5 weeks post internship and I have yet to adjust to a life that doesn't revolve around the pre duty - duty - post duty cycle. It's a bit disconcerting really, but I would have to admit that part of me seems to be missing the "good old PGH days". It may not be a particularly overwhelming feeling of loss or longing, but it's there and it's bothering me all the same.
For the most part, I think it's the "variety within regularity" that I'm missing. The fixed rotation schedules and set number of hours made things routine in a general sort of way. However, one could never really predict how a particular duty day would turn out giving each its own unique brand of excitement. As such, days were never boring. Exhausting? Definitely. Frustrating? Mostly. Depressing? Sometimes. Dull and dreary? Never. Fulfilling? Almost always.
It seemed to me that everyday I was learning something new, be it skill or knowledge or maybe just some realization or insight which would then serve as an impetus to aspire and to hope.
--------------------
Fast forward to the now. I'm not necessarily keen about it but I understand that I have to pass the Philippine Medicine Board Exams this August before I can truly be acknowledged as an M.D. What I'm about to say next might be frowned upon by my peers, mentors and loved ones alike, but I really don't think that in its present and woefully outdated form, the med boards should be the gauge with which I, or any med student for that matter, should be judged. However, I do acknowledge that currently, it is the only way with which the quality of our nation's health care providers could be ensured so I will, albeit reluctantly, resign myself to the fact that I have to take AND pass the exams.
A lot of things are at stake here. The least of which, are my personal dreams and aspirations.
I WILL pass the boards. I HAVE to.
The future of this country, its health care system in particular and the well being of its people in general, depends on it.
--------------------
Too arrogant? Maybe. But I really do want to make a difference. I will make a difference. This stems not out of any personal desire to be in a position of power or popularity. It's not about fulfilling the lofty goals and ideals of a particular organization or institution. It's not about the recognition. It's not about the potential to be immortalized in song nor tale. It definitely (and will never be) is not about me and what I want for me, myself, I and mine.
It's about you and them and they. It's about we and ours. It's about us and what we can do for ours.
It has always been, and always will be, about the greater good of this nation and its people. The difficulties and absurdities of the idea along with the naivety of idealism be hanged.
I WANT to effect positive and lasting change and with God's grace and the love and support of my family, friends, Hime, peers and colleagues I WILL be able to do so.
No agendas. No ulterior motives.
Ang aking adhikain at ang aking ipinaglalaban ay ang paglilingkod nang taos-puso at tapat sa ating Inang Bayan.
---------------------
Sorry. I just had to write that down. I have to remind myself of what's at stake here. I really wish it wasn't so but studying for the boards seems more and more like an unpleasant chore (the redundancy's deliberate) with each day.
Gratefuly, I'm still on schedule. This is just a little something to help me avoid hitting that proverbial "wall" this early into this endeavor.
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This is the reason why I am so thankful for small and not so small holidays. Facebook, blogging, Naruto, Bleach, sci-fi, music, fantasy and friends are keeping me sane. Family and friends, even with their own more pressing concerns, have been nothing but supportive. When I'm feeling particularly down and tapped out for the day, the mere thought of Len is rejuvenating, moreso the times when we would actually be with each other.
Oh and altruism isn't the same as fanaticism nor extremism. What I hinted at above might be what I'm really hoping my life's work will be, but my personal life, while connected, will remain a different but no less amazing thing altogether.
Be assured that you are a central part of that Dearie. =)
Just one more reason why I know I WILL pass the boards.
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For God.
For Country.
For Family.
For Love.
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Back to the books.
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By grace through faith Lord... Ad Majorem Dei Gloriam.
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100 percent in August!!! 09 Benign!!!
- Location:UPCM Student's Lounge
- Mood:
determined
Graduation is tomorrow. =) 09 Benign!!!
(wrote this for the time capsule which was buried yesterday at the UPCM grounds)
May 15, 2009
To our peers, colleagues, mentors and most probably our future selves a quarter of a century from now; the warmest greetings from the year 2009 AD!
Given the extremely rapid nature of change once we entered the new millennium, it would be entertaining but essentially pointless to speculate as to how things appear “when” you are. Technologically, socially and culturally things would surely have changed by the time this is being read in 2034. However, some things should and will remain constant. Among these would be the heritage of healing, humanity and heroism we all possess as products of the UP College of Medicine. Whether it is 25 years or a hundred years from now, our institution will still be the same. The UPCM will always be a bastion to the nobility of purpose and purity of service first and foremost to the Philippines and its people.
We, the members of UP College of Medicine Class 2009, hold the distinction of being the pioneers of the innovative Organ Systems Integration Curriculum of the UPCM. As of this writing however, it is still a matter of ongoing debate whether this is something that every single one of us should be proud of. Have we been privileged enough to have been brave pioneers or will we go down in history as sacrificial guinea pigs? The events of the succeeding 25 years will surely help in answering this question.
What we do know is that as the first OSI class we were able to give much to our beloved alma mater during the course of our five, or for some of us seven, years of training. We literally and figuratively toiled, cried and bled for the college as we absorbed the full brunt of the birthing pains of the new curriculum. This may sound a bit excessive, but to us there were many times when it felt as if we were being refined in flames of chaos and confusion. Let other people say what they will but our class definitely had it a bit tougher than usual.
Thus, today and our graduation day two days hence, are a testament to the collective character of UPCM Class 2009. I would be the first to concede that we were far from perfect. However, I will also be the first to say with the utmost conviction and certainty that we belong among the greatest classes the UPCM has ever produced.
25 years from now, the above will have been fulfilled many times over by the members of UPCM Class 2009.
To date, the Philippines’ woeful health care system remains as one of the most serious and most chronic of its afflictions. As a class, we can and we will make a difference. For all of its flaws, the OSI curriculum revitalized the college’s vision-mission mandate of community oriented medical education directed to the underserved. As the members of our class set out on our respective journeys into the art and science of healing, we pray that we will be able to truly do justice to the aspirations of the UPCM. One hundred years ago, 8 young men graduated from our alma mater, setting a tradition of greatness and excellence in service to our nation and its people. A hundred years later we, UPCM Class 2009, set out to forge our own paths with this as our guiding beacon wherever we may be.
It is our hope that by 2034, positive and lasting changes in our country’s health care system have been made or at the very least are well underway through our efforts.
It is with much honor and gratitude that we pledge ourselves to continuing the UPCM’s commitment to the Filipino people. Here’s to the future and beyond.
09 Benign!
Class President
UPCM Class 2009
Congratulations UPCM Class 2009!!!
- Location:Home
- Mood:
accomplished - Music:Truly Madly Deeply - Savage Garden
Len is ending her IM Ward rotation today. Being pre-duty she'll be off at 7 pm. As for me, I ended my Rehab Medicine rotation with an exam an hour or so ago. We're set for dinner tonight. Nothing fancy mind you. Just a breather before we begin our new rotations tomorrow; Medicine ER/Medicine Intensive Care Unit for her, Surgeon on Duty/Trauma ER for me.
Throughout clerkship and internship we've repeated a seemingly endless cycle of rotations. We've experienced our share of "shifting dullness", in rotation burnouts, duty day mania, patient care "highs" and the occasional BRP.
This time though, well at least for me, it's different.
I have a flair for the dramatic and I say tomorrow is special.
Tomorrow is the beginning of the end.
Tomorrow, we begin the end of internship for UPCM Class 2009.
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Today, our class countdowns at the UPCM Student Lounge and at the PGH Central Block Lobby were set to "29". That's right. 29 days to the end of internship. 29 days to the end of med school for UPCM Class 2009. 29 days before our 2010 friends and colleagues become interns. 29 days before a new and exciting chapter in our lives begins.
One month to go 09! For the next 696 hours, let us all boldly shout "Carpe Diem!" whether it is a pre-duty, duty or post duty day. Let's make the most out of every moment. Let us make our mark on the great institutions of the UPCM and the UP-PGH and let these same institutions leave their indelible mark of excellence and service on our very souls.
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09 Benign!
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I would like to take this opportunity to express my gratitude and appreciation for all those people who made my 25th birthday special and meaningful.
To my family (Nanay, Carlo, Tita Lala, Tito Alvin, Lolo, Nathan, Pisha --- We've weathered so many storms and yet we're still as resilient, determined and strong as ever, thank you for 25 years +++ of true love. Mahal na mahal ko kayo!
Tatay, Lola Pat, Lelang, Lelong --- Thank you for leaving your marks on me. I'll see all of you when I see you. I'm happy you're happy with Him in His love!
To Len, amazing can't begin to describe celebrating my first quarter of a century as your other (not necessarily better) half. Here's to many many more years of magic Dear! I'm looking to spend my centennial holding your hand. I've found you and I'm never ever letting you go. =) I love you so much my Hime!
To my cherished friends, respected mentors and esteemed colleagues... Too many to count, each one highly valued and much appreciated, your friendships and our relationships have made me a very rich man indeed. Thank you so much for looking past my imperfections and weaknesses. Julius T, Jedi, Shar, Trine, Nez, Applet, Krista, Ma'am Mercy, Ma'am Cel, Ceendz, Mami Alma, Rai, Topher, James, Myks, Jayps, Bev, Tita Nitz, Tito Ed, Ate Eden, Kuya Enos, Ate Anna, Glads etc etc etc etc... (sorry! Ang dami dami dami dami dami niyo!!!) Thank you so much!!!
To everyone I hold dear, thank you for helping make the first 25 years of my life into the amazing song that it is. Here's to the music of life and love!!!
Happy Birthday (belated!) Lopao!!!
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To my Lord and God...
To the Great Physician...
To my Master and Savior...
To the Master Musician...
To the Composer of my life's Song...
Jesus Christ
To You alone ALL the Glory belongs!!!
In reverence, awe AND most especially GRACE, I humbly bow down to worship and praise You...
Thank you Lord not because of who I am but because of what You've done. Thank You Lord, not because of what I've done but because of Who You are!
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Ad Majorem Dei Gloriam!
- Location:MyPad Internet Cafe
- Mood: happy
- Music:With You (Chris Brown)
Surreal.
This was how I felt as I was updating our class countdown at the UP-PGH central block lobby this morning. When I was done with securing the day's numerals in place, the countdown read:
I can still remember when we first put up the countdown like it was yesterday...
09 BENIGN!!! Are you guys feeling it? No fear. No doubts. We are UPCM Class 2009.
Uniquely benign. Uniquely 09'.
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Today was also my last day at the Medical ICU. Tomorrow, it's back to the OPD/ER for one last week of IM. Most of me is glad to go (finish IM that is) but a small, but significant part of me will miss the madness, stress and toxicity that most people dread about being in Internal Medicine. I enjoyed myself immensely and I definitely gained much as a physician with everything that I learned and experienced in rotation. This may be a week early but I would like to thank the people who contributed to making my IM internship something to treasure.
To my blockmates, servicemates, RICs, PODs, Service Seniors (Ward, MICU, ER, OPD), Service Consultants and most especially to all of my patients... Thank you.
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I have to say this though. I lost her during my second day at the wards and her death made such an impression on me.
To Alma Florida, my gravidocardiac patient, I know that you and your child are in a better place with Him... Thank you. I cried when we lost you and as my tears flowed, I was reminded of my humanity. You gave all of us the opportunity to be your healers and heroes and while we may not have saved you, I think you saved us...
You saved us from allowing ourselves to forget how painfully human it is to care over the years. Objectivity may have its merits and purposes most of the time... But objectivity be damned when it really matters. As doctors we treat diseases, and we should do so with all our knowledge and skill. But in being the best MD we could be we tend to forget the real reason why we are who we are.
I am a Doctor. I am Doctor Paolo Victor Nartea Medina (my nameplate proudly says so).
I am a Doctor and I HEAL PEOPLE.
Ma'am Alma, thank you for searing this lesson into the very fabric of my soul.
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When I entered med school, a career in IM was my first option. A lot of things have happened in the past 7 years and when I finally get my license as an MD, I will be going into Community Medicine as a first step towards changing our nation's health care situation. Modesty aside, I think I have what it takes to be a good internist, maybe I could even be one of the best, but I believe a higher calling waits for me.
I think I'll be able to do the most good for the most number of our brothers and sisters who have the least if I choose the path less taken.
Much thanks though to all those who have said that IM will be a good option for me if ever I do decide to go for it.
It's still in me somewhere... along with the singer/musician, the teacher and the writer...
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Credits...
Much Thanks (and Love) to (in order of appearance):
(Service 1 Number One! - set A) Ma'am Jamie, Ma'am Aki, Ma'am Anne, Ate Anna, Gracester, Alric, JM
(Service 1 Number One! - set B) Sir Mikey, Sir Allan, Ma'am Apple, Ma'am Anne (ulit), Mon, Bea, Zham, Criston, Mae
(PODs namin! da best kau ma'am!) Ma'am Kathy, Ma'am Paulet, Sir JD, Ma'am Lovell, Ma'am Anne (na naman)
(MICU pips!) Sir Ernest, Ma'am Anj, Ma'am Jamie (ulit), Charles, JC, IaIa, Dennis, Joguel (stellar), VV, PeeWee, Jan
With the very special and significant participation of:
Dr. Maria Ellen Rivera Licup whose understanding, patience, faith, encouragement, hugs, kisses and love served to strengthen me during the times when I almost lost faith in who I am and what I could do... As always my Hime. I love you.
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- Location:UPCM Student Lounge
- Mood: accomplished
- Music:I Will Take You Forever - Christopher Cross
While last night's JWAPOD duty was relatively uneventful (0 morbidity and 0 mortality), I'd still give anything for 8 blissful hours of uninterrupted and restful sleep. As a medical intern I know the futility of this wish but rotating in Internal Medicine makes one feel the loss of such luxuries more poignantly than in most other rotations. Anyway, there's only one more week to go before my rotation in the IM wards comes to its conclusion and I'm actually quite surprised at how quickly the past 3 weeks seemed to have flown by.
There are only 35 days left before my whole IM rotation is over.
There are only 78 days left before the whole of internship is over.
The clock is ticking.
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It may not be readily apparent but I am really excited to finally end seven years of med school (including Intarmed). There are days when I still find it hard to believe that in less than 3 months' time, I would be graduating with a medical degree. I believe that finishing my medical training, from the UPCM nonetheless, is one of the best gifts I could offer to those who have given so much of themselves so that I could live a meaningful, purposeful and fruitful life. This may be quite a bit in advance but at this very moment I am compelled to write these things down. For posterity's sake and for fear of not being able to have such an opportunity again, I would like to say my "Thank yous" to:
My God, Creator, Savior and Master Jesus Christ; Who in His great wisdom and love created me in His image and likeness. I would be literally nothing without Him. It was His gentle guiding hand which led me to this path that I have chosen and it is His gentle guiding hand which gives me the strength, faith and sustenance to stay on this path no matter what.
Nanay. I actually can't think of any words to express how much love and gratitude I have for the woman who brought me into the world. All I know is that while writing this there's this lump in my throat and it is taking most of my strength and resolve not to let the tears that are blurring my vision flow. With everything that my mother has gone through to ensure a good future for me and the rest of my family, a lifetime would never be enough to honor the many sacrifices that she has made. I love you Nay.
Tatay. By grace through faith I know that you are happy with the Father, Son and Spirit in heaven. I take comfort in the fact that you are free from the hurt and fear of this often terrifying world. However, I stil miss you so much Tay. We all do. I've always tried to make you and Nanay proud. I still wish you could have seen me wear white. There are days when I find myself missing the conversations we've had about life and its lessons. It would have really been something to discuss my interest in and dreams of community medicine, primary health care, health policy, etc with you. I wish we didn't have to lose you when we did. Till we meet in heaven Tay, I will make you proud. I love you.
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I'm sorry. I cannot bring myself to continue. I'm crying and I don't want my residents, co-interns and clerks to see. I won't be able to explain myself anyway and they may have the wrong idea about things. I'm still posting this though. To those of you who feel in their hearts that they should be included in my "Thank You" List, then you most probably are.
To you my brother, aunt, uncle,cousin, sister, friend, mentor, teacher, inspiration, lover, critic, etc...
Thank you.
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I love you Dear. I love you so much. Thank you!
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Service rounds in a few minutes. I hope to get to blog again soon.
God bless everyone!!!
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- Location:Ward 3 UP-PGH
- Mood:
contemplative
100 days...
To tell you the truth, it's a bit surreal, but here it is ladies and gentlemen. The day has finally arrived.
Today, we began the countdown to the last 100 days of internship. Today we began counting down the final 100 days
of med school for UPCM Class 2009.
LenLops photo op with the countdown display @ the UP-PGH Elevator Lobby
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Back when I was in first year med proper, a friend, who was a graduating intern back then told me that time does
indeed fly in med school. This was in response to my query as to how it felt to be graduating from the UPCM, a
feat which at that time was something that was quite alien to me. Now, as I mark the last 100 days of my
medicaltraining, I finally see what he meant.
I have 100 days left.
Lord, thank you for your guidance, inspiration, strength and faithfullness for the past five years. Grant me the
grace to make the most out of each and every remaining day.
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Here are the rotations, in chronological order, comprising the last hundred days of my stay in the UPCM:
Neurosurgery/Psychiatry/Anesthesiology (cocktail rotation I know) = 2 days
Internal Medicine (!) = 56 days
Rehabilitation Medicine = 14 days
Surgery (SOD and Trauma) = 28 days
IM for 56/100 days remaining in med school? Interesting. Hehehe.
--------------------
I am pleased to report that our class' graduation preparations finally seem to be gaining momentum. It's a bit
late actually, but well, better late than never. I am still bracing myself for the stresses, frustrations and
heartbreaks that will come in the next 100 days over graduation matters but hey, that's life for me.
Cest la vie Lopao.
Modesty aside, I've lived through each and every day of "it" for the past 7 years. What's another hundred days
more?
7 years as class president. Sheesh.
The countdown has once again triggered the sentimental in me.
---------------------
Do I consider it an achievement? I am not sure, but it had and still has its merits. I wouldn't trade the
experience for anything. To be candid about it, it wasn't always fun and it wasn't always great. Actually there
were periods where the meaningful and fulfilling moments were few and far in between but I gained a lot both from
riding out the storms and taking advantage of the halcyon days.
UPCM Class 2009, as cliche as it may sound, it has been an honor and an even greater privilege to serve.
Thank you.
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I think I haven't exactly been a hundred percent the past couple of weeks. I've lacked focus, been anxious and
found myself easily distracted. It may be that the stresses, pressure and resulting fatigue of internship have
finally started to catch up with me, but with the countdown I think I've regained my footing somehow. When you
think about it this countdown thing is merely an abstraction, a distraction if you may, but it has helped me a lot
by reminding me that I have something wonderful to look forward to.
The end is in sight and I have been given the second wind to make the sprint towards it.
Carpe Diem!
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Dear, I love you.
Here's to us and ours.
We are blessed.
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Ad Majorem Dei Gloriam
To Him and Him alone be the Glory!
- Location:UPCM MSU 2nd Floor
- Mood: accomplished
- Music:The Buzzing of Mosquitoes...
*sigh* Apparently, this is turning out to be one of those duties.
Again.
Cest la vie Lopao...
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With today being a Sunday, I was actually looking forward to a benign duty. However, 5 intubated (AND toxic) post operative patients out of a total of 14 definitely don't make a benign PACU duty. What's worse is that for all intents and purposes, I am alone. I'm supposed to share PACU duty with an intern from the General Surgery service but unfortunately it seems that the team on duty cannot spare one of their number.
My personal experiences of going on duty at the Surgery wards notwithstanding, I am trying to give them the benefit of the doubt.
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2:29 AM - Monday PACU
I'm trying to blog in between monitoring and procedures. Big mistake. I've spent the last 4 hours or so on my feet in what seemed to have been an indistinct blur of activities consisting of monitoring-ABG-monitoring-
If the PACU is an ICU setting then why don't I see advanced vital signs monitoring machines? Oh I forget. I AM THE VITAL SIGNS MONITORING MACHINE.
Not to mention my human, medicine intern functions.
I lost count of how many times I've wished that I was a machine tonight. At least machines don't ache, don't become hungry and don't complain.
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4:20 AM Monday PACU
My feet are sore and my back is killing me. My hand is numb from taking the patients' blood pressures. My eyes feel heavy. My head feels light. I want nothing more than to allow myself the bliss of uninterrupted AND restful sleep, a luxury that I would have to deny myself for 5 more hours.
Oh and by the way, I'm still alone.
I don't want to think ill of my co-interns but I can't help it. It's not like I didn't call. I did and for my efforts I got neither explanation nor assurance that I would have help. I keep on imagining them sleeping comfortably in their call room especially since there are clerks to go up to the OR for the 'E' cases and since q4 monitoring is being done by the nurses. Then again, there could be other, more valid explanations for the GS intern's absence.
I'm really hoping there are.
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6:30 AM - Monday PACU
For lack of a more diplomatic way to put it, I absolutely hated this duty. Somehow, I feel cheated. It was definitely not fun and I don't think I learned anything new. The satisfaction of helping patients just doesn't cut it anymore. Actually, I didn't feel like I was able to help anyone.
I have 108 days left as a medical intern. It goes without saying that I will make the most out of each and every day. However, can I just say that I really can't wait to graduate from the UPCM and leave the PGH. Don't get me wrong. I am honored and greatful to have been given the privilege of getting into the UPCM and training in the UP-PGH. For all of their faults and failings, I have never doubted the greatness and nobility of these institutions. I am proud to bear the joint names of the UPCM and the UP-PGH.
All I'm saying is that I can't wait to begin my journey towards the realization of what I believe to be my true calling as a physician.
Medicine for the people, from the people and by the people beckons.
But for now, there are more immediate concerns to be addressed. A bath would be nice as well as a few hours of sleep. In a few minutes my reliever will come and I will finally be able to go home.
The comfort of my bed beckons.
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5:06 PM UPCM Student Lounge
After 4 hours of sleep, a lunch meeting with the UPCM administration regarding our class graduation and several "catch-up" conversations with med friends, colleagues and mentors here I am again blogging.
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A classmate from the previous night's GS duty team has texted me to explain and apologize. Apparently, they were a person short since one of them didn't show up for duty allegedly due to a "family thing". This was said to have been compounded by their first year residents working them hard last night. Apology accepted guys. I'm really more frustrated at the system and the way I feel stifled by its imperfections. No lasting harm/offense done.
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Last Friday, I was able to go out with some of my high school classmates. We had dinner at Jay-J's Grill (MC Home Depot, Ortigas) and capped the night off at the nearby Starbuck's. I don't know about my friends but I had an amazingly fun time swapping stories and discussing present/future life plans with them. It was great to once again share hearty laughs with people who I was able to share such an interesting and influential phase of my life with.
My classmates are now doctors to be, lawyers to be, entrepreneurs, consultancy professionals, engineers, professors, software designers/troubleshooters,
Here's to many many more years of friendship to come guys and gals! Until the next CDO! CDOOT? Charm Day Out Of Town perhaps?
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In a week's time, our class will begin to count down the last 100 days of internship. It's actually quite surreal. It feels like I just began med school last week and I started internship yesterday. I'm deciding to save the nostalgia and sentimentality for the upcoming "last days" though. I'm terribly excited though I may not overtly show it. Besides, the magic of it all is tempered by the amount of work that still needs to be accomplished with our upcoming graduation and all related activities.
--------------------
I've begun asking people for advice regarding my plans post graduation and post board exams. Currently my plans are still too ethereal for comfort but at least the basic theme has already been decided. I still surprise people whenever I tell them that I intend to go into Community Medicine. I get the token admiration comments such as "That's very noble of you." and I also get the incredulous "Why?!" from time to time. Modesty aside, I believe that I have what it takes to be a good clinician in any specialty. I think I can even be a better clinician than most. However, my heart tells me that I can do the most for people if I won't limit myself to the traditional physician profiles. I think that I will be able to fully realize my potential out there, away from the confines of the hospital and into the thickest and darkest parts of the jungle that is society. My understanding of health, health care, wellness and medicine has been shaped by the experiences, insights and lessons I have gained in the 7 years of my training in the UPCM and the UP-PGH.
And the way I understand it, my hurting and ailing country needs me to be a hero.
Ad Majorem Dei Gloriam
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Hi my Hime. My future is your future and vice versa. It goes without saying that all plans post graduation and post boards include the "US", "WE" and "OURS" factors.
I love you dear.
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- Location:UPCM Student Lounge
- Mood:
sleepy - Music:You're A God - Vertical Horizon
I am loathe to admit it but I haven't really felt the magic of this year's Christmas season. I am certain that the reason for these "Christmas blues" is multi-factorial but I would have to concede that being a medical intern has much to do with it. We doctors and doctors-to-be remain on call this season. The nature of our chosen vocation requires us to forgo a lot of things laypeople take for granted like sleep, eating regularly and a healthy social life. Unfortunately, celebrating Christmas, especially celebrating Christmas with the family, is among the things we have to forgo at certain points of our professional and personal development.
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The idea of not being able to celebrate Christmas (or New Year for that matter) may seem alien to most of the lay population but it is one of the things that health professionals like us would go to great lengths to avoid. Thus the heated jockeying and negotiating for duty schedules becomes more competitive and emotional during the season where we all should be giving love and being merry. Apparently, and this is now based on personal experience, missing out on the season is really a big thing for those of us in the health profession. The frustration and the melancholy caused by this is all too palpably real. This is magnified to even greater proportions given the atmosphere of despair, poverty and helplessness in the UP-Philippine General Hospital. There's just no way around it. Most of us do what we do because we have to. But there are those of us who do what we do because we believe in helping others. There are those who acknowledge and value their God-given duty and privilege to be of service to others, most notably to others who have much much less. In this regard, I consider this season a season of heroism and love for us at the UP-PGH. It may not seem such from the outside but we are celebrating Christmas. In fact, we are in the best position to honor the One for Whom all of the fuss, grandeur and magic of the season is truly for.
Happy Birthday Lord Jesus!
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I was blessed enought to have had the opportunity to celebrate Christmas Eve and Christmas outside of the hospital. Regardless of what I have just written above, I would be a hypocrite if I said that I would've preferred to be on duty on Christmas Eve/Christmas Day. It's Christmas and thankfully I am home.
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Before going home yesterday, I was able to have dinner with Len and her family. It was a blessing to have spent time with them even if only for a couple of hours. Thanks so much dear! I had an amazing time with Mama, Papa, Ate Eden, Enos and you yesterday!
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Unfortunately, the exhaustion of the past few days finally caught up with me at the most inopportune time. Due to the clerks being on Christmas vacation, we've been going on every other day duties since the weekend. Yesterday, I was post duty and since there were still a number of loose ends that I had to tie up before ending my Orthopedics rotation, I wasn't able to get much rest. Anyway, I was just planning to take a nap for a couple of hours last night and wake up in time for our simple Noche Buena at 12 midnight.
I woke at around half past seven in the morning. Sheesh. Heheh.
Apparently, Nanay and Carlo tried to wake me several times last night. I don't remember any of these attempts.
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At least I still have Christmas Day to spend with my family. We're planning to watch a Metro Manila Film Festival entry later today (just like what we did in 2006 and 2007). However, none of the eight films for this year's film fest seem to be interesting enough to watch. At the moment, I'm leaning most towards the "Iskul Bukul" film. I guess we'll just have to see. We can always just have dinner or lunch together or something.
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Today is the first day of our Psychiatry Ward/ER rotation. I am not looking forward to once again interacting with people whose minds and psyches are unhinged. I am sorry but I never really liked Psychiatry. We're lucky to have our rotation coincide with the Christmas season though. Due to the holidays, we are only required to go to the PGH when we're on duty and to do paperwork. I am looking forward to one week of relatively benign work.
I find myself missing Orthopedics. I still don't enjoy spending so much time in the operating rooms but I had fun during the rotation. What I appreciated the most was the residents with whom we were able to interact with. Thanks so much Ma'ams and Sirs!
I'll be on duty tomorrow. I am praying that there won't be any ER consults. It isn't a crime nor sin to hope. Hehehehe.
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I'll be on Psych ER duty on the 31st. Hope that goes well. Either way, bring it on.
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Merry CHRISTmas everyone!!! Be blessed to be blessings!
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Merry CHRISTmas my hime! Hope you have a benign duty today. I love you.
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- Location:Home
- Mood: happy
- Music:I'm Yours - Jason Mraz
For the past 3 hours, my face, neck and arms have been at the mercy of the seemingly mutant mosquitoes that call the PGH Cancer Institute home. I am really looking forward to being relieved in an hour by my blockmate if only to escape the endless biting.
Note to self: next CI duty, OFF Lotion is a MUST.
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I think I wrote something similar post OB rotation last year during clerkship. Somehow, I find myself missing OB-GYN. Errr...I better expound more so that I don't get misunderstood or misquoted. I don't miss the toxicity nor the stress of the PGH OB-GYN experience.
What I miss are the people I've established relationships with in the 8 weeks that I was part of UP PGH OB-GYN Service A. With this, I don't just mean the residents and my co-interns. I am not downplaying or devaluing the memories and experiences that we shared during our pre-duty, duty and post-duty days. It's just that this year, I think my interactions with the patients that I encountered, whether good or bad, have truly enriched me. It goes without saying that in those 8 weeks, I learned a lot about obstetrics and gynecology.
In those 8 weeks, I learned a lot about myself too.
I won't bore you with enumerating them all. I'll just share one.
I may still think of myself as a superhero most times, but I have discovered that apparently, over the years, I have learned the value of accepting other "heroes'" help.
Even Naruto doesn't hold exclusive rights over Konoha's "Will of Fire".
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I'm weird. Lolz.
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2 nights ago (or was it 3?), Len and I had a date at the ...drumroll please... Manila Bay Baywalk!
Fine. I would have to concede that it isn't exactly the "in" place to be for a date these days and I wouldn't be surprised if most of you wouldn't even have the Manila Bay Baywalk among your list of differentials for a romantic night out with your special someone but there the two of us were.
Hand in hand, we joined a fair number of other couples who were also enjoying the cool December air, taking in the sights (the balut vendors, the streetkids selling cheap roses, the smattering of joggers and cyclers) and breathing in the stinky... errr... salty sea breeze.
Okay, to be honest, I think the both of us weren't expecting much from this sojourn of ours but I had an amazing time with Len that night. Len told me later that some of our friends, upon learning of our Baywalk date, jokingly asked her how our "day off" went.
If they were to ask me, I would look them straight in the eye and say, "Great couldn't even begin to describe it."
Wow.
The follow up question would logically be "Why?"
I have only one answer to that.
I was with Len.
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We didn't do or experience anything extraordinary that night. Unlike a year or two ago, there were no baywalk clubs and restaurants to patronize. There were no more show bands to listen to. There were no exhibits to see. No, we did not go jumping into the inky waters of the Manila Bay. No, we did not dance in the middle of the baywalk (although I really wanted to with Len prudently refusing). No we did not even try our hand at fishing (for mutant/monster fish I guess) from the ledge overlooking the dark, stinky waters.
What we did was walk under the soft glow of the baywalk lights while looking at the full moon. We chose a spot where we could sit down and we talked. We laughed. We ate balut penoy, chicharon and peanuts. We drank Pop Cola. We talked. We laughed. We talked some more and laughed some more.
We didn't notice the time because we were having such a blast enjoying each other's company.
I am very much in love. We both are.
That explains it all.
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We didn't need to spend much or go far. It was inexpensive yet very much romantic. Our date wasn't in an ideal nor idyllic spot but the experience was something to treasure indeed.
It was sweet.
It was real.
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I'm glad we did that dear. And I'm glad that it seems that we would go out on many many more similar dates. Not necessarily inexpensive nor unorthodox.
With you I could go anywhere and still be amazed.
This is definitely one for the kids and the grandkids beh.
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I love you.
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My reliever is here.
I'm OFF!
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- Location:PGH Cancer Institute
- Mood:
loved - Music:None
Nearly a week or so ago, I, in my role as the class president of the UPCM Interns' Class of 2009, along with Dr. Aubrey Taguba, president of the PGH Post Graduate Interns (PGIs) and Dr. Beverly Ho, class president of UPCM Class 2010 (clinical clerks) attended a meeting with officials of the PGH administration and representatives of the PGH Nursing services. Dr. Lita Vizconde and Dr. Rodney Dofitas represented the office of the PGH Director while the head of the PGH nursing services, Mrs. Rita Tamse held the fort for the hospital's nursing staff. Also in attendance were the chief residents of the different clinical departments of the hospital as well as the resident monitors for both the interns and clerks.
The agenda consited of the following main points:
>Role delineation among nurses, interns and clinical clerks
>Patient monitoring
>Administration of IV medications, IV insertions
>Hospital supplies
>Communication issues among residents, nurses, interns, clinical clerks
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To the uninitiated layperson, such issues, as written above appear to be bland, boring and benign topics. For our peers, colleagues and co-workers however, the above issues necessitate reading between, beneath and even beyond the lines. To the PGH trained physician in particular the points above will never fail to elicit such poignant memories, many of them unfortunately are unpleasant.
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The results and resolutions from that meeting were as follows:
>Q3 and Q4 patient monitoring are to be the responsibility of the nurses, as it should always have been. Exceptions may be made especially with stable patients who may become unstable at any time (hypertensives, etc). Such patients should be endorsed to the IOD/SIC and monitored by the latter.
It is hoped that the nurses will monitor their assigned patients AS THEY SHOULD BE DOING. The question on everyone's minds at the moment is "Will they?" Interns and Clerks go on 24 hour duties. It is rare to see BP apparatuses and stethoscopes in the hands of the ward nurses if at all. THEY COPY OUR MONITORING. Enough said.
>Mrs. Tamse has clarified that if an IV therapist (a nurse with a special license) is present in the wards, then he/she is the one who SHOULD BE ADMINISTERING THE PATIENT'S MEDICATIONS. She promised that this issue if being addressed with an ongoing program training ALL PGH nurses to be IV therapists. For the meantime, we will still be called on to help push meds pending trained nurses. I was surprised that IV therapists can give virtually all drugs (except those for chemotherapy which we don't give as well AND loading doses of antibiotics, which residents give).
IT IS IN THE LAW THAT WHOEVER PREPARED THE MEDICATION SHOULD BE THE ONE TO ADMINISTER IT. Therefore I along with my fellow interns and our clerks, am a criminal or at the very least an accessory to crime. One only has to go on Pedia Ward duty once to absolutely hate carrying a tray filled with IV drugs to push AND AT THE SAME TIME monitor Q1 and Q2 toxic patients, do procedures and attend to referrals. I actually do not mind giving the patients their medications EVEN IF THIS IS NOT AMONG THE THINGS I A
THE INTERNS AND CLERKS ARE NOT ANGRY ABOUT BEING MADE TO PUSH MEDICATIONS (at least I hope so, and for me I know so) BECAUSE THIS CAN BE JUSTIFIED BY THE CONCEPT OF SERVICE TO OUR UNDERSERVED PATIENTS. WHAT WE HATE IS THE INJUSTICE OF IT ALL - OF DOING THINGS FOR THE SAKE OF OTHERS' CONVENIENCE.
And for what reason? It is true that the PGH nurses are overworked due to the overwhelming number of patients, but if that is the argument then we interns and clerks ARE OVERWORKED TOO, MAYBE EVEN MORE SO THAN THEY ARE. We go on 24 HOUR DUTIES. They rotate in 8 HOUR SHIFTS. It can be argued that with the number of patients, they won't be able to finish their tasks if they have to monitor and push the meds of their patients as well, but I beg to differ. They will and they do argue that given the amount of charting they do they will never get anything done. This may hold some truth but the problem is exactly this: FOR MANY OF THEM, THE CHARTS ARE MORE IMPORTANT THAN THE P
WE ARE WILLING TO HELP. WE ARE WILLING TO TAKE UP OUR SHARE OF T
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After reading the previous paragraphs, I will not blame you if you think I am so narrow minded as to place the blame squarely on the inefficiencies and faults of the PGH nursing staff. However, this is not true. I think that an equal amount of blame can be placed on the shoulders of me and my co-interns and clinical clerks. We also have our faults and with these issues being raised at this time, I wouldn't be surprised if I have a counterpart nurse blogger out there who is writing about the same topics from their own unique perspective. In that piece the emphasis will be on the lazy, slacker interns who disappear during duties. That piece will be about those interns who fabricate their monitoring because they don't have what it takes to forego their comforts and niceties. That piece will be about those interns whose only concern is themselves, those WHO NEVER DID UNDERSTAND THAT THE VERY N
I condemn these colleagues of mine with EVERYTHING IN ME.
HOWEVER THEIR EXISTENCE DOES NOT LESSEN T
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Given everything that I have said, I would like to make the following conclusion. This was the same conclusion and appeal that I made during the meeting nearly a week ago. It is more of a challenge for everyone involved, which when taken into the context of the PGH , is EVERYONE.
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Ever since I attended the 3rd UP Global Health Course a couple of years ago, I have become more conscious of root causes. Every problem has one or more of them. To solve any problem then one has to address root causes. It isn't easy and given just two short, immature years of attempting to address root causes, I think I now understand why virtually all of us tend to be blind about them.
Addressing root causes is a painful, dirty and draining business. However, at the risk of undermining my credibility or my character, I would like to state that I would like to dedicate the rest of my life to attending to these root causes.
Pathologic Hero Complex...
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SO WHAT ARE THE ROOT CAUSES OF THESE PROBLEMS??? POOR GOVERNMENT SUPPORT? A FLAWED HEALTH CARE DELIVERY SYSTEM? A PROSTITUTED NATION? A DISSOCIATED HOSPITAL ADMINISTRATION?
THERE IS SOMEONE OR SOMETHING TO BLAME FOR ALL OF THIS. THERE IS SOMEONE OR SOMETHING WHOM/WHICH WE SHOULD HOLD ACCOUNTABLE.
WE ARE TRYING TO BEGIN THE PROCESS OF CHANGE. HOWEVER, WE HAVE TO ADMIT THAT AT OUR LEVELS THERE IS ONLY SO MUCH THAT WE CAN DO. BUT SUCH A LIMITATION IS OF GREAT STRENGTH IF WE ONLY LEARN WHERE TO HIT, OR WHO TO HIT.
DAVID'S SLING FELLED A GIANT BECAUSE EVEN IF IT WAS A RELATIVELY MINUSCULE PROJECTILE IT HIT THE RIGHT SPOT.
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IF I AM MISDIRECTED THEN DIRECT ME...
BUT I AM HITTING NOW. I AM HITTING WITH ALL I'VE GOT.
ARE YOU WITH ME?
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- Location:MyPad Internet Cafe
- Mood: determined
Browsing through the titles of my previous entries, I notice that several contain the terms "preduty", "post duty" or "duty" in feeble AND rare attempts at word play. <Sigh>. I can't wait to have a break from this cycle. I was intending to say that I really do want to free myself totally from this pattern altogether but at this point I still dont want to exclude going into residency after my internship.
Residency means going through roughly the same schedule, albeit with much more responsibility. With the career in Community Medicine and Public Health that I am envisioning myself to be in, it is likely that I wouldn't have to mark the passage of time by using the preduty-duty-post duty "clock". However, the future will always refuse to be fettered with the chains of certainty so I wouldn't want to be too sure of myself at this point.
What I'm sure of is that I need a break and I need it quite badly. OB Gyne isn't that bad and I have had a relatively swell time interacting with our patients, my groupmates and my service seniors/residents during these past 7 weeks or so. It's just that the 8 week rotation feels like a very long 8 weeks indeed and with all the toxicity inherent to the rotation (especially here in PGH) I feel exhausted and a bit burnt out.
I suppose I just have to dig a bit deeper into my personal reserves to get through the next couple of weeks. If I allow myself to have lapses of judgment (and character) like I inadvertently did this morning when I failed to do rounds on one of my patients who was for discharge (Sorry talaga Ma'am Roma!!!), then I would be shortchanging not only myself and my peers/colleagues/seniors but my patients as well.
Lord only knows how disadvantaged and marginalized they already are in the Philippine General Hospital. The least that I could do for them is to assure them of the best care that I (and this institution) could possibly offer given the great limitations of the flawed system we are all operating in.
Tao Pa Rin Pala
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Last Wednesday, the OLEMS band was able to play at the One Big Phi, a night of music and dancing sponsored by the Phi Kappa Mu Fraternity and the Phi Lambda Delta Sorority of the UP College of Medicine. The performance wasn't as good as we wanted it to be and actually I don't think we did well at all but hey, live performances will always be like that. Whenever we play live we tempt Murphy's Law and tempt Murphy's Law we did. Lolz. We have great photos of the performance though courtesy of Alric Mondragon of UPCM Class 2010. Here are some of them. These are well, more of vanity shots but hey, my blog, my music. Lolz!
Here's me straining to sing Chris Brown's "Superhuman". I think I pulled it off... I think
Ito pa. Kumbaga sa OB eh crowning na siguro ito! Ahahahahahahaha!
Blue! Nuff' said.
Post performance to - Hehehe. Medyo kunwari happy kahit na mejo sablay ang tugtog. Lolz
We performed "Cool Off" by Session Road, "Superhuman" by Chris Brown/Keri Hilson and "4 Minutes" by Madonna/Justin Timberlake on a preduty day. The funny thing was the day after, which was a duty day, our Service Assistant Chief Resident Dr. Marie Andal, or Ma'am Marie as we fondly call her, celebrated her birthday. She treated us all to a wonderful dinner (ang daming pagkain!) at the OB Gyne Conference Room. In return, we decided to play the three songs for her as a birthday gift. Hehehe. Kapalan na lang din siguro ng mukha. Apparently we pulled it off to her enjoyment and appreciation. Nabawi pa namin yung sablay naming tugtog sa OBP. Natuwa din daw yung mga OB residents who were there to watch.
Tao Rin Pala...
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The annual UPCM TRP (Tao Rin Pala) variety show will be held at the St Paul University Manila Fleur de Lis auditorium this Friday. It will be ineresting to watch the younger UPCM classes compete at the choral competition. Our class won 2 out of the 3 years we were included in the competition and it was an honor to have been a part of the music team which created and perfected our contest pieces for the TRP. Our class failed to perform at last year's show due to well, for lack of a better term, apathy. This year, we will perform whatever happens. This will be, quite possibly, my last TRP ever (as a performer, unless mag residente ako sa PGH), and even if I can't dance much I'll try... Hahaha. Cliche na to pero kaya nga cliche kasi totoo.
For the class. =.P
Tao Rin Pala...
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Len and I both liked the "Twilight" movie. It wasn't perfect but for book-to-film adaptations, "perfect" cannot be used to describe them given the limitless imagination of each reader. The film was a pretty decent adaptation of the novel, better than the Potter movies in many aspects. It stayed true to the novel, with few creative allowances, which made it a pleasure to watch.
I still think the novels are really written more for the ladies so I don't think I am in a position to pass much judgment on them. They definitely don't rank up there with those of Eddings' or Tolkien's or R. Jordan's or even A. Rice's but they tell a good story nonetheless.
The critics be damned, sour graping "Looooooosers" that they are (a nod to Ogie Alcasid and Michael V.). Meyer's rolling in her blessings right now and that's all because she attemped (and succeeded) in retelling and rehashing the tale of a vampire and a human being in love.
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I'm nearing the end of my 7 years in med school (counted na yung 2 years undergrad sa INTARMED).
It isn't easy and it won't be.
I am grateful for all the experiences and relationships and failures and successes.
I am grateful for everything.
I am thankful that inspite of all that has happenned, despite the amount of personal struggle at many points in my journey through med school, I am and still remain...
Tao Pa Rin.
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My tatlong bentesingko attempt at being profound.
Post duty eh. =P
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I hope you're having a benign duty my hime!
I love you so much!
MOA
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- Location:UPCM Student Lounge
- Music:Go On Girl - Ne Yo
11: 07 AM - UPCM Student Lounge
It's Saturday and I'm OB GYN preduty. This means I practically have the day off. Ideally, the dilligent UP-PGH intern will view this as the perfect opportunity for studying. I can brush up on our in-rotation concepts or even open a reviewer/book for the medical boards.
However, I have always believed that there are more important things in life. The books, reviewers and papers can wait. The preduty, duty and post duty cycle by its very nature can drive even the most level-headed people crazy.
Free days are for breaks and for appreciating the finer AND MORE IMPORTANT things in life. These may vary from person to person but I think all med students should learn that durng the course of their training, rest periods were created for one particular purpose. Names usually denote function. Rest periods and Days off are for rest and taking time off.
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So here I am. After making sure that there are no pressing orders to be carried out for my Tropho patient (I visited her at the wards), I am passing away the time blogging, surfing the net and preparing for later. Len and I will be watching "Twilight" this afternoon and I am looking forward to spending time with her. She has just begun her OB rotation while I'm in the twilight (pun intended) of mine, being in the last 2 weeks of OB GYN.
They say that with the additional gynecologic malignancy and trophoblastic disease patients decked to us "senior interns" during these last two weeks, things will generally be more toxic. This may be true but I have never let academic work or training get in the way of my enjoyment of life.
I don't plan to start now nor ever.
If this means exerting more effort during "work days" then so be it. =)
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Dearie, I am definitely no Edward Cullen in terms of reading other people's minds and even if I were him, I still won't be able to read yours. However, don't let this prevent you from expressing your feelings and from letting them show.
I may not be as strikingly handsome as Edward and I most likely won't ever be. However, i know with all certainty that the love I have for you is greater than the love he has for his Bella.
MOA beh. To the nth level. Can't wait to be with you later.
I love you.
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- Location:UPCM Student Lounge
- Mood: content
- Music:Imagine - David Archuleta
6:34 P.M - Unit 704 Dakota Residences, Malvar Street, Malate, Manila
I'm here at my bandmate/bestfriend/blockmate Jedi's unit for band practice. The OLEMS band will be playing tomorrow at One Big Phi after months of not being able to perform. Med school in general and internship in particular have greatly interfered with our supposed to be music careers. Hehehe.
We're preparing three songs for tomorrow. These are "Cool Off" by Session Road, "Four Minutes" by Madonna/Justin Timberlake and "Superhuman" by Chris Brown/Keri Hilson. Good luck sa amin. Hehehehe.
I think it will be interesting to see how we can unify these three somewhat musically divergent songs through our brand of music.
Ang yabang noh? Humor me. I'm post duty.
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Speaking of being post duty, yesterday's 24 hour duty at the OB Admitting Section was the worst I've had for my whole OB GYN rotation. From 7AM to 7PM we had a total of 24 (or was it 25) admissions. The number of consults are usually more than double this so I'm guessing we had about 50 to 60. From 7PM to 7 AM I think we had a total of 14 admissions.
Of the 24 or 25 day admissions I admitted at least half of them. This means that I was the one who inserted their IV lines, extracted their blood, etc, etc. This excludes bringing the samples to the lab, arguing with problem patients and relatives, monitoring already admitted patients, charting, completing paper work, bringing patients for ultrasound/biometry/whatever. This t
I am not complaining or resentful about the fact that I seem to be one of the interns our residents most often give tasks to. I don't mind really. In fact, I am grateful for such. Aside from the great potential for learning that is inherent in every task assigned to me, I believe that I am trusted enough to not let them down during our tour of duty. The fact that I do so much means that I am capable of doing so and I am trusted to do so. As such, it is an honor and privilege to be able to serve.
It wasn't the number of patients or the difficulty in assessing/interviewing them. There was and always is a patient factor to the stress we experience in the PGH. The problems of our country's flawed health system are magnified, emphasized and amplified in our setting. Through the years, I have learned to look at the root causes of these problems and this has helped me a lot in dealing with the so-called PGH "patient factor".
It wasn't my bloody (and I mean bloody) and grimy white uniform which I had no choice but to wear up to the conference this morning since there was no time to change due to the seemingly constant and endless flow of patients throughout the duty. It wasn't because I was only able to have one meal for the whole 24 hour duty (and this was a less than ten minute breakfast/lunch/dinner/breakfast) at around 4AM this morning. It wasn't the nature of the duty itself. It never is for me.
Each hospital duty is more often than not, toxic. For me, the "more often" part of the phrase applies but I have learned to deal with it and most of the time, I welcome it.
What I hate is when other people don't do what is expected or required of them during duty. I am not asking for superhuman efforts. All I'm looking for is the minimum requirement so to speak. I have learned (painfully I may add) that not everyone shares my attitude about work, in this particular case, hospital duty.
Always vigilant. Ever ready. No holding back. This is who I am. At times, I irritate even myself by being so asinine about these things. But I can't help it. I am wired to be this way.
I often shrug my shoulders and tell myself, "Who else is going to do it if I won't?" It may sound like a very proud, selfish and self-centered point of view but I can't avoid it. My experiences have yet to dissuade me from such thinking.
Sue me.
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Band practice is not yet over. 4 hours of sleep in 28 or so hours.
I am so looking forward to a good night's rest tonight.
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I love tomorrows and new days. =)
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Besides Len will be back from San Juan, Batangas tomorrow. Hehehe. Dear! OB GYN ka na din. Hehehe.
Uwi ka na agad! Bilis!
I love you my Hime.
MOA to the nth level.
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Ad Majorem Dei Gloriam
- Location:Jedi's Unit
- Mood: sleepy
- Music:Cool Off - OLEMS band version
6:24 PM - UPCM Student Lounge
Tomorrow is the 21st day of my internship rotation in OB-GYN. 21 days. 3 weeks. I have spent the last 3 weeks charting, looking at vaginas, inspecting cervixes (or is it cervices?), doing Pap smears, measuring fundic heights, auscultating for fetal heart tones, estimating fetal weights, delivering babies, delivering placentas, performing episiorraphies, assisting in dilatation and curettages, establishing intraveous accesses to would be mommies, extracting their blood, doing intrapartum monitoring, losing sleep because of labor watch, conducting patients to the perinatology unit/ultrasound section, etc etc.
These things are more or less the routine (i.e. normal) stuff one does if you are in/an OB GYN in the UP-PGH.
Being the toxic magnet that I am, I think I've been doing double the usual stuff plus the not so routine things I've encountered during the last 3 weeks.
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My first OR assist for the rotation was for an ovarian new growth that measured 30 plus centimeters in its largest dimension. The patient's abdominal girth was 147 cm. She looked like she was carrying triplets. No make that quadruplets. After the surgery, before being discharged, the patient told me, "Dok, natutuwa po ako na nakikita ko na po ulit ang paa ko." Her abdomen started enlarging only 8 months prior to her admission. We drained about 8 liters of ascitic fluid admixed with blood intraop. Even without the final histopathologic diagnosis we all knew that what she had was malignant. Maybe she understood this. Maybe she didn't. What was more important for her was that she was able to see her feet again. She was happy. Our residents were happy that the OR was a success. I wasn't though. I couldn't bring myself to be. I learned from her case, but this was one of those times where I wished that I'd rather not have learned from her case. Because somehow it feels that we all learned from her at her expense.
I used to feel this way a lot in years past. Now these moments still come albeit markedly reduced in occurrence from before. I am very grateful they still do.
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During my first OB Admitting Section duty I found myself holiding on to a 27 by 12 by 8 bleeding mass protruding from the vagina of a 28 year old nullipara. The mass was a prolapsed submucous myoma which due to its size dragged the patient's whole uterus along with it in its quest outwards of the patient's body. I had to keep my hand on one side of the mass to tamponade it. If I let go, the patient would most likely exsanguinate. As we were being wheeled to the OR, I found myself praying for the patient. It was the best that I could offer aside from being a human tamponade.
She survived the OR and has been discharged. She wont be bearing any children of her own but she has the rest of her life to look forward to.
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I have more interesting and unusual cases that I can share. All of them happening in the last 3 weeks. But I think I have said more than enough. I am not ranting against my current rotation. I am enjoying myself more than the down times. I guess I'm just a bit tired today.
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Namimiss lang kita sobra beh. Uwi ka na dito. Bilis.
I miss talking to you Dear. I miss holding your hand. I miss hearing your voice. I miss your presence dear... Dearly.
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OBAS duty ako bukas. Sana benign. Pero di na ako umaasa. Para na rin di ako ma-disappoint.
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But unlike the person who wrote that Youngblood article a month or so ago, I look forward to each duty. Maybe I do so reluctantly at times, but I always look forward to each duty, mapa OB man o iba. Madami man ang admissions/consults (which is more often than not the case for me) o hindi, bring it on.
For I am performing my assignment. Yes, there are instances of fear and doubt, but these are fleeting. I am performing my assignment in His Kingdom. I am doing His Work. I am strong because He is strong. Not because of who I am but because of what He's done. Not because of what I do/I've done but because of Who He is.
By Grace through Faith I perform my assignment. By Grace through Faith I have never been happier.
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MOA beh. I miss you so much.
Uwi ka na.
I love you my Hime.
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- Location:UPCM Student Lounge
- Mood: determined
- Music:Breaking Free - High School Musical
10:17 PM - UP College of Medicine Student Lounge
Hehehe. It's funny how you get to really appreciate what it means like to be post duty when you attempt to do "normal", non-medicine related stuff during your time off from the hospital. I'm writing this the day after going on 24 hour duty at the Labor Room/Delivery Room of the Philippine General Hospital. That particuar duty marked my 3rd 24 hour post in and the first week of my internship rotation in Obstetrics and Gynecology.
I feel like 3 Grand Matadors, 2 Red Horse beers and several San Mig Lights after... Hehehe. Forgive the analogy but it sure feels that way. I guess the pathophysiologies of a hangover and being post duty are very similar. I really won't go into detail but my theory is that in both, dehydration plays a central role. Kaya kesyo duty o barik pa yan, inom ng maraming tubig mga tsong at tsang!!!
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I failed to post my final reflection paper for Community Medicine last week. I was busy working on our community updates as well as the IMCI Cough Module for San Juan, Batangas so blogging took a back seat somewhat. Anyway, for those interested, here's that paper.
( Week 5... )
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Last night, at the height of the tension and toxicity of our LR/DR duty, a group mate of mine half jokingly exclaimed. "Grabe ka Lopao! Nagkakalat ka na naman ng lagim! ANG TOXIC MAGNET MO TALAGA!" To the uninitiated, the we use the term "toxic magnet" to describe a person, who wherevere he may be assigned, seems to attract the most patients and the most amount of work. I am a toxic magnet (O ayan, masaya na kayo? Inaamin ko na! Hehehe). Mapa-Community man o Medicine o OB, ang dami ko laging pasyente at ginagawa. Even for rotations which by definition and reputation are benign like ORL, Ophtha, etc I I always end up having a lot of consults, etc. Anyway, going back to last night, another group mate then said, "Okay lang yan Lops. Isipin mo na lang pag nag pra-practice ka na. Ang dami mo laging pasyente, mas malaki ang kita!". I suprised myself by saying, without any hesistation whatsoever, "Eh mag Cocommunity nga ako di ba? Hindi ako mag pa private practice."
One OB resident who overheard this then turned to me and said, "Talaga?" laced with such a tone of incredulity that kinda hurt. Hehehe. Then he said, "Ang noble mo naman"
Noble? Maybe. Maybe it's me wanting again to be a superhero. Maybe it's me wanting to change the world or "save the world" as the popular TV series "Heroes" byline goes. Maybe or maybe not. All I know is that everything about my formation as a person seems to be aimed at this goal. From being shaped as a man for others by the Ateneo to the rigors of my stay at the Philippine Science High School to my ultimate metamorphosis at the UP College of Medicine, it all makes sense. I have been given much by the Father and as such I also have much to share. I believe that by being involved in community work and community medicine in particular, I am just being true to my character and nature.
It may be a bit exagerrated and admittedly not that worthy of comparison, but just like Abraham, Daniel, Moses and Paul, I am answering a call.
I am answering His call.
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Please check out my facebook account. I am listed there as Lopao Medina. Lately, I have found it more convenient to post my pictures, etc in facebook. The relative complexity of the site with its many features and applications turns off a lot of people but for me these things are what make the site appealing. Hehehe. Wala lang. Commercial lang. Masyado na naman akong seryoso. Lolz!
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Len turned 23 last October 17. Yey! To celebrate, we went to Ocean Park Manila then had dinner with Nanay, Tita and my cousing Patricia at Aristocrat Roxas Boulevard. We had a really great night and it was amazing to have seen the assorted marine life in their underwater gory as well as to have spent time with familyand loved ones.
However, Dear, let me say this to you. It was the celebration of you that was the most amazing thing of all. Happy birthday my Hime! Happy Anniversary too! Hehehe. We may have been unable to celebrate because you had to leave for your Community Medicine rotation in San Juan, Batangas on the day of our anniversary but I'm sure that there will be many many more anniversaries to celebrate. I love you so much Dear!
Lenlops with the Stingray. Hehehe. More pics uploade in @ my facebook site.
Dinner with Tita, Shine, Nanay @ Aristocrat
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As I mentioned earlier, I have now finished the first of the eight weeks of my OB-Gyne rotation. Naikutan ko na lahat ng duty posts - wards, OB Admitting Section and LR/DR. The work is exhausting but I have this general vibe that the rotation will be lighter compared to clerkship last year. I suppose things are easier the second time around. Lolz. I suprised myself by enjoying clerkship in OB-Gyne. I hope this year will be as enjoyable or even more so than last year. Maybe it's a bit too early to tell, but from the events of the first week, things look promising. I guess we'll just have to see.
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- Location:UPCM Student Lounge
- Mood: sleepy
- Music:With You - Chris Brown
I should be preparing to go to the UPCM already. I'm meeting with my Community Medicine group mates at 4 PM for our presentation on Monday. But before that, let me post this week's reflection paper. =.)
Enjoy!
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( Week 4... Read more... )
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I also would just like to say that Lolo is much much better now! He's ambulatory and in considerably lesser pain than before. The vomiting and diarrhea lasted for only a day. Praise God!!! Hehehe.
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Here are again some pictures from my fourth week in San Juan. Check the rest out at my facebook account. User name is "Lopao Medina"
A bit unflattering... Hahaha. During the IMCI Cough Module Workshop
The BHWs in action...
L-R: James, Mat and Lops @ Kapitan Cueto's (Bgy Captain of Pulang Bato) Birthday Party. Bijoke!!!
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Can't wait to be with you later my Hime!!!
Hope okay ang duty mo diyan sa Ambu!
MOA! MOA! MOA!
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- Location:Home
- Mood: accomplished
- Music:Superhuman by Chris Brown and Keri Hilson
I wasn't able to blog this weekend due to the many requirements of the Community Medicine rotation that needed to be accomplished. I practically also had no free time because I had to hep out in caring for Lolo who is again sick. It wasn't exactly the restful weekend that I was hoping for but at least I got to spend it with my family (although sobrang stressful and tension filled nga lang sa bahay ngayong mga panahon na ito). I am also grateful that I was still able to go to church last Sunday and spend some time with Len and her family.
By grace, through faith I receive Your blessing Lord. In all humility I receive Your grace.
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( Catharsis lang )
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Again, I am posting my reflection paper for week 3 in the community. =) Dearie! Hehehe. Wala lang.
( Community Medicine Week 3 )
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The amount of work our group (and whole block!) is doing for community medicine is really quite a lot when compared to that of the other blocks with us in San Juan. Hahaha. As endorsed, Dr. Paterno's groups really have a tougher time in the rotation. However (and my blockmates would hate me for saying this) I think we are all the better for it. Hehehehe.
This week though, I chose to cut myself some slack and reward myself somewhat for a tough and tiring week. Here are some of my week 3 Community Medicine pics:
Jedi and Ricky bijoke after the Cluster meeting of Barangays Nagsaulay, Coloconto and Bataan
Block O dudes at the block lunch @ Liloy's after the IMCI Cough Module practice teaching precepts with Ma'am Bebol
With Kuya Ronnie, our submental SCCA and our patient for the Family Case Presentation
Our original Sub block: L-R (Lops, Inna, Jayps, Mykz and Jedi) - Pa-cool sa may beach!
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Hi Dear!!! Happy birthday kay Mama! Hehehe.
Excited na ako makasama ka mamaya beh! I love you so much my Hime.
MOA! MOA! MOA!
- Location:UPCM Library
- Mood: contemplative
- Music:none
I tried cross posting from my multiply account to lj. The formatting became weird so here I am editing this entry. Hehe. I don't think I'll try doing that again. It's less hassle to use copy and paste. Lolz.
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Dugong bughaw pa rin naman ako kahit papano so...
ONE BIG FIGHT!!! Go Ateneo! Lalo na't DLSU ang kalaban. Ahehehe.
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I am again posting my week 2 community medicine reflection paper as a blog entry. Enjoy!
( Week 2 of my Commed rotation. Read more... )
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Here's a few pics of my 2nd week in San Juan, Batangas. If you're interested in seeing more pics you can go to my facebook site. User name's Lopao Medina. Enjoy!
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Sunrise at the Nagsaulay Pier, Bgy Nagsaulay, San Juan, Batangas
"Dok" at the Barangay Health Center of Barangay Bataan, San Juan
R and R at the Nagsaulay Pier
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Happy eleventh dearie!!! Hehehe. Ayikee! Kinikilig ako!
Thanks so much my Hime. Here's to growing together in this relationship, growing more in love and growing in His Love.
I love you my Hime!
Great to know you're enjoying Pediatrics!
Can't wait to be with you again tomorrow.
MOA!
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- Location:Home
- Mood: happy
6:28 P.M - Home
Before anything else, can I just say that Die Hard 4 totally rocks! Hahaha. Yeah yeah. I just got to watch it a few hours ago thanks to Star Movies. It was an amazing movie. Lots of kick ass action and a pretty decent story. I now officially have two Bruce Willis movies on my list of favorite films: Tears of the Sun and Die Hard 4. I particulary liked this bit of dialogue...
Mat (hacker/sidekick): "Why do you do it?" - on being a hero
John Mclaine (Bruce Willis): "Because no one else will do it. Believe me if there was someone else to do it, I will let them do it, but for now, there's just me so I'll do it."
Coolness! Hahahaha. I don't know if I got the dialogue exactly but the gist is more or less there.
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I'm sharing my reflection paper on my first week in the community. Blog entry and school requirement in one. Saves time. Lolz!
Seaside sunrise at Bgy Nagsaulay, San Juan, Batangas - This is about 20 mins walk from our foster home. The shoreline is dotted with mangroves and while the water may not appear suitable for swimming, it was acually clear and clean. Jedi (my groupmate and bestfriend) and I went swimming in this area. Water's about 5 feet deep. Beyond the tree (which was about a good 30 meters or so from shore) it's open sea already. Can't wait to get back with goggles. According to our foster parent, there are corals in the area with lots of fish. Hehehe. We'll just have to see!
Jedi and Me before swimming. (Magkasinlaki lang kami - mas mababa lang ang tinatayuan ko. bwahahaha)
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( Week 1 in Community Medicine: Read more... )
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Missing you much my Hime. As in. Hehehe.
I love you Dear.
MOA! MOA! MOA!
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- Location:Home
- Mood: content
- Music:Tiny Dancer - Elton John
"Home"
Wow. After a really really long time I find myself blogging AND blogging at HOME.
Yay!
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I'm currently rotating in Family Medicine so that explains my relatively benign state. Funny thing is, I remember enjoying my clerkship in Family Medicine not too many months ago (March?). Now, as an intern, I'm finding it very difficult to see why. Hehehe.
My first duty at the PGH Ambulatory Care clinic wasn't enjoyable to say the least. I am not sure why it was so. Hmmm. I suppose this calls for some reflection don't you think?
Humor me.
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Wow. Sobrang frustrated ko talaga siguro! Hehehe. Owel. Baka din naman kasi biased ako because I really had an amazing time during my last rotation.
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To be honest, I wasn't expecting much from my 8 week Pediatrics rotation. Pediatrics in the UP-PGH has such a bad reputation as being extremely toxic. It also doesn't help that the UP-PGH Pediatrics department isn't exactly what people in the know consider as a model department. I've also had quite a number of bad experiences with the department during the last 4 plus years, especially with their implementation of the UPCM OSI curriculum. Basta, ang alam ko hindi okay ang Pedia sa PGH...
Now after 2 months of rotating in Pediatrics, I am actually considering it as my specialization when I finish med school.
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Well, I suppose it really isn't much of a surprise, especially for those who know me from even way before med school. It has been said more than a couple of times that I seem to have a way with kids. Most likey I inherited it from Nanay (who is basically this super pre school teacher if you didn't know). Basta, I really had a swell time in Pediatrics and I think it showed. Di lang isang resident ang nagsabi na bagay daw ako mag Pedia.
Nakakatuwa yun ha? As in. Hehehehe.
Although, if ever man I really do decide to go into Pediatrics, marami-rami akong obstacles na kailangan ma-overcome. Waterloo ko ang Cardiology at mas mahirap pa ang Pediatric Cardiology so kailangan ko talagang mag grow dun. Tapos sa Pedia lahat kailangan i-compute to adjust for the age difference. Good luck. Hehehe. Marami rami pang iba pero pag in-enumerate ko dito baka ma-discourage lang ako. Hehehe.
I guess after I pass the boards in August of 2009, then we'll see.
(Nicole - patient ko sa PER. She has a cyanotic congenital heart disease called Tetrallogy of Fallot. More pictures of my Pedia rotation in my multiply site: www.paolomedina.multiply.com )
Ang sarap ng pakiramdam na makakita ng batang gumagaling...
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So what about my Community Medicine aspirations and Public Health/ Health policy advocacies?
I can see myself training in Pediatrics and still be actively involved in such, maybe even more so.
Kailangan ko rin naman kasi isipin yung magiging pamilya namin ni Len.
Di ba Dearie?
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It's not as simple as me wanting all of this though. Hindi lang kasi ito ang gusto ko, o gusto namin ni Len, o gusto ninuman...
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Is this the path that I should take Lord? It seems so po.
But as always, only You know the answer.
We walk in Faith Lord.
And every single day, I believe You are showing us the answers... In little ways. In little steps. Thank You.
All for Your greater glory Lord.
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I love you my Hime.
Full Circle.
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- Location:Home
- Mood: accomplished
- Music:Bleeding Love - Leona Lewis
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