March has ended

All the things I’ve learned and struggled with and suffered through the past two years—yes, all of them—have found their ultimate utility and fulfillment in my first stint as a General Medicine service senior. It was as if everything was meant to prepare me for this: leading the team of residents and students to sound dispositions, focusing the direction of management, and even arguing for or against certain clinical impressions.
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Very normal

NOTHING much happens in Tom McCarthy’s Satin Island. An anthropologist, who works in-house at a big commercial firm, writes about Claude Lévi-Strauss, parachutes, oil spills, his love life, and his modern-day theories about civilization. The novel reads like a diary. The prose is magnificent.

“The terminal’s interior, despite its new façade, was dingy. Parts of it were boarded up, awaiting repair. The smell of popcorn, hot dogs, pizza and donuts hung about the concourse, impregnating air that was much warmer than the air outside—cloying and heavy, too. People were milling about, waiting for the ferry: normal, everyday folk who commuted on it daily. A few of them wore suits—cheap, polyester ones, the standard-issue outfit of the low-white-collar ranks; but most wore plain, casual clothes. They looked bored, frumpy, tired, unhealthy, overweight, and generally just very, very normal.”

Adding it all up

I see "345" in the cash registry—three digits flashed in green light on a dark background, like how they had appeared in old calculators in the nineties. I’m in a queue at Wendy’s, buying bacon mushroom melt with fries and Coke Zero—my long delayed lunch. I hand two one-hundred peso bills, and two twenty-peso bills to the nice lady behind the counter—confidently, as if had, in fact, added them correctly in my mind. “Sir, kulang pa po,” she tells me. I rectify my error, a realization that although I like mathematics, I do not like arithmetic.

Admit

WHILE I was leisurely reading my morning paper, Din Floro—my senior in IM, now a gastroenterology fellow—and Niño Lucero, the plastic surgeon who doubles as an Instagram rockstar, sat in front of me and joined me for breakfast. The music playing was John Mayer's "Love On The Weekend." Our morning chat was a pleasant surprise; but alas, duty called. It's admitting day today.

Too early, too soon

A young doctor almost my age—plus-minus a year or two—has died. Someone shot him one night: a bullet that killed him right on the spot, piercing his heart. Four years of medical education, one year of internship, all these on top of the four or five years of college undergraduate education—and then this: an armed man who, for whatever reason, pulled the trigger at him, leaving him defenseless as he lost blood and eventually his consciousness.

He was, I later learned, a gentle soul: a towering six-footer but whose voice was sonorous, whose ways were charming. And charm the entire Lanao town he did: the people he served loved him, for who would leave his family to ease the suffering of his lowly Mindanao community, many of whom hadn’t met a doctor in the flesh until his arrival?

There is no escaping death, but there are good ways to die—and his came too early, too soon.

My first General Medicine Service

THIRD year residency reaches its pinnacle during the four months of being a service senior. Under a General Medicine service are two or three first year residents, interns, and clerks, plus the second year residents who go on duty at the Emergency Room. The responsibilities are overwhelming. Aside from being a clinician, the Gen Med senior is also expected to take on administrative tasks, which include, among others, assuming primary care for patients previously handled by other specialties; providing clear-cut dispositions to patients; setting short- and long-term goals for problematic cases.

March is the first time I'm taking on the role of a Gen Med senior. I'm working with Drs. Nico Pajes (first year IM resident) and Clare Enriquez (our Neurology rotator), and it has been a pleasure to struggle with them thus far. Every night I ask the Lord for wisdom. I pray for my residents that God continually sustain them. I also pray for our students: that they become battle-tested, compassionate, competent physicians in the future.

We had a service dinner last night, something that has become a tradition during the Ward rotation. With us were our interns, Chacha Mercado, Gerald (Baby G) Mendoza, Jeff Manto, Marz Marquez, Athan Lozano, and Joan Lampac. Two of our bubbly clerks also joined us: Ichi Nakamura and Carl Marquez.



Onward, Service 4.

Abroad

The subject of my blog came up as we wrapped up our evening ER rounds—five patients so far; three we could potentially send home. But the night was young, and the ER has been notorious for getting jam-packed in the wee hours of the morning.

Our JAPOD, Chacha Mercado, whose voice resounded loud and clear at the Acute Care Unit, and the senior intern with her, Gerald Mendoza—someone we had taken to calling “Baby G,” because he does look pediatric, save for his small stubs of facial hair—asked me about my blog. I usually respond cautiously to these questions: a person having read my website must have already known a lot about me, and I must’ve overshared some points in my life during my more irresponsible, younger years.

I learned that one intern who grew up abroad had discovered UP because of my blog. At the time—and I haven’t checked it yet—there was probably no functioning website for the hospital, perhaps the least of the administration’s concern, given the other, more desperate problems in the health care system it was facing. While she was searching for “UP Medicine” online, my blog came up. She hasn’t confessed anything to me yet; she’s rotating with the Department this month.

Off to Guazon

It's a rainy morning today. I'm headed to Guazon Hall to spearhead the morning endorsements of the students. I spoke to some of them this morning as they were gathering at Ward 3: they were tired; their shift was eventful. As in: two simultaneous codes just as they were being endorsed to. My Vietnamese coffee[1] is warm, just the way I like it. Praise God for this day. Happy Saturday, dear reader!

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[1] Many thanks to Bea Uy, who gave the beans to me last year.