



We were just gearing up for the society's 26th Annual Convention when the good news came. It's even quite unexpected because it's been months since I applied for membership, and I'm so happy that I was accepted. It truly is the fruit of that long and hard labor I did with my staff at the 10th midyear.
I, my fellow clinical trial doctor Jam and former CECAP Project Manager Paul were the three inductees for affiliate membership. There were three other fresh medical oncology specialists who were inducted as fellows. It was great to see all members of the board and the PSO Officers line up to congratulate us. It felt good to belong.
The keynote speaker for the annual convention was Mr Tony Meloto, Chair of Gawad Kalinga. He did a very well said speech on the talent, wisdom and greatness of Filipinos. It was inspiring to hear him talk about how much more we could be greater than what we are now, if only we'd fight really hard against corruption and crab mentality. As such, the PSO is planning a huge project with GK, and already I am looking forward to being part of this project. Beyond building houses and painting fences, I am envisioning a bit of pap smear-ing here and there, and some hard core clinical work, too.
This is quite a feat for general practitioners like me. But to quote Mr Tony Meloto, "Despite what’s happening around us, you can look forward to better times ahead if you do justice to your talent and you use it well to build a just and caring society." When your goal is to be of service of others without taint of malice or self-gain, I believe everyone is entitled to a certain niche where this goal may be worked on and channeled to be of real value.
Super thanks to my bosses, Dr Cecilia Llave and Dr Jean Anne Toral for the support and guidance, my hardworking staff, and of course Noy, without whom I won't believe in myself the way I do now.
Cheers!

Two years ago this week, I spent the second half of 72-hour shift resuscitating newborns. One, a premature baby boy, had been intubated for a day after developing pneumonia. He kept me awake for most of my shift due to decreasing oxygen saturation every two hours or so, but he was a fighter. A little tap on the foot to make him cry usually did the trick, but at 9 am the following day he didn't even grimace. He kept his eyes closed and maintained bluish-gray skin despite all our efforts to make him go pink again. The parents themselves told us to stop; they've finally realized it was time to let go. It was a pain to even look at the clock to document the time of the baby's death.
After a few tears, I got back to seeing other patients. In the afternoon, a pregnant lady was rushed to the ED complaining that her baby was moving a lot less since that morning. We did a stat C-section, and out came a lifeless baby with a familiar facies - that of one with Down's Syndrome. This baby girl never let out a cry; she was plump and weighed appropriately for her age, but she was practically lifeless. Since she was a niece of a friend, I tried my very best to resuscitate her even when my thumbs hurt very badly from pumping two hearts - hers & of the baby boy who died earlier. After an hour, we stopped our futile efforts. I stared at the clock in disbelief - an hour ago we were recording her time of birth; now we're writing down the time of her death.
photo from Touching Souls
There it was again, the cold feeling on my palms and soles. My sore thumbs went numb and my legs felt like jelly. I was tired and sleepy and hungry - I do not another emotion or status, least of all sad or devastated or frustrated.
I sat slumped at the OR floor and cried. Really hard.

I used to criticize "office" people - those who worked the "normal hours" of 8 am to 5 pm, with an hour-long break. Such a short time compared to doctors who worked 24, 36 or 72 hours with unpredictable breaks and sleep. Some have none. While the office people strutted in their air-conditioned posh cubicles in designer clothes and shoes, we, the doctors could not even take a shower or lunch in peace because there will always be calls in between patients. The sad part is that we get equal pay as the office people, sometimes lower if the patient could not afford to pay cash.
Now that I've shifted gears to research, I'm required to work during the "normal" office hours. For the past two years that I have been doing so, I realized that the number of hours doesn't really matter sometimes. It's quite tiring to wake up at exactly the same time everyday and develop a certain routine.
Sometimes I miss just working my ass 72 hours straight and sleep the entire day the following day. I hate worrying about what to wear to the office and I miss my comfortable scrub suits and sneakers.
The boredom is pretty stressful, too. Before it was various sorts of ailments - from malingering to dengue fever, from breech deliveries to gunshot wounds, from diazepam overdose to fatal cerebrovascular bleeds - now it's just the computer and pap smears. I miss the adrenaline rush of the emergency room and the thrill of the operating theater.
I'm not complaining. I'm just reminiscing. And harboring new found respect for the people who did an 8 to 5 all their lives.
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.

I am saddened by the fact that an organized group whose primary goal is cancer prevention in the Philippines is losing support from its sponsors. It employees will leave in two weeks in search of more stable jobs.
I do not have the right to explore the un-explorable, but experience tells me the problems stems from bad management and improper use of funds. By improper I mean any reader is free to use every possible meaning and implication of the word.
Okay, this blog post is starting to feel like a blind item from a Sunday broadsheet. I wish I'd write something less sad and more substantial next time.

Well. Im kinda having THAT life right now, thanks to my clinical trial stint, the second year of which Im celebrating today. It's a happy one of course, because it means I get a salary increase. At least now I've equalled my moonlighting earnings without burning a lot of sweat.
My current life isn't exactly ideal - my husband is away two nights a week, and when he's around, I'd be too sad cooking alone at home so I'd rather hang around at the gym while he works out. Why I'm not joining him is another story. But yes, I do wake up in a comfortable bed. I do make delicious breakfast and get a lot of pleasure watching my husband gobble it up. I do declare "That's it for today." at 5 pm everyday. Well sometimes at 4 pm. Okay, 3 pm is more like it. But I do go home every afternoon. To a nice dinner, homemade or otherwise. More importantly, I sleep after a satisfying routine of cool shower, prayer, novel.
Despite all this, I am addressed as doctor at work. I get to keep my title without the associated insanity.
I honestly miss the hospital, but I'd rather not say no to this right now. I believe it's for me and I deserve it.

our boss, dr cecilia llave, overall chair of the organizing committee
fun at the fellowship night. good food and setup too.



So when I was told that I had to speak before a group of students about cervical cancer, my stomach churned. Mind you this is not metformin-related. A group of graduating Mass Communication students at St Scholastica’s is eyeing an information-campaign type of thesis, and they are definitely interested in cervical cancer and the need to increase its awareness among students.
If I were their teacher, I’d give them plus points for social impact. Cervical cancer awareness is something really important for all schools to campaign on. So I spent the ENTIRE weekend working on the slides (which I colored purple because purple is CECAP’s color), keeping everything organized based on the outline I made. I decided not to attend Noy’s cousin’s debut party. It’s my first talk, for crying out loud. I even printed two sets of notes – one for me, the other for the slide person, complete with instructions on where to click next because I like using hyperlinks heavily.
The venue was a medium-sized conference room. There were about 70 students – masscom freshies – chatting, texting, staring at the wall and simply uninterested.
I was introduced as being a graduate of UP
Brushing aside the fact that I was discriminated against by virtue of my being a graduate of school of the dukha, I went on with the talk, chirpy voice and all, not minding the fact that half the room wasn’t paying attention. Then I mentioned the word vagina. Mouths opened. The room fell silent. Eyes wandered in search of approval. Poker-faced, I went on. At this day and age, I believe vagina is a technical term that doesn’t deserve shunning up, because certain issues just would not be clear without mentioning it. For this particular talk of mine, vagina is a technical, necessary term.
When pictures of cervixes came out, the momentum was definitely on. I may have bored them with oncogenes and such, but the picture of a cancerous cervix floored them. By the time I was telling them how not to get cervical cancer, everyone was listening intently. Ah, the power of an image!
I got a lot of questions afterwards, mostly clearing up misconceptions, even when no more purple shirts were up for grabs. The thesis people printed and wore lovely purple shirts for the “event” and gave them away to lucky question-askers. They had equally cute purple landyards like this for everyone too.
My nurses – Ate Let and Leidy – whom I dragged to accompany me, got these, too. I told them later we all should have worn purple!
Apparently Ate Let is not a very good photographer, but here I am in my award moment. I honestly didn’t expect something like this, but it felt good, being recognized as someone with “authority ‘on a particular subject. I’m no ob-gyn, but it doesn’t take one to raise cervical cancer awareness among students.
These are the stuff the students gave me –
I love the coffee cup and how it matches with the planner.
The certificate is so purply, I love it.
I have literally sweated it out, and I’m looking forward for more. I want more purple stuff!
For information on cervical cancer in the Philippines, visit the CECAP website.
And if you have even the slightest curiosity of what and where PLM is, just click that part in this blog entry where I mentioned it.


I hate quoting Kris Aquino, but I agree with her hands down, that when you lose someone, you'd kill for 5 days, or 5 minutes, heck even 5 seconds, of time again with that someone. Just to be with that someone. I've never lost someone I love, and that is one of my greatest fears. This movie just reinforces my daily aim to let my husband and family know that I love them in any possible way - a kiss, a hug, tweet, SMS, email - any acceptable way. If I do get to time travel, this I won't mind doing for the first time every time for the rest of my life.