Purging Heavy Feelings in my Heart

Today is the first monday i have with no school.  i was so tired yesterday, i guess of emotional issues that i just slept and thought i would sleep in today, excitedly doing so because i didn't have class.  before, sleeping in used to feel so good.

now as i awaken, i didn’t feel good.  i felt that the time passed me by.  its already 10 am and i have not accomplished anything.  however, i think to myself, the day is still young and i can do a lot more.

i missed the opportunity to do early plana with a friend because i woke up late.

i missed the chance to pass my requirement today in manila because i woke up late.

i now turn to writing to once again rechannel and refocus what to do.  loss of a routine makes me feel confused as today does because i didn’t plan what to do today.

i guess i feel so tired and dejected because of home issues.  i realize that the home issues when you are back from training and living a real life will never go away.  things will always have to be done. there will not be any shifting out from the rotation modes when everything will be brand new.

last week, i feel my energy being sapped by family issues (parents growing old is indeed a real thing), illnesses, icu patients that draw strength from you, friends who are unavailable, not by choice, but because of their dealings with their own busy-ness.  i guess that is where the word business comes from.

when you do meet, it is always as if time together isn’t enough or you are always in a rush to proceed to the next concern.

i don’t remember when it became like this.  but it really became more marked as practice grew.  yes, the revenue did grow, but the time became so precious that you would have to decide how to spend it.  i guess that is why i feel a little guilty about sleeping in.  TUMPAK!

To often in life, i find that you have to reflect on your emotional why and just limit activities to that in order to streamline oneself and stress less.

what is my emotional why nowadays?

checking in with god.  and myself.  check.

relationships.  family.  friends.  okay, this is a bit of a problem.  friends, help me out here?  hopefully one day to have a family.  (oh lord, please let this be one day soon) 

manggamot.  okay.

become more healthy.  plana and yummy diets!

four items on the list.  I guess this is doable. 

let us do it!

resolve: to wake up early.  hence….i should sleep early. :)

there is really something to be said about writing as a release.  i feel better already. ;0)

early to bed, early to rise

i pray this tonight.

lord, let me sleep early with much restfulness. let me have sweet dreams, or maybe stay in peace with no dreams at all.

let me feel safe in my sleep.

let me then wake early.  so that i can chat with you.  so i can breathe.  so i can relax.  so i can lower my shoulders and stretch to meet to sun.  so I can be ready to meet the day.  so i can beat the traffic.

wake me up, lord.  

amen.

Cheeziness. Reader beware.

I feel like i have been waiting for my OTL for the longest time.  sometimes, the wait makes me feel like i am going to die.  i have had my fair share of people who were like this quote presented above, like my angels.  but what i ask for now is not an angel…but the person.  

will he come?

will you come?

what do i do while waiting?

in my pure panic, i find myself praying to god that the man will be like a parking space.  let me elaborate.

many of my friends are utterly amazed at my capacity to find parking in places where no one else would find parking if their lives depended on it.  i don’t know why.  early on during my driving years, i found myself having the habit of praying to the “parking angel” (as taught by my sister) for a parking space as i step into the parking lot or parking building.  i would then roll down my window to listen for a care starting up, or the sound of the stick shift going into reverse and would rush to the empty parking space.  

i always thought: i would just need one space.  just one.  and that one would be perfect as long as i could fit it it.  

given that i would ALWAYS find parking, i am never worried every time i step into a full parking lot.  my FAITH is so intense that the parking would be saved there just for me.  and it always is.  without fail.

given this and contrasted with my lack of a man, i often find myself praying, “lord, why can’t finding my one true love be just like that one parking slot?  i just need one.  JUST ONE!” 

my close friend tells me to have faith on the one true love just like i do with parking.  even if i don’t see the parking space, i know it is going to be there.  

and if god can give me a small thing i desire, such as parking, who can say that there won’t be that one true love that i desire with my whole being?

next time i find that empty parking, i hope beside my car will be the car of my one true love.  :)  the best is yet to come.  while waiting then, i just hope to bask in that faith.

Patient love is messy...

today, a patient was admitted under my service.  under normal circumstances, this should have made me happy.  excited even.  this would have given me the opportunity to practice my clinical prowess, exercise my mind, give a chance to be good and help humankind.

problem was i hated her.  i didn’t want to admit her under my service.  it was the weekend and i just wanted to do plans forma.  she was shrewd to the point that in the clinic yesterday, i charged her nothing because she wouldn’t take my medical opinion and i didn’t want to see her again because she kept on ranting about finances.  yes, i understand that finances play a major role in a place where insurance was not the mainstay of health care, but the patient would not accept the alternative of being admitted under a service hospital either.  talk about being payish.

after i sent her on her way (hoping that she would indeed go her way which would be OUT OF MY WAY), she called back my clinic (after my secretary and i had left), seemingly as an afterthought and did decide to follow my advice.  even with no clinic schedule on a weekend, i told her i would be willing to see her in the morning given that i had activities lined up in the afternoon.  she had the gall to say that she could not come, and the even bigger gall to ask to be admitted under my service and NOT go through the ER.  

trying to perform my Christian duty, i called the hospital and dictated admitting orders, respectfully asking the staff to give the orders to her.  after it was all done and complete, patient then decides to admit herself the next day.  saturday.  afternoon.  when i had my activities planned.

i prayed to the highest heavens for her to find another doctor.  i prayed for her not to cross my path because i felt that my kindness was being abused by her shrewdness.  

as circumstances would have it, she did admit herself under my service.  i went to the hospital even if i feigned being out of town to step out of her way.  only to find out that she had herself referred to another doctor.  and as such, i was the third wheel.  i believe her exact words were “paano yan doc, eh di dalawa na kayoing babayaran ko?”  

i couldn’t believe hearing those words after i went out of my way.  so i said with raising temper that i could just take out my entry from the chart and prevent nothing happened.  and she said “eh paano yan doc, kayo ang naiintindihan ko.”  

in pure exasperation, i headed out of the room “hmmping” away, muttering “discout sa PF”.  i felt smoke coming out of my ears and my face turning red in pure anger.

my thoughts were: i shouldn’t have sunk to her level and been rude.  but, i am just human.  however, i shouldn’t have done it.  but she deserved it.  she was so disrespectful (would that be the english translation of BASTOS?).  i should have understood her because she was sick.  but she was admitted under me and she did not follow any of my advice.  but that is the exact thing doctors give.  advice.  and i, as a doctor, could not compel anyone to do what i think should be done.  

it was a good thing things would solve itself.  i get a phone call from the head nurse where the patient requested that she only be seen by the other doctor.  i was ecstatic to be able to get out of the way.  i signed out of the service and charged nothing.

one would think that i should be happy.  but i was not. mainly because i sank so low.  i should have kept my cool.  shown my doctorly love. but the alta in me couldn’t do so. 

how do you balance being kind (and prone to abuse) versus being right (and being prone to complaints for misconduct)?    

Epilogue…

well, too late to do anything else now.  at least i got out of it.  at least, i got a reflection paper out of it.  at least, i got my point across (i think, or did i?).  i just hope that this lapse on my part will have no repercussions for my conduct and my referral base in the future.  but if it does, maybe this is not the place for me. 

only time will tell.

REbirth

Long ago, in grade 4, to be exact, i remember that i often got good grades in all the writing i have done.  i would always write and journal. Maybe this was because this was the age before digital technology.  keeping everything in history within your reach depended more on handwriting rather than computers, more on film rather than digi-photos, more on paper rather than online social networking sites.  given that, i don’t know what happened.  maybe real life got in the way.  maybe the writing drive in me just died.  or maybe it didn’t die.  maybe that writing freak was buried deep within, overthrown by the me that became the doctor, the teacher, the house-maintainer, the sister, the daughter.  the writer in me just died.  or hopefully more aptly, maybe the writer in me just went to sleep.

so tonight, i call on to jesus, like the relatives of lazarus did, hoping for an awakening of that dead writer self.  there are so much thoughts to be shared, so much heavy feelings to be unloaded, so many fast, turbulent and imaginative thoughts that can only be tamed as they are put on paper.  

alas, i realize that writing is not really something that comes easily.  yes, it does come naturally.  right now, i can barely stop my fingers from typing.  however, the discipline of prioritising it, making the time, quieting the mind for the fingers to begin putting down the thoughts is as active effort.  beginning is an active effort.  however, once i begin, there is no stopping it.  i hope that inertia continues this writing so that the documentation will continue and i will never have to restart.  i hope that the writing will continue so that the thoughts will be down on paper and hopefully clutter less of the mind.  i hope that i will continue writing so that, in some way, i can cleanse myself of the negative feelings that i have and explode out into the world the overwhelming positive feelings i have (if any at all!).

It is not a question of whether i can.  i know i can.  it is now an answer that i will. :)

uncomplicated

would like to quote kiddo cosio.  his post rocked my life.  thanks!

UNCOMPLICATED

 

And he sent them… – Luke 9:2

 

       “Father, do you think I should become a priest?” I asked my friend, a priest.

       “Do you want to become a priest?” he asked in reply.

       “No,” I said, “I just thought that I should become one.” I was 21 and doing full-time ministry work as a preacher and pastor of sorts. Priesthood seemed a logical option. “Actually,” I continued, “I want to get married.”

       “Then get married,” he told me. “If God calls you to a vocation, He will put the desire in you.”

       That conversation set me at ease. I never truly understood what religious people meant when they talked about calling, vocation, or having a vision for your life. It felt so pie-in-the-sky, as though God didn’t want most people to know His will.

       But when I heard my priest friend say the word “desire,” I felt a weight come off my shoulders. Desire was simple. I knew exactly what I desired: to be a husband, a father, a creator, a fun-loving, people person. Now, many years later, I am married with two kids. I help run a startup business, and spend a lot of time moving about a growing circle of friends. I serve God by trying to live an exemplary life in these places — and let my life speak for itself. It wasn’t so complicated after all. Kiddo Cosio (twitter.com/kiddocosio)

 

Reflection: Christian theologian and author Frederick Buechner once said, “The place God calls you to is the place where your deep gladness and the world’s deep hunger meet.” Think about that.

 

Dear God, please help me live out Your call for my life.

chief complaint and end point

I am now trying to explore my new mac.  In the busy-ness of the day. 

Today I was up from 730 am tending to so many items on my to do list.  First order of business was fixing the pay roll of the house staff.  I then cancelled clinic first thing in the morning as the patients were late and headed straight on to the hospital.  I was rushing to do this and that, see this and that patient, attended a conference, attended to patient with chills, answered phone calls.  During the conference, my patience was tested because I felt that the resident physicians weren’t managing the case to par.  I was so frustrated.  First time I was frustrated actually.  I usually laugh the whole thing off and accept that this is why the things are the way they are.  But today, I couldn’t wrap myself around the idea.  There were so many competencies I so believed that people should be getting but they weren’t.  like referring to a cardiologist a patient who is bradycardic with a heart rate of 37 at that.  37!  And I was just in the middle of everything.  And in the middle of everything, I asked my mentor if this was really something I should accept or struggle to change in order to meet the standard.  She accepted mediocrity 25 years ago.  Go figure.

 Before I knew it, I was driven out of the conference because I had to rush again and go see a patient.  I scooted to my clinic and there was the doctor before me who was over time-ing again.  Man, I was guilty of that myself in the other clinic but for this physician to do this consistently.  But for whatever it was worth, I just smiled, stepped inside and quickly saw the patient, tried my best to appear unhurried to the patient and then give her a quick peck on the cheek.  She was a lola.  As I stepped out, I hurriedly collected my 500 pesos for checking on her blood sugar.  And again rushed to east avenue where there were hordes of more patients looking for me.  And doled out P1200 for blood cultures of a patient with recurrent chills.  Negative earning for today.  Again. 

Another resident was there wanting my input, so I provided it and left.  Feeling that I provided by godly duty to the patient to somehow try to make her life better.  By the way, the most valuable thing I did for the patient was to check her blood sugar which came out as 7 mmol per dl.  Lowest I ever saw in my life.  No wonder she was not reacting.   The patient I mean, not the resident.

After that, I rushed to two dialysis units which were quite opposites as far as opposites would get.  I buried myself in policies, emails, professional fees.  As if it weren’t enough, after calling on all friends asking how they did it….I got a pay referral.  From another charity hospital.  And I went.  And saw the patient.  And hurried home.

All throughout the day, I was thinking…why was I running this amazing race?  What for?  Or should I give it up?

Call it a hodge podge day.   

I reflect now. on end point.  the concepts of chief complaint and end point were the two most important concepts I learned in internal medicine.  Quite useful in life.

Amidst all the hodge podge, the amazing race, the mess, the chaos.

What is my chief complaint now?  What is my endpoint?

Pause.  Sinus pause.  Or maybe second degree AV block.  with a dropped beat.

Chief complaint: everything is too fast.  Too fast that I miss my friends.

End point:

1. Doctoring everyday.  Check.
2. Being less busy.  Hm.  I have to decide my priorities.  
3. social life.   

let's work on this, shall we?