After 2 duties in Boracay, I'm back as a reliever resident in Ospital ng Muntinlupa. Scary. It's been a while since I did in-patient management. Fluids and electrolyte management seems like rigging a carburator to me. So, the first thing I did was borrowing a copy of Pocket Pedia from the post duty resident. Great book! Too bad its not available now.
Anyway, the first 8 hours of my duty was so-so: an IV line here, chart ordering there. Benign stuff. I was also the catcher in the nursery. I resuscitated 3 newborns on that half of my duty. All of them are spontaneously born so I don't need a lot of skills AND anxiety to do that. Not so toxic. Not at all.
But wait! Before I leave the next morning, everything went so fast. I had 3 admissions (all of them need a new Hx and PE) and my PICU patient is crashing while m waiting for 2 pregnant patients to give birth! To top it all, I need to do my endorsements before 9 am.
My 28-weeker PICU patient is the worst ever! He had several episodes of O2 desaturation last night. We transferred him to an O2 mask from an O2 hood to improve his O2 sats. It went up to 98-99 but he is still having chest retractions. His vitals are stable but I was wary of the chest retractions. It was way beyond normal. And I had a bad feeling about it.
And true enough, his sats dropped to 50s the next morning. I have no choice but to intubate the poor baby. In all honesty, I never intubated a preterm baby in my whole life. I was anxious but if I don't do anything, this poor baby will die before my eyes. After a few minutes, I was standing there with the 2.5 ET tube in my hand and the laryngoscope in the other. I took a long breath and inserted it between the glottis I exposed with the laryngoscope. Breath sounds were not equal so I pulled it to level 7. Both lungs expanding, equal breath sounds...whew.
But it doesn'e end there. The baby was still crashing. I gave him two doses of epinephrine and primed the parents that the prognosis is not good. His vitals were stable when I left him but all I can do is hope for the best for that baby. Poor guy.
Sunday, July 31, 2005
Thursday, July 28, 2005
Now, what do i do?
Darn!
So WHO decided to take an in-house researcher. It could've been the perfect break: a 2-month research assistant job, with pay and a letter of recommendation to help me in my residency application. Nothing could be better. It will also translate to a longer stay here in Manila before hitting the winter months in the east coast. Haaay.
Now I have to think and consider the best plan for my career.
Option 1: Go to California. Study Step 3. Apply for a volunteer research job. Take the Step 3 then proceed with the ERAS applications.
Option 2: Study here before hitting California. (I don't think this is a good idea, though.)
Option 3: Moonlight here then go back to the US next year and hope to get a post match position.
Honestly, I don't think the last two are viable option. I better stick to option 1.
Two cents, anyone?
So WHO decided to take an in-house researcher. It could've been the perfect break: a 2-month research assistant job, with pay and a letter of recommendation to help me in my residency application. Nothing could be better. It will also translate to a longer stay here in Manila before hitting the winter months in the east coast. Haaay.
Now I have to think and consider the best plan for my career.
Option 1: Go to California. Study Step 3. Apply for a volunteer research job. Take the Step 3 then proceed with the ERAS applications.
Option 2: Study here before hitting California. (I don't think this is a good idea, though.)
Option 3: Moonlight here then go back to the US next year and hope to get a post match position.
Honestly, I don't think the last two are viable option. I better stick to option 1.
Two cents, anyone?
Tuesday, July 26, 2005
Monday, July 25, 2005
Getting back to the craze
I just got back from a badminton game. A good one, that is. I've been craving for activity since I get back here in Manila. During my 2 weeks in Boracay, I hardly exercise, except for the walking during my calls. Oh, yeah, I took a swim twice in the beach but basically that's it. I need my endorphin rush.
I got hooked (understatement) with this sport after I graduated from medical school. (That was two years ago...I'm not that OLD you know). I was studying for the boards that time and I figured that I need an escape: to ease my stress and to express the aggression boiling inside me. Two years later, I'm now licensed to practice here and in the States and yes, I'm still playing the game.
My ICeT Prince racket is a little worn and the strings remain unchanged. Miracurously. it has still power despite the fact that I never restringed it. I still like the feel of the handles and the weight of it.
My play is a little rusty also since I have lesser time to play with friends. But I do always try to play better everytime...trying hard to give them a good whack on the butt. And I do manage to give them a mean whacking a while ago.
Actually, a friend and I are planning to have tennis lessons today. But we figured that the commotion in Commonwealth Avenue will hinder us from doing anything. I ended up playing badminton the whole day while he hit the gym just a while ago. I guess I'm kissing my tennis lessons goodbye. I'll stick with this. There's a tournament on the end of the month and I would rather practice for that. Maybe I'll take the tennis lessons before I leave for the States.
Gotta go...I have another game in an hour! :-)
I got hooked (understatement) with this sport after I graduated from medical school. (That was two years ago...I'm not that OLD you know). I was studying for the boards that time and I figured that I need an escape: to ease my stress and to express the aggression boiling inside me. Two years later, I'm now licensed to practice here and in the States and yes, I'm still playing the game.
My ICeT Prince racket is a little worn and the strings remain unchanged. Miracurously. it has still power despite the fact that I never restringed it. I still like the feel of the handles and the weight of it.
My play is a little rusty also since I have lesser time to play with friends. But I do always try to play better everytime...trying hard to give them a good whack on the butt. And I do manage to give them a mean whacking a while ago.
Actually, a friend and I are planning to have tennis lessons today. But we figured that the commotion in Commonwealth Avenue will hinder us from doing anything. I ended up playing badminton the whole day while he hit the gym just a while ago. I guess I'm kissing my tennis lessons goodbye. I'll stick with this. There's a tournament on the end of the month and I would rather practice for that. Maybe I'll take the tennis lessons before I leave for the States.
Gotta go...I have another game in an hour! :-)
Thursday, July 21, 2005
Boracay again
Just got home from paradise. It was a great 8-day duty. I enjoyed my cases, I get to meet a lot of new people and I had a better salary than the previous one. The last part means I saw quite a number of cases than my previous duty. I also enjoyed the beach this time because most of the days are sunny. My eyes are locked to the turquoise waters everytime I get a chance to have a glimpse of it from the main road in boracay. I wonder how can I ever leave this place? And the Philippines for that matter?
There are some notable cases I had during my duty that I want to share:
18 year old British girl. She called me up to see her in the resort that she's staying with her boyfriend. It turns out that her tongue was "twisted" and cannot open it so much. She was crying and really anxious about her condition. When I asked her to open her mouth, her jaw was deviated to the left and her big tongue was obstructing the view. My first thought was an infectious cause. No fever. Allergic? No history. Neuro? No other deficits. I just asked her one question: "Did you hear a click when this happened?" Yes. It was a simple temporomandibular joint dislocation. I just reduced it back to its place and the girl thanked me profusely, meanwhile, I, walked out from their room in a cloud of valiant air.
I had several trauma victims. Most of them were drunk and had picked a fight with another person. No spilling of guts, though. Damn.
First time to take out a toenail from an infected ingrown nail: my patient is a native of Neuva Ejica, also visiting boracay for a conference. She came up with a swollen toe. It was almost as big as a tomato. Plump and juicy, also. (Sorry for the munching people out there.) The infection got worse because she went to dive before the day she made the consult. She was pretty much grossed out to see her nailless nailbed but happy to get all the pus out. She promised to teach me how to dive. Although I did a digital block. I bet it hurt like hell.
Dig this. I had a patient who works for Albert Einstein in Jacobi! Waaay too cool. He promised to take me around the hyperbaric facility which he operates. He's a very interesting guy, actually. He has businesses in Boracay and Cebu but he goes back to the US every other month. He lives in Westchester and he would love to entertain me whenever I visit. He told me that he will tell the people of AE how I took care of him. Swell.
I had a malingerer chest pain patient who got to my nerves. And another one who had an abortion. She was even smiling when I went to her house. Grrr. I charged them twice...no, thrice my actual PF. Serves them right.
During my stay I read a couple of books too:
1. Devil in the White City: Murder, Lies in the Fair That Changed America. I think every Chicagoan (?) should read this book. Its about the World Columbian Exposition of 1984. The biggest fair at the end of the century which rivalled the Paris exposition. Many American firsts came from the fair: Aunt Jemima, hamburger, Juicy Fruit, Cracker Jack and the Ferris Wheel. And a nice gory serial killer hunt interspersed between the pages. Very entertaining, well-researched work.
2. Opal Deception. The latest installation of the Artemis Fowl Series. Best of the four Artemis Fowl series. Took me just 6 hours to read it. Hard-to-put-down book.
3. Chronicles of Narnia. Got through the first, second and half of the third book. I'm excited to see the movie!
I was planning to have an intro dive before I leave but I felt guilty spending that much money. It was P2T bucks for a dive. My patient is willing to give me a free lesson in Palawan, so why bother if I can get it for free. I just hope it will push through.
And now m back in my room. Back to my backlog books, to my Step 3 reviewers waiting to be opened and to my dial-up internet connection that I'm trying to upgrade to a DSL connection. I'm trying to figure out where to get the funds for that. Ugh.
There are some notable cases I had during my duty that I want to share:
18 year old British girl. She called me up to see her in the resort that she's staying with her boyfriend. It turns out that her tongue was "twisted" and cannot open it so much. She was crying and really anxious about her condition. When I asked her to open her mouth, her jaw was deviated to the left and her big tongue was obstructing the view. My first thought was an infectious cause. No fever. Allergic? No history. Neuro? No other deficits. I just asked her one question: "Did you hear a click when this happened?" Yes. It was a simple temporomandibular joint dislocation. I just reduced it back to its place and the girl thanked me profusely, meanwhile, I, walked out from their room in a cloud of valiant air.
I had several trauma victims. Most of them were drunk and had picked a fight with another person. No spilling of guts, though. Damn.
First time to take out a toenail from an infected ingrown nail: my patient is a native of Neuva Ejica, also visiting boracay for a conference. She came up with a swollen toe. It was almost as big as a tomato. Plump and juicy, also. (Sorry for the munching people out there.) The infection got worse because she went to dive before the day she made the consult. She was pretty much grossed out to see her nailless nailbed but happy to get all the pus out. She promised to teach me how to dive. Although I did a digital block. I bet it hurt like hell.
Dig this. I had a patient who works for Albert Einstein in Jacobi! Waaay too cool. He promised to take me around the hyperbaric facility which he operates. He's a very interesting guy, actually. He has businesses in Boracay and Cebu but he goes back to the US every other month. He lives in Westchester and he would love to entertain me whenever I visit. He told me that he will tell the people of AE how I took care of him. Swell.
I had a malingerer chest pain patient who got to my nerves. And another one who had an abortion. She was even smiling when I went to her house. Grrr. I charged them twice...no, thrice my actual PF. Serves them right.
During my stay I read a couple of books too:
1. Devil in the White City: Murder, Lies in the Fair That Changed America. I think every Chicagoan (?) should read this book. Its about the World Columbian Exposition of 1984. The biggest fair at the end of the century which rivalled the Paris exposition. Many American firsts came from the fair: Aunt Jemima, hamburger, Juicy Fruit, Cracker Jack and the Ferris Wheel. And a nice gory serial killer hunt interspersed between the pages. Very entertaining, well-researched work.
2. Opal Deception. The latest installation of the Artemis Fowl Series. Best of the four Artemis Fowl series. Took me just 6 hours to read it. Hard-to-put-down book.
3. Chronicles of Narnia. Got through the first, second and half of the third book. I'm excited to see the movie!
I was planning to have an intro dive before I leave but I felt guilty spending that much money. It was P2T bucks for a dive. My patient is willing to give me a free lesson in Palawan, so why bother if I can get it for free. I just hope it will push through.
And now m back in my room. Back to my backlog books, to my Step 3 reviewers waiting to be opened and to my dial-up internet connection that I'm trying to upgrade to a DSL connection. I'm trying to figure out where to get the funds for that. Ugh.
Thursday, June 30, 2005
My boo
I just want to share my love for my baby: my Creative Zen Extra 30GB mp3 player. Yeah, you can call me pathetic or a frigging loser...but what can I do? Nothing deserves a write-up other than my boo.
Knowing that I'll be spending the next 6 months in solitude in New Jersey, I bought my Zen player last year before going to the States. My concern is to bring my 40+ CD collection to the states and thus, preventing looming states of boredom while I am in the snowy suburbs of NJ. I also need to smuggle pirated CDs of KAPLAN reviewer to the states that time so I decided to invest in an mp3 player which can also function as a hard drive.
True enough, my boo served its purpose. I ripped all my choir CDs, all my 17 albums of Broadway musicals, downloaded mp3's and the whole season 1 of queer eye for the straight guy (which I painstakingly downloaded from the internet) into it. And yes! it kept me sane all throughout my stay. Other things made me crazy but that's another story....
I was able to rip CDs I borrowed from friend on it, Spanish language learning CDs and even mp3 copies of KAPLAN lectures. I never got bored during the long subway rides from Manhattan to Queens nor the bus rides from Port Authority to our house in Union, NJ.
Yeah, sometimes I do envy the portability and sleek Starck design of the iPOD but there are a lot of things that iPOD cannot do. One major thing is that it doesn't support file sharing between computers. I get a lot of music files from my friends and I can't overemphasize the NEED to drag my boo from one computer to another to get the music albums that I need.
To top it all, I can take my important documents everywhere I go, including my resume, letters and transcript.
I love my boo.
BONUS TIP: your Bel Ami and Falcon files will never be discovered again. :-)
Food tripping in Angeles City
Its my second week now in Angeles, doing some moonlighting. My friend happens to own this school here in Angeles and we're doing a physical exam on all the students - elementary, high school and college. And it's about 3,000 students all in all. When I checked with the nurse earlier today, I found out, that we haven't PE'd even 25% of the student body!! Gosh. Its not that we've been doing really HARD work to finish all off...but then, after 2 weeks, we haven't gone past the high school students. We're only done with 2 sections of grade school. Ha ha.
But the best thing about this stint is that 1) the pay is good and 2) I get the nights off. That means I can go around Angeles and try all the nice restaurants in town. Unbelievably there are a lot of them here. What's nice about these quaint, homey restaurants is that the owners are foreigners: meaning you get authentic Italian, Creole, Japanese meals all the time. Lets have a run down of the restaurants that we tried:
HANAMI. Great Japanese restaurant off Friendship Boulevard. The sushi is made fresh and tastes different too! It's better than the local Japanese chains like Kitaro and Sushi-Ya. (Tokyo-Tokyo is out of the question.) But mind you, the stuff there is expensive. The ambiance is so-so and when we were there...they were showing a Japanese news program. Quite irritating. P1200 for a sushi platter (for 2), miso soup, tonkatsu and San mig light. Not bad for the experience.
COTTAGE HOUSE. A few meters down from Hanami. They serve authentic Creole and Southern style cooking in here. The ambiance is hole-in-the-wall kind with lots of shadows and cigarette smoke. Looks like a place where you deal with the mafia or have dinner with an awful date. Food is superb, though. The baby back ribs are mouth watering. I even dreamt about it when we were in Manila. P870 for a baby back ribs meal (which includes beans and mashed potato), buffalo wings and 2 san mig light. Cheap for a good meal.
ALING LUCING. If I dream about Cottage House, I'm getting an orgasm when I think about Aling Lucing's sisig. Not with Aling Lucing. It's just near the train tracks and they serve heavenly, cholesterol-laden, mushy sisig. Their burong kanin is good also. I must if you visit Angeles. Ultra cheap too. P456 for 2 sisigs, 2 pwet ng manok, burong kanin and 2 san mig lights. Yum!
BAMBINO'S. We just spotted this Italian restaurant when we came home one day (after eating I guess from Hana-mi or Cottage House) Looks tattered, though, but to our amazement and glee, they serve authentic Pizza Margarita! I never had pizza this good in the Philippines! Its a basic cheeze-tomato-basil pizza that needs to be cooked in a stone oven to get that right crisp. They did it the authentic way and I'm quite happy about it. Can't stop munching on those wedges! P850 for a small pizza, a serving of eggplant pagmigiana and a half carafe of red wine. Not Bad.
After all of those food trips during my stay here in Angeles, I'm worrying about squeezing myself into my old jeans. I only have size 32 x 32 jeans and I vehemently refuse to buy anything larger than that. If it doesn't fit, it means I have to do something about my weight. Not much of a problem, though, because I lose weight so fast. But how can you resist these fabulous eats in the Philippines? Oh well, as I would always say, life is too short anyway...
But the best thing about this stint is that 1) the pay is good and 2) I get the nights off. That means I can go around Angeles and try all the nice restaurants in town. Unbelievably there are a lot of them here. What's nice about these quaint, homey restaurants is that the owners are foreigners: meaning you get authentic Italian, Creole, Japanese meals all the time. Lets have a run down of the restaurants that we tried:
HANAMI. Great Japanese restaurant off Friendship Boulevard. The sushi is made fresh and tastes different too! It's better than the local Japanese chains like Kitaro and Sushi-Ya. (Tokyo-Tokyo is out of the question.) But mind you, the stuff there is expensive. The ambiance is so-so and when we were there...they were showing a Japanese news program. Quite irritating. P1200 for a sushi platter (for 2), miso soup, tonkatsu and San mig light. Not bad for the experience.
COTTAGE HOUSE. A few meters down from Hanami. They serve authentic Creole and Southern style cooking in here. The ambiance is hole-in-the-wall kind with lots of shadows and cigarette smoke. Looks like a place where you deal with the mafia or have dinner with an awful date. Food is superb, though. The baby back ribs are mouth watering. I even dreamt about it when we were in Manila. P870 for a baby back ribs meal (which includes beans and mashed potato), buffalo wings and 2 san mig light. Cheap for a good meal.
ALING LUCING. If I dream about Cottage House, I'm getting an orgasm when I think about Aling Lucing's sisig. Not with Aling Lucing. It's just near the train tracks and they serve heavenly, cholesterol-laden, mushy sisig. Their burong kanin is good also. I must if you visit Angeles. Ultra cheap too. P456 for 2 sisigs, 2 pwet ng manok, burong kanin and 2 san mig lights. Yum!
BAMBINO'S. We just spotted this Italian restaurant when we came home one day (after eating I guess from Hana-mi or Cottage House) Looks tattered, though, but to our amazement and glee, they serve authentic Pizza Margarita! I never had pizza this good in the Philippines! Its a basic cheeze-tomato-basil pizza that needs to be cooked in a stone oven to get that right crisp. They did it the authentic way and I'm quite happy about it. Can't stop munching on those wedges! P850 for a small pizza, a serving of eggplant pagmigiana and a half carafe of red wine. Not Bad.
After all of those food trips during my stay here in Angeles, I'm worrying about squeezing myself into my old jeans. I only have size 32 x 32 jeans and I vehemently refuse to buy anything larger than that. If it doesn't fit, it means I have to do something about my weight. Not much of a problem, though, because I lose weight so fast. But how can you resist these fabulous eats in the Philippines? Oh well, as I would always say, life is too short anyway...
Friday, June 10, 2005
Just got back from Boracay
I had an 8-day stint as a physician in boracay last week. But due to the harsh weather, I need to extend for another 5 days. I opted to take the boat to manila to lessen my expenses so I have to wait for a calmer weather before I go.
I am beginning to loathe the little island now. It's becoming more and more commercialized. There's new establishments/resorts being constructed everywhere. These are not just the usual small scale resort you find in front of the beach but gigantic extensions of the small resorts like Hotel Seraph, Le Soleil, etc. Man, they're humongous! And soon they will be constructing a branch of Shangri-La hotel near Panoly and Discovery Suites Boracay near Friday's. Talk about raping a small island.
Nevertheless, the beach in Boracay is still gorgeous - with its torquoise-colored water and powdery, crystal-like sand. The sun glared for a day during my 5-day extension and during that time, my eyes did not leave the water. No kid!! It is simply one of the best sights for me. I've been to the beaches of Pattaya and Marina del Rey but nothing...absolutely nothing....compares to the beach in Boracay.
It makes me wonder if I am really prepared to leave all this for a residency position in the states. It is just okay for me to have a modest salary and a good job in the Philippines which will allow me to go back to the island once in a while. I won't become FILTHY rich that way but I can live a good, rock n' rollin' time for the rest of my life. Life is terribly tough sometimes.
Moreover, my 2-week stint has showed me that being a doctor in the Philippines is more emotionally rewarding. They treat you as a modern-day hero in this part of the world. In the US, you are practically a malpractice suit bait.
Being a doctor is never that easy. Especially in the Philippines. Its true that "you never run out of money in your pocket" - an amount to feed you for a day that is. But it never allows me to enjoy the finer things in life. Things that my contemporaries are enjoying right now. I am talking about the media executives, engineers and basically those who are non-doctors. I almost wished I never went into medicine. But then, I still have my own reasons why I love this profession.
It's the WORST choice of profession if you can't stop thinking about money but there are absolutely more than "perks" in this one.
I am beginning to loathe the little island now. It's becoming more and more commercialized. There's new establishments/resorts being constructed everywhere. These are not just the usual small scale resort you find in front of the beach but gigantic extensions of the small resorts like Hotel Seraph, Le Soleil, etc. Man, they're humongous! And soon they will be constructing a branch of Shangri-La hotel near Panoly and Discovery Suites Boracay near Friday's. Talk about raping a small island.
Nevertheless, the beach in Boracay is still gorgeous - with its torquoise-colored water and powdery, crystal-like sand. The sun glared for a day during my 5-day extension and during that time, my eyes did not leave the water. No kid!! It is simply one of the best sights for me. I've been to the beaches of Pattaya and Marina del Rey but nothing...absolutely nothing....compares to the beach in Boracay.
It makes me wonder if I am really prepared to leave all this for a residency position in the states. It is just okay for me to have a modest salary and a good job in the Philippines which will allow me to go back to the island once in a while. I won't become FILTHY rich that way but I can live a good, rock n' rollin' time for the rest of my life. Life is terribly tough sometimes.
Moreover, my 2-week stint has showed me that being a doctor in the Philippines is more emotionally rewarding. They treat you as a modern-day hero in this part of the world. In the US, you are practically a malpractice suit bait.
Being a doctor is never that easy. Especially in the Philippines. Its true that "you never run out of money in your pocket" - an amount to feed you for a day that is. But it never allows me to enjoy the finer things in life. Things that my contemporaries are enjoying right now. I am talking about the media executives, engineers and basically those who are non-doctors. I almost wished I never went into medicine. But then, I still have my own reasons why I love this profession.
It's the WORST choice of profession if you can't stop thinking about money but there are absolutely more than "perks" in this one.
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