… and this too shall pass

Two important things happened last October.

First, was my mother’s 8th  death anniversary on October 3. And second, on October 27, I commemorated the 1st time G and I went on a date.

In this picture: The Malate Chiurch, also known as Our Lady of Remedies Parish Church. First date with G--  went to the 6 pm mass then ate at a nearby restaurant. Contact lenses got dislocated so his face looked blurred  for the most part of this date.  Memories! (Image from Wikipedia)

In this picture: The Malate Church, also known as Our Lady of Remedies Parish Church. First date with G– went to the 6 pm mass then ate at a nearby restaurant. Contact lenses got dislocated so his face looked blurred for the most part of this date. Memories! :)                                                                                    (Image from Wikipedia)

That is my life, it seems, the morbid and the glorious juxtaposed with each other.

My complaint to god (if there is one):  How come the morbid parts happen more often than I want? And the glorious portions end too quickly?

I can hear god’s answer: ho ho, that’s my joke for you, my dear.

Needless to say, I am not often fond of god’s sense of humor.

***

Last September, a writer named Charlotte Kitley died. I do not know her but her words moved me.

So here they are –

http://www.huffingtonpost.co.uk/charlotte-kitley/bowel-cancer-charlotte-kitley_b_5836238.html

So I guess,  what one learns from all this is that no matter how brief and inconsequential our “stuff” may be, in the end our words remain.

And if those words manage to touch some other sentient being, then all our “stuff”, however petty, small or ordinary,  can be elevated to some degree of greatness.

***

But then again, on a morbid note, pride is one of the seven deadly sins. And the devil’s favorite, if Al Pacino (in “Devil’s Advocate”) will be believed.

Reading Lists & Random Musings

reading list

 

I have just finished  2 ebooks by Atul Gawande, an American surgeon who wrote memoirs in his  spare time. He had this writing style that gives one the impression of Malcolm-Gladwell-in-a-white-coat. “Complications” and “Better” were interesting and very relate-able to one working in the “healing profession”.  Gawande was living and describing the US healthcare system which my country borrowed, warts and all.

Next on my reading list is Sandeep Jauhar, still yet another American with Indian roots struggling to live the medical dream. I’m curious about his effort at describing the life of an, “Intern”; and I am anxious to know if he found that year of medical training  to be as horrible as I did. He also wrote “Doctored: The Disillusionment of an American Physician.”

Hmmm … if he is disillusioned, then  I wonder  what Chinese doctors in China must feel. 

I hope to find some of his books in Powerbooks or National Bookstore. Ebooks are ok and I love my Kindle … but there is just … something about the smell of paper and the weight of a paperback that does it for me. Maybe it’s a fetish.

 

***

When I was eight,  my greatest dream was to live near a bookstore. I realize now how terribly lacking in ambition I was at 8 (still am, actually). If I were more ambitious, I would have dreamed of owning a bookstore … or a bookstore chain … better yet, I should have dreamed of owning a publishing company … or owning Google!

But then, my idea of heaven was to be surrounded by stories and ideas and pictures … and to have the time and energy to absorb them all. I love that the Internet had been invented (again, thank you Tim Berners-Lee, for making the WorldWideWeb  possible). It’s like having a library without the shelves.

But still …  there is something about the smell of books …

 

***

girl after 20 plus years I used to see a lot of National Geographic magazines in Booksale. Not anymore. Is it because they have gone mainly digital? In any case, this is a picture in Nat Geo of an Afghan girl in 1985 and then 17 years later in 2002. Before and after the fall of the Berlin Wall. In 1985, her face was sad, beautiful and haunting. In 2002, she looked, sad, older, angry and tired.

 

She hardly knows how to read.

I was Minding my Own Business

When…

I read of it on Facebook. My FB friend angrily asks on her status update: “(name of hospital), are you really a hospital or a financial institution?”

That made me think. Because my FB friend (and other non-medical persons) seem to believe that one is either a hospital OR a  business. Not both. The reality, though, is in my crazy country, private hospitals are BOTH  - hospital AND business. They provide medical care and services AND they also have to make a profit.

As of 2009, a majority of hospital in my country are privately owned. Personally, I don’t agree with this state of affairs. I would prefer having a system like that of UKs National Health Service (NHS) which provides socialized healthcare from cradle to the grave. But at this moment, this is MY reality.

When I was still in training I often had to shell out money for my patients’s medical expenses (which was not done out of altruism, but that’s another story). I vowed to myself that after I graduate, I will not hand out my meager resources to strangers just because they need it. Sorry, but I am not Jesus, after all.

 

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“The triumph of Science Over Death” is a sculpture of a woman standing on top of a skull and holding a torch. It was made by Jose Rizal and seem to depict victory of medicine over infirmity, disease and death. I would disagree with perceiving medical science to have such broad powers.

Out of training, I realized that fuck! Most of medicine in MY country IS ABOUT  business. That really left a bad taste in my mouth, which is one of the reasons why I am disillusioned with private practice.

Of course, there is also public health as an alternative. And as I am currently in public health, I can honestly say that I am not impressed with the alternative.

Those in the US seem to be in a soul-searching mode as far as healthcare is concerned. And we should be too. But reading my Facebook feeds and the comments from the news article, I am left wondering if the level of discourse in my society is advanced enough for us to engage in meaningful discussions about healthcare. Of course this is a start. And perhaps I should take heart in that.

 

 

Treading Water

So today Ana was telling me of her ambivalence about having babies:

I have always been envious of good swimmers.  As someone who has been taught how to swim a number of times and has failed over and over and over again to learn, seeing someone do a breaststroke from one end of a pool to the other is kind of bittersweet. Me — I can barely keep my head above water.

What is the connection? I ask

 

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The problem is, Ana says, I am content having just my feet wet. I can’t go into the deep end (the one that says 6 feet) because 1.) I am afraid to drown; 2.) There doesn’t seem to be anything worthwhile about going into 6 feet; and 3.) I prefer reading my Kindle in the pool and it’s not easy to do that while trying not to drown.

 

Having a child is like driving a car or learning to swim. You have to have done it at a certain point, otherwise the energy or the desire to have one or learn one passes you by.

A lot of people in and out of cyberspace will disagree with you.

So maybe I am speaking only of myself. The inclination has passed me by. Although when I look back, I don’t think I have ever been very inclined to reproduce. When I think of babies or parenting, the impression I get is that of having a thankless job that you are doomed to do the rest of your life. Which makes it totally not worth it. 

The thing is, darling,  Christian wants to have a kid.

Yes, but it is not as if he’s pressuring me about it. As with all other things, he has a laid back attitude as far as progeny is concerned.

Or so you think.

Well, yes, there’s that.

So you think having kids is like swimming right? And now, you are what? Treading water?

Hmmm … more like wading in a knee deep pond that used to be a river.

Compassion Fatigue

I checked Wikipedia and saw that compassion is an “emotion we feel in response to suffering and which motivates our desire to help.”

A Tweet from a local reporter triggered a discussion on Facebook about the definition of compassion and whether there is compassion in a certain hospital that is supposedly one of the best in the country. Several blog posts have shown how the reporter got it right or got it wrong.

The problem with Twitter is it doesn’t give ample word space to present a dissertation on the dismal healthcare system in this country; the hospital just illustrates the brokenness of this system in all its microcospic glory.

What I didn’t like of the report which I watched on YouTube is it didn’t present a satisfying analysis on why there is a seeming lack of compassion in the hospital she mentioned.

Of course I am biased. But aren’t we all? Aren’t we more apt to give kind regard to those that are familiar?

Healthcare workers (and of course that include doctors) are human too. And yes, that is NOT an excuse to be cruel to patients. However, one should not judge unless one has not been in someone’s shoes or slippers, for that matter.

Cruelty should have gradations, I think. Sometimes one feels that being cruel is the most expedient way to be kind. In the movie/book, Sophie’s Choice, Sophie had to choose between her two children; which of them would live or die. Sophie was a Jew during the holocaust. Should I hate Sophie for choosing one of her child over the other?

In this country, in a lot of places, actually, compassion fatigue sets in because we have been given the unenviable task to choose who will live or who will die. Or who will get healthcare and who will not. Resources — which include our energy, our time, and yes, our compassion — are finite. We had to choose.

It may not have shown in our faces, in the abrupt way we turned that 100th patient away, the weary and sarcastic manner we told someone that she had to have money to rent a ventilator. It may not have been obvious to the television cameras –but doing what we did took away a part of our soul.  And we acknowledge that.

Healthcare workers are made to do a Sophie’s Choice everyday they work in the public healthcare system.  A far-from-perfect  system which does not help make the act of choosing an easy one.

 

Excerpt from a diary of (almost) 20 years ago

“How funny that we can’t bring ourselves to tell our children the most fundamental truth about sex, that most of the time we have sex, we have it for pleasure. ” – Alice Dreger

From the point of view of a 16 year old, sex is fascinating because it is forbidden. And it is forbidden  probably  because it feels good.

Hmmm … as good as what, I wonder? Even better than blueberry cheesecake? Or  Karen Carpenter songs? Is it  like waking up at 8 am and burrowing under your bedcovers when it’s raining outside and school is cancelled?

diary

 

I understand why grownups won’t talk about  the “S” word. My parents haven’t even said the “L” word. If they can’t bring themselves to talk about the “L” word  then S-word discussions must be like watching “The Exorcist”.

It’s like they do “it” and you are left wondering at all the fun they are having

I asked a teacher at Health Class  today why parents bother to have kids. What did I expect her to say? Because sex feels good and kids are a by-product of their parents having fun under their blankets? Of course that’s not what she said. Instead the answer was something about love and god wanting to spread love yada yada yada.

I hope  I can have the conviction to be an atheist like D. Oooops … one is not supposed to want to be an atheist. That kind of thinking can send you to hell.

***

If the Church had allowed them to grow up to be functioning adults in Irish society it would have ran the risk of demonstrating that the institution of marriage was not absolutely integral to the moral well-being of a person. - Stephanie Lord, on infanticide, unwanted pregnancies and the Catholic Church in Northern Ireland.

 

Interesting Stories

A poor patient with cervical cancer is writhing in  pain just outside the building of a big tertiary hospital. Her husband watches helplessly as she moans; all the while he was wondering when her (and his) suffering will end. They have 100 pesos with them and the wife needs at least 1500 pesos for her blood transfusion and a lot more than that for the chemotherapy.

The worst part about residency training is there came a point when the only way you can cope with all that suffering is to pretend you were a robot.

The worst part about residency training was there came a point when the only way you can cope with all that suffering is to pretend you were a robot.

 

Then comes the reporter. The reporter looks helpless and frustrated. She interviews the man and his wife. All the while, the woman was writhing in pain.

The reporter accompanies both to the heartless hospital that won’t admit them. The hospital, out of fear of negative media coverage, admits the patient and make her wait in the Admitting Section. They would still have to procure blood.

The secretary of health appears on the screen saying they are doing their best to achieve universal healthcare. A medical activist appears saying  that this is what happens when healthcare is privatized.

I haven’t heard from the doctor to whom the patient was decked.

But I imagine that this  must be his/her story:

Dr. Z has been on duty and without sleep for 48 hours. Technically, Dr. Z was on duty for 24 hours but the reality is Dr. Z has been staying in the hospital for three straight days because of complicated patients their team has to take care of. Dr. Z is  a resident-in-training and aside from taking care of the patients’s medical needs, Dr. Z has to take on the role of nurse, midwife, utility worker and social worker because the hospital lack the staff to provide adequate nursing, midwifery, janitorial and social work services to the patients. Now this cervical cancer patient comes in just as Dr.Z’s shift is about to end (the shift will end but the work will not). Dr. Z sighs and thinks, I will have to shell out the 1500 pesos for the blood, so that I can transfer her to the Oncology service, oh god 1500, I was planning to buy mommy her present, sorry mom, cervical cancer patient trumps your birthday any day, when I graduate, I am promptly going to another country, preferably first world where I don’t have to be a social worker and doctor at the same time, i am so sleepy, this day will never end .. lord please kill me now.