I Should Have Known

One of the most unpleasant experiences I had was having to go to St Luke's Extension Clinic at the time when an opportunity to go to Australia on a business trip last year was pressing. I was not given a visa, and I was immensely disappointed. Most of all, I hated the pulmonologist who saw me so much I'd kill to know her name and her whereabouts.

To quote the follow-up blog to that,

"Finally I was face to face, rather face to face mask, with the pulmonologist. I was able to tell her that I am a doctor and that the same thing happened (chest PA suspicious, lordotic clear) when I was applying for internship at Makati Med, so I was not alarmed when the xray film in question turned out suspicious as well. I stated that I had been in contact with the consul and that all I needed was a clearance from her, that Im willing to do the smear & the culture & all films she wants taken as soon as I come back. I honestly told her that as a doctor I know when I would be needing help and that of course by all means I would want to be treated and cured if I have to. I mean, who doesn't?

Then she blurted away with all the technical boo hoos (she needs old films, i can't say for sure without culture, yada yada yada..) none of which I don't already know, as if she didn't hear anything I said for the past 5 minutes. She asked me what my specialization was, ausculated me and said matter of factly that if I could present previous films, I may do so. And that was it.

I stood outside to wait for the nurse's instructions, dumped yet again. I came in there to talk to a fellow doctor who I hoped would understand the situation, expecting some form of empathy, and maybe a bit of advice, or a peek into how the system works in that place. Yes, I was asking her a favor, but for the love of God it was a well-placed notion. I had no bad intentions. If I were truly sick I would not even express my intention to join. All I wanted was to attend the meeting so I can meet potential connections and hopefully employers. Apparently she chose not to hear it and she would not care.

I got out, feeling worse that I ever had in months, trying to convince myself that it wasn't about consultants looking down on GPs like GPs had no place in the medical world, blaming myself for even considering, wondering why I have been such an understading empathic doctor to my patients while some doctors are not. Not even to their fellow doctors."

Feisty, eh? I really felt bad. I thought it was something personal. It may be. Whatever. Until Noy and I got invited last Friday to a round table discussion on the new standards of TB management. The American Thoracic Society released the New International Standards for TB Care in 2006, which says that:

Standard 2. All patients (adults, adolescents, and children who are capable of producing
sputum) suspected of having pulmonary tuberculosis should have at
least two, and preferably three, sputum specimens obtained for microscopic
examination. When possible, at least one early morning specimen
should be obtained.
Standard 3. For all patients (adults, adolescents, and children) suspected of having
extrapulmonary tuberculosis, appropriate specimens from the suspected
sites of involvement should be obtained for microscopy and, where
facilities and resources are available, for culture and histopathological
examination.
Standard 4. All persons with chest radiographic findings suggestive of tuberculosis
should have sputum specimens submitted for microbiological examination.

I should have known. This came out even before I had the doomed chest xray done. I thought about all the wasted energy hating and bitching about the pulmonologist who was only adhering to the standards and doing her job.

It's a shame I even entertained the issue of being "just" a GP when the sponsor company invited ONLY GPs to this event. This is a clear revelation that even though General Practitioners are not a very popular choice in the urban health scene, they do thrive and they are being given consideration and importance by the pharmaceutical industry.

I may still have regrets over not making it to Perth, but there's really nothing I can do about it except face the fact that if I really wanted to have that visa, I will have to face the ordeal of clearing myself of the TB scare. I just wish they'd be more friendly at St Luke's though.

My IELTS Experience

It's no secret from close friends, workmates and relatives that Noy and I are dreaming of migrating to Australia. I'm pretty sure a lot of people would understand, especially our fellow doctors who are very aware of the economic crunch and have finally shed the final strands of idealistic beliefs from their system.

The reason why I haven't updated for more than three weeks is the fact that I took the language test which is required upon application for a permanent resident visa. About three months ago, our agent (yes, we hired one! seriously.) told me that it was hard to squeeze in applications that do not hold much promise. Hence, I need a really good proof of my proficiency of the English language in order to boost my chances.

The IELTS (International English Language Testing System) exam does not cost cheap. I waited for the elusive thirteenth month pay before I was able to pay for it. I realized I have to get a really good score so as not to retake it.

I started browsing IELTS reviewers in December last year. In February I started practicing under exam conditions as per strong recommendations on the reviewers themselves. Boy, was I surprised. It wasn't easy. In fact, I had the initial urge to just ditch the entire thing up. I had the notion that the worst enemy I'd be facing in the exam would be time. And I was so correct.

It wasn't too difficult to listen at foreign accents because no accent would be too strange at this day and age of the world wide web and cable tv. The operational word is comprehension. Sure, some questions required only direct answers from the audio clip, but when they start to paraphrase what you hear and you see different words on the text, that's when the true test really starts. The audio clip is played only once, so if you panic at one question and linger on it, you won't be able to answer all questions that follow at all. It can be really tricky. They do encourage watching BBC and similar programs because it will help greatly.

I found the reading part quite tricky at first, but with practice, it gets easier and easier. A lot of review materials always tell the examinee not to read each of the three passages in its enterity, but I wouldn't recommend it. Slow skimming (yes, there is such a thing... for me at least) worked best for me. It allowed me to understand each passage quite well, but I still had time to re-read it just in case I had to. Again, time goes by so fast at this part of the test, so proper allocation to each passage is essential. I hated the true/false/not given questions, they weren't enlightening at all. Eventually though I learned how to approach that question type effectively. The key is to take each statement as it is, and NEVER overthink it.

I initially had no fear of the writing part since, duh, Im a blogger. But NO, NO, NO! I was so wrong. The blogging just would not benefit here. IELTS writing seeks a specific pattern and style, even specific words. My biggest problem was that the topics were too general. I hated practicing for the writing part because some of the topics were so not interesting for me. But I had to practice so that's what I did. I'd puke at a sight of a graph - line, bar, pie, etc. but I tried to explain each one as objectively as I could until it became second nature to me.

The speaking part was the most unpredictable of all parts, and I figured no amount of practice would truly prepare me for it. I realized I just had to be myself. My only prayer was for the examiner to be NOT Filipino and NOT gay. I heard of a poor colleague's experience of having a gay Filipino examiner, who obviously was jealous of this colleague's pleasant looks, English proficiency skills and confidence. He gave her a 4.5. I'm not that pretty, but my spoken English is quite competent and I can be maarte when I speak, so that became my greatest fear - crab mentality.

My speaking test was scheduled the day before the written test. I came in early because I wanted to take hold of the review materials at the British Council office. They let you study there free of charge as long as you've paid for the exam fee.

I was called in soon after I had lunch by myself at a nearby Jollibee. I was sitting at a couch, along with other examinees whose schedules are just right on time (as opposed to me being early), decided not to be nervous.

A candidate walks out of a cubicle. A few seconds later, the examiner, short, dark, with styled-up hair, a pert smile, and very Filipino name, obviously male, walks out calling to the assistant. I was figuring out what his social gender was when I vaguely heard my name. Suddenly the examiner and the assistant were both staring at me. "Miss Eleazar, would you like to be interviewed now?" was the next thing I heard while I was still negotiating with the denial state in my head. Denying the fact that a potentially gay Filipino male is about to interview me. Now.

Then, a plush office chair. A mildly resounding voice with a proper British accent. My high-pitched voice I kept so madly in control was surprisingly confident. A warm handshake shakes me off my denial and settles me into reality. Speaking test. Now.
He asked what my job was, so I answered truthfully. I told him him I'm a research doctor, and after a very little pause I told him what I was working with.

Here are little bits and pieces of my speaking test -

Part 1
Examiner: Let's talk about cooking. Who does the cooking at home?
Me: My husband and I both do. It's kind of a 50/50 thing. We sometimes compete with each other at cooking just for fun. (smiles)
Examiner: I see. So let's talk about sounds (sound pronounced long on the ou part). What kind of natural sounds do you like?Me: Oh (aka what the heck is that question?). The rustling of leaves on a windy day... the purring of a cat... I guess just those two.

Part 2
There was a card that asked me to describe a modern building that I find interesting, particularly: how I came to know about it, what's it built for/what's in it, what I liked most about the building and why I find it interesting. I answered the RCBC Tower in Makati, that it was right across Makati Med at the time when I was an intern there (5 years ago), some joke about its breezy architecture (which thankfully I was able to execute descriptively), and the fact that it had a posh food court where I used to have lunch with my co-interns when we were given our monthly stipend.
I learned that whatever the question at this part is, stick with the first thing that comes to your mind. I could have used other more modern buildings but RCBC was the first thing that came to me. ONE MINUTE is a very short time to prepare for a short speech. Speaking of preparing, do write down notes on the paper the examiner will give you. I found it extremely important as a guide to answering all the questions on the card.

Part 3The examiner thought it best to discuss with me, a doctor, urban infrastructure and the effects population explosion has upon it, urban rehabilitation and what I'd do about it if I were given the power to manipulate it in this country. I honestly can't remember what crap I was able to give as answers and how, but I guess he was pretty impressed.
The point is, they won't ask you about things they think you're already familiar with. They expect you to panic a little and be distracted with the impending difficulty. The key is of course not to panic. While they don't expect you to be encyclopedia-like, it's nice to have quite a range of general knowledge. But really, it's your English speaking ability they want to know about. Rattling you with difficult-sounding questions gives them an idea of how good you are at speaking English despite the situation.

With ample practice and lots of prayers, I ended up with this -

I'm extremely happy, because I honestly thought I screwed up at writing. Thank God I got an 8 despite the numerous erasures.
Plus, I'm kissing and hugging my speaking test examiner for being gracious if I ever see him again. I hate myself for not taking note of his VERY unusual name, which sounded old Filipino and had III (the third) as suffix. Geez. I probably deserve the 8.5, but I feel a little guilty for judging him prematurely. Oh well.

So that's IELTS for me. It's something to be proud of, but it really is only the beginning of a tedious journey towards Australian PR-ship. If Noy and I make it through, I promise to share whatever I learn here. =)





I love the LORD, he is filled with compassion. He turned to me on the day that I called. From the snares of the dark, O Lord save my life, give me strength.

Two Years Ago Today

Noy took me out on a date in Sydney.
Three months into that month-long honeymoon cum job-hunting trip and quite fruitless - babyless, jobless - we decided it was time for a breather.

The hour-long train ride was fun, but looking for the Sydney Aquarium wasn't. Noy apparently had the wrong information on which station the aquarium was nearest, so we ended up practically circling the area and going back where we started. Our feet already hurt from walking, and that doesn't usually happen because we're such walk people. We spotted a bar on the same building as the Philippine Airlines office and Noy bought a large cup of strawberry milkshake that was unmistakably full of strawberry goodness. Too bad we didn't take pictures. I guess we were THAT tired.

We finally found the aquarium after getting the right direction from strangers who actually knew where it was. In between we got lost some more, but decided not to get upset and just enjoy the sights.

I think this church is just pretty.

St Patrick's Church had a little unsuspecting cafe in a corner of its yard. I wanted to come inside to take pictures, but I was afraid of running out of cash since we didn't know how much the entrance to the aquarium would cost.

In fact, we brought baon - peanut butter sandwiches, which we ate somewhere near Circular Quay.

This I found out - the birds that shouted "mine! mine!" in Nemo were really makulit! They practically stared at us while we were munching, waiting for little bits to be thrown at them. They looked seriously real in this photo, giving me the creeps.

I got so scared I thought I'd actually hear them say "mine! mine!".

In our desperation we just traced the coastline to Darling Harbour, where Noy was sure the aquarium was located, having been there before, and we stumbled upon these -

a really cute car I wanted to take home, and



a super big luxury liner where a cousin's husband worked (we met with him later that day to go to the opera house together; too bad we weren't allowed to come aboard so we'd know how being inside a luxury liner feels like).

When finally we were at the entrance to the aquarium, we could not help but smile...

(Can't help but notice my hair actually being thicker during my entire stay in Australia.
I love it, I was able to grow it a little longer than usual, plus I never had dandruff.
Nope, not a single flake. One more good reason to strive to finally live there!
Noy's though, got a little unruly since he didn't get a haircut - it was too expensive.)

... and pose with the little red train we didn't know the destination of.

At the time when the Manila Ocean Park was still under construction, it was kind of overwhelming to be in a place such as the Sydney Aquarium. Everything was pleasing to the eye.

However, seeing the Opera House and Harbour Bridge in person was an even more amazing experience. It's great to finally get a grasp of something I only saw on TV and in pictures before.



The Australian Idol finals was held there the night before, and the place was quite a mess, but it was beautiful nonetheless.


For some magical reason, someone (Noy doesn't even remember who) gave us a gift card entitling us to 50 AUD worth of stuff from Starbucks. It was such a yay! moment, which we needed more than ever. So eat and drink we did.

Fraps, muffin and sausage roll on a balmy Sydney evening

It was a happy day, albeit a tiring one. But if tiring would be the key to finally live in that city, I'd definitely tire myself until I drop. Until a kangaroo tells me I can't, I won't stop.