Med school diaries

 

Thrilled to know we have new doctors! Congratulations! I remember taking the road to that almost elusive medical diploma, a process that involved micro-naps to get us through the day.

Typography

Dropped by a newly opened mall in downtown Marbel and was quite amazed at the typography.

Hebi

Having grown up buying Hebi in sari-sari stores, I was surprised that hebi is a real thing. 

Meeting friends from NDMU–Elementary Training Department

Met with Ronald and Althea yesterday. Ronald is a kind and brilliant internist who's deployed here for the meantime. We last met during Katrina's idyllic wedding, where he and John Mark left me at the reception area, leaving me no choice but to join in the games to represent the "friends of the bride." Well, anything for Kat. 

Thea is a nurse of the highest order; she is also a college professor, mother of two, and is working on her PhD. Her husband and I might be related. I hadn't seen her for 16 years. She messaged if I had free time for coffee. I had just woken up from a postprandial nap. A few minutes later, her car was in front of the gate. I was surprised that she remembered where I live. She said her kids went to daycare at St. Gabriel, in the next block. The kids would go around the neighborhood during mini-parades. I was surprised that there was a daycare center. 

We remembered Ronald, who I'd been meaning to meet. We used to ride the same sundô—the Tamaraw FX—on our way to school. Ronald arrived a few hours later; he had to take care of some matters in the hospital. 

It was such a joy to finally meet them. There's nothing quite like friends from way back to keep one grounded. I'm inspired and encouraged by their outlook and priorities. One thing we learned: spontaneous meet ups are more likely to push through. We might be cooking up the next meet up. 

My kind of DeVita

De Vita is the go-to oncology textbook.

Clinic banter at ESMO Asia 2020

Around this time last year, we were in Singapore for ESMO Asia. Karen had to leave after the gastrointestinal cancer preceptorship, but Fred, Rich, Roger, and I stayed. This year, ESMO Asia 2020 has pushed through. True to form, our posters are up, albeit virtually. I have no first-author papers, but my friends—how I miss them—were gracious enough to include me in their research. Browsing through virtual platform, I read the banter between Roger and Rich. These appeared as comments below the e-poster, Utilization of on-site pathology evaluation for lung cancer diagnosis in the Philippines' national university, with Rich as the principal investigator. With my batch, nothing is ever taken too seriously. The guys know how to have serious fun—even in international meetings. Did I tell you I miss them dearly?

Children by the sea

While looking for vintage boxes to store my journals, I saw an album in a forgotten corner of the flea market. Black and white photos of a Japanese family on holiday were collated in its thick pages. This portrait of two children enjoying themselves at the beach struck me and made me long for the sand and sea. Here's to hoping that the Sarangani beaches open soon. 

At home

Fifteen minutes after the fact, a friend called me up to tell me that her mother has died. Her mother was my patient. Her parents—kind, gentle, and who at one point told me when their hospital discharge was delayed, "Okay lang kami ah; wala problema maghulat kay senior citizens na kami"—reminded me of my own, which made this death harder to bear. After a short word of condolences, my friend and I talked about specifics: the death certificate, the paperwork, and so on. The consoling will come later, after the embalming and the funeral preparations.

I told my mother the news. She knew them from her hometown. Nanay said, "There's a certain lightness to dying when you know the person was a Christian."

There is. 

And my patient is home with the Lord. I will tell my friend that.

River, composite

Bike

Geneva, Switzerland

Tambay lang

Old peopl at HK airport

Bustling

 

Crawford Market, Mumbai, India

Writing letters

This is one of those days when I'd much rather be at home, writing letters to friends by mail, with a good bottle of oxblood ink and cream stationery. I am, of course, reading The Letters of J. R. R. Tolkien (George Allen & Unwin, Houghton Mifflin), which encourages this distraction. I might make physical letter-writing a habit soon, but whether this is sustainable is a different question. It is certainly not practical. It is easier to send emails; they also cost less. But I go out on a limb to say this: the comfort of convenience is over-exaggerated. I need to be inconvenienced once in a while: make time to compose my thoughts, write them by hand with a fountain pen, and deliver the envelopes in person to the post office. Now I'm beginning to understand why my med school friends AAce and Chevs (they are AA and Everly, if you're so curious; I have this strange habit of conferring unique and affectionate nicknames to friends) have taken particular pleasure in sending me letters and postcards from the States. I can't quite explain it, but receiving something by mail stirs up an element of childlike anticipation. Reading my friends' thoughts through their handwriting offers a strangely warmer consolation. The post office is just a few minutes away from the house. It is even within walking distance by my standards. And the thought of licking the stamps—how personal can one get!

Christmas mornings

November mornings feel like Christmas.

JRR Tolkien on sex

Tolkien's letter to his son about sex, with commentary from Dr. Al Mohler.

The devil is endlessly ingenious, and sex is his favorite subject,” Tolkien insisted. “He is as good every bit at catching you through generous romantic or tender motives, as through baser or more animal ones.” Thus, Tolkien advised his young son, then 21, that the sexual fantasies of the 20th century were demonic lies, intended to ensnare human beings. Sex was a trap, Tolkien warned, because human beings are capable of almost infinite rationalization in terms of sexual motives. Romantic love is not sufficient as a justification for sex, Tolkien understood.

Fascinated by handwritten letters, I looked up JRR Tolkien's handwriting. He must have used a stub nib in this letter, sold for auction at 8000 dollars. I read in a forum that the English professor used dip pen and ball points.

Filipino

The script reads like textbook Filipino. I show this to Manong, "Daw hindi gid Tagalog ang nagsulat sini, no?" 

The Queen's Gambit

What a beautiful show!

Knocked down

Strong rain and winds knocked this bird's nest (Asplenium nidus) off its pedestal last month. "The queen fell!," Mother said, then proceeded to give instructions prop her—the fern—up amidst the pouring rain.  Now, the "queen" comes back with a beautiful vengeance. These new leaves make us forget her past humiliation. 

It's fascinating to hear my mother refer to her plants with a devoted familiarity. I have not heard her speak directly to them. But when talks about them, she resorts to anthromorphism. If you didn't know the context, you'd think she was talking about her friends. 

Restoration

Cast irons at a local flea market. Manong soaks them in 1 part water, 1 part vinegar, and scrubs them with detergent and baking soda. Impressed that the rust flakes off, he says, "See? I know chemistry." In third year high school, he represented the school in a chemistry quiz contest. Not sure if he won!

On boredom

Dr. Russell Moore on boredom:

The Bible tells us to pray for our leaders—and we should—but all of that is a means to an end, and that end is “that we may lead a peaceful and quiet life, godly and dignified in every way” (1 Tim. 2:2). The goal is not that the arena of the state would be ground-zero for meaning in our lives—much less for excitement and interest. When the civic order is going well, we should pay attention to it out of duty—not out of constant existential crisis. Those are not always the times we have, but those are the sorts of times for which we should pray. The point is not that we should hope for a boring decade so that we can be bored. The point is that we should pray for a boring decade so that we can be rekindled with interest and affection and passion for the things that ought to fuel such things—the kingdom of God, the gospel of grace, the love of family and friends and community, the glory of the ordinary, which is where, after all, the best of real life happens. We have all seen that this year. It’s hard to find the joy we need to find in being the church, in being families, when we have to constantly wonder whether a vaccine will be ready in time, whether the next telephone call is that an elderly relative is now in the hospital.

Moore to the Point is one of my favorite newsletters, like blog posts delivered to my email each week.  

Brazo de Manong Ralph

Manong's recipe.

Faber-Castell Goldfaber 1221

Found my pencil of choice. A smooth writer.

New vintage frames

New vintage frames from a Japanese surplus store in Gensan. This may well be my 20th pair. Had the lenses replaced by Dr. Farrofo at the Farrofo Eye Clinic. Who owned these frames before? I may never know, but I imagine that it could have been the Professor whom the dog, Hachi-ko, waited on. My timeline is off, but I'm free to imagine. 

Sana all

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“Reading is escape, and the opposite of escape; it's a way to make contact with reality after a day of making things up, and it's a way of making contact with someone else's imagination after a day that's all too real.” - Nora Ephron A man reading on a mountainside in South Island, New Zealand, 2015.

A post shared by Steve McCurry (@stevemccurryofficial) on Nov 4, 2020 at 9:48am PST

Vegetable garden at Barrio 5 and driving

Auntie Cecil and Uncle Rene, my parents' best friends and practically second parents to us, have relocated to Barrio Singko, about 15 minutes away from the city proper. Beside their property is this vegetable garden maintained by the local government (as far as I know). They get their greens from this patch of land. As kids, we looked forward to the peria in the town square. There we ate cotton candy and pop corn coated with salt and butter.

Got my driver's license yesterday. Felt even more fulfilling than getting a medical degree, in a sense. Never in my wildest dreams did I imagine I could learn how to drive. My driving instructors, Sirs Jim and Mark, ran me through the process with patience. And there has been my kid brother Sean who is an excellent driver, much too defensive perhaps, who told me I should learn driving because it is a life skill. He suggested that I first learn how to operate a manual transmission vehicle, an idea that I entertained with suspicion—our family vehicle, after all, is an AT. I enrolled in a class a few weeks ago; the feeling to driving manual was akin to getting a stroke. I couldn't figure out how to maneuver the clutch and so on. I gave up. Some things can't be learned. 

It was in Auntie Cecil and Uncle Rene's house in Barrio Singko where I first drove our family car. I remember that it was a Saturday, and it had just rained. Sean closed his clinic. "Let's take you driving," he said. He was beside me, the strictest, most serious instructor. "Don't treat this as a joke, Manong. If you're careless—and you have a tendency to be—you will die," he said in crispy Hiligaynon, reminding me to place my foot on the brake as a default. He taught me the word, serbato, which meant blowing the car horn. Driving opened up a vast vocabulary for me: preno, atras, abante, menór, and so on. Hannah, his charming and gracious girlfriend, also an excellent driver, encouraged me, "Sige lang, Manong, you're doing well."

I suppose I did.

Passing away

My prayers are with Tim Challies, whose son recently passed away.

In all the years I’ve been writing I have never had to type words more difficult, more devastating than these: Yesterday the Lord called my son to himself—my dear son, my sweet son, my kind son, my godly son, my only son.

The responses on Twitter are sources of encouragement.

The quiet life in the islands

One of the best things to read this week is this article on the caretakers (or wardens) of Britain's small islands. 

Wardens have limited access to the mainland during the winter months, aren’t guaranteed fresh running water, and often live under the threat of harsh storms and perilous currents that can leave them marooned for weeks at a time. Food is delivered once a month by boat. It’s not a role that many are suited for. And yet a growing number of people are dreaming of this simple way of life, seeking to trade the madness of our busy cities for a self-sufficient life among nature.

This excellent article (with beautiful photographs by Alex Ingram) reminds me of Larissa MacFurquhar's piece on the British Falklands:

It is a place to retreat to in a time of plague. Outside the town are miles and miles of empty land, and few roads. Nothing anywhere but whitegrass, dark, scrubby bushes growing close to the ground, and rocks. Only low mountains and no trees, so there’s little to block the incessant wind that blows in from the sea. It’s very quiet, at least when the wind dies down, and some people find the silence and the emptiness hard to take. Before the war, in 1982, some of the bigger farms employed dozens of men, and there were settlements with forty or fifty people living in them, but most of those people are gone now, either moved or emigrated. These days, there is one person for every twelve square miles. Some of the old houses are vacant and derelict; others were hauled out of the settlements, leaving not so much as a gravel track behind, because the people who lived there rode horses.

At the edges of the two big islands, East Falkland and West Falkland, are more than seven hundred smaller islands, some empty, others inhabited by only one or two families: a couple of houses, some generators, a landing strip. There is plumbing and Internet. With a big enough freezer, you could stay here without contact for months.

A part of me feels like moving to one of these islands, far from the cities, almost devoid of human company. As I live my thirties, the quiet and private life appeals more and more to me. Realistically, my work demands that I live in urban places with access to hospitals and CT scans. And I can only live for a few days without talking to anyone else and without fellowship with a local church. 

I forwarded the article to a friend, a radiation oncologist, one of the most introverted people I know. Considering this option, what with the current political and economic state of the country, he replied, "May linear accelerator ba diyan?"

A productive trip

Uncle Glenn, Auntie Net's husband, invited my mother to visit his relatives in Lamba, a few minutes away from Banga town proper. The purpose of the trip was plant viewing. The underlying motive was to ask this relative if he would be willing to give some of his plants. The rarer, the better. A seaman contemplating retirement, Uncle Glenn has grown to enjoy domestic life. Gardening is his newfound passion. "Variegated" is now a household term. When he drives, he slows down, looks out the window, and appreciates the Pothos clinging on to old trees that were once ignored. They had a productive trip. My mother came back with pots of orchids. Such is the beauty of God's creation!

Targeted agents in small bowel cancers

I'm thrilled to announce that our review paper on targeted agents in small intestine cancers is out today. Read the full paper through this complimentary link.

New habits

Prof. Randy David on dealing with loss.

A few weeks after my wife Karina died in May last year, some friends of ours who had previously conveyed their sympathies, messaged me to ask how I was doing. Though at first I found this expression of concern a little odd, I soon understood what it was about.

He has developed new habits.

I have found myself building new habits because many of the old ones required Karina’s presence. I began to sleep on her side of the bed, and eat my meals while seated on her chair. I began to wear the Apple watch I gave her as a birthday present, because I could not bear seeing it unused on our bedside table. I now listen to less music and more poetry on Spotify, because my taste in music is basically a copy of hers. Every night, I light a candle before one of her last photos, and think of her and the life we shared. But, anniversaries and special occasions are tough. My children and I continue to celebrate them as though she was still there.

This is where he is.

I worry about being so overcome by grief that I must persuade myself that life still holds some meaning and purpose. That is where I am. But I also worry about getting so adjusted to a life without Karina that I may no longer feel her lingering presence. Then I will have completely lost her.