Monday, September 24, 2012

A Grand Welcome for the GI Module

How much longer 'til sembreak? Let us count the weeks...

(Lame attempt at Shakespeare right there.)

But to answer the question, it's three - all devoted to the gastrointestinal system. And right now, I'm having the best time starting off this new module - at home, with an upset stomach. Which is funny because right when we were about to start Pulmo in August, it was a respiratory glitch my body was experiencing. 

My epigastrium feels like it's in labor. (Sure I don't know how it feels to be in labor, or have dysmenorrhea, but I surmise this must be it, or somehow close to it.) Contract, relax, swirling bout of weird pain, relax, repeat cycle. 

Yesterday, I finished my fourth non-academic book since the start of school (but this statement is misleading because I haven't even finished any academic book since the start of med school). 

1. The Hunger Games by Suzanne Collins - Four months after seeing the (unfocused, romanticized) film, and I couldn't help picturing out the scenes as the pages went by.

2. A Spot of Bother by Mark Haddon - Domestic drama with a twist winningly set to words. Very, very readable and engaging, or as the cliche goes, "impossible to put down!" 

3. The Comfort of Strangers by Ian McEwan - The author is truly a master of language. Bow.

And now Walter Kirn's "Up in the Air," which is as bleak and dreary as a book on the recent American economic slump can get. I do, however, have to laud, and really, really laud, how the protagonist is written - honest, introspective. 

Oh, by the way, last Friday night was LadyMed 2012 (here's LadyMed 2011, where I played the part of sacrificial lamb for my class). The theme was "Divas," and the contestants were Lady Gaga, Katy Perry, Jennifer Lopez, Rihanna, and Madonna. Typing that just reminded me of how incredibly stupid and short-sighted the decision of the selection committee was. How on earth can you pit J-Lo against Lady Gaga, for instance?! Let me repeat that: Incredibly stupid and short-sighted. 

But I digress. Valentina had her final walk, and she was, suffice to say, still the prettiest of them all.

Photo by Leonardo Infante, whose ability to expertly capture moments in motion is in full display here.

Monday, September 10, 2012

To CPR, or not to CPR?

Last Friday during Art of Medicine class.

The topic was "pain, death, and dying" under adult medicine. An interview was conducted in front of the class between our lecturer and a patient with acute myeloid leukemia. That's AML for short, and it's notorious for relapse, so our lecturer said. In other words, it will drain you of money and resources, and the life if you're not lucky. 

But the more interesting part came after. We were presented with a real-life situation that our lecturer experienced some years ago. From the outset, it seemed to demand an answer based solely on ethical standards as provided by those declarations (like Geneva, for example). 

But. hell. NO. Gray areas are what we have in real-life, not some yes-or-no that one can easily jot down on exam papers. So goes.

The matriarch of one of the richest families in the Philippines is dying of cancer. But she doesn't know it. In fact, it's only she in the entire money-making clan who doesn't have a clue about the cancer (inside her). The family, with whom you've been friends for ten years, had requested you not to tell her, and you'd willingly and understandingly obliged.

You are called in on Saturday afternoon because suddenly, she developed pneumonia. Everyone, including yourself, did not see this coming; truth be told, you all thought she was getting by quite fine. Now you have a very old lady with cancer + pneumonia. Not, not, not good. Before everyone's eyes, she's deteriorating - and very, very fast.

The problem is, she hasn't legally passed on everything she owns because she never knew she's dying. She's now fallen into a coma. A thumbprint can be acquired and that would be enough - but only if, by 12:00AM of Monday, she still hasn't been proclaimed dead. Not sure about the exact time, but you get the gist. Why Monday? Because government offices are closed during weekends a.k.a. if she dies anytime during the weekend, the thumbprint, and in turn, the papers will be considered null and void because they were processed while government office was closed. Apparently, processed papers will only be considered legal if they are done while the person in question is still 'alive'.

What happens when everything she owns doesn't get legally transferred to her children? Inheritance Tax. More than half of her estate (so the lecturer said) goes to the government. The immensely, screwed-up Philippine f*cking government. And we're talking riches the scale of Henry Sy or Ayala. While she lived, she never wanted a single cent or acre of land to go to the govenrment. And all of you very well knows that even in death, she'd make sure nothing, not a single drop from her entire life's hard work, goes to the government.

So, keep her alive. By alive, we mean not legally proclaimed dead. And because doing a CPR on an arresting person means not proclaiming death, here's what the family asks you to do: If she goes into arrest anytime during the weekend (which you very well know she most likely will), four burly men will take turns doing CPR on her for as long as the weekend is not over. That means if she dies in the early hours of Sunday morning, you're looking at 16, 18 hours of nonstop CPR. On a body that's very well lifeless.

The question was phrased this way: 16 hours of CPR on a dead body, or no 16-hour CPR?   

It was a question that divided an entire class, 55-45(%). Even our lecturer admitted to never fully knowing whether or not he ever made the right decision.
 
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From cprcertificationtrainingonline.com. 

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Anyway, what happened was this: She arrested at around 4AM Sunday morning, and a 30-minute CPR was done to no avail. And yet, everything she once owned was successfully passed on to the heirs. The Inheritance Tax never came round in time, care of a couple of senators and some friends in government. 

As expected from this country.

Sunday, September 2, 2012

The Journey to an Ateneo-La Salle UAAP Game

I write this in the ungodly morning hours of Sunday with my mind still on Saturday; ergo, I shall refer to Saturday night as 'tonight' and Sunday night as 'tomorrow night'.

Tonight, the 2012 Palanca Awards were given out at The Peninsula Manila. By mentioning that, I am of course confirming that I did enter and lost. Perfectly excusable, since 1) it's my first time to join the adult categories, and 2) it's never not excusable to lose in the Palancas. 

It's like Viola Davis in The Help losing out to Meryl Streep in The Iron Lady - (riot alert! riot alert!) - I mean, Jessica Chastain in Take Shelter losing the nomination to Jessica Chastain in The Help - (RIOT ALERT! RIOT ALERT!) - I mean, Avatar losing to The Hurt Locker for Best Picture - (calm). 

Well, what I meant to say was, winning a Palanca is always the exception, so here's a warm and sincere congratulations to the winners, especially to that of Short Story in English. And for the curious, here's my Palanca win back in 2009, 2nd prize in Kabataan Essay in English.

Ergo, my day turned out quite fantastic. Eli - friend since 4 years old, classmate since nursery, best friend by whatever definition - is here in Manila. Again. (I say that because he doesn't even study here, yet he's here more often than either of my parents are.) Last night - Friday night - he was at the Araneta Coliseum for the Mixed Martial Arts thing (like the one in Warrior starring Tom Hardy, who's now colloquially known as Bane). The entire ordeal involved seven hours of standing, so he said.

Since he wanted to have lunch at some traditional Chinese restaurant that served 'good' oyster cake, I took him to Sincerity Restaurant along Yuchengco Street. I've been there only once, so I wasn't quite sure if it's really that good by expert culinary standards. Turned out to be not quite as good as its reputation paints it to be, but I actually don't care since I don't like venturing into the heartlands of Binondo in the first place. One, because it's always rowdy and overstuffed with people; two, because the horses and their carriages make the entire place reek faintly of horse manure. 

Eli pointed out that it's more or less the same case with every Chinatown, from Singapore to New York. I pointed out that this Chinatown is in the Philippines, where I live; therefore, its innate rowdiness and faint smell of horse manure are legal reasons for me to not enjoy walking down its narrow roads. 

After lunch, we walked from the restaurant all the way to the Carriedo station of LRT Line 1 (in Avenida, Sta. Cruz) and took the train to Vito Cruz station, or De La Salle University. The plan was to eat at Zark's Burgers, but he quickly realized the lunch had transiently left us with not enough space in our stomachs to contain the famed humongous burgers.

So we settled for hanging at Starbucks beside College of St. Benilde and summoning our dearest Iloilo classmate and friend Paopao to come to our side. She had class, then ran off to CCP for the matinee of The Phantom of the Opera. I like that word by the way - 'hanging', denoting the act of hanging out. Like how Americans or conio Filipinos say it: "Let's hang this Saturday," or "I, like, hanged with the barkada at Banapple along Katipunan."

Then, Zhou - Eli's South Korean friend who's currently having his OJT with Jeju Air - answered the summon. So it was, the three of us hanging at Starbucks like a trio of over-entitled elitist brats or med students who find it necessary to study in coffee shops. On a side note, Zhou earns way more in his OJT than most doctors in residency training in this country do.

Then, Eli decided it was time for Zark's. By the way, he'd been saying a lot about not having tickets to the afternoon's Ateneo-La Salle UAAP men's basketball game. So guess what, there and then, one of his contacts texted him saying she still had unsold tickets. He successfully bought them for P200 each. Thus, we found ourselves in a taxi, got off at Legarda station, took the LRT 2 all the way to Gateway Mall, ate a bit at Taco Bell, then got our tickets from a high school batchmate from another school in Iloilo. All that meant four 'firsts' for me: Starbucks in the La Salle area, taking the LRT at Legarda station, eating Taco Bell, and seeing a major UAAP game live.

After 3.25 years of staying in Manila, I finally got to watch a UAAP men's basketball game, and undoubtedly in its most exciting form. We were at the Ateneo side since our seller's an Atenean, but that's just about the amount of loyalty we have for Ateneo. In any case, it was loads of fun cheering the Ateneo cheers like a bunch of presumptious fake Ateneans that we were. 

Which made me realize how out-of-place a UP student/ alumni/ person would feel if he or she went to these games. The last (and first) time I watched a UAAP game, it was women's basketball - UP vs. Ateneo, and we won. But it was only because our PE class required us to watch at least one UAAP game (not in reference to why or how we won.)

We ended the night back at Zark's where Eli tried but failed to conquer the Jawbreaker challenge: 300g of fries, a glass of iced tea, and a half-pound burger - all for free if consumed within five minutes. I feel sick just thinking about it. Sadly, he lost, said he still has much practice to do. He shall return, Zark's.

1st year Intarmed students in the aftermath of a UP-Ateneo UAAP women's basketball game, September 2009.

My first photo using PicFrame.

 The monster. Zark's Burgers across De la Salle University, Manila.