annuals

I had no idea a couple of days doing annual physical exams for a company could be so tiring. I've seen more patients in one day before, but there's something about having to deal with all those stressed-out individuals in a hurry that is both emotionally and physically draining. Of course working from 7 am to 5 pm, with only a 20 minute lunch break could be one reason why I was so tired.


Here are just a few short notes:

1. I was correct to expect better dressed individuals there so I made it a point to dress up also.

2. With physical appearance a vital part of their business they also seemed more conscious about fitness and health.

3. I had expected that because of the stress level of meeting daily quotas and deadlines, more employees would be turning to smoking and drinking. As it turned out a greater number opted physical activity as stress busters. This included brisk walking, running, jogging, cycling and working out at the gym. I was surprised to note that most were involved in basic physical activities rather than more competitive sports.

4. As part of the OB-Gyne history I had to ask about recent sexual activity to determine if I could do a Pap smear. As the women themselves commented, corporate sex was "sex on schedule". That would be sex on a weekend or a Friday night when they didn't have to wake up early for work the next day.

5. The women higher up in the corporate ladder always wonder why I don't have an assistant helping me out when I'm doing Pap Smears.

6. Educated people ask educated questions.

7. Educated people who ask educated questions get comprehensive and educated answers.

8. Educated people take doctor's advice more seriously -- that is, if they think the advice suits them (read: convenient). Otherwise, they are as stubborn as a mule.

9. I've never had to explain as much about lifestyle modification as I had in two days. Same goes for the effects of coffee and tea.

10. Doctors aren't being intrusive if they ask too many questions. They just want to be sure they will give the patient the best possible care always.

happy heart

The endorphin high of recent physical activities has been addicting. It's all I can do to stop from running/walking everyday. I know I have to take it slow.

This year I would like to find the focus and discipline that was missing for most parts of 2008. I have decided I am going to use running as a tool to regain them.


A few years back when I was still working in research, I found that with my efforts to increase efficiency by multitasking I was becoming easily distracted. I was efficient and always met deadlines, but the quality of my work declined as I started to lose attention to details. I could not concentrate on one task for long periods of time.

As a remedy I decided to take up a new hobby. It was something that required me to sit still for about an hour and do only one thing.

I painted stones.

One afternoon I picked smooth and flat stones at the beach near my workplace. I bought poster colors, a brush, a fine-tipped marker and varnish. I started turning the stones into whimsical animal families. I had blue porcupines, spotted toads, "ugly" stonefishes, blue and green groupers, bright red and yellow scaly fishes, furry orange tabby's, bespectacled owls, rainbow-colored snails and tiny ladybugs.

It was wonderful. If I cared enough about the quality of the outcome I had to stay put for an hour and do nothing else but paint. If I allowed myself to be distracted for even a minute the paint would drip, I would forget what details to add with a marker and the varnish would dry. I had the right chill out music playing and for an hour I was calm and focused.

It helped teach me to plan ahead also. If I didn't think things through I would end up waiting for 15 to 20 minutes doing nothing while paint dried on a single stone. It would've been a total waste of time. By planning which stones to paint, what colors to use first and which design to pen in I could work continuously.


Running may be totally different from painting but I think I'm going to get the same results with a happy heart and a healthy body as bonus :)

r/w

Getting back to my run/walk routine after taking a break while working proved harder than I thought. I did have short 20 to 30-minute walks while I was in Mindoro. But I was walking with a friend most of the time and she wasn't very welcoming of the suggestion that we should walk with a quicker pace. We probably covered only around 2 1/2 kilometers for our half-hour walks.

While I was looking forward for the endorphin high of previous routines I wasn't exactly looking forward to the muscles aches that greeted me the morning after my first run.

Only on week 2 of my so-called beginner runner's program and I am faced with the sad realization that I have a bum left knee. On one end I blame it on all the weight I've gained, on the other end, I blame it on weak muscles that should have been enough to support my knee if only I had used them more.

I've always been on the heavy side but I used to be fitter. I miss being able to run or swim a mile and not feel achy afterwards. I miss being able to play tennis all afternoon and still have the energy to go out at night. I do feel better now that I've taken a step to becoming healthier and more active again. But I have to take things one day at a time so as not to be disheartened by what seems a very, very long road ahead.

Somebody please run with me.

first look

When an opportunity to mix travel and work arose I jumped at it. I shrugged off comments about trying to find work closer to home. I let complaints about my not getting a permanent job fall on deaf ears. After five years of barely getting out of Quezon City I wanted some R&R and a chance to explore more of my country.

Day 1: It was a little after five in the morning when I took the10-minute drive to the pier. I had barely slept. My sleep-wake pattern was still a mess and I was unable to adjust it days before I was set to leave. I was planning to sleep through the 2 1/2-hour boat ride to Occidental Mindoro but the cold and windy morning woke me up. I was expecting some high waves as we hit the open sea but the ride was calm enough. I did not have a minute's worry.

The van ride to Mamburao took 40 minutes. The concrete road cut along the verdant greens of farms and rice paddies. There were stretches where only one lane was usable, the other lane was used for drying grains and corn. A good five minutes sometimes passed before the van came across another vehicle. The drive was both calming and revitalizing. It was truly a breath of fresh air compared to Manila.

The hospital is squat and white. At first glance it was almost intimidating. I had expected a rundown graying hospital. Instead I was greeted by a wedding-cake white building roughly a year old.

We got a tour when we arrived, meeting with other residents, getting introduced to the attendings. After a quick lunch we were taken to the Capitolio for a courtesy call with the governor. I sat down, smiled and tried to look professional as I introduced myself to the governor, vice governor and a mayor. As it turned out, someone I was going to work with happened to be the governor's nephew.

It's true what the Lonely Planet guide said. Mamburao is a dusty little town with a bad case of tricycle-itis. Tricycles are the primary mode of transport. There are few jeepneys. Like the vans, the jeepneys only seemed to operate to transport produce or to carry passengers over long distances. After the first ride through the town I was looking forward to exploring it on foot. Later in the day a group of doctors was going for a swim at a beach resort only 2 kilometers away from the hospital. Too tired to do anything but sleep, I declined the invitation to join them and just made a mental note to check it on a later date.

I slept soundly that night. I knew I needed all the energy a good eight hours of sleep would give me. The next day was going to be an entirely different day.

getting the groove of things

Three days was enough for me to get the rhythm going -- that was one 24-hour duty, a from duty status and a day as the OPD officer. It was enough to get my eating right, enough for me to know the general lay of the hospital, and enough for me to know that in the next seven days I would see more cases of acute gastroenteritis, intestinal parasitism and malaria.

It's almost sad to admit that the major diseases I see everyday can be easily remedied by good hygiene and proper sanitation. This may seem a straightforward solution for disease prevention for other locals but I understand a lot of traditional beliefs may hinder the minorities into taking positive action for better health.

A case in point: Most minorities in the ward do not think taking a bath is necessary. On the contrary they avoid taking baths because it goes against their belief. Any illness is brought upon by actions that have angered gods or from the ill will of spirits. A plea for cleanliness and hygiene with a gift of a bar of soap may not always get the desired result. A family given soap to bathe with was found the next day still oily and grimy. Not even their faces had lightened with washing. As it turned out, instead of using the soap for bathing, the family had used the soap to wash clothing.

When you are up against decades of tradition it sometimes feels like you are fighting a losing battle. It makes you feel that for every step forward you take, you take not just two steps back, but three. And then a day comes when you do the morning rounds and find out one boy was actually given a bath. It erases all the frustrations and pushes you to take one more step forward, only to find that you're still two steps behind.

Coming to the hospital I didn't think I was going see so many malaria patients. By the end of ten days I would admit 4 patients with blood teeming with Plasmodium falciparum. There were already three others in the ward receiving treatment for it. These are just the pediatrics cases. Internal Medicine had it's own share of malaria cases. If in urban Manila, Dengue was the disease to rule out for every febrile, flu-ey patient, in rural Mindoro Malaria was what I had to watch out for. I had no idea they saw so many cases. Although most patients came from far away towns I still felt unsafe without prophylaxis.

On a lighter more hopeful note, the workload in the hospital isn't all that heavy for the most part. I enjoyed walking trips to the center of the town and a short tricycle ride to the beach. I hadn't taken a camera with me since I wanted to focus more on the work part of the trip. But standing on the powdery white sand beach at Tayamaan watching two kids tumble into the water as the sun set I could not resist the urge to capture the moment with my phone camera.

Sometimes, life's a beach. All you have to do is breathe deeply.

is this really what I want to do?

January 5:
I took a jeepney ride, two bus rides and a taxi to get to "work". I saw over a dozen patients in the few hours I was at the clinic. I kept asking myself is this what I really want to do?

Realization 1 - It turns out that sometimes responding when patients flirt with you actually makes for a more productive consult. It probably makes your patient's day also.


January 6:
I was staying at an uncle's place so I spent the whole morning playing with my 4-year old cousin. She was so lithe and tiny, like a graceful ballerina or an agile gymnast. It was a wonder to watch her tumble around, dance on tiptoe, do cartwheels, then swing around a bar.

I was such a klutz compared to her horsing around the treadmill and falling down. I have an abrasion on my left knee to show for it.


January 7:
Clinic duty again. 26 patients plus a couple of follow-ups. It's funny because today I actually enjoyed being there. I enjoyed spending time with my patients, it makes me feel I actually made a difference.

Which reminds me, the best times are when a patient asks for your card and clinic sched because they want to make sure that when they come back you're the one who gets to see them again. I almost felt sad when I had to reply I was just relieving for a fellow doctor for a couple of days and won't be back in the clinic again.

Realization 2 - Good doctor-patient rapport does go a long way. It sure made my day.


Now imagine the high I felt when as an intern a patient asked about the consultation hours at my clinic. How do you say Ma'am, I just see patients here at the OPD under the supervision of a resident since I'm only an intern politely and without causing embarrassment?


All in all, it was a good day.

going home

After spending half of my life away from home living in dorms/apartments for school or for work I am back at home.

I finally finished moving all my stuff from my apartment to my grandmother's house. My contract ended (after being extended). I feel sad. Like it's somehow a defeat. Like this going home somehow signifies a loss of independence.


Whatever. Life goes on.

what to read

Somebody tell me what to read next. For this year I have started reading books I normally would not read.

I'm not the kind of person who would read on business/customer service,self-help or inspirational books. Either they never appealed to me (too cynical) or I never had need to read them before (I didn't think I was going to set up a business before). But lately I'm trying to figure out why other people read the books that they read. I'm trying to find out how all the supposed "words of wisdom" from these books make other people act like they do.

I need better people skills. Socializing has never been easy for me. When I'm tired at work I don't get crabby or cranky. I clam up. I may still be able to smile but I highly doubt that I sufficiently advise my patients when I'm tired. Maybe knowing a bit about why people behave like they do will help me develop into a better communicator. This would certainly be a plus for me as a physician and would also help me in running our group's small business.

I have more then a hundred books on my to-be-read pile but I can't figure out what to read next. Somebody tell me what to read :)



Currently reading: Baha'i Book of Prayers and Other Selected Writings

moving forward in 2009

2008 was the year I slacked. Big time.

A venture which was supposed to be a lateral move proved to be a step back.

My midyear indecision has caused me too much embarrassment on one end and almost a year's delay in personal and professional growth on the other end.

I did build new partnerships, new relationships. I did rebuild old friendships. But I still made the mistake of looking up to the wrong people. I made the mistake of putting value on something that was almost worthless.


This year, there is no room for mistake.

This year, I am moving forward.

This year, I am actually going to work hard. And with working hard I vow to play even harder.

It begins today.