Friday, April 27, 2007

A Tradition of Pfffft

WARNING: Negative, Crappy, Very emotional Post Ahead. Skipping this junk is good for your health.

Also, i intended not to use the exact names for several reasons: 1. once someone googles the keywords, this blog might be discovered 2. for security reasons - i didnt name names here. Someone has to use his or her neurons in order to figure out who im referring to. In short, if you'll react to this crap then you're guilty.


I have yet to see a hospital where the "captain of the ship" in every surgical procedure is the "pain-free department". This crap hospital however where i am in is truly one of a kind. The supposed to be captain of the ship who are the "cut-me-up" quacks are the kind who cant stand up for themselves. As for the risks of the operations, the last word always comes from the pain-free department. Oooops, i'm mistaken. I would like to correct myself. The last word comes from us. Our cp evaluations are the ones that determine the success or morbidity of the surgical procedure.

I shall lay down my premises to support such claim:
1. Cardio-pulmonary evaluations is not automatic for an above 40 years old patient with no medical problem. Why is it that we still accept referrals for evaluation once the patient is >40 years old? Should there be any electrolyte problem, then it's not a CP evaluation anymore. Take note too that the bible of the "cut-me-up" quacks has a chapter on fluids and electrolytes. They're supposed to be capable of managing any electrolyte problem of their patients.

What happens here is that the pain-free department shall suggest cp evaluation prior to a proposed procedure. What the hell are we going to evaluate in the pulmonary and cardiac aspects? The only laboratories that we request are CBC, ECG and CXRAY for a CP evaluation. Can you find any electrolyte examination there?

The supposed to be captains however are unfortunately chickens. Once the pain-free department would hold the or first for a cp evaluation prior to it, the cut-me-up quacks recede and follow blindly. They cant stand for themselves or for their patients. Speaking of lack of confidence to one's self. If the patient needs an immediate operation, why the hell wait for an evaluation from us? Will our evaluation change the prognosis of your patients? Should i give a high risk evaluation, will you defer the procedure? What i would like to emphasize here is that the success of your procedure doesnt lie in our cp evaluations. If you arent skilled enough to pull your patients out of the hell that they are in, then dont use our cp evaluations as your scape goat once you screw up.

2. If you're going to deny the truthfulness of the one mentioned above, then why the hell are you looking for all reasons just so to refer your patient for evaluation? A patient without any medical problem so long as he or she is more than 40 years old suddenly has hypertension or pneumonia. A normal ecg suddenly becomes abnormal.

Why am i ranting about this? It's not because i hate to accept referrals. Heck! Been toxic all my life and i'm used to receiving a lot of referrals. What i just can accept is the fact on how the supposed to be egoistic, thinking-they're-all-knowing cut-me-up quacks chicken out. Is it just to avoid conflicts with the pain-free department? Sheesh! If this is the reason then let me define it as rather plain and simply apathy topped with a cream of insecurity.

So long as noone moves to stop this tradition, so shall the pain-free department continue to rule over them. A lot of referrals become unnecessary. I hate to say this but i am tempted to think that we are the best residents in this crap institution. Why will our evaluations matter much if we arent? Why cant a procedure push through without a word from us? I just hope we'll stop all these craps. We all are under training. We too arent as good as you think we are. What separates us though from the rest is that we know how to stand on our ground for our patients' sake. We know how to mask our lack of confidence and we too know how to make up for it. In short we dont let it obvious how stupid we could get sometimes just like what you guys are doing.

Now, just so you'll feel better before i end this blog, ive got a secret to reveal here. When you call us for an intraop referral, you guys feel so confident that we are around. Without your knowing, we too almost goes into cardiac dysrrhythmia with the patient. So the next time around that ill be asking for diazepam, ask me first on who's going to have it first. The patient or Me?

Pest Control

As the appointed "elder" of the six renegades of the department, i am always called to the office of the chief of clinics for meetings. While waiting for the other "elders", i seated myself at the meeting table. In front of me were different letters from different offices addressed to the chief of clinics. I didnt care about those letters except for this draft that's staring at me. The one who wrote it must have taken the seat i was currently occupying.

We'll be having a graduation for the hospital interns this upcoming week. As a tradition, the interns' graduation is held in a hotel. For this year, due to lack of budget (which almost always is the case), the current interns shall graduate at the hospital hall instead. It is nice to note that this month, the hospital fed almost all of its employees during the blessing of a new infrastructure in the compound. That budget was supposed to be alloted for the interns' graduation - as the hospital "buzzers" would say.

Heck i dont care where they'll be holding the graduation. I dont even care where they took the money for the activity i previously mentioned. The gist of this blog is that finally, the interns shall graduate in a hotel. A budget was requested. The draft that i saw in front of me was the budget proposal for the said activity. It contained the exact date, time and venue of the said graduation. What bothered me the most however, which even gave me doubts if i'll be attending was this heading:

Environmental Sanitation and Pests and Rodents Control Seminar

No wonder the rats here in our wards are as big as the cats that roam around here and that the sanitation is very apt for a hospital in a 3rd world country.

I wouldnt be surprised too why the pests and rodents here became administrators and employees.

Tuesday, April 24, 2007

A Business Proposal

I have a business proposal.

Working here in this crap hospital isnt just tiring. Aside from our delayed salary, numerous admissions, toxic patients and folks, i too have to adjust to different personalities. From the patients to their folks, to the nurse and helpers, to a colleague, a superior, to the hospital administrators, these are the people i have to deal with everyday. Good thing if these people have had a good childhood but majority of them i guess didnt have one. In short, my toxic life in this institution becomes all the more toxic and consuming because of them. I really dont mind going on 24 hours duty even if it's every other day. Not even the toxic admissions, both in quantity and quality. Physically, i still could sustain them. What really consumes me are the negative people that surround me. They really are energy sucking creatures who have the capacity to leave you limp like a veggie.

This is the impetus of my business proposal. I know that this will not just give me an additional source of income just so to augment my always delayed salary. With this proposal, i believe that i could help make this world a better place to live in - speaking of civic responsibility, eh.

I have no units in business nor am i well-versed with business proceedings. I shall present my proposal the "best-est" way possible, from a physician's point of view.

PRODUCT: Attention

Nopes! Not a typographical error. Yep! I'll be selling ATTENTION (a-ten-sh'n). Otherwise defined as notice or interest, better yet, appropriate treatment. I grew up with an analytical mind. Not in a mathematical way of analysis (i hate math!). Analytical in a way that i tend to analyze why a certain thing or person acts in a way. In short, when someone tends to piss me off, my mind automatically analyzes the action and the person. Why is he behaving like an a--hole? Why is she such a b*tch? When you tend to share with a piece of my mind, then it only meant one thing - after all my analyzations, i have all the reasons to snap out on you.

I began to hypothesize that those people who are difficult to deal with and those people who really get into my nerves are lacking of one thing - ATTENTION. These are the people who i guess grew up to be neglected children. If they arent, then maybe they simply were lacking in attention, were attention-seekers or worse, gifted with an attention deficit disorder. If they were showered with such when they were growing up, then they wouldnt tend to draw all attention unto themselves as adults. In whatever way possible, if they were deprived of attention as a child, they will try to shift the limelight unto themselves. They may grow up as egoistic, self-absorbed, or power-tripper kind. This brings me then to the target population of my product.

Government employees specifically:
a. hospital administrators who are too preoccupied with "throne-grabbing", experts in mudslinging and corruption - they shall avail a 50% discount off from my product if they are eligible and i could even give it to them for free if they would admit that they are guilty of either of the aforementioned traits.

b. doctors/nurses/employees who are loud, irrational, unjust, immature, insecure and inefficient. Discounts shall be given depending on their salary grade. Again, the product will be given for free if they admit guilt for either of the above-mentioned characteristic.

c. politicans who have the "Star-complex", are "incoming corruptibles", who are experts in giving promises with subspecializations in breaking them. No discounts shall be given unless they already are in the position and are currently keeping a fraction of our national budget in their personal bank accounts. For the latter, this product shall also be given for free.

I shall sell the product in two ways depending on the client's personality. If he has some trace of autism or those who are comfortable being alone, i shall offer it in a small room. Its walls are all lined with mirror. Mirrors that only reflect the goodness in one's person. Yep! I believe that there's something good in everyone. Hell yeah! Even if he's as calloused and as unethical as someone i know (tee-hee!). He'll be seeing himself, all good and perfect until his eyes pop out. All his imperfections shall be hidden from him. Everyday, someone, an authority figure, his parent or child, spouse or special someone, shall talk with him, feeding him with all the positive words he'll expect to hear until his ears bleed to death. His every action shall be noticed even the way he picks his nose.

As for those with star complex, I shall sell my product in a bigger venue. A football field, a concert hall or a coliseum. I need to fill it with people with my client standing at the center with all the lights focused on him until he scorches to death. I will let him talk to the crowd and allow him to pour his heart out. Praise himself, divulge his assets, brag his achievements, yadda, yadda, yadda. The crowd on the other hand shall do nothing but to clap and praise him complete with wooohooots and hurrays! The catch, aside from the microphone he's holding, he shall wear a pair of earphones amplifying the sound of the crowd until his eardrums would give up and get broken.

In such way, who the hell shall be wanting for more attention?

My business shall have its boom upon its introduction. All people from all walks of life shall try his or her best to acquire my product. Parents who couldnt give enough attention to their children shall purchase it to cover up for their deficiencies. Governments shall buy my franchise for its employees and schools shall buy some rights to include this in their curriculum.

I could see my business falling off however after a few years or even months. The time when people would realize how difficult it is to draw too much attention to one's self. When people would feel so uncomfortable having all the attention to themselves. When people would realize how good it is to work unnoticed and on how gratifying it is to be recognized for an extra mile he's extended. In fact, some would even get even by giving attention to others. In such way, noone shall be wanting.

My business shall then close but then again, i already gained profit from it and i have made this world a better place to live in.


Sunday, April 22, 2007

Sick...Weather Sick

I'm on a weekend off. Nah! Dont be too excited for me. I still have to report to the hospital, make rounds with my patients and supervise my junior . The off doesnt mean i'm totally OUT of the hospital. It's just that i was off from a 24-hr duty. It's been 3 years that i havent experienced being off from the hospital even for just a day. Except of course when i went on a force leave. That whole week away from the hospital was like heaven to me. Away from the sick and the dying, not exposed to the beasts of the jungle and of course far from the crap hospital that makes me sick.

Fact is, im feeling sick. It's a subjective feeling alright. Physically, im afebrile and it's just the weather that raises my temperature to a febrile state. A 36 degrees on the thermometer? Heck it feels like 38! I dont feel like getting out of the car. I dont want to leave an airconditioned room. I dont even want to get out of the water when im already in the tub. Sheesh! I guess this supports my claim that i really am a mermaid! Aside of course from the fact that i love the beach, i dont eat big fishes (blue marlin, etc), and did i say i love the beach?

Emotionally, im not having any hang ups and finally, noone's stirring up my peace. I just want to feel sick maybe? I wanted to call in sick tomorrow for my duty. I dont feel like moving a limb. I just wanted to lie down on my bed and sleep the whole day. Or sit on my chair in front of this panel and blog or chat all day. I dont want to see sick people. I dont want to pronounce a death. I dont want to smell the hospital. I dont want to hear an ambulance coming.

Whew! Sometimes, this kind of weather dries up the csf that bathes my brain. I didnt realize that this humidity could cause such behavioral changes. I was feeling ok with my work this morning and why this sudden change of mood? It's hot! It's humid! Take note it's nighttime but it still feels like the sun is still up. The aircon's not enough. I feel like cramping myself inside the freezer. If only Alaska's just a few minutes away.=(

Aaaaargh! This calls for a bubble bath!

Ey mom! Can i sleep in the tub?

Friday, April 20, 2007

Cut the Crap

It's the 20th of the month and tomorrow's supposed to be the 21st. The third pay week. However, twas just yesterday when our salary was released. This should have been given out on the 14th or the 15th of the month. In other words, since tomorrow's a weekend, we'll have to wait for next week for another week of pay. By that time, it would be the 23rd already. Another 2 days of delay in our week's pay.

Hearing me talk about this thing would definitely make you suspect of my dire need for money. In fact, I am single, living with my parents, and have not one dependent. Where in the world will i be using my money then? Why the hell am i so concerned with our delayed salary? A delay of 3 or 4 days wouldnt be a big deal at all actually. Why am i ranting about it then?

This post isnt about myself at all. Fact is, I survived my 1st 3 months of work in this hospital - unpaid. Which reminds me...where did that money, (of almost 3 months) for the said item i applied to, go when it was not granted to me? Fortunately, my parents were patient enough to provide for my daily allowance. They might have programmed themselves that i'll be having a prolonged adolescence. Heard not one complain when after the boards, i still was asking baon from them despite of being employed. Goodness! I am one lucky soul.

As for this blog? This is for the manongs and manangs who work in this hospital. This is for the nurses and the helpers. The silent majority who receive only a fraction of my salary. Those who raise 4 kids the least, all of which are studying. Those who are already buried in loans and debts before the payday. Those who have no other option but to borrow money from the "collector's guild" that gives them an interest of as high as 20%. Imagine how a 3 or 4 days of delay would affect them. By payday, their money will just pass by their hands for it'll end up with the "vulture's" who are already waiting outside of the cashier's building. I even witnessed one helper who have six kids, one of which was very sick (now dead), receiving just a hundred pesos for a week's claim because of a lot of deductions. On the contratry, I received more than 20x of what he'd got. I was taken aback.

This delay in our monthly salary distributions has been happening in this institution eversince. What's the problem with those who prepare the payroll? Isnt the payroll just their only concern? What's happening to the money that's supposedly be given out on time if not for the delay in the release of the payroll? Is it true that some people benefit from it? That some people gain bank interests out of it? This is quite a sensitive topic to talk about in this venue however. I too dont have enough data to validate this story. What i am more concerned now is the job performance of every employee of this crap hospital. If the helpers or nurses are reprimanded for a poor performance, why arent those who are responsible for the payroll berated for a delayed payday? If the doctors and nurses who are more harrassed here (i'm speaking not because i am one of them), are strictly monitored for their work, why are those people in the payroll left on their own?

This place really is full of crap. I can count with my fingers, and toes included, the number of people who work efficiently well here. If i am only given the power to exterminate...err i mean terminate those who arent useful in the government, i shall start in this institution. I realized that it isnt just our patients who are exploited here. The helpers, nurses and doctors included should also be in the list. But really, speaking of extermination, a former colleague and i had plans for mass annihilation - Schindler's list movie inspired.

What can i do however? For four years here, i have started to develop my horns. This gave me the confidence to attack anybody who have done me wrong. I am no vigilante though. I am just a mere resident. Someone who's temporary and who's not going to stay. Besides, this former colleague of mine already left this place. Half of the plan was with him. Also, should i lead the complain alone, i could see noone behind my back. I could picture out myself in front of the pack with one arm raised, clenched fist, shouting for an injustice - ALL ALONE. The pack, silent, only looking at me, unconcerned, appreciating my best actress performance...woohoot!

I realized that these people whom i am representing are quite adjusted to this kind of system already. If not, someone must have lead the pack a long time ago to correct this inefficiency. These people were here for years. I have been here for just 4 years - not even qualified to apply for a longetivity claim. What the crap am i ranting about here then? I, fighting for an injustice yet the aggrieved party remained to be apathetic? What is there to fight for? For whom will i be fighting for? For their family? For their kids? Heck! They cant even fight for themselves.

Oh self, cut the crap! Back to your autistic mode. It's more peaceful when you're in your own world.

Thursday, April 19, 2007

Thank You

If you're a regular reader of this crap...err i mean blog, you might notice this button at the bottom of this page.

If you have no idea what this is, i installed this thing to keep track of those who get to read my posts. If you'll be asking me for reasons why? I too dont know why. I just happen to hop into one friend's blogsite and found this link. Might as well have this one too in my own site, so i thought. Actually, i became amazed by my visitors when i started to check on my sitemeter. People from the us, canada (shawcable communications? do i know you? =p), middle east, australia, and my beloved philippines became my regular visitors. I dont even have any idea of who you are guys. All i can see in my sitemeter are your domain names and location.

Anyhow just some warning. This blogsite isnt meant to entertain you or to let you feel good in anyway for this is actually my trash bin. Some negative thoughts or energies that arent meant to be shared with the people around me are all poured here. If by some fate however that you were brought here, my apologies. I am in no way deliberately destroying your peace of mind. I have no intentions to dishearten you or to dampen your spirits. What you can read here are products of human emotions. Of course, i am trying to be humorous sometimes. Hell, humor is my most mature coping mechanism, i cant live without it.

After this very long introduction, what am i just trying to say is that, thanks for dropping by.

You guys are my counselors. In your silence, you share with my deepest emotion.

An Old Commitment

I was transferring my stuffs into a new wallet (a long overdue christmas and birthday gift from my sister), when i came across these two, almost worn out pieces of paper. Been changing wallet for years yet these two pieces of paper never left my wallet. For me, they're more important than the credit or atm cards and id's or license that i own. These papers are worn out yet these papers continue to inspire me.

The first one was an old newspaper clipping. It's a poem that inspired me to keep on doing what i have already started. Tore it from my Sunday newspaper. When i was an intern, i attended 6am masses at the school chapel. I would usually drop by a newspaper stand and buy the Sunday papers after it. The column of Dero Pedero kept me glued. It contained mostly glimpse and inspirations on human life. This clipping was taken from a newspaper that was dated 5 years ago. I guess this is not just worth keeping. It's meant to be shared too. Let me direct you to a blog i made a few years ago...on ANYWAY.

Lastly, the second paper was more of a commitment i've made before i started my junior internship. This would be the first time that i'll be revealing what that is. A commitment that i held on to even until now that i'm already in my residency training. Dated March 20, 2002, i could count five years from the time i wrote it. It's a commitment that actually helped me through the toxicities of medical life. A commitment that made my life a little bit easier and more tolerable unlike if i have none.

You can read what that commitment was on the picture above and I might be sounding so saintly there. Rereading it right now makes me puke. I didnt realize how idealistic and martyr i was. Or maybe, the institution that im currently working in, created some hardened areas in my heart for me to react this way upon reading it.

Who wouldnt feel hardened when after you have invested your all, from your time, effort, knowledge and skills, and even emotions, this crap hospital gives you nothing in return but headache? You would always feel uncompensated for a hard labor. You would always feel disappointed to the administration. You would always feel disheartened for your patients. You will always be battered by every 24-hour duty. Yep! To the point that you'll sometimes forget about your family, your friends, your own self. Only to realize at the end of the day that heck! there's life outside of this crap hospital. There are people around me other than my patients and these beasts in this jungle where i am currently in. Despite all of these, why do i still prefer to be here? Am i just being stupid? Am i running for a place in heaven?

When i opened this piece of paper, i realized what kept me going. I was reminded of a commitment ive made five years ago. I realized that i didnt just keep it inside my wallet. I internalized it, i lived with it. Maybe, this institution didnt change me after all. If i did change, i might be just a little wiser or more mature. Braver maybe. More concerned with others especially with the patients that i am more responsible to.

Heck! After all these years, I realized that I still am a martyr after all!

I need a dose of Kytril! Something inside my mouth regurgitates.

Sunday, April 15, 2007


A few days ago, i was surprised by the batch of junior interns who have just graduated. I know that a number of them could read this entry. Anyhow, let this be a venue to thank them too.

I need not mention what happened, but it was really my honor to have attended their graduation ball. I feel so indebted to them for several reasons. First, i was made to realize that an ordinary gesture for me would be extraordinary for others. I was just doing what i was expected to do and to be recognized for such was quite a big deal for me. I am used to receiving expressions of gratitude from others. Been serving a government-ran institution for almost 4 years. Being thanked at however to the point that it made me feel that someone owes me something is a different story. It becomes a responsibility for me...something that i have to live up to.

Second, i was exposed to a group of interns who i guess stands out above their peers. Future doctors who would change the medical practice here in town. I've worked with them for a year and another year for some of them. I've seen them in their high's and low's and ive witnessed how they treated their patients. Majority of them have a heart for service. This made them different from the rest. As one of their resident's who wouldnt be honored to have worked with them?

Well, to those of you who could read this, i just would like to thank you too. It is not just you who are indebted to me, but i owe you guys a lot too. You were instruments on how i could give back to my alma mater its goodness to me. More like a "paying it forward" thingie. I just hope that when you become residents too in the future, you'll always put in mind what makes you different among others. I dont want to sound so patriotic here, but i guess our alma mater has embedded in us something that makes us different. Remember that you'll become doctors too. Doctors who are best in your field and with a heart.

Monday, April 02, 2007


here's something deviant from the context of this blog...since it's my day today, i tried this thing know for self-review. to my surprise, it speaks a lot about me...around 99% of the time maybe...hehe