Random poem 7/3/2012

Pregnant women. Their faces mingling

with each other – a kaleidoscope.

Does  the promise of a new life  make the pain

of giving birth– the howling

abdominal contractions, stinging vaginal tears, pain  upon  pain

to endure — all worth it?

Not knowing the answer, I’m left

wondering. For that is all I can do.

Despite the seemingly lofty title my eduction gave me.

image from http://cutcaster.com/vector/800978633-Pregnant-woman-vector/

Coping mechanism

I delivered 6 patients today, each with her own story. All I can remember, however, are their vaginas and vulvas which I stitched, closing gaping wounds. There is a part of me that want to “establish rapport”, get to know them, but other duties had to take precendence. I remember having this same impersonality when I was in training. I thought that once I got out I would be able to get rid of it. But there are times when I still see them more as work rather than as “patients” (whatever that should mean). Does that make me a bad doctor? The culture of my workplace certainly contributes to the degree of my insufferableness. When I was younger and anxious to learn all that I could about this specialization which I chose, my whole demeanor was, 80% of the time, harried, hurried and abrupt. Fast forward to now. The income is not commensurate with the work I do and the qualifications I have but I stick with it because I like my coworkers, the income is steady (albeit small), and I like the feeling of doing something good (“something good” meaning delivering service to those who cannot afford to pay). 80% of the time, I can be quite nice. I am nicer to myself, for one. But there is always that part of me that is unconfident and cynical about healing others. So I look at them(my patients) with detachment. There are times when I the only way I can cope with this responsibility is by thinking of them the way I thought of that interesting rock formation I saw along the street. That is not as bad as it sounds. Looking at something (or someone) with curiosity, I would think, is better than seeing them as cash registers.

Underemployed

That is what I currently am right now. Is is because of A. laziness, B. high expectations or C. lack of opportunities? A little of each, I think:  50% A, 20% B and 30% C.

I went through 7 years of tertiary education which includes college and medical school, 4 years of specialty training and 2 more years of sub-specialty training and now what do I have to show for all of that? 20 thousand bucks in the bank, a 2nd hand car that I don’t know how to drive  and depreciating or rotting home appliances and furniture. Oh and a ton of books, accumulated since I was 12 when I still dreamed of becoming a writer.

How does one without fortitude, self confidence and creativity become a writer? I can rip off from other people’s work. Done that before, never been caught … hurray!

The thing is I’m not exactly thrilled to be where I am now but I don’t know where to go. So where does that leave me?

Random Notes 4/15/12

4:45 AM
I am setting up my friend Y (who gave a nice speech during my wedding and whom I am eternally grateful) with this medical representative (med rep or, basically, a salesperson that promotes branded medicines to doctors) who was recommended by my midwives. As adept as they are at birthing babies, let us see how their matchmaking skills would turn out.

I am at this point when I try to reconnect with old friends. Tracing forgotten paths to my childhood, re-reading Erica Jong. I am hoping to find a voice and stumble upon the fortitude to write.

Around 7:00 AM
Conversing with my midwives this morning, from-duty day. I said that I don’t mind Dr. R staying over longer than he should and taking my place in the callroom. I don’t mind, really, because I respect him too much and all that he’s done in the LIC where he has been for 28 years. I told G and Ms. E that the LIC will not be like this were it not for him.

This is actually one of the better institutions I have been in. Not perfect but humane. I can say that now because I experienced hell for 4 years and I know the difference.

Hell becomes what it is because the people who should have been taking care of it have let it go. Maybe because of greed or laziness, take your poison.

Yes, I’m still bitter. I realized how ripefully bitter I am last night taking to K (the med rep) whom I was thinking of setting up with my friend Y.

My mother’s death has partly to do with it. Until now I still can’t forgive the institution where she died for the way that I was the last year of her life.

I am trying to get over my self-loathing. The guilt I have already dispensed with but the disgust for that person I was — the timid, virgin, child that I was — is still there.

Since self destruction is not an option, I would have to devise some form of sweet revenge. I relish it and sometimes, in my mean moments, I am consumed.

I wonder if this is what brought about my mother’s cancer. Overwhelming anger at something that she felt she could not change. The anger crystallized, solidified into a tumor too stubborn to be excised. Too maniacal to be contained. Maybe it was what destroyed her.

How Not to Start a Private Practice

I tried, I tried, I tried. Please don’t say that I didn’t at least try. But maybe I was just too lazy or too proud to really get at it.

I hated waiting. And I hated haggling. And I hated asking for payment.

Does it all really just come down to it? A measly 250 bucks for a 15-minute consult. I couldn’t extend it further. And I couldn’t do more. I couldn’t do “sales talk”.

Now I’m in a contractual position in a public health job that is slowly draining my brain and turning me into a moron.

This is my fault for expecting the moon as a reward for all that training. There is really no pot of gold at the end of the freakin rainbow. There is  no rainbow to begin with. It’s all just one fucked up crap after another.

Shit! I hate my life. I never thought I’d say this again after the end of 2007  but here it is again. Shit!

To Be or Not to Be (an OFW)

Just went to a job interview and got a job offer to work in middle east.

Then started googling about how it is working in middle east especially the country where I was accepted to work in health care sector.

Of course responses were divided, others finding it hard, others just ok. Boils down to, if salary is worth it then go. But then there’s the placement fee to consider. Worth 1 month of salary which I don’t have right now.

Kinda ironic, one paying so that one can work to earn more money than what one is earning now. Think of it as investment. Living is all about investing anyway, in one way or another.

Still, dilemma. Another text came from placement agency for job interview now in Singapore. Closer to my country but (according to the internet forums) atrocious working conditions. But then working conditions where I am now is not excellent either. Choices, choices.

I started praying. For guidance, I think.  Didn’t finish it though. Maybe disconnected from God.

All about my mother. Who is Dead now so She can’t kill me for this.

It is a bitch.  To be female

in a World of Men.

A cunt to be fucked

and nothing more.

A hand to tie

another’s shoelaces.

Your body, your legs

the conveyance

that carry them.

To where They Want to Go.

(The Grand Scheme of Things

certainly does not include

where you want to go.)

It is about simpering and flattering

And smiling even while

Choking on a man’s cock.

You pretend happiness

to buy Their love.

You pretend contentment

while dreaming of passion

watered-down devotion

gets you through the day

toasty crumbs your main meal.

You never learn! Because you are a woman.

You go home and start the whole shit all over again.

What is my country?

What is my country?

Is it these clumps of soil strewn together

On the Pacific ocean?  Mounds of volcanic ash

Rocks with no meaning.

Countries are in the hearts

Of men (or women, for that matter);

Not in lines  drawn on maps

By powerful men (said Michael O).

And this is what I believe:

My country is in my heart,

All the imperfect parts of it -

The slavery of the past

And present

And the whisper of a future.

The shadows and the rain.

The hands with grime,

Swollen bellies, forgotten uteruses

Littering streets paved with gold.

My country is that sound tapping against

My car window as we speed

Through a traffic light.

Poetry

This week before the New Year

I listen to typewriter keys

The aircon hums a pathetic whirr

In this room where friends  come in threes.

I kill time with furtiveness

Pretending to be busy with my scribbles

My ink-stained notebook is a candidate

Witness to lunchtime, snacktime, dinnertime doodles.

This week before the New Year which happens

To be Annus Rabbitus (pardon the imaginary Latin)

I imagine that I am,  a writer, or a Poet

Filling my page with tasteless snippets.

I’ve never  liked, or aspired  to be, Shakespeare

I read Romeo and Juliet for the sex scenes

Though poetry is my juvenile pacifier

I love the way it hugs me,  like a well-worn sweater.

 

2010

 

 

 

 

 

On training

Residency training and vicarious traumatization

To give a name to something is to acknowledge its existence, to give it a name is to validate its being. I had been through 4 years of rigorous training in a physically and emotionally demanding specialty. I have, at first, decided to embark on it because of the optimistic “vibes” regarding the field – the kind of patients I would manage and the cases I would see—which did not seem to be as depressing compared to other specialties. For one, this field has very few mortalities that to lose a patient is considered a “mortal sin”.

The hopeful optimism of youth – that is the main reason why I chose to dedicate 4 years to delivering babies and taking care of laboring mothers and seeing women with diseases in their reproductive system. I am a female, and what better reason to go into this field than that? No one else can understand my patients’ condition as I do because I have the same XX chromosomes as they have. I will be able to empathize and help them and that would be fulfilling and a worthwhile thing to do everyday.

Somehow, though, disillusionment set in. There were just too many patients and too many demands. On my time, my strength, even my finances. There were days that I literally would dream awake because of lack of sleep. I would snooze standing up, and sometimes even on the operating table! A full day would pass with me going hungry, having missed breakfast, lunch and finally eating a lone dinner at 10 pm because there were just too many things to do. I wouldn’t go home on days on end, and even when I get home, it would be to shower, get a fresh batch of clothes and off I’d go to the hospital again.

I found myself getting easily irritated with my patients. My patience with them, was frayed to the hilt, to say the least. I was abrupt, hurried, unsympathetic. What happened to me? Why do I treat them, these people whom I have vowed to help, like pests and nuisance that I have to get over with. I did many things that I am not proud of. Good clinical practice was sacrificed for expediency – because I was just too tired and too preoccupied with a million and one things.

I can easily say that it was all a traumatic experience. But how can I say that when I have learned so many things as well? There were also times of happiness. A woman grateful for me saving her and her child, that old lady with cancer comforted by me talking with her (in the guise of getting her history), a small child whose abdominal pain was relieved by an operation I’ve done. In the end, do these moments make the whole experience worth it? This is a question I am still grappling with until now. Precious moments with my family and loved ones sacrificed for this training. Precious moments that I could have used to watch a movie, read a nice book (aside from the prescribed clinical texts). In the end, my training defined me. I cannot now be contented with being less than busy. And I have this great urge to always do something important; otherwise I’d go insane. I am grateful for everything I learned. They are just as precious as the things I chose to give up to learn them. But I am only now realizing the enormous cost of that learning, that choice.

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