Two weeks into my elective. I constantly end up facing a wall of unintelligible equations and would have to take a step back and read on the basics. I really should have taken more math courses during my undergrad years. Then again, the BSPH program is not so heavy on the math part although I wish it would have been. It would be so nice to really understand Biostatistics and Epidemiology inside and out.

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Met an MD working as a research associate in our department. He advised me to take up a graduate degree in the Philippines first before applying to a grad school abroad. But but but... I don't want to take my master's degree here. The most I would do is take some math and statistics (maybe even economics) courses that I know is lacking in my education.

And I should also find my "patron" who will support me in my career and my grad school applications. I guess that's sound advice. I often hear that doors just open once you graduate and get your license. I do hope that is the case.

In any case, I need to join an organization that has good linkages, good pay and lots of opportunities for personal growth. I need to be impressive when I face those scholarship committees.

data cleaning. not the most fun job in the world. another task that I will have to inflict on the research assistants I will hire someday.

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I think I need some new button-up shirts and pants in warmer fabrics.Can't wait for Japan this December.

Last LRDR duty tomorrow and we have ICCs. I'm so happy that OB-GYN is ending that I almost forgot that I still need to look for my missing BP app that is less than a month old. I'm still puzzled as to how it disappeared since it has my name written all over it.

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The OB-GYN department gives good services. Too bad it's also very wasteful of resources.

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Saw Looper. Sci-fi short stories make good movies. 

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Chance encounters (clean encounters, you dirty person you). The habit of staring at people isn't too bad I guess.

I hate that I'm so close to the SC and I can't even find time to join the Cybercrime law.

I effin hate how it sounds like this law was made by people who do not use the internet.

It boggles the mind how this law was passed and how that person managed to sneak in such a nasty provision.

Knowing the speed of the legislature here in the country, we cannot settle for amendment. What will we do during the time that is in effect? Keep silent? Repealing it is the only way to protect our freedom.

OB-GYN starts tomorrow and then elective after.

This is bad. I'd rather read up on regression analysis than OB-GYN CPGs.

Witness to death as it approaches slowly but surely.

She's one of the fortunate ones. She is comfortable and the family members can say their goodbyes.

Failed to gain 5 pounds. Then again, there is still a week of Fammed left.

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How unfair is it to expect you to know a patient you have never seen in your entire life and answer questions regarding her status based on a piece of paper?

I'm anticipating the hell we'll go through next Monday. Apparently, we need to know about unresolved patients admitted at the OBAS by 7 AM even though we are not part of the duty team and we've never seen the patient. What do they want? Do they want us to go to the OBAS at midnight or around 5 AM and check out the unresolved cases?

Then again, at the very least, I should read on the theoretical stuff. It's time to consume CPGs like there's no tomorrow.

---
I can't bring myself to work on that damn research manuscript. I need a pressing deadline and the editors of the journal aren't giving any.

I don't think I'd ever want to be a hospice and palliative care specialist. I can't handle that many problems. Biomedical problems seem like a piece of cake compared to psychosocial problems. I guess I just find it so difficult to force people into changing their behavior.I'm also uncomfortable interfering in family issues.

I do appreciate the lessons on disclosure and the opportunity to focus on the psychosocial assessments of patients.

My endorseable pedia patient died today.

I'm not rotating in pedia anymore. The new student-in-charge just sent a message to me this morning. Some part of me wishes that I had been there when my patient went into code. Maybe the resuscitation would be successful if at least one of the original team who handles him is there.

I actually feared that my patient would die after I shift out of the ward. He just received a new resident-in-charge and a new student-in-charge. They would not be familiar with his own brand of toxicity. Of course, it could very well be that he is beyond saving at that point in time.

At the very least, I want to comfort the mother of my patient who had worked so hard to keep my patient alive.

There's nothing like a patient to make you realize the inadequacies in your training. I wish they would have taught us how to run codes and advance life support during ICC year so we won't be so lost and be such a burden during the early parts of clerkship. Sure, they teach us about compressions and protecting the airway but they don't really teach us the specific steps and roles we as medical students can play during codes and resuscitation efforts. I hate the feeling of being a burden to my service team. And if I must act as a runner, I should at least be taught what materials we need rather than learning on the spot and being scolded for it.


OTOH, I do not like the inadequacy of materials in this hospital. Why should the medical students provide the basic needs like tape, scissors, syringes and gastric tubes? Why should we be forced to do a scavenger hunt in the hospital for necessary medicine for our patients? Shouldn't there be a stock supply of these things? I do not like the role we are put in to: walking supply cabinets. Sure we can opt not to provide these materials but you'd still have to produce them somehow. Frankly, it's much easier (and it looks better to your seniors) if you just have these materials on hand rather than run back-and-forth between wards and supply rooms. It teaches students to be resourceful and sneaky but is it really good to be proud of being resourceful if you work in a broken system?

Objective for the week: mastery over the fountain technique.

I dread the Pedia ER duty tomorrow. Monitoring at 4AM after a night of no sleep is probably one of the worst experiences a person can ever have in his lifetime.

I don't know which is worse: getting assigned a patient where it would be difficult to perform procedures on (e.g. psych patient needing restraints, leukemic patient with very weak veins) or getting the vital signs of patients in the ER every hour.

I'm just relieved that the pedia ER week is almost over and I have just only one duty left. I don't think my wallet can take any more abuse. I had to go to Bambang in order to replenish my stash after one lengthy ER duty.

Cinemalaya 2012 notes:

-The Filipino family. Diablo, Mga Dayo, Aparisyon, Requieme and Ang Nawawala; all films tackled family. Weird or maybe not. The concept of a Filipino family seem to be in a state of flux and each generation seem to value the family differently.

-Aparisyon is one of the best shot films I've seen in Cinemalaya. The film makers really hit the jackpot with their cinematographer.

-Requieme paints a really good portrait of Philippine society. Some scenes are almost too painful to watch, sapul eh.

-Ang Nawawala is a coming-of-age film done well. Can't help but notice the Norah-ness of Edin. Can't say it's a Filipino coming-of-age film though. If this is how upper and upper middle class kids are, substance abuse psychiatry sounds like an attractive specialization.

-Pwedeng wag tumawa sa mga eksenang hindi naman dapat tinatawanan? Mature mehn.

-Avoid watching any movie with med students or doctors. They can't help but cringe at the mistakes films make with regards to medicine and health.

"We tested the efficacy of those mosquito traps in areas with the highest reported incidence of dengue. In 2011, traps were distributed in Bukidnon—which had recorded 1,216 cases of dengue in 2010. After distribution, the number of cases decreased to 37—that is a 97 percent reduction rate. In the towns of Ballesteros and Claveria in Cagayan, there were 228 cases of dengue in 2010; in 2011, a mere eight cases were recorded. In Catarman, Northern Samar: 434 cases of dengue were reported in 2010. There were a mere four cases in 2011."

Right... The figures seem to good to be true and I remain skeptical. I have failed to find papers evaluating the effect of lethal ovitrap on dengue incidence. The ones I found are on mosquito populations which showed no effect or reduction to around 50% of mosquito populations.

I also have a problem with their indicator. Using DOH reports of dengue cases is not the best way to measure efficacy of this intervention. Dengue fever is probably defined differently from one doctor to another and may change every year. I think the WHO case definition (using the algorithm) is too sensitive and not very specific that it should not be used for research purposes. Seroconversion among a cohort should have been done as this is the best way to determine incidence.

At the very least, I hoped they used a valid control community where they implemented the same dengue program except that  the traps do not contain larvicide.

It's Cinemalaya time again and clerkship will not prevent me from enjoying this years selection of movies.


True to Cinemalaya spirit, lines still take a long time to clear up and tickets get sold out for many shows. Looking at the bright side, I get to see two films that was not part of my original choices. I think the two, Diablo and Mga Dayo, were in the bottom. Although I was not happy with Diablo, I do appreciate the wonderfully shot nighttime scenes. If the director had pushed for a more suspense-type movie, he would have been more successful. Mga Dayo was a pleasant surprise.

Mga Dayo has a really nice ending theme hence the link. I also see why it was chosen for this years festival despite having a much explored theme: immigration, OFWs, Filipinos abroad. The way I can best describe it is that it has a lightness rare in Filipino movies. It has a delicate touch I guess. It doesn't bash you and scream, "Look at me! I'm a Filipina abroad and my life kind of sucks too!"


Granted, I still want to see my top choices so I bought tickets for the next two movies I'm going to watch this week. No more lines! Yey!

Met a fammed case in ortho opd. I hate that these "surgeon" residencies often ignore the other problems of the patients. We are often told that we should always look at the patient as a whole and address the most pressing problem in the patient. This may or may not be within the area of specialization. This may or may not be related to the chief complaint. We are all trained to become general practitioners first and we should always act like one if the patient has problems outside of the specialty. Often times it means referring to another physician and at the very least, educating the patient and giving preliminary management.

---
Today, I met a breast cancer patient who is deferring chemotherapy. It sucks that she got sent to Ortho. Surgical OPD clinics are not known for their use of the biopsychosocial approach. They don't even use the complete clinical approach. It was clear to me that her problem is not the shoulder pain but lies in her family. Something is terribly disturbing if a patient who just underwent MRM continues to view her cancer as death sentence. Maybe I should have sneaked in a referral to Fammed or Hospice on her chart.

Participated in another code.Again the patient was not revived. I wonder why our block is so unlucky.

On the other hand, I realize what skills I need to develop so that I could provide better care.

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Is it normal that I view my patients as puzzles that need to be solved?

Codes. Not as tension-filled as I had expected but really tiring. Or maybe this is just the de-humanization process kicking in.

finally got to see my grades. surprisingly, I got lower grades at the subject I thought I did well at and my decent grades for subjects I felt I really sucked at.

Rationalizing this experience, I shouldn't care that I probably won't get an MD with honors. I won't be going to residency where grades still matter. But I don't really know what scholarship committees look for and having good grades wouldn't hurt, right? And I'm losing my chance of giving a good graduation gift to my parents.

Cynthia explains why and sings Blackbird cover [HD]

Safe journey Cynthia Alexander. Thank you for the music.

I hope I can catch you live someday.

One down.

Mostly happy that I started with a rotation that allowed me to work out the twisted system of PGH. But also happy that I return to clinical work in a rotation that values a good and through history and physical exam. I'm already lazy as it is.

I'm also fairly sure that a resident's life is not for me. Weekends are that important apparently.

So I suddenly thought of how my own house would look like. I'm not even sure if I'd have enough money to have my own house built. My generous parents have bought some land but the rest is up to me. The easiest to build in my mind was the kitchen/dining room which would have to be adequately equipped and stocked for my forays into the culinary arts. I'm pretty sure I want my house to be have two floors. It would allow lots of light to enter and would have good ventilation. At the entrance, it would have a space to remove and store shoes like how those areas the Japanese have. I'm sure I want my bedroom to be on the first floor. I think I'll keep the living room pretty open and sparse. The second floor would have the guest room, the study and again more open space for whatever hobbies I might have in the future. The space would probably be my default reading area. I'd have a wall with lots of books and comfy chairs. The study would be my home office. It would have my other books, a decent computer and a printer that doesn't suck. Wooden floors seems nice. Tiles would be easier to clean though. Oh yeah. I'd have my child's room in the 2nd floor. I plan to deprive him or her of computer games until he or she gains a strong reading habit.

Okay. Stop dreaming and get back to studying.

okay. I'm not yet in my study-or-die mode.

This day sucks. My stethoscope is missing. I seem to have misplaced my penlight. I have two relatively weird patients.My lunch was too expensive and the vegetables didn't taste right. The weather is hot and humid. It took a very long time to enter the LRT station. A classmate accidentally spilled coffee over my laptop rendering its keyboard useless. The BSFs need to be resampled for the nth time. An issue I thought had resolved seems to be rearing its ugly head again.

Fortunately, I have made a back-up of important reference materials in my USB, all the BSF files are in my Dropbox, my classmate in his guilt would pay for the repairs, my friend made onigiri and gave me two, I don't have duty this week and this ugly head will not be seen much due to clerkship.

Clerkship starts tomorrow.

 Our block is lucky that we won't be experiencing the worst version of "shifting dullness" since we'd be starting with Rehab med. Unfortunately, this specialty demands a more comprehensive history and physical exam with the addition of ROM measurements, functional history, special MSK tests and, if you're unlucky, a psychiatric history. At least there won't be patients to monitor.

I feel the urge to accomplish the things that need to be done but I'm to lazy to do it.

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I like solving problems. Problem is when I know how to solve it or at least have the conceptual framework down, I stop. That's why I think I work best in groups.

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Listing down things helps keep the brain calm. Makes me think that I have at least accomplished something.

So that's the buzz of alcohol. Maybe I should have drunk another glass.

Knee itches though.

it seems that I haven't posted any pictures for quite a while now...

I should fix that.

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My tutee got a score below passing for her finals but she still passed the subject. *sigh of relief* One hour is just not enough to cover a semester's worth of topics. *sigh*

my fingers hurt. the sampling frame is nearly complete. damn hospitals with non-functional phones.

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I dread the day that this will happen to me.

on one hand, I get money. on the other hand, it means she is in danger of failing the subject. *sigh*

and I still need to brush up on molecular orbital theory.

thank you hard working government officials. I just hope we have a better information system in place so we'd have an updated database of all things important regarding our health care system.

These government records are giving me a headache.

Beach finally...  Can't beat the feeling of mildly burnt skin and sore arms.

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Just  a thought. Whenever I share to some MD that I don't plan to be a clinician (in the sense that it won't be my main source of income) and shudder at the thought of spending the rest of my youth in a hospital, they warn that I shouldn't be surprise if this outlook changes after clerkship. One advised me to not be too set on my goals of practicing in public health. I wonder if they would ever say this if I say that I dream of becoming a super specialist instead of becoming a research or a public health person. I wouldn't be surprised if they replied, "Good for you. Be sure to go to hospital X for training."

Small ways the system discouraging non-clinician careers for MDs. hmmm...

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Based on my fb feed, the outside world (e.g. the corporate world) still has a lots of extra-curricular *ehem* activities outside of your job description. Mental note to self, remove dancing under skills and the dance orgs in org affiliations. Must avoid becoming the resident choreographer/performer for any organization I join in the future. Unless I'd be working with people with uber dance skills.

one less book off my summer reading list. I'm excited for the Last Battle but I really don't want to read it from Rand's POV. I don't know why I hate the main protagonist in this entire series but I do.

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Boss is imposing a five day week for our research team. Goodbye 3-day weekends! I'm sad to see you go but... this also means that goodbye to 10-hour workday! Good riddance!

And it looks like he's serious about us calling all of those BSFs by June.

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 Better get started on the novel mentor wants us to read. Finally going to read a "general" fiction book after years of fantasy and sci-fi and manga.

turns out our universe and sampling frame is off. not by some ten facilities but a little less than 400 facilities. damn. And boss still wants us to call all those facilities. It took us three weeks to call 275 facilities. It's annoying because the agency which commissioned this work should have given us this information months ago or corrected us that the universe is not just 300 facilities. Getting the sampling frame wrong is such a rookie mistake. damn it. I should have known better. But no use crying over spilled milk. We just need to move forward.

But I do hope that we won't need to call all those other facilities. Can we just call those facilities that have missing information? If the local departments can provide us with complete information enough to perform sampling then we just call the facilities that are included in the sample. We can call all the other facilities but it shouldn't delay the data collection.

Besides we still need to do a whole lot of stuff. Whoever can  give a suitable Filipino translation of the phrase "model the cost-effectiveness" gets a Magnum bar.

Diagnostic kits and technology is a big field of research. Name a disease and you'd find lots of laboratories working on different ways to diagnose it either through the use of clinical data, serology, nucleic acid technology and lots more. In the past hour, I've read about ultrasensitive biosensors, a game that can diagnose malaria and a urine-based malaria diagnostic test. I seem to recall some people creating a mobile phone app that "diagnoses" dengue (it doesn't. It just determines platelet concentrations).

It's nice to hear people innovate and try out new stuff. New stuff is good. New stuff leads to breakthroughs and revolutions. Coming from a community background though, I can't help wonder if creating new health technology is worth it. Wouldn't it be better to invest in old but proven solutions? The addage "If it's not broken, don't fix it." comes to mind.

For example, microscopy maybe the oldest method in the book but it doesn't mean that we should stop using it. Besides, technology is expensive. Between a diagnostic kit that can diagnose only one disease and a microscope (plus training of a microscopist) that can be used for lots of things, I'd invest on the microscope.

Or maybe I'm just being a Luddite.

I'm responsible for editing and finishing up the study tool. The Universe continues to find ways for me to appreciate my degree in public health.

Hey! I've played a role in the design of study tools for two national studies. I still have room for improvement though. I tend to design more for data encoders rather than data collectors. I also need to work on making study tools pretty. Pretty study tools make the job of data collecting less of a burden.

On a side note, aside from those who chose to go to med school, no one in our BSPH batch is unemployed.

I'm working for two research projects called Twilight and Eclipse. It's about blood banks (our technical term is Blood service facility). Get it?

criticizing the work of someone else is so much easier than making your own. yes, I'm still not done with the amoeba paper.

I should really stick to the deadlines I set for myself. Ah screw it, I'll just write something and hope for the best.

In other news, we finally have a clear plan on how to conduct the blood bank project. Sadly, we still have many centers left to call.

This paper editing thing is taking longer than expected. I'm too tired to work on it on weekdays and I'm only interested on it for about an hour on weekends. Not to mention that I'm starting to think that we need to do an additional experiment to prove the validity of our methodology. *sigh* I just need to mull things over and wait for something to click. The words don't seem to string together and form a coherent passage. Hopefully, going to a meet-up later would be the sort of distraction I need.

---

Also, Pusheen is god.

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Someone please hurl me to a beach (throw in some lunch money too). I need to feel the sand and the waves.

As my feed gets flooded with status and pictures of classmates taking their electives, I feel a bit jealous.

Not that I regret my choice of working as a research assistant this summer. I get to do something that I like and get paid at the same time. More importantly, I get to experience how social research is done in our local setting. Something I will not experience even with the very liberal UPCM curriculum. As I was talking to my friend about how I'm like a call center agent for the past days, she thought I'm hating it. But I'm not. Even though it's grunt work, what I'm doing is my preparation for when I head my own research projects.

And I could always go abroad for a real vacation.

But I would hate myself if I don't get to go to the beach this summer.

I probably won't be doing field work again for my summer job. It's nice to see the admin side of research projects though. I was hoping to go to at least one new province I've never been to but it's okay. At least, I can have my trigger points lysed and present our research to an international (albeit Asian) audience. And I won't have to suffer through this summer heat.

the universe doesn't want me to gain weight and be fit in time for clerkship. hello subscapular bursitis vs scapulothoracic bursitis! I hope the health service refer me to rehab medicine already, NSAIDs do decrease the swelling but it comes back once I stop taking meds.

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I may not go to my summer immersion this year. Grandfather is sick and I don't trust his current doctor.

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So this is how it feels to live in a condo with high speed internet. Good thing roomies will be gone for a month, I can download all the torrents that I want.

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Editing the manuscript wasn't as hard as it initially seemed. I just need to write two or three more paragraphs and I can return it to the Editor.

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I'm hankering for a photowalk. Time to take a shot at capturing that Manila sunset.

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I think I won't be seeing the beach this summer but we'll see.

working again in research. I love it but I'm dreading my tasks for this month. I'd be surprised if I don't become crazy after this venture.

at least I now know the password to the office's net connection.

I'm in the mood for some blasphemy today.

that was not fun.

watching an MMK episode wherein two brothers walk from Manila to Samar.

oh look, older brother got a wound on his foot... this sounds like a set-up for a sepsis-related ending.

happy that the comprehensive exams won't be based sample exam based. because so far, LU5 seems to measure your ability to recall sample exam questions and not actually knowing the material required of med students.

noticed a progression in materials that I read for exams. I've "graduated" from transcriptions and have now moved on to actual medicine books, SIMs and CPGs. Unfortunately, most of my reading material is in my laptop. Not being able to highlight stuff isn't much of a problem, the problem is I am perpetually at the mercy of power sockets and the temptation of the internet. Good thing, I'll be spending some time in Bulacan for the next two days and the net connection there is weak.

last Sunday, I facilitated a workshop on return of service. It seems that I found that thing that I can do next year outside of clerkship. Got me thinking about the DTTB program again. I'm fairly certain that my personality doesn't match the full community medicine experience then again, I'm not a good judge of what I am incapable of doing. I will have to think about these things again during my community medicine rotations in LU 6 and 7.

bursts of funny memories...

1: paano ka naging top ng PH?

2: uh... pumuntang Canada iyong top 1 and 2.

1: what?!

received the review of the amoeba paper. so this is how it feels to be a researcher. good thing I still have an adviser I can approach.

encounter with a stage IV breast cancer patient unaware of her diagnosis. I don't know if I'll ever be ready to talk to these kinds of patients. Must make friends with people interested in Palliative care.

character witness na ba ngayon ang labanan?

good luck funding skeletons in my closet, actually, you need to find the closet first.

slogans another way to waste procrastinate. one more site to destroy once you realize you're going to fail compre. best slogan I got so far: "The World's Favorite Ado" and "Naughty but Ado" XD

The additional costs of med school. My classmates often complain of the cost of traveling to the communities we serve during community medicine, family medicine and COME posts. Although it would be ideal if the costs are included in the miscellaneous fees we pay, I think of it as a form of spending similar to how we spend for transes, medical equipment and hospital supplies. It's a necessary cost of our education and we should not be so angry about it. Truth is the cost of traveling to these areas are quite low and in all likelihood, will be well within a normal medical student's daily allowance. Maybe you won't have some money to spend on that iced drink or would have to defer that new haircut, but unlike those things, this is crucial to your education. It would be even cheaper if you use mass transportation like the train and jeepneys instead of riding cabs all the time.

so I will be facilitating a workshop on return service programs for physicians in 2 weeks and I don't have a concrete plan yet. The idea is to determine to what extent our organization will act on this issue: are we promoting the idea of a compulsory service for all medical graduates? do we limit it to public school graduates only? or do we just encourage it? I've been searching for good papers on the topic. I found one which looked at return service (also known as obligatory or required service) programs in 70 countries. They described various mechanisms to implement the program. Still, issues I have been contending over the past weeks were brought up. The most glaring of which: Why should graduates of private medical schools agree to this program? I don't have an answer for this question. Of course, another question that we pose in the workshop is what factors or reforms should be implemented in order to make the reform more palatable to graduates. Maybe I should leave it to the participants. But I have this thing. I don't like facilitating workshops when I don't have a definite stance on the issue. It's not that I try to influence the participants towards my position but it's a way for me to prepare for most of the issues that will arise during the discussion. If I know the issues, I know the questions to ask so participants will have an easier time discussing the issue.

day 2 sucks. --- Hello Carly!

even simple steps look brilliant if you have perfect control and swag. digging this movement away from the manic and big movements one often see in hip hop nowadays. (disclaimer: has not been attending classes since 2010)

from stitching a person up to getting stitches on my head. what a way to end ICC-year.

Difficult patients. I don't like them. It's not just kids who cry even with the slightest touch. It's the patient who refuses undergoing physical exams because the doctor at the other clinic already did that. It's the informant who keeps butting in because she thinks the patient is incompetent in answering our questions. It's the parent who doesn't say it out right but is clearly annoyed that they have to wait more for the consultant. It's the patient who refuses to answer history questions because they have been interviewed numerous times and it's already written on the chart.

Still, we must perform our task. I feel for their frustration at the system but that's the trade-off for consulting at a teaching hospital. When I'm in a bad mood, I become stern and just finish the damn thing as quickly as possible Or if we're working in pairs, I sign off and just volunteer for the PE. The best though is put on your best smile, provide a good explanation on the matter and project that you know your stuff. They'd often come around and at the end of the visit, they even thank you for all your help.

Although in one recent patient, the patient thought we were just playing around or something so she was angry and shit but then when she realized that we are going to be the actual "doctors," she became much nicer. Even thanked us after the visit.

Still difficult patients, I don't like them.

Tumblr's eating my life and I don't even have a Tumblr account!

Virgin coco oil great for sex and cholesterol

I highly doubt it but let's wait for full report. Excited to dive in and analyze the data. Hopefully, they'll publish it online and the paper is not behind a paywall.

Points that triggered alarms:
-n = 189
-no mention if healthy subjects or subjects with dyslipidemia were used
-unequal number of treatment and control
-just 4 months
-use of placebo instead of identifying which oil
-no change in BMI and weight
-a chemist as team leader

Still even if the study is true, I won't be advising use of VCO just yet.

bwiset ka.

It's logical to plan for massive events such that you won't disrupt the lives of hundreds of people. Manila City Government, I'm looking at you.

I was able to witness that sheer number of commuters in Manila walk the streets not in protest but in resignation. They just have to walk home or at least far enough from that massive clog so they can ride a jeepney towards home.

Also, you don't allow any organization to use a venue if you know for a fact that that venue will not be able to contain their desired number of attendees.

bakit ba ang manic-manic ng mga usong dance numbers ngayon? covering lots of styles in a span of 30 seconds. I commend the skill needed for this and the unique talent for creating these types of pieces but I would really like to see choreography that exhibits the full potential of a style or fresh use of the different dance styles. But that's just the me who demands to be inspired and not just entertained when I watch a dance.

prior to LU 5, I feared for my med education since I wasn't using Harrison's and the other med books during LU4. I often hear that the reason why other med schools fare well in the boards is because they were able read these. That fear is now gone. I am learning to appreciate the design of the curriculum. As we encounter patients, we are forced to read about the diseases (and yes, I use the plural) the patient has. Due to the variety of patients we encounter, we get to go through Harrison's, Nelson's or William's one way or another. And  the design treats us as graduate students who should take a proactive role in our education.

It's funny how some people on twitter are responding to an atheist on TV. Some are questioning his atheism because he has a nice attitude, just angry at the Catholic church, his name means God is with us, and, the reason I found most laughable, open to the existence of God.

I'm offended at how lightly these people treat our decision to let go of a god (or gods). I would like to think that for most nonbelievers, it is a product of a long period of soul searching. From birth, my family would instill the value of the Christian God in my life and realizing that I don't care for that almost amounts to betrayal of my family. Eventually, I had to try and compromise. Maybe I can still believe in a god but not it's religion. Maybe this is just the wrong religion, I should test others. Maybe I'm not trying hard enough. In the end, I just let it go and choose to live life freely without these things. I still need to tell my parents about it but they don't need to know right now.

Of course, I'm still open to the existence of a god or gods. I just don't feel the need for it and its teachings to guide my life. I have a brain and I will use it.

 

so much for being stellar in OB-GYN. Will have to work hard on other exams to maintain my average and ensure plans are intact.

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Grey's Anatomy reacquainted me with My Funny Valentine and I'm now searching for my preferred rendition. found it

Got an sms from my old boss offering me a position in WHO. Unfortunately, it's a full time position from February to April. Again, med school gets in the way of life.

Update: He told me he has a lot of projects on hand and is interested in hiring me this summer. He's hinting that I can be involved in more than one project. This means more experience, learning and money! Japan doesn't seem so unreachable any more. hello summer elective equivalent!

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Post-LRDR duty. Got to "catch" a baby, deliver 2 placentas (one on my own), rupture a bag of waters, IE a dilated patient, perform labor watch, perform toco-monitor, "manage" hypertensive patients, insert a Foley catheter, "assist" in laceration repair. High yield indeed but am not looking forward to doing it again next school year.

and still I am surprised. Thanks.

I should stop. But I can't and I don't want to.

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Adele sings too much about my life.

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My tasks for January has overflown and drowned March. Can I not have a month of a normal ICC life?

OB please end soon. Then again, the end of OB signals the approach of tons of things: AMSEP, Flash mob, NMSC, Finals, Compre, Grand OSCE and clerkship. Feels like being stuck between a rock and hard place.

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Something surprising happened today but I shouldn't be reading too much into it.

performing internal exams, not fun. as much as I accept the fact that I am still a noob at these two subjects, I want this rotation to end. Or maybe it's just life getting in the way of studying.

not turning in early last night might just have been one of the best decisions I made this week. this and deciding to switch duties with my blockmate.

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So I say goodbye to pedia with a sore throat heralding in upper tract infection. Kids, disease incubators you can't stop playing with. I'm still investigating why kids (mostly 3 years and below) have this weird, almost in awe look when they see me and my big head.

Despite having a very disorganized learning paradigm, pedia was a good rotation to train your history taking and physical examining skills. This is one of the rotations you get to develop your style in handling difficult patients and their mothers. Lastly, brightly colored clean blocks can save save your ass in pedias, that and a good supply of breastmilk.

just talking is good enough for now.

gusto ko na matulog. pwede ba next year gumala na lang sa New Year... without the family? Or mag-volunteer duty sa PGH? Gusto ko mag-treat ng naputukan.

Our neigbhorhood seems quieter this time around especially with that blasted boga of yesteryears gone. Sadly, I do notice that there are increasing encounters with kids who smoke and drivers who smoke inside moving jeepneys. I am not aware of any program for kids but the LTO or LTFRB program is failing. Even drivers who have No Smoking signs inside their vehicles, smoke. I say confiscate matches and lighters and ban cigarette peddlers especially in terminals.

sana dumating na iyong dapat dumating. in the meantime, Skyrim at transcribing interviews.

why am I still at home?

(oh hello 600th published post!)

Bah humbug.

PhilHealth will be releasing funds for treatment of Sendong victims in both accredited and non-accredited health facilities.

Something is wrong with me. I'm thinking too much like a manager. This is a logistic and bureaucratic nightmare. I feel for the people who will be handling the tracking, disbursement and reimbursement of funds.

Apparently, people already know what is wrong and what needs to be done to be prepared. You think a country which experiences at least 20 typhoons a year would be better prepared for these things.

 

or google help sendong. There are lot's of ways. My feed is full of links and probably, yours is too.

let's be selfish for a moment.


I want a new canon body (60D), a zoom lens with further reach (up to 200mm), new prime lenses (10mm, 35mm, 100mm), an external flash unit (yongnuo is fine, canon is better), hardbound copies of the final "book" of Wheel of Time, a roundtrip ticket to Japan, a new stethoscope, a Welch-Allyn diagnostic set, tennis strings, tennis shorts and clothes (shirts, slacks and jeans) that fit properly.

I obviously need a well paying job in  the future.

Finding it hard to function and it's not just due to the lack of sleep. This is might become one of the worst breaks ever.

I don't think I've ever been this busy for TRP. Being involved in the stage design, assisting at the backstage and at the gates, teaching dance steps, practicing a very difficult dance routine, practicing the choral piece and documenting the midnight set-up. I had roughly the same number of performances. I think what drained me is the all-nighter for setting-up the stage design. It's a good thing that I'm in the benign part of Pedia. Benign, meaning, I don't have to study for preceptorials or SGDs.

The following day was fun too. I got some new books, bought Pedia stuff and met Jesus and Margie Holmes. Had fun shooting haters too.

Nearly two decades after the International Conference on Population Development in Cairo, the Philippines has still not laid out a clear national policy on reproductive health in line with its commitment to the ICPD Program. More than our failure to meet our commitment to the global community, this lack of action highlights the State’s failure to recognize reproductive rights of Filipinos.

 

waiting and confused. It's a good thing I have TRP to occupy my mind but what's going to happen after that? 

I'm sick on one of the busiest weekends of my LU5 life. This sucks.

whirlwind week of walking and talking... let's be optimistic as Dido plays in the background singing "It's not so bad. It's not so bad." (the title is "Thank you", thank you very much.)

Aside from the lunch treat by November celebrants, this long weekend has been another bust.

I plan to have a better week ahead despite the hectic schedule.

I didn't know that this was a cover of Depeche mode song.  Must now rethink my judgement of Depeche mode

Urbandub - Home


Depeche mode - Home

. I think the cover has a richer, darker yet more hopeful sound than the original. Yes, this is how I spend the 4 days of "sembreak."

This and browsing graduate school websites. On one hand, I have a goal and I'm laying out my plans. On the other, I think I'm so obsessed with getting out of med school and going to real grad school that I find it relaxing to browse through curricula, funding mechanisms and student profiles. Realistically speaking though I would probably need to work at least 3 years after med school before I even become good enough for grad school and have a fighting chance to get a full scholarship.

 

Studying medicine is really about learning how to communicate. It could be with fellow doctors, allied health professions or our cherished patients. I feel that the difference between a great doctor and an average one is determined by his or her ability to communicate his or her thoughts to the intended audience. It is imperative that doctors have a good grasp of the dominant language or languages in the their area of practice or in, UPCM lingo, community whether it be Filipino, English, Bisaya or swardspeak.

Unfortunately, UP students have lived very sheltered lives within the confines of the university. Although we know Filipino, we do not have a good grasp of the Filipino being used outside academic circles. For example, multiple classmates were shocked that the term for masturbation is Mariang-palad. And yet, still many do not feel the need for our community exposures. Compound this with our still rudimentary grasp of med-speak and the variations that occur for each hospital and each department.

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Again, in retrospect, I should have been more attentive participative eager during Filipino and English class. I still regret not being able to gain a good grasp of effective communication, in writing and in speech, much earlier in my education. I've always told myself that writing and public speaking is not my thing. Someone should have told me that these two things are the vitals things a doctor should have in his or her arsenal.

committed my first blooper for the 2nd sem* even before it started. It seems that I would have a very full day on November 12. Must start taking in more calories. Of course, my new-ish friend tells me that I should say carbs or fat instead of calories.

* - technically, we don't have a 1st or 2nd sem in ICC I year. I'm just considering Nov 7, the day of our enrollment as the 1st day of 2nd sem.

just when I was in the mood to post pictures, my PC starts acting up. this sucks...

at least the suspects were quickly identified and nabbed unlike in multiple other murder or disappearance cases.

Gah! This is not a good day. Survey woes... I'll just have to assess and plan on Monday.

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I'm itching to do procedures yet I really won't need any of those skills in the future. I guess it's just that desire to prove myself. I should really get my priorities straightened out.

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Really, why this urge when I know that I'll be suffering through those very procedures next year?

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And that my friends is called rationalization.

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Everyone is talking about their summer electives. I've long given up hope on finding a really good research elective abroad so it's PGH for me. I've decided that an RA position looks better on the CV. There will be much more learning and best of all, I get paid. Still, I must brace myself for the deluge of elective-related fb posts and pictures this coming summer and the jealousy I will probably feel. Money money money sounds like a good chant.

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I resolve to discuss salary with my future boss. Getting the minimum wage is not fair given what I can now offer.

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Insults and snark comments. I guess it's better that I take it all instead of some poor sap. It's better for the group dynamics. And other blocks wonder why we function so well. I do fear that one day I'll explode and utterly destroy someone.

ICC year has been good so far. Stress levels are manageable and spike up only when I have pressing extra-curricular activities. I have ample amount of time to study and relax. My motivation to study is so I could perform a good interview and assessment of the patient and not because I would do poorly in a written exam. Very much unlike LU4. It's helpful that the consultants are very supportive and tolerant of our relative lack of knowledge.

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I also view this year as my year of redemption from ignorance of basic anatomy and disappearing knowledge of physiology and biochemistry. Finally, those anatomical landmarks are put into useful context and I wouldn't have to rely on rote memorization.

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Last week, I had another CEA worthy experience. CEA is a tool primarily utilized by Family Medicine specialists to handle psychosocial concerns of patients. CEA is an abbreviation of Catharsis, Education and Action. It works on the theory that talking about a problem helps solve it. I wasn't a great believer of this tool but the universe wants me to convert me and has put me into CEA patient encounters. Ironically, it is not during those sessions where we were expected to utilize CEA. The first one was during our musculoskeletal module in LU4 (2nd year) involving a patient with a fracture needing surgery. She's greatly troubled by her finances. I was interviewing her alone when she suddenly started crying. Hence, C of the CEA.

This time I was interviewing a patient again on my own as my groupmates were talking to the bantay. I was having a hard time getting a good history of the patient as she keeps going on about how she has no money, how she doesn't know why she needs another surgery and her desire to go home. I guess I should have read the  clues and started CEA but I have little time so I pushed for the obtaining the "pertinent" history. A seemingly innocuous question from her daughter whether she really wants the surgery or not opened a dam of emotions which frankly overwhelmed the shit out of me and my classmate (who was really an innocent bystander). Apparently, she feels abandoned by her family, fears that she will lose sight from her remaining good eye and feels betrayed by the PGH. I was put in a tight spot, I know that I can address at least one of her issues and allay her fear of becoming blind but I am not comfortable in interfering with the management of a patient who is not mine. In the end, I think she really did went home untreated and it's sad that her remaining years will be full of pain, anger and suffering.

In one of the Peace month events I attended, we were asked how can you contribute to achieving peace? It seems so easy to answer. Just give a cliche albeit like I will not be violent to anyone or I will strive to achieve inner peace. But are these answers valid? Do they really contribute to peace?

How is peace defined? Scholars through the years have debated this issue and currently there are three kinds of peace. The most common one is that peace is the absence of violence. Note that this definitions allows for conflicts. Conflicts are an innate part of the the human experience and help us learn. In a peaceful situation, conflicts are resolved in a nonviolent way.

The second one builds up on the first and seemingly borrows from the WHO comprehensive definition of health: Peace is the ideal state of harmony and not just the absence of violence. This definition agrees that violence should be absent but if people are not in harmony with themselves, others or their environment, then there is no peace. It is an encompassing definition which then allows concerns such as health and environment to be concerns also of peace workers. Peace is not limited anymore to just eradication of war and disarmament. Peace work is now making the environment not just safe but promote human growth and development and harmonious living.

The last one is the trickiest one for me. Peace is not just a state but it is a capacity of an individual. That is a peaceful individual is not just in harmony with ones' self and his or her surroundings but is able to handle situations in peaceful ways. This definition again adds another dimension to peace work. After (or while) ensuring peace within a person, he or she must then learn to live and act peacefully.

Based on these definitions, achieving peace or peace work covers almost anything a "good" person can do. These definitions also imply that peace work cannot be the work of just a single individual. Peace is a complex entity which demands a comprehensive approach. Thus it entails the contribution of every peace-seeking individual.So those cliche answers are valid. Vague and general but valid. In my case, I can answer that as a health worker I will strive to ensure the right to health as health is a necessary component in achieving peace.

Sadly, health workers around the world are ignorant of this health-peace concept. That by being health workers they are peace workers. That they are potentially the most powerful bloc of peace workers as they not just treat individuals but if they apply the biopsychosocial approach, they can treat communities. Commitment to preserve the health of an individual should spread to preserving the health of the community he or she lives in. As violence would eventually come into play, health work then covers prevention of violence and achievement of a certain peace.

Ovitraps are now being marketed by the DOST. UP Manila students set-up a drive to collect empty cans that can be used to build ovitraps for our rural community partner. But does it really work?

First, let's tackle what ovitraps are. Ovitraps are primarily surveillance tools researches use to determine the number of breeding mosquitos in the area. It is made of a small container partially filled with water and a strip which serves as the site for egg-laying. During my undergrad, we used it to catch our mosquitos for our entomology project. So, if you just want to catch mosquitos. Yes, it works.

Ovitrap yo!

Now, some people thought that maybe instead of just for surveillance we can use it to kill those pesky mosquitos in our area. So they made a lethal version of the ovitrap by adding instecticides such as bifenthrin. They call this the lethal ovitrap. Basically, it attracts gravid mosquitos to use the can. When a mosquito touches the strip, it comes in contact with the insecticide. Thus, whether it decides to lay eggs there or somewhere else, it will die. Gravid mosquitos die, less mosquitos in the area, less mosquitos, less likely to be bitten and less dengue cases. Like most innovations, it sounds good on paper. But again, do we reach our end objective of less dengue cases?