I hope we do this more frequently.
Wednesday, October 29, 2008
I hope we do this more frequently.
Tuesday, October 28, 2008
Last night, four of our friends came home from the US for a 2-week vacation. We took this chance to gather for a few hours and reminisce. Some things just don't change. Reggie is still our Baldy Daddy, almost forty with a mind of an 18 year old (hehe). Lims is still the butt of all jokes because of his Limwelisms. Meann has lost more than 50% of her original weight, but is still as tsismosa. Jen is still bading. And a lot more.
Housemates. Cuevas Buena Familia sans Cinderella.
I remember going all the way from Manila to UP Diliman just to have lunch at Mang Jimmy's then feast on dirty ice cream at the UP Sunken Garden even if our tummies were already sticking out a mile. Despite our toxic PGH duties, the 24-hour days were spent in laughter, gossip, cards, alcohol, whatever we could get our hands on. Oh, those were the days. Five years of great friendship in the most grueling of situations, where Charles Darwin's Survival of the Fittest is most manifest. We survived. And we made the most out of it.
Monday, October 27, 2008
As chief resident, part of my job description, though unwritten, is to see patients from all the big guys in the business: my esteemed consultants, the PGH director and administrators, college deans, university officials, politicians from all over, even the secretary of DSWD. I take care of indigent patients who seek their help, the families of their drivers, household helpers, or special people who are not part of their immediate families. As long as these patients do not resort to name-dropping and subsequently mandating me to grant them special privileges (my pet peeve, grrr), I really don’t mind. This enhances my people-skills, I get to pretend I'm actually in private practice and I simply miss talking to patients.
This morning, the secretary of the Dean's Office called. The dean was sending someone - a retired professor of Pathology who was having bipedal edema. The secretary said they were having difficulty talking to the old lady, since she already had dementia, with severe memory problems, an annoying attention span deficit, and some tangentiality of speech. I readily accepted. I have such a soft spot for old people that I maintained all of my Continuity Clinic patients who were more than 70 years old.
Thirty minutes after the secretary's phone call, a diminutive, adorable old lady shuffled into my office. She had an air of dignity around her. She radiated an aura of wisdom and wealth of experience that can only come from a well-lived life. Very simply dressed, hunched back with age, her hair gray, her skin shrivelled, she immediately proceeded to look at the portraits of previous department chairs hanging on the walls. She was talking to herself. "Patay na yan. Ay, kaklase ko yan. Patay na rin yan."
I approached her and almost bowing, I greeted her like I would a UP professor emeritus. I knew I was not worthy to be treating this great woman, someone who has probably trained some of my most esteemed teachers. She warmly clasped my hands, looked at me with a joy and innocence of a child. Seeing her eyes, I knew it was the look of dementia - a huged amount of wisdom clouded by so much innocence creating an almost painful cocktail of sheer detachment from the rest of the world. I was touched. And she prudly said, "Doctor ako."
Wow. So much pride of our profession. She must have accomplished so much. She must have loved this profession so much that even in her demented state, it still preoccupies her. I proceeded to examine her. I took her blood pressure, examined her eyes, neck, abdomen. Took out my stethoscope to listen to her heart and lungs. Checked her swollen legs. I asked several questions to the young woman with her, someone obviously hired, who answered most of my questions with I-don't-know and I-don't-care shrugs.
It was insensitive of me but I had to ask, "Ilang taon na po kayo?" She said, "Seventy-eight. UPCM Class '56 ako iha, ikaw?" "Twenty-eight po, UPCM Class 2004. Nasaan po ang mga anak n'yo?"
And then the old lady said, "Single ako. Ikaw, may asawa ka ba?"
Her insensitive maid even added, "Kawawa sya 'no. Single kasi e." And just like that, my heart raced wildly. The old lady, in a bout of dementia, was repeating the statement over and over again, to the amusement of everyone in the office, "Single ako e. Doctor ako. Taga-UP. Single ako. Ikaw, single ka rin?"
With a straight face but a frightened heart, I proudly replied, "Opo. Single rin."
I finished looking at the old doctor-professor. I was proud to have served her. Because I didn't trust her maid (I doubt she understood any of my instructions), I had to write down a detailed history (whatever her fragmented thoughts told me), my physical examination and plan of management, hoping that she has a nice former student who would read it and assist her and carry out the plans, someone she previously helped who would take care of her.
I hugged her before she left my office, and she hugged me back. Then she started rattling the names of her dead medical school classmates, and the names of her former students who are now well-known clinicians. To me, she seemed happy.
I hugged her again.
When she was out the door, I wondered, did I just give the me 50 years from now a hug?
Sunday, October 26, 2008
I had planned this trip since more than 2 months ago, immediately after my Leyte and Samar adventures alone, and after my fantastic escapades at Iloilo-Guimaras with my trusty travel buddies (see previous posts). Cebu Pacific had a promo last month so instinctively, without even contemplating the pros and cons, I bought a round trip ticket to Dumaguete. Two of the sort-of-eccentric people I've recently met have recommended Siquijor, claiming that a certain mystery about the place engulfs anyone bold enough to visit it. And I, being a fan of eccentrics and anything strange, immediately included Siquijor in my list of must-see-places for 2008. I had planned to bask in its mystery on my own.
Ahh, perfect. We haven't mapped out an itinerary. We didn't know where to stay. All we knew was we were going somewhere far away from PGH, some place where the wind is cool and the night is pitch black and where the fireflies thrive. Somewhere where magic can happen. Ahhh, magic. We desperately needed that.
(Pats is sooo kind to trust my amateur exploring skills. It's good she hasn't travelled with me yet. She still doesn't have any idea about the mishaps I always get into whenever I'm on the road. haha!)
And then there's VicVic, another of my favorite travel buddies. A diver and photographer at heart, she was dying to see Apo Island. November happened to be a relatively benign month for this Allergy fellow. In fact, she would be going Down-Under and the Lord-of-the-Rings paradise on that same month. Suddenly, last Friday, she decided to come along. I hadn't expected her to make it. It's her birthday on the day before we will be leaving. But when there's a will, there's a way. Having travelled with her several times, I'm sure she has also caught the disease: the Travel Bug that by experience, is certainly not easy to kick off. No wonder they call it lust. The need to travel simply consumes you until you obey it's becking and you allow your feet to take you where they want to go. (Please Vic, let's not be rainmakers this time...)
So, there we are. Three gorgeous (haha!) women, struggling in this huge hospital, with their sanity hanging on to that hope of a great adventure waiting for us at the end of two weeks. Three women who haven't stepped on the isle of Dumaguete in their entire lives. Three women would be enough to have a marvelous time. The practical side of me however reminded me that three women would be too much for a motorcycle habal-habal ride to handle, but too few for a hired jeepney, and too few for a hired banca. We need more people.
And so, I had to call on my trusty travel buddies again. Suspect number 1: Paulo, my med school and residency batchmate who is also a photography buff, snorkeling addict, and fellow lakwatsa enthusiast. I can't believe he actually went to Apo Island last month! (darn! we work in the same hospital and he didn't even get to tell me about it! this is how inhuman our working conditions are these days. tsk tsk). And so, both he and Joyce (his adorable girlfriend) are out. Sigh. Too bad. Suspect number 2: my ever elusive good friend Jojit who I consider my personal travel guru, the only lay person (aside from Joyce) who has sort of penetrated our little snobbish (yikes!) all-doctor travel group. By some miracle, he decided to take a break from his back-breaking hardwork and indulge his itching feet. He has been all over the area and so the man, though most of the time, almost nonexistent, will be very useful (terrible phrase? hehe peace!). Suspect number 3: Jill, my great outdoor buddy and cardiologist batchmate and a Dumaguete native (terrible word?). Always hating paper work, she still hasn't finished processing her appointment papers, which is equivalent to not receiving any salary at all for the past 7 months! Hence, the difficulty in making up her mind (oh, i hope she joins us. please, please). Suspects number 4 and 5: Two of my second year residents, Karla (who I did CDO and Camiguin with) and Omar (who also joined us in Caramoan) are still fixing their schedules. And I, their evil chief resident, is actually teaching them how to dodge work and travel instead (waaah! this is hilarious and really evil! remind me not to teach them to use the diarrhea excuse).
So for now, the group will just be me, VicVic, Pats, and Jojit. We would appreciate more takers.
So to anyone out there interested in joining, the final schedule is November 7. Destination: Dumaguete City. We ladies will leave Manila at around 2PM-something via Cebu Pacific. Our flight back to Manila will be around 4PM-something of November 9 via the same airline. (Jojit, an AirPhil guy, will probably say we have poor taste but I call this practicality and good sense. We'll keep on taking CebPac until all the other airlines lower their fares. hehe)
The itinerary? Don't ask me. That's exactly the point of this trip. We just know the destination: Dumaguete. Since I'm outnumbered by water enthusiasts, the trip might have to end in Apo Island (though I might break away from the pack to see my Siquijor shaman). Frankly, I'm tired of making plans. I've realized that the best travels are those that are unplanned. Just know your destination and the rest of the steps will come along the way. This way, there will always be more room for serendipity.
After all, this is what life is all about too, isn't it?
(Ahhh, serendipity again. Let me get a supranormal loading dose of it in 2 weeks time, please.)
Saturday, October 25, 2008
This is a very surprising transformation, I believe. When I was in high school, I remember starting everyday with a fixed schedule, a list of things to do, with tick boxes to boot. And I would spend the entire day meticulously accomplishing what I had planned. Now, I'm the exact opposite. I spend days painstakingly avoiding the things that ought to be done. For some strange reasons, a planned task is more difficult to do than those that just spring up during the course of the day. Thankfully enough, bursts of passionate efforts at catching up save me, even fooling some people enough to believe that I'm actually a workaholic.
Dismal. Squalid. This is where people survive some of the most inhuman of sufferings.
But oh, how I will miss it. Ward 3, PGH.
A perfect shot of the perennial problem. Anyone willing to adopt them?
(great photo c/o Dr. Mark Vicente)
This is my first duty in the last set of SHO duties before I finally step down from my job as chief resident. My office table is a mess. I have a feeling there is so much to do but I can't even identify those tasks. My schedule book is empty. Schedules are for the careful and the organized, not for us crazy people who move in bursts of passion.
This week, my old stethoscope was again put to use. I had once again taught students (outside of the usual morning endorsements) and seeing them gain more confidence enough to speak up and question my own diagnosis inspires me. These are the perks of this job. You get to see these brilliant minds develop and you become part of it. You look in their inquisitive eyes hungry for learning and see how you were 5 years ago.
Sunday, October 19, 2008
This morning I didn't want to get out of bed. I have always found great solace in sleep. Just like food, sleep is a barometer of my depression level. Sleeping time is directly proportional to my depression. Hence it follows that my length of sleep is inversely proportional to my degree of self-satisfaction at the moment.
Despite my claim of being the greatest sloth in the world, I find comfort in work during Sundays. If anything, it keeps my mind off certain things I shouldn't be thinking about. A bit escapist, but I'm one of those who feel that working is therapeutic in a lovely, albeit painful way. So this morning, I decided to kick off my lethargy with two cups of San Miguel Extra Strong coffee and work the day away.
Thursday, October 16, 2008
This was how the great Dr. Ernesto Domingo ended his talk during our Adult Medicine Conference (aka Tuesday's with Tony) two weeks ago, when he was asked to shed some light on the many career dilemmas an internal medicine resident has at the end of his or her training.
I have always been fond of the word "serendipity", and although I had quite a good idea what it means, I have never really pondered its entirety. I can enumerate many serendipitous scientific discoveries that have changed the course of the world: penicillin, nitric oxide and recently, Viagra. So after Dr. Domingo's talk, I didn't wholeheartedly pursue the meaning of this word. Until today.
According to the trusty Wikipedia (degree of reliability unknown), serendipity is the effect by which one accidentally discovers something fortunate, especially while looking for something else entirely. Interestingly enough, the word has been voted as one of the top 10 English words that are hardest to translate. I looked up the thesaurus but there's no appropriate synonym, not even one that comes close. In Wikipedia, I also found several quotes about it:
"Serendipity. Look for something, find something else, and realize that what you've found is more suited to your needs than what you thought you were looking for." - Laurence Block
"Serendipity is the faculty of finding things we did not know we were looking for." - Glauco Ortolano
"Serendipity is when you find things you weren't looking for because finding what you are looking for is so damned difficult." - Erin McKean
Why the sudden fascination for this word? Today, I think I stumbled upon serendipitous lines.
Let me walk you through the crossroads of my vocation.
April 1997. Scenario: Jean not wanting to go to UP College of Medicine but preparing for admissions interview. Wanted to go to UP Diliman with her high school friends instead.
Papa: Why do you want to be a doctor?
Jean: (Just to piss him off) I want to be rich.
Papa: (Disappointed) I didn't bring you up to think that way. Remember, you are what you are now because of the people who need you. You're supposed to do something good, make yourself better so you can help people.
I went to medical school.
August 2003. Scenario: IM rotation. Jean, who has decided to go to Surgery or Ortho, is JAPOD. Very toxic service. Service senior getting married and going on leave.
Junior resident: Our senior has gone on leave and our other junior resident has decided to quit.
Jean: Now sir?!? How can she quit when we have 16 patients and we are admitting today!
Junior resident: That's why you have to help me. I need you to do more than the usual JAPOD. I'm giving you 3 patients to co-manage.
Jean: (silently) Whaaattthe?!?! Uhhmm, okay sir, I will.
I fell in love with Internal Medicine and went into residency.
August 2007. Scenario: Time to choose the new chief resident. Nobody else wanted to get the job. Batchmates badgering Jean to get it.
Non-IM friend: I heard they're making you chief resident. So, are you taking it?
Jean: Me?! No way! I can't even talk to people, I'm so scared and disorganized, and the outgoing chief is just so good!
Non-IM friend: Oh, that's hard. But, hmm, I just never thought you're the type who'd say "no" to a chance to do something good.
I took the job and became chief resident.
Based on my brief career history, short, seemingly insignificant remarks have created tremendous impacts on my life. Words of wisdom that were unsought for, made by the most unlikely people unexpectedly altered my course. All in a good way. Today, I've again been blessed by those serendipitous lines.
Today. October 16, 2008. Scenario: Sixty days before ending chief residency. Jean doesn't know what to do next, contemplates going home, but is very scared. Talks to favorite consultant (big time, huge name in the field).
Dr D: I'm so excited for you. You can do so much there.
Jean: But knowing me sir, I'd probably just go back. I will miss PGH after some time. I will need to be with UP. So expect me to be back again in utmost a year.
Dr D: I'd bet against that. The way I know you, you will stay there. And you will start something new - something good, that UP will look for you because it will need you.
Jean: But what if I become just another shark in the ocean sir?
Dr D: Haha! I'm sure that will never happen.
Let's see how this one will turn out. Yesterday, I had one foot in the door and the other one out, and I was so scared. Today, I'm bringing my other foot in as well. Instead of being terrified, I am now more excited for new possibilities.
It's a fantastic feeling. Somehow, during our life's crossroads, God has a way of speaking out loud through these "serendipitous" lines. Indeed, I am very grateful. Because all the time, He has more faith in us than we have in ourselves.
Wednesday, October 15, 2008
Perhaps my biological clock has already acclimatized itself to this habit. This morning I was prematurely awakened by a strange dream. And I very seldom dream. I started my day a bit disturbed, although I couldn't particularly identify the issue. There was only a certain emptiness that was almost palpable, a void that was slowly sucking me in. I didn't want to get out of bed.
But I had to.
Hospital work was the same. Morning endorsement conferences, meetings to attend and organize, residents to talk to, grades to compute, endless reminders to be given out to students, residents, fellows and consultants. By mid-day, somebody remarked, "Jean, you're already at your crossroads."
Ah, a blinding light was immediately switched on in my consciousness. The unknown but disquieting stimulus that was bothering me was this: in the next 2 months will be a potential pivotal moment. Today, I am quite sure I will be saying goodbye to the institution that gently yet sometimes painfully cradled me in the past 11 years. I will be leaving behind not only a system I have grown accustomed to, but also people I may never see anymore, and a way of life I may never return to. Separation anxiety - this is it. I'm a child learning to ride a bike. I'm someone about to step off the edge of a cliff, with one foot already off the ground. I'm someone who has to make a choice. And the choice must come before the next 15th day of the month comes.
I managed to get through the day in a daze. This 15th day of the month thing is making me sick. I couldn't help but pray for old times. Those old times.
On second thought, perhaps it's time for me to stop remembering.
Monday, October 13, 2008
"Home" has become a relative word now. Perhaps I'm one of those people who no longer know what that means. I've spent the past 15 years living in dorms and I relish this freedom. Home has been PSHS-MC, UP College of Medicine, CWL Dorm, Cuevas Apartment, Paz Street in Paco, Apartment in Nakpil Street, Residents' Callroom and now, Medicine Chairman's Office.
It's been 6 months since I last went home. With my recent jam packed schedule, getting to spend 3 days there is already a treat. There's always something soothing about the Southern sunshine even if it's several degrees warmer down there. Even the dry and dusty Digos breeze seems more refreshing. After spending a few days at home, I come back to Manila invariably recharged, with a stronger resolve to someday return and finally allow my roots to sink in.
This little boy might as well be me...
There is an area outside our house that I particularly love. It's that junction where the concrete ledge of our little terrace meets our front wall just adjacent our front door. I fondly call that Jean's Corner - where I have always enjoyed basking in the afternoon sun, waiting for dusk while lazily strumming my green guitar, or simply watching the dust settle . Even during mid-afternoons, that spot remains cool, being shaded by the tall talisay trees Papa planted soon after we moved to that place. Sometimes I just watch birds tend their nests on the nearby kawayan bush, listening to the rustling of the leaves of the mango, balite and talisay trees around me. Sometimes I just sit there, legs curled, my back on the wall, hunting fleas off one of our dogs until daylight makes way for the pale light of the moon. Other times I just while away time, doing nothing, thinking of everything unimportant.
I spent some time in that nook last weekend.
The shade from the talisay tree was gone. The late afternoon sun was no longer soothing, the rays that seep through the trees were just too bright I had to close my eyes for a while. I tried to listen to the rustling of the leaves but I can't hear them anymore. There was something unsettling about that corner. A certain loneliness, and with it, a sense of being out of place, a music that haunts me that I know isn't mine.
I couldn't stay in that place long. Somehow, it's not my corner anymore.
Thursday, October 9, 2008
It’s not that I’m not used to this. I’ve always been big for as long as I can remember. Not the pear-shaped type obese, but just big: big arms, big legs, big hands, big feet. While other obese women can still be called voluptuous, that’s impossible for my case. Nature deliberately missed out on compensatory mechanisms – my boobs and my ass are as flat as the board your keyboard is resting on. This is the curse of the XL, my type of XL – a BMI of 25+ with an A cup size.
It seems that my weight is the greatest indicator of my happiness level - it is inversely proportional to my degree of self-satisfaction. I don’t eat when I’m excited. I don’t eat when I go to lovely places, when something exciting is happening, or when I’m with people whose company I’m enjoying so much. These past few weeks, I’m rapidly regaining all the inches I lost during my Visayas stint. Something terrible is going on. Something wonderful is missing.
The scales don’t lie. And the inches are corroborating evidence. It’s time for me to cut down on junk food and do some exercise. I have to go on a strict diet and adhere to a regular fitness regimen.
Something tells me all this self-encouragement will never work anyway. It’s not the chocolates. It’s the reason why I keep craving for those chocolates. That’s the more difficult part.
I have to be on top of this. I have to bring my groove back. Tomorrow.
Wednesday, October 8, 2008
Today I had to make choices. Out of 46 hopeful individuals who completed pre-residency, I had to select the Top 30 who will be interviewed. From this 30, the next batch of residents of the UP-PGH Department of Medicine, only 21 of them, will be selected. This means I closed the door to 16 aspirants, perhaps shattered some of their greatest hopes. Perhaps at least one of them is in a corner now, silently weeping for lost chances, wondering why his or her best was not good enough. I just prolonged the agony and encouraged futile hopes of 9 people too.
May God bless these decisions and me, the unworthy person commissioned to make them.
Tuesday, October 7, 2008
Homoios = like
Stenosis = narrowing
Homeostenosis is just a geriatric concept that refers to the characteristic, progressive constriction of homeostatic reserve that occurs with aging in every organ system. This is the impaired ability to compensate to physiologic challenges, such that what used to be normal is no longer normal. A diminution, a decline, a deterioration, a limiting of your world brought about by time.
Hearing the word struck a chord in me and I do not understand why. There is something profound about the idea but I do not even know how to start thinking about it. Perhaps one day I'll find out. Hopefully, before homeostenosis hits me.
Nevertheless, it's been a good year for my wonderings and wanderings. I have weekends off! (At least on paper. Weekends-off-to-catch-up-on-backlogs is more like it.) Those undergoing fellowship training in PGH can now haggle for at least one weekend off in a month (if they had the gumption). So despite the busy schedules and the heavier responsibilities, the Fellowship of the Itching Feet has had several conventions in several of the loveliest areas of the country.
I've read somewhere that we should "travel only with thy equals or thy betters; if there are none, travel alone." I have never blurted this out loud to my reliable and endearingly quirky travel buddies, so I might as well put it on record while I can: From the depths of my being, I am grateful for your company.
Until the next adventures...
Some photos courtesy of: Pau, Claire, VicVic, Fe, Queenie, etc. Thanks!
Monday, October 6, 2008
Still recovering from my post-travel high (or post-travel depression?), I browsed through my 'My Pictures' folder and well, I realized, I may be an almost-pro in the solo-flight department, but I'm greatly in debt to these people for the wonderful adventures this 2007 - 2008.
I'm too tired to write about them tonight so I'd better post the pictures.
A nice shot with Carlo and Jill (Puerto Galera, March 2007)
Breaking away from the pack with Claire and Vicvic (Hidden Valley, Oct 2007).
To be continued in next post...
Sunday, October 5, 2008
A soothing scene at dusk.
Puraran is a paradise well-hidden by the mountains. It took me almost 2 hours to get there by tricycle. The road leading to the place was rough. The only jeep that goes through it, plying the Virac-Gigmoto route, has only one trip a day. I was at the mercy and the kindness of the locals. The way they treated me only reaffirmed my faith in the Filipino people. Yes, there is hope for this country.
After the long journey to Puraran, I was not surprised when I was greeted by an almost deserted place. There were only two other guests in that rustic resort: a foreigner who never spoke a word and a poet invoking his muses. The poet I was able to have a great conversation with. Looking back, I realize finding Puraran on my own was a great adventure. Getting a glimpse of a poet's solitude was another.
As always, being in a strange place renews me. It heals me in a way that I cannot define. What is it about the strangeness? Why do I have this urge to get away from it all, to momentarily disappear from the rest of the world as I know it? Why am I so drawn to being alone? What is it about new faces in new places? Why do I yearn for new things so much?
I love my solitude. Yet I keep on praying for that day when I can finally share it.
The time I spent journeying to Catanduanes was much longer than my actual stay in the island. But as the cliche goes, it's the journey, not the destination. My few hours in that place prepared me for yet more arduous battles in the city. The soldier has rested well.
Next destinations: Masbate, Siquijor, Palawan. And then... Batanes. Sigh...
Thursday, October 2, 2008
Tomorrow is my scheduled diarrhea. For the first time in my residency life, I'll be faking the bowels. Not that the staff in the office are not aware. They're part of the conspiracy. Only the bosses don't know. Sigh... I hope karma will not demand its share.
I mean, I deserve this, right? After weeks and weeks of being a slave, sleeping in the office, not reading my novels, not listening to music, not enjoying my coffee in Harbour Square by the bay, not talking to my friends for hours on end, I deserve to at least have one bloody weekend off!
Ahhh, I can almost feel the breeze on my face. I can hear the surf, smell the brine.
I will be alone this time. Like, duh! As if I'm not used to this loneliness, uh-oh, solitude. What's the difference between the two anyway? Oh yeah, solitude is the remedy of loneliness. Solitude is my friend, loneliness the enemy. I'll be relishing my solitude in a few hours.
I wish I have someone to enjoy the quiet with, though. Someone who will find my solitude as interesting and as lovely as his own...