Malaria Strikes!

Malaria is a parasitic infection that is endemic in tropical countries including Nigeria, where my husband Jabar works. He was having chills two days ago and low-grade fever accompanied by body malaise. I was already contemplating on malaria but I was in denial initially. This is his second bout of infection so he must have known the symptoms. He was telling me it could be malaria, I told him to observe it for 24 hours and have supportive treatment first. Forty eight hours later, his symptoms didn't relent so he took blood smearing test for malaria. His result is (+2). Subhanallah! Confirmed. 

Malaria is a potentially life-threatening disease caused by infection with Plasmodium protozoa transmitted by an infective female Anopheles mosquito. It has a high mortality rate if untreated but has an excellent prognosis if diagnosed early and treated appropriately. Apparently, uncomplicated cases of malaria in Nigeria does not call for immediate hospital admission. In fact, Jabar bought the meds (artemether/lumefantrin or Coartem) over-the-counter.

How do we prevent malaria? I've been constantly reminding Jabar to always put on Off lotion and use mosquito nets when he sleeps. But he can be stubborn sometimes, even feeling invincible. The only way to prevent is by wearing protective clothings, using insect repellent lotions and sprays and using bed nettings soaked in insecticides (yes, they are commercially available). Drug prophylaxis can be taken by travelers to places with high malarial endemicity. Presently, no vaccine has been approved to prevent malaria but scientific studies on the vaccine is already on its way. 

Jabar finished his first day of treatment (treatment lasts for 3 days with a total of 24 tablet intakes) and is experiencing the worst side effects---headache, dizziness and loss of appetite. And I feel so bad that I'm not even there to see over and take care of him. If I could have the power of teleportation, I would do so in an instant. :( Right now, I can only offer my prayers and making sure that he's taking his meds on time. 

Please get well soon, my love. 

Meet and Greet with the Aetas. :)

One of our subjects in our Master's program at the Development Academy of the Philippines is Social Marketing in relation to Health Systems. We conducted a practicum in the form of a medical mission at different far-flung barangays here in Luzon. Two groups went to Bulacan and the other two at Pampanga. After the activity, we were tasked to submit a reflection paper. Here's what I wrote. 

The recently concluded medical mission as part of our HSD Practicum under Social Marketing was something I wasn’t personally prepared for. Per instruction, we were only told to bring our stethoscope, sphygmomanometer and diagnostic set. Nevertheless, being a doctor to the barrio and having conducted multitudes of medical missions in our respective areas, we somehow know already how to do about it. Upon orientation, doubts and queries as to the intention of the medical mission slowly dawned on me. The relevance of the activity in relation to social marketing was a bit blurry, especially the timing of the medical mission now that it is election time. My idea of a social marketing practicum would be that, we, the students are the ones who would create or think of an activity by coordinating with different stakeholders to partner with. In the medical mission that we did, everything was laid down to us requiring only our presence and our service so I don’t see the essence of doing a practicum when we’re already honed in doing medical missions. When the specific flow of the activity including deworming and vaccination were raised to us, people began grunting because those services were already being given by the RHU. But we still went with the flow by waking up as early as 1AM to go to our respective areas.

Our patients patiently waiting in queue. 

Our group was assigned to Brgy. Nabuclod, Floridablanca, Pampanga. I never expected the place to be that far, perhaps because of the idea that Pampanga is a nearby province. To my surprise, it took us almost four hours to reach the area and much more I was surprised upon seeing the Indigenous People (IP) we would be providing health services for. During the whole activity, I believe there was inadequate coordination with some partners. We were told primarily that we will conduct it in a school for proper compartmentalization, however, we were informed when we were already there that we cannot utilize the school rooms due to a prior commitment. We conducted the medical mission in an open space where there is, well, a perfect view. There were notable flaws but we were able to manage. The number of patients did not meet our expectation, in fact we were expecting more. In other words, our services were not maximized. 

A typical Aeta family. Most of them are farming their lands to sustain their  basic needs. Some of them are able to go to school but rarely finishes high school until they get caught up in what seemed as "natural course of life"~~~having kids. 

Doctors at work. 

I was asleep inside the bus for most of the travel time so imagine my surprise upon opening the curtain to see this body of water greet my sleepy eyes! Lol! Yes, we crossed a "little" river to reach the area. 

Doctors to the Barrios and a member of the army who made sure of our security in the area. Thanks, Sirs! 

During consultation, I asked my patients if they have sought consult at their RHU prior to our arrival. Most of them have not been seen by a doctor due to the distance, their RHU is located at the town proper which is quite a number of kilometers from them. I can relate their situation to the patients I meet at my area of assignment in Talitay, Maguindanao. It was my first time to meet the Aetas and was pleased by their behavior around us. Unlike with other med missions I attended, the Aetas are not demanding as to the services we offered. They listened to our health advisories and participated in our "dagdag kaalaman" games. They seemed to be compliant patients as well. :)

 We may have been "forced by circumstance" to do the mission, but being too rational made us overlook the positive impact of our presence among our Aeta friends. There are instances when we should put our personal clamors aside and look at things at different perspective. Only then we can fully understand what is going on around us from a macro level. At the end of the day, all of my doubts as to the intent of the medical mission vanished leaving me with a fulfilled heart and a sense of joy. It was really nice to meet our Aeta friends. :)

P.S.
I owe you an article on my DTTB (doctors to the barrios) experience. It's been six months since I signed the contract with the Department of Health. :)

Lili's Little Angel

Meet baby girl Zahraa Reem Mamari Dimakuta, weighing 5.6 lbs, delivered via low transverse cesarean section. BFF Lili's first baby! MashaAllah! May you grow up as gorgeous as your Mom and as kind and religious as your Dad. 

"May she be granted beauty, and yet not   

Beauty to make a stranger's eye distraught,   

Or hers before a looking-glass; for such,   

Being made beautiful overmuch,   

Consider beauty a sufficient end,   

Lose natural kindness, and maybe   

The heart-revealing intimacy   

That chooses right, and never find a friend.

May she become a flourishing hidden tree,   

That all her thoughts may like the linnet be,   

And have no business but dispensing round   

Their magnanimities of sound;   

Nor but in merriment begin a chase,   

Nor but in merriment a quarrel.   

Oh, may she live like some green laurel   

Rooted in one dear perpetual place." 

-William Butler Yeats

A Letter

At one point during the board exam review days, most of us were at the brink of emotional (and nervous) breakdown. The anticipation of what was going to come out and the result after the exam was gradually killing us. Because we were phone calls away from our families, my classmates/friends and I hold on to each other for emotional support. We perfectly knew how each one feels about the board exam, unlike our families and other friends outside the medical field who were also supportive but did not have an inkling as to the amount of pressure that was on us. My good friend Alvi, our class valedictorian and epitome of beauty, intelligence, patience, kindness and everything good in this world, wrote me a letter which really boosted my self-confidence. I was flattered beyond words and I couldn't thank her enough for that. Here goes. 

My dear friend Aisha,

        I have always admired you. You're a woman of faith. You're diligent and pious. I know you will be a great doctor in  your community in the future. And so let your dream of becoming one strive and push you more to work hard for your future patients. Personally, I have just yet realized that what I said when I was interviewed for the application in med school that being a doctor is to serve humanity, is indeed service.  And in service, there are sacrifices. This review for the board exam is one of those; it's one step, it's one of those mountains we have to climb. Many times we feel that in every step we take is so hard, so painful that we think of giving up. However we do not realize that if we will just be faithful, that another step is already the finish line. So be joyful, be glad; rejoice on hardships, in difficulties, for like gold, we are being purified by the trials of life; impurities are removed and in the end is that shiny, precious, pure gold. One that is treasured, one that is perfect. In everything you do, do your best for God deserves nothing less. Give it all. Life is too beautiful to waste it on the miseries of this world or the sadness of this world. And in your preparation, couple it with prayer. For it is said to WORK and PRAY. Pray hard. Pray constantly. Pray at all times. When you're sad, pray. When you're about to give up, pray. Then God will renew you, He will give you grace and hope. And so run in such a way as to get your prize. Do not run aimlessly, run with all your might, angels are there cheering for you. We can all do this. Though time has not let us come together for words of hope, but my prayers are with you and the rest of our batch. 

Just keep it up. Never give up.

God bless.

It was so dramatic because she left the folded letter on to my study table and I got teary-eyed after I read it. Haha! Alhamdulillah, our prayers were answered and all of us passed the board exam. I wish our class all the best, good luck to us as we embark on a brand new journey! :) Cheers to the Class 2011!

Sisters In The Metro

There were blessings disguised as troubles, and if we fail to recognize them, we'd be in deep shit. However, if God really wants us to see the light behind the dark clouds, He will guide us through meeting wonderful people who will help us in pulling ourselves together and getting back on track. 

Just when the world seemed to play its treacherous tricks on me and was shouldering a gigantic problem on my own, there were two women who helped me back up. They welcomed me into their abode and treated me like a real sister. Alhamdulillah. With their presence in my life, it seemed like all troubles went away. Thanks for the positive energy and for bearing the person that I am!! I will miss you housemates!! Expect me to still come and go at the unit. Haha!  Love you both!! :)

P.S.


I'm beginning to develop separation anxiety. I have already loaded my stuff at Fairview but I'm still here at the unit. I don't wanna go yet. Lol!!

Why This Jungle

 Written on April 21, 2011; 2:55 pm, thousands feet above the ground on PAL flight PR 186.

I am writing in a plane bound for Manila, where after spending my whole life in Mindanao, I will be settling for a year (and more) to pursue my internship. I left my loved ones with a heavy heart due to the distance and the fact that I will not be seeing them for the coming months. I melted when my aunts and uncles threw a surprise send-off party two days before I leave, everyone was there! I was ecstatic! Then, my mom invited them for dinner a night before my flight. Happiness! I couldn’t help my tears though when it was time to bid farewell.

Several months ago, I was confronted by a major confusion on where to pursue my one year post-grad internship (PGI). There were several aspects to consider and after a long mind boggling battle, here are the reasons why I chose a hospital in Metro Manila over Cebu and Davao:

1.       It is Manila, the Capital of the Philippines which monopolizes almost everything that is supposed to be shared to other parts of the country. Hence, Manila has almost everything. Here is where is you can see and observe everyone from the opposite ends of the economic scale. Exploring this urban jungle will help me become strong and vigilant. I will meet plethora of people with different personalities, way far from where I came and for that I believe I can adapt proficiently. *cross fingers*

2.       It is UP-PGH. The National University Hospital. Need I say more? Yes, toxic na kung toxic, OA sa katoxican but how can one become better if one doesn’t push himself a little harder? One has to try to the end of his limits to test what he is capable of.

3.       I have my cousins here. Like I always say, nothing beats being with the family. Knowing I have my cousins here, my parents are quite comfortable sending me here. They need not worry about me coz I have people to run to whenever something untoward is up.

4.     I have my friends here. More than half of my highschool berks are Manila-based. Some are raising a happy family here (yes, they have children, I’m so old!), some are pursuing post grad studies while others are earning bundles of bucks here. My Quasar friends are here also, in fact, Rox is a co-intern ad hopefully Jehan will join us here at UP-PGH, soon! Happiness!

With this, I can only pray to God to give me the courage and strength (physical, spiritual, intellectual and emotional strength) in facing and beating all the ODDS.

HBD T'lowa!

My fraternal triplet sibglings: (L-R) Alexander, Amanee and Zul. Photo taken TWO freaking years ago! Too many changes took place but I can't find a recent photo of them together. 

Happy, happy birthday to this three people who added exponential joy to our family since they were born. They made our Mom famous for delivering them via spontaneous vaginal delivery with normal birth weights, all three of them have APGAR score 9,9. Yeah, beat that!! No noted prenatal and fetomaternal complications. All three of them have unremarkable growth and developmental history with complete immunization c/o private pediatrician. They were breastfed until 6 months of age (don't ever ask me how many boobs our Mom has. she has only one pair. now go ahead and ask her how she managed feeding them!), weaned thereafter with all the nutritious foods that our Mom can come up with. Indeed, she's a wonderwoman at that. 

Trivia: all throughout Mama's pregnancy, we thought there were only two babies in her tummy. That's what her OB-GYN said because that's what she saw in the ultrasound. "You got two boys in your uterus, Missus". That's what she told our parents. So when the nurse went out of the delivery room announcing that the second baby was a GIRL, my Dad couldn't fathom how the doctor mistaken her daughter for a son!! The problem was, he wasn't ready for a girl's name for he prepared two names for both of the boys. Haha!! 

Now, when the nurse went out again informing us of the arrival of the THIRD baby, I swear I was only five but the scene plays vividly in my mind, my Dad and I were jumping back and forth outside the delivery room screaming "We got triplets, we got triplets!!!" (In Maranao though, we don't speak English at home! Haha). I also remember my grandmother scolding my Dad for being overjoyed when we do not know if Mama was still alive. Alhamdulillah, Mama was fine all throughout her birthing period she didn't even look like she'd given birth to THREE PEOPLE every FIVE minutes! How crazy could that be? 

Growing up, I often tease my sister of being "ampon". Nyahahaha! I used to tell her that her real mother was the woman who was also inside the delivery room with Mama who cannot afford to raise her and since our parents are generous, we adopted her. Hahaha! Good thing she didn't took it seriously. 

Happy birthday T'lowa*!!! I wish you all the best in this lifetime. I hope and pray that we just don't grow old but we GROW UP too, that's more important because it entails maturity in dealing with the harshness and glories of life. Cling to what Papa keeps on teaching us, and Inshaa Allah, we will all be guided. I love you three and I miss you much!! 

*T'lowa is Maranao word for triplets. 

When the time comes, I want to have a kid as smart and as cute as you. Love you Sabreen! :)

Wrapped Up ORL

This is a two-week late entry for we were already done with otorhinolaryngology (ORL) a.k.a ENT for ears, nose and throat. I was a bit of having a cold feet for this rotation since we didn't have it back in clerkship. The last time I studied ORL was during the upper respiratory module in medschool freshman year!!! That was eons ago, my friends! This is a confession, but yes, I just learned about the thorough ENT exam here in PGH!! I compelled myself to master it in anyway that I can---identifying the normal tympanic membrane from the perforated ones and visualizing the vocal cords and the posterior nasopharynx no matter how the patient gags! And I'm more than glad that after two weeks of our rotation, I brought with me a lot of things I didn't know before. Naks!! Hail, ORL! Hail, ORL!

What we do at the OPD. I'm so sorry Suzie for capturing your awkward moment! Hahaha!

This is Fiona, 5/F, who came in due to a foul discharge dripping out of her right nostril. She's so makulit but very cooperative little girl. Children her age are expected to revolt and throw tantrums upon examination, but her? No, she gaily sat on the examination seat and followed every single step of instruction! I wish all kids are like her! Haha! After suctioning her nostril for a better view of the turbinates, we found a greenish rubber material that was inserted deep inside her nose!! Apparently, her classmate put it there and was accidentally pushed deeper when she inhaled that they could no longer pull it back. She didn't report the incident to her mom until that day we found the foreign body inside her nose. Hahaha! Kalokang bata ito!

This is Dr. Caparas. Being the FIRST alumnus of the Philippine General Hospital Otorhinolaryngology Department, he is an institution in this field. He graduated in the 1960s, the time when ophthalmology was still incorporated in ORL. He's also the author of the book I used to read back in medschool. It's kinda awesome hearing straight from the authors. I remember my OB-GYN days when the people who wrote the Clinical Practice Guidelines used all over the country are those consultants teaching us during the Malignancy or Trophoblastic rounds. Great. Great. :) 

For a speck of time, I considered ORL as a specialty field because it's both surgical and medical plus the cases are really interesting. However, upon realization that the field deals with all the most filthy and most despicable odor you will ever smell in your entire life coming from all the cavities of the head, my friends, I changed my mind. Hahahaha!!! I really enjoyed ORL, I must say, one of the best rotations ever!! :) 

TRAUMAtized.

"Oi Aisha, sobrang sorry kanina ah. Zero sleep kase ako kagabi tas nag-assist ako til umaga kaya pagdating ko jan knocked out ako. Tapos andami dami tumatawag na nanonoxic na wala ko kaalam-alam sa mga sinasabi nila kaya natoxic kita dun sa charts. Sorry talaga ah."

That apologetic text message came from my resident after an incident at the ER when he sort of raised his voice at me when I delayed gathering the patients' charts for him. After the morning rounds with the Trauma* team captain, she instructed me to give all the charts to the nurses so they can immediately carry out some of the orders and I did what I was just told. By and by, this resident arrived at the ER slumped on the table to steal some naps after, I guess, weeks of being on straight duty!! Once in a while, he would raise his head to ask if we have referrals but it was obvious that he was half-asleep half-awake. He spoke as if he's sleep-talking. Hehe. I heard his phone ringing several times but he was still in deep sleep. I hesitated disturbing him as I fully understood how it feels to be sleepless. Later on, I guess when he was fully awake, he sprung his head from the table and was reading his text messages. He then asked me to gather the charts. I bet the senior residents were asking him stuff about the current status of our patients and since he wasn't present during the morning rounds, he's not updated about anything. That's probably why he wants to see the charts. Problem was, the nurses were in the middle of carrying out the orders and they wouldn't give the charts to me. If I steal those charts, the carrying out of doctor's orders will be put off and if that happens, I will answer to the team captain. I thought the resident can wait, I even showed him our logbook where we wrote  patients' updates but he insisted on me collecting all our charts. I told him the nurses won't give the charts and that's when he got mad and raised his voice, but not to the point of shouting. I didn't answer back as it is not my habit to answer back to people older or senior than I am. I kind of giving in to their whims with all due respect to the position they hold over me. So without any words, I returned to the nurses' station and started begging for the charts. I saw him stormed out of the room, he was probably called at the ward. I was disgusted by him that morning I didn't wanna see him again.

At around afternoon, my co-intern Sherwin and I were conducting patients to Radiology when that resident called him up asking for my number. I told Sherwin not to provide my number as I assumed he would just give me series of orders nanaman. Do this and do that. Plus, I'm loathing him pa, I told Sherwin. A few while later, I kept wondering ano nanaman iuutos niya so I decided to just phone him. He said he'd just text me. Gah, mahaba-habang utos nanaman siguro 'to, I thought to myself. That's when I was surprised by that text message. I am humbled by the humility he has shown. Very few residents would have done that. They'd just assume we understand what they're going through and would never bother to apologize. That's one of the things I like here in PGH, residents do not terrorize interns as much as in other hospitals do. At least, we are not being treated as slaves to them like the stories on asking interns to buy them food, or groceries or withdraw money for them. You know, stuff which are no longer hospital-related. Those don't happen here in PGH. You will get terrorized if you cannot explain what happened to your patient. Nothing of those monkey businesses. 

All Trauma first year residents (3 of them) had been on what seems like a perpetual duty. They don't have the leisure time to go home to even change their clothes. They were either at the ER, at the ward or at the OR assisting at operations. They are the first people to be called regarding patients' status. These three residents help and cover for each other, so nobody among them goes home. That would explain their mood. Seeing them in that state discourages me to go into residency in a government-owned hospital. I'm not sure if I can devote that much time, or rather, if I can devote my whole self in the spirit of training when I can have the same learning if I go into a private tertiary hospital. I do not know yet. I haven't made up my mind yet where to go for residency for I am yet to take the boards!! Hahaha!! 

If you wonder what I replied to that message, I said. "No probs, Sir" and a smiley. He again said sorry. My crazy co-intern Issa suggested I should have replied just a plain and simple "K"!!!!!!! I wonder how the resident would react to that!! Seriously, apology accepted. I admired the humility. It's either humble lang talaga siya or ayaw lang niya masunog at the end of the year!! Either way, apology accepted pa rin. :)

*After everything I said about Trauma, yes, I ate my words and now I am a Trauma intern! Grrr! I had to shift over to Trauma because they lack one person in the group so I volunteered after realizing it might be of help in my future practice as doctor to the barrio. The way I feel for Trauma is just the same. 

BFF's Days Out

Lily and I have long planned to go on a getaway trip immediately after she passed the medical board exam, however due to our obvious incongruent schedule, it never pushed through. She's Marawi-based now practicing her craft as a general physician while I am here in the metro to reach the point where she's already at. Another plan came about last December---we plotted our itinerary--either at Anawangin, Zambales or Baguio City but her work inhibited her to come. Nevertheless, she promised to visit me here before she gets married!!! Hah!!

Yes, my bestfriend's getting married!! People are getting married while I'm the only person stuck in the state of lovelessness. Ouch. Lovelessness. The word strikes like a knife. Hahaha! Not that I'm in a hurry for it. No, no, no. Back to the topic,  it actually came as a surprise---that she agreed to tie the knot because the moment her groom expressed his desire to her family to marry her, she unhesitatingly opposed the idea for many reasons. But in our culture, once the bride's family saw the sincerity in the groom and his family while reaching the minimum requirement set by the former, then the wedding bells will begin to ring. Moreover, a boyfriend-girlfriend relationship is NOT a prerequisite for marriage. She tried talking to her parents out of it but most often than not, the family's wish always prevails. Besides, I think she saw no point in arguing. Among us, one shows respect to parents by following their will (I say whims) even if it is against one's own. Now I ponder, sometimes it's not a bad idea to become a bad girl. LOL! 

Two weeks before her wedding date, she arrived here and stayed with me for almost 5 days. We lost two days of bonding due to my duty schedule but I fully gave all my time to her on the remaining three days. Just like the old times, we talked about our current lives and the following phases to come. Since childhood,  Lily and I were at odds at some things but as we grow older, we managed to cut the opposite points and agreed to meet halfway. I guess that's friendship is all about, a two-way relationship between people who both want to be understood (specially during our teenage years when we fight at least once a week but we still go to school together and go home together even if we didn't speak to each other!!). That's how we become best of friends, because we have tolerated each other's slip-ups!!

Since we didn't have time for a well-planned out of town trip, we instead basked in each other's company hopping from one mall to another in search of perfect tops and shoes. I even accompanied her to the place where we buy scrub suits (seen in the rightmost, lowermost photo above). The usual girly stuff---clothes, food..and boys. Her boys, at that. Haha! There are a lot of things that happened while she's here, I don't think I'm authorized to divulge some as they will remain as bestfriend's secret but suffice it to say that her trip was a memorable one! A life-changing one we will never forget for the rest of our lives. I am extra thankful that I was there for her when she needed me most. She scared me to death, I've never seen her in that state before and never worried for her  like that in our entire two decades of friendship, but I believe I played my role as a friend. :'(

Bez, as you embark on another phase of your life, I wish you open your eyes and see the goodness that it will bring. When you were here, I feel bad that I can't relate to what you were going through because I never had that thing, you know (haha! loser!) and I can't seem to form the words that would at least appease you. I thought I lost the spontaneity of speaking. But I felt you. I know you very well, therefore I know you will be the happiest. I wish you all the love, joys and blessings in this lifetime. I may not be there on your momentous day but I am sending all my love to you! You will always be in my prayers. :) I will end this entry with a verse from The Holy Qur'an and I hope you will ponder on it as you find in your heart the beauty of  acceptance, letting-go and an ability to give love a second chance. 

“And it may be that you dislike a thing which is good for you and that you like a thing which is bad for you. Allah knows but you do not know.” (AI-Baqarah, 2:216)

BFF #2

Bestfriends.

Celebrating singlehood.

Celebrating love.

Celebrating two decades of friendship. 

Celebrating life.

Our story here. 

Warning: NEVER LAUGH at our old dugyutin faces way back grade school and high school! 

BFF #1

MY BEST FRIEND'S AROUND!!!!!!!

THIS IS GONNA BE A LOOOONG NIGHT!!!

I'M SO EXCITED I HAD TO WRITE IT IN ALL CAPS AND REALLY BLOG ABOUT IT AND PUT A LOT OF EXCLAMATION POINTS!!!!

Ahem.

Excuse my manners. :)

I just miss this person A LOOOOOOOT!!!

Say No To Prejudice!

As I scroll down my Facebook homepage, I come across this post by Atty. Algamar Latiph to Atty. Toie Mitmug's  page. 

"Glad to hear that Anti-Ethnic, Racial or Religious Discrimination and Profiling Act of 2011 is in bicameral committee. glad to be one of the first lawyers who wrote the first working draft during the time of then AMIN Cong now RG Mujiv Hataman who first introduced and sponsored the bill at the House of Rep. I still remember when we sat with Amie Sangcopan and Raissa Jajurie i think on Nov 5 2008 at Greenhouse. Couple Atty Toie Alonto Biruar-Mitmug and Ras Mitmug also volunteered. Hopefully, this bill will be enacted into law so Muslims in this country can have a legal mechanism to redress wrong against discrimination on account of ethnicity and religion."

I am more than glad to know that there are people who exerted an effort for passing such bill. Majority of non-Muslim Filipinos, especially those in the northern area (Yes, I mean Luzon and the National Capital Region) may deny that there is an actual racial discrimination going on, as they claim that we are their "Muslim brothers" who enjoy the same rights as everyone else. However, they may be unconscious of their words or actions, but racial and/or religious stereotyping is an undying epidemic.  For instance, I was walking with a male co-intern to grab a lunch when my phone rang. It was my cousin who I normally greeted with "Assalamu'alaikom"  preceding our conversation. I absolutely heard this male co-intern let go of a loud sneering sound while I was talking over the phone. As I put down my phone, he asked me what "Assalamu'alaikom" means so I did a little lecture on how we, Muslims, politely greet one another. As the person that he is who keeps on teasing me a lot about every little thing, he said: "Hindi eh. Sinasabi nyo yun kasi by default, at war kayo sa lahat ng tao kaya kelangan niyong i-declare muna na at peace kayo with the person na kakausapin niyo". He was saying those words guiltlessly while a mocking smile was painted on his chubby face. And then our endless debate about my being a Muslim and his being a judgmental, narrow-minded person began (Of which, he wholeheartedly claim that he is a bad, bad, judgmental person). He would utter sentences that imply prejudice such as, for instance, when I unintentionally commit a mistake, he'd say "Ganyan ba talaga kayo?", or, "Muslim na 'to oh". He say those words in a joking manner, because he's really funny by nature, but I honestly take those words as a form of discrimination. And yes, I tell it to his face how pernicious he is. But you know, you can never straighten a crooked perception until you show them the truth through actions.

I think it's pathetic that we actually NEED to create a LAW so that majority of this nation's citizens will change the way they see us. But this is just the first of the baby steps towards achieving "total freedom" without declaring independence from the entire system. 

And yes, I am more than glad for the passing of this bill because when the time comes, I can literally file a lawsuit against this co-intern of mine who enjoys and loves bullying me. Hah! *evil grin* Now I can actually hear him say "Ganyan naman talaga kayo eh!". 

Facebook It!

While Facebook has become the perfect avenue for giving people a piece of your mind, there are stuff that you can't put on Facebook because you know it will light a fire and you don't want that to happen. In this tiny nook of mine, I know this is the perfect place for shouting:

DO NOT PROVOKE ME! I BITE TOO, BITCH!

I may be keeping my silence most of the time, laughing things off and pretend it didn't occur, but hey, I know exactly what you're talking behind my back. Now I'm telling you this, YOU'RE NOT PERFECT EITHER SO DON'T PRETEND LIKE ONE. Nuff said.

P.S.
I wish the font size could get any larger than that. My emotions are way too huge for those font size! Haha. 

Love Actually----Hospital Setting

If you remember the movie “Love Actually”, the opening scene was at an airport where, as the narrator says, the most sincere kind of love can be perceived. There’s more to that----the hospital. I have been rotating for three weeks in Internal Medicine and never did I see such form of sincere love as that of the love I have seen among my patients and their family members—fathers, mothers, sisters, brothers, husbands and children. 

Patient A.M. is a 48 year old female, married with one child, and was diagnosed to have colon cancer earlier this year. She underwent colon resection and had been on six cycles of chemotherapy until three months ago when a palpable mass was noted in her abdomen. The mass have been growing gradually and was seen by her medical oncologist but they cannot rule out whether the mass was a primary growth or a metastasis from her previous colon malignancy. On my first week of rotation, November 4 to be exact, she was admitted at the ER due to “agitation”. She was restless and agitated, shouting at her husband and her brother who accompanied them to PGH. The physician on duty considered the increased levels of toxins in her body as a cause of her behavioral changes (uremic encephalopathy), that’s why she was admitted under our service. Apparently, her abdominopelvic mass impinges on both of her ureters which causes her minimal urine output, hence, accumulation of toxins in her body. She underwent series of hemodialysis and marked improvement of her sensorium was noted. She was herself again. We referred her to different services such as OB-GYN, Med Onco, Urology and General Surgery for possible intervention to relieve her of her symptoms. Laboratory work ups were done, her abdominal CT scan showed an ovarian new growth which obstructed the pathway of her urine that led to chronic kidney failure resulting to all her symptoms. Since we have treated the encephalopathy, we were contemplating on transferring her to other services particularly the GYN-Oncology. While waiting for the response of other services, I visit her everyday at her bedside to ask on the progress or relief of her symptoms. Her husband and her brother were always there too while I pass by for a quick chitchat, they never failed to meet my patient’s needs. What I appreciated most was that they were very aggressive; they comply with ALL the laboratories we request no matter how costly it would seem for them. I never had any difficulty facilitating her labs because the husband and the brother were always on the go. She was my patient for more than two weeks and despite the asymmetry of her face caused by congenital neck muscular problem (torticollis), she’s always ready for a warm smile as she slowly raises her hand to wave at me. I always feel important whenever I visit her because she stops whatever she does saying “Uy, ayan na si doktora”. She always tells me how she feels about her illness, her high hopes and her fears. While I can only offer my listening ears and an occasional light encouraging rub on her back, she would usually hold my hand tight while she complains how awful she feels about her edematous feet and her abdominal mass which frequently cause her pain. 

After more than two weeks, her encephalopathy had resolved, all labs were done, the decision now lies in the hands of OB-GYN. They did a transvaginal and abdominal ultrasound and saw the strongly adherent mass on the abdominal wall, it would be a difficult operation and the result may be unfavorable, the OB-GYN senior resident said. They can only do mass debulking and staging, which, obviously is already stage 4. They presented the option to the patient, they can do mass debulking followed by chemotherapy but the prognosis is still bad, OR we refer them to the Hospice for counseling and terminal illness care. After a lengthy discussion among the family, they decided to just do home care. My patient was crying while she was telling me “Doktora, hindi na raw ako gagaling. Wala rin namang mangyayari, gagastos pa kami. Uuwi na lang po kami”. I do not know what sympathizing words to say. I only stood beside her and held her hand tightly, trying to utter comforting words (of which, I am very bad at) and reminded her how lucky she is that her husband and her brother never left her side. I reminded her of the love her husband had shown and given her. That, I said, makes her the luckiest person on earth because despite her illness, she was loved sincerely by her family. 

They already went home yesterday, and because I got so very busy at the other ward tending to another dying patient, I lacked time visiting her. Besides, I suck at goodbyes and I hate being attached to patients because it’s not just right for people like us who see dying and hopeless people every single day. But with this patient, it’s different. I noticed her empty bed on my way to the interns’ callroom and felt a pinch in my heart. I had many unsaid goodbyes in the past and this patient is an addition to my semi-regrets. Suddenly, I heard her brother calling me asking where he can possibly find the Nephro Fellow who attended to them. I asked the whereabouts of my patient and told me she was at the ambulance outside. I hurriedly ran outside, saw the parked ambulance and peeped behind the green curtain. Her husband swung open the back door and saw my patient lying on the stretcher while weeping and saying “Doktora, hindi ko po kayo makakalimutan. Maraming salamat po.” I jokingly told her not to cry because she got me teary-eyed as well. I pacified her by telling her to have her picture taken with me using my mobile phone. Her torticollis made her unable to smile normally but she still attempted to give me a good one. 

I will never forget this patient and her family who stood by her from the beginning all the way until all the possible means were exhausted. Through her husband, I saw the picture of what true love is. I can only pray that he will never get tired of taking care of her until the very end. There may not be a cure for her disease but when the time comes that she has to leave this world, I know that her heart is full of love and contentment by what her family has given her. That, for me, is true love.

Photo with my patient inside the ambulance right before they went home against medical advise.  

11.11.11

What to do on a postduty Friday night that corresponds to a date deemed astrologically important? 

DINNER with Friends! 

At Martabak (Malay-Indo resto) with (l-r) Rox, Jay-jay, Sam (na mukhang tanga in this photo!), Isaw, moi, and Jehan

 Post-birthday dessert treat at Chocolat [sho-ko-lah], named derived from Johny Depp's movie under the same title. We had loads of chocolate maple cake, chocolate hazelnut, New York cheesecake, chocolate carrot cake and tiramisu. 

Tell me a girl who doesn’t love chocolates and I will tell her what she’s been missing!

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While strolling around, I passed by at Regalong Pambahay and found these super nice stuff! They can be make-up or jewelry boxes that came in Eiffel prints! So cute! Kinda costly so I didn't buy. I so want it! :'(

Skin Food and The Face Shop

Pat, my co-intern whose mother just came back from Seoul with lots of freebies from Skin Food and The Face Shop generously gave all these to me! Apparently, the price cuts half when you buy it there compared here in the Philippines. Because I am yet to become a globe-trotter (ahem!), I have no means of buying Korean beauty products there. I might as well endure the price or just resort to NOT buying at all. Haha! And because I'm a free loader, I accept blessings from other people. 

 I have only tried Skin Food’s Egg White Pore Foam and The Face Shop’s The Smim Toner and Emulsion yet and I loved them for my skin! Thank you Pat!

Service Dinner

Service 5 residents, interns and clerks. We are a team! 

For Internal Medicine (IM), our block was divided into different services to be with interns from other block. It's kind of mingling with other interns as well. Last week, we had dinner at Patricia's house at Forbes Park (!). She's rich but she's not mayabang. Good times, good times. :) 

Coffee for me. Cigarettes for A.

Mexican cuisine. Three Musketeers. Chat about self-generated theories.

Sometimes we need to surround ourselves with people having totally different perspective about life. It nourishes the mind and is also a form of escapade. :)