Cast & Curious

Tag: Medicine

  • UP Medicine College Council Resolution supporting Dr. Jose Gonzales as UP-PGH Director

    RESOLUTION OF THE COLLEGE COUNCIL OF THE UP COLLEGE OF MEDICINE ON THE APPOINTMENT OF THE DIRECTOR OF THE PHILIPPINE GENERAL HOSPITAL UNIVERSITY OF THE PHILIPPINES MANILA

    • Whereas the University of the Philippines Board of Regents in its 1252nd meeting on December 18, 2009, appointed Dr. Jose Castillo Gonzales as Director, Philippine General Hospital, University of the Philippines Manila from January 1, 2010 to December 31, 2012;
    • Whereas Dr Jose Gonzales took his oath of office as Director of Philippine General Hospital, University of the Philippines Manila before the BOR Chair on December 21, 2009 and before the UP Manila Chancellor on January 7, 2010;
    • Whereas Dr. Jose Gonzales has already served as PGH director and has performed responsibly since January 4, 2010 with honor , integrity and transparency;
    • Whereas under Civil Service Laws, Dr. Jose Gonzales can only be removed as PGH Director for due cause;
    • Whereas the removal of Dr. Jose Gonzales as PGH Director is unjust and arbitrary, he should therefore continue to perform his duties and functions as Director of PGH for the welfare of the Filipino people;
    • Whereas the College Council of the UP College of Medicine upholds Academic Freedom, human rights, due processes and the protection of its constituents under the Civil Service Law;

    We, the members of the College Council of the UP College of Medicine resolve, as it is hereby resolved:
    That we recognize and support Dr. Jose Gonzalez as the duly appointed UP PGH director from January 1, 2010 to December 31, 2012 in accordance with his original appointment.

    Approved on the 2nd day of March 2010 at the Class 64 lecture room, UP College of Medicine, 547 Pedro Gil St, Ermita, Manila.

  • Statement of Indignation, LABAN UP-PGH Movement on PGH Director Controversy

    The PGH Director controversy continues to heat up with sudden twist and turn of events that will for the first time in so many years, fire up into a UP Manila/ UP-PGH wide constituency (Laban-PGH Movement) barricade tomorrow morning, March 1, 2010.  I’m publishing a copy of this Indignation Statement here verbatim. Chronology of events that led to this controversy will also be published in my succeeding posts.

    On the historic day of Feb 25 and the 24th anniversary of the People’s Power Revolution, the UP Board of Regents under the dark clouds of a walk out by the student, alumni, faculty and staff regents and a dismissed temporary restraining order against a decision to remove the student regent Chari Banez, declared null and void a board decision that appointed an already functioning PGH Director in Dr. Jose “Joegon” Gonzales.

    A grave abuse of power that has been done in the State University where we were taught the importance of dissent and critical thinking and where we learned to love democratic principles and idealism. Spearheaded by UP President Emerlinda Roman, supported by the three other GMA appointed regents, Congresswoman Cynthia Villar and CHED Chairman Manny Angeles ( CHED Chair Angeles voted in favor of Joegon in the December 18, 2009 BOR meeting, made a sudden and very suspicious turn around by now following the lead of GMA’s BOR appointees in January 2010). They have oppressed a UPCM faculty member and employee of the UP-PGH by arbitrarily removing Joegon a legally appointed, sworn in and functioning PGH Director under very extra-ordinary and highly suspicious circumstances. Civil servants are protected by law from such arbitrary actions even by the highest governing body of any institution in the Philippines. To make matters worse, his replacement by Dr. Eric Domingo a known political ally of GMA, was removed from the list of nominees for PGH Director in December 2009 because of his lack tenure being a part time employee of PGH.

    It is time to wake up from our apathy and fight not just for Joegon but also for what he represent and for what our conscience deems as just and right. Many have maligned him for his unambiguous stand on controversial issues in PGH and foremost is the disadvantageous deal made between UP’s BOR and the Daniel Mercado Medical Center that will soon operate a private laboratory, diagnostics, pharmacy and outpatient clinic within PGH itself. He has been singled out as the main stumbling block to the estimated hundreds of millions of pesos in profit that is grossly slanted to favor only a non-PGH entity.

    Therefore on Monday, the first day of March at seven in the morning, we the LABAN UP-PGH Movement and all our allies will barricade the PGH Director’s office to protect Director Joegon and rightfully keep his position as PGH Director. The All UP Worker’s Union have already committed to join us. UP students from Diliman, Manila and other units are rallying their constituents to join this barricade. We are counting on the PGH Faculty, the UP Medical Students and UP Medicine Alumni to be there. Anyone who cares for UP and PGH should be there physically or in spirit. We need all the help we can get. We can no longer afford to sit on the fence or watch from the sidelines. We need to act now and we need to act fast.

    OUR STATEMENT

    Respect the civil service law protecting the tenure of all government employees including the Director of UP-PGH. The arbitrary attempt to remove and replace Director Jose Gonzales under suspicious and extra-ordinary circumstances is unjust, oppressive, illegal and immoral.

    Kung ginawa ito kay Director Joegon maari din itong gawin sa lahat ng empleyado ng UP at PGH

    Ituwid ang baluktot, itama ang mali.
    Kung Di ngayon kailan pa
    Kung Di tayo sino pa.
    Si Joegon na Tama na.

    LABAN UP-PGH MOVEMENT

    A copy of the indignation statement can also be found on Facebook, here. Pictures of previous indignation rallies can also be found, here

  • The captain of your ship and a bosun too.

    The legal, ethical and aged (almost wise, but not quite) captain of the ship medical adage always stand true in any physician led health team. This autocracy is no more apparent anywhere else than that inside a surgical theater orchestrated by a feel god surgeon. I will not contest that Machiavellian theater governance (will write another post for that) but focus instead one ghastly annoyance that hound surgeons both inside and outside the OR once in a while. This:

    You are always the captain of your ship but oftentimes, you need to be a bosun too!

    I’m not sure if this is unique to any not so lovely practice environment but often something has to be done (short of putting a gun inside your mouth)  un-captainly in order to stop a captain’s sinking vessel.

    Take this one anecdote shared by another surgeon in one far flung province here.

    It was ten PM then when I receive a hospital call informing me of a VA victim who sustained open injuries to his right lower extremity. Already sleepy and tired from a surgery an hour earlier, I reluctantly hurled my ass to the ER and evaluate the patient around 10minutes after. While our hospital have 24 hour, “resident” staff physicians to attend to these emergencies, I rarely see one who makes an approximate diagnosis and institute an measures expected of a trained physician. So I need to go to the ER as soon as possible, if I need a better assessment of the patients status and institute immediate treatment myself less I get sued for malpractice for someone else’s missed steps.

    Anyhow, I came in 10 minutes late and was horrified  that I neither have an x-ray of the patients injured extremity (he has skull, chest and abdominal x-rays that are all significantly insignificant somehow) nor a splint stabilizing his grossly deformed extremity. I asked the nurses (couldn’t find the resident inside the ER) why this procedures wasn’t done earlier (or even prior to calling me up) and they unanimously said none has been ordered at the time patient was brought to the x-ray room. The gaping wound plus the bleeding “fracture” is repulsive prompting them not to do anything but plug the wound with tens of OS and tens more of leukoplast. In the meantime, the patient is wriggling in excruciating pain (an NSAID was already given IM earlier though) as they waited for me to appear in the ER’s doorstep. Not interested in witch hunting at the moment  and keeping my composure “respectable”, I asked for sterile gloves so I can examine the wound, pack the bleeding properly  and then put some form of splint before bringing the patient to the OR. One nurse went scurrying for something immediately, which made me sigh in hope. But this was short lived as I soon discovered, he just actually made a prescription for sterile gloves! I said, “you gotta be kidding me! If this is not for my patient, I (and the patient possibly) could have walked away in sheer disgust over the incredulous situation I am with! But we have no choice but to make sanity out of this proverbial serendipity (composure some more). I took some moment to breathe. I went to the CR and peed while waiting for God to bring in sanity to this ominous chaos.And the sterile gloves.

    On my way back to the ER I grabbed one pair of clean gloves and abdominal pack  from the sterilizing room, snatched a wooden handle from broom stick lying around, grabbed a newspaper and went back to the ER to do what I’m supposed to do. Then I waited for two more hours just so the patient can be cleared for OR. And I was ten minutes late?!!!

    In the OR theater, the same operational amnesia goes on unabated. No available sutures, inadequate or barely working instruments, robotic assists with pillar like extremity dexterity and blurry dioptic visions. I get lots of stymied fans standing all around me doing everything except being helpful to the ongoing surgical orchestra. I cannot describe how I moved assess and turned OR cabinets to look for this and that but we managed to produced the needed stuff anyway.I bring a back up OR stash anyway for frequent detours like this. It was however, brutally exhausting and tension filled voices and breathing almost always kill the fun inside the OR. Luckily, the patient survived the procedure well and went back to his normal (drunk driving) life again despite the chaotic serendipity. Now, I know some hospitals are ill equipped and manpower deficient most of the time, but occasional like these are totally unacceptable if we want better service for our patients!

    The poor surgeon obviously was holding himself in one piece and acted magnificently composed despite his horrific ER/OR encounter. For some, this incident is rather minor and might not constitute an annoying occurrence. Me however, in my zaniest complaining attitude, will whine in sheer frustration. Not this surgeon I guess. He simply went on doing some “extraordinary” stuff to fill in gaps in the proper delivery of health care service. We are abused in our training to do more than being just the surgeon. Who couldn’t forget having to buy sutures for your patients or pleading another patient’s extra OR needs during residency? Un-surgeon-ly? In our day to day encounters as a medical and surgical professional, we might find ourselves in similar situations and do one un-captain-ly act  for patient to recover uneventfully. You might  need to be as a resourceful and quick thinking para medic just so you’ll salvaged a patient. Or your career…

  • Ironic absurdities for Bonedoc: A Mini-Series of some sorts…

    Last night when I was reading Bongi‘s blog (Other Things Amanzi), I came across his brutally hilarious (but freakishly realistic) post on (his sort of) “surgical principles”. Bongi is a general surgeon based in South Africa and though I see striking similarities between our “surgical worlds”, I found the guy’s witty and humorous ways of narrating his surgically bugged life, intriguingly interesting. Anyhow I’m particularly inspired (nah, copycat) by his post on how he came up with “his principles”. Not that I subscribe to all of  these but most went straight out of his operating theater making it egoistically fascinating for us surgeons and surgeons neck peckers. The one thing that strike me most was this “flat” referral to his bloody (or organically graphic) reality and how he finds way to “enjoy” it ( at least once ) to the point of gas-tronomic absurdity.

    So I thought, why not write about disarming eccentricities of provincial orthopedics too? I surely can make up a few wigwams out of my usually unusual orthopedic (mis)encounters. Obviously, these are anecdotal too and are tested only by me. Some may even be unique to the proverbial orthopedics to which I am helplessly thrown into. So Bongi, don’t care about my being a copycat. I call mine ‘ironic absurdities’ (instead of your principles) for Bonedoc anyway.

    1. You are (not only) the captain of your ship.
    2. Slowing down makes (near) perfect. Haste makes waste.
    3. Schedule surgeries on your vacations (and not on patient’s ‘ workdays).
    4. Flirt, to make surgeries less boring.
    5. It is always the some other surgeon’s fault. I mean, your “other” surgeon.
    6. Exercise outside OR.
    7. Have lots of fun, even when your obviously exploding in rage.

    Somehow those are the more common situational ironies I can think of for now. Others, I will add (or subtract, depending on my gut feeling) up as soon as they hit me hard with a hammer. Some I actually relish now. I will link each of these absurdities to their individual post as soon as I figured it out of my mind and into my computer’s main memory. Hopefully,I will not kill my practice and blogging career with this ghastly concoction of experiential ironies .

  • Townhouse blogging: Will it be for real?

    Here’s a spin of my epic reawakening.

    When I started blogging about health care issues a year ago, I restricted my so called “online journal” to personal nuances that rarely touch anything substantial beyond my own epidermis. It was easier back then, having to simply blurt out personal experiences in order to keep the curiosity of my readers. It was this curiosity that enabled some readers a window into the often chaotic and enigmatic life of medical students, physicians, residents and the tears and glitter that came with our job. Grey’s anatomy, Scrubbs and House MD entertained more viewers rather than offering realistic solutions to health care debacles. But they did succeed in bringing health care personnel into some different form of popularity.

    When I stumbled on foreign medical blogs that espoused critical thinking on health care issues that affect their system, I became deeply interested and got hooked. The realization in my situation was not something of a “late bloomer syndrome” or this epic, numbnut, out of touch physician. It was rather a realization that I too failed to acknowledge (and kept it that way for so long) there’s something screwed with our health care system but I walled in myself saying it wasn’t my business after all. I chose to be blind and remind blind to these imperfections believing I couldn’t effect some change.

    That soon changed as I went by writing about whats happening “inside the system” and reading what “outsiders”(distinction mine) say about my health care system. It’s simply too much to ignore. I couldn’t simply box in myself to personal nuances and leave others to rot for themselves. One could not simply close thy eyes to the worsening health concerns just because we can afford to salvage our privilege arse. Thus, I slowly drifted into an opinionated blogger that criticizes anything and everything thrown on our health care system and our lives as heath care providers.

    Even political ones.

    I may not have the soundest and most elaborate dissertations on health care issues nor I profess to offer the sanest solution to any of these pressing problems. I hope though, that I can create awareness, encourage readers to criticize, to participate in the discussion and to offer reasonable solutions to issues affecting their health. That, is essentially what became of my erstwhile “blog for glamor” attitude-an advocacy.

    Admitting this is rather not easy as it looks. Nitpicking issues that are far more complicated than syndromes in medicines is not an endpoint in solving these issues. Simple solutions to complicated issues are as elusive as finding a cure for cancer. Nonetheless, it is still possible. This is where I pin my hope. That after I put forth health care issues affront, invite a melee of discussions(townhouse discussions of Obama) to such issues, a simplistic and reasonable solution may come out and be implemented to address our most basic health concerns. It takes political will to do that, but that is outside my advocacy at the moment. I leave the politics side to my political readers.

    One thing I can promise my readers though, that I will continually read, challenge, criticize or applaud works that tend to improve our health care situation in general. Of course expect me to give a wrath whenever something else take our stride to down turns. We has had our enough of health care screw up, we need none more to hammer a coffin nail.

    So, shall we start a discussion?