Cast & Curious

Category: Uncategorized

  • Medical Blogging Summit , anyone?

    I’ve been mulling with this idea for quite sometime now and perhaps its high time I’d bring up this here, so I’ll get more hundreds of ideas.

    Why not a Pinoy Medical Bloggers’ or Medical Blogging Summit?

    It would be the first ever here, and will be the pet project of MDs behind The Blog Rounds. I admit it, that whatever up coming social media that’s going to transform the way physicians deliver the best of healthcare, we have to take advantage of it. The huge potential is astounding. And we’re not even talking yet of Web 2.0. If we are going to do it for us physicians, someone else will jump on it soon. I’ve seen the other more techie friendly professionals grabbed the opportunities of blogging and Web 2.0 and I’m really awed by the progress their taking. Not just hype.

    The healthcare industry in the Philippines is seen as a late bloomer in terms of taking opportunities like this. But perhaps it is one way of bringing in closer the archipelagic distances we have to give out the best in healthcare we can offer to our countryman.

    Do you have any ideas on this? Please leave a comment!

  • Cooking tinolang manok for the whole community: The unsung hero in our dinner table.

    Prologue:

    In the last few days I was finalizing my entry to this edition of The Blog Rounds (Unsung Heroes, hosted by Doc Gigi of Beyond Borders: The Lei Si Chronicles), I had a hard time choosing which one of my “unsung heroes” will grace this blog post. Not that I ran out of people to write about. In fact there are too many of them this blog couldn’t possibly feature them all. After finally deciding who shall I brag about, I Google-d for pictures to “carry” my post. Suddenly, a loud call hit my ears.

    “Kain na!!!!!!!”

    I smiled while “shelving” the post I previously wrote. I found my unsung hero right in our own dinner table.

    Disliking politics for a good laugh

    I woke up in this world hating the kind of politics our politicians is brandishing. So the whole time that I grew up and went to school, I stayed away from politics as far as I possibly can. I became one of those passive silent lurkers that hated politicians trampling at anybody to forward their own interests. Ironically, within my family, there exists a sphere of politics that made me gasps in complacency. My mom and sis are both staunch (read: right hand) allies of politicians belonging to two opposing fences. Like having a republican and a democrat one same party, only this time they both live interdependently within a family. Whatever circumstances that brought them into two opposing fences, be it values or principles, it is not my cut to remake. The fact that two seem to be the strongest allies in any major decision- making in the family made me think their political affiliations is just one for the good, educated laugh. I tersely smile in the kind of annoying democracy our family lives in. We only laugh about it during family dinners and night outs whenever talk hit politics!

    The early years of helping others

    My unsung hero’s story goes as far as my high school years. It all started with her aspiration of helping her fellow kabaranggays in what seems to be a common community bayanihan endeavor- leveling dirt roads and canal dredging. Her exhilarating feeling of “sarap pala ng makatulong sa kapwa no?” brought out a longing to help others help themselves. Catching up with the volunteer fever, she was so contagious and pervasive she never stopped since then. That “dirt road shoveling” started a barrage of so many other volunteer work she could get her hands into. She immersed herself into so many community work and training. Despite not having a college degree herself, she learned community health work, cooperative concepts and community organizing.

    Community work and voluntarism continues, politics or no politics

    There isn’t enough space to count her good deeds for the volunteer community work she gave in. While my Isko political education and sensitization probably has thought me about politics and service to humanity, this person is living service, on a daily basis, to her community. When I asked her what she knows about politics. She answered me this, in the bisaya vernacular.

    “What is politics? I do not even know what it means. I just know I wanted to help others. When our people will show any signs they don’t like me as a public servant, then I’ll stop with what you call politics but I will not stop helping others. Yan na siguro ang bokasyon ko sa buhay.”

    The day her name propped up in one meeting as a nominee for purok president, our family gathered to talk about the upcoming political litmus test. I was first to oppose aggressively about her running any public office at all. Politics, no matter how “small time”, is such an annoying field. In fact we had reservations because we knew politics is so darn dirty she might just get frustrated and that desire to help others will die a monumental death. We were wrong. She said she wanted to serve our community in any way she can, politics or no politics. Winning or losing this race will not hinder her to continue community work. So our family decided to let her have her way just this time. That was two and a half decades ago.

    The uterine CA survivor and diabetic patient, is a baranggay health worker first class, an on call baranggay tanod, charismatic women’s federation president, a tricycle driver and operator’s president, multipurpose coop board of director, a kapunungan president, a citizen’s watch officer and so many other things voluntary I couldn’t imagine she all could possibly take. Her track record will speak for itself. You can find her in any community information drive, health consciousness missions, women’s concerns, coop education drive or just in any shoveling on road widening projects, lipat bahay, injecting immunizations to dogs, etc . She graduated 4 community high school scholars, while sending 2 others now with her own personal savings.

    The politics of service

    She won a landslide that first time she “walked into” politics. Her opponents courteously bowing out of the race after her name would up as a nominee. That night was so memorable because it marked the day when she officially started as a public servant. The same person elected to office two and a half decades ago can be found in her “office” from 7Am till 5PM six days a week, on call at night and on Sundays and holidays for anything unimaginable for sane human beings. Her honorarium couldn’t even pay for her electricity bill. Four presidents, 4 top notch professionals and 8 grandchildren after, she is still is a public servant losing not any political race she joined.

    Not one.

    And those retirement signals seem to be nowhere in sight. In the last election, despite living in a community where we don’t have any single relative to boast of, not a political clan to rely, nor fame to put forth, and not even the money to run a well oiled campaign, she won a whooping third consecutive term, in second place, the highest and her biggest margin in all her run for public office.

    A mom, after all.

    I can only sigh in disbelief. Here was I, who can put a thousand words to malign “politics”. She was busy living one with public service unbesmirched for two and a half decade, My family is praying she retires next election. Her glucose swings is getting nastier. Her back, hips and knees showing signs of too much shoveling and cooking for the community. My unsung hero is human after all.

    One of my unsung heroes, going through all the difficulties of wearing a formal dress (outside her jeans and tennis shoes casuals), just so she can see her son earning a board certification!

    “To, kain na!!!!” Shouted our hero.

    Epilogue

    Nga pala, kakain na kami. Nagluto si mamang ng tinolang manok. I was smiling going to our dinner table. I need not look outside for my unsung hero. She is actually amidst us cooking tinola and dining every night with us when she wasn’t on call. Politics or no politics.

  • The Blog Round editions’ 7 and 15 is up!

    The Blog Rounds 15th ed is up at Doc Manngy‘s blog No Special Effects. Head on to Manggy‘s blog and read an “I Wanna Sex It Up!” style of blogs’ round up that dissected gender issues in the clinics under scrutinizing eyes.

    Doc Ian‘s TBR 7 entitled Mission: I heart the Philippines, is up too, in his blog So far So God. This much awaited edition of TBR is a compilation heart warming stories and essays of MDs who love Philippines in so many special ways.

    The upcoming TBR 16 will be hosted by Doc Gigi in her blog, Beyond Borders: The Lei Si Chronicles. Call for articles is up in her blog!

    The Blog Rounds is a biweekly compilation of the best in Philippine’s medical blogosphere, written by physician bloggers (or the medically inclined bloggers) and hosted on a participating blogger’s weblog. Archives and edition schedules ( plus the host blogger) are listed here. The next edition of TBR will be up this Tuesday, July 22 ,2008 7am PST.

    Physicians and medically inclined bloggers interested in joining this blog carnival, please contact me through my email kokegulper[at]yahoo[dot]com or any of the participating TBR bloggers. Guidelines and updates are posted here in my website, The Orthopedic Logbook.


  • Wrong side of surgery: Which site?

    Although rare, wrong site surgery happens even to the most able and busy OR team such as in this hospital. Imagine the horror of both the OR team and the patient discovering the closure stitches in the normal side after the procedure. But thats another story.

    What I’m a bit surprised is how the hospital administration managed to “rectify” the error and came out with better policies to prevent future incidents like this to happen. Their CEO even blogged about it, so the whole community would know about the lapses, the steps taken to correct it, and prevent further “errors” to happen in the same way.

    I can help but wonder if most of our health institutions here in our country have the same attitude towards wrong site surgery and medical errors. A universal protocol for wrong site surgery has been existing and updated regularly for quite sometime already. The American Academy of Orthopedic Surgeons (AAOS) also had its recommendations to reduce surgical sites error in orthopedics. Most of the stories I hear in our country from the gossip tree end up in long, expensive court duels. And even with the pay off, none of the parties learned anything (but money and pride) from the mistakes which should have been preventable in the first place!

    Not to be over simplistic about this but parallelisms can be drawn between mistakes like this one and that of mistakes done on people you care of. Admission is a braved act. Facing the consequences is an even braver act. But taking actions to prevent such errors from happening is a mark of a true caring physician. That is how we deal with people we care. To us physicians, that would be our patients.

  • Gender awareness for physicians: What needs to be done and how to do it!

    Quite a number of studies showed that differences in gender awareness exist in the health care industry. However, this is not limited to professionals on the opposite side of the arguing fences, but also within professionals of the same gender. Consider this;

    “Ms. applicant A, considering this is a very “masculine” dominated training program and specialty, do you have any other training program in mind, that you applied for also and which is more “feminine” that would fit your built?”- Female Interviewer B

    I don’t know if the interviewer was just “sensitive” enough to “enlighten” the applicant further by giving her options, but its pretty obvious such question is consequential to the bias created by a less gender sensitive workplace.

    But what is gender awareness in the first place? Here is one conceptual definition like most.

    When comparing men and women it is important to clarify the concepts of sex and gender and describe the gender perspective applied. Sex is a biological categorization based on reproductive organs and chromosomes while gender views women and men from a psychosocial and cultural perspective. When studying differences in health, behavior or attitudes it is generally not possible to know what is biological and what is social in origin. A constructivist perspective [1] of gender is then suitable since it underlines that sex and gender, biology and culture are related and inter-reliant. In this perspective gender refers to the constantly ongoing social construction of what is considered “feminine” and “masculine”, based on sociocultural norms and power. Gender is not a fixed or ‘natural’ category, but subject to change and negotiation. We all “do gender” in all kinds of social interactions [2–4]. Risberg et al.Gender awareness among physicians – the effect of specialty and gender. A study of teachers at a Swedish medical school BMC Medical Education 2003

    This same study showed that in popularly male “dominated” specialties like surgery, gender awareness is notably low. It is not limited and unique to these specialties however. Similar patterns of an overall lack of gender awareness exist even in “female” dominated specialties and not surprisingly, in our patients’ lounge. The segregation is arbitrary, the debate continuing to no end. But what is glaring is the consequential biases that results from the on going gender tug of war and are whether manifested in the workplace, at home and in our clinics. These consequential biases always implies a dysfunction in the level of gender awareness going far deep amongst ourselves.

    That is the bad news.

    The good news is- there is hope for change. While the ongoing gender debates may at best be educational to all parties involved, the call for action needs ideas that work. Our society in general, and our profession in particular, should put in place a mechanism to sustain a growing “gender sensitive” policies in the work place. Some training programs I know actually had these policies on paper. But if these mechanisms are just there to attract applicants from the “marginalized gender”, then the stop gap mechanism might just be boosting the pervading culture of the “gender insensitives” .

    As a physician- educator I believe something can be (or should be) done to correct gender issues. Need a better and a more gender friendly physician workplace? Here are my few advices that goes deeper than the rabbit hole:

    1. Start young, start at home. How young? Nobody knows. But ss soon as the kid discover that phenotypic sex have different biological needs, parents can introduce gender friendly concepts. Remember that most gender biases apparent in the adult life can be traced to the person’s childhood.Most of them proved to be very difficult to change.The formative years has the greatest “stick on” knowledge than any of the stages in a child’s life. It is important that the child understand the difference between sexes and gender and how one is related or how to be “sensitive” about it.
    2. Start in school. Education perhaps has the single most effective way of combating future threats of gender issues aside from the family.This is more important to a child person who’ s family dysfunctional . This is probably the best area to introduce gender awareness concepts. Sex segregation in this stage is often a result of a misguided awareness by some educators themselves. This is passed on to their students. Parental reinforcement then becomes an essential tool.
    3. Quality and productivity driven medical school and specialty programs. This is a very controversial issue and often the most debated upon. Thee issue is not about depending one’s gender from another, or gaining points for that matter. Qualifications and productive outputs measures who is best suited for a job description. No giving in or pluses to the gender. If the program do cultivate a culture of “gender insensitive workforce”, it is the taint of the program and not the trainees themselves. If the training gets more sex a than b, the only reason verifiable is because their evaluation and qualification process allows (or disallows) them to and thus cultivate such culture. Change the policies to implement more gender sensitive workplace. No excuses.
    4. More role models. Perhaps one of the more effective “enticing methods” by the few who braved to the opposite sex dominated specialties. Most of the applicants interviewed for a particular gender dominated job alludes there persistence to role models entrenched in the workplace itself. The domino effect of such roles models often determines the number of gender wanting to gain access to that workplace.
    5. Educate the patients lounge. If you can’t do it for yourself, get someone else more comfortable to do it for you. We get patients we deserve, in one way or another. The quality physicians do not stop at treating their patients only. They educate too. As a physician, we are in a powerful position to create an impact, just like we do when we harbor negative issues on it!
    6. The last but the most important of course, is to educate ourselves. You can never teach someone else gender awareness without you being “aware” of it in the first place. We all knew what is gender sensitive and what is not. Sometimes we just do what is easy and
      our patients take cues on our actions. And there’s no denying actions speak louder than words!