Atheista -

My blockmates  and I have been rotating as Surgery clerks for the  past month. We’re counting down our final days before we all move to Internal Medicine – one of the most demanding of all rotations — so I guess it’s just fitting that I chronicle how the past weeks have been for us.

Everyday, clerks are expected to be in the Clerks’ call room by 7 AM. There’s a log book in Ward 4 where you have to sign in to prove that you really were punctual for a particular day. If you fail to sign up before a resident grabs hold of the log book, you run the risk of being marked absent for the day. During the orientation, we were told that we should be prepared to everything and anything.

They weren’t kidding. Continue Reading »

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This won’t be your last breath, I know
I could see the tears form in your eyes
But we’ve almost made it
It will break my heart to see you go
Because we almost made it

- You’re Killing Me, Chicosci

For the past six weeks, I’ve been regularly sacrificing an entire night’s worth sleep to man my post at the Philippine General Hospital. It’s been a story of fatigue, mental anguish, twilight zone moments and stolen naps recurring every three days for four weeks running. Most students go into an entirely new setting when they’re up for a 24-hour tour of duty in the emergency room. The amount of work can be very daunting and at times, it can seem that finishing all tasks with an acceptable level of efficiency and competency is close to impossible. But I manage, we all manage. This early we’ve already figured away to circumvent challenges  to our alertness, energy level, heart strings and various bodily functions to be awake enough to triage patients, put intravenous lines, extract blood for diagnostic purposes, insert all sorts of catheters, suture nasty wounds and allay fears of nervous relatives. How do we do it? It’s part-adaptation, part-mind control and part-paradigm shift into this no-nonsense-yet-not-cold mode that we all are refining with every duty. Continue Reading »

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Though I’m still a shade under two years away from completing my medical education, the current curriculum already allows students like myself to be in the frontlines in various parts of the Philippine General Hospital. In five weeks as a clerk – that’s Learning Unit VI for those familiar with the UP College of Mecidine — I’ve rotated under the departments of Anesthesiology, Emergency Medicine and Surgery. It’s been physically-tiring as well as mentally and psychologically taxing for the most part but in the end, it’s been a rush.

Death is the great equalizer. We will eventually face it one day and no matter how much we romanticize the esoteric beliefs on life-after-death, death will continue to remain as a concrete and irreversible termination of somebody’s life. It’s like having nature remind us that the phenomenon of life was never meant to look after the welfare of the individual. It was never just about man. We die – just like everything else that is living. The difference of course is that our species have figured  out ways to challenge the natural order after years of practice and research. Continue Reading »

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Dark Knight  is among the most  anticipated films this year. With the very strong merits of the last Batman movie (Batman Begins) and the death of Heath Ledger – the actor who plays the intriguing role of the Joker — the movie could break all sorts of records in the box office aside from kudos from movie critics and casual moviegoers alike. The film also stars Christian Bale, Michael  Caine, Aaron Eckhart and Maggie Gyllenhall.

For those who want to watch Dark Knight before everybody else, the Philippine General Hospital Sagip Buhay Foundation  is offering premiere night tickets for the reasonable price  of 250 pesos each. Sagip Buhay Foundation is a non-stock non-profit organization that helps indigent patients in the PGH wards and intensive care units avail of potentially life-saving medications and  diagnostictests. It has been helping needy families of the seriously ill for the past fourteen years already.

For a ticket that’s not even twice the usual ticket price in SM Mall of Asia, you can enjoy Dark Knight before most people would get to watch it aside from also giving those in need a hand in helping their loved ones fight the biggest challenge of their life.

What: Dark  Knight Premiere

When: JULY 18, 2008 (Friday) 7PM

Where: SM Mall of Asia

How much: 250 pesos

Again, all proceeds go to the Sagip Buhay Foundation. For more tickets and inquiries please text Dr.  Adrian Paul Rabe  at +639163333603.

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Most people would actually write an on hiatus post  to warn their readers of an upcoming lull but unfortunately, I didn’t have the foresight to do something similar to that. For the past week, I’ve been engulfed by the art and science of Anesthesiology. I’ve been learning how to make people numb, paralyzed and amnesic for extended periods of time so that surgeons could do their life-saving work. Though most people have a dismissive outlook towards anesthesiologists, I’ve really gained a good sampling of what they could offer. Patients at the brink of death could be sustained at that point thanks to the skills of a good anesthesiologist. I’ve seen a stab patient lose more than 90% of his total blood volume and still live. That alone is a tremendous testament to the skill and competence of Philippine General Hospital-trained anesthesiologists and surgeons.

The downside to all this learning is the not-so-little problem of not having enough time to sleep, eat and yes, blog. A clerk rotating under anesthesiology is expected to spend close to 80 hours a week in the operating room – with stretches  of  continuous 36-hour shifts being the worst-case scenario.

 In thirty minutes, I’ll be back in the operating room. And yeah, anesthesiology is supposedly one of  less toxic (demanding, difficult, exhausting etc.) rotations in Clerkship. Wish me luck. :p

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Despite the high number of mortality and morbidity that Filipinos experience first-hand, people are still in the dark when it comes to concerns related to cardiovascular disease. For instance, most people would go see a heart doctor or a cardiologist if they show sudden spikes in blood pressure readings. Physiologically speaking though, hypertensive disorders would fall more into the nephrologists’ (kidney specialists) side of the court. Hypertension can potentially cause problems in the heart in chronic cases because the heart has to work against an increasingly steep pressure gradient, but in the end, the heart pathology is a mere secondary effect and hypertension is rarely borne out of a cardiomyopathologic etiology.

Most people would know that the heart is the pump that sends out oxygenated blood from the lungs to the peripheral structures of the body – i.e. everything else. All structures in the body need nourishment from the blood and the heart itself is no exception. We’ve been hearing the word atherosclerosis a lot lately because it has become one of the more epidemiologically-abundant medical phenomena of our time. As medicine improves and as the life span increases, we’re now seeing how the body reacts to a prolonged high-fat and high-cholesterol diet. Atherosclerosis is the narrowing of blood vessels due to the formation of plaques on the surface of blood vessels. Narrowed blood vessels easily translates to less oxygenation and as if that wasn’t bad enough, the plaques could rupture and cause the blood to clot. This clot could potentially case myocardial infarction or cardiac ischemia. Cardiac cell death can lead to many bad things for the patient – the most grave of course is this condition we call death.

My family has a strong history of heart disease. Atherosclerosis doesn’t limit you to dying of a simple heart attack. The plaques could also break off and cause a stroke in some other part of the body – the worst case scenarios would be the brain and the lungs.

Atherosclerosis may or may not present with symptoms. My Dad had a 95% obstructed artery, but he never experienced chest pains. An electrocardiomyogram showed that his heart was already exhibiting arrhythmia and could have had a heart attack any moment. Fortunately, he was seen by a competent doctor and ablation was done via percutaneous transfemoral coronary angioplasty.

There is plenty to learn about our hearts and how we should take care of it. Of course, I can’t expect everyone to just pick up Harrisson’s Internal Medicine or Netter’s Atlas of Anatomy all of a sudden. It’s a good thing that there are non-threatening, well-written and informative websites out there that discusses the ins and outs of medical conditions.

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