Confessions of a Primadonna and Control Freak

(A big sister's note to her little brother.)

Dear PB,

A week from now, you should be here in Indianapolis. I can't imagine what sorts of emotions you are going through right now. You must be so excited to make the trip. At the same time, I know you must be anxious about working here. As you know, I am the eternal optimist, so I am telling you that things are going to work out for the best. The worst thing that could happen is that you wouldn't like working here. And even then, home is just a plane ride away. You must be asking yourself, how would you know that you made the right choice to come here? Here's the simple answer. If you find yourself even closer to God, taking up an office in the Church, perhaps, being more spiritually active in general; then you would know that this is where God wants you to be. I have even picked out an office for you :). What do you think of Finance (Pananalapi)? I think it would be a good fit.

And for the record, contrary to popular belief, I am not a primadonna nor a control freak ;). I can do up to 50% of the household chores. I'll do half of the cooking, cleaning, etc. Oh yeah, except for ironing. I don't really know how to iron and even if I did I wouldn't want to iron anyone else's clothes. I have plenty of my own clothes to iron, thank you very much. (Certainly, you can volunteer to iron my clothes, if you would like :)). And yes, I do like making suggestions. But don't you worry that I'll take it against you if you don't agree with my suggestions. Just don't come back to me whining, ok? :) Seriously, I would really like for you to make your own decisions. You can consult me every now and then. But please don't be afraid to make mistakes. That's really when you can learn the most.

I do think that we will get along fabulously. We're both easygoing and laidback. We both want the best for our family. I am sure that all of them are cheering us on! :)
See you soon!

Ate Mhy

ER humor

Growing up, there were Reader's digests lying around in the house. My dad must have had a subscription. I especially liked the vocabulary and jokes/funny stories sections. I learned last summer that one of my med school classmates actually had one of her funny stories published there. It inspired me to think that maybe I could also publish one of mine someday. I think that there is a section called All in a Day's Work. (Hmmm, is there also one called Laughter is the Best Medicine?)

So I worked in the ER today. I absolutely love working there. Sometimes you just click with some of your patients. They are appreciative that you care for and actually care about them. Sometimes they are delighted that you are actually funny, too. Today, I actually had one of those patients. This is his story.

A 32-year-old white male comes to the ER complaining of a deep laceration in his forearm gushing with blood sustained early in the morning. He had been drinking and fell through a glass window. As we prepare to suture him, the registration person comes in and hands him some paperwork.

Registration: Sir, this paper explains payment procedures for those without insurance.
Patient: I wonder how much all of these would cost me.
Med student: It would cost you an arm!
Patient: It would cost cost me an arm and a leg?
Doctor: No, just an arm.

I know it's probably not as funny on paper. But the patient's family laughed really hard. It definitely made my day :).

Michigan On My Mind

My port of entry 15 years ago was Detroit, Michigan. I finally got to see the chapel and attend the worship service there last January. A friend started his fellowship there this past summer. My rotation partner in Peds grew up there. A friend's boyfriend will start a job there next month. A classmate is about to date someone who lives there. Finally, my radiology mentor told me the other day that she knows of this small residency program there that might take someone who has below average grades and board scores. She is suggesting that I do an away rotation there next year to up my chances. All along I've been thinking of some place warmer like Texas. But I guess, Michigan it is!

Physician Under Siege

During my very first day in my Family Medicine rotation last month, the office staff were abuzz that there is this doctor being investigated for overprescribing strong narcotics and short-acting anti-anxiety drugs. I didn't really pay much attention. I overheard them saying his name as Dr. Minilo (?). In the next few days, my preceptor would get calls from his former patients wanting to know if she would prescribe the narcotics for them. I think I already wrote about my preceptor's position on this matter and so the answer was no. One day, we had one of his former patients come in as a "work-in" (walk-in)patient. The receptionist wrote out on front of the chart that this is a former patient of his. So I read his actual last name and it is actually the same as Bro. Felix's. So I told my preceptor that he could actually be Filipino and I tried to educate her with the correct pronunciation. I guess it's hard for some Americans to pronounce the "a" sound like in apple in his name. So anyways, it occurred to me to google him and see where he went to medical school. And in fact, he graduated from UP. He is a cardiologist but he would have patients on cash basis in his office even until after midnight waiting for a prescription. It would be sad if his motivation was primarily money. I guess it would be too naive to believe that he just really wanted to ease his patients' pain and anxiety. But clearly boundaries have been crossed in this case.

Time for some pictures. I spent last weekend with college friends Tala and Carolyn.

Tala is growing an organic lettuce garden. I was tasked to pick some for lunch.


This is where Tala works. Carolyn dreams of working here next year. I dream of using some of the "appropriate technology" developed here someday.













I took this picture of the Seattle chapel. It was a very spiritual worship service last Sunday. The district minister of Australia happened to officiate the service. His daughter residing here got married last weekend.




Waiting for the Dave Matthews concert at the Gorge amphitheater, quite possibly the most gorgeous outdoor concert venue.











Tala and Julio (her husband) salsa dancing. Tala and Carolyn are avid salseras so we salsa danced for 2 nights. I probably should take lessons. My hips still do not want to move. I still yet to find my inner "landi" (flirt) ;).




Carolyn is running a half-marathon next month. She has inspired me to sign up for a 5K run this month. I'll be sure to ask PB to take pictures of me running then :).

The Dread Has Lifted

I just ran into one of my neighbors who gives me updates on the 'hood since most of the time I am oblivious to what's going on. The house across me has been boarded up. My neighbor who I suspect may have broken into my house before and probably stolen packages on my porch has been arrested last Sunday. He is one creepy guy. He was a new neighbor last year so I let him cut grass for me before. He also helped me clear snow a few times. He just creeped me out because I would used to go home from the library at midnight and he would cross to my side of the street as soon as I pull over. Everytime I come home it seems that he is watching me. I am glad that he is now locked up.

The other guy who lives next to me is also gone. He was also a new neighbor last year. I also suspect that he has broken into my house a number of times. I thought he was a person to trust. He was helping me fix my house. Last month, he knocked asking for sandwich bags. I told him to come back some other time. A few days later I noticed that my door was open and my sandwich bags were gone. For the next few days, I would come home and my door would be open. My window was not fixed properly so it was easy to pry it open. I didn't really notice anything else missing at first until on the fifth day or so my little refrigerator was gone. That really pissed me off. I confronted him but of course he denied that he took it. I got the refrigerator for $30 I think at a pawn shop so it wasn't really valuable. But I was just pissed that he would steal from me. Since then he has not been able to look me in the eye. So for a month now I don't even have any cold beverages. And I think he also stole my friend's old checkbook which he left on his side of the house 3 years ago. I would get these letters that his checks have bounced. Of course he didn't write them because he is in the Navy. But anyways, apparently he moved out of the neighborhood last Saturday. So it looks like in one weekend both of my shady neighbors left. Sweet!

On a much happier note, I heard this really cheesy 80s song on the radio the other day and it might just be my song of the moment. It keeps playing in my head. I will write part of the lyrics here with the hopes that it will go away ;).

The Colour of Love
Billy Ocean

If I had to paint a picture
To show the world how true love can really be
I would use the brightest colours
To create a vision of harmony
It would be a reality
'Cause its only what's inside of my heart
You would see I've always loved you right from the very start

Tell me what is the colour of love?
What do you see?
Is it warm is it tender when you think of me
I see the colour of love when I'm thinking of you
As a picture perfect painting of love forever true

Mama Mia

My mom is 100% nice. (I only have half of her genes, so you do the math ;).) But don't be fooled by her sweet gentle childlike innocence. Underneath it all actually lies a resilient woman, emotionally strong even in the face of a catastrophe. She had the misfortune of going through a horrific business failure. She tried to save a sinking ship that could not be saved. Regretfully, in the midst of it all, I was not there for her. I was thousands of miles away, starting college, unable to afford even a phone call home. Nobody was really there for her to understand what she was going through. But I guess all of us have that defining moment when we are at our darkest hour. That is when our conversations with God becomes deeper. Our belief that we are His child is affirmed. Never again do we lose confidence that He will always comfort us. Never again do we doubt that He will show us the way. The financial repercussions of "the problem" cast a long shadow in our family. But really we are ok, that is our only problem; we've learned to get by with having nothing. We have the more important stuff. We have our health, we have each other, and most of all, we are strengthened together by our faith.
Each new day only gets better.

On this day, I wish my mom a happy, happy birthday. I thank my mom for all that she is and all that she is not. What I admire most about her is her endless capacity for unconditional love. Thanks so much for all your love, mommy! May all your dreams come true!

Charmed, Part Deux

So I went to his office sort of chanting in my head, don't be charmed, don't be charmed. He was trying to explain something to me but my mind wandered off, the algorithm running in my head. He is not that cute but he always make me smile. He is kinda chunky so maybe he knows how to cook. He is very smart and very passionate about what he does. He seems to be that kind of guy who will take care of you. I know that he is not married. I am not sure if he has a girlfriend or not. But a friend of mine saw him at brunch one time and she reported that he was by himself. I don't get the vibe that he plays for the other team, so that's good :). But where will he be say 10 years from now? I strongly suspect that he will be exactly right here. And I just don't know if right here is where I want to be then. (Sometimes I imagine being in another country learning a new language.) Who knows even where I'll be in 2 years for residency? Should I ask him now if he goes to church? I don't think I like his last name. Ok. That's enough. Please stop the silliness :). Focus. Where were we? Right, short gut...

Difficult Conversations

I am really liking my Family Medicine rotation a lot. Hands down, I like it even more than my Pediatrics rotation, very much to my surprise. I still see kids but now I get to hear their heartbeats while they are in their mother's womb. I see them as they miraculously go through the birth process. I see them reach their developmental milestones. I see kids go through adolescence. I see grown-ups, moms and dads, grandmas and grandpas. You see a whole gamut of patients each presenting with an interesting story. Even the family dynamics are quite fascinating.

We got asked earlier in the week what kind of doctor we pictured ourselves to be when we first thought of becoming a doctor. This is very much what I imagined a doctor will be doing, taking care of each member of the family. I still remember our town doctor, Doktora Palacol. I don't think she delivered babies but she took care of adults and children. I don't know if she continues to practice. I remember her favorite diagnosis: kidney disease! She would hit you on your sides and if you complain of flank pain, she'd say -- aah, you have sakit sa bato! (kidney disease!) :).

Today was very interesting. My first patient was almost near death a couple of weeks ago. She has long-standing pulmonary hypertension and she was being worked up for its cause. She went in for a routine outpatient endomyocardial biopsy and the last thing she remembered was somebody saying, "oh, something is terribly wrong". They had punctured her heart! Her husband was told that they weren't sure if she would live through it. Obviously, she did, thankfully! :). She just got so wary of medical interventions now that she did not feel comfortable starting a CPAP for her sleep apnea which may very well be the cause of her hypertension. Another patient was a teenager with bipolar disorder. She came in with her mom who she adores and thinks of as her best friend. I went through the review of systems and physical exam. Then she requested that her mom leave the room because she wanted to tell me something. I thought she was going to confide some sort of risky behavior but it turned out that she just has questions about female stuff. It amazes me how much trust goes in a patient-doctor relationship. Another patient was a 9-month old girl with congenital heart defects. She has a very loud heart murmur complete with a palpable thrill that even I could not miss :). They were initially waiting for her to grow more prior to additional surgeries but my preceptor suggested that they call the cardiologist immediately since she seems to be getting worse fast. I pray for her surgeries to be successful.

My last patient for the day was a 17-year-old on Vicodin for migraines and joint pains. He is a new patient and I was curious to find out whether he should really be on Vicodin which is a strong narcotic. His mom was in the room when I came in. I
asked about his migraines and whether he would be willing to try out anti-migraine meds. His mom was adamant that he stays on Vicodin which he's been on for 2 years now. I tried to explain that it's not good for him to be on Vicodin long-term. I told them that there are different kinds of pain and we have different medications to treat them. I even mentioned that if he is really in so much pain, we can even refer him to a pain clinic for pain management. I left the room with the feeling that I have at least let them know of different options that we have in managing his pain. I staffed him with my preceptor and then we came back to the room. My preceptor told him right off the bat that she is not the type of physician who would prescribe Vicodin to teenagers with migraine pain without exhausting other alternatives. His last doctor prescribed him 60 pills and he finished it all in less than a month.

They were really upset about this so when my preceptor left the room I purposely stayed behind. I felt our conversation earlier went very well and I had a connection with them. I told them earlier that my classmates tease me that I have the genetic condition he has because I can bend my little finger all the way down. I told them that I have a strong fascination with Medical Genetics and he is the first person I've met with that syndrome. So I tried to convince them that my preceptor has his best interests at heart. And I didn't think it was a bad idea to try other medications. So I eventually convinced them that they should at least try some of the sample meds that we have. I didn't realize that I had a lengthy talk with them. My preceptor teased me later that she wasn't sure if I needed "rescuing" :). I just didn't want them to leave totally upset. Pain is one of those iffy areas for me. Maybe they'll come up with a blood test or something to diagnose the level of pain :). Maybe it will be easier to figure out if a patient is having legitimate pain. Then I don't have to second-guess myself whether or not a patient is really having as much as pain as they say they do. Maybe they would not have to manufacture fantastic stories or harm themselves even just so they can get their hands on strong pain meds.

Culture of Poverty

Race. Class. Gender. Aaahh, the formidable trio. I want to ponder on class today since we had a discussion this morning. It's interesting how one table can articulate part of your family's experiences. On possessions- we're happy to have each other. On money- to be used, spent. On food- quantity important; key question: did you have enough? On time- present most important, decisions made for moment based on feelings or survival. On destiny- believes in fate; cannot do much to mitigate chance. On driving force- survival, relationships, entertainment.

The reading goes on to say that one of the biggest difficulties in getting out of poverty is managing money. I've always teased my parents on why we've never got a handle on money. Maybe they are right, it is an unfair question. How can you manage something you've never had? I used to always ask why they had more children than they could comfortably raise and put through school. Again, probably a very unfair question. But I look at my brothers and sisters now and realize that everyone is so precious. My youngest sister just gives so much joy to everyone. I can't imagine my parents being happy without her. My youngest brother gives most of his income to my mom and that just totally warms her heart. It's been a financial struggle all the way but I don't think my parents would have it any other way. They would say, "No worries. We survive somehow." They will still not save money because there is nothing to save. There would still be no budget since their income is not steady. There will still be unexpected expenses. My heart will still break every time I get a plea to send more money on top of what I have budgeted for and I am unable to oblige. Am I supposed to cancel my vacation plans so I could have sent the extra money to them? At the end of the day, yes, I will still take that vacation. I would never want to have feelings of resentment. I don't really like the word "sacrifice". I prefer the term duty. I feel joy when I fulfill my duties. I do have to define for myself what my duties are. Once defined, whatever it takes to fulfill them, I will gladly do with love, joy and peace. If you are happy doing all the things you do, is it still considered a sacrifice? There is only one example of ultimate sacrifice. There would be nothing that I can do to even compare. My purpose is not to sacrifice. I'm here to accept my duties and fulfill them cheerfully.

Challenging the Process

The job interviewer asked me if I could change one thing about my college, what would it be? My gut answer was that I really loved my college experience and I would not change a thing. The second those words left my mouth, I knew that I would not get a second interview with that company. Oh well, I try to be authentic, I told myself. I was interviewing for a business consultant position that spring of my senior year. Consultants by definition are called upon to study a company, find areas that could use improvement, and then provide solutions.

I am not one of those people who naturally seeks ways to improve the system. If somebody points out a problem, that's the only time I try to think of solutions to the problem. I can't really come up with problems on my own. Is there such a thing as being too content? I alternate between admiration and curiosity for those who are always finding something wrong with the status quo. I do agree that there is always room for improvement. I do have empathy for other people's concerns. I am curious though, do you have to be personally discontented to challenge the process? Or is it enough that other people are? I don't know if I ever want to be discontented. I somehow equate that to being unhappy. And I wouldn't know what to do with myself if I would become unhappy :).

Other things come a little bit easier for me. Making connections... encouraging the heart...inspiring others.. modeling the way. But challenging the process, thinking outside the box, aaahh my Achilles' heel! ;)

First Baby

My preceptor got paged twice while we were in the middle of talking to a patient. The baby must be coming out soon! The hospital is just 3 miles from the office so we were there in about 5 minutes. My heart was pounding as we ran to the delivery room. I didn't really know what to expect. My mom delivered at home at least thrice and I can remember her yelling and screaming :). We got to the room and mom looked calm thanks to her epidural. It's her fifth child so she did not have any worries. It felt surreal as the baby's head started to come out as mom pushed as hard as she could. It was going on smoothly until the baby's shoulder got stuck. It seemed like an eternity to me. I could see the baby turning real blue. My preceptor then helped the delivering intern put pressure on mom's abdomen until finally the baby came out. Whew! I was afraid that something would go wrong. I was tense until the baby finally let out a loud cry. We left the room with baby on his mother's arms while his dad proudly looked on. We're going back tomorrow to circ him. His birth is probably one of those images that will stay with me for a long time. So that's the story of my first baby :).

The Princess Has Ugly Hair Color

So I got new highlights and hair color last Friday. I immediately suspected that the new color looks absolutely horrible on me. My friends noticed the color change but were too polite to let me know what they really thought of the new color. So for the last few days I've been trying to see if the color would grow on me. Finally tonight, the minister's wife, seeing me for the first time with the new color, whispered to me that I've got to do something about my hair. That's what I thought! I wished that somebody would have told me sooner ;). So I got one of these hair color stuff from the drugstore. Here's hoping that it would work. I'm supposed to be reading up on the differential diagnosis for the acute abdomen my patient had today. But here I am instead being vain trying on a new hair color. And I used to think that people who color their hair are so fake :).

Real Estate Markets

Of the nation's 40 biggest metros, which one has the most affordable housing?

Famous College T-shirts

My favorite college T-shirt was featured in the New York times recently.

Pisay the Movie

Ohmigosh! Has anyone seen this movie? I thought I heard rumors that a movie is being made but I lost track. I happened to just see an article on inquirer.net that it will be shown at the Toronto International Film Festival. Can someone get me a DVD copy whenever it comes out? I still remember the exhilaration upon finding out that I passed the entrance examinations. The trailer shows the school as I remember it-- front lobby, grandstand, soccer field, chemistry lab, dorm room. It's hard to forget our uniforms, dances, stargazing activities and best of all our camaraderie with one another. Here's a description of the movie.

Spring Break 1995

Edith, Glenda and I decided to spend Spring Break '95 in the Washington D.C. metro area. The parents of Glenda's boyfriend then had offered to host us. We also invited our 2 new friends from the class above us, seniors Toby and Jessica, to come along for the ride. Toby and I share the same birthday. I was turning 19 that week and Toby was turning 22. So we packed our bags, rented a van, and excitedly left Mount Holyoke for the nation's capital.

The nation's capital did not disappoint. We loved the Smithsonian. The Holocaust Museum moved us. We also went to Mount Vernon and Colonial Williamsburg. Edith also wanted to visit her friend who was then studying at the College of William and Mary.

I met up with Edith and Glenda in New York last December. Edith has been living in Ecuador. Her husband works at the Guayaquil U.S. consular office. She was just back in town to deliver her 2nd child. Edith mentioned then that her friend that we visited that Spring Break has been murdered. It was so sad to hear of a promising life so quickly extinguished. I remember him as being very smart and very committed to public service. Edith just sent me this link that a year since the murder, the case remains unsolved.

Happy Birthday Daddy!

My dad is probably my blog's #1 fan. So today on his 59th birthday, I am dedicating this post to him. I am told that everyday he checks if I have written something new. I think my dad gets very much amused by my silly stories, comparative sociological analysis and deep insights into the human psyche ;).

I'm sure that he is proud of where I am now, almost a decade and a half from the day he let me go to experience the world. I suspect though that a part of him longs to know the specifics of my journeys. Every little post then becomes a clue to the person I have become. Every story adds color to my past and present. With every sigh, he gets to share my yearnings for the future. I then become less of the "imaginary" daughter, I become more "real", a little bit closer each time.

I meant to write on Father's day that truly I could have not asked for a better father. I may not be "needy" in the usual ways, but I don't want my dad thinking that I don't need him. He doesn't need to worry about putting me through school nor making decisions for me. But part of what has given me courage during times of uncertainties is the implicit assurance that he will always be there for me no matter what.

I thank my dad for not giving my mom any reason for her not to be crazy in love with him after all this time. I thank him for being kind, logical, and selfless. Providing for seven children surely has not been easy for him. Through his blood, sweat, and tears, he made sure that we all got an education. I asked him earlier what he wants for his birthday. He said that he just wants us to remain as good children. With him as our role model, it should not be too hard to do :). Happy birthday, Daddy ko!

Occupational Hazard

I was seriously examining the cutest 5-day-old newborn today when he decided to relieve himself just as I was taking off his diaper. He did not get my face but he did wet my pants :). Welcome to outpatient Pediatrics!

Transformers

more than meets the eye.. autobots something something... decepticons.

i watched a lot of tv growing up. here are other favorite cartoons i still remember:

1. Superbook
2. Super Friends
3. Bugs Bunny
4. Richie Rich
5. Astro Boy
6. Mighty Man and Yukk
7. Smurfs
8. Popeye
9. Scooby Doo
10. Flintstones

Charmed

I might look back to this day and say that this was the day when forever started. It's probably highly unlikely but I thought I would at least mark this day with a short post. I know, I know, I'm such a hopeless case :). But a girl can still dream, right? ;). Here I go again daydreaming, as usual. Sorry, it's my nature, I can't help myself hehe.