"It's a matter of growing up. You don't move on. You just become a bigger person until the void doesn't feel as big." -Issey Tolentino, Dagitab

This boards review process is painful.

I don't know if I can bear to read all these references for a third time. I know I need to but I don't know if I could bear it. Already, I'm very much ready to burn the Pathology reviewer.

I'm finally a doctor. Now, on to making "real" life decisions and career moves. Oh shit, may boards pa pala.

Going to present my research again this Tuesday. I still haven't practiced my calm face. Ah screw, I'm just going to be frank, direct and honest with the judges. And I won't hold my tongue. If they ask impossible questions,  I will return the question to them.

So I got that appendage in the diploma.Yahoo!
 

got beaten by snails. damn.

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I should have asked, "So sir, if you were to conduct the same study and faced with my dilemma, how would you determine the cost of medications not available in our hospital?"

The end is near.

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Something is going to happen on Monday. I hope I do well.

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The Universe is playing with me then again, it has been playing with me all my life. I just need to keep rolling with the punches.

I've been asked to some things that I shouldn't be doing. As interns, we are the hospital's slaves. Despite how the official statement says that we doctors-in-training and members of the health, we are the slaves. At the bottom of the hierarchy, you can't protest if you are told to do something. You just nod and follow. We can not refuse any request or order given by a senior (a resident or older) as long as it doesn't kill or harm a patient directly. So the only thing we hope from them is to inhibit themselves from making us do things we aren't meant to do.

Less than a hundred days left for my internship. I'm happy that it will be over soon.

This elective period is the best thing in med school. I have had two months wherein I was left on my own to conduct research I designed. I enjoyed the experience despite all of the red tape I had to go through to finish my projects. I'd rather fight administrative and bureaucratic hurdles than go on hospital duties.

ayaw ko ng paasa. nasasayang ang oras ko.

If it hurts too much, you're probably doing it wrong.

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In other news, my maternal grandmother died last week. It is also the day Nelson Mandela died.

Protocol got approved!

Except I'd be showering in charts soon and not US dollars.

So I was de-stress-ing by browsing through grad school websites and stupid me decided to go and see how much attending these schools cost.

I now regret doing that as I realize there is no way I could attend those schools without a decent scholarship and massive tuition waivers. Or I could and be forever in debt to my parents.

One month away from the start of my elective period and my two proposals are still undergoing review. It's a good thing I can do one of the projects without ethics approval. I hope I'm not biting off more than I can chew. Aside from passing the review, there is a daunting task of collecting data from around 300 charts.

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Plans don't always push through especially if it is highly dependent on the participation of other people. I don't know why this certain plan not pushing through put me in such a bad mood. And I'm reminded once again that this shouldn't be too hard nor should it affect me this much. Stupid brain.

Drowning in research and TRP tasks. Wag na nga umasa maging stellar, okay na ang pass.

I still haven't gotten myself a copy of UDD's album.

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I am bothered that PGH fails to comply with many of PhilHealth's regulation. The most shocking discovery for me is that residents do not recognize the NBB and new case rates for emergency cases. This is stupid really because many of the cases covered by the new policy are emergency cases like appendectomy and CS. This is unacceptable. Is this a reflection of how ignorant MDs are of health insurance policies in the Philippines? Or a reflection on the inefficiency of the hospital PhilHealth office in ensuring coverage? As a paying member of PhilHealth, I demand full access to my benefits and not selective coverage because of the hospital's fault. And as a member of the health team, I am ashamed that PGH once again fails to serve the people properly.

I keep getting notices that there would be medical missions to different areas severely affected by the typhoon. I'm not a big fan of medical missions because they offer the same services the local health team can provide but in a big fancy attractive package. And now, I'm questioning the need to have medical missions for post-flood victims.

What problems do these flood victims have that require a team of doctors to go and provide medical services? I acknowledge that this is a tricky question. An area who experienced flooding during the heavy rains is different from a community who remains submerged days after the storm has passed.

Judging from one paper I found, the top morbidity causes among flood victims reflect the top consults in a local health center that is URTI, skin disease and hypertension. If this is the usual case, do were really need to conduct a medical mission every time a flooding disaster strikes an area? Do we need to deploy teams of doctors? If it were me, I won't. You would just need to establish a clinic with the disaster area, maybe temporarily transfer the center of operations of the local health team to the evacuation center. It could also be as in the case of the paper, a mobile health team that will go around the area to treat patients. The clinic or team would operate for the whole duration of time that the community is acutely recovering and will be removed once the formal health system is again capable of handling the health concerns of the area.

Actually, if the health facility and health team remains capable in managing the health problems, no medical mission should even be conducted.I think what we need are volunteers to conduct rapid assessments; a public health mission so to speak. This will ensure that the community and outsiders know what the community needs and we won't be wasting time and resources on frivolous activities such as medical missions.

so I've been neglecting my blog.

weekly community medicine reflections drain the desire to write more stuff.

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Got drunk yesterday and now I'm feeling itchy all over. not planning on drinking again, the buzz you get from alcohol is not worth the pruritus.

Apparently Introduction is the hardest part to write in a proposal. I miss having group mates that can write stuff for me and I'll just have to edit it. Of course, sometimes what they initially wrote is far from the final version but having some paragraphs to work on aids in the writing process.

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And the clock is ticking for this research project. I only have 4 months left to finish the paperwork and social preparation and not to mention that ERB approval. I 'm glad I won't have human subjects this time around.

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Community medicine rotation will start soon. I hope we do something substantial. Also, maybe I should change topics for my health policy elective. My preceptor wants me to write a policy analysis paper using the force field analysis. Unfortunately, my topic doesn't lend itself to that form of analysis.  

post duty monday

wasted an hour of sleeping time to read through someone's fb page.

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encountered a person in active seizures in the arms of his companion on the way home. being full costume tipped the bar and I decided to approach the pair. I asked the companion if he wants to bring the patient to the hospital and he replied that they've been to PGH and they were just driven away. He said they'll just wait for the seizures to stop and they'll be sent away again. Post duty status got the better of me. Instead of explaining about the limited admissions policy on Sunday, that of course you will be discharged once the seizures stop and that a person probably needs to go to the hospital if he's been seizing for around 5 minutes, I just asked, "Are you sure?" He said yes and so I replied, "It's your decision." So I just watched and waited for the person to stop seizing and once the seizure stopped, I walked away.

I know a better person would have convinced them to go to the hospital but I'm not that. Nor am I willing to be inflict a patient with an unwilling bantay into the PGH ER. The ER is still only working because of the willingness of many bantays to go the extra mile.

At the very least, I could have taken the post-ictus vital signs I guess and made sure the seizure didn't recur in the next 5 minutes. I could blame post duty status but I think I'm just really evil.