Tuesday, January 1, 2019

2018, in Glimpses

Cavite, January 1, 2018
It’s 2 AM. I am home. I wish I don’t have to go back to Manila come daylight. I’ve only been here three days since the 14-hour drive back from Ilocos Norte and I have no idea when I’ll have the chance to come home next. When I packed my first travel bag to the brim with clothes and shoes for UP 10 years ago, I did not realize that it would be for good – that it was going to be the first of the countless packings and unpackings that will soon erase all traces of me living in this place. The life I live in Manila will always be foreign to that small-town girl who only learned to cross a busy intersection at 16, that same girl who was so hell bent on fulfilling her promise to take the Hippocratic Oath before turning 26. Now here we are, a full-pledged physician feeling like a stranger to the very place where she built those dreams.

This is the first real break I had since getting that MD. I managed to cram 4 years of medical school in 2 months, took the boards for 2 weekends, spent the next 5 hell days battling panic attacks and finally getting the results, decided over the course of the next 3 days that followed before applications deadline whether I can survive 4 more years of training without taking a gap year. Two days after sending in my application, I took the pre-res exam. Pre-residency started the next day and 2 weeks after, they’d announced the 2 applicants who made it to the program. It was October 2017, exactly 20 days after I passed the boards, I was transitioning to 1st year residency. I never got to stop after that.

When I was 8 years old, my family and I happened to pass by PICC on a particularly happy day. The newly beautified lawns were filled with people, mostly families dressed fancily, on an endless spree of smiles for cameras big and small.

“It’s Physician Oathtaking today”, I remember Tatay quipping. My mother replied with a long “wow” while peering through the car window and as I watch my parents marvel at this warm and blissful scene, in that moment, I knew I would one day take them here for when I take the Oath myself. What I didn’t envision though is that 17 years later, I would go back to PICC as a from-duty 1st year resident who’d only spend the entire ceremony sleeping. Ugly and unglamorous, but real.

It’s 3 AM. My toes, which had been mostly purple throughout the night, are starting to hurt. A few hours shy of making another trip to Manila, back to the arms of residency, back to life in the fast lane.

Intramuros, January 2018
The clock just struck 8:00 in the evening. I decided to wear a black sleeveless turtleneck blouse to match my ankle length black electropleated skirt. I had just come from a nearby Starbucks to purchase tokens for two of our senior residents who will be graduating tonight. In a large hall with one too many doctors and their families and consultants gathered around beautifully set round tables, I’m seated across my deparment’s chairman and our academic training officer, both dapper in a jusi barong and black coat, respectively. One of the many things one learns as a first year resident, apart from basic surgical skills and a great deal of scut, is taking good care of the consultants. Dinner had depleted my arsenal of small talks and anecdotes to keep everyone entertained.

“After 4 years, I will dress up for your graduation too, ha. No quitting...”, my training officer nudged as I set the leche flan and chocolate mousse plate in front of him.

Tonight was the perfect time to hear that. Almost 4 months in and I had already lost count of the times I thought about walking away from all these - the program, the new dream. I’ve never quit on anything my whole life. Never did I imagine that I would one day find myself wanting to quit on anything, but residency just does that to you. It strips you of the rose-colored lenses through which you used to see the world when you were a clerk or intern. You now see the hidden setbacks, the ugly, the strings attached. The body can recover from the physical tiredness, but being so emotionally spent is what gets you.

Although I hate to admit it, I am officially tired. Some days, I feel so inept, so clueless about what the hell am I doing. On the flipside, I should remind myself how lucky I am to be here – to get one of the two slots allotted for accepted applicants every year, to train under one of the founding institutions of ORL in the country (OMMC was the 3rd hospital in the country to open an accredited ENT residency program), to actually have the big guns in this field as my mentors. I keep telling people that the universe will always, always conspire to bring you home, where you deserve to be, where something waits for you. I dredge up memories of how I almost never showed up for my pre-residency examination back in September because I was badly intimidated by the other applicants and how Ma’am Karen, who graduates tonight, convinced me to try my luck. As they say, the rest is history. I will always thank her for that. I am so so tired, but I am too far in and too grateful to turn my back now.

Centuria Medical Makati, March 2018
I’m spending the day at The Surgery Center. I type this on my smartphone as I finish munching on my apple pie. We’ve just finished ironing out the glitches with the tech team. It’s MIFAS Day 2, spanking new red scrub suits on. We had spent the past months preparing for a series of postgraduate courses. I covered for everyone at the OPD, ER and wards 4 days ago while they were at The Medical City’s CASSTI for fresh frozen cadaver demos. I spent the day that followed at East Avenue Medical Center for Rhinoplasty Masterclass Manila. Back at CASSTI the day before yesterday, we each partnered up with MIFAS lecturers and preceptors for fresh frozen cadaver pre-dissection. Inheriting the department’s property custodian line, I was the instruments girl. I used the first hour after we’d arrive making sure all dissecting tables each had surgical instruments, all clean and complete. We had the nice techs’ assistance from the bioskills company at our disposal. It was my first time seeing fresh frozen cadavers and I was excited. By sheer luck I was partnered with Dr. Arzadon, a very soft-spoken man, who as I’d learn later on, was past president of the Philippine Academy of Facial Plastics and Reconstructive Surgery.

“Scalpel please…”, he requested as he extended an open hand in my direction.

The next few hours were spent mostly on one-on-one mentoring as we explored fascial planes, released retaining ligaments, isolated arteries, veins and nerves on half the face of the cephalus assigned to us. These heads were all latex injected and the way the structures were all very clear and marvelous and well preserved had me speechless. Excuse the language, but it was as if what we were dissecting had just died. It even bleeds sometimes. Nothing like the cadavers we used in freshman anatomy.

“I’ll see you tomorrow”, the humble doctor bid me farewell. I was left to work on the cadaver alone and as I was suturing the cadaver face in key points, I could not believe my luck. Who was I anyway to deserve those few hours dissecting this cadaver head with one of the top guns in Plastics? I cannot believe I got a free solo walkthrough of everything there is to know about facial anatomy, on a pristine specimen, in a well-equipped skills laboratory. Fellows train abroad and pay tens of thousands of dollars for a short course of this caliber. And as I finish my last few square knots, I realized this is one of the reasons why they say our program’s strength is in Facial Plastics apart from Head and Neck. I cannot believe this is what I was bound to miss on had I really quit the program a few months back. So thank you, universe, for helping me stay.

Sandbar Puerto Galera, May 2018
It’s 4AM. I had woken up to find my co-residents still purring in their sleep. It was apparent my body clock is still running on Manila mode. This is my usual bath time on OR days in Manila so I’d have enough hours left to clear the ER, do wound care on all the ward patients, do morning rounds before bringing all surgical paraphernalia to the OR and setting up the suites at 6AM.

I cannot go back to sleep. My muscles are sore from the snorkeling and island hopping yesterday. I decided to walk down to the beach alone. The wind was crisp, the water was chilly and my feet are sinking under the damp sand with every step. I never had this much calm in the months that had past. I needed this. People do not know it, but I’m always scared. I always tell myself, I eat anxiety for breakfast. As they say, it’s what keeps us running day in and day out - a little anxiety to power through and be productive. But sometimes, my anxiety is a little way too much. Sometimes, I don’t think it’s fair to subject myself to this much overthinking, to too much reading between the lines.

Puerto Princesa, Palawan, May 2018

“What time’s our return flight again?”
“7:05 PM, sir.”

Four people, four times the time of departure on the boarding pass got overlooked. I write this to kill time at the airport. Apparently, our plane takes off at 7:50PM, not 7:05. At the pre-departure area, I sit next to my immediate senior who had just been mistaken by a World Vision representative as my boyfriend. For the past days, I’ve been feeling uneasy, thinking about how I might get stopped by airport officials for carrying a considerable amount of surgical equipment in my check-in luggage. I went instruments shopping for my and Kiel’s tonsil sets at the Midyear Convention held here and I was hoping I don’t have to explain why I have sharps, so many tonsil clamps and 2 Dingman retractors in my luggage.

The past week had definitely been a breath of fresh air. The time I spent here in Palawan has been nothing but amazing. Nature here is breathtaking, the food always gives a party in your mouth, the people are extremely hospitable, there’s so much to do and go to in the city which, thankfully, has kept its provincial charm. This place is one of the very few that easily etched its place in my heart. Suddenly, private practice here in the future seemed like an interesting and feasible idea. I may be leaving tonight, but I’ve already made plans to come back.

I have mixed feelings about going home. When the plane lands in Manila tonight, I will be assuming post as the duty resident. Goofy and carefree mode off, agitated mode on. I was at Cowrie Island in Honda Bay taking a break from kayaking this morning when I received the news that 2 days from now, we will be admitting my and Kiel’s first elective tonsillectomy patients. I got extremely excited that it was all that I could think about on the boat ride back to Puerto Princesa. And as I type this tonight, in this city that I do not want to leave, I realized how scared I actually am. True, we’ve been accumulating OR techniques as early as October, but this is going to be my first elective case under general anesthesia. One of the consultants volunteered to supervise and assist us in our teaching case, which is comforting as much as it is daunting.

The past few years have taught me that anything can happen in the OR and being the surgeon, it’s all on you. A human life is literally in your hands. It had been one of my observations as a medical student that it was our professors who are surgeons who are the most demanding. From requirements, to reports, to even the sound system in the lecture hall, everything had to be perfect when they come in. They always need an assistant. I’ve always wondered why. I’ve always thought it was the ego that came with the cutting fields. But now that I am slowly becoming a surgeon myself, I realized I’ve become one of them too. And that is because in the OR, everything is prepared for you when you’re the one holding the scalpel. Being juniors, it is our job to make sure the OR runs as smoothly as possible so the surgeon can focus on nothing else but the patient and the surgery. Where I come from, the non-scrub junior residents, especially in my department, function as the circulating nurses (OR nurses here are a different story). We autoclave the instruments on premeds night, establish the sterile field on the crescent table and mayo table, arrange the instruments, alcoholize micromotors and cameras, prepare the cautery and suction, serve sutures, hold the surgeons’ phones to their ears during a call, run here, run there. Every malfunctioning paraphernalia is all on us. But it’s perfectly justifiable. As the captain of the ship, you cannot be bothered to worry about a malfunctioning suction or cautery, when someone’s life is on the line, when you have someone bleeding out on the table. Every step is crucial. I cannot believe I’m actually about to be that surgeon. I am very scared. In three days, I will be in an OR suite, heart racing, praying to God and the universe for guidance. It’s all on me. When I did an appendectomy as an intern, I had nothing to lose. Now, that I have a license that was 22 years in the making, I have everything to lose.

Ortigas, September 2018
“He’s gone.”
“What?”
“He’s gone.”

I woke up to see Kiel lying prone beside me on the bed, holding her phone and updating her consultant. My eyes had hurt from the bright light emitted from her phone’s LED screen and I ended up flailing aimlessly with my eyes closed until I found my own phone in the dark. It’s 4: 20 AM. We had spent the night at Kiel’s loft-type condo in Ortigas after a last full show of Crazy Rich Asians and a night of shopping in AyalaMalls The 30th. I was from duty yesterday, my legs edematous and my head throbbing from a restless premeds duty. Our elective surgeries finished rather late yesterday, and we were able to only leave the hospital at 6PM, but I insisted that we both go out and relive what it feels like to act like normal human beings. It has been an emotional week for all of us, even traumatic for my only batchmate, most especially. It was the first time I’d seen Sir Migs cry and the first time I also cried over a patient since residency started. The past few days had us running countlessly to the operating room and pediatric intensive care unit, on a daily basis. We’d run codes every 5 minutes, until he stabilized, only to repeat the same thing the next day.

“42 codes total”, she sighed.

I was not able to speak. I do not know what to say. I sat on the bed and saw the gloomy weather outside. Rainwater was trickling down the floor-to-ceiling windows as smog covered the city below. Hauntingly beautiful, I thought, as if the heavens have decided to grieve with us. Painful, yes, but there was no one to blame. Everyone did everything by the book, by the guidelines. And yet we lost a life. But being captain of the ship, it was Kiel who had to face the family.

“I don’t know what to do had I been in her position”, I remember Sir Migs telling me 2 days ago. I don’t know what to do as well. I hope I would never have to.

I must have dozed off again. The next thing I know, the rain had ceased temporarily, the windows gave a better glimpse of the Ortigas skyline but I could not remember what day it was.

“Do you want to grab breakfast? Or should I book a Grab now?”

Remembering Kiel was supposed to be at the hospital by 8 AM for duty and that I have to do rounds on my post-op and update my consultant, jolted me up. In fifteen minutes, we were out the front door and into the chilly Sunday morning air. I still don’t know what to say to my batchmate. I was never good at comforting people. But I only know I have to be here, to just be present. Sometimes, it’s all you need. Sometimes, it’s all you can be.

Mactan International Airport, Cebu, November 2018
It’s 12: 15 PM. My family’s plane had just taken off for Manila. I’m typing this while stuck at the Starbucks in Mactan airport. I had booked a 6PM flight 2 months ago as I initially intended to explore Cebu alone after my parents and sister had left the city, but Tatay, being always worried about his girls, wouldn’t allow it. Recently, I have this constant itch getting lost in another city alone.

I just submitted my ward, ER and OPD census. You’re really doing a great job, self, for bringing work hundreds of miles from Manila on your supposed leave.

After a little more than a year, I finally got to take a leave of absence. Technically, I am allowed to have one since June, but there was too much work to be done. I used to ask a lot why we are required to take a leave, but now I get it. One of the saddest things you can hear as a resident from your ward nurses is “Doktora, nagtransform ka na.” Although it pains me to admit it, perhaps, I really have changed. A year’s worth of agitation from hospital problems, loops in the system, research stress, millennial medical students, crazy duties, and toxic life-and-death surgeries, I have transformed. When you have to be present in the ER, ward and OPD simultaneously every three days on duty for one whole year, it changes you. When you have to make ends meet in the a highly stressful situation on a daily basis, you can’t help but snap easily. It happens to all residents at one point, and it is happening to me. Cebu had been a really great distraction. A week away from everything had taught me to live normally again – to wake up without having to worry that you have rounds to do, procedures or surgeries to perform, books to read, consultants to update. Everything is a breath of fresh air and I needed that.

I’ve also realized something paradoxical recently. Sometime October, I noticed that somehow, I started to get my own rhythm as a first year resident. Maybe it’s the wisdom that comes after being bombarded with so many experiences and being made to feel a lot of different emotions and being subjected to the rigors of training. I’m more comfortable managing my ER and dealing with the flow of OPD patients recently. I’m less agitated during ORs and more confident with how I want things done in the wards, without being worried that I may not have enough time to do all tasks before endorsements. But just as 1st year started to become comfortable, easy and really fun, just as I felt I started to find myself in this place, it’s already the start of transition to 2nd year. More tasks, more responsibility, more expectations had started to tip the scales once again. Transitions and beginnings are for me, the hardest. And when my plane lands in Manila tonight, I go back to that life.

Thursday, October 13, 2016

Idiopathic

Photo circa 2012. Canon EOS 40D.

I have this stupid nodule that grew near my right eye, look…” I leaned in closer so you can see the lesion better.

Hmmm, doesn’t look infectious…” you smiled and resumed eating your cheesecake. Our close friends sharing the same table looked at each other, and from the corner of my eyes, I caught them catching a sigh of relief.

People rarely ask me now about us, and on the very few occasions that they do, I can finally smile without faking and say it’s over. For two years now, it is over.

I saw some old photographs of us today. They were preciously and genuinely beautiful. They made me remember how some five years ago, I wrote this about you:
"...You like pinching my oily nose, you would walk me home rain or shine, you listen to my photography babbles, you tell me I’m not cute but pretty, you know when to take over when I’m overworked, you debate with me, you listen and give me brotherly advise, you call me 'doktora', you laugh when I wear sky-high heels, you reprimand me for not getting regular eye check-up, you know I can’t calm down when there’s work to do, you know when I feel like being radical, you know how to match my unnecessary toxicity, you treat me like a thinking woman instead of a baby, you talk to me about adult and family life while watching the sun rise, you like challenging me and I like competing with you.
You can be Lancelot when I’m Guinevere, Mr. Rochester when I’m Jane Eyre, Mr. Darcy when I’m being Elizabeth Bennett, Pierre when I’m Marie, Clyde when I feel like being Bonnie..."
I’ve always thought it would be you – the one I’d end up going home to, the one I’d constantly bring to family reunions and homecomings, the one I’d be licensed to annoy for the rest of my life. My old roommate once told me that people never really end up with the ones they genuinely loved. I never believed that. But now I do.

When the wounds were as fresh as our younger memories, I’d look at you and wonder how doubt and jealousy had creeped their way in our peace, tormenting us relentlessly until we let go of the beautiful future that should have been ours. We were the garden that would never see spring come, the piece of art that was left unfinished, the prose that never had the ending written. We’ve become the disease that never saw a cure.

Remember how we once got lost in Chinatown? Remember that summer when we went crazy exploring museums and parks? I’ve been revisiting a great number of them, trying to rewrite memories, where there exists not a ‘we’, just a ‘you’ and ‘me’.

There are things I wish we did and did not do, things I wish we said and did not say. After years of keeping it in, just let me say this… thank you for the four amazing years. We were spectacular, but the spectacle wasn’t meant to last for eternity. I hope you find peace, because now, I finally did.

Tuesday, April 26, 2016

Stump

We saw each other last night. Through the cocktail and pool water-tainted lenses of both our glasses, our eyes met. In the past, this would’ve been easy – me, referring a deranged vital sign, or waking you up to inform you of the salient features of a new case, my diagnosis and the work-up I suggest be done, or me asking you to check the stitches I’ve placed on this and that laceration, or me simply badgering you to allow me to do an appendectomy on my own; You, double-checking my assessment, approving or vetoing my chart orders, overseeing and assisting me as I stab body parts with a Blade 11, cast someone else’s broken bones, debride devitalized tissue, or you asking me what antibiotics and analgesics I want to put the patient on, asking me jokingly why you always had to take care of all my "post-ops", or you allowing me to close during surgery. Instead, all we both could muster at that very moment were widened eyes and a shy, longing wave vividly illuminated by the mobile bar’s crazy, flashing lights. Right off the bat, the air smelled of unfinished business.

The last time we worked together under lights this bright was in the OR, you trying to hide your anger at me for screwing up your schedule with a 5AM emergency appendectomy and me, profusely expressing my regret for working up a patient without consulting you first.

Kung kaninang 2 o 3AM lang sana ‘to, sa’yo ko pa pinagawa…” (Had we done this [case] at 2 or 3AM, I would’ve allowed you to do this [appendectomy])

I wanted to kick myself so bad, for incurring your ire and for missing what would’ve been a great milestone before I end clerkship. And because you have a history of allowing me to do procedures clerks are not yet allowed to do, I had been preparing for that one appy that I can do on my own, so I can learn and show you that you taught me well. I then realized that it should have been this, but the timing, the circumstances wouldn’t allow it and well, better luck next time. It turned out to be your last surgery. It was mine, too.

The party lights suddenly flashed a bright purple and red. Our last memory of lights flashing this crazy was in the ambulance, when we transferred this pediatric patient suffering an epidural bleed. That was your last conduction. It was mine as well.

I once told you of my excitement over coming back for internship because of how most of the residents here made me feel amazed over the mentoring atmosphere, how some told me they’ll wait for me to become their junior one day, how people here treated me like friend and family. You found the last one miserably funny, but you never found out how you were one of the few who made me feel just that, like I have a dedicated mentor and an older brother. I’ve always wanted one.

You left suddenly without a warning, without a trace, without a goodbye.

A few days after, you messaged me confirming the news, still not spilling the reason, still unsure of your plans. All I was able to express was an intense gratefulness for every lesson, every skill, and every inch of patience for my baby steps. We agreed to go out for coffee one of these days, and that was it.

Di mo na ako pinapansin” (You’re ignoring me now), you told me when we finally found ourselves in a quieter spot last night. All I could give you was a “Sorry” because the alcohol had already kicked in. I didn’t know how to respond when you pointed out that I was giving you the silent treatment because I did not realize I was, until then. My ineptitude at making small talk and your natural quietness was making the awkwardness severely palpable.

Ano nang plano mo?” (What are your plans?), I asked. Your reason for quitting the program was the last thing we talked about, so I picked up where we left. For two people who used to do pinky promise-sealed coffee bets over nerve innervations and who decided to take a stolen Starbucks trip using the ambulance just a few weeks prior, my question was pitifully generic and too formal, but at least we’d have something to talk about.

Ortho. V.Luna.

It came as no surprise. Of course, it would still be surgical. Anyone who’s been with you in an OR would know that you belong to it and it belongs to you. You shyly told me you wanted Ortho on our first ER duty together while waiting outside the X-ray door for our stab wound patient.

Hindi mo ba kami namimiss?” (Don’t you miss us?)
Kaya nga ako nandito.” (That’s why I’m here), you said while lighting up a cigarette.

I miss my teacher too. In a place where clerks are the lowliest of the low, you asserted that I act like a doctor. You allowed me to choose and make decisions in cases when all I thought I could do was scut work. You told me once that my clerkship goals should include successfully intubating in the ER, where patients are a lot more unstable; the conditions, a lot less controlled than in the OR, where we the bottom feeders, are normally allowed to do the procedure. I did not even know we can be allowed the same in the ER, but you insisted I push my luck, just as I would always do when I ask you to supervise me on something. When I finally did one successfully, I thought of telling you, but you were gone. When I finally lived up to your challenge of doing stitches without putting my thumb inside the needle holder’s ring the way you and the consultants don’t, I was so eager to tell the news to you. Again, you were no longer there.

Nagtatampo ako sa’yo.” I never wanted to tell you that. It was not my place and that was uncalled for, but my degree of inebriation was letting everything go unfiltered.

Leaning in closer, you chuckled and asked me why. Now that I think of this in retrospect, I think you’re perfectly aware of the reason.

Nagpromise ka, marami ka pang ituturo sa internship” (You promised, you still have a lot to teach come internship)

Marami pa namang residente diyan.” (There are still a lot of residents back there.)

But we, your students, might not find another you. True, your seniors chide you a lot, often for your shortcomings, at times for trusting us too much and letting us run around with blades and syringes so we could learn on our own. You left us all wondering, because people agreed you were not just great; you were badass, and your leaving was a loss to the future clerks and interns who would’ve learned from you the way we did… the way I did. In a place filled to the brim with expectations and worth waiting to be proven, someone taking you under their wing is priceless. Take that away, and you’re suspended in mid-air, stuck.

---------------------------------------------------------------------------------------------

We talked again last night. To rid the air of the uneasiness that had filled our conversations since you left, you asked how my vacation was going. Naturally, I told you of the boredom looming over this one, the same way it loomed over almost all of my previous vacations. I inquired how you were and you told me you enjoy being a moonlighter, how you are in charge of both the ward and the ER, how you finally had control of your own time and what your plan is while waiting for September, otherwise known to us creatures of Medicine as pre-residency season. 

When you were still my resident, we used to talk a lot; everyday, even. From everything surgical, to mundane mistakes, to our same desire to get a tattoo, to the exes we loved, to the things we hate. When you jokingly told us months ago that you don’t like to pursue General Surgery anymore, we scoffed in disbelief. It happened in a flash, but in a nutshell, we dismissed it and with all due respect, reminded you of the 4 more long years before you finish your training. Looking back, had we taken your fleeting joke seriously, you wouldn’t have given us the surprise of a lifetime.

In all our conversations, you laughed a lot, but you never sounded as happy until last night. The way you spoke of your new work, and your plan, the way you spoke so genuinely excited for the future… it made me understand you now. I forgot you were a student as much as you were a teacher. You needed to grow, too. And you deserve to be happy, too. And while we back home may have lost an amazing talent, it would be a shame to deprive the future world of your passion and skill in orthopedic surgery. You needed to be taken under someone else’s wings, too. I get that now.

Before all these, my only focus is that I need to take charge of my own education. You taught me that. But when I come back, I come as a child, still with a mountain of skills and knowledge to acquire, but not a baby anymore. In a matter of months, I'll have little doctors to guide and mentor too. I may never get to pay you back, but I sure can pay it forward. So thank you, for inspiring me to teach and generously share what I know and what I can do. For showing me the beauty of calculated recklessness. Thank you for making me hungrier than ever. For making me want to push the next generation, so they can stand on our shoulders and be better than us. Thank you, for being the best teacher I had yet. You taught me well and I never want to fail you.

Maybe one day we’ll bump into each other in conferences, and you’ll be surprised I ended up being a surgeon instead of an internist. Maybe. I don’t know. Maybe I’ll change my mind. Maybe one day I’ll be the anesthesiologist in your OR. Maybe you'll forget how many cups of coffee I still owe you. Maybe I'll be the cardiologist I keep harping on becoming. Maybe you’ll change your plans again. 

...Maybe one day we’ll figure out why it rains appendicitis at 4AM.

But for now... Go... Find yourself. Soar.

Thursday, August 13, 2015

"The world is too big for love to be real. There are too many people in the world to ever know, beyond everything, that you are with the right person. That your heart is as swollen as it can be. Think of all the people in China. It is unlikely anyone will ever meet all of them. How can we know for certain, that trapped inside a foreign language and thumping in a foreign heart there isn’t a love that is meant for us.
The infinite possibility of existence, its limitless potential, is the proof that we need that love is nothing more than an imagination, a human folly, friendship swollen with self-importance, a final retreat from the storm of possibility. The love of our life could so easily have been someone else. It is random and accidental, haphazard and unsystematic. That which we feel for one person, clinging on to the delusion of destiny, could so easily be felt for a million people should the timing and the meetings and the mutual readiness have coalesced at some other time in some other place. Should someone else have accepted us or rejected us then everything would have been different.
And once we know this, we know that all love is a lie. Not honesty but deception. Not heroism but cowardice. An unspoken agreement of mutual consolidation and compromise, a shield from possibility and a bed in which to sleep, nothing more than that. But I do still miss her."
~ Daniel Kitson

Sunday, November 2, 2014

For a long time, she held a special place in my heart, like a “Reserved” sign on a quiet corner table in a restaurant.
 -- Haruki Murakami

Sunday, October 12, 2014

At a Standstill

Allow me to write this so that some years into residency, I would have something to back read and laugh at.

Life the past few months had been all about reports, cases, daily exams and weekend booze sessions. In between reports, we squeeze in Facebook and Twitter breaks, only to get reminded after scrolling our feeds for a minute of how much family or even personal time has become a luxury for most of us. Suddenly, a dinner with the parents, a coffee break with the barkada or sometimes, even just a day of pigging out at home has become news-worthy.

Yesterday, you see a highschool batchmate’s wedding photos; a day after, you hear a friend just gave birth to her first child; another day after, two more batchmates get engaged. You go to class and let your Gynecology professors tell you that the best time to have a child is when you’re 24 to 26 because that’s roughly when fertility peaks for women. You do the math and laugh miserably with a hint of desperation and panic because you well know you’re still in medschool by then, strapped financially and constrained by time for hospital duty.

When I made the decision to go into Medicine, I knew this moment would arrive. Some 3 years back, I swore to never ever write this cliché of a post because I thought prepping myself for 17 years that I am gonna be a doctor will make it easier to accept the fact that physicians marry late, have kids late and give up a hell of a lot of family time because we swore an oath to patch up the broken and keep total strangers alive. When you’re an optimistic med freshman who is so hell bent on becoming the physician you promised you would become, it all seemed so easy to say “It’s part of the dream.” But when the time comes when everybody else’s lives seem to be taking off and soaring and you’re still here, doing what you’ve been doing for the past 20 years of your life, with some aspects – romantic or otherwise – falling apart and you remember your aging parents, suddenly it’s not so easy.

With clerkship being just 5 months away, you suddenly feel you haven’t enjoyed your life enough and you’re already committing to something unknown and difficult, you tell your family this coming Christmas is the last one you can spend with them “duty-free”, you’ve already booked flights so you can temporarily be off the grid after finals week, you suddenly feel willing to break bad like never before, you get wasted every weekend, because you can feel the clock ticking. Everybody else, it seems, is finally enjoying what has become of their lives, while you are trying to beat a deadline. It’s similar to when people learn they’re dying and they try everything, only you’re not gonna die and hell’s not gonna be over anytime soon.

You hear classmates whine about how we are spending the prime of our lives answering multiple choice questions while our peers deal with more relevant life problems like paying the rent, sending toddlers to school, paying the car’s insurance, etc. You tell them it is okay but deep inside, you feel the same way. When your seatmate starts questioning his reasons for choosing this life, you start to wonder why you didn’t pursue becoming a journalist, becoming a Broadway star, becoming a chef or perhaps becoming a photographer, too.

I remember when one of my former roommates passed the physician licensure exam back in 2010, I asked her what’s next. She replied with, “Maghahanap ng mapapangasawa. Or gagawin yung mga hindi ko nagawa dahil sa Med.” I swear I might have replied with a scoff. Less than half a decade later, 2 years away from the same situation, well… crapola just got real.

Dan Ariely once said that happiness is relative. Anyone surrounded by big circles would naturally feel small. At that phase when our peers are attaining life and career milestones left and right, it will always feel like being in medschool has put our lives at a standstill. Taking everyone else out of the picture, however, and looking at yourself in retrospect, you do realize it’s not so bad after all. It’s been a long way, actually.

Finishing 4 or 5 years of undergrad, 4 years of medschool, 1 year of internship and choosing 3 to 5 more years of residency, sometimes 3 more years of subspecialty is something only a crazy and brave soul can and would do – something you’d realize we’ve been committed to do since Day 1. When you finally feel the weight of being trapped in an academic arena, when you feel burdened from realizing what a long and treacherous journey is still to come, sometimes, a simple, “Good morning, Doktora” can wake you up and make all the difference. Medschool may not be a walk in the park, but I realized I’m really really happy to be here. I’ve missed out on a lot and is bound to miss out on more of my 20’s but I’ve never wanted anything else so bad – so bad it made me willing to put my life on hold.

Funny how we chose to bite off what’s difficult to chew. Perhaps only a few will understand. But wearing the white coat will never be as fulfilling without all the cut-throatness and imperfections of medschool. For all the times that felt like a perpetual blood bath, I say one crappy day in medschool is still a day closer to the dream :)

Monday, March 31, 2014

Letting Go and Moving On

 “Memories are bullets. 
Some whiz by and only spook you. 
Others tear you open and leave you in pieces.
Richard Kadrey, Kill the Dead

No, this is not going to be my own "tale of woe" but hear me out, Mr. Rochester. Twitter version of this post: I live in a dormitory and I just had to switch rooms. Now, as to why in the world this thing deserves a whole post in this blog, well... let's just say moving has made me realize a lot of things about myself :)

The past six years had been the most amazing years of my life yet, and one of the things that had been constant throughout the roller coaster ride all those years is the room where I used to stay. It looks nice for its age, thanks to all the meticulous hands that had kept it clean ever since. Earlier this year, my roommates and I got a memo that we need to transfer to the newer, but smaller rooms. My sister, who has been staying in the same room with me since last year, got the wrong intel about the date we need to switch rooms, overshooting it by a week. I was caught off guard when they told us yesterday that we need to vacate the place within the day. The knowledge that I would have to give the room up eventually is the sort of thing I just kept at the back of my mind and I had intended to move out on the latest date possible (which, in my head is not gonna happen until next week) because I just want the feeling of being in it. Now that the 17-exams-in-two-weeks battle has officially ended 2nd year of medschool, there's time to focus on other things, like well, be sentimental about the room that wasn't mine to keep (haha). But then, I had to leave the room so prematurely which had me feeling I haven't had enough time to grieve.

Packing things is relatively easy, but not when you have to move six years worth of wonderful memories - four from undergrad and two from medschool to be exact. Every end of semester, I make it a point to separate the junk from those worth keeping, but my old room is so big, the huge bureaus always make it feel like it's okay to leave a lot of things behind because they all look relatively few compared to the many spaces waiting to be filled. Moving to a smaller room yesterday initially saw my things spilling out the hallway which was horrendous and amusing at the same time :)) I just had to ask myself why I have so many things.

I also learned I do have hoarder tendencies - a further proof that I am my father's daughter (haha). There were times when the things I recovered from one of my cabinets left me with so much nostalgia, I felt like keeping them was justified, but there were times when I just can't understand why the younger me refused to let some things go. Like, why in the world am I hoarding a foley catheter insertion set in my closet for 4 years?! Or why is there a huge box of expired vacutainers with my art books?! It's funny but I don't blame the mnemophile in me. I guess that's the beautiful thing about time. Maturity allows you to refine your perspectives and let go of the extra baggage weighing you down :)

I'll miss that old big room. Leaving it meant giving up single beds instead of the bunk beds the newer rooms have, the huuuuge study table which housed all the books I ever owned these past 6 years (which is a lot since I buy all the prescribed books), the closets big enough to serve as my comfortable shelter in case of a zombie apocalypse, the bouncy wooden floors, the empty space which allowed me to do resistance exercises and yoga, the isolated location enough to quiet down the hustle and bustle of Manila and the private toilet and bath (admit it, we all hate shared bathrooms :p ) Lesson learned, don't get attached. Bask in the memories, but learn to let them go. That way it's easier to move on. Thanks to summer payback, I have more than a month to get used to my new one. After all, I felt this way about my old room when I had to leave home at 16.

On the bright side, I feel like this experience will definitely make me more ready for the final moving out soon. This is inevitable as by this time next year, with the grace of the universe, I should already be a month into clerkship. With my attachment to this place slowly being kept at bay and my things ready to be placed in boxes, it is easier to leave and settle where life takes me next :)

Tuesday, February 4, 2014

“The human spirit was meant to fly into the horizon. Meant to see sunrises from different latitudes. Meant to see sunsets from different longitudes. It’s the natural curiosity in us. We’re all birds at heart.”

- Brian LaFaille

Wednesday, January 1, 2014

So long, 2013

Yes, you read that right. It's time for another end-of-year list of the things I am grateful for. If 2012 had been a roller coaster of extreme achievements, 2013 was a year of basking in moments left and right - a rather chill year, but a good one just the same. Shall we?

Baby steps


Freshman year of medicine ended with these two conferences where we got to make our first major diagnoses. While we do that on a regular basis during Physio case conferences, these two were a little different because there's a whole panel of professors and consultants. It somehow made me feel like I was doing the real thing doctors do. I was chosen to be part of the 6-member team to defend our diagnosis on behalf of the class for CBC. This one is special to me because not everyone in the class helped in coming up with the paper and report but we still managed to get 2nd place. I'm not going to rant about how I've learned how unprofessional some people can really become because I've already posted an angry post for that. But here's one more thing I've learned: Going the extra mile can get you places :)

Promotion to year 2 and maintaining my full scholarship

Promotion boards, April
For others, this may just be a piece of paper, but for me, this is a step closer to a dream. While first year med may not be as taxing as undergrad, it was not a bed of roses either, so getting a confirmation that I just made it through was quite the news for me, plus, my parents won't be paying tuition again for one whole year. Medicine incurs a huge amount of expenses as it is, so taking enrollment fee out of the equation is a lot of help. It's my only way of helping my parents out.

A sweet surprise

Freemasons scholarship letter, April
By summer, I was called to the med admin office and was handed a letter. The top 20 students from first year were called out for an interview for a private scholarship for the rest of our stay in medschool and they didn't care if most of us were already on full scholarship; they were willing to pay our miscellaneous fees and give us monthly stipend. I wasn't chosen as the final recipient; they only chose 1 out of the 20, but I'm already on full scholarship anyways so might as well let someone who deserves it more have it and it's opportunities like these when you just feel amazing for others to even consider you and trust you enough to offer you one. It's like life saying, "hey kid, you must have done something right."

Baguio and NMSC 2013

Doc Hilario, Rob, Aimee, Ate Gemmy, Kuya KimPat, Ate Pauba, me, Louis.
SLU-Baguio, April
Believe it not, the decision to join NMSC 2013 - a conference I've never been to before, with people I haven't met, to be held in a city I haven't visited, is quite spontaneous. It is one of those decisions that gave me a bargain not only because I gained a group of friends, but because it jumpstarted my journey with the Asian Medical Students Association - Philippines (more on that later) and PLM's ComDRS. We got to listen to the likes of Dr. Kenneth Hartigan-Go, do something crazy in the streets of Baguio in the wee hours, sight see a little and get inspired a lot. It is with this conference I started to promise I would keep on attending, both for the learning and the fun. After all, I'll be doing this for the rest of my life.

TIEUP

Last day of CPC with Dra. Munarriz, End of summer

Every summer, a bunch of freshies and sophies get to have mentoring with one of our feared faculty ala House, M.D. I feel lucky to be chosen as part of this team. There was never a promise that the training is going to be easy, not when you have to read Harrison's, Henry's, De Gowin's, Hurst, etc as a freshman and go on overnights discussing cases, coming up with strong diagnoses, anticipating how she and the rest of the upper years are going to overthrow your differentials this time, when you also want to be like the rest of the batch YOLO-ing because it's well, summer. But, I like it this way. I'd rather be grilled all summers before clerkship than be grilled on the bedside. Most people are afraid of her, but sometimes, you just have to be grilled by someone long enough for fear to be replaced by respect... so much respect that you don't want to fail the people who put their trust on you :)

1-Amazing, Alcohol, Absent, Awesome

Pansol, summer
Domo buffet, End of summer
When I hear 1A, only one thing comes to mind: the class which taught me to chill out and calm down. For someone with a type A personality, who is always on the run like me, 1A seems an inappropriate company. But it is with these people that I learned to stop every now and then, take some air in and relax. When other classes were winning competitions left and right, this class opted out and partied like a boss. At first I thought I hated the lack of alpha people who can lead a class to do great things, but after we've said goodbye, I realized we all need that group who you can be with and make you feel like you only need to accomplish one thing and that is to be happy and make you forgive yourself for the little mistakes.

AMSA

With the presidents of AMSA-Jonelta, AMSA-UERM, AMSA-UST, ACSIS-Ateneo, AMSA-SLU
and the president, the external vice president, the regional coordinator and
the IFMSA liaison officer of AMSA - Philippines
EB - CLMO meeting. UP College of Medicine
Asian Medical Students Exchange Program Philippines for Indonesia 1
Intramuros Tour with UP MSSR-IPPNW & PLM ComDRS. August
AMSA members from all over the country at the Philippine
Conference on Community Health by UP - RSO. October
Asian Medical Students Exchange Program Philippines for Indonesia 2
Intramuros Tour with AMSA-UERM & PLM ComDRS. November
Outside the Box - Medical and Research Forum. November
Back when I was still in first year nursing, one of our professors told us how nice it is to be going to school daily, sitting in a classroom and learning but that there is a world somewhere out there that will teach us more things than we could ever imagine. Six years after, I can't help but think how AMSA is doing that to my life as a medical student. In conferences and tours, I meet a great number of nice future colleagues and friends not just locally but internationally, I get what I pay for because the speakers and the activities are always top notch, I get inspired by trailblazers in this field, and most of all, I get a different perspective of the things they teach us inside the classroom. The thing about staying cooped up in the same building for years, going to classes with the same people, being trained by the same faculty that bred batches of physicians before you is that you get to imbibe the same aura, take in the same dogma, which is absolutely not a bad thing, but admit it or not, it also tends to limit your experience and perspective only to what you were exposed to.

This field is so dangerously dynamic, which is why I always feel like I have to break free from the walls of the classroom, hear new stories, have fun with a different family, get supplements for what I learn in school, see things from a new and sometimes radical vantage point and interact with ones who can understand my work ethic. It's funny how sometimes I hear something in class and remember that I once sat in a talk by an expert on the matter who told us otherwise. Those moments tend to brew up a battle inside my mind, but then again, I'm thankful because it's an opportunity to process what I learn, instead of blindly taking it in.

UPCN
UPCN 2011, 2012 and 2013 at PCCH Socials Night.
Nasugbu and Tagaytay daytrip with undergrad friends
Two years after leaving UP, I always find myself missing it (obviously, because I'm still talking about it). It's not just the place, the toxicity, but the people. UPCN is still the most (mentally, emotionally and physically) gruesome thing I've experienced, but that's what made it the most awesome thing that ever happened to me, handsdown. It pushed me to the edge and so I had to learn to fly. 

Family

My mom's birthday. Trader's Hotel Manila
The best thing about 2013? My lovely family. I think it's that time in our lives when my sisters and I feel like we finally get each other, when childhood cat fights seem funny and very pointless and when we all feel like our parents are our best friends. What are achievements for if you don't have people to dedicate them to, right?

So that was 2013 for me. I hope you also had an amazing one :)

Monday, October 21, 2013

"He wanted to shield her from the deterioration that eventually took place in the course of a marriage, and from the conclusion he sometimes feared was true: that the entire enterprise of having a family, of putting children on this earth, as gratifying as it sometimes felt, was flawed from the start. But these were an old man's speculations, an old man who was himself now behaving like a child."
 - Unaccustomed Earth (Jhumpa Lahiri)