Thursday, March 31, 2011

Pruning and Popping

Was scrolling through my old blog entries and chanced upon a really old one last year when I was mocking, ridiculing, debasing, and all-around laughing at Smoketh's state-of-affairs as an unpaid fellow, in particular her poverty. How she would roll her car over a tube of toothpaste just to squeeze out any remaining Beam toothpaste, and how she would ask for the used ABG cups so she could drink the remaining water in it. In pure poverty. She was a prune, but now she is a self-confessed blossoming "cherry". Her word, not mine.

"A blossoming cherry waiting to be popped." My words.
"Do you pop cherries?" she and enjh asked. Obviously they haven't had any experience with porn.
"Yes. Smoketh, you can ask Churfuck (her boyfriend) to pop your cherry. You can say, 'Churfuck, please pop my cherry'. But practice saying it or you might accidentally say, 'Churpop, please fuck my cherry'." Although either way it's the same idea.

But now, poor, ugly, old, and dry, I am the prune. A poor, ugly, old, dry prune. And how could I forget rusty. Just a couple of months off residency and it already takes much effort to remember things. For instance an OB resident accosted me and asked how to compute for dopamine, and whereas before I would mouth it off automatically in the generic teaching-teachingan Gen Med voice (there's the generic Gen Med senior voice that I couldn't quite describe), this time I suspect the OB resident could my hear the clunky tiny gears in my head turning as I struggled to remember. I remembered it eventually, but not after a few brain cells popped and died to produce the information.

Prune. What can you do with a prune. Nothing. Except give it to constipated people.

Wednesday, March 23, 2011

The Art of Medicine--Oh Yeah.

                In a fantastic season 4 episode of The X-Files entitled Clyde Bruckman’s Final Repose Clyde Bruckman is a sort of clairvoyant whose precognitive abilities are limited to knowing how a person will die. It is therefore apt that his day job be that of a life insurance salesman. In one circumstance he directly tells a customer that he should buy a particular form of insurance because he would die in a car crash. “Mister, you should really work on your closing,” man says.

                I am reminded of this fun tidbit because more and more I realize that this particular new field I’m training in probably requires more human/social art than anything else. There’s the art involved with disclosure (probably the most difficult, so I’m still trying to mostly evade this part, don’t ask me how I do it I’d embarrass myself); the art in dealing with the C&N, ie, clinginess and neediness—a tricky one as clinginess and neediness should not necessarily be viewed as bad given the circumstances yet those two are what get to me the most at the present;  and the art of closing particularly during the initial consult, as I am always under the impression that we should always somehow end a consult with a sense of hope. I personally know what it’s like to be at the opposite side of the desk during a cancer consult, so that probably confounds things as there is the tendency to be overly artsy.

                It is somehow convenient, in this early stage of our training, when patients are as equally evasive of the issues. I would evade and dodge with them, because at this point we are both unprepared. Occasionally a few would opt not to beat around the bush and look at me directly in the eye and ask if they would get cured. I think I am good at beating around the bush because I love bushes and other bushy stuff and bushy stuff you could smoke, and I could probably tell them that “cure” could mean a lot of different things etc etc etc, but we all know what they’re talking about, and that’s total destruction of that annoying thing called cancer. The first thing I should probably learn is to how to look at them directly in the eye, and not say something stupid like “well, I think…. ano.” Just yesterday someone asked this question about cure, and the first thing I said was, “Well, cancer is… the new cough and colds. A lot of people have it. Siiiiige po!”

                Cough and colds. Yes, I really need to work on my closing.

Monday, March 21, 2011

The Ketobora Phenomenon

Back in 2008 when we were first year residents Tessieloopagoop got this perplexing text message from a nurse in the pay floors:

"Informing Dr. Ketobora that patient (name) is dyspneic."

This caused a general scratching of the head as no one in the planet is named Dr. Ketobora. No one in the hospital has a name that vaguely sounds like Ketobora, and we know no signature no matter how bad it is that could be misread as Ketobora. Calmly Tessieloopagoop texted back and clarified who the heck Dr. Ketobora is.

"Sorry hindi po pala Dr. Ketobora. Si Dr. Uto po pala."

This caused a general scratching of the head as no one in the planet is named Dr. Uto. No one in the hospital has a name etc etc (repeat all sentences from the previous paragraph and swap Ketobora with Uto). Really, who the hellellellel are Dr. Ketobora and Dr. Uto, and even if they exist in the 52 parallel universes how could Ketobora be misread as Uto? To this very day we've never learned who the heckeckeck those two strange doctors are.

This morning one of my favorite breast cancer patients texted me to inform me that there is no vacancy and that she couldn't be admitted.

"Good morning Dr. Adansan, di po ako ma-aadmit today."

Drs. Ketobora and Uto, whoever you are, you have a new colleague by the name of Dr. Adansan, whoever he is. I hope to meet you all in the next twenty lifetimes.

Tuesday, March 15, 2011

Plug Stuff With Stuff

And so it was one fateful night that I discovered that music can give you a higher high. You know junkies, they yearn for new, escalating sensation of high with the substances they are addicted to, hence the phenomenon of autoerotic asphyxiation--which deserves another blog entry--ten blog entries all together. After graduating from my clunky walkman and discman in 2003 I started using my Palm as my personal music player. That was the time when such device was still called Palm Pilot and the Graffiti mode of writing could make you write "fuck" instead of "fuse". I used some extremely cheap earphones with it, which could be bought in Pedro Gil once a week. Once a week because it could cause all sorts of headache and would malfunction in all sorts of malfunctionification. And so during that fateful night, as what always happens, I fell asleep with the damn earplugs, face down on the pillow, with yet another pillow covering my head--fantasy position for those who want to kill me. I woke up in the middle of the night with Lauryn Hill not singing, but sending direct telepathic music to my brain. What the hellellell I thought, thinking it was some kind of alimpungatan, speaking of which, I've been really curious how you could conjugate alimpungatan into a verb.

With much amazement I discovered that I was sleeping with my nose pressed against the earphones, and with  the pillows surrounding my entire head the earphones were sending music directly to my brain through my nostrils up through my coke-damaged cribriform plate and directly to my brain. The joy at the discovery was akin to having discovered by myself for the first time in my hormone-ravaged youth the pleasure of... let's say playing tetris in our Mitsubishi family computer. I tried it multiple times--I plugged the tiny earphones up my nostrils and covered my ears with some earmuffs and yes--Lauryn Hill, Radiohead, Creedence Coldwater Revival, Alanis, etc were sending telepathic songs directly to my brain. I looked it up on the internet and apparently some other freaks were doing it too, and when I saw what the freaks doing it looked like I felt embarrassed and resorted to some other addiction, preferably one that involves plugging something with something. This is obviously the reason why iPod earbuds are white--so I would feel guilty doing disgusting stuff to it.

Thursday, March 10, 2011

A Second Call For Marth!

In the pure absence of things to talk about in our current zombified state Frichmond, Smoketh, and I started waxing nostalgic. Truly I had no stories to tell them.

"I tried breaking open an ampule today. The ampule fell on the floor. Luckily it didn't break. So I picked it up," is the most exciting story I could tell, hence the desperation to rummage old stories.

"Let's try to imagine what Robinson's Ermita looked like when it was still poorita before it transmogrified into Midtown," one of us, whom we shall call Zombie 1 instead of their proper codenames, said. "Where was Starbucks before?"

"A stone's throw away from Fridays, near the Pedro Gil entrance," Zombie 2 said. There is no point discriminating among the zombies, as everyone is now properly zombified. "What restaurant was beside Starbucks?"

"Some restaurant. That area is cursed. It used to be...."
"Cucina Victoria!"
"And then in a few days it became...."
"That crap restaurant that serves expensive crap food, Oody's,"
"Which is beside...."
"Faggaro!"

Stay away, all sorts of political correctness activists, we did not coin the term. Faggaro used to be a popular colloquialism for Robinson's Ermita Figaro, because it used to be a tambayan of all sorts of drag queens surrounded by young, heavily-made up women in tiny skirts. We're not morons so let's cut the political correctness crap--those drag queens were pimping the girls to foreigners. When Robinson's was expanded and Figaro sort of underwent a transformation, however, all them draggies disappeared. Frichmond started to ask whatever happened to one of the mainstay drag queens there.

"One of them became my patient in the ER in 2009," I explained to Frichmond. At that time he was totally devoid of make up, and he had a very scary manly voice. He's been admitted for chronic kidney disease with creatinine shooting to a thousand and he had absolutely no money. Or a bantay. A few times a couple of them short-skirted girls visited him, but that was it.

Luckily before we fell into the boring trap of tracing all the establishments from Starbucks to Dymocks or Tower Records or Cinnzeo in the Faura Wing, Frichmond went farther in the nostalgification and time-warped to the year 2001. We used to go to UP Diliman and one of the restaurants in Katipunan was called Ken Afford. I'm not sure if it's still there, but Frichmond frequented the place back in college. One time after a weekend in Mount Banahaw for a PI 100 class Frichmond and her friends went directly to Ken Afford. They've become so accustomed to screaming to hear each other in the mountains for two days that by the time they were in Ken Afford they were still screaming.

An old mestizo guy behind them called their attention and nicely asked them to lower their voices. Mestizo guy looked familiar, but they couldn't properly identify him, but he looked quite familiar, like he was some Sampaguita Pictures actor but who is this, they thought, maybe he's, no that guy is dead, maybe he's...

There was no need for further guessing as the old, more familiar woman beside him spoke, eyebrows shooting through the orbit, and in true kontrabida fashion scolded them:

"Don't you kids know you're practically shouting?!?!" scolded Rosemarie Gil. Guy beside her is her husband, Eddie Mesa.

There was nothing else to talk about, so we tried to identify all the local actors and actress from the Rosemarie Gil-Eddie Mesa clan and it proved to be too confusing, not being regular watchers of local soaps or subscribers of Yes magazine. We need emergent help. Calling Marth V!

Monday, March 7, 2011

Positively Providential, Said Smoketh

Smoketh had a rather disheartening experience today in the hospital, hence the five lurs being lurred all at the same time. Truly, positively providential could turn into a negatively.... see, even my alliterative abilities are failing. Positively providential could turn into a negatively.... Nega. Let's settle with that: nega, although that term is quickly falling into disuse, and deservedly so.

This reminds me, back in 2009 during one of my duties as the night MHAPOD (night ER duty) and that post was still quite toxic, having to take care of up to thirty patients (and during the lepto craze, Tessieloopagooparoop had a record number of 43 patients), there was this one patient everyone has been having difficulty transferring to the ward. This guy was practically brain dead, and since he did something really nasty and unspeakable to his children he had no bantay, and as we all know bantay equals life. Someone should probably make a study on  this: quality of bantay to chances of making it alive in our emergency room.

So this patient was all brain dead and stuff, or as I was insisting in the chart, he probably had "lock-in syndrome". I know, playing all neurologist and stuff, and I think I did refer this patient to Neurologist Shipper Jack Knight. I was just embarrassed to admit my basis for the referral then: I saw this on CSI.

After weeks on end some distant relative finally arrived at around 2 am and approached me, saying she would request to have the respiratory support and all removed and she would take him home. But then when I talked to the police guy on the phone I was basically told that: I can't let this patient go home as he still has a criminal charge for the disgusting stuff he did to his three female kids.

What the hellellellellellel, with extra ellellellel's for the insufferable heat, kaantukan, stench, and over-all infernal condition of the blasted ER. I think I whined some lowly, unprofessional whine to the police and ordered him to get out of bed and to come to the ER right that moment. He got to the ER in two seconds. Ordering a police is fun--this is for all the almost-tickets I got, you police guy still in your sleeping shorts, how could that possibly be speeding when I am always a nervous wreck when I drive?!?!. So much angst building up, only to come out in a whiny: Pe-pe-pero.... di na po sya makakatakas.

But in my head of heads of heads of heads of hearts of heads: Or couldn't he?
In exasperation with all the legalese I just had the guy admitted after hawking and making tiktik and guarding a potential vacant bed for hours on end. To this very day finding a vacant bed for that patient is one of my finest accomplishments.

If there are any lawyers reading this, I want to know: If I allowed to have the guy go under a "home against advice" waiver, and he escaped because he has been faking brain-deadness all this time, would I go to a selda, get gang-raped, and grow weird boils all over me? I am deathly afraid of selda. Which makes me miss my batchmates all of a sudden: Let's have a batch viewing of Selda!

Wednesday, March 2, 2011

Premature Whinings

Last graduation each graduate received a fun, tiny Oblation trophy--perfect for endless batch peekchurifications with all sorts of strange/erotic/esoteric poses. Marth V has done peekchurification wonders with all sorts of weird implements in the past, so an Oblation trophy was a no brainer. Strangely, specifically for the batch, there was very little peekchurification. Gone were the days when every single tiny nook and cranny must be snapped by five different cameras, all to be copied around and uploaded in Facebook, every single photo to be commented on by everyone involved, each comment wittier and funnier than the ones before it. As if instantly, after the whiplash events, everyone has prematurely grown weary and old and tired of life. And for more, just after a couple of days in this new state of life called Hell-owship, I see my batchmates walking around the pay floors like soulless vessels of... sleepiness. We miss a lot of things, but more than anything else, we miss that chance to just take a twenty-minute--or a four hour--nap in the middle of the day. Very early whinings, so we know things can only get worse.

"This is my Grammy for best new artist as a fantastic singer-songwriter," I told Popopopoker Face Popopoker Face as we posed for the official group photo.

"Well this is MY TONY!" Popopopoker Face Popopoker Face exclaimed. Popopopoker Face Popopoker Face is currently an Internal Medicine consultant in Samar. We need to have contingents all over the Philippines for one purpose: so they could get rich, come back, and treat us to dinner.

Uni-Horned Beef Jerky Alanis Whore has made karir AVP's as tribute to our consultants and families. Remarkable quotes were put up. Our favorite would have to be "There is nothing in fairness about it!!!" as said by one of our consultants during a rather toxic audit in response to the presentor Franny Glass's "Ma'am, in fairness to the service..."

"It's okay, Franny Glass," we told our beloved Franny Glass in the ICU afterwards, "it could have been worse, like if you instead said subconsciously, 'Ma'am, in FAIRVIEW to the service..."

All together now: There is nothing in fairview about it!

Tuesday, March 1, 2011

Yung Tipong Walang Effort sa Pagsusulat, Kung Ano Na Lang ang Maisip

Maraming salamat sa lahat ng nagbigay bati sa aking kaarawan, kahit in general weird ang pagiging non-existence nito. Kahit hindi na dapat ito big deal sakin dahil hindi naman sya ganun ka-special, in real life, ang tanda-tanda ko na ay naiirita pa rin ako, at bakit naman hindi, looking forward ka na birthday mo kinabukasan tapos biglang ibang date ang darating. Nung grade 2 ako, dahil walang 29 ay wala ni-isang nakaalala sa mga kaklase at teacher ko. Kahit parents ko ahahahahah for more drama. Dahil dito pinapaalala ko na ito sa mga kaibigan ko every year. Every year ay tinatanong ko rin, more like bina-badger, ang nanay at tatay ko na baka naman nagpapakaspecial effects lang sila kaya 29 kunwari ako pinanganak. Hindi daw.

"Or baka malapit na yun mag midnight at March 1 na talaga?" tanong ko pa.
"Hindi, lunch break ka pinanganak," sabi ng nanay ko, sabay kwento ng mga details sa small clinic kung saan ako pinanganak, na kesyo kilala raw nila yung ibang tao dun etc etc at which point ay nag shu-shut off na ako.

Nung med school ako may nakilala na 29 din pinanganak, yung kaklase kong si Mildred.
"Matalino ang mga pinanganak sa 29!" sabi ng isa pa naming kaibigan. Except--EXCEPT!!!--as if on cue ay renal physio exam namin yun. Highest si Mildred. 98 sya. First year med pa lang sya naiintindihan na nya ang mga creatinine at tubules and stuff. Ako, 51. Ahahahahahah. Hence grand finalist ako nung final exams na. Grand finalist ako sa lahat ng bagay na pwedeng mag-grand finalist. AHAHAHAHAHAHA. In fact hanggang ngayon, nakapasa na ako ng boards at naging doktor, nakapag-residency na ng internal medicine sa PGH at nakapasa sa specialty boards nito... ay in real life hindi ko talaga nauunawaan yang mga sodium transport whatever crap na yan. AHAHAHAHAHA.

Next year may birthday na ako ulit. Madaling tandaan, basta divisible by four ay may Feb 29. At basta may Olympics. Laging may isang Feb 29 sa bawat stage of life--high school, college, medicine, residency, and this time, fellowship. Ano na kaya ang kalagayan ko next year, ngayong walang sweldo ang fellowship. Dati inaasar ko si Smoketh na sa sobrang hirap nya bilang fellow ay iniinom na lang nya yung tubig sa baso ng ABG. Walang ABG involved sa onco.

And, as if on cue, ang biglang nagplay sa aking iPot ay ang pinakamalalim na kanta ni Janis Joplin entitled Mercedes Benz with the first line: Oh Lord won't you buy me a mercedes benz?!?

Oh Lord!