BURN For Me Baby.

This is where we literally skin people alive. Does that made you cringe? I do, too, upon seeing and hearing them scream as we peel of necrotic tissues from their burnt skin while begging us to do it slowly and gently. Indeed, we do it as slowly and as gently as we can but it is really painful. Ideally, burn patients should be sedated during debridement, but what can we do? It is literally painful to be poor. :'( 

Rumors about my crush couldn't be true or my world will begin to crumble. Therefore, I must face this with a bias-free and an open mind. An investigation must commence. 

Seriously? Haha. 

PedSx

My surgical subspecialty of choice. Too bad I only have one week to bask in the subjects of Intussusception, Hirschprung's disease, Imperforate Anus and other pediatric surgical cases. It's frustrating though that subspecialty rotating interns do not assist in their ORs. :'( I wanna see how PSARP (posterior sagittal anorectal plasty) procedure  and pediatric intestinal anastomosis are being done. :'(

I don't have plans of pursuing surgery but this sparks some curiosity in me. 

The only pediatric surgical OR I assisted was herniotomy at the Major OPD OR which was done in like 30 minutes, my gloves weren't even stained!! 

By the way, we have a rotating German intern  from a certain university in Germany. I don't talk to him much like I would do to someone I can easy-breezily have a conversation with mostly because I have difficulty understanding his accent!! Lol! German-English accent!! Nakaka-nosebleed!! So I would usually allow him to do his thing while I do mine and ask him once in a while how he's doing. Awkward? Hahaha!

We had a laparoscopy workshop along with PedSx residents and consultants. It was fun manipulating beads and rubber bands by using the graspers just like in an actual laparoscopy although it takes huge amount of patience and good hand-eye coordination!!! If I would become a surgeon, I would most probably opt for an open laparotomy than laparoscopy!! Haha!! 

On another news,  I found the perfect place for studying!!! Taaadaa!!!

It's a walking distance coffeeshop near our place where everybody goes not to chat but to read! Awesome! So you get to read books with pure serenity, plus the high-ceiling structure of the place allows enough light for ventilation. :) This place is a huge help for me to avoid many temptations at home: TV, internet, bed, and fridge. :) 

Also, our photo with a cardiac pacemaker recipient patient was published in Heart and Health Magazine. This was taken during my MICU (medical ICU) rotation, and together with the resident-in-charge, Ma'am Gelay, we posed for this photo which was sent to Heartbeat International Foundation and Pusong Pinoy Foundation for the purpose of seeking funds for this lucky patient. 

Credit goes to my blockmate Alaric Salonga for taking this one. If you look closely, he manually wrote his name underneath the photo while bantering why his name wasn't on it. Lol! 

*All photos were taken using my iPod. Such poor qualities, my point-and-shoot Canon should have been used for that DSLR-like shots I'm so proud of. Haha. 

"While we are robust and in the prime of life, we imagine our deathbeds, the wisdom we mean to impart, and the precious words, like jewels on a necklace, that we intend to bequeath to those around us. 

But it is rarely to be.

We perish quickly on the battlefield, or in an accident, or in a lingering illness that will not announce its schedule for our destruction. 

And so our words perish with us, and those left behind are condemned to clutch at memories, at what they imagine we wished to say."

-Margaret George's Helen of Troy. 

A Hearty Prayer

I swear I do not know how to start the forewords for this entry because I feel so shy about actually putting this into writing. Fine. So, I wrote a letter to God. These are the words that were sitting silently in my head but were uttered with difficulty by the tongue. Since He is Omnipotent, the All-Seer, the All-Hearing, I know He recognizes my unsaid prayers. This was inspired by the people who painted the town red during Valentines Day. Thanks to them, I got reminded how lurve has been elusive to someone like me. I hate musing about the state of my hearty flakes. I am so contented with this extended adolescence and having plain crushes, but I keep a secret prayer which is to be divulged now. Oh well. Here goes. 

Dear God,

I pray that You guide my heart to the right person, the one who will be courageous enough to wall off this coldness that envelopes me, the one who will help me strengthen my faith in You, the one who will fill the puzzle of my being, the one with whom I will share my happiness and all the success I will have to acquire while we wander in Your beautiful earth. 

Please guide me to the person who will cherish, love, honor and respect my parents and my siblings as much or even more than what he shows me. The one who will value and love me unconditionally. Inshaa Allah, we will bring out the best in each other.  Ya Allah, please guide my heart to the person who will never do anything that will break my heart and that of my parents'. 

Ya Allah, please spare me from loving someone who will only bring misery to me and my family. I pray that whoever You choose to be my future better-half would be someone that my parents and I also desire. If this person will only bring me misery then please take back all my feelings. I'd rather live with a stale heart than cause havoc in my most prized possession---my family. 

However, if this person will prove that he is worth his salt then allow our fate to meet at the soonest appointed time. I know You've been designing all of these in perfect manner for the past 26 years of my life, Inshaa Allah this person will emerge in the perfect moment perhaps near to what I have imagined. Only You can fashion a love so excellently that can be hindered by no one. Hence, I leave it all up to Your care. 

Please guide our hearts as all of these shall become futile without Your Holy Guidance. 

In the Name of Allah, the Most Merciful, the Most Beneficent. 

Ameen. 

You, what's your prayer? :)

Cefazolin 2g loading dose now then 1g Q8.

PGH Intern does:

IV insertion

blood extraction

drug administration

vital signs monitoring

paperworks: clinical abstracts, discharge summaries

first in line at the ER

triaging

pushing stretchers and wheelchairs

chest compressions and ambubagging if patient has no bantay

Anything amiss?

Remorseful? NOT.

I say, grateful. :)

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. 

Of Lights

Lights and I have this unspoken, secret relationship that we only recognize once we are bounded. It's comparable to an old friend you haven't seen for eons and when you bump into each other, you felt that certain amount of nostalgia flaming inside of you. It pokes your heart and spontaneously opens that well-guarded vulnerability in you. It brings this seemingly secret message that can only be fathomed mutually. It makes your jaw drop in utter amazement. It makes your mind wander to the vast infinity of possibilities. It resurrects hopes, dreams and infinite love.  

Under the lights, you decide to drop your guards. :) 

Lantern Festival in Taiwan.*

I'm no Christian but I love Christmas because of the lights.*

I always look forward to every New Year hugely because of fireworks display.*

I would always looooove the night sky because of the glittery stars decorating its pitch-darkness. *

Something I look forward to see for myself in this lifetime, the lights at The Eiffel.* :)

*Googled photos.

Mark Onglao, August 2011 Physician Licensure Exam Board Topnotcher, and currently a 1st year Surgery resident, sat right next to me last Wednesday during the department mortality and morbidity (M&M) conference. I wished I possess some sort of mental imbibing powers so I could have grabbed the opportunity! Hahaha! 

At the OPD Major OR, this patient was supposedly for hemorrhoidectomy. But because he weighed 122.6 kilograms, the anesthesiologist had difficulty doing the spinal anesthesia so he resorted to general anesthesia. However, when the surgeon assessed the surgical field, he knew he would have difficulty doing the operation with that weight so he deferred. After the intubation and all, the patient was brought home. Haha! Morale: LOSE WEIGHT!! 

Surgery resident waiting for the anesthesiologist. Postduty Ma'am? :)

Now, here's something smurfed to scare those tiny mosquitoes away! 

...buzzz.....

Update: we're shifting out from GS2.

Have a blessed Friday! :)

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)

Hand Me Tha' Scalpel

Back to some hospital lovin' stuff, I'm already on my third week in Surgery. This would be our second to the last major rotation, we still have one month remaining at Pedia after ORL and Ophtha. This is my second most loved rotation next to Pediatrics, perhaps because I've had too much amazement of the subject back when I was a clinical clerk. I also see surgeons as the COOLEST people in the medical field, they're neither the nerds nor the laid back guys. They're just awesome! As it turns out, I have a thing for Surgeons rather than Surgery itself. LOL! Kidding! Seriously, I am enjoying every single moment in this rotation just like when I was a clerk. 

On our first two weeks, we manned the Surgery-ER where we did wound suturing and inserting IV lines, the usual stuff. There were less suturing here as compared to when I was a clerk, that's because of the existence of hierarchy (residents > interns) and there are separate Trauma interns to share the job with us. Reminds me of my good ol' clerkship days where I had seen practically ALL kinds of TRAUMA cases and had to suture ALL kinds of avulsed or lacerated wounds. Kanya kanyang style ng pagtatahi! The good thing about our first two weeks was how we are entrusted to do our own operations at the Minor OR. I never had that experience---breast fibroadenoma and polyp excision! Awesome! I thought I couldn't do it, but hey, I DID! High five for that! :) I was really nervous on the first day. My resident just made me palpate the mass and verbally instructed me how to do it. I figured it in my mind and continued with the surgery squeezing out all that confidence in me. I succeed with the first patient and the others except on our last day when a a certain patient's mass was so deep and quite large (~3 x 4 cm) and I kept hitting on arteries which bled quite profusely! I was so scared I had to seek my resident's help! She controlled the first bleeder by ligating the bleeding artery using cotton tie and came my lightbulb moment. Aha! Oo nga 'noh, bakit nga ba hindi ko naisipan yun. I am such a panic. So there, I used the same technique for the rest of those lecheng bleeders I encountered. 

Five days later, one of those patients followed-up at the OPD and I was thankful she had no complications. Haha! Otherwise, I don't think I can forgive myself.

Surgery is one helluva coolest and tough field! That's why I don't blame Surgery residents who feel so astig  even if they don't look like one! Haha! Peace yo! :) 

We are currently at the Wards under the GS2/3 services. That's the Colorectal and Hepatobiliary services. Good thing about Surgery here at PGH is that we are given the option which field we might wanna take. So I took GS2/3 rather than GS1/Trauma. GS1 comprises of head, neck and gastric cases. I avoided Trauma simply because with all conviction, I would explicitly say I loathe Trauma. I don't like the subject and I don't like the patients. Most often than not, they are those who are brought to the hospital because of their own fault. Usually vehicular crashes and/or stab wounds are the cases. These are the social liabilities that I feel like they don't deserve my time and energy. I am so mean at that, but I just feel exactly that way towards Trauma.

On our last week, we would be exposed to subspecialty fields however we are only to choose one among the four subspecs (Plastic Surgery, Thoracocardiovascular Surgery, Pediatric Surgery and Urology). I chose Pediatric Surgery. :)

I don't see myself as a Surgeon one day but I am happy that I'm enjoying this rotation. 

Plus, I always wear an extra smile on my face pa everyday. :)

Rx: Ice Cream.

There's no medical prescription to cure bad days. I tell you, only ICE CREAM can do the math! I deny having sweet tooth but with ice cream, it has got that magical feeling that wipes all the blues away!! Yes, magical, that's the term. Woot! :)

Homemade banoffee pie ice cream. It was made from FRESH BANANA mashed into the coffee-flavored ice cream. Voila! 

My bad. I forgot the name of that Japanese homemade ice cream store located at the 2nd floor of Robinson's Ermita, Midtown wing. The one with purple furniture? That is so visible. 

I had banoffee pie ice cream that came with a message: 

"To live is like to LOVE---all reason is against it, and all healthy instinct for it."

I didn't get it. Something wrong with the grammar, perhaps? 

Next time you have bad day after assisting a consultant who doesn't seem to get satisfied with  how you assist ("iha, hindi ganyan. i-retract mo pa." "'wag mo masyado i-retract, masisira ang tissue". ano po ba talaga? e kung kayo na lang mag-retract? try nyo lang po. LOL.), try some scoop of ice cream! :) If you have funds, try Caramia's gelato. I bet you'll forget you ever had a bad day! Nomnom! 

The Artist's Walk

As we are about to leave the hospital this morning with my co-interns, I walked the opposite direction as I wave my hand goodbye. I had in my mind to pass through the hallway at IM wards that leads to the hospital's main entrance which faces Taft Avenue. One of them noticed my unusual route and suggested to walk with him instead to the usual route we normally take, the one passing through ER and OBAS emerging to UP-College of Medicine building and then to Pedro Gil street. As we go along...

A: O, sa'n ka pupunta? Ba't dun ka dadaan?

Me: Wala lang, para naman maiba yung route ko. 

A: Nag-transfer ka ba ng bahay? Ba't sa Taft ka dadaan?

Me: Same place pa rin naman ako. Sa Taft kaya front ng building namin kaya okay lang din ako dun dumaan.

A: E mas mapapalayo ka pa dun....tingnan mo, kung dito dadaan..blah blah blah... (and we talked about energy expenditure and the distance and so on and so forth.)

Alam mo, artist ka nga.

Me: Ha? Hindi ah.

A: Artist ka. Mi tawag jan eh. ARTIST'S WALK. Yung mga artists daw, ginagawa nila yan. 

Me: Ang alin?

A: Yang ginagawa mo. Naglalakad. nag-iiba ng ruta. Wala lang. Para mag-reflect or something. 

Me: Arte lang ako, hindi artist!! Hahaha! Sandali, ba't mo alam yung mga ganyan?

A: E, artist ako eh.

Me: Kapal mo! Self-proclaimed artist ka! Well, photographer ka nga naman. Sige na nga, artist ka na nga.

A: Seryoso. Artist's Walk tawag dun. :)

He's not wrong about the love for walking I have in my system. It is something that I have developed along the years out of necessity (haha, MSUans can relate!). There is a sense of contentment and mirth I get from walking. It's like an astral projection that allows my mind to wander as I take every single step. I plan in details what I will do for the day as I walk towards my destination. I get a clear picture of my expectations and how I will overcome the obstacles I am half-expecting. 

But me being an artist? That's quite debatable. Haha! I never drawn a perfect picture way back kindergarten. I never perfected Home Economics artsy projects. I used to ask my gradeschool classmates to sketch a pretty gown or dress for my paper doll. My Humanities I painting project was so bland and boring considering it was just a simple apple to paint!!!  Do I need to emphasize how much of a failure I am in that department? 

I'm no artist but I am a HUGE fan of artists and their works. I love arts and the sense of nostalgia or wistfulness that it brings. I have artist friends and I admire them for their God-given talent which I unfortunately lack. :)

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! 

Remaining Days

Kick-off party for the remaining 100 days of internship!!

ONE-HUNDRED FREAKING DAYS INDEED!

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!!!

#feelingsikat

Yehess!!! This blog which I started for more than a year now has reached a whooping 10,000++ views!! LOL! Thank you to my untiring audience! Although most readers do not drop their comments, I am happy to know that sharing a tiny piece of my life publicly don't go futile. :) 

This year, I hope to write substantially as this blog was originally meant for. Bismillahi Rahmani Raheem. :)

Nomads On Expedition. Again.

I do not like being unsettled, I never liked the nomadic way---changing from one place to another. Traveling is different from living at different places for shorter terms. I started my nomadic life since I entered med school where I had to rent a house with three roommates. I lived comfortably in that niche for three long years until I had to look for another house for clerkship  where I happily lived for a year. Then I found a beautiful condo unit here in the metro with three other roommates where we struggled to live for 3 months. Some problems arose so we decided to separate ways and now I am gleefully living in another unit of the same building! I guess that story deserves an entry as a form of gratitude to the people who caught me wholeheartedly when I was badly bruised. :)  

In addition to the seemingly life-long pressure chamber I'm into, board exam is just around the corner!! So my med school friends and I hurriedly bus-rided to Fairview to house-hunt and see for ourselves the location of the review center. It was a long bus-ride from Ermita to Fairview!! After seeing the rooms, I picked the 7-person capacity room. It would seem crowded but the moment we begin reviewing, all of us would shift into a serious mode  having a single goal: TO PASS (or even, top! echoserang char char!!). So I believe it wouldn't be noisy after all. :) *fingers crossed* 

Because I felt the tension in the air among those reviewees we met there, I felt my heart drumming as I figured I would be in their shoes in few months' time! OMG!

So, to calm my almost throwing-a-tantrum child-self, I treated her to a P15 worth of sorbetes on a sugar cone. Happy heart! :)

Last Saturday was the 4th session of our monthly board review series at the Buenafe Auditorium of UP-College of Medicine. The subject was Microbiology and was productive as I unexpected it to be. Previous ones, the first two because I was absent on the third session, were really boring lectures I had to bring coffee inside the hall to keep me alive.

All interns are excused every second Saturday of the month since November 2011 to attend the 4-hour lecture on basic medical subjects. It's an opportunity to leave the humid environment of the ER when the review falls on a duty day. Hahaha! :)

As always, I took notes. 

P.S.

LAST FOUR GRILLING MONTHS OF INTERNSHIP!! WAAAAH!

An addition to my Eiffel stuff! A planner gifted by @rocayaaa! Thank you soooo much! :)

Now I have two planners for 2012, I get a bit confused where to write my daily activities. LOL! This Eiffel planner won the daily routine while Mr. Coelho's is for outpouring of emotions aka diary.