It's 1:33 AM on my clock and it's jologs time!! On my way back home from MOA to meet up with Doc Ikoy, this song was played in the taxi and it never left my mind. It's called "You Are The One" by Toni Gonzaga. I know this hit the airwaves after Toni and Sam made a movie under the same title, but you know how things lose their meaning when you hear them over and over again? I didn't know the lyrics of this until tonight when I googled it because I hated how the line "you are the one that i've been searching for my whole life through" repetitively rings in my mind. Here's the fruit of the significant research on this song: lyrics and music c/o youtube. 

Cheesy eh? From now on, this is gonna be my pirated counterpart to Ala's letter to her future husband. I declare this song as my future theme song to my future The One, Yikes!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I hate solitary moments like this coz it reminds me of my love life and the lack thereof. LOL. 

I have a new crush by the way, a Muslim surgery resident who I ran into at the cafeteria this morning. I hope he hadn't mistaken my face for a frying pan. Ugh, that postduty look---which, I don't really mind. Kebs. 

And oh, I got stuck at the elevator with another cute surgery resident for a little good than five minutes. I secretly wished for the elevator door to open a longer while. 

I can't wait for my surgery rotation which will be NEXT YEAR!!

Hahaha! I don't know. There's something about surgeons.

It's heartbreaking when the people you put so much trust into decided to leave you hanging the air. There is indeed no loss among those who chose their friends carefully. However, you can never tell what lies ahead. Never give 100% trust to people especially involving legal matters. And that, my dear friends, I learned the hard way. 

TRY PUTTING YOURSELF IN MY SHOES. Indulge in the pain and the impending name stain. 

Conclusion: Real and true friends do not exist in my world. There is no one to save me except Him, whom I have my full trust and faith. Ya Allah, I seek refuge. 

Status: postduty at OB Admitting Section (OBAS)

But, before going back to the hospital's daily grind (which I secretly admit to have been missed), I went out with my HS friends last week to hang out. It was a spontaneous trip to Greenbelt and Rockwell. I didn't know it was Rox' and Fatz' post-birthday celebration pala so I wasn't able to prepare anything for them. Unlike Jehan who knew it beforehand so she tricked us to stop over at F21so she can buy them something while I drooled again for fancy and pretty tops and dresses. Well girls, I'll make it up to you inshaAllah. :) 

If there's one thing I promised myself before internship was to live life normally despite the heaviness of hospital responsibility, the unfixed schedule, the sleep deprivation, and all the abnormalities associated with medical internship. Therefore, I go out as often as I could and always make myself available (unless I'm on duty) whenever friends text me to dine out or simply hang out and talk. In other words, yes, you may date me now. Kidding! 

We dined at Mr. Rockefeller and had dessert at Conti's. I went home with a light heart and a heavy stomach after indulging with too much food. The best thing, of course, was our celebrants paid the bill! Best things come in free! :)

 Afterwards, we decided to loiter around at Rockwell where there was an ongoing Love Japan Fundraising Bazaar. I love my cheap finds!! I wanna go and see, feel and taste Japan!!

Rox, Fatz, Jehan and I at Mr. Rockefeller. 

The birthday girls posing with their kisses-filled complementary birthday cake. :) 

Belated happy birthday girls!!! :)

*credits to Jehan for all the photos*

Another Season Has End

                                Our last week in the community was filled with mixture of excitement, triumph and heartbreak. Excitement as we finally go home for good, triumph for we have survived six-weeks of intense community immersion and heartbreak as we bid farewell to the homes that temporarily sheltered us. Turning back on the days we spent in the community, I mused on the significance of my stay and what I have learned thus far. During our block evaluation, this question was also raised and it seemed as though each and everyone has their own views and explanations about this immersion.

                While others may find the past six-weeks futile and a waste of time, I find it fruitful and an eye-opener. Witnessing people in dire need of health services is nothing new to us but exploring deep down into the roots---psychosocial and even political causes is what community immersion has taught me. If the entire internship is a movie, this rotation is the “behind the scenes”. It made me understand why an old man who is a TB suspect with atheromatous aorta had to wait a month after consultation to go to the laboratory and have his sputum examined and his chest x-rayed. Because he has to wait a month to adequately fatten his pig in order to sell it at a reasonable amount that will cover his medical expenses. It made me understand why an entire family came in with impetigo contagiosa which apparently started from the mother who had prior check up at the same health center and was given meds but still the skin infection persisted and even spread to her younger children. Because there is shortage of Cloxacillin at the health center and since she cannot afford to buy the said antibiotic to cover the entire regimen, she took the meds one capsule daily instead of taking it 4 times daily for a week. It made me understand why a three-year old boy who came in due to cough and colds can be mistaken for a 2-year old. Because he is the youngest in the brood of six to a 30-year old housewife mother and a fisherman father who earns at most P200 a day. Ultimately, it made me understand clearly the bitterness of social hierarchy. Those who gets better education can acquire power and wealth and most often than not, such assets are used as weapon against those who fail to acquire such. The latter are being displaced and ripped off from their own lands with a little compensation by the former that will be benefited for the rest of his life. Sounds more like the Hispanic era in the land of the Indios, eh? Indeed, history never fails to repeat itself.

                A colleague mentioned that we might as well leave these people alone and allow them to continue believing that a boy who seizes is “nasapian” or a girl who has cerebral palsy is a result of “karma” to his parents or a woman who had anaphylactic shock is “nabarang”. Accordingly, what we are doing in the community is just complicating matters to them and the aftermath is piles of debts from medical expenses. In simpler terms, we are ruining the peaceful life in the community. I beg to disagree. We are not heroes to change lives (we can’t even change ourselves, much more others). We are not here to turn the lives of community people into another direction we perceive as the better one. We are not here to change their beliefs and tell them not to seek the traditional healers. We are here to implement primary health care defined as equal distribution of health care for all people regardless of culture, race, religion, and social and political status. We are here to give them the options and show them that there is another path aside from traditional healing. What is education for if not being shared and applied in a manner beneficial for all? 

                We may never return to San Juan, Batangas for community medicine (we may go back for the beautiful beaches though) but the impact of the entire experience will forever be with us. For every patient we see in the ER or at the OPD or even those haggard-looking patient-watchers we ran into the hospital hallways, picture of where they came from will always flash in our minds so we can have a better understanding of them. We may have miniscule role in the empowerment of the community, but it is undeniable that the community itself has a major role not only in our medical career but as human beings per se. Therefore, our six-weeks were never put to waste. Others may not have realized it yet, but I know they will.

               

Oh that O! O_O

Old houses

I don't know if it's a municipal ordinance to preserve their century-old homes or perhaps renovation is prohibited but houses at Poblacion, San Juan, Batangas are really old and vintage!! Remember my entry about Cafeno? Last week, we were introduced to Orange Grill restaurant. I thought it was just an ordinary old house like its neighbors until I saw the tarp plastered at the fronthouse. I presumed this used to be a home to a prominent family and they decided to turn it into a restaurant which is a smart idea because people from the metro will definitely visit this place for that unfamiliarly cool ambiance. 

 Look at those enormous windows! It certainly felt like time traveling to the 19th century where you were gulped by a strong wind and ended up standing at Kapitan Tiyago's mansion where Maria Clara was sitting covering half of her face with a fan.

Gastronomic satisfaction guaranteed!!

 If you live in this house, you will definitely suffocate in too much ventilation! You will have excessive amount of sunshine, wind, rain, and unsolicited visitors!

Ultimately, they got great foods!! We ordered for Orange Chicken and Chicken Teriyaki which are both approved by our tastebuds. What we loved most was their Orange Lemon Iced Tea which comes at a super cheap price of P30!! Imagine?!? 

Chicken Teriyaki with fried camote on the side. 

Off-key

I know, I know. I am not supposed to post this because we are not supposed to meet at the community unless it's a Tuesday or a Saturday due to the NO-BARANGAY-HOPPING rule,  but hey, we are adults!! (alright, are we?) Anyways, last Friday night, our block decided to sleep over at Alaric's place (he's from San Juan, Batangas by the way) for practical reasons since theirs is near the staff house where we conduct our weekly Mortality and Morbidity report before going back to Manila. Now, guess what? They have a videoke machine at home!! Us, girls, sang our heart out, non-stop, from 5:00 pm to 9:00 pm!! We didn't notice the time as we continued to enter songs! 

Biritan na 'to!!

I have many discoveries among my blockmates that night such as:
a.) Crystal, our elitistang blockmate can turn into the most jologs person ever!! Well I guess, every person has that secret side.
b.) Suzie can actually rock Linkin Park's Papercut and rap In The End!! Memorize niya ang lyrics!!
c.) Tina is not just your average doctor-to-be, she has the capability to join in a singing contest!
d.) Alaric keeps on singing "Dahil Ikaw" by True Faith and up until now he cannot perfect the song...nice try by the way.
e.) Irving!! *Bakit Ngayon Ka Lang starts playing in my head now!* Woot, Julius Babao!
f.) Despite singing off-key almost the whole time, I picked Adele's Chasing Pavments to be included in my videoke song box!! LOL. Yun lang ata yung nakanta ko ng medyo tama!

Any of my blockmates will kill me if they get to read this!!

OMJ--as in Oh My Journal!!!


Suzie and I worked last night at Figaro to finish and "rehearse" our journal reporting that took place today.

Here, Dane is reporting on their cluster's journal. Reporting was done in front of 4 consultants, 2 residents and members of the 3 blocks currently rotating in the community: Block U (that's us!), Block T and the newcomers, Block S. Unintentionally, my crush is in the photo!! Yiiiheee! Kaya pumapalakpak puso ko while reporting. Hihihihi. 

Ombrella!!

Can I spell umbrella that way, just now, please? For the sake of this entry. Hehe. It's raining so hard. Another low pressure area, I guess. 

Ombrella display at the UP College of Medicine. 

***

We got only two more weeks of packing and unpacking!!

Reflections

*this was what i wrote on our third weekly reflections in the community.

The medical field may be broad but the vastness brings one to narrow down into an array of choices. After passing the boards, a new physician may choose to a.) further master a specific specialty by going into residency, b.) earn financially by “moonlighting” or c.) become a public servant by going into isolated communities where there is scarcity of medical doctors. I see myself going into the third option before proceeding into the first one. This is not merely dictated by a particular scholarship that demands a 2-year compensated community service, but because of some personal wishes I want to fulfill before going hard core in the hospital for residency. Being a community doctor is advantageous in such a way that I get to have a break from the toxic hospital environment, I will have to spend more time with my family (or probably have my own family then), I get to give back to my community and to the government which provided me my education, plus the monetary compensation is not bad.

However, it is not all perks. Being a community doctor breaks all the clinical idealism in a new physician. Although we encounter benign cases, inaccessibility to simple laboratories such as x-rays, urinalysis and blood exams interfere with the accuracy of our diagnosis. We are taught not to rely on laboratory exams for diagnosis but it is undeniable how helpful labs are in confirming diagnosis that leads to proper management. Now it gradually dawns on me why patients from far-flung areas arrive at a tertiary hospital already on the terminal stage of the illness.

Few nights ago while we were watching the news reviewing what the current administration had accomplished on their first year on the seat, there was an emphasis on their negligence about health. Sadly, our country is filled with too much politicking that our beloved government officials deals only on projects that can be seen by naked eye such as infrastructure and agriculture and least on the core that allows a human being to act and think efficiently---health and education. I believe that our progress as a nation is impeded due to our failure to deal with the basics; we jump into the tip of the problems without knowing the roots. Unfortunately, our public officials address problems which answer only to their personal interest. They are unaware of what is happening into the less civilized part of country, how those people behind the mountains suffer physically and economically.

As a would-be community doctor, I will be dealing with a whole lot of the abovementioned social problems. I don’t know yet what I can do about it, solutions are definitely not seeping into my mind yet. But what is two years of dealing with social disease? It won’t be long, I would face physical diseases again which is way easier to cure. 

*we're about to begin our 5th week, and yes, about to end. which reminds me, i haven't written my fourth weekly reflection yet!!!

A Story

She was walking down the alley bearing the weight of the world on her shoulders. Sporting her bagpack filled with kilos and kilos of books, she’s dragging herself towards her destination—home. That’s her everyday route—home then school, and vice versa. There are occasional visits to the bookstore or to a coffee shop or a hormone-induced hunting for that perfect pasta drowned in too much cheese, otherwise she’s heading home. She may not be wearing spectacles but she’s the typical picture of a lifeless geek. She’s the familiar face for many, but her name is unheard of.  Nobody really cares about her, oh well, not that she ever minds. All she cares about is how to pass her brain-wracking exams which explains her present mood.

She was walking like a zombie staring at the blank road, slowly kicking tiny stones that come her way. She muses about the number of pages that needs to be done about tonight, or, just finish a movie to relax her mind for the exam. “What would life be if I were at a party at the eve of an exam, drinking my heart out, dancing and singing ‘til the break of dawn?” She paused and pondered. She began to imagine the lights, the glittery clothes, the towering shoes, and the intense noise coming from the sound of the party music mixed with voices of giggling women. She imagined herself in the crowd. How will she act? How will she sway her hips to the music? How does it feel to have a hang-over? How does it feel to have no inhibitions, whatsoever?

And then the music died.

“I don’t belong there.” She declared to herself while picking up some few study materials she dropped in the midst of her daydreaming. She stood, fixed her bag on her back, finger-combed her hair, and continued her journey wearing her usual burdened face.

“You know what, give yourself a break” said an unfamiliar voice from her back. She almost jumped and screamed to her astonishment, she wasn’t aware someone was trailing her. As she was turning around to see who it was, he walked past her pacing swiftly. Hands on the pocket of his blue hooded sweatshirt, he didn’t turn around. He was walking fast as if chasing for the unseen.

He disappeared at the end of the road while she was standing blankly wondering who he was. 

Friends were inviting me to watch Transformers 3 at iMax. I refused because I am not into violence-related movies, specifically robots.
Hence.
At a coffee shop alone.
Caffeine overdose.
Advance OB-GYN reading (weh!).

That's what future spinsters  single ladies do on Saturday nights.

Cafeño

My likeness for coffee shops is a known fact,  not because I'm a coffee addict but because of the ambience. I look for coffee shops filled with eternal silence where people do their own thing, either getting their noses buried in their books or wandering in the world wide web. Here in the community, there's Kappe Brako just within our vicinity so it's not much of a problem where to loiter around. Just this Tuesday after our arrival in San Juan, Batangas, Alaric introduced us to this old-school coffee shop that is quite famous not only for their kapeng barako but because of its vintage interiors. It's not like they actually meant the place to look vintage, IT IS REALLY OLD!!! This is owned by a Batangas old-rich family and they have preserved the place from its original form dated back in the 1950s.

I googled this. 

Googled, too. 

Here, Suzie showing her back at the camera. Look at the interiors. Anay na lang ang kulang. Haha! Seriously, it has this 1950s-1960s feeling. Missed my lola's old house. 

Aside from kapeng barako, they're also famous for their tamales, sticky rice suman with shredded coconut bits.

Block U at Cafeño. :D

Yes, this is the generation where women stands up while men are sitting comfortably. 

Brighter Side of Flood

The rainy season is so IN which is directly proportional to the rain boots fad! Gone were the days when rain boots are for farmers only because now, rain boots come in wide variety of fashionable prints and colors. Perfect for the typhoon-y Philippines. Just last week, typhoon Falcon hit our country causing flood all over the metro. According to a friend, almost everyone at the hospital including interns and residents were wearing colorful rain boots. At least, colors and pretty prints can still be seen submerged in the flood---not just garbage, iwas leptospirosis pa!

My housemate Emily bought a pair that came in girly color pink and it's loaded with awesome cuteness!!! I feel inggit so I'm contemplating of buying a pair for myself. I can imagine wearing this one below walking drenched in the ankle-deep flood along Taft. Hehehehehehe. 

But this one totally looks ABSURD!! Wedding rain boots? Hello!

RIP, Des. :'(

Along with the drizzly morning, my clogged nasal cavity and nonproductive cough came the news of her untimely death. The entire day was gloomy as though the world mourns her passing.

Our friendship started when we became classmates in junior high school, we weren't really that close as we had our respective barkadas but I came to know her better during senior high when we both write for our school gazette. We had our occasional trips to downtown Iligan City to "check on the progress" of the school paper and "do some editing". Those were the days when my parents' strictness was at its peak. To make things more convenient for us, Des would volunteer their house for a sleep over then we'd go back to Marawi early the following day. Just like some common all-girls sleep over, we'd watch movies and talk about stuff. I don't remember the movies anymore but I perfectly remember the arrangement of their house at Del Carmen and her hospitality (aka, she prepares no-pork food for me). Des was one of the sweetest girls in class. When we separated ways in college, she'd really make beso-beso three times just the way Muslims do whenever we saw each other at the university "canopies", she hugs so tight and will never fail to say "I miss you" wearing her sincerely sweet smile. 

It wasn't long ago, around October 2010 if I'm not mistaken when she was diagnosed to have acute myelocytic leukemia. Ironically, the most curable leukemia. The last time I checked on her was she was undergoing treatment so my jaw dropped when Jessie called me up in the morning to announce her death. :( All the while I thought she was on the road to recovery.

Desiree T. Taburada, RN. 

Des, know that I am forever grateful for being a tiny piece in your colorful life. Thank you for the wonderful friendship which will forever be cherished. Without you, Quasar 2003 will NEVER be complete. Wherever you are, may your rest in eternal peace. 

Lakbay Tayo!!!

My Lakbayan grade is C-!!! Aaaahhh!!! 

You may want to know your Lakbayan traveling grade here.


C'mon, TAKE ME AWAY RIGHT NOW!

Unusually Better... Or Is It Just LUCK?

How often do we fail our expectations? How often do we heave a that's-life sigh while accepting our fate when things turn out worse? Or, what is the probability that things will turn out BETTER?

I was having some anxiety attack prior to our 6-weeks community immersion due to the possibility of having a not-so-nice experience from my would-be partner, would-be foster family and the community itself. I was faced with many issues and what-ifs like what if my partner (a choice between Crystal, Suzie and Tina) is someone who isn't tolerable enough (okay, that is vague), what if my foster family is reluctant to have a Muslim foster child, what if we need to hike kilometers of muddy and unpaved road to be able to get to the health center, how about my safety and security in the place? A lot of questions were running through my head I almost didn't wake up on Tuesday for our early morning trip.

Our block is divided into four clusters: Bataan, Bulsa, Imelda and Laiya,  meaning two sets of girls and another two sets of boys. We draw lots with our hands in tremors. Luck was on our side that fateful afternoon when Suzie and I picked LAIYA APLAYA!!! It's the farthest yet it's the best! For one, our foster home is a public resort which only means that our room is the one rented by guests during summer vacayes. It's not the million-dollar worth kind of resort but hey, it is absolutely NOT BAD as we expect it to be! Imagine the comfort!! Suz and I decided not to brag about our place to avoid depression among our blockmates who are, well..... unfortunate. Sorry guys. :'(  The distance of 22 kilometers from the poblacion of San Juan, Batangas is all worth it.

So guys, welcome to our home!!

Island Sky resort is owned by Ate Edith Abanilla, our foster ate who lives with a lola (non-blood related to Ate Edith, apparently, inampon daw niya si lola kasi pinalayas ng anak!! ) and her niece whose parents are OFWs. Our room is that brown door immediately from the terrace while Ate Edith lives at the back house, that silver-colored door at the rightmost. Technically, we don't live together as a "family" in it's real sense. Well, they're not a real family in the first place. I think that defeats the purpose, but we don't care so long as we have a tiled CR with a ceramic bowl, two large beds, fridge, electric heater and an aircon!! Ok, that part we do not want to brag to our blockmates coz they might cry sands and stones!

Another good thing is that the health center where we hold clinics every Wednesdays and Thursdays is just a five-minute tricycle drive from our home. Hailing a tricycle is one of the difficult things in our place but thankfully, Kuya Raffy's just one text away! We mingled with Ma'am Ellen, the barangay midwife and some of the barangay health workers who are more than willing to accommodate us. Most of our cases were just upper respiratory tract infections and systemic viral infections, rarely do we have hypertension and others. The most toxic one was a diffuse toxic goiter which we referred to the district hospital for the work-ups. Alhamdulillah. Things went really just fine on our first week.

We had a courtesy call to the Barangay Captain on our second day. This captain is not your ordinary captain because he owns Kabayan Resort  and most business establishments at Laiya Aplaya. He welcomed us into his mansion within his resort, and he offered us their trademark kape barako. His friend, Mr. S. from the Aplaya Corporation was also there that morning. Too bad we weren't able to linger around the resort kasi nahiya kami!!! 

Kap also owns this quiet and quite high-end coffee shop located just a few meters away from the HC. We arrive here after clinics at around 3:00 pm and that's the time they turn their aircons on, which could only mean that we are probably their only customer for that day! LOL. We stay there until nearing curfew time connecting with the rest of the world through the world wide web aka Facebook and Twitter. 

Meet the lucky duo, Suzie and I! 

Hello, Laiya Aplaya!!
If you woke up everyday to this magnificent view, don't you just wanna lie down and daydream all day loooong? 

FIVE WEEKS TO GO!! :)

Currently Thinking About These....

Photo courtesy of www.stylecovered.com

Clothes.
I want some shopping spree..
But I am on my way to becoming broke due to the expenses that our community rotation demands.
I need to withhold some personal wants for a while. Chos!
I'll be off to Batangas tomorrow.

FamMed With A B-A-N-G!!!!!

It was Suzie and I's last PM duty at the Ambulatory Care and instead of the hackneyed Last Duty Syndrome, this is what we got!!!!!

Lights off. Basically, our role last night was "bantay" ng Ambu. LOL. This scene was opposite from our last PM duty na 4:30 AM, may mga pending patients pa.

 Empty Ambu!!!! Weeee!! Record breaker kami! We had only one patient at around 11:30 pm who came in due to palpitations, shivering and a feeling of choking. We thought of a medical condition like arrythmia or some endocrinologic problems, but upon probing, we found out that she's been worrying about a lawsuit against her and the future of her 8 children, 7 of which married at an early age without finishing college, unemployed and with children of their own. It's a bitter world for that old lady. Hence, our verdict was: 

I- panic disorder, without agoraphobia 

II- defer

III- hypertension, diabetes mellitus, obese 2

IV- financial and family problems

V- 71-80

Another good news, our block received a 12-hour merit "for actively participating during EBM conference". Technically, it was only DS and Irving who should receive the merit because it was they who did most of the talking but we were just so lucky to have been showered by their blessings. The two got an additional 5 points though, perhaps will be added to their shifting exam score. Speaking of shifting exam, bukas na pala yun!!!! 

Alhamdulillah. Allah's the best! :)

FamMed Week 2

Ang sarap mag-duty sa Ambu kung ganito ang eksena. Walang tao. :)

Lalo na pag ang nasa katapat na Pedia Triage ay ang crush na benign din. Kung close lang kami, a wave would suffice to make my day. <3

At the FamMed-OPD, this sight greets us everyday. Kulang pa nga 'to eh. 50% lang 'to ng total OPD consults, our quota is at least 70 patients everyday. It doesn't seem toxic at all because there are at least 6 interns and around 5-7 residents catering to patients. So around at most 7 patients everyday for each. Plus, our cases are the super benign ones like dyspesia, UTIs, BPHs, acute gastritis, hypertension and etcetera.

 What I appreciated most about this rotation is we get to make our own assessment and plan for every patient we handle. The resident would check what's unnecessary or lacking in our management so we are being corrected. The most rewarding feeling is when the resident agrees with my management and is being carried out. I know I did the right thing. Love it! 

The one with the arrow below is the genogram I did for a patient, yan ang toxic! Mahaba-habang chikahan yan with the patient. 

We're about to end in few days time and we're off to the Community. I'm so not looking forward to it. But let's see. Baka mag-enjoy din ako. 

EBM Dilemma

I'm on my 2nd week at Family Medicine which is our last week in the department. I'm enjoying every single moment of my OPD duty especially when the resident agrees with my diagnosis and my management. There are always glitches but it feels good when the resident gently discusses the case with me and tells me what should have been done. I'm enjoying my learning experience EXCEPT for this Evidence-Based Medicine shit that I have no knowledge about. I wonder why our school didn't teach us such! Thanks to my blockmate who sent a copy of an EBM self-instruction manual to our yahoogroup. The introduction goes:

Medicine is a dynamic endeavor. Everyday challenging problems

arise, new modalities of treatment are promoted, disease 

management done under minimal or far from ideal conditions etc. 

Because of these challenges the quality of care also changes.  

Suppose a patient who consulted in your clinic with a diagnosis of

dyspepsia is asking for another prescription because the antacid

you previously prescribed was not effective. What will you give H2-

blocker or proton pump inhibitor? Or you may see another patient 

consulting for cough productive of yellowish phlegm who asked for 

a prescription of an antibiotic. Will you prescribe an antibiotic or 

not? These are common problems that may escape our attention 

and diminish the quality of care we give if we make inappropriate 

decisions. 

In the old practice faced with this question, a physician will just ask 

a colleague or an expert for the answer or rely on his/her prior 

knowledge of the disease. He may also prescribe a drug because 

of the promotional lecture he attended previously about the 

product.  

In evidence-based medicine a new paradigm is introduced. Before

he makes a decision, the physician will first try to retrieve his latest 

article about the topic that he kept from his file, appraise the article

then makes a decision. Later, he evaluates the effectiveness of his 

decision. This loop ensures improvement in the quality of care.  

The purpose of this self-instructional manual is to introduce to 

family physicians the concept of evidence based medicine and the 

use of these concepts to improve the quality of his/her own 

practice. 

EBM is real complicated for someone like me who will start from scratch. Formulating a clinical dilemma is non-tedious, clinical appraisal is. 

I'm contented with the pacing of our duty hours: 12 hours at Ambulatory Care, we receive patients from the triage who are not suited for admission. Not toxic in terms of the work load, toxic lang ang history taking and PE! Like you need to include a genogram and you're not supposed to abbreviations! Ayos lang, ganun naman talaga ideally but my hands hurt a lot! Tsaka, ubos na ink ng ballpens ko! 

When we're not on duty, we do OPD works at FamMed OPD, which means we're free on weekends like this. I want to watch a movie tomorrow but I don't know who's available to accompany me. 

We're off to the community in one-week time and I'm cringing at the idea. I just don't like going off. Hmp. 

My mind's clouded. I'm going senti. Need some shut eye. 

Hijab+Uniform+Pork

On some days I wear my old skirt, on most days I wear pants which is the "proper" uniform. I felt the urgency to shop for more pretty tops. This is the time I wish I am rich. :D 

P.S.
My blockmates inquire about why I wear my hijab. They ask too many a question while I try my best to enlighten them about it but most of the time, the conversation falls to why I don't eat pork! I might as well have a deeper Islamic research about that. #choz!

Poor Brain, Rich Eyes

First of all, I know that this blog was created to air my insights and all that weird things boiling down inside my thoughts. However, due to the swift constant revolution of my everyday life, there has been some scarcity of musings nowadays. Or probably I get used to the wretchedness of this world---the hospital, that is---that I lost connection to my inner humanity. While it's good to escape and find diversion, I'm afraid to get stuck into  the "other world" that I might get lost on my way back. Still, I escape because I need that diversion. Now, instead of sharing a piece of my brain, I'm gonna share pieces of what my eyes see in my everyday life. I don't have a great camera, I only have my mobile phone with me hence the poor quality of my photos. :( 

Last weekends, I was fortunate to be duty-free on Saturday and Sunday morning, so I went home to Merville at my cousins' home. I haven't been there since the start of internship. I was so glad to be back and play with my nieces. Here is Sabreen, my cousin Ate Pie's eldest. Such a cute darling!

In this photo, she's pretending to read. I love it when she mumbles un-understandable words while pointing to every single paragraph. Haha!

Sab. She's only two.

 Before I went back to my dorm. I accompanied Ate Hannah to SM Makati where I had a chance to feast my eyes on the pretty dresses and blouses of Forever 21! Aaaaah! How I drooled! But I was broke I went out empty-handed. :(

 I loiter nowadays at our condo lounge at 10th floor where there is swimming pool and free Wi-Fi. I never tried the pool kasi stagnant ang water! Haha. One fine afternoon, I had this view from where I was sitting and tweeting. :) Love the sunset sky! I imagined myself to be sipping coffee with a loved one sitting beside me...but nerrrhhh, it didn't happen. Most probably it won't happen. Aaaaahh!!! Nooooo!!

 My housemates: Emily and Sal. We're gonna have a new housemate since Pie moved out. Yay for that! :D

Meet the Block U. "We Revive, U Survive!". That is our temporary slogan until we come up with a smarter one. LOL. Taken at Pedia-ER on our last day. Photo courtesy of Renzo G., our Track B co-intern. 

First row L-R: Crystal, DS, Dane and Rex
Second row L-R: Tina, moi, Suzie
Back: Alaric

 Our Pedia-ER team. I'm gonna miss them, they're the best so far! They're so sweet and all. I admire Ma'am Glo, our senior resident, for being so composed and calm no matter how toxic we are! (except for that time her voice rose because of a cruel patient's watcher).

L-R: Suzie, moi, Ma'am X-Tina (thanks for allowing me to write my own order!), Ma'am Glo (the great!), Ma'am Inah (thanks for that recommendation for 24-hour merit!) and Tina. :)

 Block U's first lunchdate. So, these are the people I'm gonna be with for the rest of internship. :)

Done with my first month in Pedia. Next round of Pedia-OPD and Ward will be April next year.

Next stop: Family and Community Medicine. I am so ignorant about Evidence-Based Medicine. We just don't have that back in MSU. Aaaah, why oh why!!! It will take time for me learning that while my blockmates are so knowledgeable about it. 

Talk To Me, Kid.

I declare: I LOATHE STUBBORN KIDS! Only because I wasn't when I was little. I wasn't afraid of needles, of people wearing white, i.e., nurses and/or doctors, and most importantly, I was easily talked to! I still am, by the way. Why do kids nowadays are so maarte like they are trying to act like an adult and they wanted their whims and caprices to be followed? BRATS! You know what, parents and older sibs out there, these kids MUST know who takes the lead and who is the follower. Right? 

We had a patient last night, 9 year old male, brought in at around 9:00 pm and was complaining of right lower quadrant abdominal pain. He was s/p appendectomy last year so we were contemplating on bowel obstruction secondary to adhesions. In other words, he will be transported to the OR as soon as possible to prevent further compromise. The Pedia-Surg resident asked us (Suzie and I) to insert a foley catheter and nasogastric tube. I was the one who inserted his IV line so I knew he was so inquisitive like he asks too many questions and since you cannot lie to a child, I had to explain tiny details including why I need to place leukoplast all over the IV cannula. Then comes foley cath insertion, we had to explain ALL the details that need to be done. The parents were there to console and assure him. So we thought everything's okay. When Suzie was about to enter the tip of the tube, he shrieked and closed his thighs together which made it impossible for us to perform the procedure. We talked him down in our most soothing voice, said all the things that would probably make him comfortable. Epic fail. We left and decided to return when he's ready.

Two hours later, we came back with another set of foley cath. Still wearing our baby voice, we talked to him as if he's an adult hoping to alleviate his apprehension. Yet, no effect. We called a resident, who did a lot consoling. The kid was shouting: "Hindi niyo kasi alam ang pakiramdam!", and the resident answered: "Naku hijo, pinagdaanan ko na ang lahat. Lahat na ng klase ng tubo nagawa na sa'kin..Kaya sige na please, mabilis lang naman eh. Please?" in her most begging look.We even mixed lidocaine with the lubricant to make him a little numb. Still, no effect.

Five hours passed and he was still throwing tantrums. We called the Pedia-Surg resident to help us out who did a lot of bargaining with the boy until she almost lost her patience. He was so whimsical he wanted everything he says to be followed. We were initially giving in to him, until the Pedia-Surg resident noticed how stubborn he is. So much talking on our part and so much yelling and shouting on the boy's part. He's 9 years old and difficult to restrain. He doesn't listen to anyone, not even to hisparents. We gave him midazolam which sedated him for like a few minutes, but when he felt the NGT poking on his nose, he struggled again and regained his energy!! Aaaaack! This time, we had other watchers help us restrain him until we successfully inserted both the NGT and the foley cath at around 3:00 am! The worst part is, when I pushed 10cc of water on the catheter for inflation, he squeaked and struggled so the needle passed through my skin! That was my second prick last night. On the positive note, both needles were not used for blood extraction...otherwise, I need to panic!

It was a long 24-hour duty. We bagged almost whole day, two of which expired. :(
Conducting patients who doesn't respond to midazolam to the CT-Scan room.
Suzie and I had "The Phenobarbital Incident".
And, THAT BOY.
We left the ER this morning with the preduties bagging again. *Sigh*

Bagging Tina

Triage Area. 

Adult Triage. Sitting and looking from the Pedia Triage, parang ayoko mag-duty diyan!

Finally, na-sedate na rin ang patient na ayn!

L-R: Tina, Ai and Suzie! :)