Took her history yesterday.
First few minutes into the interview, we could sense that she was a bit worn out so my interview partner and I tried to keep our voice as soothing as possible. She gradually warmed up, sometimes spending minutes talking about her kids, her favorite food, her diet strategies, her work, her financial woes, her health pre-op, and her post-op pain. My partner and I sometimes could not follow the prescribed checklist of things to ask, because we couldn't well just jump from one question to another like a quiz show master bombarding the hapless patient with questions she might have been already asked about ten times over and we spent extra time listening to the patient elaborate on her answers that sometimes veered away from anything related to her case. Thank God my partner could steer the interview in the proper direction, because had it been solely up to myself (and had I gotten a chance to skip my next class), I would have spent so much time just hanging around the patient, listening to and chatting with her. I am such a hopeless case when it comes to being too available for people who want to talk.
During the full course of the interview, I observed two clerks (i.e. fourth year students) check on our patient. One was assigned to take the patient's vital stats, and the other was the clerk who must have scrubbed in on her surgery. The first clerk calmly went about her duties and apologized for our sake, saying that all med students (and their unfortunate patients) had to go through the tedious task of establishing the medical history. The second clerk's visit brightened up the patient's mood considerably, and the patient kept telling us proudly that the clerk was forever etched in her mind and heart; apparently, the clerk was the last person our patient saw before she went under anesthesia, and the first person our patient saw upon waking up from surgery. The clerk was like our patient's anesthesiologist, watching over the patient throughout the surgery.
Our patient couldn't resist telling us that she was so grateful for the care given her in the hospital by the clerks and doctors. What stuck to me was that she fervently wished for us, second year students, to grow into the same mold of compassionate and caring healers who had taken care of her; she would squeeze my hand or look directly into our eyes to emphasize her point. Towards the end of the interview, she repeated her sentiments so my partner and I reassured her that we would be doing good on our promise to become caring doctors. We wished her well, checked if there was anyone who would take care of her post-op after being discharged, and thanked her for enduring our hour-long interview. She thanked us immensely-ironic because I think we should have been the ones thanking her profusely for helping us learn to become very good physicians in the future.
Maybe it's because she's my first patient that I regretted not being able to visit her today before she got discharged and bring her favorite bread. I hope our patient recovers well.
Sunday, June 22, 2008
03 May 2008
Early this morning, with enough clothes for eight days and a brand new mountain bike in tow, I started my second journey of the summer in Cubao. This was no ordinary vacation where I'd expect to completely chill out to the sun, sand, and sea; I was going on a eco-tour to save an unspoilt island threatened by mining. By noontime, the bus was on its way to Batangas pier, and by 5 PM, we were on the MV Xenia for an overnight trip to Romblon Island. The participants of the eco-tour were given a briefing about the island and our purpose in doing the eco-tour, and as the sun set, we turned in for the night on the steel beds, in a room occupied by people from all walks of life, wishing ourselves a safe trip over the calm seas.
We slept here.
No privacy.Guard your belongings.
Bring your own pillow and blankets.
Definitely no prima donna behavior allowed.
04 May 2008
The nervous chatter and gossip of fellow passengers made sleep almost next to impossible last night, and now I am awakened by the noise of passengers making their way in haste off the boat, as we dock in Odiongan. My companions reckon it will be another three hours before we reach Romblon island.
I am awake now and I make my way up to the deck to enjoy the sunrise, the salty air, the view of the islands dotting the horizon, and the sight of the ink-black sea stretching before my eyes. I tighten my grip on the rails of the deck for I am quite perturbed by the fact I am traveling on very deep waters, judging from the color of the water. I remember that the seas going to Boracay and Palawan were bluer, and hence shallower than what I am seeing right now. Yes, I can swim and all, but the very notion of being such a tiny speck amidst of all creation, vulnerable to the moods of nature in all its primordial power 'shivers me timbers.' At this realization, I am humbled by my seeming insignificance, yet comforted by the fact that God is watching over such a tiny creature like myself.
The marble monument to the island, the marble capital of the country.
Heck, even the streets have bits of marble embedded in the cement or asphalt.
We arrive at Romblon island and disembark to explore the first church built in the town by the Spanish friars and to buy a quick breakfast for ourselves. I am thankful that the seas are calm, that the weather seems to be cooperating with us, and that our bikes and our stuff and our selves are already in Romblon. As I make my way through the area, I see marble, marble, and marble. I am, after all, in the marble capital of the Philippines.
If not for the locals of the island, we would have been left behind by the ferry Maria Querubin, which would take us to Sibuyan Island. Thank God the crew was patient enough to wait a little bit for us. As we settled on our seats to enjoy the air that was slowly being warmed by the waking sun, we were informed that we were to arrive at Sibuyan in about two to three hours' time.
Restless and curious, we (Ate Monette and I) explored the small ferry, eventually ending up at the deck. To my surprise we saw Atty. Cuñada chatting up the captain and the crew, trying to learn how to steer the ferry. The captain was gracious enough to let us watch and take pictures of the deck, and even told us to watch out for dolphins who would usually race alongside the ferry. I saw the instrument panel all in Japanese and asked them whether they could really understand all of those switches and buttons. Turns out they trained for four years in a maritime college and an additional year on board, so it was all good. To my infinite amazement, I saw that they were using a GPS device to help chart their course amidst the dark waters of Romblon; I was thinking that the rickety ferry just had a compass of some sort, but then again, the orientation of the island group, the changing seas, and the emerging technology made it quite imperative for the vessel to have one.
These kids were always the first to spot the dolphins. About the lack of the dolphins in the photo, well, the dolphins were too fast. :P The images of the sleek creatures racing alongside the ship/ferry will forever be etched in my mind.
Dolphin sighting! Dolphin sighting! Dolphin sighting!
Got down at Ambulong Pier, with bike in tow. The parish priest of Magdiwang welcomed our group and led our caravan (and us bikers) to his church and the convent, where we were immediately fed brunch and allowed to freshen up before the Mass. I had my first sip of the cleanest and sweetest water I had tasted in my entire life; Sibuyan certainly seems to be in the running for the cleanest island on the planet.
It seems that we are going to the home of a doctor from Magdiwang, after the gathering and the Mass. Kuya Boy and the other volunteers have raised the seat of my bike; I had such a hard time biking two kilometers when my quads were screaming against the injustice of the horrible ergonomics of my bike. I actually ride on the van, while I allow Kuya Boy to bring the bike to the place; I am in no mood to start the Sikaran without having taken a bath after almost two days of traveling. My appetite has quite fled in the face of lack of sleep as well, that I can't help but take small servings of the extremely delicious food that was served.
The kindness of the councilors of Magdiwang has allowed us girls to actually enjoy a good scrubbing at last. I was quite relieved to be able to finally change into my cycling clothes and check if I indeed needed some feminine implements. (My uterus completely hated me at the said moment, and happily chose to expel its contents at the most inopportune time.)
We start biking to the parish of Sto. Niño in Danao, in the heat. I am focusing on just conquering the ride without incident, that I almost miss the beautiful flora and fauna surrounding me. The streets are amazingly clean, there are animals roaming free, and every living plant or tree is lush with life. I almost run over some hens and a rooster as I bike, and I look to the locals for help; I was told not to worry, as they would only take my roadkill and make it into a stew. ("Hayaan mo, doctora, gagawin lang naming tinola yan.") I am so distracted that I narrowly miss seeing the sea as I go around the side of a mountain on an incline.
It's a blessing that my bike has gears to help me through the tougher slopes, but my pelvic bones are starting to complain of the lack of suspension, especially on the rockier paths. I feel my lungs start to burn as I try to catch up with Bishop Pabillo and Ate Sol, and I am grateful that the air that rushes in is completely clean. I don't think I'd last very long on a bike in Manila's polluted streets. Maybe it's the great abundance of all sorts of trees that blanket the land so thick, Sibuyan is already known for having forests four times thicker than the usual.
Father Toto has been yelling out, "Kaya pa? Kaya pa, Kel?" for the past how many minutes from the tricycle that's been following me through the route. I sense that he's so ready to ride the bike, that I readily turn it over to him and gratefully chug down the contents of my water bottle in two gulps. (Yes, it's gonna be bad for my stomach, but hey, physiologic needs first.) I gratefully ride the van with the others and allow myself to stretch my muscles to keep them from bulking up unnecessarily. I am already wishing I lost some of my excess weight in the ride.
We are about 500 meters from the parish and Bishop Pabillo has stopped (I observe he hasn't got a bead of sweat on him and he seems to be enjoying what was turning out to be a grueling ride.) to allow the caravan to clump together so that we'd arrive as a huge group in the parish. I learn that my bike has not survived the ride, one of the pedals actually fell off. The other volunteers actually have the video of the pedal falling off and the bike still going and Ate Monette looking all confused. So much for Sikaran. I volunteer instead to take Ate Sol's bike up to the parish.
We were graciously met by the parishioners and the seminarians of the parish. They are all pushing us to eat, eat, and eat all the food they had prepared in advance. My appetite was gone, due to the physical activity and amount of fluid I had earlier, so I went down and attended Mass again. The parish priest really must have had advanced notice of our arrival as the church is packed with people.
The women from the parish were still offering food, so to be polite, I took small bites of empanada (pastry filled with chicken or pork and some vegetables) and suman and maja (sticky rice molded into cakes and coconut milk squares with glutinous rice). I wandered around and found that most of my co-volunteers are still taking their rest.
I was greeted by the booming laughter and the flawless Tagalog of someone who appeared to be Santa Claus in the flesh. It was Fr. Ortner, an Austrian missionary who was the parish priest of Lumbang, the next town we would be going to. He kept on cracking lots of jokes and generally made the simple affair of an afternoon snack a very joyous one.
Bikes, luggage and people loaded on the open truck, Fr. Ortner proceeded to drive us to Lumbang. They reckon we won't make it before nightfall if we were to ride the bikes. Along the way, we are stopped by locals who wished to welcome Bp. Pabillo with beautiful and fragrant leis of flowers and ask for his blessing. Kuya Rod, our official tour guide points out various trees and wildlife, all the while firing out factoids about Sibuyan island with great pride. He tells us to watch out for payas, branches from trees or plants that seemingly come out of nowhere to hit you in the face with a mighty slap. Fr. Toto tries to scare us with tales of elementals and otherworldly being residing in the bamboo branches that keep on hitting us on the way; appraently the creatures like to bend down the tree to enable them to hit passersby. I am unafraid, even if the sky begins to darken as the majestic sun sets, unlike the time when I was passing through thick forests inside a closed van in Palawan. Maybe it's the presence of Bp. Pabillo, Fr. Dujali, and Fr. Ortner that reassures me that no unseen elemental or spirit would dare hurt me, or likely, I frighten these creatures overmuch that they dare not approach-after all, Daal said something about an aura about me that simply signals "DO NOT DISTURB!" to these unseen beings.
I arrive at a gloriously rustic place, the parish of St. Therese of Lisieux, with Fr. Ortner beeping his truck's horn several times to announce our arrival. A handful of his pets joyfully greet us as we all get down, muscles sore, from the back of the truck. We are shown into our spacious rooms on the third floor of the convent-to-be with solid double deck beds enough for ten people and we hurriedly unpack and shower. The sun is fast disappearing and the chill is starting to set in. We are told that we are to eat an early dinner.
As I go down to the driveway, I hear bells signaling the Angelus. I am quite surprised to see several bells moving on their own, no ropes or people needed. One of the parishioners whisper that it is Fr. Ortner who had constructed a system that automatically announces the Angelus three times a day. I learn that Fr. Ortner is the all-around architect/engineer/carpenter of the convent/seminary/auditorium/church that is rising on a small hill opposite verdant fields and majestic mountains. He had started the "Palace in the Sky" through the kindness of foregin donors, his family included. These foreign donors likewise sponsor the needs of the people in the parish.
Fr. Ortner allows us a sip of red wine to warm ourselves against the growing chill. I sense it is also to allow us to relax after endless activity for almost two days. With the hum of the conversation between the clergy and the men of Sibuyan in the backdrop, I begin to observe the surroundings. The unfinished cement beams and smooth wooden planks hold the promise of becoming a beautiful structure once construction is finished. The cold breeze comes from all around the open area, rustles the leaves of the mighty trees sheltering the convent, and carries the scent of roses in bloom. I go around the veranda and I am greeted by the amazing sight of pots of beautiful roses blooming with all their might; in Manila, it would take handfuls of plant food to make the plants bloom as lushly as they did in that place. I spend the next few minutes adoring the queenly flowers.
Dinner starts with a prayer and more wine. We are expecting some more guests to drop by, but apparently we are to meet them instead on the next day on Mt. Hagimit. We fill our bellies with fragrant rice and fresh pako and rich dinuguan and juicy fish. The place is already quite cool that the fat in the meat dishes start to solidify. I am seated beside a parishioner who tells me to keep eating and eating, because I would need all the energy to climb up the mountain on the morrow. Amidst more sips of red wine, we begin to talk about life in Sibuyan. I hear the locals' displeasure with the artificial rice crisis created by the politicians in Manila; they have no problems with rice in the island yet the prices began rising as news of the rice crisis from Manila reached them. The parishioners tell me that if prices would continue to escalate, they would resort to feeding their families root crops instead; after all, they reason, that was what they'd eat in the mountains before. The person beside me also confides that she's been unlucky trying to find means of regular employment and says that her allowance as a choir leader cannot support her children's education. She looks at me imploringly, her eyes quite desperate and asks if I know of any opportunities for her on the island, a 40-something woman who had not finished any formal education but was willing to work as long as she could send her children to good schools. She is torn between working for a measly sum on the island while raising her family and working for a good sum in Manila but leaving her family behind. She echoes what other Sibuyanons have been whispering to me since we arrived on the island-they need livelihood programs that won't force them to leave the island and would help their families survive. Although they are blessed with nature's bounty, they still need money for other basic needs. (They are also blinded by consumerism our own society promotes, of all things. They are duped into believing they have to have objects signifying material wealth to be having, when it fact, these created needs are nothing more than products meant to enrich the top of the economic pyramid.) This is where the temptation to sell their lands or their rights to mining companies come in, as a lump sum given in exchange seems heaven-sent gift to enable their families to survive even for a short while. Why do we permit ourselves to be indifferent to the truth that the greedy businessmen and corrupt politicians are taking advantage of the gentle people of Sibuyan?
Wednesday, June 11, 2008
Discounting all the little things that made the flow of work a little more challenging, starting the second year in med school was quite...benign. Note the use of the term "little things." The term applies not to the important details that matter so much in the long run/for the bigger picture, but the petty insecurities, normal inconveniences (in the words of a nurse in a medical ethics forum, "complexities of life"), and existing consequences of past actions that would ruin my mood if I let them. No time for any worthless whining or draining drama. This time around, it's just a matter of taking the "truly-really-seriously-no BS-important" things as they come and blending that with skills/capabilities/abilities/talents, to be able to allow myself to bridge the gap between status quo and what I imagine to be a better state. This endergonic process (should it be exergonic, I don't care at the moment) derives its energy from the exhilaration I've experienced from the liberating realization that I have an identity, and has produced a great many wonderful products, including positive vibes that would help sustain what my third year friends call "One Big Fight (towards finally wearing the v-neck uniform)." The overflowing optimism at the moment is coming from the sheer amazement of being able to affirm myself through life experiences and being able to start to unify what has seemed to me as a life filled with great entropy. And probably getting enough me-time, down-time this summer.
Enough chemspeak now.