2017 "YearStarter"

I'll admit that I was a bit lazy to write my annual yearender blogpost last night, so I decided on a compromise, to make a post on the first day of the new year. :)

As usual, Christmas has come and gone, and in this instance, the New Year celebration as well. So, here I am holed up in the hospital for the first duty of 2017, and I hope this will be a quiet one so as to not interrupt my annual retrospective..

This year has really been a struggle for me, and I bet for a great number of you as well since this has been a very difficult year all around.. My umpteenth "Senior Year" found me finding solace in the fact that I no longer had to man the Emergency Room, but I was now straddled (once again) with the responsibilities of being the highest official in charge (especially during night duties). With this, I am forever grateful for my formative years back at the old hospital where gutsiness and confidence were bred into our systems, by force if need be, due to the overwhelming demands of a government institution. Having said this, the "senior's load" was surprisingly still quite heavy, and I'm not just talking about the responsibilities of being senior to a group of newbies to the trade, but the task list seemed to grow heavier as well..

I was grateful though for the opportunity to head out-of-town due to a midyear convention, but boy did it come at a price! Being a contestant for an inter-institution debate is no joke! While all my compatriots were lounging around and resting, I was busy burning the midnight oil even up until the night before the event! :P Apart from that, the little challenges that came my way seemed to all stack up on a regular basis. I have had barely enough time to catch my breath and get my bearings when I had to move on to another equally challenging time-limited objective. And given my penchant for both procrastination and being OC once I got started on my work, this combination proved to be very deadly indeed. :(

Having said all that, I really enjoyed my stay out-of-town, and will definitely return with loved ones in the future :D

This year was not all about toxicity though.. This is also a year where I began seriously contemplating how it would be like if our family finally got our very own car. Granted we are working with a relatively small budget, but there are numerous offerings out there, and the priciest may not always be the best choice. ;) Steps have been taking, and we have been reading up on a lot of stuff as well, but we admittedly have a long way to go.. but at least we got the ball rolling, right? :)

This year I was also able to meet up with my Other Half's friends, and she was able to join me and the guys on a couple of BNOs as well. Things seem to be going quite smoothly, and I pray that this continues in the years that follow. :D

I guess the theme this year for me was exploring the limits of, and going beyond my comfort zone.. I guess it's also a part of growing up (?) but one cannot ignore the fact that there is someone else that helped me overcome these barriers and continues to inspire me to be brave to this very day. ;)

I guess I could say that I really grew more this past year, both in knowledge and experience as a doctor, as well as in love and wisdom as a person.. Even though it has been a bumpy ride, I am grateful for the year that was, and I face this new year with nervous anticipation for a brand new start! :)

A few resolutions would also have to be in order, since this technically still is a yearender post. The resolutions would be as follows:

- Spend less time (close to none if possible) on Facebook. It's a great time sink, and it stealthily consumes more time than you would expect, giving you little in return.

- Less time online (including game time) and more time interacting with the real world. This one is a no-brainer, and deleting applications is a priority

- Live and love more. As I will be set free from the constraints of the training schedule, I can finally try to live life the way i was meant to be lived.

- Travel? (As budget allows though)

- Blog more. I know it seems to go against the principle of the second one, I can still create these intellectual exercises offline and just jump in to post for a few moments.

- Be a better brother. Not just to brother dear, but to the BNO bros as well

- Be a better son. (duh!)

- Make time for the Big Man Upstairs. Its been a long while, we seriously need to catch up..

- One last exam. I know it will still be a year from now, but fortune favors those who are prepared.

There, that should do it for now! I have now made it a goal to put up a post at least once a month so the blog doesn't grow stale. :D

Warning: Rambling Rant ahead...

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

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

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

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

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

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

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

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

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

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

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

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

Safe at my sanctum

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

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

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

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

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

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

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

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

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

Feels a little different..

It's now the penultimate month before the end of my term as a medical resident. As things begin to wind down, the last-minute "pahabol" work seems to wind up even more as we scramble to finish the necessary requirements for promotion and graduation.

An all-too-familiar feeling pervades the atmosphere at the office, with the residents wheeling and dealing with their in-out schedules and planning for the Christmas party where we have the "initiation" performance of the incoming first year MRODs, as well as the sendoff for the outgoing seniors.

It feels a little different this time around because, after 3 long and tiring years, it is now OUR turn to be sent off back into the world, to either pursue further training in our chosen subspecialty, or to carve out a name for ourselves as we begin our private practice as a general internist. Of course, this must be taken with a grain of salt, as the beginning of success depends on our performance in the forsthcoming PSBIM examinations, which fortunately for us, has ben moved a couple of months from January to March. This would hopefully provide us seniors with ample (?) time to hit the books and study our brains out in a last desperate attempt to prove that we actually learned something from 3 years of "service" interspersed with training.

Three years... Has it been that long already?.. I know this is already a cliche, but it seems only yesterday when I got word from TMC Neuro that I was not accepted as a part of their staff.. It was a major gamble that I had lost big time, when I opted to turn my back on a reputable school-based Neurology program due to personal reasons and tried my luck closer to home at TMC.. My luck finally ran out, and I was drifting aimlessly about, wallowing in self-pity.. I really thought that was it, that I had no more future since I had already squandered a pair of perfectly good chances in well-established programs that had already accepted me as one of their own..

Fast forward a couple of week, and here I was at the doors of the hospital, making a last-ditch attempt to salvage what had seemed like a promising medical career when I had first graduated. They say that beggars can't be choosers, so I grudgingly took what was given to me, knowing that I had blown what could have been a lifelong dream come true.. Little did I know that third time was the charm, and that I would finally find a home as part of an Internal Medicine program of a little known local government hospital. :)

I shall forgo the telling of my evolution as a resident here since that is a long-winded story for another time.

Changes

Before I get started, I would like to share an interesting comment I saw on an article I was reading..

"... Filipinos indeed have this unspoken social protocol of "not allowing others to get ahead". Consider the reverse custom among Filipinos when it comes to celebrating one's birthday. In other countries, your friends throw a party for you (should you be "party worthy" that is), all expenses on them and not on you. They celebrate you being their friend, not as benefactor. In the Philippines, whether to celebrate your birthday or a job promotion, the protocol is "mag-pa-blow-out ka". It's ostensibly done to "share the wealth", but if that were true, then why would people feel resentful if you don't treat "them" during "your" day of celebration? In the process of spending for that blow-out, whatever financial gains you might have had from your job promotion is negated..."

This pretty much sums up one of the things that has been bothering me lately..

I have never been a fan of mooching on other people, and I'm disgusted by those who do... Oh well..


This post is entitled "Changes" for good reason..

It's now the halfway mark of our senior year at the hospital, and as such, our chairman decided that it would be befitting to make some changes to the leadership of the department.

They say that the position of Chief Resident usually winds up to those who want it the least.. I guess I must have disliked it too hard then.. :(

Now saddled with the overwhelming responsibility of leading the department through the rest of the year, I find myself even more exhausted and drained.. A far cry from the relative freedom I enjoyed when Kirk was still the head honcho..

Add the fact that I seemingly have a bunch of insubordinate juniors who are good for the happy times but evaporate when actual stuff needs to be done, and this makes a great recipe for the resumption of the "Anger Games".. :(

It's really frustrating when you look around you and find that you can get minimal to no support from the people, which I find kind of unfair..

Not to sound very prideful or anything, but during the first half of the year, the chief had no problems because I always had his back, went to the hospital on time, and carried the leadership role when he could not be around.

Now, when I find myself stuck in a jam, I find myself standing alone. My supposedly assistant chief nowhere to be found (chronic tardiness syndrome. Guess who won't be getting any referrals from me when we graduate), and the rest of my batchmates too preoccupied to care...

It all boils down to lack of support.. It's sad to say, but I don't think I can rely on anyone to really help me out as I finish the year.. Which means that my chances of passing the boards has become slimmer than ever.. :(

Why did it have to be this way? Why was the department unable to attract solid reliable residents during my batch who could ensure a stable foundation?

I'm sorry, but I really just need to repeat this.. One of my pet peeves is tardiness, and it really makes me mad when someone we need to rely on ALWAYS comes in 2-3 hours late!! This person "tries" to make up for it by staying extra hours as a form of "pakitang tao"  which is not right at all. This person has shown no remorse for these actions and in reality has gotten worse over the years. Its just so freaking unfair! In my opinion, had we not suffered from a lack of residents, this person would have been removed from the roster a long time ago already.. This latecomer has no respect for the time of others, and probably lives with a distorted view of life wherein everyone is against him/her and that he/she is always the victim. In reality, this person makes very poor choices and lacks even the basic self discipline to get up early in the morning in order to help out everyone else to do their work ON TIME. On top of being a habitual latecomer, this person is also a well-practiced habitual liar, who honed this particular skill through the need of lying through ones teeth to make up for the tardiness.

It's really so remarkable that this person has been able to stay in the department for so long. Had this been a different institution, things would have had a much different outcome and this person would never even have finished first year, as with other individuals in the group that I would not care to mention anymore..

So there we go, another rant because of another person with poor insight who makes other people angry. Is it on purpose or not? I couldn't care less. My patience is running thin, and I'm not one to cover the rottenness of other people, especially if I'm the one aggrieved.
Saddled Filipinos indeed have this unspoken social protocol of "not allowing others to get ahead". Consider the reverse custom among Filipinos when it comes to celebrating one's birthday. In other countries, your friends throw a party for you (should you be "party worthy" that is), all expenses on them and not on you. They celebrate you being their friend, not as benefactor. In the Philippines, whether to celebrate your birthday or a job promotion, the protocol is "mag-pa-blow-out ka". It's ostensibly done to "share the wealth", but if that were true, then why would people feel resentful if you don't treat "them" during "your" day of celebration? In the process of spending for that blow-out, whatever financial gains you might have had from your job promotion is negated. That is one custom I am glad to not partake in.

Seniorhood blues

4 months? Really? Man, 4 months is a long time to stagnate on a blog,

It's the tail-end of February, and I'm now knee-deep in my senior year as an IM resident at the hospital. The comic book saying "With Great Power comes Great Responsibility" is painfully evident as my batchmates and I have learned to embrace the jobs (and perks) of being the ones on top.

The transition period went by so fast.. One moment I was teaching the incoming sophomores how to efficiently man the ER, the next thing I knew, I was the highest ranking IM resident on duty during those sleepless toxic nights when I was already manning the ICU full-time.

The jump from second to third year was more difficult than I had imagined, although the transition from first to second (especially during OUR time) was one for the books. Due to the lack of manpower of our batch, taking on "senior responsibilities" proved more challenging than it is on paper. Good thing the juniors were up to the task of taking the reins.. Well, most of them anyway..

We find ourselves stuck with our not-so-favorite cow, a 43-year old morbidly obese and totally unhealthy case of severe sleep apnea and narcolepsy who is just too stubborn to quit but is also too hardheaded to be taught anything useful. Oh, and he's pretty bossy too, despite his juniors and batchmates being WAY ahead of him in terms of work standards, work ethic, and general fund of knowledge. He claims to wish to emulate his reknowed mother who happens to be a well-respected endocrinologist and thus shows great enthusiasm (?) for endocrinology and little else. I've got news for you, fat boy. Before your momma became the great Endo that she probably is (I have no idea who his mom is), she first had to make the cut as a competent internist!

Removing him will prove to be very difficult due to the circumstances of his entering our program, as he was ushered in by the powers-that-be. (There are times that I hate being a part of a political hospital). Last time I checked, he would flat-out be denied entry into any other normal reputable training program, as he is clearly not fit to undergo the rigors of Internal Medicine residency, in a toxic public hospital to boot! Ever since first year, he's been screwing up time after time. His tendency to fall asleep anywhere non-withstanding, he also already has a family and thus his priorities are a bit skewed.. He's unwilling to put in the extra time at the hospital to get stuff done because of various family excuses. He knew what he was getting into as an overaged resident with learning issues, and yet he expects special treatment. He's unwilling to make sacrifices for the greater good because he is too selfish  to care (or his brain is too hypoxic to comprehend). His screwups have resulted in forcing the chaiman to create new boneheaded policies which makes everybody else miserable. To top it all off, he thinks he's doing a great job!! Oh my goodness, such poor insight... No wonder our department is a laughing stock.. :(

I just hope this will not happen again (the acceptance of clear-cut incompetents), and that he won't mess things up by foolishly attempting to take the board exams immediately after graduation which he CLEARLY will have no hope of passing, as he will just mess up the passing rate of the department as a whole.

I initially planned to write this piece as a means to take stock of what happened in between, but wound up making another rant.. It just leaves you really drained sometimes..