Hello Fellow

There is a lot of confusion generated by doctors with the title of FELLOW, especially among the non-physicians. It can get quite convoluted, since sub-specialty trainees are called fellows, but so are esteemed members of medical societies who are obviously not trainees anymore. So, to set the record straight, I did some light research and here are the best explanations I have read:

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1) The FELLOW as a TRAINEE:

A fellow is a physician who has completed their residency and elects to complete further training in a specialty. The fellow is a fully credentialed physician who chooses to pursue additional training, the fellowship is optional and is not required to practice medicine, but is necessary for training in a sub-specialty.

2) The FELLOW as a distinguished member of the medical society:

Fellows are a special group of physicians who are dedicated to continuing education in medical practice, teaching, or research. Fellowship is an honorary designation given to recognize ongoing individual service and contributions to the practice of medicine.
Fellowship is a mark of distinction. It says that your physician has made - and continues to make - special efforts to be a better physician. Ultimately, it says your physician cares about delivering good health care.

How does a physician become a fellow?
Physicians must show that they are always growing and learning in order for the honor of Fellowship to be conferred. They may show this through activities such as teaching, hospital appointments, public service, community health planning, continuing medical education, publishing articles, and advanced training.
They may also be recommended by other Fellows who must attest to their character, ethics, and excellence in professional medical activities (This is usually the case here in the Philippines)

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 * A quick additional note about the distinguished fellows. Being conferred the honorary title of fellow of the society grants you the privilege of adding an additional acronym after your name comprised of the title (Fellow), followed by the society that gave you the distinction, and this is usually placed after the MD.

Example: Juan Dela Cruz MD, FPCP (Fellow, Philippine College of Physicians)

There you have it! I hope this clarifies things for a lot of people out there, especially the younger doctors or doctors-to-be, who still get confused by the hospital hierarchy.

Gratis

I'm getting tired of working for free, especially with paid opportunities abound. You can just get by on so much good will and good intentions. If nothing improves, I might have to make drastic moves I never thought I would do.

Death in the family

A beloved relative passed away recently due to natural causes. Prostatic malignancy with spinal metastases to be specific..

There were plenty of coming-of-age moments I encountered because the last death in the family occurred when I was still quite young and not yet taking part in the responsibilities of family logistics.

I was able to watch an embalming process for the very first time. I have seen my fair share of cadavers and patients who passed away in front of my eyes, so I was no stranger to death. However, since this struck a little closer to home, it made me be a bit more introspective with my musings. My father commented while we were watching the process that when someone passes away, the body is reduced to a mere shell.

He was right, of course. The person, the very essence that defines who we are leaves the world with death. The body left behind is a mere representation of the person who once was.. It suddenly dawned on me that this was going far beyond the physiologic concept of cellular death..  

What makes a person alive? Is "living" just a summation of all the different specialized cellular processes that occur inside everyone every single day? It kinda baffles the mind to think that we have evolved from a single-celled organism, that eventually banded together with other cells forming aggregates. Eventually the mass of cells developed particular functions for different parts of the cellular mass, like digestion, circulation, sensory perception, higher intergration, etc.. So if this is the case, is the very essence of who I am (well, at least the cognitive part of me), defined by the mass of neurologic tissue situated within this bony skull? Am i just a living brain, subserved by masses of other organs that work with the single goal of sustaining the brain? If this last statement were true, then why do bodies still work in the case of comatose patients or those who have already suffered ireversible neurologic injury? Could we say that a person is still truly alive when the brain is gone? I'm not talking about cellular life or death here, but the essence of who the person is..

Does that body become just a living shell, able to sustain basic life functions but unable to truly live?

I still find myself going back to the evolution from a unicellular organism. In essence, the eukaryotic cell, with all its specialized organelles, is a microcosm of the multicellular creatures with different organ systems. No wonder the multicellular organisms evolved like this, they were just following a pattern inherent to nature itself.

Does my brain organically define who I am, since it is the source of all voluntary acts, and is the repository of information for all my experiences?

I'm still struggling to fathom how a densely packed bundle of gelatinous material capable of electrical conduction could be the cause of so much in this world, both good and bad..

Going one step further, why would the brain mass be so concerned with pursuing things that would only serve to pamper the shell which it it housed?.. But yeah, I re-read that sentence and it seems to make sense after all..

I think I'll stop here for the meantime.. All these cellular concepts are making my protected cellular mass hurt :P 

Getting back on track

No, this is not a kickstarter post to trigger a cascade of productivity, actually it's quite the opposite. Believe it or not, this post is actually a byproduct of enhanced productivity.

I recently attended a seminar on motivational interviewing as part of my duties as the SC clinic head. It wasn't really heavy content-wise, but I guess that was not the point of the speaker. She wanted us to experience various aspects of being interviewed in order to be able to develop insights into empathy  which would hopefully lead us to develop techniques that would work on the patients that we see.

Some of the exercises of the seminar involved making one vulnerable by opening up about a problem or roadblock that you have been encountering. I think it was about things you needed to change/give up for the better. The responses were varied, but most people went with food excess. I chose to discuss my excessive screen time, particularly with the tablet. I identified this as problematic because it cut into my productivity and even my sleep time. I guess I;m at this point where I wasn't to maximize my productivity but am still struggling with leaving the past behind (in this case, my 3-year old Galaxy of Heroes account hehe).

It's still a struggle, but I guess opening up to someone about it (my OPD boss nonetheless) has kind of set something in motion inside me. Owning up to the solvable problem to others enables them t hold you accountable for it, and may thus drive change more than just a simple note that you would keep to yourself.

I have also been contemplating taking up a masteral course, since my prospects for subspecialty training abroad have gotten slimmer when I took a step back to consider the massive logistics (and finances) that it would take..  A strong, solid program that can be accomplished locally and satisfy the bigwigs at the hospital would be more of my style. I'm not getting any younger either, so I find myself less than eager when faced by the prospect of spending my money frivolously.

One of the things my auntie doktora told me before she passed away was that a doctor is a perpetual student, that one should always strive to learn new things in order to move ahead in life. I guess that applies to beyond the business of "doctoring". I do have a thirst to learn something new, and hopefully be of service to others in the process.. So yeah, I'm taking a step and holding myself accountable.. I'm openly declaring that I will be pursuing further studies by next year (after certain commitments have already been resolved).

I hope I'm not biting off more than I can chew.. But then again, I already know the answer to that, right? ;)

Trapped in a corner

Ok, that title seems more serious than this post really is. 😅

Things have been pretty busy lately, but not so much writing-wise, and I kinda need to get started again because of a lot of paperwork that is coming my way. I guess I got a little burned out from the previous month with all of the Lung Month stuff that went on, and all the work that went with it. So with that, I begin this post.

Life has been stable for the most part. Work is picking up somewhat, and referrals are really helping make ends meet. Still not confident though, because cash flow still is unstable.. 😩 I guess that's the problem practicing in the Metro as opposed to starting out provincial..

I guess that's enough for now. I want to make these kickstarter posts separate from the ones with actual content.

NBA Memories and the 2019 Finals

So my last post was way back in January huh? Talk about your long intervals..

Normally you wouldn't find me blogging about the NBA anymore, but I decided to make an exception this time around in celebration of this momentous event.

First off, you gotta give mad props to the Toronto Raptors. They pulled off a highly improbable victory against a feisty Golden State Warriors team that fought toe to toe until the end despite being hobbled with injuries to key players at critical moments.

I won't go into the debate wherein people would say that this was just a fluke for Toronto and that they would be forever be questioned since the Warriors did not have much of Durant during the series and lost Klay Thompson to an ACL during the final game. I will say this though, that people also need to remember that Golden State capitalized on injuries during their championship runs too. In short, "Quits lang" :P Ok, enough about that..

I have been following the NBA avidly ever since late grade school, around the time of Jordan's second coming. It started kinda late for me because I wasn't really into basketball as a child due to my physical limitations because of my neurologic deficits. That and the fact that the only NBA exposure I used to get was the odd episode of NBA action that I would see from time to time on Saturdays.

My interest shot up when I got together with the boys. One of my earliest NBA memories with them was watching the NYK-HOU Finals during a birthday. After that I was pretty much hooked.  BestFriend even gifted me with a Barkley jersey from one of his trips abroad for use during our jam sessions.

Eventually cable TV and the internet came around and made the NBA all the more accessible to my corner of the world. Dynasties were pretty much the norm in the NBA, what with all the championship gear the Celtics and Lskers have accumulated through the years. Chicago was also pretty dominant in the day, with Jordan getting 6 rings before eventually hanging up his sneakers for good and becoming a back office guy for the Hornets. Too bad Barkley was denied his own trophy though. :(

I was also witness to the impressive performance put up by the Pistons to win a chip against a heavily favored and methodical Lakers team bannered by Shaq and Kobe. That was a series for the ages.

One of my most favorite runs in recent years was the 2008 championship run by Boston's "Big Three" of Garnett, Allen, and Pierce. Being a Garnett fan since his time in Minnesota, it felt really good seeing the Big Ticket get to win one for himself.

The emergenco of Lebron James seems to have ushered in a new era in the NBA where the balance of power would tip where the players would want it. Now you have superteams of players getting together by themselves, putting  together their own teams for a shot at immortality. AS expected, the competitive balance of the league began to be heavily skewed. It seemed like the championship trophy would follow lebron whereever he went, although the Spurs had a lot to say about that. :P

The most recent iteration of a superteam is embodied by the Golden State Warriors. They have a pretty stacked team that was seemingly unstoppable. I initially had no problems with them, since the team was patiently built over the years to become the powerhouse they are. I respected that. Then came the serpent known as Durant. He joined a stacked team that had just beat his ass the previous season and didn't really need him to win anyway, and just made them totally unbeatable. That's when my interest in the NBA waned dramatically, since the championship outcome seemed to be a forgone conclusion. What would be the point in watching anyway?

That's why I'm really happy for Toronto. I seem to have this tendency to root for the underdog, and also tend to side with the team that has not won a chip ("Give chance to others" is a big part of my morality). I'm also happy that the stranglehold of Golden State has been broken and the NBA can be fun again. 

This may sound pretty cold, but I'm happy that Durant will be taken out for a season to recuperate. I hope when he comes back he would have reflected on the impact his actions have caused in the league and how he ruined the competitive balance of the teams. Truth be told, I liked him a lot when he was with harden and Brodie on the Thunder. That was a pretty fun team. 

Leaving a legacy

Ok, so the title seems a tad too heavy compared to the actual content. However, I had a moment of clarity a while ago (while in the shower) about legacy-building, and how the stuff we leave behind will affect others. It may be something grand like a monument, an amazing architectural feat, or an impressive achievement that would stand the test of time. Looking things on a smaller scale though, you would find that each of us is leaving his or her legacy in our own little seemingly insignificant way.. I'm talking about the stuff everyone puts online.. 

I won't go into the intellectual and philosophical arguments about one's online presence, but will instead be commenting on my own footprint on the web, particularly this blog.. Looking back at the archives, I apparently started blogging 15 years ago as a way to pass the time during medical school.. I believe I had started out in Blogger before I migrated to multiply, then back again when Multiply decided to sell out and convert itself into a pure online marketplace, which left the casual bloggers and photodumpers out in the cold (remember, this was way before Instagram became really mainstream). I do not remember what content I had there, or if I was able to successfully migrate the entries to Multiply. As such, 2004 will now forever mark the starting point of my official blogging history.

Going back to the theme of this post. When I took a trip down memory lane and viewed the blog posts from the very beginning, I realized that I wasn't really producing much content as I was just using this as kind of a stream of consciousness dump for catharsis. It may have been good for my psyche at the time, but now it all just looks so messy and disorganized. Having said this, it is now my goal to clean up this blog and get rid of all the unnecessary drama or negativity. I won't be altering posts since I still want this blog to be a life chronicle of sorts, but I shall be deleting what I would consider as just background noise which are deemed irrelevant to the overall narrative.

I guess that's all for now. This is gonna take a lot of work. :P

2019 Yearstarter (Better late than never)

I have been looking for an opportunity to just sit down and jot stuff down but the chance always escaped me..

It is now already a couple of weeks into the new year, and I have failed to put up my annual retrospective, nor the "yeartstarter" that usually takes its place when I lag behind. hehe.. 

Seriously though, so much has happened this past year that I don't know where to begin.. Couple that with all the negativity in the news and in the country at large, and I have an exhausting pile of data to sort through and work with.. @_@

So now it has come to this. I shall try to try my best to condense what has been a roller-coaster of a year into a few paragraphs. :P

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2018 has been a year of tremendous upheaval in my life. It was a whirlwind of life-altering changes and fresh new experiences I never thought I would witness..

Obviously there was \bringing everything to conclusion by passing the boards. At the same time my other half has began her training in earnest, and we're quite pleased to say that she hasn't looked back ever since. Sure she ran into some hurdles along the way, both academic and otherwise (especially the annoying problem of bad incompetent seniors), but I guess the experiences have toughened her up and helped her personal growth. The hurdling of the examinations led to a new frontier, the start of practice. I wanted to try to accomplish things firsthand, like registering with the taxman, walking the papers and whatnot, until I was satisfied that I had a grasp of how it was to run your own simple practice the right way.

I was also granted the brief opportunity to present a couple of papers at an international academic forum. Who knew that research could turn out to be so satisfying and rewarding? ;)

A great many minor things have also happened along the way, some of which I consider as big steps in terms of personal growth.

Overall, I guess the themes of this past year was LEARNING and GROWTH, and I hope this year will see more of both. :)

Having put this down has apparently defused my need to rant about the ills and failings of society, particularly the local variety.I guess that is going to be a different piece for another time.