Cast & Curious

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  • Standing on the shoulder of giants- My Family

    I would be a leap of faith just to believe I can be where I am today, but my family just made it all possible.

    “Our family is everything to me. No matter how remote my actions and decision are before, today and in the future, you’ll find a “connection” between those actions and you, my family” –R.A., an excerpt from a letter to his mom and siblings, during the “hard times” of med school.

    Third sibling in a family of four, the eldest of the boys, a father’s pet and the family’s nightmare, I am cut for an outrageous fate. Fate, it seems, is full of ironies.


    The passing of a beloved father
    My dad died when I was just eight years old and my family was plunged into an abyss of compounding problems fit for a telenovela.

    And so goes the story of my re-education.

    A cut for survival
    It was surviving that was central to the family’s agenda. So, a “cut” is made in all the basic needs of the family- food, shelter, education, for us to survive.

    It was education that was hardly hit, thanks to EDSA revolution back then. A sibling in college, another one entering college soon and a younger brother in elementary- all surviving and being supported by a single working mom. The loss of our dad has had the ripple effect in no time. But there were signs of disasters waiting to happen.

    The grim reality
    “You gotta have a scholarship in high school or you’ll not going to any school at all” this grim reality my mom told me with tears welling in her eyes. “We can’t afford to send you to school”. These words, sunk into the deepest recess of my brain and bled my heart to no end. It was a cut my mom made to ensure the survival of our family. And though, I sense the simmering helplessness and agony in her, she has shown a firm and decisive role to govern her family through the hard times.

    “Why me? Was it because I was the third or was it because I was expendable to the family?” At a young age of 12, I knew a storm of hard ships is coming our way. But this was just the beginning. And I was one of the hardest hit.

    One step at a time.
    So, while gnawing in pain and agony for the luck I got, I took it on as a challenge. “I will loose nothing in this uphill battle. I have no way to go but up.”

    My dad wanted a doctor in the family and this was his plan for our eldest sister early on. But he did not lived long enough to even see my sister step into college. The dire financial chaos my family is in only dampened the spirits of my sister to even enter premed. She went into accountancy instead.

    Meanwhile, I was inching my way though high school scholarships. The initial taste of success emboldened me to “I want some more” type of aggressive academic greed. Daunting the challenges were at those times, I stood my ground and leaned on the “walls” of my family. If I was victorious , that is because I was so darn proud of my family. We were beginning to shatter all the gloomy expectations for our family

    Undaunted and victorious over the challenges given to me in high school, I trained my gun next on college. Opportunity then knocked when UPCAT applications came into my mailbox. “A scholarship and a thick stomach is all I need” I jokingly told my mom and sisters. “You got to be nuts” said my sister. “Even if you get inside UP and get a scholarship, will you be able to survive on that alone, through college in a far away place? Away from us?” They’re afraid I’d land with the “great thud” when I hit the ground of failure.

    “Give me just a year. If I fail, I’ll stop at my wishful thinking and go back here…” My family knew that with my initial success in high school, I am virtually unstoppable. So I got my way. Though afraid of what I might get into, they supported me all the way through, hugs and tears included. I am embarking on a path no one else in my family had gone into. So the benchmark is, unknown.

    The Ebb and Flow Cycle
    So that serie
    s of “one year” came and lead into another… and another. My family and especially my mom was an inspiration. She never spent a dime on my tuition fee, that is because I felt, she has had enough of her share of hardships. So I made it a point my mom would be proud of me, and she be proud of her self. That despite having to bring up all four ostensibly ambitious children, her hard work did pay off in thousand folds. So every year during my college, she has to travel from our place to my school, climb up the stage and receive an honor in recognition for growing up four fine and ambitious children, proud of their mom, proud of their family. It was a memento of her marvel for survivorship.

    It was like these since then, the same story repeated through med school and even training. I, haughtily pursuing my medical career and my family giving the turbo charged after burners in times of chaos. I was busy carving a path for my career, and my family asphalted it for me.

    Whether my decisions would run for and contrary to their wisdom, they embrace me and hug me though my journey. How I became a doctor despite all of these, is another story to tell. But my family is pivotal to all the decisions I made in the past.

    I stood my ground through years. But I have shoulders to stand on- my family.

  • Tormented learning: A paradigm shift?

    For most of us, the mentor-stimulus for learning is a unique experience. Our “receptors” for learning may accept signals from nice, approachable and likable professors. The feel-good- mentor attitude is irresistible.

    But I learned most from the hard hitting, no holds barred tor-mentors. Not that I liked getting hurt or being hit upon for me to learn. But squeezing something positive from such “despicable challenges” always give me the “high”. Even if it was just for survival.

    That’s what I think happened in these snippets of paradigms shifts during my college days.

    “You got a 0.5 grade for your term paper?!” Grinning, my friend Joselito added “that’s higher than 1.0! You’re amazing!” and then he burst out in laughter. Already red in shame, I grabbed my paper Joselito was waving in air inside our classroom. I went into cold sweats and then froze humbled on my chair. “A 0.5? How the earth can that be?“

    “That was for you’re ink Mr. Tito! To give credence to your ink! You wrote a reaction paper instead of a concept paper, you *@#$!” This scumbag professor just didn’t remembered my name right. He also insulted me in front of our class. Judging from his snicker, he was visibly satisfied with my agony. I grimaced in anger while wishing the earth will crumble and I can smash the face of this fag.

    “How many times do I have to remind your weightless nut brain? You wrote a concept paper while I was asking for a reaction paper!“ So you get another 0.5 for your ink! Thats a 1.0 on a scale of 40 points!


    Getting a 0.5 on two term papers and zero on the other two are not just pranks and whimpers. It is sabotage! For that I hated English and Communication as GE courses in Pre Med.

    And then wished my bike would run over that darn professor.

    That wish never came. I never had the chance to smash the face of that prof, nor I was able to wreck his neck. For some miraculous reasons, I did finish the course without having to take removals. On the last day of our our class (which was also a mini speech competition with chocolates and free cinema tickets as prizes), he walk straight to me and told me

    “You were one of my most improved students. I never thought I could turn such charcoals into diamond snippets that you are right now, speech wise. You owe yourself some chocolates and a movie! Thank that 0.5 you nut brain!“

    Just like that…

    But I have this copycat habit of emulating some mentors in an attempt to incorporate their traits while forming my true self. Let’s face it, we take the values and personality we like and junk the others we deemed “crazy”. And mentors, are icons whether we like it or not.

    “Is that him? He looks like a bodybuilder to me than a professor.” I whispered to my seat mate. “Good morning!” came the booming voice over the classroom speakers. “I am Dr… and you are entering blah blah” The tall, muscled guy sounded like he’s going to mince us one by one. “…nobody said med school is easy. And being in the premier state university, you are expected to excel. So study harder…” The cool, smooth voice of this professor is surprisingly boring and frank. He means business and he is a no fun fare teacher. “He’s definitely making sure I’m par the slot I got in this premier medical school, or he’ll kick me out!”

    “Hell no! I wouldn’t want him to do that! Not ever!“

    “I want to be like this professor.” No, not his macho image nor his stern look. His frankness and no holds barred attitude is worth emulating. I thought he was a surgeon. But he is not. He devoted his time after med school to learn how to make medical students learn. On a very young age, he’s quite making an impression. “You flunk any of the exams. You better study harder.” So coming in to his office means you’re in trouble. At least for the time being.

    For one whole semester of listening to his human anatomy and dissecting cadavers to no end, I am both scared and emulative of this professor. His brutal frankness scare the wits out of my brains. On the other hand, I liked his habit of telling the truth first and only. No dicing. When he talks, I make sure all my ears, including my brain, is listening. Even if I can only absorb a handful of medical information.

    But his frankness is coupled with fairness. “I only record and calculate what scores you give me. You do the studying I do the grade calculations. Plain and simple.”Making sure you reflect the “results” you store in, is his concern. “You are actually grading yourself”. He told us in one didactics.

    For the next 5 years I marked my medical school days with attitudes I first stumbled with this professor. Frank, cool and fairness. “Keep your medical life simple. Study hard and you will get what you deserve.

    Though medical life is never simple as I’ve learned later, the attempt to simplify it was a fulfilling exercise nonetheless. I had paradigm shifts.

    These mentors were part of my paradigm shifts- changes in perspectives that saw the positive in every opportunity that knock in, scary and the not so scary. They were my windows to the new world.

    Mentors or tormentors?

  • Too good to be true! What lies beneath?

    “You’re too good to be true” a friend lamented I’m not into some form of “vices” these days. “I couldn’t afford any vice, I mean physically and financially” is my usual reply to this sarcasm.

    And for a reason.

    Sticking it out with “practicing what I preach” creates a “positive” impact on my patients and practice. But we all knew that of course. In a provincial setting and in a community so keen on nitpicking physicians for their lifestyles, vices and personal lives, I have to be on my toes always. Or I’ll loose my job.

    But, I do it with a twist, in my own terms. Something I developed to avoid being too goody-goody but effective to the majority of my patients. Apart from the health benefits, if you translate what you preach into some monetary losses or financial gains, I get attentive ears. Like these lines;

    “Smoking is expensive”
    I couldn’t afford to die of Lung CA if I smoke. The hospitalization cost is just to darn expensive. Besides, every penny I spend for a stick of cigarette would probably be enough to buy me a car during my lifetime.

    Never mind the difficulty of having to breath on COPDied lungs, I vomit on smoke aftertaste! The bad stench just don’t fit my stomach. So if you wanna go and make those cigarette companies (ciga-lords) and pulmonologist get rich, go smoke.

    “Drink moderately”
    Often a cliche, drinking what or how moderate is a debatable topic. Before, I seldom drink but when I do, nothing is near moderation. There’s no such thing as moderate drinking for alcoholics.

    But now? Gone were the of drinking binge and the alcoholic swagger to lure liver cirrhosis. My dad died of that. And I hate the next day hang overs! Well, this doesn’t hit my patients of course. But if you compute the expense of their day to day alcoholic drinking plus the complications it gets and then tell them not any cure has yet been found for cirrhosis, you will be surprised.

    “Alcohol plus driving= ER/surgery”
    Half of my patients where intoxicated with alcohol while driving. Driving a motorcycle at that.”Thank you for making my practice boom, dude. With the severe injuries you got I’m pretty sure you’d go broke after this surgery” This is a joke of course, but most patients don’t get to see the benefits of prevention unless they’re already in deep shit!

    “Over exercise regularly”
    I have an overdose of this prescription. Now I’m into almost all sorts of extreme sports fitness program. But I did lost a lot of weight, and trimmed my waistline. No, no six pack abs yet. But I gained some savings from buying over sized pants!

    There are so many other “preachings” I follow not only because of the health benefits I get, but also because of the financial woes I can avoid doing it. Practicing what we preach is a matter of personal choice indeed, but no matter what, our actions creates an impression on our patients and the community we live in. That is something we always have to think about.

  • An Electronic Health Record for Philippine healthcare system

    screen shot of FFEHR, an EHR for Philippine health care (photo taken from FFEHR project site)

    Long overdue and much awaited, an Electronic Health Record or EHR has been released for the Philippine healthcare system. Quoting DabawGNU, the co-developer of this EHR,

    The first beta release of FFEHR, an electronic health record application commissioned by the ASEAN+3 node of the International Open Source Network (IOSN), was released to the public last April 28, 2008. This release comes six months after the University of the Philippines Manila-National Telehealth Center tasked free/open source software (F/OSS) programmer Nathaniel Jayme and Davao-based F/OSS organization DabaweGNU, Inc. to jointly develop FFEHR. This release marks an important milestone as the project now opens its doors for public review.

    Basically just a first step towards implementing a well designed and stable EHR for our healthcare, it will definitely fuel an onslaught of interest from the so many healthcare professionals who have wanted a robust, scalable and free EHR.

    Details of this said project can be read here in FFEHR website or the DabawGNU site. A beta version for linux and windows can be downloaded here.

  • I "heart" the Philippines: The reason I’m staying…

    Loving the Philippines is not exactly the most popular addiction nowadays. The myriad of reasons (financial gains tops these reasons) for us to “pack up our things” and go somewhere else is all too alluring.

    “Hearting” the Philippines (as Doc Ian would aptly term it), is a costly fling I should say-one that is volatile and daunting. And for some ironic reasons, I grew to love My Philippines despite the countless setbacks I have and will endure. Here is the “why“.

    I heart the Pinoy.
    Okay, screw the corrupt, scoundrels, bigots, trapos, charlatans and the wicked. I’ll happily kick their butt to the scorn pit and the ass burners. There are countless other people however who overwhelmingly overshadow the rotten traits of these kibitzers and traitors. Joy, Russ, my family and the good people I learn from and serve.

    Russ my fair boy…

    Joy of my heart..
    A family that stays together…


    Some of the people I served…

    I am forever bound to them, and not even any monetary promise (unless that monetary renumeration is enough to save the whole Pinas) will separate me from their love and service. I hold them dear. And they are here in My Philippines.

    I love the place
    You see, whenever I get tired or bored from the so many bad news around, I go hopping places inside my Philippines on backpack and wits.

    Marvel at the ingenuity and diligence of our Ifugao brothers when all seems hard enough in life…
    Climbing mountains to get close to heaven…

    Frolic in the beach after a weeks hard work…

    Find a cool soothing underground river whenever you feel lost…


    Kid around with friends on some hidden paradise..

    Or simply jump below some crater lake for the heck of it…

    Awed by the beauty that I long so ago overlooked, I am astounded as well by the rich flora and fauna that littered the archipelagic
    Pinas. And I can travel incessantly without having to dig deep into my pockets.

    Simplicity is a way of life
    I have grown accustomed to the way of life here in my place.

    No matter how disadvantageous some of our traits will be, I still don’t think it decayed the unique hospitable and magnanimous qualities of us Pinoys. If you go to the country side, you will see the simplicity, the resilience, the hope and the enduring attitude of Pinoys that survive waves of colonization.

    We have a rich culture and history
    So rich and so diverse, I still haven’t understood half of it.

    I am however fascinated by its evolution and of its unfolding. Leaving, means being not part of this history unfolding. That is something I am not ready to let go, yet.

    The cut for living
    If I had a choice where to be poor, I’d still choose to be poor in my Philippines.

    I don’t know but whenever I go hungry, there’s always anybody who would willingly share a bread for me to eat. Yes, I don’t have a penny in my pocket, but some people don’t just bother to ask for a dime when they help you. And that’s why Id say it’s a lot better to be poor in this land than anywhere else.

    I want my future family to be “homegrown”
    There is no better place to grow and nurture a Pinoy family than ‘Pinas itself.

    That in a nut shell, is more than enough reason for me to “heart” Philippines.