Rant aftermath

Whew.. That was a long one..

I would like to make clear that I am not targeting any individuals as I have no beef with anyone from that religion individually. Its just the system as a whole that sickens me..

Enough of that.. I'm gonna draw a line on all this negativity caused by religion and go back to our regular non-religious programming..

--------------------------------------------------------------------------------------------------------------

The UAAP season is now in full swing, and al eyes are on DLSU with their spotless 4-0 record. I think we have a pretty even field this year, and that games can go either way for the most part. A good example of this would be Adamson's 1-point victory over perennial powerhouse Ateneo off a last minute jumper near the top of the key.. I really missed the UAAP, and I'm glad it's finally back onj track. I'm thinking of following the NCAA as well. a 10-team field seems interesting, and the balance of power seems to have shifted a bit away from San Beda and San Sebastian which to my recollection have been really successful in recent years. Sana lang hindi na sila larong kalye unlike before..

-------------------------------------------------------------------------------------------------------------

I'm in the library for research yet again. This time it will be in preparation for a speaking engagement on a much bigger stage.. It is a burden I had no wish or intention to carry,. but I guess my chief had no other choice but to put me on the chopping block since everyone else already had their turn..I just hope I could put this off without a hitch..

Religion Rant

I'm sorry to disrupt the flow of the blog, but I really just need to let off some steam...

I have tried for the longest time to keep this blog free from any negativity concerning politics and religion (except for that moron Pakyu, who never really deserved to get into the senate in the first place), but recent events have struck a nerve and compelled me to put this down.. This is an accumulation of years of pent-up outrage, and I really have to let this one loose lest I go insane..

I have no love nor even the least bit of liking for this so-called religion which preaches love for life and respect for others but those who claim to be true followers do just the opposite.. I am sick of reading about their religious intolerance in their home countries.. I am sick of hearing about how they treat women as second-class citizens.. I am sick of hearing about all this rhetoric of killing all who do not believe in their faith.. I am sick of how they force their religion unto others in this modern and supposedly more civilized age.. I am sick of all the killings that their nutjobs do in the name of their"great" god.. I am sick of their strict implementation of their religious law, which curtails basic freedoms and preaches a culture of hate and barbarism.. I am sick of reading about their religious texts which seem very inappropriate in this time of decency, which people still blindly follow by the letter since it is a supposed word of god.. All those abuses committed in the name of religion based on texts which seem very open to negative interpretations by the wrong people.. Yes I do fear them taking over the institutions of this civilization that people have struggled through centuries to put up and perfect. I have no wish for out culture to descend into barbarism, where basic decency is nonexistent and the rule of law seems animalistic.. I am so disappointed in them because even though the "decent" ones among them supposedly speak out against the evils their brethren have caused, it is often nothing more than just lip service to appease the outraged. They seem totally incapable of policing their ranks, or are they? A more sinister side to this is that they probably have a hidden agenda of letting their religion of evil run rampant across the globe, swallowing up all others in the name of their twisted ideologies.. The ones that they won't convert, they will kill.. all of this in the 21st century.. How disappointing.. Other religions have moved forth and adapted to the times, why can't they? Why can't they get along with the rest of the world? Why can't they accept that there will be others who will not believe what they do? Why do they have to force other people to adapt to their beliefs when other people don't really give a rat's ass? Why do they have to be treated extra special? It's kind of like a brat who makes a tantrum when it does not get what it wants and when it does get it by being persistently annoying, would desire more and try to get more since the trick already worked before.. Is it because they are truly evil? I'm sorry if this post may be offensive to some, but to tell you the truth, I have been offended too you know.. Do I not have a right to say my piece when I have been offended? It's just my opinion, or will you not respect that as well? This just proves my point..

Some would say, "you've made your point, but what could be done about it?" Its simple. Police your ranks! The change has to come from within. The other religions will not have a say in this, because it is yours and it is your responsibility to clean up your act because you will be held responsible by the deity that you follow. Change is badly needed if you want to change the perception of how the world at large sees you. If you are unwilling, then that's your problem, and sadly, it becomes the rest of the world's problem as well, which I find unfair because that's your choice, not ours. Why should you be a burden to the rest of the world if you already know the problem but is still unwilling to change..If you tried but are still unable to do anything about it, it might be time to look at yourself and change religions if the belief system does not suit you..

I am not here to convert anyone or force my belief system upon others. I am not calling for violence of any sort because I do not believethat it is appropriate for this situattion. I am just pleading with those people who can do something to go out and make a positie change to help everyone get along. Change what you have to, do away with any unecessary of potentially inflammatory statements in your texts that would do more harm than good. I don't know.. I just wish there would be less hatred and less opportunities to create hatred in religions name by altering the teachings to suit the needs of this more enlightened and civilized age where people are supposed to act with decency and not barbarism..

Sometimes I wonder how religion fits into today's modern society.. It was good to serve as a belief system during the olden time because you needed to unite people under a banner to create change. But seeing the way things are evolving now, with religion more often being used as a tool to try to move society back to the dark ages by way of adherence to and blind acceptance of outdated teachings that preach a lot of violence, intolerance, and sometimes dumb concepts that we now know have no place in the modern world we live in..

A long, long while...

It feels like it has been ages since I last posted something worthwhile, with the last I recall being a blurb I got out while in the midst of my much-enjoyed Sleep Medicine rotation (which I unfortunately was unable to maximize because f all the concomitant paperwork and presentations that happened during the given time span. Its a Sunday duty, and I resolved to make the most of it while the lull lasts..

A lot of stuff has been happening both in my life, as well as in the world at large, and I shall attempt to cover these things through a forthcoming blogspam..

 Nah.. I'll just put everything into one giant hodgepodge post and let you guys sort things out for yourselves. :P

------------------------------------------------------------

THE BALL PIT

I recently went with my Other Half to check out the Ball Pit Manila, which happens to be situated in Makati very near MMC.. weird.. :P People that know me well know for a fact that I tend to avaoid Makati like the plague due to horror stories of getting lost and getting caught for weird traffic violations due to unclear or hidden traffic signs, or basically a puzzling road network with unforgiving and corrupt traffic officials manning the streets who would pounce on you at every opportunity, taking advantage of the fact that you are lost and uncomfortable.

My fears were allayed by the fact that I had the guidance of Waze to help me through the ordeal. An additional motivation was the fact that this was actually a Girls' Night Out (GNO?) for thm, and I had just been invited to tag along. Not wanting to be a spoilsport, and having excused myself from a previous meeting already before, I decided that I needed to go with the flow on this one, and go out of my comfort zone for someone else, and actually meet new people for a change.. (what a run-on sentence.. :P)

Needless to say, it was truly a unique experience, and a very relaxing one at that.. As a kid, I shied away from these ball pits since I kinda disliked all the running and shouting that go with these playgrounds. Now that I'm older though, there was a strange calming effect of lying in a pit filled with white PVC balls and stumbling through the entire shifting mess.. It lasted for only an hour, but the fun memories from that place are gonna last a while..

We had dinner at Kanin Club at the Ayala Triangle shortly thereafter. There wasn't really anything significant to write home about since I had been to Kanin Club with my family before, but the company was different, and I could say that I was glad to have gone out and tried something new for a change..

After we parted ways with her friends, we began our long and anxiety-filled trek back to the car, and eventually getting home safe and sound via Gil Puyat and EDSA.. As weird as this may sound fro a fully grown adult, I guess I became a bit braver that day, and it seems that I had shown myself that I was capable of overcoming yet another psychological hurdle to my development as a person. :)

-------------------------------------------------------------------

B-DAY 2016

A few weeks back, I finally used one of my leave credits to take time off and celebrate my birthday after so many years of just going with the flow of the hospital schedule regardless of the occasion. It felt so liberating to be able to wake up on our day and know that you won't have to go to work since you had already arranged for the day off yourself.. #GiftToSelf :P

As my luck would have it, my scheduled break coincided with an unexpected rest day for her as well! So needless to say, we were able to spend the better part of the day together. Adding to my joy was the fact that her parents were cool with the idea of us going out in the middle of the workweek since it was my day after all.. :D

All in wall, it was a very memorable day, and I am deeply grateful to have had the chance to experience something like that, although it was just a simple day away from the hospital. :)

-------------------------------------------------------------------

KINGSGLAIVE FINAL FANTASY XV

Before I forget, I watched Kungslaive, and it was AWESOME!!!! :D

Long overdue

Finally! After a couple of months worth of exhaustion and procrastination, I have finally been able to revise my research protocol, and now I don't have to hide from my adviser anymore! :D Now the challenge lies in maintaining this momentum that I seem to have gained for myself..

This has been a grueling past couple of months for me to say the very least. Being SHO and ICU at the same time during duty nights for two straight months can suck the happiness out of anyone, not to mention a considerable amount of energy and zest for life. :P

Finally I have broken free, and am now happily tucked away at the sleep lab for an entire month where I have minimal interactions with the outside world and can finally have a bit of peace and quiet..

I've recently been diagnosed with Obstructive Sleep Apnea, a diagnosis which I have long suspected anyway. What remains to be seen is the severity which would be revealed when my poluysomnogram results come out. Sleep Medicine is a fascinating science, and I never thought that there would be more to sleep than just, uh, sleeping..

The implications of this OSA diagnosis however, means that I may have to invest in a CPAP device which would greatly aid in improving my sleep quality. I'm a little apprehensive though, since theses devices tend to cost a pretty penny, although the Sleep fellow says that it costs about as much as the latest iPhone.. Problem is, I'm not really fond of buying top of the line devices, so the price is still gonna hurt my wallet badly.. :(

Putting things in perspective though, I guess I'm obligated to keep myself healthy since I intend to live a full and happy life with another in the future ;), and I'll be damned if  I'd let something like this get in the way. :)

I've also been thinking a lot about purchasing a vehicle for the family. We've never really had a car we can call our own since I was a child (since we've never had the finances to do so). I'm not thinking high-end here, since it's really going to be impractical from my standpoint. I just need a reliable vehicle to get us from point A to B without any hitch and would seat my aging parents comfortably. You see, I notice my parents now seem to have a difficult time getting in and out of sedans.. but a regular SUV is out of the question due to the prohibitive cost.. Sigh.. We'll just have to wait and see what develops... :/

Growing up is really expensive business.. I guess I consider myself lucky that I still do not have kids to worry about. Seeing my bros with their families often leaves me a little bothered as to whether I can deal with all of that once it does come my way eventually,,

It has been raining like crazy lately, and all that without a definite storm in the country's area of responsibility, with the threat of massive flooding always a grim possibility. In fact, I already encountered a bit of flooding the other day as I was making my way home.. Good thing I was able to find a place to stop and wait it out.. I hope the days that follow won't be as bad..

From Russia with love...

Just a quick hit before I return to my regularly scheduled programming..

I just saw on the blogger control panel that this blog has recently registered a whopping 252 hits from Russia!

So.. uh... hi to all my Russian readers out there. :)

Please do drop me a line. It'd be great to hear from you. I can't speak or read your language though :/

(*though I think the hits may not really be legit and are just part of a greater scam scheme or something..)

Antisocial

There are days when I neither require nor desire human interaction. This is one of those days..

Being around other people can be such a chore, and it makes it even tougher when the very nature of your work requires engaging with others on a regular basis.. :/ 

It is yet another duty day, and by the way things are shaping up, I think I'm in for on hell of a ride..

I had a brief conversation last night with my Other Half (Hi!), and she told me that she was feeling pretty much the same way about work and what we are doing with our lives.. Unfortunately I had nodded off before I could give her a satisfactory reply.. (sorry!)

I wish I knew all the answers, but I was just as lost as she was.. Even now, with the present state of rhings in my life, I sometimes drift back to question the path I chose to follow so many years ago..

It really doesn't help that I'm not really fond of the people I'm presently working with.. Sad to say, I can even barely consider some of them as my friends. They are all just co-workers to me, some of which I may have a better understanding with than most. Unfortunately, lasting friendships does not seem to be in the discussion.. They are just really too different for me to be able to form an inrimate bond of friendship with.

I hate to use this line, but mom was right. In life, you will only meet a handful of individuals who you will consider as your true friends, and I'm glad I have my BNO boys for that.

Sigh.. Other people are just so irritating at times, and even more annoying is the fact that they have absolutely no insight that they are the root of the problem and are either too stubborn and set intheir wicked ways or too goddamned stupid to change for the better. Maybe its also due to advanced age, i dunno. I've pretty much given up figuring these people out. I've already removed the Facebook application since I was tired of all the shallowness and superficiality that is on display. I desire to have real things, real interactions, realexperiences, all of which is according to my design.

That is something I will not be able to accomplish until I am rid of training already, and the following 8 months can't go by fast enough.. :/

Compulsion

For some strange reason, I feel compelled to blog today. It's as though I'm driven by a need to jot down something profound..

Nah.. :P

--------------------------------------------------------------------------

Our new president had his first Stae Of The Nation Address (SONA) yesterday, which to me seemed like a pleasant departure from what we see year in and year out, which is pretty much more of the same detached nonesense that the one in charge spout out. It was really different this time around. Although there were still shades of a well-prepared speech, our prisident made a lot of ad-libs and cracked a lot of jokes, making light of the situation and delighting both the atendees and viewers alike. He also gave the militants their free space to approach the venue, and the rallyists in turn did their part by not causing any trouble and even had pleasant interactions with the police, including the police chief himself.

Changwe has truly come to the Philippines, and I hope this will be all for the good of everyone (excluding the bad guys of course. They'll be dead :P)

---------------------------------------------------------------------------

I've been contemplating getting a vehicle for quite some time now, since the one we've been using has been suffering through a plague of various maladies associated with old age..

The market is presently rife with soooo many options despite my efforts to narrow it down given my very low budget..

I never knew car research could be so exhausting..

But I've had a recent breakthrough, like just a few minutes ago, which has helped me narrow things down by a great deal.. ;)

---------------------------------------------------------------------------

I should be going home in a few minutes, unfortunately there will be a Webinar (Web Seminar) later at the office, so we can't leave just yet.. :/Oh well, at least I get free grub..

Just the same..

I'm spending a bit of quiet time here at the hospital library, since I'm already done with my rounds and the callroom suffers from lack of any semblance of air cobditioning. :P

I often find myself in this kind of funk when I had just experienced a wonderful weekend in the days that preceeded.. Having had the rare opportunity to spend a full day's worth of quality time will always give anyone an emotional high.. Sadly, the crash that follows seems to get worse and worse as the experiences becone more pleasant.. Its kinda like the allusion of "the higher you fly, the further you crash".. :(

I'm personally sick and tired of this emotional roller coaster that I go through whenever I get some much-needed R&R only to return to a situation I am no longer really happy with.. :/ I really do wish things would seem a bit brighter, but I'm at a loss with how I could make things work.. Its no fun going to work everyday with an apparent cloud of gloom over your head.. I guess this stems from my general  dissatisfaction  aboit life and it's every 3- or 4-day cycle... Or maybe the SH-ICU duties for two straight months have been really getting to me na.. :( I'm sorry to makeanother badtrip post, as I know I have promised to try and be more positive in the blog, but the problems remain, and sometimes grow in complexity and weight, which defeats my attempts at supressing them..

Sigh.. Things just seem to be so depressing right now, and I have absolutely no idea why... :(

I miss writing..

I really do.. Now more than ever, as it seems..

I find this quite odd, as I have gone for months at a time very no creative output to speak of, and it really didn't affect me as much..

I'm trying to make some radical changes in my life, so I could live life better, so to speak. But as everyone knows, change is hard, and habits are sometimes hard to let go, especially if you find pleasure in them..

I'm mainly talking about my love for mobile gaming through the use of my ever trusty iPad which has been in my possession for roughly 3-4 years now..

Though I have made some strides with my mobile problem, which is probably responsible for the deterioration in my eyesight, as I have successfully deleted my Facebook app and have resisted the temptation to reinstall it and go back to waste much of my time online. It was such a drastic change for me, but one I do not regret the very least. I still keep my messenger app handy for my chat group with the boys and my dear ones, but the temptation for easy access to the time sink called Facebook is long gone. :P

Now I find myself with time to do other things like continuing my Xbox NBA career, or catch up on my readings (since i have more than a dozen novels still lined up on my reading list)

I also miss writing, my main creative outlet for self-expression, and now with more and more time on my hands, I hope to be able to do this (and other things) more and more. :D  

Sigh..

China, why you so selfish?

Anger Games

I just have a short thing to say.. It's really difficult to go on duty when your batchmate refuses to receive endorsements from juniors because of this or that excuse, or probably because s/he is just too goddamn lazy Sadly, the burden goes to you, being the more kinder and approachable senior, to sort things out. But then again, it is really difficult if that person does not repect the authority of the SHO just because s/he is so goddamn selfish!

These are experiences that one will remember for a lifetime, and will leave an indelible mark on the person's record and will forever taint other people's memories of him/her. I personally will not be referring any patients, nor will I be entertaining any favors for that person. S/he is not my friend, and it just so happened that we were co-workers at one point in time. I don't tolerate assholes in my friend list.

Warning: Rambling Rant ahead...

I need something, anything, to get myself started again.

On duty again today as the Senior House Officer.Man, being a SHO here is a lot different from when I was in QC.. In those early years, it was more of an annoyance, with not really much responsibility to bear, since the Chief of Clinics was always just a phonecall away, and the THOCs were handled directly by the different departments. Not so here in our institution, when the SHO has greater power and responsibility. One of the things I dislike the most as SHO is the constant level of anxiety that stays in the air in anticipation of something happening, be it a midnight call for a THOC or an unexpected call for help from the emergency department..

Lately it feels like I've just been floating along, without any motivation to do well in my work.. Is this burnout? I do not know. Frankly speaking, I have relatively little to be burned out about. But then again, the constant flow of work that I have been through in the past few months may have left me with very little in the tank..

Actually I'm feeling depressed, with very little evidence of anything to be depressed about. However, that's the thing about depression.. It just comes around without warning to bite you in the ass. :( You often have nothing to really be sad about. Your mood just turns all gloomy without warning, and it affects everything you think, say, or do, and recovery is slow and difficult.. :(

Hmm.. It's actually raining now.. A welcome development compared to the sweltering heat we have endured for the past months.. A lot of lives have been affected by the drought, especially our poor farmers in the countryside..

I wish I would be having my training under happier circumstances, but with the current situation among the trainess, especially the infighting among seniors, makes this a less than desirable place to be if one is looking for someplace to rest and "make tambay". I won't go into specifics since I feel that my blog does not deserve to be contaminated by unimportant trivialities caused by unimportant people...

Still, the office and callroom remains a relatively unhappy place, filled with unease when opposing parties are in the same room together. As for me, well, I'm caught right in the midde of it, being civil with either side, without favoring one or the other. And these guys know me well enough not to drag me into their petty squabble lest they endure my wrath. :P

On the side, I have also been reading stuff about possible electoral fraud due to supposed technical corrections done to the transparency server. This to me seems like a load of crap, and I think the media is just blowing things out of proportion, as well as the supposedly affected parties who seem to be looking at absolutely anything they can get their hands on to say that there has been foul play despite there not being any in the first place..

But then again, looking at things the other way, why would there be a need to make such a trivial adjustment to such a an unimportant thing at the even of the elections if said change would only be cosmetic anyway? The end result being that the electoral result is now in doubt.. Hay naku..

I have recently deleted my FB app from my device, in order to minimize distractions and remove myself from all the negativity that go with it. FB is good per se, but I think it has been doing more harm than good to society as a whole. Another goal of deleting FB is that I would be able to concentrate on things and people that matter to me. :) I have half a dozen pocketbooks which I have bought in the last couple of years that have yet to be read because I lacked the "sit-down time" it would take me to read these books, as I usually read each book in one sitting (yeah, I'm a book nerd like that :P)

------------------------------------------------------------------

It is already 2pm, and I should really get started already on the paperwork (I started this entry at 10am, with pauses in between for lunch and to check the present state of the ER and the fellow manning that post.

I'm thinking of shooting hoops again with brother tomorrow, that is, if my stamina would allow it. :P Shooting hoops gives me such relaxation which I have not felt for a long, long time.. It's just you and the basketball out there on the court. I also discovered that I still have a pretty decent free throw shooting arm, putting down 6 out of 10 in one continuous sequence. :D

Running out of steam

It has been HOT lately here in the Metro (and even all over the archipelago), with ambient temperatures averaging around 38-41C!!

I guess that's the main reason why everyone seems so sluggish lately. This heat just takes a lot out of you. :(

As usual, I'm typing a blog post again to jump-start the creative side of my brain in n attempt to overcome yet another persistent writer's block which has always been my nemesis whenever I have something important to do..

I took advantage of the recent long election weekend to get some much needed R&R via a staycation which resulted in buying a new basketball and getting the opportunity to shoot a few hoops with brother in XS. :) It was really nice to go back to the old school with brother, to finally be able to shoot hoops with him at a proper court! The experience was great, but it made me realize how terribly out of shape I was, And my legs hurt like hell from al the running and jumping.. to think that it was only just a shootaround with no real game taking place! :P

How Doctors Die

I recently ran across this great article which struck home due to its relevance to what we see day in and day out at the hospital.. To forgo extraordinary measures to prolong life is never an easy decision for relatives of the sick and dying, especially if the concept is very new and unthinkable to them. However, doctors (and other allied health professionals) have a better grasp of what this would entail, and many opt for DNR for a  myriad of reasons, but mainly because they already know what to expect, and do notlike to put themselves through it anymore and just go quietly into the night.

You can find the original article via this LINK

Article was Written by Dr. Ken Murray, MD

------------------------------------------------------------------------------------

How Doctors Die

It’s Not Like the Rest of Us, But It Should Be

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds–from 5 percent to 15 percent–albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

Of course, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits. And they know enough about death to know what all people fear most: dying in pain, and dying alone. They’ve talked about this with their families. They want to be sure, when the time comes, that no heroic measures will happen–that they will never experience, during their last moments on earth, someone breaking their ribs in an attempt to resuscitate them with CPR (that’s what happens if CPR is done right).

Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.” They mean it. Some medical personnel wear medallions stamped “NO CODE” to tell physicians not to perform CPR on them. I have even seen it as a tattoo.

To administer medical care that makes people suffer is anguishing. Physicians are trained to gather information without revealing any of their own feelings, but in private, among fellow doctors, they’ll vent. “How can anyone do that to their family members?” they’ll ask. I suspect it’s one reason physicians have higher rates of alcohol abuse and depression than professionals in most other fields. I know it’s one reason I stopped participating in hospital care for the last 10 years of my practice.

How has it come to this–that doctors administer so much care that they wouldn’t want for themselves? The simple, or not-so-simple, answer is this: patients, doctors, and the system.

To see how patients play a role, imagine a scenario in which someone has lost consciousness and been admitted to an emergency room. As is so often the case, no one has made a plan for this situation, and shocked and scared family members find themselves caught up in a maze of choices. They’re overwhelmed. When doctors ask if they want “everything” done, they answer yes. Then the nightmare begins. Sometimes, a family really means “do everything,” but often they just mean “do everything that’s reasonable.” The problem is that they may not know what’s reasonable, nor, in their confusion and sorrow, will they ask about it or hear what a physician may be telling them. For their part, doctors told to do “everything” will do it, whether it is reasonable or not.

The above scenario is a common one. Feeding into the problem are unrealistic expectations of what doctors can accomplish. Many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor. I’ve had hundreds of people brought to me in the emergency room after getting CPR. Exactly one, a healthy man who’d had no heart troubles (for those who want specifics, he had a “tension pneumothorax”), walked out of the hospital. If a patient suffers from severe illness, old age, or a terminal disease, the odds of a good outcome from CPR are infinitesimal, while the odds of suffering are overwhelming. Poor knowledge and misguided expectations lead to a lot of bad decisions.

But of course it’s not just patients making these things happen. Doctors play an enabling role, too. The trouble is that even doctors who hate to administer futile care must find a way to address the wishes of patients and families. Imagine, once again, the emergency room with those grieving, possibly hysterical, family members. They do not know the doctor. Establishing trust and confidence under such circumstances is a very delicate thing. People are prepared to think the doctor is acting out of base motives, trying to save time, or money, or effort, especially if the doctor is advising against further treatment.

Some doctors are stronger communicators than others, and some doctors are more adamant, but the pressures they all face are similar. When I faced circumstances involving end-of-life choices, I adopted the approach of laying out only the options that I thought were reasonable (as I would in any situation) as early in the process as possible. When patients or families brought up unreasonable choices, I would discuss the issue in layman’s terms that portrayed the downsides clearly. If patients or families still insisted on treatments I considered pointless or harmful, I would offer to transfer their care to another doctor or hospital.

Should I have been more forceful at times? I know that some of those transfers still haunt me. One of the patients of whom I was most fond was an attorney from a famous political family. She had severe diabetes and terrible circulation, and, at one point, she developed a painful sore on her foot. Knowing the hazards of hospitals, I did everything I could to keep her from resorting to surgery. Still, she sought out outside experts with whom I had no relationship. Not knowing as much about her as I did, they decided to perform bypass surgery on her chronically clogged blood vessels in both legs. This didn’t restore her circulation, and the surgical wounds wouldn’t heal. Her feet became gangrenous, and she endured bilateral leg amputations. Two weeks later, in the famous medical center in which all this had occurred, she died.

It’s easy to find fault with both doctors and patients in such stories, but in many ways all the parties are simply victims of a larger system that encourages excessive treatment. In some unfortunate cases, doctors use the fee-for-service model to do everything they can, no matter how pointless, to make money. More commonly, though, doctors are fearful of litigation and do whatever they’re asked, with little feedback, to avoid getting in trouble.

Even when the right preparations have been made, the system can still swallow people up. One of my patients was a man named Jack, a 78-year-old who had been ill for years and undergone about 15 major surgical procedures. He explained to me that he never, under any circumstances, wanted to be placed on life support machines again. One Saturday, however, Jack suffered a massive stroke and got admitted to the emergency room unconscious, without his wife. Doctors did everything possible to resuscitate him and put him on life support in the ICU. This was Jack’s worst nightmare. When I arrived at the hospital and took over Jack’s care, I spoke to his wife and to hospital staff, bringing in my office notes with his care preferences. Then I turned off the life support machines and sat with him. He died two hours later.

Even with all his wishes documented, Jack hadn’t died as he’d hoped. The system had intervened. One of the nurses, I later found out, even reported my unplugging of Jack to the authorities as a possible homicide. Nothing came of it, of course; Jack’s wishes had been spelled out explicitly, and he’d left the paperwork to prove it. But the prospect of a police investigation is terrifying for any physician. I could far more easily have left Jack on life support against his stated wishes, prolonging his life, and his suffering, a few more weeks. I would even have made a little more money, and Medicare would have ended up with an additional $500,000 bill. It’s no wonder many doctors err on the side of overtreatment.

But doctors still don’t over-treat themselves. They see the consequences of this constantly. Almost anyone can find a way to die in peace at home, and pain can be managed better than ever. Hospice care, which focuses on providing terminally ill patients with comfort and dignity rather than on futile cures, provides most people with much better final days. Amazingly, studies have found that people placed in hospice care often live longer than people with the same disease who are seeking active cures. I was struck to hear on the radio recently that the famous reporter Tom Wicker had “died peacefully at home, surrounded by his family.” Such stories are, thankfully, increasingly common.

Several years ago, my older cousin Torch (born at home by the light of a flashlight–or torch) had a seizure that turned out to be the result of lung cancer that had gone to his brain. I arranged for him to see various specialists, and we learned that with aggressive treatment of his condition, including three to five hospital visits a week for chemotherapy, he would live perhaps four months. Ultimately, Torch decided against any treatment and simply took pills for brain swelling. He moved in with me.

We spent the next eight months doing a bunch of things that he enjoyed, having fun together like we hadn’t had in decades. We went to Disneyland, his first time. We’d hang out at home. Torch was a sports nut, and he was very happy to watch sports and eat my cooking. He even gained a bit of weight, eating his favorite foods rather than hospital foods. He had no serious pain, and he remained high-spirited. One day, he didn’t wake up. He spent the next three days in a coma-like sleep and then died. The cost of his medical care for those eight months, for the one drug he was taking, was about $20.

Torch was no doctor, but he knew he wanted a life of quality, not just quantity. Don’t most of us? If there is a state of the art of end-of-life care, it is this: death with dignity. As for me, my physician has my choices. They were easy to make, as they are for most physicians. There will be no heroics, and I will go gentle into that good night. Like my mentor Charlie. Like my cousin Torch. Like my fellow doctors.

Ken Murray, MD, is Clinical Assistant Professor of Family Medicine at USC.

Drained..

Wow, that really took a lot out of me..

It's Thursday, and that means TB clinic day here at the hospital. As usual, the OPD was really toxic probably because I was the one rotating there..

Add the fact that it was SO FREAKING HOT today, and you have a recipe for disaster. I mean, I haven't felt this tired since my ER duties.. Thats how intense today was.. :(

I should be working on my protocol now, but I'm just too damn tired... :( I have to do this later though, but maybe at home na lng so I can work on it uninterrupted... :/

My Other Half has been feeling under the weather lately.. although I think it's more of vertigo. She got herself checked out by Ophtha and ENT already, and she's gonna have some bloodwork done later.. I hope everything turns out alright.. :(

Safe at my sanctum

The second curriculum year of my fellowship is in full swing, and I have been blessed by the fact that we do not have any conferences this afternoon after we finished our OPD patients.

I find myself confronting another deadline yet again, mostly due to my procrastination, but also in part to the never-ending fatigue I feel every time I go home and take to my bed..

I thought senior year would be a lot more benign, but boy was I ever wrong! Or maybe because I'm really just a toxic fellow-in-training. (*sigh..*):P

I should really get myself checked out for OSA, and I definitely will, probably during my Sleep Medicine rotation.. Oh yeah.. I need to have spirometry done as well, just to resolve once and for all the question of whether or not I am asthmatic..:P

It's been getting really hot here in the metro, and I mean that literally.. Temperatures have been constatly on the rise, as we feel the effects of El Nino.. The air is always so dry and warm, and it can get reallyunpleasant at the OPD.

The problem is even worse for our countrymen working in the agriculture sector, as the drought has caused entire crops to fail, destroying the livelihood of our farmers..

I honestly wanted to go to the gym today but thought better of it since I still have stuff to do.. XD Now I'm making a conscious effort to cut down on what I eat, though wrestling with a voracious appetite can be really difficult at times..Still, this is something I need to do in earnest for my own health and my future happiness. :D The gym can probably wait after I have all the paperwork out of the way..

Ok, that's enough of a starter post! My brain is probably revved up enough already so I should now go forth and type stuff!

(with the added motivation that I can go and see my Other Half later this afternoon ;) ) 

Cruchtime

This a blog post that I actually have no business of writing down at the present time, given my current situation, but I'm in a bit of a writer's block right now, and I often use my blog entries as a starting point to get my creative brain going, whether it be for a lengthy story for my blog,or an upcoming case conference report.

This case conference has been assigned to me roughly 3-4 weeks before, whilst I was still finishing up my  (hopefully) final month at the Emergency Room, so I really shouldn't have an excuse for not completing my output yet, but bear with me..

The past couple of weeks have been really busy for us fellows as well, what with all the different activities going on, especially the annual convention of the society which really messed up our schedules and left everyone dead tired from all the travelling and the skeletal duties, thus rendering it impossible for me to string together a coherent intellectual output of any kind since it was not really a holiday, and the workload did not change just because the lung doctors had to go elsewhere to talk about things..

So now I find myself less than 24 hours away from my report, which I hope will not be a total bust, depending on the output I can spew out in the next 10 or so hours. :P Looking back, I think this is the first time in a long long while that I have had this much free time to myself where I was able to have ample rest before I needed to work on hte report. Because these past days have been filled with ABG readings, cover rounds, and scutwork in general which left me so exhausted that I could barely work.

Though its true that there was also a bit or procrastination on my part, but there were also those times in the library where I fell asleep in front of the monitor because I was really just too damn tired to do anything!

Oh well, I hope this is enough to get my engine warmed up. I really need to get started.. :P

PSBIM 2016 Results

I know this is relatively old news, but I will still post it for the benefit of others..

Congratulations to the new Diplomates of the College!

Shout out to my juniors (Mike, Donna, Chabs, Mira), and my batchmate Kirk!
Kitakits na lang sa convention! :D

List originally posted at the Philippine College of Physicians' Website

---------------------------------------------------------

PHILIPPINE COLLEGE OF PHYSICIANS
PHILIPPINE SPECIALTY BOARD OF INTERNAL MEDICINE
March 6, 2016  -  UST College of Medicine Bldg., España Manila

LIST OF SUCCESSFUL EXAMINEES

NAME
ABABON, MYLENE SULLANO
ABADILLA, MARVIN STEPHENE FELIPE
ABALOS, ARLENE CABUGOS
ABANILLA, RUDOLFO MARK BRIONES
ABARQUEZ, IRICAR DAWN BRIONES
ABDULLA, ADAMIER PANDUGA
ABDULMAJID, MOHAMMAD KHASIM IBRAHIM
ABENOJA, ELAINE JANE BONDOC
ABOU ZAKI, SHAFIQ DEXTER BASAÑEZ
ABRIGO, VERONICA ROSA CUBILLEJO
ABUNDO, CELESTE GARGANTA
ACOSTA, JOSEPH JASPER SATURINAS
ACUNA, AVELAINE CLAIRE DELA CRUZ
ADRIANO, HEHERSON BALLESTEROS
AGBANLOG, FAITH PILANDO
AGUSTIN, SILVEROSE GARCIA
ALABA, EVAN ANGELI MAGBANUA
ALARCON, BILL ALLEN DE GUZMAN
ALIMON, KRISTIN JOY IBRADO
ALMIRON-RAMOS, FREYJA DIANA UY
ALQUIZAR, MARIBEL EBDANE
AMBA, NEIL FRANCIS ADAP
AMOLOZA, KAREN GASGAS
AMOROSO, SUNDAY III ALIVIO
AMURAO, MADELAINE FRANCISCO-CHAN
ANDALES, AUBREY DAGOHOY
ANDALES, DEXTER GIOVANNI ARELLANO
ANDIN, ALMA CRISTINA AGRA
ANDRES, MARK DONN DELFIN
ANG, ALFRED ERNEST TO
ANTONIO, KARREN LADIA
ARAJA, ADVENT GENESIS MARASIGAN
ARANAS, REESHA MAY PONCE
ARCE, SIMEON JR ACEVEDO
ARELLANO, FE-AILEEN FELICANO
ARRASTIA, CLARISSA ANNE FERAREN
ARRIOLA, LORDEL MANALO
ARROSAS, MICHAEL RAMOS
ARZADON, AISLINN MAE DANCEL
ATANACIO, SHARI ANN CHUA
ATUTUBO, CYRIELLE MARIE NAPA
BABARAN, HASHAMIIYA MORALES
BACANI, JOSE MA. ANTONIO DELAPAZ
BACLAY-LARAYA, DIANA MAY UMAHAG
BACONGALLO, EHRLICH NICKEL ESTARIS
BADIANG, HONEY JIRL REYES
BADILLA, JOHNNY III PABER
BADIOLA, PAUL RYAN NIEDO
BANDOJA, GIANNE MICHELLE DEANNA ALVIS
BAQUIZAL, CARINA MALILLOS
BARCELONA, MICHAEL JOHN NGO
BAUTISTA, RONALYN RUCIO
BAYANI, BENALY ERECE
BAYSON, RICHELLE JOY DIAMANTE
BELISARIO, CLEVAN TERESITA ALABA
BELLO - RIVERA, NENA NOEMI ACOSTA
BELLOSILLO, FEMAE LOVE PLAZA
BENDITA, JESSON GUAY
BENITEZ, VICTOR JONATHAN SILVERIO
BERMUDEZ, GHERALD ROSALES
BIASON, MELISSA VENIEGAS
BIBERA, ALBERT VILLON
BISPO, KAREN ANNE GONZALES
BISQUERA, RUBY ROSE SANTOS
BOLIGAO, LOURDES RIZADEL SARENAS
BONDOC, RAIZA GEIRES GARCIA
BONGO, ALLAN LABORTE
BOONGALING, MARY ERVIE DE CLARO
BORJA, JENNIFER QUINTILLAN
BUAN, ALDELIA REYES
BUARON, MICHELLE JANE AGUIRRE
BUDHI, AGUNG NUGROHO
BUGHO, MARIE LIZ SALUDARES
BUTI, ALLEN MARIE ARAGONCILLO
CABADDU, JACK ADDUN
CABALLERO, TRIFON ANTONIO DEL MUNDO
CABAYA, NORMAN FLORES
CABIGAS, KAREN SUMAGIT
CABUYAO, ANGEL BRYAN DONCILLO
CACANINDIN, JEZRELINE MARIE IMPERIAL
CADANO, MARY JOYCE GOMEZ
CAHILOG, CANDY TOMAS
CALABIO, ALEJANDRO TOPACIO
CAMENFORTE, JENIS EMMANUEL LOPEZ
CANO, CHRISTINA TULUD
CAOYONAN, IRENE ESTEMBER
CAPELLAN, LORETO CLUTARIO
CAPERONCE, ERIKA JOANNA VILLANUEVA
CARMELO, MA. LIZA QUETULIO
CARRIEDO-SANVICENTE, MARIA CENIZA SILVESTRE
CASAO, CHING OLAND REY CANTAVIEJA
CASTILLA, MA. TECELYN SIAROT
CASTRO, DENNIS MARTIN ABIOG
CATALUNA, CATHERINE PASCUA
CATALUÑA, JOSE GUILLAIN ESTEBAN
CAYABYAB, JANILOU CALARA
CAYAD-AN, CHARLTON BUGNOSEN
CEA, EVANGELINE GREGORIO
CERVAÑEZ, MARILOU TINOY
CHAN, CHARLIE JR. ENRILE
CHIO, MITZI GARCIA
CIOCO, NINO CARLO SANTIAGO
CLARIDAD, KRISTINE RILLERA
CORDOVA, GEORGE HO
CORPUS, WILFREDO SIAO
CORTEZ, BERNADETTE ECHON
CRISOSTOMO, MARIA THERESA DE RAYA
CRUZ, RIZA RAMADA
CUENCO, FRANCIS MARTIN TINED
CUEVAS, MICHELLE ANGELIQUE SANTOS
DACLAN, FRANCIS PAOLO ROJAS
DAHAL, VIJAY KIRAN
DALISAY, FERDINAND GUSTILO
DAÑEZ, MARDI ANTENOR
DASKEO, HARTZELL LAGUITAO
DAUD, NASHIBA MANGORANGCA
DAYEM, RODILYN ESTOLLOSO
DE  LEON, MARIA LOWELLA FACTORA
DE CASTRO, JOY ANN VERGARA
DE GUZMAN, BOBBY GARCIA
DE GUZMAN, KRISTOFFERSON FERNANDEZ
DE GUZMAN, RAQUEL ISABELLE BARBA
DE LA CRUZ, ALISTAIR KASHMIR CARPIO
DE LA CRUZ, JULIUS JOSEPH LAGTAPON
DE LOS REYES, RECO PROSPERO SINCO
DEBUQUE, EILEEN MAY BALBASTRO
DEDASE, LYNN MAE CELIZ
DELA CRUZ, VERLENE ANNE VELASCO
DELA ROSA, PATRICCIA ANNE VALCOS
DELES, LORA GRACE JORDAN
DELOS REYES, MARITESS TAN
DELOS SANTOS, ISABELLE YAP
DENOPOL, RYAN MARTIN KYAMKO
DEOPANTE, CARYL ERMA SODSOD
DIAZ, JAMES PATRICK
DIDELES, ALLAN SANTANDER
DIMALALA, MARIA GRETHEL CORTEZ
DIMAUNAHAN, DIANNE CHARLOTTE CASANOVA
DONG-AS, DARIEN ANN MATBAGAN
DOYDORA, NINO JESSIELITO NUNEZ
DY, KRISELLE RAE SANCHEZ
EDEP, MARY JOY ANTONIETTE ABORQUE
EGAR, MARK JULIUS SABANPAN
ENERO, REYIA JOIE VEGA
ENRIQUEZ-FILARCA, CHARO TOLENTINO
ESCALADA, ROXANNE RUFINO
ESCASURA, MARIAN IRENE CAPILI
ESPINOSA, RHEA SANTERVA
ESPLANA, CHRISTIAN CESAR MONTEMOR
EUGENIO, KARL PABLO
EVANGELISTA, IVAN ZAFE
EVANGELISTA, MA. ISABEL GALLENO
EVANGELISTA, ROEL VELCHEZ
EVASAN, AGNES LORRAINNE MONCAL
EVILLA, ROSEL LLAGAS
FANG, MARK DAVID GOTACO
FAUSTO, ADRIAN MANUEL MALIWAT
FELIPE, ROY RAOUL HECHANOVA
FERAREN, ANNA REGINA CHAN
FERMANO, LYNOR NERPIOL
FERNANDO, EMMALINE ZANTUA
FERNANDO, JOSEPH NOEL SOLITO
FESTEJO, KATRINA MARIE CINCO
FLORA JR., ANGELITO ANICIETE
FLORO, GERALDINE CLAIRE OBSEQUIO
FRAGANTE, MARJORIE ANTONETTE CARDENAS
GABA, ARNOLD JR. AMBAS
GABAT, JULIE ANNE LUCZON
GADONG, LYZA CAMILLE PO
GAFFUD, PRIMA BIANCA NILO
GALANG, DAN BRIAN PINO
GALERA, LORALIE ESPEJO
GALON, CHUCK EDUARD BABIERA
GALON, MYVIE PADERANGA
GARCIA, ELVIN DORONILA
GAVINO, RHEA ANN BEUP
GENIL, FRANCES GERARD DE MESA
GEOLINGO, LIONEL FIDEL
GERONIMO, EDRIAN ORDONEZ
GIBRALTAR, FELLI CLAIRE GERSAVA
GILAPAY, NELSON JR. PLANDES
GO, MARIA THERESA MAGDA
GONZALES, ARTHUR GEORGE SAN PEDRO
GONZALES, IRISH JUDY BAYONA
GOZUN, JELLY ANN MANALOTO
GRAJALES, ENRIQUE JR MANCIA
GREGORIO, DULCE CORPUZ
GREGORIO, MARIA TAMIKO TEVES
GUERRERO, MARY JANE PENEYRA
GUEVARRA, BIANCARITA PANGANIBAN
GUIANG, ADA MARIS ESPIRITU
GUMPAL, AARON-JAMES IBARRA
GUTIERREZ, RICKY VALERIO
HASHIM, FRANZEED SAKALURAN
HIDALGO, RITCHEL ANABEZA
HILARIO, ED-MARVIN CHUA
HONG, CHHAY N/A
HORNILLA, DONNA RICCA MORANTE
IBANEZ, RACQUEL CAMPOS
IBRAHIM, AHLIAH ESMILLA
IGUALADA, VIVALDI OBLEADA
ILAGAN, BRYAN CHRISTIAN GAZA
ILAO, MARY ANNE MAGSINO
INDERAWATI, CITRA
ISNANI, SARAH-LAIDA JUPLI
ITALIA, MAYCE GARANA
JAEN, ANJULI MAY PABIONA
JAMBARO, MARVIN JAY GAN
JAMPAYAS, MARIE MICHELE JULIAN
JARA-TANTOCO, MIKAELA NIKKOLA AQUINO
JARAVATA, CLARENCE PENAFLOR
JERMEO, TIFFANY GAY VASQUEZ
JO, CAROLINA MARGARET
JOCSON, MARY ANN SASI
JUMALON, CHIELA LARCIA
KANNO, MARIA NATHALIE YUKI AMABLE
KHAN, ANNIE LORAINE ESTROPE
KHO, RON RUSSELL APITA
KINTANAR, NOREEN ANTOINETTE OPINA
LABAJO, HANNAH RUTH VICTA
LAFAVILLA, JIMMY REYES
LAFORTEZA, ALEXIS ROBERTO YAMANE
LAGARDE, LUIS JR. CORREOS
LAMBAN, MARJORIE LOSTE
LAO, AYN MARIE BASCUG
LAQUINDANUM, SERAH KAE LABITAD
LASAFIN, KENNETH JORGE A.
LAXAMANA, ABEL GALANG
LAZARO, DESILU ALISA PACETE
LAZO, REGINALD AVERIA
LEBRILLA, CLEOFE LACUESTA
LEE ROI, FULLON BUENAVENTURA
LEE, AILEEN MAE BERNARDO
LEE, JUDY REMYLYN TANG
LEE, RAYMOND VILLASIS
LEGISLADOR, MARIAN GRACE GALLERA
LEJOS, MANILYN BERBA
LIBO-ON, JOSE MARIA ALESSANDRO PAMINTUAN
LIBUTAN, AURABELLE PATIGAS
LIM, AILEEN ANNE GO
LIM, BRYAN ALBERT TAN
LIM, PATRICK JOSEPH OLEGARIO
LIM, WAYNILA MAE PEREZ
LINDAIN, AILEEN LIQUICIA
LISDA
LLUISMA, EMERALD HOLLANES
LO, ANGELIQUE ELGA CANO
LO, VIRGILIO JR. SANDICO
LODRIGUITO, JOFEL RAMON PITPIT
LOMAAD, EARL JAYSON CINCO
LOPEZ, ADELAINE JAO
LORENZANA, AURORA LACONSAY
LOZANO, VICTOR ANGELO DUCA
LU, JOHANNA MESINA
LUCERO, ANNA LORAINNE SAMONTE
LUMAPAS, IRENE COLINA
LUNA, KATRINA DE CASTRO
LUNA, LORETTA ANNE ARDIENTE
LUY, SYBIL CLAUDINE RANIDO
MACAGAAN, INDIRA SARIP
MACAGAAN, NASHEBA LIMBA
MACAILING, JOESELYN MONARES
MADERAZO- MORALES, CRISTIA MAYSOL TOLENTINO
MADLANGSAKAY, LILY ANNE SANTOS
MAGALE, EFFIE NADINE SY
MAGALLANES, GHALSWENDY LAMPEL NOCON
MAGALLANES, JONRAY RAMOS
MAGBOO-GOMEZ, MA. LOURDES MATEO
MALALA, JAMES ABRAHAM DACANAY
MALALUAN, NAMPHRIL GARCIA
MALAPITAN, NOEL NAVARRO
MALICDEM, MADELAINE AGUSTIN
MALIG, MARIELLE ESMEN
MALLARI, AILEEN MANALANSAN
MALUNDO, ANNA FLOR GABOY
MAMITAG, BEVERLY LOU TRINIDAD
MANALO, RACHEL PALISOC
MANALO, RENE XAVIER PALISOC
MANALOTO, JASTIN GILBERT GABRIEL
MANANGUITE, CHYRELL LYN TORAYNO
MANGORSI, OMILKHAYR BORANSING
MANGUBA, ALEXANDER JR SABBUN
MANGUERRA, GREGORIO JESUS CONSTANTINO ESCANO
MANONGAS, KEN PHAM
MANSUKHANI, SUJATA MAY HERNAEZ
MARANION, MARIA CRISTINA ACOSTA
MARAYAG, PATRICK JOSEPH ANDRES
MARCOS, JOCELYN MULI
MARQUEZ, EDUARD CESAR LUMAUIG
MAYUGBA, ZYRA MARISSE DIAZ
MEDENILLA, JHUDIELLE FRANCESCA RODRIGUEZ
MEDINA, KRISTIANNE RACHEL PALANCA
MEDINA, VON ANDRE MEJICO
MEJIA, CRISTAL Randiline MENESES
MENDOZA, ALISA JABINAL
MENDOZA, GRACIELLE MAY CINCO
MENDOZA, JUVELON GUTIERREZ
MENDOZA, MARVIN JONNE LIMBO
MENDOZA-GARBO, DAISY MARIE BALLESIL
MERCADO, JONATHAN PILAPIL
MIGUEL, RHODA PEÑARANDA
MIRASOL-LATADE, KATHERINE OMEGA CHAVEZ
MOHAMMAD, ABDELTAZER YUSOP
MOLINA, RAMON MIGUEL MALIKSI
MOLON, SHERYLENE ALONZO
MONTON, LALAINE BABIERA
MORA, JEFFREY PASCION
MUDANZA, HENRY JR BONIFACIO
NAMAN, MAGNOLIA ADVINCULA
NAMOC, CHRISTINE LIMBAROC
NARCISE, ALESSANDRA NICOLE PICORNELL
NAVARROZA, ANN MARGARET CARAAN
NER, ZANDRO JANSUY
NG, CLAREL CAMILLE BAYLON
NICOLASORA, ANNIA RAE MOMBLAN
NISPEROS, MICHELLE TELADO
NOBLE, APREEL MARIE PICARDAL
OCAMPO, JAN MICHAEL PULIDO
OJEDA, KHRISTIAN FELIPE
OLIVEROS, MARY JULIENNE THERESE MANGAHAS
OMOLON, ELLA REYES
OMOLON, LARSEN CARLOMAN
ONG, RENATO JR CRUZ
ONG, YUMI CZARINA TAN
ORDILLO, LUWALHATI SARA PADON
O'YEK, JENNILYN TANG
PABLICO, MARK ANTHONY RUBIO
PADATE, INTIZAR MACALBE
PAGAR, NORMAN DUMAPLIN
PAJARILLO, RYAN JAY APAN
PALILEO, JUNE MARIE DUREMDES
PALMA, KRISTINE LEARI MERCOLESIA
PANERIO, KAREEN LOU CLARIN
PANGANIBAN, MICHAEL JOHN MOJICA
PANGWI, CARLO DOMINICK LOPEZ
PANJAITAN, FERONI PELLA
PANLILIO, CHERISSE ANN PANGAN
PANUDA, JOSE PAOLO PACAIRA
PARAS, KATHERINE CARAS
PASAMBA, EDMUNDO MAMUCOD
PASCO, CARLO ANTONIO OSORIO
PATRICIO, IANDROF GAGELONIA
PATRICIO, MARION DELA CRUZ
PEÑA, MELODY CAMO
PERALTA, MARK CARIÑO
PEREZ, JAYPEE VILLANUEVA
PEREZ, JOAQUIN III SARTORIO
PEROCHO, MADELEINE PALANG
PHOA, TIMOTHY BREN DY
PILAYRE, ANNE ZYRA TARUC
PINEDA, ERNEST HOPE GULPAN
PINOY, KRISTY MONTE
PLAZA, INA ISABEL BALINGAN
POBLETE-VICUNA, MARIE EILLEEN CRUZ
POLISTICO, JORDAN MICAH FERNANDEZ
PRIETO, REI JOSEPH PAGUIO
PUA, MARIA SOPHIA FORMOSO
QUETURAS, REGINALD RASALAN
QUIMPO, JR, ROLANDO DILAG
QUINAGON, MADONNA VIDA REALUYO
QUINITIO, JENNILYN VILLARROYA
QUINTO, MILRAAM LONTOC
RAHARDJA, CAROLINA KIWIK
RAMA, SARI PEPITO
RAMIREZ III, REGALADO CERVO
RAMIREZ, FLORDELIZA LIM
RAMIREZ, GLENN ESTRELLES
RAMIREZ, RONALD PILI
RAMOS, PATRICK RAYMOND GARCIA
RAPISURA, CARIE QUITIQUIT
RAQUINO, JOHN RUDOLF JR. SABAS
RAVELO, ROEL ANDREW ANDRES
RAYOS - CATAPANG, CAROLYNE MARIE VILLANUEVA
RAYOS, DANIEL CHRISTOPHER ABANTAO
REBUGIO, JAARMY FLOR
REBULLIDA, SALVADOR PEDRO GENATO
RECIO, MARIA KRISTINA GARRIDO
REGALADO, JOSEPH JUSTIN HIPOLITO
RELOTA, FRANCIS GABRIEL HINOLAN
REMALANTE, PATRICIA PAULINE MANGLAPUS
RESPICIO, VEZ JALBUENA
REVIL-TING, CHARISSE ANNE JUMANGIT
REY, IRINA MUNOZ
REY, MARK ARCHINAR CHUA
REYES, ALEXANDER DELEÑA
REYES, AURELIO PANTALEON SANCHEZ
REYES, ROLAND BENEDICT CALIMBAS
REYNALDO, CHERRIE MAE SIA
RILLERA, DOLORES JOY OCAMPO
RINGOR, MARCELINA MABATAN
RIVERA, MA. ABIGAIL RAGASA
ROA, JANICE MAE YAP
RODRIGUEZ, JENNIFER PORQUERINO
RODRIGUEZ, KATRINA REFUERZO
ROLDAN, CRISTINA DELA CRUZ
ROLLUQUI, GERALD FILEU TAROO VILLANUEVA
ROQUE, JOSEPHINE CECILIA VILLAFLOR
ROQUE, MARY GRACE ANNE REYES
RULONA, IVORY ABARQUEZ
SABANDO-CASTRO, LICCI DAGSA
SABUERO, LORA LEE SINET
SACDALAN, DANIELLE BENEDICT LEONCIO
SAGURIT, JOCELYN TAMAYO
SALAZAR, JANELLE VICENTE
SALAZAR, RICCEL BASACA
SALCEDO, VON EDWARD SUBANO
SALES, MARIA STEPHANIE ALESSA ROMANO
SALGADO, CHRISTINE AUSTRIA
SALVADOR, LESTER LOZANO
SALVADOR, MARIA AMIRA CABUSAY
SAMPAGA, AILEEN PAREL
SAMSON, ACE LAZATIN
SAN JOSE, MADONNA CACHERO
SANCHEZ, KATRINA JONNAMARIE SERVANDO
SANCHEZ, LEMUELL KARLA ARCETA
SANCHEZ, ROMMEL RAY REYES
SANDEJAS, KATRINA ANNE COMIA
SANTIAGO, KAREN MARIE HOFILENA
SANTIAGO, SHEREE GRACE BANDIOLA
SANTOS, BRYAN JAMES TABORADA
SATUNA, ARLYN DE GUZMAN
SEIDENSCHWARZ, FRANZ CHRISTIAN CINCO
SEMENIANO, RUSSEL REDOBLADO
SENGA, ISSA RUFINA LIBORO
SERENCIO, LUCILE CORTEZ
SETIAWAN, EDI
SINGANON, JIMMY JOHN IVAN TOLENTINO
SINGKEE, MARIA NOREEN ENRIQUEZ
SISTONA, RAYMOND ENTIENZA
SO, EDGEL MAY BAYAG
SO, MARICHELLE PE
SO, ROIZZA BETH KEH
SODUSTA, JOYCE PLARAS
SOMBRERO, MARIA CRISTINA ANSON
STA. ANA, SHEILA GARCIA
SUAREZ, IVY MARIE ZANTE
SUAREZ, KARL RAYMOND ISRAEL
SUBONG, NESTOR JR. URIARTE
SUNGA, YORADYL DALUPANG
SURATOS, MARIA RODALLA CONCEPCION
SUSANTO, ALWYN N/A
SUSUSCO, MIKA ANA CODIÑERA
SY, THERESE ANGELI ARANETA
TABULA, JOEY ALCONES
TAM, LYZANNE MARYL CABRERA
TAN, DEREK LEAND UY
TAN, GEORGE BAUTISTA
TANALGO, RAINIER TABUGA
TANCHANCO, CAMILLE ARIADNE CONCEPCION
TAPPAN, SWEET GARLLIE ALBERT REYES
TARONGOY, VANESSA CATOLICO
TIANGCO, NEIL ANGELO BORJA
TINOCO, EMELROSE GARRIDO
TIOLECO, DANIEL OBORDO
TIONGSON, MARC DENVER AQUINO
TIROL, LAURENCE ELLIOT RAMIRO
TIU, EMELITA DE LEON
TIWARI, MOHAN LAL
TIZON, JANET IBAÑEZ
TOLENTINO, MARIA LOIELIN ASIDO
TOMAS, ARNOLFO JR BALANAY
TONGCO, VALENTINO ONG
TORRES, EUNICE DEMETILLO
TORRES, MANUEL KHELVIN GONZALES
TRINIDAD, CARLO NEMESIO BATOON
TUAZON, ADELFO JR. PARAS
TUÑACAO, MARIA ROUSSELL NENNETTE PULVERA
TUPAS, MARIE PIODENA
UICHANCO, ANN CELESTYN PAYAWAL
UMALI, JANICE ANDAL
URSUA, IVY LADOT
UY, ERNESTO JR. JAVIER
UY, GERRARD DENNIS DY
UY, MELISSA CLAIRE KIAT
UY, RODOLFO JR. DIONELA
UY, ROMEO FERRAN
UYTIEPO, KRISTOFFER JAN VILLACIN
VALENCIA, JOSEPH ABEJAR
VALENTE, KATHLEEN JOYCE DE LEON
VALLES, ATHENA JORDAN
VASQUEZ, RHODORA BACALLA
VASWANI, PREETI PRERNA MAHBUBANI
VEGO, ESTHER JOY VELASCO
VELASCO, MARIEL DIANNE SOLORIA
VELEZ, EDUARD LAURENCE SHIU
VELOSO, ROMMEL APUADA
VERALLO, SHEIRA MAE LUISON
VERGARA, JOHN PAULO BERNABE
VIAR, JOHN RYAN GUEVARRA
VILLANUEVA, MA. AIMY DONESA
VILLAPLAZA, BENJAMIN COCA
VILLASIS, RAMON CHRISTIAN STA. MARIA
VILLEGAS, KATRINA JAVELOSA
VISTO, FRANCIS ROGER MANUTA
WONG, JENDY ANG
YANG, RAYCHELLE ANNE BANAL
YAP, EMILY MAE LIM
YBAÑEZ, MARIA MAYIDA PUREZA CONCEPCION REYES
YEO, ELEONOR SERRANO
YPIL, GERARD III LACAMBRA
YU, ROANNE MARIE LIM
YUSOPH, JOMYLAH OLAMA
YUZON, JUDY ANNE GATMIN
ZAINODEN, WEDAD LUMNA
ZAMORA, JESRELLE MENA

10 out of 10

This post was written on February 28, 2016 at 1pm

-------------------------------------------------------------------

At last, I'm finally here! The final official ER duty of my life (I hope...) 

Frankly speaking, I'm not really in the mood to celebrate anything, as the day has pretty much just begun.. :/ Nor do I think I will be when the next day finally arrives, especially since I have to slide into a new duty schedule, and thus may be too tired to do anything else..

I've been feeling down a lot lately, especially since this is an ER month.. There's just something about the whole situation that weighs heavily on my shoulders..

Hmm.. I'm kinda feeling a bit under the weather myself right now.. :/ I just have to survive this duty night then rest my ass off tomorrow after OPD so I can get ready for my return to the ward.. Sigh.. I just hope that I CAN survive this duty day..

Being depressed is something that is not new to me.. As I may have mentioned before, recent experiences during my training at a different institution had left me in desolation, and pretty much broken.. Luckily, I had the support of the people around me which helped me get back on my feet and try again anew. What followed was a whirlwind ride through training which I never expected, but was able to experience since I surrendered myself to what life has in store for me..

I really hate this ER anxiety along with all the unpleasant sensations that go with it.. :/ top it off with the fact that I'm feeling a little sick right now...:( 

8 out of 10

This post was written on February 22, 2016

----------------------------------------------------------------

I think and worry too much, especially in uncomfortable situations that I get myself into, notably residency and fellowship training.. You see, these things are really just optional.. Nobody really compels you to go into this or that since its no longer part of a school curriculum like clerkship, or a requirement for the physicians licensure exam like the post-graduate internship.

Sigh.. I should really learn to get my head out of my ass when things get rough.. The ER is especially traumatic for me because I am not comfortable with dealing with an endless stream of patients, most of them seeking immediate attention for one reason or another. Its not easy to deal with that because i feel like I run out of compassion too soon.. My only consolation is that it will all be over soon.. (I hope..)

I kind of hate myself because of the mess I'm in, since this was a result of a conscious decision to become a freaking doctor.. 😕 As I have said before, once you realized what a freaking shitstorm it is, you find yourself way too deep into it to turn back and choose another path, which I find kind of unfair.. Other people go through life switching jobs until they find something they can live with eventually. Doctors don't normally have that luxury, unless of course you're filthy stinking rich that you can afford to turn your back on the amount you've spent on your one-way trip through medical education and just start from scratch elsewhere..

I'm normally very eloquent when I'm sad and frustrated.. I guess its due to the fact that have so much to say, and so much emotion to back it up.

A one-way ticket.. Yeah, i think i like that statement.. 

3 out of 10

This post was written on February 7, 2016

--------------------------------------------------------

Yup, third duty of the month.. 7 duties to go, and the end can't come any sooner.. Not liking ER duties in general isn't really helping either.. Sigh.. :/

I really just wanna rant.. I know this is getting tedious, and I'm sorry to those who are put-off by this.

I've had a relatively happy past few days since I was able to meet up with my Other Half and have dinner together on a couple of occasions. But you know what they say, the higher you fly, the further you crash. This is even moreso reflected when you have to go on duty the following day, because the taste of how much better life is outside the hospital is still fresh in your psyche..

Adding to my present woes is the fact that Ihave to give yet another report two days from now.. This should be relatively easier since the content is solely from the book, but I have not started work on the presentation yet and am just reading through the material today.

Yesterday was a rare day off, in fact, i think this was my first real day off in the last month or so, since my weekends last month still had me going to the hospital to make rounds regardless of duty status..

Fast forward to 3PM.. It's been relatively quiet for the most part owing probably to the fact that its a holiday tomorrow ( 新年快樂!), so i hope this tides over until I leave for home tomorrow..

As hard as it is to admit, I think I'm getting too old for this duty stuff.. :/ I might probably be good for one more year's worth of duties, but I think my reserve for ER duties will have reached its limit by months' end..

Now its 10PM, and I had a sudden moment of clarity and I realized that the most toxic part about going on duty at a specialty center like this is dealing with those patients who are not supposed to be admitted here.. (Primary problem is not Pulmonary)

Blogspam alert!!

I know I've been away from blogger for quite some time, but that doesn't necessarily mean I haven't been busy offline. ;) So, what follows will be another blogspam fueled by my everlasting dislike for ER duties.. XD

What a way to start the month..

Late post which was written on February 1, 2016

----------------------------------------------------------------

It's just 9am and I'm already feeling absolutely TIRED.. It's my first day back on what would hopefully be my last month at the Emergency Room.. 

I guess you could say that I hit the ground running with this one, as there was a ton of patients endorsed by the outgoing Doctor. 4 intubated patients, plus one on BIPAP.. Argh.. Looks like I've got my work cut out for me this time around.. 

As I pause and look at myself in the mirror, I realize that so much has changed.. Gone were the days where I would see a bright young doctor wannabe filled with youthful optimism and idealism. Nowadays all I see is a worn-out old dude just trying to get by day-to-day with the hope of reaching an end to all of this someday. The fire in his eyes all but extiguished in the face ofwhat he's seen and been through so far, with nary a promise that things will get any better in the near future.. A faint glimmer of hope remains though, a spark ignited by something far greater outside the confines of the dreary hospital life.. Something that he looks forward to after all this stuff is done and over with..

I still feel like I've thrown my life away though.. The best years of my life being spent drowning in some textbook or rotting away in some hospital away from the warmth of family and friends, trying to make sure some complete strangers (some of them totally ungrateful, especially the pay patients) would be able to get better whilst my loved ones suffer quietly at home..

Yes I'm being bitter about it. I have said it one too many times that the realization about the hardships of a doctor's life comes too often too late, with students having invested far too much on their education and chosen career to backtrack on find another path..

I'll admit that I used to scoff at doctors who were saying that the doctor's life is hard, and just thought that they must not be doing so well to say such things. Now I realize that they were telling it like it is.. The feeling of being trapped and disillusioned is actually very real, and depression is always looming just around the corner.. 

I'm really glad I have this blog and this device where I can type my thoughts and frustrations away.. Sorry to my readers if things seem a bit negative, but I'm just telling it as it is.. There may have been some great moments interspersed in between, but training was mostly a wild collection of tiredness, toxicity, frustration, and heartache..

I miss sleep.. I miss being able to go to bed and wakeup late the following morning without a care in the world. Lately its been so negative from the moment I wake up, especially with the entry of February, since it represents yet another 9 days at the ER for me, or collectively 216 grueling hours of nonstop exhaustion..

I wish I REALLY had the time to do what I want in life, not just steal some moments interspersed within a greater scheme of things like training, as chasing after those temporary highs seem so empty and lonely.. To make things worse, the higher you feel, the worse it gets the following day when you have to drag yourself back to the daily grind..

I find myself retiring to my bed more often these past few days, and i can actually feel the enthusiasm drain from my psyche.. Am I depressed? Probably.. I can't say that I haven't been here before. Sometimes I have the impulse to throw up my hand and say "Fuck it!" and just walk away. It's a really tempting scenario if you look at it.. 

I think I've ran out of happy things to talk about, and this blog hangs heavy with gloom and doom.. 

About love...

This topic has been pretty much taboo on this blog for the longest time already, what with everything that has transpired in the past years.. But now I guess I'm ready to take that brave step, and make a revelation to the world...

Some of my more sharper readers may have picked out my mentioning of my Other Half in certain entries, but I never really went into much detail about her, and I guess I still won't, since I don't really make things too public here.. Or anywhere else on the internet for that matter.

Anyway, my Other Half used to represent an ideal. A lofty idea or concept if you will, about a woman who would totally get me inside-out from the get-go because she, by some force of magic unbeknownst to man, would essentially be my clone, except that she would be a girl. The "female me" in a matter of speaking.

Best Friend and I had this conversation when we were younger when I asked him what girl would be right for me.. He gave such a specific answer that I never forgot to conversation. He told me "You'd probably want someone like you, except that she'd be a girl".

Eerily enough, a woman came into my life some time ago who matched the description PERFECTLY.. Getting to know her flowed seamlessly, as she immediately got what I liked and vice versa.. We never had trouble deciding on things together because we actually even thought alike in a majority (if not all) situations.. It was so uncanny.. Weird even..

The attraction followed naturally, since she was quite the pretty lady herself, and she thinks I'm quite the stud (Haha!). After that awkward initial first meeting which found us both struggling to keep our composure around each other, we finally began to settle into a comfortable routine that even long-time lovers aspire to have.

It also helped that I got to know her folks and get on their good side early on, as she got to meet my parents as well and left a good impression. I had no idea that being in a relationship could be this fun or effortless.. There's no point in keeping secrets since we can be totally open to one another without any need for second-guessing the other's reaction. We're both free to speak our minds, not in a superficial "Its ok, juat tell me" kind of way, but a "I trust you well enough that you won't freak out at this" kind of way.. Then there was that car accident and the run-in with the traffic police.  It was such a grueling experience but she never left my side even though I had already sent her home (since she lived nearby from where we had the accident). She actually even came back for me! It was like a scene from a movie or something! I wanted to cry on the spot but I was too busy listening to the cops to do so :P eventually everything ended well, and we had a hell of a story to tell when we got back! XD

I thought that getting involved with someone so similar would be boring and get old really fast, but boy was I ever wrong! Being similar means that you both enjoy the same things, and you don't have to force each other to sit through stuff while only one of you enjoys what he or she is doing. Those little differences with regards to what guys and girls like become negligible and instantaneously forgivable, since you still have so much in common to like and get along with. 

Needless o say, I'm quite pleased with the way things are right now, and I expect things to remain this way for a long time to come.. :) after all, so does she.. ;)

On the other hand...

This was written shortly after the previous post...

I'm also grateful for the chance to get away from the hospital for a while. My patients are (hopefully) pretty much stable for the past few days, except for that newly intubated one which made my morning pretty busy after going through that grueling case conference.

Hey, I guess I got through that pretty much unscathed! Thanks to my dear consultant moderator who took one for the team and gamely answered most of the weird questions asked by the consultants. I had to answer the basic academic stuff of course, but the advanced technical stuff that a level 1 fellow wound not normally know were covered by him. I'm also grateful to my consultant reactor, who really took time out to make a presentation in front of the body so that the conference would be a lot more interesting.

See, this is what happens when you let a burned-out doctor rest. He becomes a lot less crankier and a lot more insightful. :) I just hope this tides me over the next couple of days until the seniors go back to their original posts after all the craziness of the interhospital conference has subsided.

Come to think of it, i never really had the time to bask in the thought that my case conference ordeal for this month is finally over.. And to think that it was accomplished amidst a lot of tiredness and procrastination. Such wonders a looming deadline has on the productivity of a person. I think it shot up by about 200% i actually even left the house at 5am the previous day to make early rounds just so I could lounge around the house for roughly half the day, and devoted 8 intense hours to the completion of the presentation. Hehe :P

Although it is an experience I don't want to go through again.. XD

I promise to put on a much better showing next time, especially if I find the topic particularly interesting..

My ass hurts from all this sitting though.. i wonder when I will be relieved?..

This is stupid

The following post was typed the day before while at a different location

-------------------------------------------

Among the myriad of jobs a fellow has to do in our institution, accompanying patients to dialysis ranks among my least liked. It's a total waste of time, especially if your duties for the month leave you pretty much occupied. Its a different deal when you're the floater though, as you can use the tine to kick back and relax as you waste the day away. XD

I can't wait for this damn academic year to be over.. I absolutely despise going on ER duty, and i yearn to taste a bit of a schedule change beyond the Pre-Duty-From cycle that I have grown accustomed to throughout the years.. Heck, I just wanna be done with training, period!

I yearn to have the opportunity to finally live my life according to my own design.. I long to break free from the confines of a duty schedule, from running after annual academic requirements. I want to be able to take an actual vacation where I can truly rest my weary mind and body which has been worn down through the years as a result of the rigors of hospital training.. It may sound shocking, but I want to have the opportunity to not be a doctor for a while... I just want to live anonymously in peace and not be bothered by anyone, including patients. Call it being antisocial, call it whatever you like. I don't really give a crap. Chances are, if you're reacting like that, you're probably one of those kinds of people that I'm trying to get away from..

I'm really going to stick to my rule of not giving out my phone number to patients. I value my personal time, and patients have no business bothering me when I'm away from the hospital or my duties. I don't think I would love my job enough to be immersed in it 24/7. Besides, there are some other roles in life that I need to make room for in the future which would demand my utmost attention, like being a dad or a husband.. ;)