his new soccer ball and David Beckham soccer shoes.

Christmas. No matter how old we are, we’re all just kids on Christmas day.

scenes from the dinner table

One: My uncle who is a priest is showing of his belly which, although still the size of a volleyball, is definitely smaller than when I saw it last. He has lost 30 pounds in a little over a month. The improved self-image and health is giving him an indescribable high. The other priests staying with him in the parish are also going on a diet and increasing their physical activity. One of the sisters was not so thrilled about it. “Ay naku, Father, hahabulin lang kayo lalo ng mga babae,” she complains. To which my witty uncle replies, “kaya nga po nagpapapayat, para maunahan sa pagtakbo ang mga humahabol.” He then relays an incidence when he was on a sick call recently. He was blessing the sick woman on her bed and the daughter was shaking her mother admonishing her to open her eyes. “Nanay, mulat!” the daughter says, “Mulat kayo at gwapo ang pari!” And of course this little tale of his has all of us laughing.

Two: As expected every time there is a family gathering talk eventually leads to my “non-existent” love life. As if being young and single is such a crime. If they only knew about the complicated mess I’m in. At my age, my grandmother points out, she already had four children. At my age, an aunt-in-law retorts, she has been with my uncle for eight years. Not to be left out, an aunt who is a doctor exclaims “Basta pag clerk ka na dapat may boyfriend ka na.” She pauses and looks knowingly at her husband seated beside her before adding, “para may magdadala ng pagkain sa iyo pag duty ka.” Peals of laughter.

Of course I was glad when the focus of attention shifted as another aunt-in-law shares a phone conversation she had with my sister. She had asked my sister if she had a boyfriend and my sister had no choice but to reply in the affirmative. Aunt-in-law was joking “Hindi siguro alam ng lola mo, ano?” To which I replied “Alam po niya, in denial lang.” More peals of laughter.

Three: Auntie doctor out of nowhere remembers her apo and her long letter to Santa. “Dear Santa, gusto ko po ng doll at saka damit at saka clip at saka . . . at saka . . . at saka . . . at saka . . .” And after what seems to be ten at saka’s the apo adds “at saka po pera pangbili ng mga gusto ko.” Kids, sheesh!

While on the topic of letters to Santa, aunt-in-law shares the root of his 9-year old son’s irritation. In his letter the son was asking Santa to give him a PSP. Aunt-in-law teasingly told his son that he should clarify what he meant by PSP. Son replies, “Santa knows what it is already”. “Okay,” aunt-in-law counters and to his son’s horror adds, “Santa will give you a Pack of Special Peanuts.”

Each day leading to Christmas Aunt-in-law keeps repeating to his son that he will be getting a Pack of Special Peanuts. To this the son can only shout out while almost in tears “No!!! I am not getting a Pack of Special Peanuts!” Come Christmas morning the son gives a sigh of relief after opening his presents and finding a shiny white PlayStation Portable.

this christmas feeling

Christmas always surprises me. There are, of course, the wonderful surprises of gifts from generous friends and family that are entirely customary. What I find uplifting in a peculiar way are the greetings of holiday cheer from people I least expect to remember me.

While it is quite commonplace to receive greetings from vague acquaintances and long-forgotten friends during the holidays what is disconcerting is that during the holidays the greetings I do receive are usually from this group of people only and not from my close friends. No, it is not that I feel hurt or slighted by this. It’s pretty much understood that my close friends wish for my happiness and the health and prosperity of my family. A close friend does not need to thank me profusely for a favor. I know they appreciate the good deed done even if they don’t say anything. Yet sometimes I wonder, maybe by not voicing out our gratitude we are taking each other for granted.

There is always something in the air during Christmas that turns me into a reflecting, sentimental schmuck. It could be the cold air and the lights. Or it could be the fact that whatever time of day it is the atmosphere feels like a cold early dawn (or a quiet late evening), something which I have always associated with the right time for deep thought. You see, there is nothing better than an early morning walk to clear my mind and prime me for the day. Well, perhaps there is nothing better except for a long walk home in the late evening to reflect upon the day that has just gone.

Christmas always reminds me of those lucid nights of insomnia back in college when I would sit by the fire escape and watch as the world sleeps. On the good days I would remain in the fire escape waiting for the world to rise again. On the bad days I would lie down in bed and try unsuccessfully to sleep.

Those days are gone now. I do not have the luxury of time to while away my days in deep thought. Nor do I have the endurance to stay awake all night and still feel alive and well the next day. There are no more nights of lying in the “gutter” and looking at the stars. There are only curses of reluctance to awaken in the morning.

I am only 25 and yet I already feel old. My grandmother was asking me how many more years I had left for my studies. She has this notion that my schooling would end with my post-graduate internship in two years. Even as I become a licensed physician after the board exams my education cannot end there for I doubt I will be successful and content. I jokingly retorted that I would probably be 35 before I settle down.

I wonder how it really feels to have lived my life. How does it feel to be really old and to look back on one’s little triumphs? I always say that I can die if I’ve done something worth being proud of but I can never really explain what I mean by something worth being proud of.

Christmas always makes me feel sad and lonely. There is always something or someone that’s not there. It’s always a compromise. It’s never getting the best of both worlds, whatever both worlds really mean to me.

Adam lives in theory. Everything works in theory but that is not the way it is in reality. Christmas always makes me feel like I live in a fantasy, but every time I stop and think I am confronted by reality - that Christmas only lasts one day and there is still the rest of the year to try and be happy.

People say Christmas doesn’t have to last just one day. People say that we should strive to make every day Christmas day. But then, if that were so, there wouldn’t really be any Christmas at all. There would just be EVERYDAY.

Merry Christmas. May the peace and grace of the season bless you and yours.


(Adam lives in theory . . . Now can you tell me what, what we’re gonna do now, where we gonna go now, what we’re gonna say now . . .Lauryn Hill)

these are the events that transpired today

Setting: Around four in the afternoon at the Institute of Medicine. It is the day after the last day of exams, the day after the last day of classes before the Christmas break. There are no more students in the whole building. The offices, although open, are empty. Only the guards by the doors remain at their posts.

Characters:
Resident – smug female who delivers each line with a sneer or more denigrating, a smile; bored and power-tripping
Harassed medical student – AKA me

Harassed medical student enters the department office in full view of the resident who ignores her completely. The harassed medical student ventures farther inside the office and tries to catch the attention of the resident who refuses to look up.

Harassed medical student: Doc . . .
Resident: (no reply)
Harassed medical student: Doc . . .
Resident: (grunts)
Harassed medical student: (looking meek and smiling) Doc, nandito po ba si Dr. X o si Dra. Y (Doc, is Dr. X or Dra. Y here)?
Resident: (smugly) May nakikita ka bang tao dito? Do you see anybody here?)
Harassed medical student: (still smiling) Nandito po ba sila ngayong araw (Are they here today)?
Resident: (sneering) Mukha ba akong secretary? (Do I look like a secretary?)
Harassed medical student: Nasaan po yung secretary Where is the secretary)?
Resident: Di ba Christmas party ngayon (Isn’t it that today is the Christmas party)?
Harassed medical student: Ah. (Enlightened pause) Thank you.

The Harassed medical student exits the department office.

Harassed medical student: P-tang ina! P-tang ina! P-tang ina! (sarcastic) Merry Christmas to you, too!


In the light of the Christmas season, I will refrain from narrating the events that happened in the next office I entered, the Dean’s office. Let’s just say an almost threat was conveyed to stop me from pestering the Dean, combined with an almost slamming of the door in my face.

Hay, buti na lang pasko (at mabait ako).

the morning after

The morning after the exams, after the party, after drinking and barely sleeping. I am surprised I don’t have a hangover or any other noticeable effects of alcohol intake. The party was okay, so-so for the lack of stimulating or revealing conversation. It would’ve been better if a lot more came but I’m not really complaining. The morning drive with M to Baywalk did not materialize but I was quite happy with the idea of it. It was something to hear M toying with the idea. Coming from her (and from C) it seemed rebellious enough. God, we’re so square.

I think I need to sleep. I’ve killed too many neurons from not sleeping. I’m sure the alcohol has done added damage, too.

Good night.

ano raw?

Last day of the exams. Last day of school for the year. Two more exams to go. I can't study anymore - which is pretty obvious because I'm blogging two hours before an exam. I have slept less than four hours yet I have covered only half the material for my first exam. I have all but neglected my second exam.

Honestly, at this point, I really don't care much about the results of today's exams. I just want to sleep and then party, in that order if possible. And then read. And perhaps take pictures afterwards (it's been a while).

[Sigh]

Samplex (sample exams) time!

books!

Back to the ordinary daily musings.

Yesterday Cathy and I met up with a former co-worker at Glorietta. She was in Manila for a week for a job training. After eating at Mexicali we found ourselves looking for gift items at National Book Store. Yes, I am the type who gives books or other learning materials to her little cousins for Christmas. But the agenda for the day was not to look for gifts for cousins but to search for a book that was requested for our class Kris Kringle. Unfortunately, the book By the River Piedra I Sat Down and Wept by Paolo Coelho was nowhere to be found. I did find other books to give to friends, though.

One Hundred Years of Solitude by Gabriel Garcia Marquez goes to a Friend C who has expressed her desire of reading it when she saw my copy. I’ve read the book years ago and although I’m usually happy with reading magical realism this book unfortunately fell short of my expectations. I suppose high expectations prior to reading was the cause of the disappointment.

The second book is Eat My Frog: Get More of the Important Things Done – Today! by Brian Tracy. I’ve never read it before but I’m sure Friend M would get the joke, laugh about receiving it and possibly actually read it.

I bought You Know You’re Filipino If . . . A Pinoy Primer edited by Neni Sta. Romana-Cruz for my sister in the States. She has been asking for it for a long time but I haven’t been able to find a copy until now. I think she would like to share it with friends for them to know more about the Filipino mindset. I would like to look for more children’s books in Filipino with English translations to send to her. She’s teaching three levels in grade school and I know she would love to read a few tales from the Philippines to her students.

The last book I bought is for myself. (It will serve as my Christmas gift to myself because it was worth so much that now I am left with no more money to spend.) I splurged and bought The Lonely Planet’s Guide to Experimental Travel. And when I say I splurged, I mean I really did splurge. The book burned a P1k+ whole in my shallow pockets. In any case, I’m pretty happy with the buy. I do hope this will quench my wanderlust and my penchant for the quirky and bizarre until I feel I am entitled to splurge as much for myself again (which will probably be next Christmas).

So, what are YOU getting yourself and your friends and family this Christmas?

alta presyon

A knock on my front door at midnight is what drove me to write this entry. It was Neighbor 8’s aunt inquiring if I had a BP apparatus while pointing to an unmistakable redness in her left eye.

She had just taken a calcium channel blocker to lower her blood pressure. Prior to the intake of her medication her systolic blood pressure was 160 mmHg.

Having been alerted to her increasing blood pressure she had taken her medication and asked her niece to take her BP immediately afterward. It had risen to 180 mmHg. Not entirely convinced about the accuracy in measurement of her niece’s new BP apparatus, Neighbor 8’s aunt was knocking at my door at midnight to have her BP checked.

Prior to having her BP taken she explained that her niece’s father (a doctor) had just been there and told her that the redness in her left eye was possibly a “hematoma” resulting from her increased blood pressure.

I took her BP. 190/90 mmHg. I reported it to her. Mistake Number One. She was asking me if her systolic BP was indeed 180 mmHg and in my honesty I informed her that it was actually 190 mmHg. The knowledge of such a high BP became a source of additional concern to Neighbor 8’s aunt who had already been anxious about her BP from the start. Her BP had never increased to this level before and she was visibly agitated.

Having been seen by a doctor previously who dismissed her eye problem and only advised her to take her medications I was left with no other option but to try to downplay the gravity of her condition in order to allay her fears. In so doing, I only suggested that she retire early and rest. She had already taken her medication and her BP would eventually go down anyway. In any case, she had admitted that she was worrying too much about her blood pressure and this might have caused it to increase even more.

Mistake Number Two. Advice from a student like me (solicited or otherwise) would never be enough to allay her fears about her condition. Especially since I had been the one to alert her about it and it was one that she had not encountered before. On my part, knowing that the hospital was only a short walk away, I should have offered to accompany her to the OPD for a check-up. Just as I was about to hit myself on the head for this oversight there began a slight flurry of activity next door. In a few minutes Neighbor 8’s aunt, accompanied by her niece, were on their way to the hospital.

“Magpapatingin na rin ako para sigurado,” she said, indicating that to be safe, it would probably be best if she would go to the hospital, saying so while pointing to her left eye, the one with the ocular hemorrhages, saying that it had been there since Friday.

The point of all this seemingly senseless narration is that amidst her gratitude and my level-headedness throughout the entire episode I have actually handled the situation unsatisfactorily. The score is 0-1, the incompetent medical student leads this time. I just hope that this does not happen again and that this incompetent medical student will hopefully turn into a competent doctor someday. To ensure that this does not happen again I am logging out right this very minute to read further on hypertension, its ocular manifestations, management and recommended medication.


Note: The onset of action of the particular calcium channel blocker used is 30 to 50 minutes. The peak action occurs between 6 to 12 hours. That being said, the effect of the drug is not seen immediately (as in only a few minutes) after intake. And yes, worrying too much about hypertension may contribute to an increase in BP.


[To the more knowledgeable readers (that is assuming I have readers) feedback in the form of advice, corrections, clarifications and criticisms are welcome.]

follow-up

A follow-up on Neighbor 8's Aunt:

In the hospital Neighbor 8’s aunt sat beside two other elderly patients. One was having difficulty in breathing and was being nebulized. The other one had a heart condition.

At this point Neighbor 8’s Aunt was getting more anxious then ever, fearing that her condition would get as worse as the person she was sitting next to. She was eventually accommodated a little after two in the morning. By that time her blood pressure had risen to 220/100 mmHg. She was given a nitrate sublingually to effect vasodilation. Blood pressure monitoring showed that the sublingual drug was not enough and she was given another calcium channel blocker in. Her BP was continuously monitored until her systolic BP went down to 160 mmHg.

It was already past 4 in the morning when she was sent home. She was advised to continue her medication and avoid eating fatty and salty food.

I had an hour-long conversation with her earlier and on hindsight she kept insisting that she was really afraid of the sudden increase in blood pressure. She had been around too many sick relatives to take health matters lightly. As well she should, I thought, as she ticked off a litany of heredofamilial diseases in her family.

But all is well now. She is going off to the market to buy bananas. And I have a box of Danish cookies to show for my efforts.


[Tell me if I shouldn’t be writing about this. Seriously, please do.]

white out

Another afternoon not well spent.

I have been saddled with envy every since the next-door neighbor came over with her new HP notebook (P135k) with it’s wide screen and shiny exterior. My Compaq Armada is what you might call top-of-of the line . . . 10 years ago. It certainly pales in comparison with her HP.

I am never one to be envious of the shiny things other people have. That is to say I cannot understand why every one I know has to have the newest mobile phone/ipod/PDA every time. I am the type of person who would still be using her 4 ½-year old Nokia 3310 if it didn’t just stop working properly one day.

The reason for my present envy stems from the fact that my laptop is useless when it comes to presentations in class. The screen has this horrible tendency to go all white (due to an unknown reason -- overheating, perhaps). When this happens I am left with no other option but to restart. Unfortunately, mine is not the one-click type that reboots in less than a minute. I need to suffer through disk checking and starting up processes that on bad days could last for 3 or 4 minutes. This “white-out phenomenon” occurs for no apparent reason and at the most unpredictable times. Sometimes I can totally forget that it happens as my laptop is white-out-free for weeks. Other times the screen is white longer than it is in color and virtually useless. The most frustrating times are when I have just rebooted the system and finally about to finish with the start-up then the screen just goes white. Take this white-out phenomenon away and I will embrace my laptop lovingly and never let it go.

NOTE: In the time I took to write this entry the white-out phenomenon has occurred thrice making what should have been a 5-minute blogging update to last more than 30 minutes.

face off

Face/Off

Remember that movie starring John Travolta and Nicholas Cage? I'm sure you do. It was a good enough action movie based on an unbelievable and entirely out-of-this world premise that people could exchange faces.

Guess what? It can actually be done today.

Face Transplant Gives Hope to Disfigured


Well, almost.

hell week

An ability to understand the true cause and meaning of a situation coupled with a disturbance in form of thought results in utter failure. To illustrate:

Intellectual Insight: understanding of the objective reality of a set of circumstances without the ability to apply the understanding in any useful way to master the situation.

plus

Irrelevant answer: answer that is not in harmony with the question asked

equals

BAGSAK na naman sa exam!

The hell week (exam week) has just begun. Three down, 11 more to go.



Definition of terms taken from Sadock, B.J. and V. A. Sadock, 2003. Kaplan and Sadock's Synopsis of Psychiatry, 9th ed. Lippincott Williams and Wilkins, Philadelphia, USA.

The illogical equation stems from my own sleep-deprived mind :)

events on pothole monday

Monday. Oh, Pothole Monday. The proverbial pothole in my road of life.

Early in the morning we were fuming over the demands of the professor handling our class. She was nitpicking regarding our presentation of clinical cases. The reporters were repeatedly reminded to keep their transparencies straight, to mind their grammar, to maintain eye contact with the audience and to completely abolish the use of ah’s and um’s as fillers. The reporters were chosen randomly so each student had to prepare for the case. The break between cases became a time to exchange rants about her demands.

Looking back on it later in the afternoon I realize that her demands were reasonable. When you are reporting or lecturing on something it is but natural that you should be knowledgeable about the topic and not resort to reading only what is written on the transparencies. The transparencies are only visual aids, they do not make the report. Her plea about speaking in straight English, using correct grammar, avoiding fillers and keeping eye contact only speaks of her desire to make us good communicators. A little effort on our part to improve upon the areas she suggested would surely go a long way. In other words, there is certainly a lot of room for improvement for most of us.

* * *

It was already 9 pm when my “health team” adjourned the meeting after creating a problem tree and formulating objectives to address the problem at hand. In my opinion it would have been really stimulating and more worth our time if we were discussing health concerns such as immunizations or increase in non-communicable diseases. We were not discussing any of those. What we were discussing were the unsatisfactory photocopying services in the Institute of Medicine and its “detrimental” effects on the students. We were bringing our blood to a boil and exhausting innumerable neurons on that matter simply because of the topics we proposed (immunizations, additional skills training for medical clerks, CPR, addressing risk factors for diseases present among medical students) it was the only one that was approved. Problems regarding poor photocopy services seem simple and easy enough to address but we are nowhere near the completion of the first step in program/project management. The final project proposal, all two pages of it, is due in a week’s time. We have a long, long way to go yet.

* * *

Side note no. 1: Another round of massive cheating for the quizzes and pre-prelims exam occurred today, entirely tolerated by the residents. Given that the quizzes are just for bonus points or additional grades it is a great help to improve our class standing. The downside to it is that it does not do anything to improve our knowledge or aid in our learning. Bottom line: I’m too square to cheat without my conscience nagging me forever.

Side note no. 2: I just bought a mix of ground coffee which, according to the label, is a blend of Arabica, Brazilian Variety and Baraco. I want a strong cup of coffee but the extended roasting has resulted to a bitter blend which is not not to my liking. Too bad.

Side note no. 3: Something must be done to improve my writing. I am too wordy, entirely unorganized and discuss matters only tangentially. Something must be done to improve my narration. Learning to write in the active voice as opposed to habitually writing in the passive voice would help also.

breathe

I am drinking Yogi tea, Breathe Deep Tea to be exact, and mulling over the adage found on the piece of paper attached to the teabag string.

"A plant can't live without roots. Your soul is your root."

Err . . . okay.

I am drinking tea, trying to cut down on coffee, and willing this blasted upper respiratory tract infection to go away. I hate being sick. I have not done a single thing related to school. Tomorrow, as always, my Monday will be hell. Four cases to submit, four quizzes, one chapter outline for Oncology to finish, one pre-preliminary exam in Head and Neck Surgery. I'm sure there must be something else I've forgotten to do.

I just want to lie down in bed and get better.

more SA

I’d like to believe that we are finally getting somewhere with our situational analysis. There is a copy of IM student’s chief complaints from the Pay Treatment Room (PTR) on my desk. I have finished tabulating the data assigned to me and have found out that for 44 students, fever is the number one chief complaint. Of the 44 students, 35 are female and 12 are students of Medicine. Now what?

On my desk, too, are statistics obtained from the library regarding books borrowed by the students and the purpose for borrowing (reading, Xerox, overnight). The most common reason for borrowing books was for reading inside the library but the numbers borrowing for Xerox increase to a comparable number during exam period. So what? What do I do with this data now?

Certain points of the project and the action plan are already mapped out - Point A the problem, Point B the survey, Point C the action plan and alternatives. Our main concern right now is getting from one point to another – from SA to point A, from point A to point B, and so on. There is a gap between these big stepping stones and at this point I can’t figure out how to utilize the still non-existent small stepping stones.

Do you get the picture? Am I getting my point across? Things would be better if I could work with people who are actually trying to make this project work. It entails too much effort for me to put my point across, even more to push people into action. After 25 years of life I have not developed characteristics that make me a leader. I’d like to believe that as a good member I am still a valuable part of the group. As I always like to say there will be no good leaders without good followers. I have no problem with working hard. I just wish that each member of the group would work equally as hard as well.

Thursday. It’s Thank God it’s Thursday!

situational analysis

Situational Analysis. SA. Words for the day.

I came out from my class without sense or direction. My group, or "health team" as our adviser would like to call it, is nowhere near completing a project proposal targetting issues in the Institute of Medicine. First and foremost we cannot seem to grasp the idea of a situational analysis. On paper it seems easy enough to comprehend. However, when we are seated in front, all in a row like in a firing squad, we can't seem to put across the fact that we have actually done a situational analysis. While our SA is neither comprehensive or sufficient for us to identify areas for improvement (problems) and formulate a course of action, it is not fair to assume that we have not done any background check at all. We have.

We have one more week to do a situational analysis, identify a problem, make an action plan AND defend our project proposal. Program and project management is definitely not my cup of tea. Lock me up inside a laboratory any time.

Situational Analysis is HELL.


Still reading: The Dante Club by Matthew Pearl (just because I had to put it down to catch up with schoolwork)

maximo

Tuesday. Aha!

I am reminded that the movie-week is about to end. By that I mean that it is almost Wednesday, the day that cinemas change the previous feature film shown and start screening a new one. I am reminded of this because the movie I was so glad that was released commercially is now about to be replaced. I have regretted not being able to watch Ang Pagdadalaga ni Maximo Oliveros when it was shown at the UP Film Center and now I am about to miss it again.

In the event that the screening of the film has been successful and the cinemas opt to extend the screening I doubt I can still be able to watch it. It is the week before the preliminary exams. I am buried neck-deep in reading material already.

That being said I am itching to watch Truffaut’s Day for Night. A re-viewing of Coppola's Lost in Translation or Wong Kar Wai's 2046 will do also.