Surviving med school

Last Sunday, the UP College of Medicine graduated the UP Medicine Class of 2012. Seven years ago today, my class graduated from the UPCM. Up to now, knowing how terrible my study habits are, I am still in awe that I survived med school. Without a doubt it is through sheer grace from God, nothing else.

I remember saying this prayer at the start of all- well, most- um, alright, many duty days, whenever I have time to drop by the hospital chapel:

Lord, it’s showtime, and You are the Star.

Please keep my mind alert
My eyes keen
My ears piqued
My tongue patient
My heart compassionate
My hands steady
My knees sturdy
My feet quick
(I add- My stomach cooperative- if I have some diarrhea issues)

Lord, may I see You in all of the people I will encounter today
And may they see You through me.

Amen.

I don’t remember when was the last time I uttered this prayer. Probably when I left the university. I really should be praying this more. While I may not be a practicing clinic-based MD, I still am actually on duty, everyday, looking out for Christ’s wounded ones, in whatever form or place...

Never lost, always found (17): Tongue in check

Moses, however, said to the LORD, "If you please, LORD, I have never been eloquent, neither in the past, nor recently, nor now that you have spoken to your servant; but I am slow of speech and tongue."

The LORD said to him, "Who gives one man speech and makes another deaf and dumb? Or who gives sight to one and makes another blind? Is it not I, the LORD?

Go, then! It is I who will assist you in speaking and will teach you what you are to say."

Exodus 4:10-12

I had a major presentation last week in the huge ballroom of a top Manila hotel. In it were dozens of physician colleagues, past and present teachers, and many kindred souls who took time out (and shelled out serious money) to listen to updates in the field of Family and Community Medicine. The latter's presence ought to have made the presentation a comfortable ride. However, a couple of hours before my scheduled talk, I was so nervous I thought I would pass out.

At the height of my anxiety and self-doubt, I requested a colleague to pray with me. We found a quiet spot at the back of the hall and he began to pray with me in earnest. And as expected, as soon as he uttered "Amen" a great wave of peace began to quiet my troubled heart. While awaiting my turn to speak, I quit fiddling with my slides, I stopped surfing for answers to any and all possible questions, I closed the ten or so web browser tabs I was nervously juggling and jotting notes from.

Soon after, I was called to the stage and I began my presentation. I did my best to convey the message I was assigned to deliver- Preparing for Outbreaks and Epidemics- in the time alloted. I struggled a bit during the open forum part but I would like to believe that I was able to more than just "wing it." Then, before I knew it, I already had to descend from the stage to give way to the next speaker.

In my confusion, God is my clarity. In my anxiety, God is my peace. In my folly, God is my way forward.



(A bonus after the presentation, seeing this amazing sunset over Manila Bay just across the hotel's parking lot =])

And they're off: UP Medicine Class of 2009

The tarpaulin backdrop provides a muted understatement of the celebration and promise it represents.


I was in the University Theater attending the 100th Commencement Exercise and Internship Closing Ceremonies of the University of the Philippines College of Medicine – Philippine General Hospital last weekend, almost four years to the day of my own graduation from medical school.
Dr. Esperanza Cabral, Secretary of the Department of Social Welfare and Development, and alumna of the UP College of Medicine, gave the Commencement Address.


It was with a mixture of wistful delight that we launch into the greater world outside the UP Medicine Class of 2009. This batch of students will forever occupy a special niche in my heart because they are the first ones I have taught full time. As their names were called and their faces flashed in the white screen during the capping and hooding ceremonies, I can still recall many of the words from the papers they’ve written, the conversations we’ve had, the activities they’ve facilitated in the urban poor communities we immersed in as part of their third year medical school curriculum. Some of them, I can hardly I can hardly remember or recognize- the skinheads then now have hair, some slimmed down, some- well- did not =] But I must admit that it is an honor when they do recall who I am, from among the 660-strong faculty of the college =]

Posing with UP Medicine Class of 2009 Class President Paolo Medina, his mom, and UP Medicine Class of 1993 Class President Dr. Portia Marcelo, and myself, UP Medicine Class of 2005 Class President.


After the capping and hooding ceremony, faux diploma on hand, many faculty members swarmed at the foot of the steps leading from the stage. We were not so neatly lined up with hands outstretched, shaking the hands of the graduates and their parents, some getting hugs from us, especially the ones whom we worked very closely with.

Dr. Brian Vincent DG Salvador, cum laude and class valedictorian, with Dr. Nina Dizon, Dr. Delen Dela Paz, and Dr. Jimmy Galvez-Tan.


What almost wrung tears from my eyes was when the parents thanked us for taking care of their children. I must admit that there will always be bad apples in any heap, but for the most part it was an immense joy with their children, and any group of students for that matter. It is an honor to have worked with and for these young doctors, even if it was just for two weeks within their five-year stay in our medical school.



I am confident that I will be taken care of by their able minds, hearts, and hands should the time come I or a family member be taken ill. God speed, UP Medicine Class of 2009. Blaze trails in honor of your parents, your patients, your teachers, your alma mater, and the country who look forward to your selfless sharing of compassion and competence.

The Fourth U.P. Global Health Course

After a two-year hiatus, six months of intensive preparations, and last-minute edge-of-chaos activities, we're very proud to have successfully conducted The Fourth U.P. Global Health Course at Silungan in Morong, Rizal last April 13 to 18, 2009.

The UP-GHC 4 has brought together 28 students studying in the health professions schools of the UP, UST, Ateneo, Emilio Aguinaldo College, FEU, St Louis-Baguio, and West Visayas State University, including two students from Australia. Through marathon sessions last week, the UP-GHC 4 endeavored to re-focus their education towards a preferential option for the underserved as we talked about topics that our respective university curricula hardly touch: topics like globalization, the current financial crisis, war and health, culture and health, health and the environment, the use of ICT, urban agriculture, among others.

UP-GHC 4 faculty members came from the deep bench of the UP College of Medicine, as well as equally engaging resource persons like Sonny Africa from the IBON Foundation and Professor Giovanni Tapang, PhD of the UP National Institute of Physics who talked about the advocacy against the re-opening of the Bataan Nuclear Power Plant.

The UP-GHC 4's student coordinator, Angela Wee, as well the student facilitators Bev Ho, Rom Imperio, Venjune Tansiongco, Renzo Guinto, Tina Langit, Micko Perez, Myx Caampued, and VJ Mercado all ensured that the course had the correct balance of youthful perspective, practicality, and fun.

The course may have ended, but our work towards making quality healthcare available to those most in need have just began. Welcome to the wonderful world of public health work Nikka, Jam, Leeo, Ginger, Jackie A, Jackie M, Mitch, Yen, Myk, Paul, Peter, Migs, Omar, Jessica, Kim, Kevin, Leslie, Danni, David P, David C, Dana, Angel, Nery, Jopapz, Nicole, Ezra, Jim, and Dalvie!

Congratulations, everyone! UP Global Health Course 5, coming up!

PhotoHunt: Warm

To say that the last four weeks were hectic is the understatement of the year. We're in the thick of preparing for a week-long course for health professions students to be held this April; rolling out a project between the University and the Philippine Department of Health, and; laboring on the first draft of a book about our work among urban lower income communities. These on top of my regular academic load and activities with my Catholic renewal yuppy group.

This week brought some respite though as one of my classes held its last session for the year. The special seven-year Doctor of Medicine program of the University has a year-long once-a-week course called Introduction to Patient Care or IPC. The course title is a misnomer, carried along from its inception more than two decades ago. Thanks to its evolution, IPC does not only aim to make the medical student a good clinician. Moreover, it furthers the development of excellent physicians through a guided journey of self-discovery by way of activities that clarify their values, shedding light on their family's lineage, practice their skill for asking and giving feedback, among other activities. The course approximates a values and personality enhancement class that will hopefully ultimately lead to our students becoming caring, compassionate, and competent physicians.

As I have mentioned, the Wednesday past was our last day in IPC class. With all the things in my to-do list, to finally have all my Wednesday afternoons free starting next week is a tremendous blessing. But before we parted ways, all three of us facilitators received this token of remembrance from them. They wrote heartwarming messages on the other side of this framed sheet bearing the amazing illustrations of our likeness.

I will surely miss the 10 students we've been facilitating for the last 8 months.
They're a bunch of articulate, effervescent, talented, sincere students who displayed genuine interest and resolve to better themselves through the course. It was such a joy to have been given the chance to work with them. If they remain as diligent and human as they are now through medical school and beyond, I would entrust my health or the health of a loved one to them in a heartbeat.

Php 1:3-6
I thank my God for you every time I think of you; and every time I pray for you all, I pray with joy because of the way in which you have helped me in the work of the gospel from the very first day until now. And so I am sure that God, who began this good work in you, will carry it on until it is finished on the Day of Christ Jesus.

UP Manila - Ayala Recyclables Fair, February 10, 2009

Start the new year right, light, and green!

Join the 3rd UP MANILA-AYALA RECYCLABLES FAIR to be held on Tuesday, February 10, 2009, 9am - 3pm, at the UP College of Medicine carpark (behind the Paz Mendoza Building and in front of the CAMP Building) University of the Philippines Manila, Taft Avenue, Manila.

Get rid of the clutter from your homes and stand a chance to earn from the following:

Used paper at posters, old newspapers at magazines, obsolete books
Plastic bottles, sando bags
Plastic furniture, Tetra Pak cartons
Aluminum cans at tin cans
Used lead acid batteries
Non-working electronic appliances
Betamax, cassette tapes
Old CPUs at monitors
Toner at ink cartridges
Tarpaulin streamers, household batteries, Styrofoam, mobile phones, chargers

For inquiries, please get in touch with Angeli Guadalupe angelgwen24@yahoo.com or Renzo Guinto ramonlorenzoluis@yahoo.com

Connecting learning to global health trends: ICEHS 2008

In celebration of the Centennial of the University of the Philippines (UP) and in keeping with its mandate to be the leader in education, research and service to the nation, the UP College of Medicine and the National Teacher Training Center for the Health Professions spearheads the First International Conference on Education in the Health Sciences (ICEHS), from October 1-3, 2008 at the Science Hall of the UP Philippine General Hospital.



Centering on the theme “Connnecting Learning to Global Health Trends,” the First ICEHS brings together noted local and international experts to collective chart the course of health education in the face of the challenges and opportunities of the 21st century. Health science educators from the Australia, Hong Kong, Singapore, Vietnam, and the United States will be flying in to share best practices in their respective institutions. Most notable among them perhaps will be Prof. Frances Baum of Flinders University, Commissioner from Australia of the UN Commission on Social Determinant of Health, a dedicated teacher and researcher in the field of community health and its interrelation with politics and economy.

Included in the roster of some 25 Philippine experts on health and education are two former Secretaries of the Department of Health and UP professors Drs. Alberto Romualdez and Jaime Galvez Tan; former UP Manila Chancellor Dr Marita Reyes; Metrobank Foundation Outstanding Teachers Drs. Antonio Dans and Rafael Bundoc, and; TOYM Awardee Dr Alvin Marcelo, among others.

Participants will experience two and a half days of plenary and symposia tackling issues ranging from distance learning to MD-MBA education models; effective teaching of courses like Gross Anatomy to community-based learning initiatives to admissions policies. This First ICEHS will not only assume the worldview of teachers but it will also paint a more complete picture by presenting perspectives from students as well as institution administrators.

For those with the passion for the business, art, science, and vocation of health education, do not miss this chance to enhance your capacities by learning from the best. Be part of the First International Conference on Education in the Health Sciences (ICEHS).

For inquiries, please get in touch with:

THE CONFERENCE SECRETARIAT
INTERNATIONAL CONFERENCE ON EDUCATION IN THE HEALTH SCIENCES
c/o University of the Philippines Centennial Committee in Manila
Rm. 125 Ground Floor, National Institutes of Health Building
Pedro Gil Street, Ermita, Manila
1000 Philippines

Ms. Rhea Obera (UPM Centennial Office)
Telephone Number: (632) 524-7571
Email: upm.icehs@gmail.com
Fax number: (632) 526-0371, (632) 536-1329

PhotoHunt: Beautiful

It's interesting how this week's theme is so common that the vast array to choose from renders me immobile. I've rummaged through my photos from various provinces in the Philippines, photos from Hong Kong, the USA, Finland and Sweden just to find the photo perfect for this week's hunt.

I still came back to my original choice, though, the one I've picked weeks ago.


He lives in one of the lower income communities our university works with. He's one of those boys who tease his female playmates but charm our medical students who serve in their village. His laughter echoes amidst poverty, his demeanor is never long nor fallen, his energy never diminished. He greets us with the glee of familiarity, but he always manages to evade us when he feels a "health lecture" is about to unravel. His a good boy with j-u-s-t that streak of mischief. And enough hope in his eyes.

(I love the graininess of this photo. It comes from the first roll of expired slide film I've ever used with my Woca, which I then had cross-processed. Those were the days, of dabbling in lomography...)

Yes, it is worth it

Two years ago this week, I began my stint at the other side of the teacher’s table in the UP College of Medicine. My first major task then was what I did today, act as preceptor for a group of second year medical students who visited a health center in Pasay City and its environs. Our aim was to give them a glimpse of the local healthcare delivery system and the state of the constituents the center serves.

It was a great bonus that the students who I acted preceptor for was the same group I worked with the last year, during the first week of their class as first years. We proceeded to our present task on hand, trudging along under the hot 1pm sun towards the Light Rail Transit (LRT) Pedro Gil Station. We quickly found ourselves jostled in the packed train en route to the Taft-EDSA LRT-MRT (Metro Rail Transit) station where we were to ride a tricycle to the San Pablo Health Center.

And then it happened. My own version of a wardrobe malfunction.

Before I left the office to meet my group, my belt died. I was adjusting it too vigorously that the buckled broke loose from the belt. Despite my best MacGyver attempts, the belt died. Since I was wearing a rather lose pair of pants, I opted to secure them to my waist by using a foldback clip- that black, some-kind-of-a-mini-black-hand-bag-looking office supply. It worked.

Until we were walking up the stairs from the LRT station headed to the MRT side. The foldback clip suddenly became loose and my pants fell 1/5 of the way down my bum. I just caught it in time- before the students, who were before me, beside me, AND behind me, could see what a side of their teacher that can scar them for life.

And so I left them to fend for themselves at a fastfood joint while I scoured the mall joining the two train systems for a clothing store that sells belts. As is wont to happen, no such luck in the first two stores I tried.

The store sold a benign belt in MY size so I just grabbed it and brought it to the cashier. Only to find out that I only had 60 pesos in my wallet: I gave part of the money in my wallet for the typhoon victims in UP Visayas and I bought lunch. Good thing I had my BPI atm card, I can just pay straight from that card. But the machine won’t accept my card. Finally, my credit card consummated the sale and I was off to meet my students, pants securely fastened to my burgeoning waist.

We literally waded through a sea of humanity, crossing from the mall to the other side of EDSA. Thousands of people were making the same trek as we were, plus a thousand others were trying to get into the MRT station via a new, one-way traffic scheme. It took us almost forever to get to the other side. Once there we went right away to the tricycle station to scamper towards the San Pablo Health Center.

It was one of the bumpiest 15-minute-or-so tricycle ride I’ve ever had. It didn’t help that I was riding behind the tricycle driver and we were crossing a major thoroughfare. We safely reached the San Pablo Health Center a good hour late, no thanks to my wardrobe malfunction.

Once there, we were introduced to the local health system of Pasay by the health center doctor, Dr Sy. He explained the protocols and personnel which make the center run. The students fielded a good number of questions such as the average number of consults, types of patients seen, dealing with emergencies in the community, among others. The volunteer village health workers then shared their own experiences as partners in promoting health in the community. The group then split into five groups which toured the different areas of the barangay.

After thirty or so minutes, we all came back to the health center to discussed what we all learned in the afternoon’s session. There was a steady stream of questions ranging from BHW compensation to health and sanitation issues. But the most difficult question was not about a DOH policy or some health concerns. The question that struck me the most was this:

With all the hassles of riding the LRT, the tricycle, all the dust and the heat- is it worth it? Coming to Pasay and working with these communities?

I paused for a millisecond, and put on my self-effacing hat:

I replied, yes it is worth it.

It is worth it, I explained, because I am a person with low EQ. I am impatient. I can’t wait to improve the health system by dealing with one patient at a time. By working with communities, I can help effect wider, faster change. How? By engaging communities, like training volunteer village health workers through whom I multiply myself as a health service provider. The outcomes are worth all the hassle, when erstwhile idle mothers, wives, grandmothers now feel a certain amount of empowerment because of some knowledge or skill I have shared which in turn they are duty-bound to share with their families and neighbors.

That answered seemed to suffice for the students but it really got me to thinking…

Is it really worth it? Do the rudimentary hassles of traveling, politics, seemingly abject poverty really pale in comparison to what I gain as a, in a way, community doctor?

Yes, they do.

Especially when you hear the village health workers share that they no longer panic when a baby seems to have diarrhea because they now know how to take care of him at home. They also know when to take him to the doctor.

Or you hear them give an excellent lecture on nutrition or family planning to a group of young parents.

Or you listen to their discussion on fighting for the allowance that should rightfully be theirs as stated in the Barangay Health Workers Incentives Law.

Or they show off their skill in taking your blood pressure measurement, report on the number of pregnant women they have encouraged to go have pre-natal checkups, or lovingly chastises a patient who self medicates because of the danger of drug resistance

These are just some of the reasons I am staying in the Philippines. These are just some of the reasons I am going against my parents’ silent wish for me to join them in the US, supportive they maybe of my decision to practice community medicine here.

But I guess a major, major reason I am staying here in the Philippines is what another student shared as a major lesson he learned this afternoon: That hope and faith are currencies that may hold no value inside the classroom- but he has seen it in action with the dedicated health professionals and village health workers holding the fort in San Pablo Health Center.

I totally agree. I know that the Lord answers the prayers of those who pray for better health and more decent living conditions, especially among the urban poor. I do have faith and hope for our country springs eternal within me. The students I have been blessed to work with the past two years are a testament of the Lord’s faithfulness that He is looking after the Philippines. I know there is a steady crop of doctors-to-be who I can help nurture to be more pro-Philippines.

But until they grow into medical maturity, I have to be one of those who hold the fort for them. One of the best things I’ve heard during my stint in Gawad Kalinga is that while I pray for answers to our country’s problems, I’d like to be one of the answers to the prayer of our fellow Filipinos.

This ends my second year in the UP on the other side of the proverbial teacher’s table. This likewise marks the beginning of my third year. It’s been a great privilege to be of service to the communities of Pasay, acting as preceptor to some 400 medical students, and working directly or indirectly alongside the 600-strong faculty of the UP College of Medicine.

The Lord continues to affirm my decision to remain in the UP for now. He makes everything worth it. He has taken care of all my daily needs- from the mundane to the exotic to the most academic.

Even the provision of the right belt with the right color and right size, at the right place and right time.

The First Quisumbing-Escandor Film Festival for Health

*UPDATE: Click here to find out the winners in the 1st Quisumbing - Escandor Film Festival for Health*

Be it to Victorian England, or Times Square in New York, or a parallel world of wizards on broomsticks- the movie house is that proverbial transportation hub that ships us out to worlds other than our own. For many, movies are an unwitting means by which we get to be transported to a place so distant we temporarily escape the harsh realities of the milieu we are in, if only for two glorious hours or so. Vicarious victories are enjoyed, onscreen riches are savored, and communal catharsis is reached just as the end credits begin to roll.

Then there is another role of film- to force the spotlight from things mundane to things that ought to REALLY matter. Film has the ability- and responsibility, actually- to attract attention to things that have been rendered unimportant, voiceless, faceless by society too distracted by frivolities. Film can- and must- act as that magnifying lens that helps dissect issues, clarify details, and stimulate discussion that will lead to appropriate action.


Film takes seriously that responsibility as the plight of health is placed front and center with The First Quisumbing-Escandor Film Festival for Health (QEFF). The QEFF is a nationwide competition for amateur filmmakers whose main challenge is to capture on film that delicate interplay among the socioeconomic, political, cultural, and environmental factors affecting health and wellbeing.

The film festival is named after two alumni of the UP College of Medicine- Dr. Honorato Quisumbing (Class of 1945) and Dr. Johnny Escandor (Class of 1969). Dr. Quisumbing was a medical intern at the Philippine General Hospital as World War II was drawing to a close. He was killed while in the service of the sick and needy Filipinos housed in the PGH. Dr. Escandor was a prominent student activist who eventually gave up a promising medical career to fight the Marcos dictatorship, resulting to his death said to be carried out by Marcos’s henchmen. True to the nature of its namesake, the filmfest promises to be a bold expression of the dismal state of healthcare delivery in the Philippines while at the same time it aims to be a medium for inspiring and spurring people to action.

Some 60 entries and guest presentations from Filipino and foreign filmmakers will be shown for free from February 18-20, 2008 in the following venues:

at the Cine Adarna – UP Film Center in Diliman from 5-9pm;

Rm 222 of Calderon Hall and the Center for Community-Oriented Medical Education at the Paz Mendoza Bldg, both in the UP College of Medicine, Pedro Gil Street, Manila from 6pm onwards.

Competition winners will be announced at awarding ceremonies at the PhilAm Life Auditorium along UN Avenue on February 21, 2008 at 6pm.

The First Quisumbing-Escandor Film Festival for Health is a collaboration among the Mu Sigma Phi Fraternity of the UP College of Medicine, Health Futures, Inc, and the Department of Health, with the participation of other partners companies and institutions.

If we can support films that showcase senseless gore and violence or TV medical dramas that tug at our hearts with their endless love triangles and “insider’s view of the real life of doctors”, surely we can rally behind the QEFF. It’s time to see the real state of health in the Philippines, minus the spin and whitewash.

It’s time life takes its cue from art taking cue from life.

15th Grand Scientific Symposium, February 1-2, UP College of Medicine

In celebration of the Centennial of the University of the Philippines, the UP College of Medicine thru its Postgraduate Institute of Medicine is holding the 15th Grand Scientific Symposium on February 1-2, 2008 at the Hyatt Hotel and Casino, Pedro Gil Street, Manila. With the theme- The Brain and Behavior: Optimizing Function from Birth and Beyond- the 15th GSS is a collaboration of the Departments of Neurosciences, Pharmacology and Toxicology, and Psychiatry and Behavioral Medicine of the University.

The topics lined up for the two-day symposium consist of everyday challenges doctors, patients and their families and communities face. Below are just some issues to be tackled in the GSS which I personally am very interested in:

Brain and Development: IQ vs EQ, Family Role in Child Development

Dysfunction of Brain and Behavior: Autism, Learning Disabilities

Neurologic Problem in Children: Head Trauma

Bangag o Baliw: Neurobiology, Psychology, Pharmacology of Addiction

Issues in Children and Adults: Behavioral Problems, Teenage Pregnancy

Crossroads: Gender Issues, Midlife Process, Spirituality in Healing, Death and Dying

Neurology of Aging: The Aging Philippine Population, Successful Aging

Dementia: Makakalimutin lang o Ulianin na?, Pag-aaruga ng Ulianin

Neuropharmacology: Psychopharmacology in Geriatrics, Polypharmacy

Epilepsy Primary Care

Optimizing Stroke Management: Stroke Mimickers, When Medical Therapy Fails

Special Topics: Herbal and Food Supplements, The Living Will

There are other topics which I have not listed above. But suffice it to say, this two-day CME ought to cure some of my anxiety about encountering patients with neurologic or psychiatric problem NOT because of the physical harm they can inflict on me but because I HARDLY know what to do to help them.

To get to know more about the 15th Grand Scientific Symposium of the UP College of Medicine, please get in touch with the GSS Secretariat at +632.536.1319 and look for Ms. Agnes Enagan or email upcmpgim@gmail.com.

Registration fees: P2,500 for medical practitioners; P2,000 for residents in training; P1,500 for teachers/ allied medical professionals; P1,000 for government employees.

You can also visit the UP College of Medicine site or the symposium invitation at the Department of Health site. PDF files related to the 15th GSS can be downloaded there.

On PGH duty: Christmas 2004

Christmas is a big family event in our home, with decors usually up soon after All Souls’ Day, get-togethers left and right. But the changing family dynamics over the last four years (my sister’s marriage and my stay in medical school plus my parents' eventual migration to the US) made this day extra special.

With six days to go before Christmas, nostalgia is an unwelcome guest, especially when the vistas it brings are wistful at best. A most memorable Christmas was in 2004. Here’s another blast from my blog past on why that particular Christmas was special.

And I hope I’d be able to endure this year’s…

--==+==--

December 23, 2004, 10.26 am

With most of my gifts left unwrapped, or worse, unbought; my Christmas cards unmailed, or worse still blank; and with the very cruel reality that I will spend Christmas eve for the first time outside of our home sans my family, and worse, in the hospital! since I am on duty from 7am of the 24th til 7am of the 25th: this Christmas is on the verge of becoming the worst Christmas of my life, displacing the current record-holder- being down with the flu while in Las Vegas last year (2003).

But then again, compared with Mary and Joseph’s constant rejection by innkeepers that first Christmas Eve and then our Lord and Savior eventual birth in a lowly manger soon after . . .

Yes, Virginia, I am Joe’s myopic, selfish, humble-pie-eating ingrate of a brain.

(Thank you, God, for the gift of Jesus, the Greatest Physician, the Most Eloquent Wordsmith, the Most Inspiring Leader, the Most Faithful Friend, the Most Obedient Son, the Most Caring Brother. May I become as close to the example He set as possible in my feeble humanity’s attempt to don these hats He’s worn.)

---==+==--

December 29, 2004 5.05 am

While most times I’d HATE it when I’m wrong, this Christmas, however, shooting way off target gave me immense joy and great relief. And how!

I thought going on duty during Christmas Eve was going to be sheer hell. While it still sucked, the timely apparition of my parents- and bearing food for us imprisoned slaves to boot!- did wonders in lifting my dreary holiday spirit. Just when I thought I’ve “outgrown” my need for parental warmth and affection, I received a megadose of TLC that almost wrung tears from eyes. The thirty minutes or so I spent with them that Christmas Eve was probably the most heartening half-hour we’ve had the past year.

And the food- aah yes- the food. My mom’s cooking was the stuff that made our Christmases at home complete. It was one of the major things I expected to be irreplaceable this Christmas. Nonetheless, our team on duty put together a meager dinner table so that we’ll all be as close to home as possible.

Our “meager” banquet- filled with potluck goodies brought with the idea that they should be enough to feed 30 or so people in mind- ended up as a feast that could have rivaled a Presidential State Dinner. Nope, the caviar and foie gras were ostensibly absent but in their stead, we had four different varieties of noodle dishes; delights from home like caldereta and deep-fried chicken; heaps of artery-clogging and corner-of-our-mouths-smearing pork barbecue; and most importantly- varied desserts ranging from ensaymadas, to puto, to chocolate cakes, and of course, the quintessential leche flan.

We had chow enough for us to come back for a second, third, even fourth round of Noche Buena feasting. We were only hampered by two things: One, that we were STILL on duty; thus we did carry on with our work in between trips to the buffet table. And second, we inevitably consumed all disposable spoons, forks, and plates. Then again, what are these hands for?! The feeding frenzy carried on into the wee hours of the morning.

One key factor that allowed us to observe the traditions of the typical Filipino Christmas Eve (read: stuff ourselves silly) was the relative dearth of patients who sought consult at the ER. There was approximately a 50% decline in the number of women who came to the hospital. We were expecting a deluge of women seeking to get the highly economical gift of co-celebrating their kid’s birthday with that of Jesus. God heeded our prayers: He delayed their labor pains for a few hours, enough for us to celebrate His Son’s coming the best way we could. And as for the babies He did give the honor of being born on the day His Son was said to have joined our party on earth- He gave their moms quick deliveries with just minor hitches here and there. For our entire duty, we didn’t list any morbidity or mortality.

As Ara Mina put it succinctly- you can never can tell. With all the good food, great friends, superb family, and safely delivered babies, I probably- unwittingly- had one of my most memorable Christmases ever.

Just 362 days til Christmas 2005.

I can’t wait.

Midnight in the garden of good and evil

Even before I finished training in medical school, I have already felt a calling to work in the world outside the hospital. The promise of attaining better and sustainable health outcomes faster by engaging populations rather than individual patients led me to the world of community development and public health. The overpowering atmosphere filled with sickness and gloom, hospital politics, and stifling routine hastened my footsteps away from hospital work.

But as I've began to spend more time in the university hospital again over the last few days, there's this unshakable nostalgia of my previous hospital-based life: the flurry of activity in the emergency room; the stress of rounds and reports; the need to devour books and journals; the camaraderie among overworked and underpaid fellow health professionals; the adrenalin rush of a toxic duty in the ward; the extremely sound sleep after a toxic duty. What I miss most is the almost unbridled interaction with individual patients, as they and their families put their lives in my hands and they take on the unwitting role of my mentor and teacher.

One of them I will never, ever forget.

He wasn’t the nicest of sights to behold. With his not-thoroughly-bathed elderly scrawny body, yellow to the hilt due to his liver disease, I opted to ignore him during my rounds with patients. He seemed stable and comfortable enough; my presence was warranted elsewhere. And so I went to the beds of the more “toxic-looking” patients who were endorsed to the team for closer monitoring. I thought I can avoid him- until his shaky voice pierced the already rickety peace prevailing in the ward-

Dok, hindi ako makahinga.

I rushed to his bed to check what was wrong. Gasping for air, he looked at me with eyes wide open; it was a plea for help more than an FYI. I calmly reassured him that everything will be okay if he only relaxed. Right. I then whipped out my stethoscope and listened to his chest for any problems with his lungs. His lungs seemed okay so I checked next his oxygen support. There were no kinks on the tube delivering the oxygen to this patient; the oxygen tank was delivering a steady flow of five liters of oxygen per minute. And yet he hollered as if on the verge of death-

Dok, hindi ako makahinga.

And then it got worse. His wife began to cry. I thought it was out of fear that her husband was dying. But no- she was crying out of sheer anger and frustration at having been left to care for her husband all by herself. She lashed out at her sisters-in-law for leaving her to care for her husband, their brother. It was a real circus: the wife seemed more distraught than the patient who managed to bawl out-

Dok, hindi ako makahinga.

Other patients were beginning to stir from their precious sleep; I was worried that those patients much sicker than this wailing couple will turn for the worse because of this undue stress. After I reassured them that everything was okay and that they just needed to breathe deep and easy, I started to walk away from the bed so I can check on the other patients. But then the patient proved his scrawny hands were not as feeble as I thought they were: he grabbed my arm and wouldn’t let go. I eventually peeled his hand off of me, while gently explaining to him that I had to go see all other patients in the ward because the entire ward is under my care. I reassured him that he was ok, that he just needed sleep, that his hollering was an unnecessary expenditure of energy. I adjusted his bed, I checked his oxygen support again, and I instructed his wife to immediately call my or the nurses’ attention should anything go wrong. I was not more than two feet away from the patient when his all-too familiar voice rang loud and true-

Dok, hindi ako makahinga.

Throughout the night we did this sequence around six times. He hollers. I go to him. I reassure him, check his lungs, his tubes, reassure him, ask the nurses to adjust his bed or his O2 support, instruct his wife to inform the nurse or me about any trouble, reassure them that they’re ok. I believe that I handled his “outbursts” pretty well; I managed to bury my exasperation underneath my genuine concern for his well-being.

However, I am human, I err.

After checking him for the sixth time that night (only to find yet again that nothing is wrong with him), I was ready to resume my rounds when he let out that awful, almost deathly moan of

Dok!

I snapped. I lost it. I shouted back-

ANO?

Salamat po, was his quiet reply.

Si Dok naman ang biglang di makahinga.

Originally posted in my old blog, October 13, 2003, while doing my clinical clerkship in the UP-PGH Department of Medicine.

UP-PGH Post-Graduate Training Oct 11-13, 2007

We're inviting you to the UP-PGH Department of Family and Community Medicine's 22nd Annual Postgraduate Course entitled: "EXTENDING PRACTICE BOUNDARIES: FROM FAMILIES TO COMMUNITIES" to be held at Dining Hall Function Room of the Philippine General Hospital, Taft Avenue, Manila from October 11 to 13, 2007.

Topics include:
Stroke Spectrum: Prevention to Rehabilitation, Nutraceuticals: Evidence-based or not?, Diabesity, Education and Counseling for Improving Compliance, Rashes in Children, Notifiable and Newly-emerging Diseases, TB in Adults and Kids, Establishing Public-Private Mixed DOTS, Clinic Practice Management, Setting Up Hospice in the Community, BIR Special Issues, Handling Addictions and Co-dependence, Handling Cases of Violence against Women

Postgraduate Course Fees :
Pre - registration (UNTIL October 8, 2007)
Government MD - P 800.00 / Private MD -P 1,200.00

On Site Registration (AFTER October 8, 2007)
Government MD - P1,000.00 / Private MD - P1,500.00

CME units: PAFP: 30 units (Category I); PMA 100 units


FOR REGISTRATION OR INQUIRIES PLEASE CONTACT THE DFCM OFFICE:
TEL # : 521-84-50 loc 5303 / 5302 or 523-2358

The learning cub

It’s been a year since I began teaching- last July 4th to be exact.

But it was only on this first week of June 2007 that I received my appointment as temporary full-time faculty member of the university. Despite the delay- no thanks to the election ban and my own sluggishness in processing my papers- I am immensely grateful to finally *belong*.

Over the last year, I have given lectures, facilitated small group discussions and health education activities, toured barangays, saw patients, checked papers, heard the rants, basked in the applause, emailed and texted, coaxed into dealing free meals- to, with, for, by, and of students- ranging from one at a time to as massive as 160 at a time (plenary discussions and not dinners, mind you).

I have agonized in front of the computer as I prepared lectures. I have sweated buckets when key presentations wouldn’t display the intended animations or students miss getting a ride on the same LRT train as I en route to places unfamiliar. I have played willing driver, peacemaker, photographer, explainer, jeepney fare collector, jester, career counselor.

I loved- love- every second of it.

My professors then are my colleagues now, not just as fellow medical professionals, but as fellow teachers. From seeing them in smaller 20-strong academic committee meetings, to the hundreds who attend the College Council meetings, to the crème de la crème who participate in the University Council.

So this is what it feels like to sit at the other side of the teacher’s table.

My classmates and friends from batches of medical students a year or two before or after me still call me by my first name. I am and always will be Ian. I’m still a bit distracted when people call me Doc; you can just imagine my happy consternation when students greet me as Sir, whether in Robinson’s Manila or just around the campus or hospital.

Surreal.

While it *feels* great to be looked up to as a teacher, to say that is *hard work* is an understatement. I have to admit that the first few classes I had, I sort of just winged them. No sweat, I thought. But student can and will hang on to every word you say and do; once uttered and/or demonstrated, they will be elevated to the level of almost-gospel truth. But the trickier one is Getting Caught With Your Pants Down, when students *actually* know what you’re talking about AND find out some inconsistencies in your statements versus standard medical knowledge. Or worse- common sense.

A couple of Fridays ago we had our orientation for new faculty members. They dished out the usual HR stuff about leaves (where I learned there is a mandated 7-day paternity leave and the Solo Parents Act of 2000 where maternity leave benefit can be granted to an unmarried solo parent) to GSIS details to special seasonal bonuses and allowances. I was still surprised (though I shouldn’t be) when one of the resource speakers from the faculty intimated that an Associate Professor VI in UP gets a take home pay of about P24,000 while an Associate Professor VI in UST gets a whopping P86,000. So just imagine what my take home pay is as Assistant Professor IV, which is eight ranks lower than Associate Professor VI…

Life.

I thought I’d be disheartened- I should be disheartened- upon knowing how little pay I will get. After all, this- teaching- isn’t a mere hobby I got into out of sheer boredom.

I am not backing out though.

Appending the letters U.P. with my name will open doors, throw them w-i-d-e o-p-e-n. They already have- to entrance ways leading to Jakarta and in three weeks’ time to Helsinki.

The job may not be paying much but I am working day in and day out with arguably the most brilliant minds in the country, today’s health policy makers and powerbrokers and tomorrow’s leaders and industry influentials. God-willing, we'll all be part of the collective answer to what ails our country.

It’s not a perfect world, teaching. There would be problematic students, problematic topics to discuss, problematic circumstances. It’s like any other workplace, any government workplace as a matter of fact. There are budgetary issues, office politics, challenging fellow civil servants, systems to question, policies to comply with whether we like it or else. Name an organization free of such hassles and I’d say you must’ve died and gone to heaven already.

I know of some people who continue to remain adrift and wandering, or hold on to a rock ledge deemed stable but is consistently being pummeled silly into a state of unhappiness. On a more personal level, I feel that I’ve discovered my niche, the milieu where I can best thrive, considering all my strengths and idiosyncrasies.

I am blessed. And grateful.

Very grateful- to God, the One True Source of Knowledge and Healing; to my parents and siblings, my most ardent fans, pillars of strength, welcome critics; to my teachers, erstwhile mentors and now- friends; to my students, partners in learning, feigning interest when there is none, yet unstoppably loquacious when sufficiently warmed up; to my friends who understand when I unceremoniously call off or walk away from carousing and singing because of papers to check or lectures to prepare for the next day; to my Lingkod community brothers and sisters who continue to storm heaven with me, knowing fully the ordeals of a teacher; and this blog and its readers- for keeping me sane and grounded.

You are all both inspired and inspiring.

Again, I am blessed and grateful, and filled with much hope.

Kontonjensi: Jakarta (1)

We just ended Day 2 of our 7-day course on disaster management held at the Fakultas Kedokteran Universitas Indonesia (FKUI); I know I need not translate. Main proponents of the course aside from FKUI are the Spanish International Aid Agency, the University of Oviedo – Unit for Research on Emergencies and Disasters, the Office of the Surgeon General – Indonesia and various other Indonesian and Spanish government and non-government agencies. Twenty-five participants from Indonesia, Malaysia, the Philippines, Sri Lanka and Vietnam involved in the different aspects of disaster management and emergency preparedness in our respective countries. The main facilitator is Dr. Bastaman Basuki of the Department of Community Medicine, FKUI

The Philippine contingent is composed of myself representing the UP and a non-government organization Gawad Kalusugan; Dr. Rex Prudente and Dr Rolly Rivera from the V. Luna Medical Center and Office of the Surgeon General, respectively; Dr. Chito Mendoza, Provincial Health Officer of Albay and one of his staff in the PHO, Ms. Elvie Alejo, RN; Dr. Joey Abary from the Bureau of Fire Protection; Dr. Sally Espeleta from the Department of Health – National Capital Region; and Dr. Des Jimenez, Chief Resident of the Department of Emergency Medicine, UP-PGH.

In the photo above at the lobby of the Sari Pan Pacific Jakarta Hotel where we’re staying:
Dr. Rex, Dr. Sally, Dr. Rolly, Dr. Chito, Dr. Des, Maam Elvie, and Dr. Joey.

There are four Spanish resource persons and about a dozen Indonesian experts whose depth and breadth of experience come from stints in Sarajevo to Sumatra to Southern Leyte, dealing with earthquakes, wars, and yes, tsunamis. What we’ve covered so far are general trends and patterns in disaster management statistics (deaths and injuries according to disaster types), the learnings of Spain from its current emergency medical system, and the learnings of Indonesia from the 2 Bali bombings, the last Yogyakarta earthquake, the 2007 Jakarta floods, and the 2004 tsunami which hit Aceh. There were special segments detailing the role of the Indonesian military in the delivery of much needed assistance during the critical period following the disasters, including its presence in Guinsaugon, Southern Leyte.

In the photos below: Dr Arcos delivering his lecture; with participants from Malaysia, Indonesia, the Philippines, and Vietnam.

I asked Dr. Pedro Arcos of the University of Oviedo – Unit for Research on Emergencies and Disasters, one of the resource persons from Spain, how extensive their disaster management course was in their medical school. He said that disaster management occupied one week in their six-year curriculum for poly-health professionals. I told him that disaster management as a separate lecture was an innovation in the UP College of Medicine and I was lamenting the fact that we only had 2 hours for the topic, versus his one week. To which he responded that it took twenty years for them to include disaster management in their curriculum. I am both grateful and optimistic: In my capacity as a teacher, it is heartening to note that what we’re imparting in the university to third year medical students in the form of a two-hour lecture over the last academic year is a rather nice distillation of what we’ve taken up since Monday.

My interactions with my fellow Filipino delegates are a source of immense joy as well. From where they are coming from, I am learning much about the disaster management situation in our country, outside of the official National Disaster Coordinating Council annual reports online. One cannot help but feel something warm and fuzzy as they detail their extended hours doing orthopedic surgeries for war vicitims, wading in waist-high waters in Legazpi City, tours of duty with firefighters sans decent pay, the continuous efforts to update tertiary hospital care in the Philippines in anticipation of imminent disasters in our country since we are embroiled in unending socio-political strife; we are blessed with 22 active volcanoes; we are residing over restless tectonic plates; and we are the doormat of typhoons entering Asia from the Pacific and leaving Asia from the South China Sea.

Hopefully, I’ll get more ideas on how to establish a community-based disaster management program for urban and rural poor communities, the most vulnerable and at risk when calamities strike. As of late, the facilitators have focused on the macro level of governance and action with rather little time allotted for community empowerment strategies. Hopefully, as well, Cooperacion Espanola will choose the Philippines as a pilot site for a multi-center disaster management program they are setting up in Asia. Fingers, legs, and eyes crossed!

--==+==--

If ever I would experience The Twilight Zone, it would be now, in Jakarta.

It’s Manila’s twin city, replete with hordes of motorcycles, Starbucks branches, shanties propped against the walls of gated communities, enterprising sidewalk vendors, San Miguel and Chippy in the supermarket and very Filipino-looking fellow human beings. As an exclamation point to this observation, the bus which was transporting us from the seminar venue to our hotel suddenly stopped because a public utility vehicle made a sudden U-turn and narrowly missed hitting us (or being hit by us!). I thought to myself- Wow, Indonesians do know how to make one feel welcome, even simulating the prayer-inducing driving techniques of Pinoys…

Off to Jakarta

Rushing, rushing to finish everything in my proverbial work inbox before I leave for a seminar-training in Jakarta and Yogyakarta June 3-12.

More details next time!

I *excite* =]

Unit 3, Anglo Bldg.

Attending the graduation of UP Medicine Class 2007 unlocked the floodgates to related memories.

I wrote this entry in my old blog some days after we moved out of our med school apartment. It was a task that I wouldn't wish my worst enemy to undertake. Moving out of that apartment was a Herculean undertaking that only my parents had patience for; if they were close to disowning me then, they didn't let it show. Too bad my old computer crashed and I lost all photos that I ever took of and in the apartment, save for this photo of my desk which says quite a lot about the state of my third of the room...

This one's for Johann and Vergel as well, the best roomies a sloppy packrat could ever wish for.

May 1, 2005

Dear Unit 3,

So. Paano ba yan. End of contract na. This is it. Lipat-bahay. Iwan ka na namin. Apat na taon mo rin kaming inampon. Mami-miss kita. Ikaw at-

Ang mga kalendaryo na taun-taon e kung saan-saan namin nakukuha: 2001- Allied Bank; 2002 & 2003- Mercury Drug; 2004- Chamber of Mines of the Philippines, at; 2005- San Juan Food Products, Inc (makers of Joy Hotdogs, Ham, Bacon, and Specialties);

Ang ref na walang naging laman kundi tubig, ice cream, beer, Coke Light, Pepsi Blue, at samu’t saring mga pagkain na may sarili nang buhay, pamilya, at kolonya sa malalamig na suluk-sulok sa hinaba ng pagkakalagak sa kanila dito. Andiyan din pala yung mga nakadikit sa pinto ng ref na bills ng tubig at kuryente na laging disconnection notice na ang itsura bago may pumansin sa amin;

Ang wood parquet na unti-unti nang parang nalalagas na ngipin ng lolong ulyanin. Salamat at naaaliw kami sa paghahanap na animo’y puzzle kung san kagrupo yung napahiwalay na tuklap na kahoy sa sahig. Pero di biro yung semi-matalisod dahil sa baku-bakong sahig;

Tanging litrato sa apartment, matatagpuan sa pinto ng banyo, litrato ng anim na nakatalikod na toddlers, ipinagmamalaki ang kanilang puwet. Pedophilia ba ito? Wala lang. Regalong pambahay ng isang kaibigan namin. Sweet… kanino kya sya mapupunta?

Humigit-kumulang dalawang dosenang pares ng sapatos na bumubulaga sa bawat bisita namin dahil nakasalansan sila sa may pintuan. Klosetang Imelda Marcos kaming housemates;

Ang wall clock ko na frozen sa oras na 4:40. Inabot ng buwisit at katamaran kya di na napaayos;

Ang TV na matanda pa yata kay Alexander Graham Bell pero panalo pa rin. Salamat dahil stuck sa Channel 9 ang iyong channel changer- na-memorize ko na ang mga shows ng Prime Shift. Minsan may sumpong- maski Channel 5 nakukuha. Nakatambay pa ko kahit papaano with Friends at naging The Apprentice pa;

Ang “Rich Dad, Poor Dad,” “Lives of Saints,” at iba pang mga libro’t babasahin sa banyo. Pag talagang nagagahol sa oras at exam season, may pakalat-kalat pang dermatograph, stabilo, at Faber-Castel na highlighter sa sink. Talk about multi-tasking;

Ang sofa na nagka-identity crisis dahil ni minsan yata e hindi sya naupuan. Sa dami ng tambak na nakasampa sa kanya, inakala nyang cabinet sya. Ano na nga bang kulay ng sofa na yun?

Ang banyo na nagsilbing takbuhan sa oras ng pangangailangan- stress diarrhea, semi-food-poisoning, sobrang inom, pakikiligo ‘pag walang tubig sa mga dorm- ng hindi iilang katauhan, hindi lamang ang mga tenant ng apartment namin; at

Ang iba’t ibang mga kalat, kalat na libro pala, libro at mga pira-pirasong papeles, papeles na may mga random notes lang na ipinapasa-pasa pag may boring na lecture, notes na nakakabit sa mga regalo, mga regalong di nabuksan, regalong nabuksan pero nalimutan at nabalumbon sa ilalim ng kama, kama na hindi na nahihigan dahil sa dami ng kalat, kalat na libro pala, libro at mga pira-pirasong papeles…

Gaya ng sinasabi sa mga historical places- if those wall could talk… Mami-miss ko ang mga gripe session, sermon session, magkuwentuhan-tayo-til-madaling-araw-kesa-mag-aral-dahil-wala-nang-pumapasok-sa-ulo-ko session, mag-inuman-tayo-til-madaling-araw-kesa-mag-aral-para-wala-nang-pumasok-sa-ulo-ko session, mga pop quiz ng roommate ko, mga true confessions session, post-Sadako takutan session, mga pat on the back session, mga pray with each other session…

Home daw is where the heart is. Where your hat lands on. Sa ‘kin- home is-

Where you toss your tons of books on after a looooong day.

Where you sleep in after a 36-plus-hours duty.

Where you gobble up boxes of Yellow Cab goodies.

Where you study til you puke.

Where you try to study but puke instead because of all the booze (rather than knowledge) you’ve so earnestly tried to wade into.

Where friendships are forged, secrets shared and held sacred, fears assuaged, confidence boosted, defiance squashed, dreams fulfilled.

Bunutin na ang lahat ng naka-plug. I-check lahat ng mga gripo. Patayin ang main switch ng kuryente. For the last time- ilock ang pinto. Hataking maigi. Make sure naka-double-lock. Yung susi- kailangan na palang isurrender sa building administrator.

Good night and thank you, Unit 3.

Lovelots,

PS: May the new tenants treat you better than we did. I know- the once-a-year cleaning was really unfair. You deserve a bi-annual event.

And they're off...

I had the distinct honor and pleasure of attending the 98th Commencement Exercises and Internship Closing Ceremonies of the UP-PGH for Academic Year 2006-2007 last night at the Meralco Theater. I previously thought of skipping the event but then I got a gentle reminder from our department’s secretary so attend I did.

It was a mad kaleidoscope of emotions and memories for me, even if I was not the one graduating.

- It was my first time to attend as a teacher in the college. The moment we were asked to lineup per department and our entrance to the theater was announced- The Members of The Faculty of the UP College of Medicine- it was one of The Most Surreal Moments in my young professional life. It was one big WHOOAA.

- But before that, light dinner/ cocktails were served at the lobby area. I was sharing a table with my Pharmacology and Pathology professors plus ENT, Plastic Surgery, and Community Medicine stalwarts. They were very cordial, very nice people (underneath the veneer of strictness and seemingly unchangeable straight-laced demeanor!). I was hobnobbing with my teachers, my colleagues, AND fellow faculty members. Surreal. (Above with members of our department, from the right: Dr. Delen Dela Paz, Dr. Nina Dizon, and Prof. Linda Coniconde. Thanks to our photographer, Dr. Portia Marcelo!)

- On an uber-personal level, I also discovered I sort of enjoy dressing up for events. After all, it’s not everyday one can wear a barong and the U.P. sablay (academic sash). Don't these university bigwigs look regal and visually eloquent? (From the left- Dr Abad, Special Assistant to the Dean; Dr Balgos, Assoc Dean for Planning and Development; Dr Wang, Assoc Dean for Faculty and Students; Dr Valbuena, Assoc Dean for Acad Development; Dr Alfiler, PGH Director; Dr Roxas, Dean; Dr Arcadio, UP Manila Chancellor, and; Dr Ernesto Domingo, former UP Manila Chancellor, one of just 12 University Professors, Professor Emeritus of the Department of Medicine, Commencement Speaker.)

- I tried my best to sit still and soak the sights and sounds of the ceremonies; after all, it was one of the rare humongous events that I am made to attend without me having to rush back and forth, working behind the scenes.

- I tried my best to sit still and soak the sights and sounds of the ceremonies- but I couldn’t quit comparing Class 2007’s graduation with our. Or rather, recall my own graduation… I can still remember Johann and I still garbed in our janitor attire while most of our classmates and their families were already at the UP Theater lobby dressed to the nines since it was already- what- 1.30pm (and we were still overseeing the physical arrangements in the theater!). But that evening, two years to the day come May 22nd, and the ceremonies I attended last night, they were really for our parents who, more than ourselves, deserve the congratulations and recognition for having held us aloft through med school.

- As I watched UP Med Class 2007, it was impossible not to think of my classmates, who not too long ago sat with me in those rows, donning those academics gowns, embraced by that cumbersome hood and uncooperative cap-and-tassel complex. Some are in the US already, some have still not gotten enough of the PGH and have stayed on, some have families, some have taken on totally different career paths. I miss them all terribly…

- It was a joy to see friends two years my junior becoming full-fledged colleagues. Those seemingly lost third year students during our internship year now have that palpable air of confidence about them. From memories of presenting a number for the Ob-Gyne Christmas party (below) to assisting them as they do their first IV insertions at the ER- it was an absolute joy to see them complete their own medical school undergrad journey.

- Nothing compares to saying out loud the Oath of Hippocrates for the first time. I remember that sense of awe when we recited it during our own graduation ceremonies two years ago. What made it more special was when all other doctors in the theater were asked to re-commit themselves to the physicians' oath, when the emcee said- Physicians, all please rise- and dozens of colleagues stood with us. It felt as if we were really being ushered into a select society of servants. Last night, I was part of that crowd who stood with the graduating class as they said the Oath for arguably the first time. Re-dedicating myself to the life of a physician using the words of the Hipprocratic Oath, t was a very timely reminder for me why I am doing all the "doctor-ly" and "not-so-doctor-ly" things I do in the course of my UP and GK work.

- I come home with one thing ringing in my head. It’s what the class valedictorian said in her speech- that no one is too young, too unaccomplished, too inexperienced to make a difference in our country and in people’s lives. Amen to that.

Congratulations, Class 2007! Let us not fail the people who eagerly await your leap out of the safety of your med school nest. Pluck them out of the muck, take them on your wings and let them soar with you.

Many marry in the merry month of May

As the emcee in Tin and Vince’s wedding reception put it- it is a celebration of the years that passed and the years that are to come. The same goes for Jo and Mund’s.

For the tender ceremonies; for the timely reunion with friends; for the warm reception, the great food, and the delightful music; for the genuine glimmer of joy when you guys saw us; for sparking the impromptu introspection among many a single person and yet-to-be-engaged couples; and for making me still hope in finding The One -

thank you for sharing with us your amazing evening.

Salvador – Sison Nuptials
Holy Mass at the Sanctuario De San Antonio 2.30pm
Cocktails and Reception at the Manila Polo Club

Jo and Mund at the altar

Chang and Johann dispensing with their cord duties

Grand send off to the reception

With some rarely seen med school classmates- Edhel, Jim, Gracie, and Hugs

Enjoy cocktails at the Manila Polo Club with Marvin, Eileen, Toyang, Pepper, Chang, JP, and Les

Gloria – Cunanan Nuptials
Holy Mass at the Sanctuario De San Antonio 7pm
Cocktails and Reception at the Mandarin Oriental Makati

An unmistakable beautiful blur in the crowd

Tin and Vince at the altar

Dapper First Reading reader (thanks for taking my photo, Capits!)

Lighting their Unity Candle

Preparing for the first kiss

Welcomed by guests at the reception

With UP-PGH Internship blockmates- Lester, Kate, Julie and Lizza

Our next-table neighbor: Tin and Vince’s!

With the very lovely couple

Reunion of the Waterboy with some members of the class basketball team

Be still my heart: My Two Favorite Girls – Pam and Tin

--==+==--

To Dr. Mund Sison and Dr. Jo Salvador-Sison and Dr. Vince Cunanan and Dr. Tin Gloria-Cunanan – bon voyage et bon appetit! Godspeed!

(Major, major, major thanks to Tina DLC for letting me use her SD card! Life-saver!)