Just Another Long Day

Today was a long day. The kind that begins before the sun is up and ends only when your bones start whispering, enough! 

I woke early to prepare for my 8 AM lecture, made pancakes for Marga, and squeezed in a few urgent echoes. After dropping her off at school, I proceeded to give my Physical Diagnosis lecture, then headed to the hospital for patient rounds. At noon, I picked up Marga, brought her home, quickly reviewed my slides, and drove to the university for my 1 PM Medicine 2 class, my first face-to-face session, which stretched to a full two hours.

As I was wrapping up, a text from my secretary popped up: there were already 14 patients waiting in my clinic. While I was hurriedly driving over, the ER called: two admissions. One intubated and with no blood pressure. So I rerouted to see the ER patients first and stabilized what needed to be stabilized. Then headed to the clinic.

Oddly enough, clinic was where I was able to catch my breath. I enjoyed conversing with my patients. My patience and energy were strangely maintained and I genuinely enjoyed my time with them. Despite the long queue, the time passed gently. I finished at almost 7 PM, and by then, a few pharma reps were waiting to talk. After the usual coverage and product detailing, I made my way back to the hospital to check on my in-patients.

By the time I started making evening rounds, my eyes felt like they were closing on their own and I was dragging my feet along the hospital hallways. I was drained. Completely.

And to top it off, it’s been five days since my last run. Seven days since my last strength session at the gym. I can feel it, not just in my stiff back or my sluggish steps, but in my spirit. If I continue a lifestyle like this, how long will my body hold out? How long will I continue to find joy in what I do?

Isn’t it true that those who burn the brightest often burn out the fastest too?

When I got home, my daughters needed help with their homework. I dug deep for one last push of energy. And only after they finished, only after the hugs, the endless curiosities, and the seemingly useless negotiations with children, did I find some quiet time to pause.

To sit. To reflect.

And there it was again, like a quiet but persistent whisper: the unread echoes, piling up in my inbox like a tide that never recedes. For every one I finish, three more seem to take its place. The to-do list stretches endlessly, like a thread I keep pulling but never reach the end of. And somewhere in the midst of all this, I can feel it: the version of myself I’m slowly leaving behind.

I know I need to make space. I need to let go of some things, not out of failure, but out of wisdom. I need to loosen my grip on the irrational FOMO (fear of missing out) and begin to embrace the sublime JOMO: the joy of missing out. Of choosing rest. Of choosing presence. Of choosing well.

Tonight, I can only muster a prayer to the heavens: for strength, clarity, and discernment. Strength to allow me to continue with the same level of energy, if this is what’s being asked of me. Clarity to let me see through the clutter that my life has now become. And discernment to identify those that hold the greatest value in the larger scheme of things.

I am tired. Very tired. Scared and confused. But I am listening.

To Academe or Not

 Lately, I have found myself at a quiet crossroads, the kind that doesn’t come with grand announcements or life-altering revelations. Just the slow realization that maybe something beautiful in my life needs to be set down. For now.

I have been thinking, really thinking, about giving up my academic post. Not because I’ve stopped loving teaching. On the contrary, I think the opportunity to teach is one of the most beautiful gifts life has given me. I love the quiet electricity of a good discussion, the way teaching demands presence, clarity, heart, and even a bit of performance. I know I’m good at it. I know my heart is in it.

But I also know this: that sometimes, finding your ikigai is not enough. 

Because this opportunity, this calling, came at a time in my life that feels painfully misaligned. I am, above all else, a mother. I have two school-aged daughters who need me not just in the abstract sense, but in the everyday: in drop-offs and pick-ups, in homework and projects, in bedtime stories and butterfly kisses, in mornings filled with misplaced socks and last-minute art projects. I don’t want to look back years from now and realize I was present in other people’s children’s learning but absent from my own children’s becoming.

And there is the practical reality that tugs at the heart of every working mother’s decision: time versus worth. Government academic work, no matter how noble or fulfilling, pays very little. The emotional and physical effort I pour into it does not translate into financial security. Compared to private practice, the imbalance is stark. I find myself exhausted from teaching, mentoring, managing, and planning, only to come home and feel the cracks of my own home life widen.

Adding to the weight of this decision is something even more personal: two years ago, I enrolled in a Master’s program in Health Professions Education. It was not a whim. It was a deliberate choice to grow, to become a better teacher, to serve students more meaningfully. But now I find myself asking: what was it all for? If I walk away from the classroom, from the very platform where I hoped to apply these learnings, will it still make sense? What becomes of all that time, energy, and hope I invested in becoming better?

So here I am, not quite making a decision, but circling around one. I haven’t filed any papers. I haven’t packed up my books. But in my heart, I am weighing the costs of holding on, and of letting go.

Maybe this season of my life is meant for something else. Perhaps I need to step away from the auditorium platform to sit more often on the floor, building castles out of blocks and memories. Maybe this is the time to strengthen our financial footing, so I can one day return to teaching with more freedom, and less compromise.

And maybe, if academic work is truly meant for me, God will open another door in a place more aligned with who I am and what I value.

For now, I hold all these thoughts with tenderness, not certainty. I let them simmer. I whisper to myself: it is not failure to choose your children. It is not weakness to prioritize your peace.

It is, perhaps, just another kind of teaching. This time, teaching myself how to live with gentleness and grace. Perhaps I can prove my worth better if I muster the courage to let go of beautiful things, so that I can spend time with the mundane, everyday things that matter the most.

Homecoming

 

I arrived home today after a three-day conference in Penang, Malaysia. I was part of a group sponsored by a pharmaceutical company. Yes, one of those trips with convention halls by day, sightseeing tours by late afternoon, and overfeeding sessions by night.

I’m not a big pharma kid. I don’t usually do these things. But I said yes this time, mostly because I knew I’d see old friends, especially Mark and Lowe, my junior fellows from PGH. We used to call ourselves The Fellowship of the Wandering Pacemakers, back when life was all cardiology, backpacking, and piso-fare bookings. Over a decade later, we’ve all gained titles and stopped being poorita, but I’m so grateful that they’ve kept their humility, their laughter, and that quiet way of respecting people. I love them even more for that. It was indeed refreshing to laugh with them again, talking about memories that used to induce anxiety, but now bring only cackles of joy. 

And yet, despite the change in scenery, the trip didn’t really feel like a break. I was constantly sleep-deprived, not just from the travel, but from chasing deadlines in hotel rooms. There were echo backlogs to read, lectures to finish, work that followed me across the sea. So when I finally arrived home, I wasn’t refreshed. I was exhausted. The torrential rains in Manila brought about by habagat also brought with it terrifying air turbulence during my plane ride home. The dread and the exhaustion gave me a pounding headache.

But when I arrived home, my dog Dolphy gave me a wet, sloppy welcome with his licks and cuddles. Then my kids ran to me. Their laughter, their chaos, their sticky little hands pulling me back into the world. I realized this was the medicine I needed.

I had gone away hoping to escape the noise. But in the end, it was the very noise I longed to escape that healed me.

Now I’m back in the mess of it all: the toys, the hugs, the unfinished breakfasts. And more than ever, I know that this is where I’d rather be.

The Magic of Vitamin O

Two weeks ago, I attended the launch of a new drug, a so-called miracle that promises 15–20% weight loss in just two years. The room was buzzing with excitement. The science was impressive. The potential impact, enormous. One injection a week, and the pounds melt away. Ozempic, initially used for diabetes, now also proven to have wonderful cardiovascular benefits, is now reborn as the golden child of weight loss.

A miracle? Perhaps, for those who can afford it.

But for the many who can’t? It’s not a miracle. It’s a dream. A distant, glittering promise glimpsed through the pharmacy glass, priced out of reach. For people already struggling to make ends meet, to put food on the table, to survive, this “miracle” may as well be magic. The kind that only works for the chosen few.

In a world where thinness is prized and judged as a marker of discipline, desirability, and even moral worth, this drug will become more than a medical intervention. It will become a status symbol. A badge of access. The final, gleaming wedge that drives the chasm between the privileged and the poor even deeper.

Because now, even health, one of our most basic human rights, is being commodified, branded, and sold to the highest bidder.

I sit with the discomfort. I acknowledge the marvel of the science, the promise it brings. But I also see the danger when medicine forgets its soul. When we forget that healing is not just for the wealthy, that weight is not the only measure of wellness but of privilege, and that dignity should never be tied to a price tag.

Sadly, however, it is.

Now, I’m not saying I won’t be using it. I’ve gained 20 pounds in the last two years. And yes, I can afford it. So let’s see if Vitamin O works wonders, shall we?

But even as I joke, I know this isn’t funny. Because for every one of us who can buy our way into better health, there are hundreds more who can’t. And that should make us pause.

I'm going to use it, out of desperation. And I won't feel guilty for it. But I do know that when medicine becomes a luxury, we risk forgetting its purpose. And that's another weight in my mind that I need to lose.

Only Twelve

 

Yesterday, our medical students graduated.

From the 55 students who were accepted into our program four years ago, only 12 walked up the stage. Just twelve.

They’re not doctors yet, not officially. They still have to complete internship, then hurdle the board exams. But what they’ve achieved so far is no small feat.

Those twelve carried with them the courage of fifty-five. They are a testament to resilience, to grit, to persistence in the face of sleepless nights, missed family milestones, heartbreaks, breakdowns, and the quiet burden of becoming. But they showed up, and they succeeded.

I am deeply honored to have been part of their journey, to have witnessed them grow, not just as future physicians, but as humans who chose to keep going, even when the road was unforgiving.

Congratulations, dear students. Padayon.

Crazy Good Mornings

 These days, my mornings are nothing like the ones I used to imagine.

I dreamed of slow breakfasts, with me holding a classic novel in one hand, a cup of coffee in the other. I pictured quiet moments, thoughtful conversations with my husband, a little peace before the day begins.

But no. Reality is two little monsters storming out of their bedroom wearing pajamas, crying loudly, "Mommy, come back to bed!"

Whenever I sneak out of bed in the wee hours of dawn to log in my morning runs or work on my echo backlogs, I hear sleepy voices demanding, "Mommy, don't go. Cuddle me!" They want to hug. They want to cuddle. And because there are two of them, they fill both my arms. Their sleepy bodies cling to me like I’m the only safe place they know. And I stay. Because they need me. And maybe, I need them too.

The rest of the morning unfolds in beautiful chaos: a kindergartener who insists on having pizza instead of a cheese sandwich, a toddler who refuses to take a bath for nursery school. There’s loud singing, hip-jiggling to songs they invent on the spot. Toys everywhere. Ribbons and scrunchies mark their tiny, joyful territory. Butterfly kisses. Bear hugs. Sticky hands and tearful goodbyes.

I am not rich in material things, and I am ordinary when it comes to career milestones. I cannot even have slow, quiet mornings. 

But in my life, joy overflows. These chaotic mornings, these messy little humans, this house filled with shrieks and laughter, show me that love thrives in both mayhem and drab. I offer a quiet prayer, take a deep breath, and soak it all in: the noise, the chaos, the mess, and the magic.

And I realize: I am the richest human being in the universe.

Writing on Water (Or the Blog That Nobody Reads)

 No one reads my blog anymore. And oddly enough, I take comfort in that.

When I started Walking on Water as an internal medicine resident at PGH, it was mostly a survival strategy. By the time I became a cardiology fellow, the blog had become a faithful confidante. Between rounds, referrals, and ECGs, I wrote frequently, feverishly, as if my survival depended on it. 2009 to 2012 were my golden years, when a few kind souls began to follow along, quietly rooting for my words from behind their own screens.

Then real life barrelled in.

From 2012 to 2016, the early-career hustle left little time to write, much less reflect. After that came the world of social media: quicker, louder, more fleeting. Instead of reading essays or poetry, I scrolled through Facebook comments. My literary brain, once nourished by Steinbeck and Tolkien, was now subsisting on digital crumbs. My writing muscles atrophied.

I stopped writing because I stopped reading.

I stopped reading because I stopped pausing. I had to hustle to live.

Now, after a five-year hiatus, I am learning how to pause again. To pick up my pen, well, technically, my keyboard. Clumsily, hesitantly, but with intention. I am writing again. This time, for no one. To write without the need for validation, without the imagined reader perched on my shoulder, judging the tone, the grammar, or the depth. That is oddly liberating.

There is no audience to impress. No applause to chase. No criticism to fear. Only the blank page and I, finally brave enough to return.

So I write again. Not to be read, but to be real. Sometimes I feel that I have stayed in the comforts of my boat for too long, and I am now too scared to walk on water. The stakes are just too high. The fears are heavier because my life is no longer mine alone. It belongs, in large and sacred ways, to my daughters, too. 

But maybe this time, I can just leave my boat once in a while when I want to. And learn to swim, or at least be still and learn to float. 

The Epidemic of Group Chats

        There was a time when news traveled through quiet conversations: at the corner sari-sari store, during random, unintended meet-ups in hallways, or a late-night phone call made without the dread of bad news. Back then, a ringing phone was not synonymous to an emergency, not an alert that someone is having unstable ventricular tachycardia. It was simpler, something to look forward to: a cousin’s story, a forgotten detail about a meeting, or a mundane laugh with an old friend from high school shared across the wires. Now, the way we talk has changed, and with it, the weight of every message we get. 

        Now, it comes through group chats. Viber, Messenger, Microsoft Teams. What used to be pinned to bulletin boards now floods into our phones: these pipelines of endless updates, flowing faster, louder, harder to ignore. They were meant to streamline communication, to keep everyone connected. But somehow, they have made life heavier, aggravating our already alarming technology-induced mental health issues. 

         Messages come at the unholiest of hours: in the middle of your lecture, during hospital rounds, while you’re in the bathroom trying to piss in peace, or worse, jolting you awake in the dead of the night when you are indulging in a rare deep sleep. And it’s always something: an announcement barely relevant, a document that could wait until morning, or a question someone could probably answer themselves (Google mo, gago. Or better yet, ask ChatGPT). Instead of convenience, the constant pings feel like chains, pulling you into conversations you never really asked to be a part of. 

        There’s a group chat for everything: family updates, the homeowners’ association planning yet another pointless meeting, colleagues arguing about politics, old friends debating who impregnated which celebrity, your batch trying to organize a dream trip abroad that will inevitably die at the polls. Like the old gossip circles, the messages spread. Every ding, every notification, piles up, and it becomes too much. Too much clutter, too much noise, too much of everything you wish you could ignore. 

        And then there are the generic messages, the high-tech version of verbal clichés: happy birthday, condolences, congratulations. They’re quick and easy. And dangerously empty. Instead of driving over to hug a friend who just lost a parent or sitting with someone whose world has fallen apart, we fire off a one-word “condolence” in the GC and pat ourselves on the back for being human. It is a hollow reassurance, a digital mirage of compassion, convincing us that we have done something meaningful when all we’ve really done is… nothing. And it doesn’t ease anyone’s pain. Not theirs, not ours. It only makes real connections harder to find. 

        These group chats were supposed to make everything easier. They were supposed to streamline conversations, keep us connected, and make announcements quick and efficiently. But instead of connection, they bring chaos: a never-ending stream of words, reminders, and updates that burrow into my chest like a stone, heavy and persistent. Maybe we thought technology could fix the gaps in the way we talk to each other, but all it did was make the talking endless. There’s no pause, no quiet moments, no space for meaning anymore. Sometimes, I think it was simpler back when people said what they needed to say, finished their story, and, as that old coffee commercial once said, “Let’s sit and talk awhile.” Now, it’s reduced to “Post mo lang sa GC.” And somehow, it feels like we’ve lost more than we’ve gained. 

        And so, to keep our sanity intact, we hit the snooze button. The group chats are muted, their constant clamor reduced to silence, checked only during the rare moments of downtime when life allows us to breathe. We skip the happy birthdays, scroll past the condolences, and slowly, deliberately, become selective in what we read, and even more selective in what we respond to. It’s the only way to survive, the only way to push back against the relentless tide of noise that threatens to pull us under. 

        We leave the group chats that no longer matter, the ones cluttering our screens with nothing of value. The toxic ones? We ignore them entirely. And as for me, anything posted in the GC is automatically filed under the folder: “non-urgent.” Because if it’s truly important, if it needs my attention, my time, my care, then call me. And if you truly care, come find me. Sit with me. Talk to me. The way conversations used to be.