News from the frontlines

* Before I begin, I would like to state that the following piece I write here is based on my opinions and observations alone, and am not part of some cockamamie government plot to spread disinformation or other shit. Don't associate me with that garbage. A lot of crazy people of the internet throwing crap at innocent observations lately. Sheesh.

**EDIT: I have to clarify that my observations are from the standpoint of a Metro Manila hospital only, since I know the situation is  different elsewhere like in Cebu where cases are unfortunately spiking as of the moment.

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Ok, now that I got that disclaimer nonsense out of the way, its story time.

Things seem to have been winding down with regards to Covid at the hospital. One of the designated Covid wards has been converted back to regular (non-covid) use, and hopefully we'll be able to get the Sleep Lab back within the week. Though it is true that the number of cases is still increasing, the death rate remains quite low, and the Covid admissions has slowed considerably when compared to the shitstorm that was March 2020. Even though the general rate of admission has not slowed down, a greater proportion of the cases we are seeing are the usual admissions to the hospital which do not necessarily have Covid.

I think the reasons for this are threefold:

1) More testing and faster turn-around, so of course you would have more positive results, but we are now catching more asymptomatic and healthy individuals which do not need to be admitted at the hospital and are able to safely recover on their own.

2) We are getting better at managing Covid cases. Let's face the facts, this was a new disease and treating it was such a struggle for everyone across the globe since nobody had any idea what to use or what would specifically work since there was no preexisting data. Doing research on new treatments isn't easy, and if you're such a smartass to say that doctors slacked off, why don't you get off your lazy ass and do the clinical studies yourself to see just how complicated things are?

Sorry, I got a bit sidetracked for a moment.. :P I'm just so sick of all these armchair scientists who aren't worth a damn in real life chastising healthcare workers as if their opinions mattered.. Anyway, there are now more interventions in our armamentarium like the use of tocilizumab and hemoperfusion, as well as the modification of protocols like the shift from early intubation to a preference for non-invasive oxygenation like high-flow nasal cannulas. As more information is gathered and shared across the board, we will get better in managing the disease collectively. Gotta give props to all the researchers that shared their information freely as soon as it came out which helped all of us treat the patients better. (No, not you China. You sit in the back.) Thanks  to the deluge of vetted information, people are more confident in their management approaches. Compare that to the early panic we experienced during the first two months where patients were expiring left and right and we felt powerless to do anything about it.

3) The lockdown worked (somewhat). Let's face it, the Philippines has never been a perfect example of good governance or a compliant population, but somehow I think we got this one right.. for a few weeks at least. Yes, the lockdown could have been a little earlier, and yes the ban on Chinese travellers should have come much, much earlier, but when I compare the present Philippine situation to whatever the hell is happening in the United States and Brazil, I can't help but say to everyone that "you did a relatively better job, somewhat.." Consider that if we did not have as strict a lockdown as we did during the crucial first couple of weeks, our numbers could easily surpass the crazy infection and death rates they have in the States. People eventually got cabin fever and began violating in little ways, but for the most part people have been compliant, and I noticed that during my daily drive to and from the hospital. I follow the news in the US to see how they were coping as we went through our own pandemic experience, and I have to say that I'm shocked at the way these Americans seem to value freedom above safety and common sense, to the point that their obsession with absolute freedom borders on lunacy. I can only shake my head and scroll down.. No wonder their healthcare system is so overwhelmed. I honestly expected so much better from the country where we get our medical books from, but then again, its' not the fault of the doctors there, but the uncompliant populace.. Oh, but it's also unfair to blame it on an uncompliant people, because their leaders initially didn't believe in all these social distancing measures either. I never thought I would see the day that I would encounter Filipinos (who admire the US a lot ) who would say that "I'm glad I don't live/didn't move to the States". Grabe, how times have changed.. and now you have these racial tensions boiling over at the worst possible time.

Going back on-topic, we have to bear in mind that the lockdown was not meant to make us hide in a bunker until this Covid plague blew over like a passing storm, like the Israelites hiding in their homes during Passover while death befell the firstborns of Egypt. It was meant to push transmission rates down so that the hospitals could catch up and prepare better for the surge which unfortunately came earlier than we would have liked. Eventually we caught up though, and the hospital underwent a major restructuring to convert a majority of the hospital infrastructure into isolation wards which are better equipped to handle these Covid patients. Proper donning and doffing areas were put up, and designated "hot zones" were strategically created for safe movement of patients and personnel. This also helped a lot in keeping the hospital personnel infection rate to a bare minimum.  It was such a massive undertaking, and we have to thank the many donors who lent us support to help make that happen. Many thanks also  to the PEE and food donors who sustained us especially during those early trying times when despair against a lethal invisible enemy was the general feeling all around. We could not have done it without you.

4) People are still generally careful, and it helps. With the exception of those stubborn idiots with uncontrollable cabin fever (and probably underlying psychiatric illnesses),  I'm happy to observe that people are following distancing and protection guidelines as they are issued. Just to be clear,  I'm not beating down on those people who were forced to leave their homes to try and make a buck, because people were already getting hungry because of the shortcomings of the government, especially at the LGU level where I heard that even barangay officials were at fault due to greed, politics, or both... Really? In a pandemic?.. How low can you get?..

Wow, this has been quite long already, but expected since I had such a long time yo ruminate on what I wanted to get across. As we slowly open up to this new normal before us, I hope that people will still be responsible and keep each other safe, To those who suffered through the lockdown, thank you for your sacrifice and compliance. It's because of your contribution that things didn't spiral out of control as much as is happening abroad. Like I said before, I am cautiously optimistic that we can all get through this safely and not be overwhelmed by the pandemic, since the mass production of a viable vaccine is still a few months away.

Please, let us help each other get through this.  Comply with distancing guidelines. Keep the vulnerable at home for a little while longer. Wear a mask in public. Support local businesses. Don't be an irrational asshole who just wants to do whatever he/she wants without regard for others. I hope this experience would change a lot of people for the better, and help them realize that there is more to life than always just looking out for yourself.

Locked Down

Damn.. A lot can happen in a  couple of weeks..

We are currently about 1 week into the lockdown of Metro Manila which was brought about by the onslaught of the new coronavirus which originated in a wet market somewhere in China *why am I not surprised?).

It hasn't been pretty. Thousands have died in China alone, and although it is seemingly fizzling out already there (new case rates have allegedly bottomed out to ZERO for the past several days in mainland china), it is just emerging in other parts of the world..

An actual PANDEMIC.. I never thought I would see this in my lifetime..

Tensions are running pretty high, but I guess people have kinda adjusted to this new norm. In my part of town people have been generally compliant, although I'm not too sure in the less fortunate areas where people are often belligerent about following rules and regulations due to a poor understandign of the current situation.

There were some really crazy scenes during the leadup to this lockdown. I witnessed firsthand a couple of panic buying situations at the local supermart. We had luckily stocked up on other esentials just the week before, so I wasn't reallly pushing around a cart with a mile-high pile of tissue paper. :P It was soo errie. The mall where I had clinic was basically closed except for the basement level containing the supermarket, a bakery, the clinic, and a cafe (presumably for those senior citizens awaiting their companions who went for groceries). The fastfood was obviously closed. Since I had some lead time before my clinic hours, I explored a bit. The air conditioning was turned off, and the mall was deserted.. I had never seen that place so quiet, save for the occasional footsteps of random store staff checking on their places of work.

As the days went by, stricter measures were put into place, hence the second wave of panic buying. The entirety of Luzon was now under community quarantine, with travel out of homes strictly being monitored and implemented by the local officials, law enforcement, and armed forces. It has been peaceful thus far, with most of the battles being waged in the hallways of hospitals across the country. Being a respiratory physician, I find myself thrust into the frontlines of this new conflict, and I have to admit that I am afraid not only for my life, but more for the people I love.. But these are trying times, and I have to put up a brave front to do what I have to do because this is what I signed up for.. Make no mistake, there is a great temptation to just run away and stay huddled indoors amidst the safety among family. There could always be excuses, to take the easy way out. But this is not compatible with the reality on the ground..

I want to go on, but it feels so heavy already. So much sad news in such a short span of time..

It all boils down to greed

I noticed that the tone of this blog has lately veered from the personal to the realm of current pressing issues. This entry will be no different. There is just so much going on in the world now that bothers me, and even though it is not my objective to polarize people by way of my opinions or be a social media influencer (whatever the hell that means), I feel this need to put my thoughts down as it has proven very cathartic for me to do so. 

In short, I'm doing this not for your amusement or attention, but for myself and myself alone.

Among the great many issues floating around today, few have been as enduringly infamous as the so-called war on drugs here in the Philippines. It's actually a good idea if you think about it. The president of a nation declaring an all-out war on one of the most virulent ills of society, promising to use any means necessary to pull it off. Although I do not personally approve of the mounting death toll, I won't exactly call out against it either. Let me explain..

Drugs are a menace to society, period. Drug make people do a lot of crazy things, including heinous crimes like rape and murder. Personalities are destroyed due to addiction, and you are left with a hollow shell that would do absolutely anything and everything to get another fix. This is why you get reports of people killing their parents/grandparents because of the latter's refusal to provide money for drugs. Drug addicts are a scary lot. You have no idea what they are thinking. Previously personable individuals are converted into these monsters who would do violent stuff on a whim, or may easily be set off at the slightest provocation. They could do dangerous things on a simple "trip", causing much harm to themselves and others. I mean, I wouldn't really give a rat's ass if a crazed drug addict commits suicide, but when that act involves an innocent drug-free bystander getting hurt or killed, that's one of the most senseless ways to die in my opinion and thus should be prevented at all costs. The addict is usually beyond redemption, while the innocent bystander could very much be a productive member of society.

Addicts in their drug-fueled states could have no inhibitions or remorse whatsoever, and are thus an ever-present danger to those around them. Then when they wake up from their drug fix behind bars, they act all surprised and horrified at stabbing a baby or decapitating their ailing grandmother. The list of atrocities just goes on and on, and thus I agree that it most definitely is a war.

These substances in question, especially the synthetic ones, serve no true useful purpose to society. They are just created by unscrupulous individuals for the sole purpose of generating a quick buck without any regard for basic human decency of human life in general. I agree that all of this would be able to stop when the drugs are cut off at the source, otherwise the cycle would just continue.

The junkie would continue to commit crime in order to get his fix (think of those who rob peope in broad daylight then stab them as well), which in turn would support the supposed "livelihood" of the pusher/dealer (who turned to peddling drugs in the first place  because it was such an easier way to make money than to get an honest job with an unfortunately smaller paycheck). The money trail would then be traced back to the big shots who get all the dough from the manufacturing of said substances, and as always, they also prefer this mode of "livelihood" because it is an easier way to make lotsa money.

So I guess it all stems from the greed of those individuals at the top of the illegal drugs food chain. They are unwilling to let their empires go because it makes damn too much money which would support theit overly lavish lifestyles since they aren't accustomed to simple living. it's just greed, pure and simple.

Imagine a perfect scenario where all the illegal drug manufacturers (along with all their stockpiles) suddenly just turn clean, (or are carted off to hell where they belong, I dont really care). The supplies would dry up. Sure, some addicts who are far gone might not survive the subsequent withdrawal, but the rest of the population would hopefully pick up new decent lives and work together for the development of all. Remember that the drug problem permeates all levels of society, so in addition to the masses becoming more compliant (since drugs are no longer an issue), the people higher up would hopefully take up cleaner pursuits and actually serve the public for once now that they're no longer preoccupied with keeping their trail clean or doing shady dealings with the underworld.. 

There would be other great effects when humanity as a whole would decide to just drop greed and be more focused on helping everyone else. It's too much of a utopian vision, I know, since these syndicates are too far gone along their path of evil acts that it does not bother them anymore. Heck, I don't think it even bothered them in the first place anyway.. And that makes me sad.. I find it impossible to imagine anyone cooking up this plan to sell poison to people on such a massive scale with all the associated societal ills it would bring. People are capable of effecting massive change and doing great things in the world. The seemingly far-off dreams of a human race maximizing a sustainable environment and exploring what lies beyond the planet is supressed by humanity's inability to just chill out for a moment and see that being collectively selfish ins not good for anyone.

The trend in society today is to place a more intense focus on the individual. Now before I say anything else, I would like to state for a fact that I do not like the idea of communism. Its another extreme that would inevitably destroy people's lives and only works if people are not people.. :P

Everything today seems to be centered on making the individual happy, like feeding our individual egos through seeking hollow approval via  social media likes, or promoting this culture of ultra sensitivity or ultra-tolerance. I hate a bigot as much as the next guy, but it is also foul when someone goes the other extreme endlessly pushes this selfish agenda just because of a presumed notion of self-importance and entitlement. 

People sometimes laugh at nuggets of wisdom passed along by our elders, but I guess the saying "Too much of anything is no longer good" applies universally given the very basic nature of people. Taking something to the extreme on one end of a spectrum or another is never a good idea and just promotes hatred, friction, and intolerance.

I'm sorry to have been posting such negative stuff lately, but there is just so much I need to get off my chest..

A follow-up to "Imposed Brotherhood"

I realize that my previous post may have raised more questions than answers due to the nature of the content.. I will admit that I also found it quite lacking, and so will do this next article to clear the air and drive certain points home which I want to get across. So, lets get to it, shall we?

I was a neophyte once, and I didn't like it. I quit after 3 days. The stuff I said about not experiencing any form of physical assault was 100% true. I cannot speak for the rest of the inituations (since I quit already)  or the experiences of neophytes from other med frats whether they were physically hazed or not, so I will just leave it at that.

Why did I quit? To tell you frankly, it was so exhausting, and I began to see my grades suffer. I was flunking the easiest quizzes. My family knew what I was going into and was worried sick every night, and though they did not physically prevent me from going through it, I knew I had to stop. My tuition wasn't being paid for me to join an exclusive society, but to train to become a doctor. I was deviating from the goal.

I had a tongue-in-cheek comment about regretting not getting the frat swag, but in all seriousness, I may have felt a bit of regret at first since I was somewhat invested already. As time wore on and I climbed the proverbial ladder of the hospital hierarchy, I began to realize that it was just a foolish pursuit all along, and that membership in these organizations is NOT NECESSARY AT ALL for future success in training and practice. Though it may be true that it would give some minor advantages at certain points, you will do just fine without them. ;) Given the current state of things regarding fraternities in general, I would like to say that I am glad and relieved that I didn't push through with it when I was still a student (as are my parents).

It is definitely NOT something I would recommend to try "just for the experience". You never know what goes through the minds of these people, especially those in leadership positions during their time. So be smart, be safe, and just stay away from membership. These people can still be your friends outside the context of the org anyway. If not, then they probably aren't really meant to be your friends to begin with. :)

Imposed Brotherhood

One of the prevailing headlines recently is the unfortunate passing of a first-year law student who apparently died of complications arising from severe physical trauma due to an underlying hypertrophic cardiomyopathy. This may have been from either an arrhythmia or a myocardial infarction (less likely). The main point of this post is not to discuss the medical side of this heinous event, but to put in my own two cents on the fraternity issue which overshadows this entire scenario.

 When I was much younger. in high school in fact, we were made to watch this locally made 80's movie entitled "Batch '81" which was centered on the story of an aspiring neophyte and his initiation into a Greek-letter society (aka fraternity, although some fraternities here do not necessarily use Greek letters). I will refrain from reviewing the movie here, as there are a great many more reputable sites that you can turn to for that information.

I guess the point of having us watch the movie was to show us the "horrors" of joining these so-called fraternities, these secretive societies founded on precepts of brotherhood which was forged through a common horrible experience known as "initiations". Another point driven home was the inherent danger of unquestioning loyalty to these organizations which resulted in spats with rival frats, which could then evolve into full-blown criminal activities like homicide and murder, all done in the name of one's fraternity above all else. :(

The initiation rites themselves that were portrayed were pretty brutal, and the physical punishment meted out was likely founded on solid facts based on injuries sustained by hazing victims in real life that were examined postmortem, as well as testimonies from former neophytes.

There was also a chilling example of a fraternity rumble which may or may not have resulted in a fatality or two.. (spoilers much? :P)

Needless to say, my teachers got the message across, as I found the movie to be deeply disturbing which was more than enough to keep me away from fraternities in college.

To be honest, being a part of a fraternity in college never even crossed my mind and I wondered what would convince some people to join. They were perceived as troublemakers more akin to street gangs than honor societies. I have seen evidence of this outside the confines of the university, where fraternity graffiti used to be seen contaminating the walls and gates of our neighborhood alongside what were eventually identified as gang signages. Thank goodness these things are now long gone..

I only knew of a handful of individuals in college who were members, and none whom I knew personally. You would see them congregating at a designated place on campus meeting, scheming and hanging out. While I had no personal interactions or incidents with any of these identified fratmen, they gave off this seedy vibe not unlike what you see among neighborhood toughs or gang members, which was a far cry from the educated university students they were supposed to be. I once had a classmate whose cellphone was stolen by an alleged neophyte in broad daylight which was supposedly part of their initiation. The neophyte probably had no choice but to steal the phone since his "masters" told hin to do so.. Nevertheless, it was a blantantly criminal act, and my classmate never recovered her property. (I guess it would have been a much different deal if it was eventually returned to her by one of the fraternity members, apologizing and explaining that it had been all part of the initiation, but I guess they're not as honorable as we would like them to be)

Initiation? More like on-the-job training if you ask me.. :(

Perhaps my limited exposure to these university-wide fraternities was because I was in the medical field, as I heard that membership was much more rampant in the other courses like engineering and commerce. 

As life went on and I got a little older, I was able to reflect on what would drive someone to join one of these organizations  despite their dubious reputations and shady activities.. Organizations that force you to have absolute loyalty to these other people and have their back regardless of anything they do just because of some twisted manifestation of "brotherhood". It doesn't matter if you would get along with them outside the confines of the frat or not, it doesn't matter kung masama ugali niya and he would seemingly get you into trouble. You're brothers now, and that is all that matters..

At this point some of my more avid readers would point to the fact that I had once attempted to join a fraternity myself when I was in medical school. I promise that we'll get to that later on. Generalities muna tayo.. ;)

A fundamental concept these organizations preach is a true sense of brotherhood (or sisterhood for sororities) which is forged in the fires of a shared traumatic experience (initiations) which had been endured to the end, thus granting the survivor the "elite" status of "fraternity/sorority member" because he/she was able to prove his/her willingness to be a member as well as his/her loyalty to the frat/sor. The initiations would serve to galvanize that trust between neophyte batchmates, as well as provide a sense of solidarity with those that have already gone before (since they supposedly went through the same thing, so, brothers/sisters?). Some of these organizations have such wide membership scopes encompassing different colleges/universities, and some even have community-based chapters (but the latter seem to be more gang-like in their activities)

Admittedly, a mild version of this could be seen in daily life. An example I could draw from would be our personal experience as medical trainees, be it in clerkship, internship, residency, or fellowship. There is this prevailing sense of community with one another since going through training is admittedly a tough experience. Completing a program (and passing the boards) earns you full acceptance among your former trainors-turned-peers, as well as others who have attained the same level. I personally liken the people from my residency program as a kind of family, and I have this desire to help them achieve what I have achieved. Loyalties are not mandatory however, and you have no right to call someone out for being disloyal to a program unless you're being a fanatic and/or a total nutjob. :P

Since the former neophyte is now a full-fledged member with supposedly unbreakable ties to his organization, he could supposedly reap the benefits of being such. In college it would sometimes mean access to old examinations (or even upcoming exams if a prof is a brod.. but hey, isn't that cheating? Oh, they don't give a shit), or even better grades (same principle as before). For the more violent people, it would mean you would have an automatic "resbak" (backup) when you get into a scuffle, which would further embolden the troublemaker since violence is really his thing. Other benefits promised could be aid in securing a job from brods positioned in higher positions, or even government assistance when caught in a pinch (akin to criminals going scot free despite the evidence because they have bribed a judge or someone higher). I can only shake my head in disbelief at this.. I would expect that these organizations would have a code of conduct set up by their founders to prevent abuses, but if you think about it, would you turn your back on a brother who went through hell with you just because of some stupid infraction of some stupid rule written long before by some dude who probably didn't have the absolute same initiation experience anyway (being founders and all)? This dangerous situation is probably why these organizations find it difficult to clean their ranks (if they ever tried at all) and would thus descend into the gang mentality.

Looking back at the histories of fraternities (what follows is NOT Wikipedia gospel truth, since this will be just from my memory of previous researches out of curiosity and discussions with lots of different people), these Greek-letter societies weren't all bad to begin with. In fact, the idea behind them was pretty idealistic. 

Fraternities in US universities started out from a need for companionship. Think about it, the typical college student in the US would be miles away from home, not really knowing anyone (a few friends from high school if he's lucky), and would be struggling to fit into college life. These frats would provide supposedly undying friendship which would be nurtured in school and continued after graduation. They would have all sorts of activities to engage the community as well, and probably serve to make the college experience more richer than it would if you went through it all by your lonesome. A lifetime of benefits in exchange from a temporary agonizing experience.  I heard that it wasn't really that violent in those days, with public humiliation being more of the norm rather than being beaten up black and blue. I won't delve into the state of those US frats nowadays since this would be way off-tangent already, but based on the news I've been reading, it appears as if these Greek-letter societies are now only interested in parties, booze, drugs, and rape.

Fraternities arrived at Philippine shores during colonial times, and I guess the concept was pretty good before as well. The big universities would have enrollees coming from all parts of the archipelago and the Filipino freshman would be alone in the big campus without anyone to turn to. It would be heartbreakingly lonely, and it is human nature to seek out a sense of belonging. That's where the frats would come in. They would promise you lifelong camaraderie, and exclusive benefits that you wouldn't even begin to imagine. All they would ask is for you to undergo their initiation rites, some of which can last for months depending on the by-laws of the organization. It all seems very neat and systematic. So why the hell should anyone have to die?

I would understand that any society promising exclusivity and an elite status would have very stringent requirements for membership. However, the amount of violence that comes associated with these hazing rites is just batshit crazy.. Humiliation is already a very potent tool, as it would bring a person's morale down to the point of giving up. So is making a person do endless exercises to the point of exhaustion (although this would also be deadly if done in the wrong situation). So why would violence be needed? To prove toughness? What for? Is it because violence is also a part of what being in a frat is all about?

The amount of sadism needed to inflict such injuries to a helpless person is just mind-boggling. I imagine a neophyte hunched forward with his pants down enduring hit after hit by a hard wooden paddle or other similar blunt instrument, and I get sick to my stomach.. :(

There have also been stories of girls joining sororities who would get felt up and raped by "masters" from the equivalent fraternity during initiations. These victims do not come forward because they fear for their lives and/or value membership in the organization. :(

They say the purpose of the initiations is to break you down, ego and all, to lose your individuality and hopefully emerge (after much brutality) an absolutely loyal pawn who would put his organization and its members above all else, never mind ethics and basic human decency, because you literally went through hell and back just to get this far.

The adult in me looks back at these college organizations with a tinge of disgust at the audacity and stupidity of youth. It appears as though these are a product of bad, poorly-informed choices made by insecure teens who don't know any better and value a sense of belonging above all else.. Which in turn would speak volumes about that state of families nowadays, but that is a discussion for another time..

Now we move on to the postgraduate fraternities, particularly those in law and medical school..

I would expect that being a part of a fraternity at this level would be less about being all lonely and weepy in school since the studentry is comprised of more mature individuals who have already passed the tumultous years of raging hormones, some of which have already worked for some time before returning for further studies. The reasons would now seem more logical and practical, as will be discussed below.

I'll be dealing with law school first, since I don't really know much about them, and then proceed to the med school stories which will be from personal experience. For my friends/colleagues associated with frats/sors, don't worry, I won't be throwing anyone under the bus here, and I will be respectful as possible. ;)

The law fraternity involved in the latest hazing mortality has already made a name for itself by producing a large number of bar exam passers among its alumni. It's kinda hard to argue with that kind of success. Benefits of being in a law frat includes access to extensive case libraries painstakingly collected through the years, being able to rub elbows with prominent brods (and eventually find employment), and have an unquestionably loyal intellectual to discuss schoolwork with. Ok, I admit I have no idea how law frat benefits work, but I assume it has more a lot more academics and a lot less "bugbugan" associated with it compared to frats in college (although there has been a recent rumble incident (Nov 2016) involving said frat during the bar examinations).

All that being said, I have so idea why they would need to beat the guy black and blue to the point of inducing arrhythmia and/or MI.. :( Bah.. it gets more mind-boggling the more I think about it.. Is this a machismo thing? Gantihan na lang ba? Why start such a tradition in the first place? Bakit ganun? Being someone involved in the care of the sick and dying, it boggles the mind why people would kill an individual who wasn't expected to die anytime soon, and worse, why would he willingly subject himself to that in the first place..

Lastly, is it worth it? I mean, sure, you might get a leg up on another guy when applying for a job at a law firm, or you might get a favorable decision in a case from a judge brod (this last one, I can't wrap my head around.. I thought lawyers were all about fighting for the truth and the rights of the people who can't defend themselves?..).

Talking about lawyers has made me sad.. Let's round up the discussion by talking about med school fraternities..

I'll bet every medical school has its own fraternities and sororities. These organizations are often sanctioned by the administration and are exclusive to students from that  med school, although there are some which have chapters among different schools, but these are the exception rather than the norm..

At last count, there were six fraternities and five sororities in my school of origin, all properly recognized by the school admin. A number of faculty members are frat/sor members themselves, with a number being recognized as the founders of their respective organizations. 

I remember the freshman welcome week, where we were toured around the different areas of the university by the seniors, with each stop handled by a specific organization. It was here where we were approached by the different fraternities to invite us to their group.

Medical school is a much smaller community than the university at large, and it is inevitable that you would see familiar faces from pre-med now sporting the labels of their orgs and inviting you to join them. 

I still had the same apprehensions about joining a frat as once before, but somehow seeing these former org seniors of mine inviting me to join up got me curious.. These were straight-A people, active in the student government, and were generally recognized as good influences, a far cry from the perceived  thuggery that fratboys supposedly indulged in..

After much debate, I finally agreed to attend an orientation of sorts after school hours with a few friends from college. It was well organized and the people were generally comgenial. We were allowed to ask questions (even controversial ones) and were treated kindly, They seemed like a nice bunch, they were as intellectual as I imagined, and now I kinda wanted to be a part of them.. but I guess that was part of the hook to get you in..

The supposed benefits of joining a medical fraternity included joining medical/surgical missions ("tuli" missions for the most part where the aspiring surgeons got their first taste of an actual operation under the guidance of the senior brods), access to old examinations (which were eventually shared with everyone else anyway since most people in medschool wanted to work for the good of the batch anyway), early access to intellectual mentors (senior brods who were residents, consultants), and a cool group of guys to hang with, as well as the associated cool identifying swag like pins, jackets, mugs, stickers, etc.. Some people also claim that fraternity ties are important when looking for residency placement abroad, since there are brods in influential positions in hospitals in the States, a highly-competitive prime destination for those that wish to train elsewhere, but in line with the medical way of doing things, you have to prove yourself by acing the USMLE first (which is a situation where fraternity ties don't matter one bit). I guess fraternity ties could also help in getting residency positions, but based on personal experience, the personal merits, intelligence, and trainability of an applicant would trump any fraternity ties any day in the eyes of a good residency training staff.

Eventually I decided to give frat membership a try, and subject myself to the rigors of initiation in order to become a member. Long story short, I quit after a few days and just contented myself with being a barbarian (fraternity parlance for someone not in a frat). In all honesty, I was never punched, kicked, or hit by any of the frat members in any way. Interestingly, they found ways to make things difficult for you without physically assaulting you, and I was really thankful for that. I remained on friendly terms with those fraternity guys until we parted ways after medical school, especially since most of the guys who came from my batch were already my friends from before. In fact, even the junior fraternity members recognized me as a friend of the frat despite not completing the initiations and becoming a senior brod. I found it a little heartwarming that they considered me as kind of like a "lost brother" and bore no ill will towards me for leaving. :)

I guess the question now is "Do you regret not being part of a frat?" Well, to be honest, I kinda regret missing out on the cool swag. :P The free accommodations at the frathouse would have been nice too, but since I never really had to use a dorm, so it didn't matter. I was invited to a handful of medical missions  despite not being a member, although I kinda stuck out 'coz I wasn't wearing the "official" scrubs. Hehehe :P 

I still had my wide array of friends in medical school, some with frats and sors, others without. Those that did never let their fraternity or sorority ties get in the way of our friendship or our journey towards our medical degrees. Even in clerkship where it was said that fraternity ties had more weight, I honestly didn't notice any difference because the residents I dealt with were trying to be as fair as possible to everyone. I guess I consider myself fortunate (?) to not be in a situation where I would be driven to think that joining a frat would be the only solution, though I find it difficult to imagine how such a situation would come to be.

As far as studies went, I believe that tutoring could only get you so far, and that you're gonna have to go do it by yourself for the most part anyway. Career placement didn't matter, because I wanted to get into a program and stay there based on my own merits and nothing else.

Med school Fraternity life may seem neatly packaged into a fun, exciting experience with lots of opportunities both in and out of school. However, in the end, it all boils down into how well you've studied, how well you're treated your colleagues, seniors, and juniors, and how well you deal with your patients. These are things that you do by yourself, fraternity or no.

Getting past the (writer's) block

The downside of not writing for a really long time is that it gets really difficult to get started again, and that includes writing scientific papers. So, in order to get past this writer's block that I seem to have hit (and thus finally get my paper going), I shall return to the blogging scene after this apparently long hiatus.. hehe

A LOT has happened in the months that passed, and it would be too exhaustive to go into detail about al of them, but I guess I'll give it a shot.. :P

Its been about 5 months since the end of training. Finishing the aforementioned research paper and preparing for another diplomate exam should keep me occupied for the next few months. :/

Finally achieving this much-desired change of pace is something really new for me. I'm finally rid of having to go on duty at the hospital forever. (Bwahahahaha! :P) I've spent the better part of the first month clearing out stuff from my room, including setting aside some little-used clothes for charity. :) There was also a lot of catching up to do with the considerable sci-fi backog I had built up in the last couple of years or so.. hehehe

I've actually missed this.. being able to just creatively unload my thoughts on a blank slate which would serve as an online memoir of sorts in the years to come.

My wrist hurts.. probably carpal tunnel syndrome.. Serves me right for all those late-night sessions with the iPad before going to bed. I've already gotten rid of most of my games, especially those that can run offline, but I just cant seem to remove a couple which tie me and the guys together (since we're such total geeks :P). A litte more self discipline won't hurt, and will probably go a very long way..

I realize that I really need this writing session to help me get used to being productive in front of the computer again. Otherwise, I would just wander off to read some sensationalist news or social media garbage.. I really miss the good old days when people would just blog or participate in forums, where people had to actually exert an effort to go out and read stuff and think about it (since they had already made an effort to find it in the first place), instead of just being stuffed right infront of an immature audience who tends to have this underlying impulse to freely comment whatever shit opinion they may have at the moment without really thinking about it just because the info was so easy to come across.

The hate and vitriol on the internet, primarily on social media platforms like Facebook and Twitter is sickening, and makes me question where humanity is really headed. I'm no saint, and I admit that my emotions have been swayed at times based on some stuff I had come across.. Even more sickening is the fact that governments have finally resorted to using the internet as a tool, and in the wrong hands could cause a lot more harm than previously thouht possible. Just take a look at what is happening now in the US, with their hateful and spiteful leader taunting people over Twitter like a spoiled child. Or if one would go locally, the presence of these faceless social media trolls whose main aim isto make people angry, opinionated, or downright nasty against each other, and the das fact is that some peope are actually paid to do this..

The world was never really a perfect place to begin with, but the outpouring of such negativity online has me wanting for better days, when things were much simpler, when people were actually more civil towards each other due to the lack of anonymity, and when opinions were better thouhgt out before being displayed in the public forum for all to see.

Social media has allowed everyone's inner jerk to reign free, since there is no apparent threat of actual retaliation in real life. People have abandoned decency at times just to satisfy a pathological need to be noticed and be right no matter what the cost.. :( Is this really what we will become? A race of entitled brats who pounces on anyone who does not see things their way? I believe in free speech, but it does not grant you the license to act like an asshole towards others just because they don't know or won't be able to know you personally anyway.

I used to think that the creepy side of the internet was confined to stalkers, sexual predators, serial killers, shady individuals who wish to rob you through technologically advanced means (or even just through simple scams for those who are gullible enough), and probably some other deep web stuff that I probably wouldn't even want to know about.. :/ But now all of a sudden its the basic creepiness of human nature that resides in all of us that scares me.. :( I can't believe I'm saying this, but I'm disappointed at people..

I used to laugh at the concept of people saying that society is in decay and all that stuff, but when I take a look at the internet and see how much it has permeated all the aspects of our life, I can't help but believe that its true... :(

I've been watching sitcoms lately, and currently have FRIENDS in my sights, and I must say that even though its funny, it sometimes gad a little sad at times due to its unspoken commentary about the way things are in this modern age. I won't go into details at the moment though, because think this post has been depressing enough.. Still good writing therapy though :D

Selective Resetting

Il bet everyone wished at one time or another whether it would be possible for life to have a reset button. Different folks would have different needs ranging from an "entire-life reboot" to something as simple as making a different choice somewhere down the road. This entry deals with the latter.

I admit that I have made my fair share of decisions in my life that I wish I never made, but none to the extent that I would want to go back and change something.. Well, that is, until recently..

Being a little bit older and being able to take stock of my life from a more mature viewpoint has its ups and downs. It's good because of the wisdom you gain from certain experiences in your life that you were not able to understand at the time. On the flipside, it is that same increased level of intellectual maturity that may lead you to be disgusted at some of the things you've been through. It's like saying "What the hell was I thinking??".

It is the unfortunate fact that regrets come only after the event has transpired or an error has been made. Even more unfortunate are those regrets that come and hit you much later, years after something which cannot be undone. This seems to hurt more because of the helplessness you feel. With a more proximate event, it would definitely easier (for the most part) to make up for what had happened since if you go by the temporal profile, it's not really too far off. But when the regrets hit you a decade later, BAM! Its like being hit by a ton of bricks. You're suddenly reminded of the decision itself, but moreso of the multitude of possibilities and other pathways you could have taken during the great span of time between now and the past decision. In some cases, your imagination may go into overdrive as you envision totally different scenarios, the other roads not taken, and feel a deep sense of regret from within.. sigh.. 

There are some things I wish I could have changed, but on a positive note, a different kind of change is coming, and may possibly impact my life for the better, permanently.. :)

Losing my religion

I know I should be studying, but I decided to take a little time off the books since there's a ton of backBLOG I have to make up for. :P

(pic source here)

Up until very recently, I was in a quandary of sorts, wherein I found myself slowly slipping away from my beliefs.. I don't really know what brought this about, but I guess it was a combination of frustration, disillusionment in the church, and the effects of media.

And how was I able to figure that this what happening to me?

I discovered I no longer knew how to pray.

As shocking as I may supposed to seem to me, I was strangely unaffected, and instead had this feeling that it had been coming all along. Let me explain.

I have to admit I was a little angry at myself over what has transpired a few months ago which lead to my current state of, well, doing nothing really important. All the while the people I love where always telling me to "keep on praying and everything would be ok". The problem is, everything did not turn out ok, in fact everything turned out much worse than expected. :( Thus began my frustration.

The disillusionment came from the local church's apparently endless meddling in affairs of the state especially concerning reproductive health, which is a very touchy topic in our country. With my responsibilities as a physician, I had very strong feelings on the matter and felt that something should be done. I will not state what views in particular are the ones I support or am against, but the way the church handled the entire thing was, in my opinion, pretty messed up. Being reminded of the fallibility of man who is trying to run an institution established by God, those higher ups seem to have bungled the job (IMO only).

The effects of media are a little more silly.. and as such I will not go and shame myself for al the world to see just to get a small point across. To make a long story short, I began to seriously question certain fundamental tenets of my faith.

Fortunately, despite my despicable thoughts, I still had the people I loved whom God had placed by my side. A combination of serious "faith talk" with sweet inspiration and my regular "wisdom talks" with dad may have just saved my soul from eternal damnation..

I was made to realize that the thing fundamentally wrong with me is that I was no longer grateful. No matter what your circumstance in life, there will always be something to be thankful for. Its inexplicable, but I guess in faith there are some things that just aren't meant to be explained. Once I began accepting and started seeing the things I had once taken for granted, it's as if a fog had lifted before my eyes and everything seemed just a teeny bit better than before.. Truly, God works in mysterious ways... 

Thank you..

In dire need of a reset

About 2 months have gone by without me putting up an entry despite the fact that I have been planning to do o for the longest time. There are so many stories to be shared, so many thoughts to put down, and so many experiences to be cataloged. Yet I have failed to do so. I have become trapped in my own little world due mostly to faults of my own doing.

But no more.

I've decided I've already wasted enough time, not just with my procrastination with blogging, but with every other aspect of my life.

Ever since my career took a sudden (and unexpected) stop a few months back, I have been wallowing in a kind of pseudo-depression and in shallow pools of contentedness and mediocrity.

People who really knew me commented that I wasn't myself. That I was so much more that what I have presently shrunken back to.

You know what, I think they're right.

This ends now.

The games await, and I will rise to the challenge to go into the thick of things once again, As I was always meant to do.. 

I owe it to everyone who's believed in me, who's supported me as I went through these tough times, who never gave up on me even when I gave up on myself..

Most of all, I owe it to Him, who always took care of me whatever the heck I chose to do with my life.. 

and this time, I'm really playing for keeps..

BrainiaxMD has reentered the building.

Let's play.

CGH Memories…

Looking through my files to delete clutter, I came across this blog entry that never made it to the presses and was apparently written during one of those days when I was feeling really "angry" and "militant", seemingly agitated by what someone had said to me earlier... :P Here goes...

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Quite a number of people have asked me why I remained loyal to CGH, the hospital where I had my postgraduate internship, especially those people who opted to remain at UST who sometimes sneer sarcastically when asking whether I liked it there. (Bato-bato sa langit, ang matamaan wag magagalit, ang pikon ay laging talo.. Besides, kayo naman ang nagaantagonize sakin eh. ;P)

The answer is quite simple really. I loved it there, and having come from the very hierarchical internal community of UST, it was like a breath of fresh air. Make no mistake, working there wasn’t exactly a walk in the park. For a private hospital, the patient load there is just insane, especially in Obstetrics. Hehehe The hospital itself wasn’t small either, and presented a lot of ground to cover. Although some people may contend that they had a tough time in UST with it’s endless warrens of narrow corridors that you need to navigate to reach patients’ rooms, try being on duty at CGH while in charge of two separate buildings!

Why then, did we like it there despite the toxicity and the obvious physical burden? I guess mainly because of the friendlier and less hostile atmosphere. I’m not just talking about the way residents treated interns, but the general interaction of everyone in the hospital as a whole. Doctors (including interns) and nurses generally get along really well. Consultants don’t treat underlings like dirt, and senior residents generally don’t treat their juniors like neophytes. Even the interaction with the other members of the hospital staff (like the guards, manongs, etc..) are generally favorable. It’s a more relaxed, friendly atmosphere which facilitates better cooperation between health care providers. In short, the system makes you feel that you’re an important part of something, and doesn’t kick you in the shins and forces you to eat dirt. :P

People may contend that staying at UST is better, as you are more exposed to the academic side of things. I don’t dispute the fact that you may have the opportunity to learn more. However, having my internship “outside” gave me a glimpse of how a “real” hospital works, away from the academe and away from all the politicking and shaming of underlings, and I found that it was quite efficient! I was really impressed with the way things were handled there. The consultants may not be academics, but they were damn good at their jobs! A sick person was able to go home healthy, with less financial strain (since I understand that CGH has relatively lower prices). It was that simple. Isn’t that what physicians were meant to do? To heal the sick and ailing? ;)

In CGH we also experienced unparalleled generosity from our consultants. Our summer outing to Batangas was sponsored by solicitations from the various consultants and departments. There was one time when the monthly allowance for the residents and interns was really late. The chairwoman of the Department of Pediatrics used the department’s fund to pay the Pedia residents and interns while we were still waiting for our delayed stipend. We had to pay it back when the money eventually came out of course, but still, the idea that she would go out of her way to do that to make sure her people were getting paid struck a chord in the hearts of many.

We also have our share of “nasty” consultants, but they were the exception rather than the rule (unlike some other places where it’s the other way around :D).

Its just too bad that a few people from our batch were always sourgraping and whining so much about what they didn’t like about the hospital that word spread throughout UST that CGH wasn’t an “ok” place to go (despite the consensus of the majority who loved the place). The end result was that in the following year the hospital got only a handful of applicants from UST, which is really sad because CGH used to be labeled as a “2^nd UST”, due to the fact that it was traditionally filled to the brim by interns from UST. Even the nurses lamented this fact, and some have even told me that they missed the good old UST days, when everything would be running smoother.. I don’t exactly know what they meant with the statement, but I was really honored by it. ;)

Let me make this clear. I don’t hate UST. I studied there and done my share of work there as well. In fact, I’m extremely proud to be a Thomasian doctor. I’m just deeply saddened that it could be so much more, but the system is so firmly entrenched that it’s impossible to change it for the better.. L Its so sad that instead of opting to have internship at the alma mater, people are fleeing to other hospitals to escape the apparently stifling system. I can’t really describe why we feel so uncomfortable about it. As one of my co-interns put it, the moment she set foot upon UST hospital, it was like the air was different, stress levels shot up, and a general feeling of gloom was prevalent. Or maybe we’re just used to a happier place.. ;) Oh well… *sigh*

Trust vs Mistrust

You just can't trust anybody these days..

I just learned recently that a close friend revealed a secret that I said was supposed to be kept under wraps as much as possible. It's just so frustrating because I wouldn't reveal this particular bit of info to just anyone. Although it's not secret that is life-threatening or anything of the like, the fact that it was revealed leaves me feeling betrayed... :(

I really hate it when people attribute this to "its just his/her nature". This destroys all accountability for the revelation. I don't want to sound self- righteous or anything, but when a person confides in me and tells me not to tell a soul, I really honor that request although the secrets may seem harmless, they are being kept secret for a reason. In fact, I've kept a number of secrets through the years so long that I may have already forgotten all about them because I never told anyone.. Sigh.. its really difficult to find someone you can trust, and I'm learning that the hard way..

Plans

There are those rare instances in your life when an event, or an emotion elicited by an event is so strong, it kind of just hits you and makes you step back for a moment and wonder what the hell you are trying to accomplish at present.

I shall not discuss the event that transpired which ultimately resulted in this blog entry. Rather, I would like to discuss the nature of my current state..

“Planning ahead”, two simple words that may seem so ordinary, so plain, and yet they hold so much significance. On the battlefield, a well-laid plan may spell the difference between total victory or an overwhelming defeat. A builder uses plans to ensure the proper construction of whatever structure he intends to erect. Even a physician utilizes plans of treatment to tackle the management of different diseases.

We use plans in our daily lives. It may be as complex as the examples stated above, or as simple as a mother making a to-do list for the day a driver visualizing a route to his destination, or a student deciding on which topic to study first.  Whether it’s a short-term or long-term goal, plans are an inescapable part of our nature

Alas, no plan is perfect, and even the best-laid plans can be undone. An overlooked minor detail may bring about disaster, depending on the nature of the goal intended by the plan. Which is why the wise make contingencies, backups that can be utilized in the event that their perfect masterpiece somehow goes awry. This is why ships are designed to have lifeboats, fighter pilots are given parachutes, and cars are constructed with seatbelts and airbags.

But what if one blindly decides not to make a contingency plan? What if that person puts so much faith In his perceived plan that he or she makes no allowance for failure? What if there is no “Plan B”? What then?...

I went through a period like this when I dropped out of pre-residency some 8 months ago. I was so adamant that I would stick to the path I laid out before myself: (Med school > Internship > Boards > immediate Residency) that I never thought of what other alternatives  I might explore should my original plan falter. It was an unpleasant experience. When I decided to stop for the meantime, I saw all my plans crumbling down. I was scrambling for alternatives, thinking about options I would never really have considered in my normal state. I lucked out in the fact that the family was very supportive and I somehow got back on track (while actually living life for a change :D). Thus it came to be that I’m sitting here now, typing away, during what would arguably be the most productive year of my life.

I now have a new plan, of course, but it seems more flexible than the first. I finally listened to the advice of my folks to just “let things flow”. At first it seemed a bit too carefree for my overly uptight nature, but this vacation does things to you.. ;)

It seems like such a nice story, right? I mean, everything came around full circle, and I’m presently preparing myself to get back on the path to being “all that I can be” as a physician, but as we say in Medicine, there may be more than one pathology involved…

Recent events have brought me to question the very core of my plans for the future. No, I’m not talking about where to have residency or what program I should enter. I’m talking about stuff that would define my practice of Medicine as a whole, things that could spell the difference between living a life happy and content, or one filled with longing and regret. All of this is hinged on just one apparently simple decision, and the decision is influenced by one simple fact… a fact that I made absolutely no contingencies for in case anything goes wrong.. And therein lies my folly..