Tuesday, February 28, 2017

sibling love

 I know that over the past few days, my view of medicine has been dark (because of the toxicity).  However, there are daily events and commentaries happening within the wards and ICUs that are often miraculous.  These events make me want to continue going on becoming a doctor.  Such is the case of AO. 

No, I will not be sharing the clinical details of her case for a medical discussion.  I wish to share the vents because of the lesson beyond medicine that it has taught me.  

AO was admitted due to incoherence and was referred to me because of anuria or absence of urine output.  We went about our medical management.  But what was more amazing to me was that every time I went to attend to her, it was her brother who was with her.  I will never forget this brother.  For one, he had the same name as my dad.  And he watched over the patient.  Every day.  Each day.  With no reliever.

As time passed by, I began to know more about the family.  Yes, AO was married, but barely saw her only daughter.  I never got to find out what happened to her husband.   As circumstances would have it, she would now live with her brother, who would take her to the doctor and care for her.  And it was just the two of them left. 

I grew more and more amazed as the days passed because Mr. JL, the brother, was very much involved in patient care.  A kind man, very decent, he would always thank me every time I chatted with them.  I noted that he called ALL of the nurses by first name.  He would update me on every detail regarding her sister: what she ate and didn’t eat, how much urine was in the foley catheter, what stories and in what language she talked that day, how her shoulders were hunched today and so on.  There was such an involvement of this brother and such compassion that I have not seen of a sibling in a long time.  Spouses and children, yes.  But of siblings, this was very rare.  His reply was always the same, "Eh kami na lang po ang magkasama."

As fate would have it, Mrs AO would pass away after eight days of hospital confinement.  But in all that time, there was no angry word from Mr. JL.  At the end of it all, he would contact me and thank me for my services and for caring for her sister.  He would request for a discount because his hospital bill amounted to Php 500,000.  Yes, the cost of medical care.  But there was no hint of complaint in his voice.  Only an acceptance.  That it was fate.  That his sister was in a better place. 

As a token of my admiration for him, I would text him, “Thank you very much for devotedly taking care of Mrs. AO.  Where is the wake?”

I was more surprised with his reply.   “Wala pong wake doktora.  It costs Php __ for the direct cremation, no casket and no wake.  Simple lang po lahat.  Pinagdasal ko lang po siya sa church ng 9 days.  We are just waiting for the death certificate.  God bless and Buddha bless.”

I guess it is a pleasure for me to take care of patients like this.  In the brink of death and in sickness, I find that people can react in two very polarizing ways: forget family, or stick together until the end.  And seeing families stick together like glue, share kindness with others is always a sight to behold in this seemingly hopeless world of ours.

My lesson learned and relearned is this: in the end, it will always, always be your family.  And more special in this case is the love for siblings.

Many thanks, God bless and Buddha bless, Mr. JL and Mrs. AO.

the struggle is real part 2

Today it happened again.

Today, I was given a WHOLE red ribbon chocolate roll by a grateful patient, and carbonara fetuccine pasta with iced tea by a medical representative, and a bag of peanuts care of a secretary.

At breakfast this morning, I was given 3 cupcakes lovingly baked by my sister and my niece. 

Yesterday, I was given a huge pack of multiple flavored ferreros (my favorite!) by the grand daughter of a patient.  

I am thankful for them and really appreciate their tokens of gratitude.  I remember thinking when I was younger and decades back, ‘Ang swerte naman ni Tito and Tita (Doctor!)!  Ang dami nilang food and its free!”

However, now that I am in that position, the struggle is real!  Very real!

I find myself walking on the road to diabetes as walked on by my mother, her siblings and our other relatives before them.  I have seen this future in a lot of the patients that I have dialyzed.  I want to get off the road, have tried doing so by exercise.

But I am failing in the diet department.

I see that this notion of food being a token of love is present in my family, among my patients and my colleagues.  When I stand receiving that cake or that box of chocolates, I receive that love.

As a citizen of the third world country, I want to save food, or finish it. 

But how do you gracefully turn the calories down to get out of that road to diabetes? 

Suggestions anyone?


Friday, February 24, 2017

hope even when he is silent

i share this very inspiring piece.

The text for the piece was found in a concentration camp after World War 2:

“I believe in the sun, even when it’s not shining.
I believe in love, even when I feel it not.
I believe in God, even when He is silent.”

when the dream becomes: to have time for myself

one week ago, the unthinkable happened to me.

one of my most ultimate idol-nephrologist asked me to cover for her for a weekend.  three days to be exact.

and i had a glimpse of the life of the successful nephrologist.  what a lot of doctors (i think) would aspire to become.

it was three days of a fast turn over of patients, rounds on rounds, patients on patients, calls on calls.  it was 72 hours of pure sympathy and empathy for the patients and the families who were in critical condition, the bargaining with fate regarding the outcomes of the patients, the constant second guessing of oneself regarding the management of the patients.

though the monetary reward was increased, though this was the thing i worked for, i realized that maybe this was not what i wanted.

yes, i wanted to help the sick, make them feel better, be kind and compassionate.

but there is a sheer volume of it that becomes difficult or maybe intolerable.  there is a point when you give too much of yourself and then you have nothing left to give.

i remember 7 years back, in another but no less truer context, someone told me that i should always leave something for myself.  and he was right.

this is manifested itself because by sunday i was in tears while running around trying to catch up with all the patients.  by friday night, i was down and sick with a bad flu.

i had (lucky) thirteen in-patients, the highest census i every had in my entire life.  i thought i wanted this.

but by the end of that run, i found myself screaming for me and alone time.

by wednesday, i found myself saying no to all my commitments and engagements: i was absent from choir practice, i turned down meeting out with friends, round table discussions and even the gym.  i was in a constant rush to get home as quickly as possible.  in the car en route to my different clinical rounds, i found myself catching up on sleep and having no verbal output as if to conserve energy.

i found myself excited to come home early, have dinner, spend time with my family, get a massage and watch movies streaming online.  you know, the pointlless stuff.  and yes, i did finish the three star trek reboot movies via 123 movies.com, as recommended by my brother.

but i realize now, that it was not pointless.  i find myself recovering today.  i had breakfast with a really valued girlfriend, queen bee, reminiscing about old times and finding that we both wanted that time for ourselves.  however, as life is, this is not be be so at all times.  hence, careful planning of vacations, staycations, or whatever -caytions becomes necessary.  "ah, kaya pala laging out of town ang mga consultants natin before!"   we got it.  it dawned upon me that we are not really after accomplishing that dress-shopping or the movie-marathon completion.  what we really want is the freedom to breathe when so many other people demand so much of our time and energy.

to further drive home the point, after i did rounds, i spent time for a little self care. :) (my self care best friends: lay bare, nail it, and my dentist!)

there is really a wisdom to God when he designed Sabbath.  it is a time to regroup, recoup, reorganize, re-energize to have the strength to resume our calling.

however, there is also another realization i draw from all this.  10 years back, my idea of success was to have a place of my own, a car, a MacBook air, and an i-phone.  my own driver would be a real plus.  being able to sing in a choir and exercise is a big plus.  and i got it all.  true, i still have to yet have my family and fall within my ideal BMI, but i realized that i have already achieved my definition of success that i dreamed up for myself 10 years ago.  when i realize this in the middle of the day, when i ride in my car, when i type in my laptop, i consider myself lucky.  i remember the time when i barely had enough strength to take care of myself, and i didn't even know when my next meal or my next shower would be.    i am lucky now.  I must continually remember this.  that maybe, with this state, my previous dream of the long patient lines, the consults peppered with fees, the travels etc, are not really the things i want.

if not careful, though, the pull of money and toxicity can draw me back to the point when i could hardly take care of myself.

as such, i find that when i think to myself, "i want more time for myself", maybe i shouldn't work to hard.  maybe i should rebalance.  and maybe, just maybe, i am enough of a success that i don't need to drive myself further.

because the things i consider important are things i already had 10 years ago even when i was not successful: family, friends and good relationships.

when the dream becomes: to have time for myself, one must listen and focus on the values that are more important.  this means the people more than the things.


the struggle is real

i have always struggled with my weight, food and exercise.

lately though, i have noted that exercise has become my best friend…but food has not.

i must share this struggle.

after a master's class, i found myself walking through the (not-so) hallowed halls of robinson's place manila, a place i used to call home for the longest time.

i was gallivanting merrily through the corridors when i saw it.

auntie ann's.  i imagined the freshly baked pretzels, sweetly admixed with lovely saltiness, possibly with cream cheese topping melting over the top.  and with a nice coooooool glass of lemonade with lots and lots of ice.  mmmmmm…

i shook my head no and walked away.

after which, i saw figaro stall at the middle of the mall.  i saw the oatmeal cookies, and the delicious smell of coffee wafted to my nostrils.  mmmm…

i shook my head no and walked away.

then, i saw the churros of the relatively newly opened la lolas, spilling over the paper cone, with chocolate dip dripping form the sides.  the churros with grease and chocolate deliciously wrapping the insides of my mouth with sweetness, the crunch of the chorus rebelling against my teeth.  mmmmmm.

i shook my head no and walked away.

next, i smelled the buttery scent of the bibingkinitan.  i saw the rich, yellow, fluffy rice cakes gloriously glazed with butter with the salted egg royally set on top.  i could imagine the warm feeling in my mouth, stomach and heart upon eating that bibingka.

i shook my head no and walked away.

i then saw the potato corner stand.  i could imagine the salty cheesiness or sour creamy flavor coating the newly fried french fries.

i shook my head no and walked away.

i finally reached the exit of the mall but it was raining.  and then i saw it.  a lady was carrying a big box of goldilocks.  my brain immediately conjured up pictures of the  mocha roll, fluffy, airy, with overlying creamy icing.

i succumbed. i bought a mocha-butter slice for P21.

i can really be a certified foodie.  i love food.  it speaks to me.  the struggle is real.

any tips?