Pet Peeves

 After a pair of failed attempts to try and squeeze a yearender blog out of my brain, I just decided to scrap the entire thing and just go with more of a stream of consciousness thing.

But yeah, I did skip more than a year of blogging, and to tell you quite frankly, I did miss it. :P

Anyways, this one is about pet peeves, mainly the things I have unfortunately seen on the net, and this will be a short list since I'm not really in any shape for long-form writing right now. So here we go..

- I dislike reading things where people write "y'all" all the time, even if they are presumably not American. This goes double for those grown, fully educated people who start off their discussions with this, thereby showing off their inner hillbilly. Whatever happened to proper language? You can call me a grammar nazi all you want, but that won't change the fact that you are either too lazy to write properly, or too stupid to care.

- Equally annoying are those people (presumably children) who comment "i'm wheezing". I mean, really? 🙄 Because if you are, its either you go grab your nebulizer or bring your ass to the ER. As a lung doc, I take wheezing very seriously, and some patients live in total dread of it. So stop making light of a potentially important symptom and learn to react properly to those dumb videos you are watching.

- Short form vids are temporarily, amusing, but when you take a step back and think about it, these are just absolute wastes of time, especially those that show randos doing stupid dances that nobody really cares about (apart from other similarly inclined randos who have nothing better to do with their lives). The focus today on generating content for just the views, likes, and subscriptions have ruined Youtube. Instead of a great repository of interesting discussions, in=depth investigations, or well-made entertainment, it has become just a total dump of random pathetic people putting in anything and everything just to glue your eyeballs to the screen. You still get the serious content, but sometimes these get lost amidst all the trash. The sad thing is that this is here to stay, since the conceited nature of humans makes it impossible to wean people off the desire for attention.

- Comments sections in general. I miss the days when skimming through the comments section exposes a person to lively civil discussions. Now it is dominated by bots, spammers, and trashy individuals (mostly children who don't know better and probably never will). The anonymity of the web has emboldened cowardly assholes with worthless and oftentimes misleading opinions. I wonder how many of these individuals would actually have the guts to say what they wrote in an actual face-to-face conversation. (So yeah, I don't read random comments sections now)

- There are way too many vlogs made by way too many untalented people with nothing good to say or have zero skills in putting their ideas forward. These people are just obviously in it for the money and should not be rewarded for their pathetic attempts at content creation.

Wow, that got very real very quick. I guess I had so much pent up frustrations that I needed to air out.

This felt great, I should do a part two another time.

 

2021 Yearender

Finally! A proper yearender post! 😛

Now that things have pretty much normalized for me, with the previous consultant routine slowly getting back on track, this time with a bit of accommodation for further opportunities opened up by my recently-concluded training. 😉

Hmm.. I would say that this year pretty much picked up where the shitstorm that was 2020 left off.. The introduction of vaccines early in the year brought a faint glimmer of hope, as cases were trending down and the vaccine rollout caught steam. This optimism was curtailed shortly thereafter though, as the more contagious (and no less deadly) delta variant finally hit our shores a few months after wreaking havoc in India. I would say that this particular wave finally brought the fight to all fronts here in the Philippines, as the outbreak epicenter shifted to the provinces. Fortunately, we were able to see a bit of change in the trend of admissions.. Vaccinated individuals were apparently less prone to wind up in the hospital and hooked to the ventilator. People who got their jabs still tested positive occasionally, but usually had little to no symptomatology to speak of. That's science at work, and no amount of denial by crazies or the ignorant is going to change those facts.

As the year wore on, the trends showed an ever-decreasing case count as more and more people began to shed their unfounded fears and got themselves protected. People started to go out more, and public areas slowly but surely became congested again, the only difference is that people were wearing masks (thank goodness!).

Enough about Covid for now though.. I admit I was a bit apprehensive about getting back into the game after having been away for so long. Fortunately, he clinics were always so supportive, and old familiar faces started to reappear during consults. In fact, I was extremely touched to learn that an old patient had been waiting patiently for my return and refused to see any other physician, because she said I was the only one she trusted. Fortunately, she followed my last instructions and continued her maintenance therapy religiously, which quite predictably resulted in minimal adverse events in the interim. 😛

I thought that I would have become quite rusty with my pulmo management, but apparently its just like riding a bike, you never forget how to do it once you already tried before. ;)

Let me just say that it really feels so good to be able to conduct face-to-face consultations again. I have become extremely sick and tired of telemedicine consultations as it was the only medium we used during fellowship training. I'm sure patients feel the same way, well, those without heightened anxiety about going out anyway. 😜

Hmm.. it's roughly 10pm, but things have still been relatively quiet outside. Perhaps people in the area have finally wised up and learned that it is not cost-effective to waste your hard-earned pandemic money by burning it all away on celebratory explosives. (Although if the news reports from Bulacan are to be believed, people are still going to be such petulant children who are unable to follow sound advice and still do the stupid things that they do, and lose fingers and limbs in the process. Not really my problem though, as long as they don't cause harm to me or the people I care about)

This past holiday season has been one of the weirdest I have experienced. I don't know if its because 24 and 31 are set during thursdays which threw off my internal calendar, but I seem to have trouble telling the days apart. Unlike previous years when people were more than happy to take time off during these holidays, this year seemed to be more busy, as people were taking advantage of relaxed restrictions to conduct business in an almost-normal setting, something most of us have not been able to do for the past 2 years.. I guess this explains my disorientation, since everyday seemed like a regular workday, only with more people at the malls doing their old-school face-to-face x-mas shopping, something they have not been able to do for ages.

Now we stand on the precipice of starting a new year, with a new, highly contagious variant already within our shores. I can only hope that the reports from Africa are correct, that they have already apparently weathered the storm and cases have already significantly dropped, and that this new variant apparently caused milder illness than previously encountered..

So yeah.. It has been a hodgepodge of a year, with equal measures of hope and anxiety mixed in, causing a roller coaster of emotions for all of us. Still, there was some silver linings that happened, and I am grateful for that.. But there are tragedies as well, especially the severe destruction in the southern part of the country brought about by the typhoon Odette, which caused unimaginable devastation as was seen in clips shot by brave individuals caught in the middle of it all..

Let's all pray for a better tomorrow, and a brighter 2022! Stay safe everyone! Please, keep wearing your masks and keeping your distance by avoiding crowds. Its for everyone's good. If you insist on being bullheaded about it, I  will just pray for your family such that you don't put them at risk with your reckless and inconsiderate behavior, because if anything happens to them, it will most likely be all your fault.

More stories to come, and I hope you will be here along with me for the ride. 😁 Have a Happy New Year!

One month later...

 It is quite late at the time of this writing, so this entry will probably be quite brief. 

After around a month of resuming practice, I have confirmed that I really, really miss doing face-to-face consultations. 😅  I hope that the low Covid numbers hold over the next year, so that it would be so much better for eveyone.

So you wanna be a specialist?

 

 

Original image found here

 

Whether you're a medical student, a recent board passer, or even a veteran GP who is now looking for a change of pace, the prospect of choosing a particular field of specialization to pursue can be quite daunting. There are just so many to choose from, and it weighs heavily on you when you consider that it will define your practice for the rest of your life. Not to mention the hardship and sacrifice you need to endure for a few years as you go through residency training.

I will try to make this as objective as possible, so as not to steer the reader towards any particular area of specialization.

 

Given that this blog can be seen by everyone, let's start of with the basics.

Throughout history, the role of the physician has been continuously evolving. The exponential growth in scientific knowledge has created a need to subdivide the practice of medicine into many different fields, each with its own unique approaches to the identification and treatment of illness. Pretty soon, it became humanly impossible to contain all that accumulated (and still currently growing) fund of knowledge under just one title.

By my own estimate, there are about a dozen "basic" specialties that one can apply for residency (here in the Philippines). Almost all of these specialties allow you to pursue further training in subspecialty fellowships available both here and abroad. Not included are the other special trainings that you can apply for outside of the formal fellowship programs. I shall only touch on the latter briefly, since I am not really familiar with what's available.

Given this intimidating and confusing plethora of choices, its easy to feel very lost and confused. Remember, the most important thing here is that you should be prepared to give yourself wholeheartedly to the specialization that you ultimately choose. It won't be easy by any conceivable measure as you are expected to go through the crucible of residency and emerge as a properly-trained specialist. I shall be discussing residency training in a separate entry, as this one is all about making the choice. In the event that you realize that the specialty is not for you, there is no shame in turning in your resignation. However, it would be much appreciated if you would decide earlier, preferably when the final selection of residents is not yet done, in consideration of the schedule of the remaining residents.

 

I once had a conversation with a relative who happened to be a physician, and he was able to break it down quite elegantly by lumping the choices together into clusters, after which you choose your path from there. After a bit of refinement, here is what I was able to put together:

 

You can lump the different specialties into 5 large groups, based on what you will be expected to deal with:

 

1) Adult

2) Kids

3) Pregnant

4) Cutting

5) Diagnostics

 

I am also adding a 6th Miscellaneous category to accommodate certain specialties that cannot be shoehorned into any of the 5 aforementioned groupings. More on this later.

Lets go over them one by one:

1) Adult - basically refers to Internal Medicine and its vast multitude of subspecialties which are based on the different organ systems.

2) Kids - obviously talking about Pediatrics, as well as its own umbrella of subspecs.

3) Pregnant- the specialty of Obstetrics and Gynecology gets its own category, since the attendance to childbirth is a unique discipline in itself

4) Cutting - refers to all the specialties that involve surgery (excluding OB-Gyn). This would include General Sugery and its various disciplines (Urology, Orthopedics, Thoracic and Cardiovascular, etc), Otorhinolaryngology (ENT-HNS), and Opthalmology.

5) Diagnostics - this would encompass Radiology and Pathology, as well as their respective subspecialties

6) Miscellaneous - Included here are those that do not clearly belong to any one particular category. These are:

- Family Medicine (technically trained to be all-around, if I understand it correctly)

- Nuclear Medicine (the practice of medicine involving the use of radioactive materials defies classification)

- Dermatology (I wanted to put this together with IM, but remembered that they can serve both adult and pedia)

- Anesthesiology (was tempted to lump this together with the cutting specialties since they all share the OR, but thought better of it because they are technically "Internal Medicine in the OR", as what some of our Anesthesia colleagues might say)

The next step would be to choose a particular category, and get things started from there. This advice seems to be catered to those going into IM and Pedia, where they have 3 years to figure stuff out while they choose which subspec they will be going after. Its a bit trickier for the surgeons, as there are certain "straight programs" available where the trainee does not have to undergo the General Surgery residency program before getting started on the subspec.

 There you have it, a simplified overview for choosing a specialty. Hope it helps! 😁 

A new leaf?

 Been a while since i last did a backread of the blog, and I wasn't too fond of what I saw.. I know I had started this blog over a decade ago as a kind of online public journal which has afforded me some catharsis and creative release, but I don't like what it has become in recent days.. All I see are angry rants, COVID news and warnings, and little else other than the occasional entry about specialty training.

I guess its safe to say that I have grown sick of it, and will now try my best to make this space a bit more informative, while retaining the same informal narrative style that I have used from the beginning. Just so we're clear, I have no intention of making this a "fake news" site where I post random scientific musings that can be fodder for the ignorant.

 Oh, and I have decided to clean up the blog again as well, and as such will be removing the random short rants that don't really contribute anything.

Ok, now that I have gotten that out of the way, it's time to jot down stuff that will be more worthwhile, See you at the next entries. 😁

Consummatum Est

 

Image source here

At long last.. I never thought I would actually see this day..

Well, actually this post is roughly more than a week delayed, with the examinations having concluded a while back already. Oh well.. 😅

Once again, I am FREE! 😁 Best of all, mission accomplished! 😎👍 Before anything else though, I would like to thank the Big Guy Upstairs for his unfailing support. None of this would have been possible without Your help. Thank you so much.. 🙏🙏🙏

 As I breathe the much needed sigh of relief, the next question that looms over my head is "What now?". This one is a little tricky, as it will involve both the reorganization and reactivation of previous clinic commitments, as well as an exploration of possible new opportunities that have opened up before me. Things have begun to get interesting, so we shall see what eventually develops.

I miss doing clinics at my usual spaces. I have spoken before of my disdain for telemedicine, so I guess I shall refrain from opening that can of worms for the meantime until I really need to hehe. The art of medical practice was never meant to be conducted behind digital screens. I hope things will really be safe enough when I do begin venturing out into the world regularly, as the last thing I need is to get sick or to bring the virus home to the people I love.

Although the examinations have been hurdled, I find myself in a sort of limbo as the oathtaking to be sworn in as a full-fledged diplomate will be taking place much later during the first quarter of the following year. As such, my practice will be limited until I get myself fully installed in the subspecialty. 😅  All good, I guess. Good things come to those who wait. 😉 Hopefully my practice will eventually return to full swing, and I shall be making more efficient use of my time so that I can finally move on to other, far more greater things in life. 😁 That's the update for this episode. This is actually a creativity primer for another project I have, but that is beyond the scope of this  post to discuss.

Procrastination as a prelude to productivity?

 Yeah, I have something else to do right now.. Typical, huh?

However, I find that doing a bit of creative work like this immediately before doing the more important thing kind of resets my mind for the more arduous task at hand. I have been sitting on this plan to prepare a presentation about my recently concluded paper for a couple of days now, and I just can't seem to get started. It seems that I am having trouble with initiating important tasks, and instead fall into the technology trap of browsing soc-med ad other frequented sites instead. (No, I do not consider Blogger to be a soc-med site. I hardly ever come here except to bridge myself into working shape)

So, now what?

I really didn't have a topic in mind as I began this post, as I find it therapeutic to just sometimes let my stream of consciousness flow.

I now am seriously contemplating the question "What do I get out of blogging in the middle of procrastination?"

Lately I have found myself struggling to find focus. Practicing  a small bit of the mindfulness I mentioned in a previous post, I noticed that when I write creatively, it helps me focus on myself as I type away. I begin to zero in on the keyboard, the letters, the grammar of what I want to say (although not too much, since this is a stream-of-consciousness thing). I was never a touch typist, nor will I ever be because of certain physical limitations, so I tend to look at the keyboard as I type.. Ad now I find looking at the keyboard quite soothing.. It's just me, my thoughts, and this platform on which I will put them up on.

Part of me is tempted to go into another long tirade about the evils of social media and how it affects the modern way we do things, but I don't think that would be appropriate at this time since there are other more pressing matters that demand my attention and effort. I don't have the time or energy for another angry rant. 😅 

Going forward, when everything has been said and done, I have decided to follow a 31-day blogging plan, which I hope would increase my creative output. Hoever, if the topics scheduled may seem too personal, I may just abandon the project altogether. I dunno.. we just have to see what traspires in the coming weeks..