Quiapo Medical Center

Schedule a trip to what Dr. Michael Lim Tan calls the “Quiapo Medical Center” and the other big medical / private hospitals in Metro Manila any day prior to August 25, 2015 discussions. [Tuesday, August 25 at 1-3 pm on SDH: Culture and Illness]. Dress simply; try to blend in with the other consumers and/or church goers. Explore as many facets of the medical centers' - “wings”: emergency room, OPD, lobby, admitting section, pharmacy, wards [if any], cafeteria, other areas. As expected of a health professional, be respectful and observant. Keep your eyes open, listen to the sounds, smell your surroundings. Keep safe, be alert. Be aware of wonder.

A question of authenticity 

The first thing that concerned me about the whole Quiapo Medical Center concept was whether the 'personnel' really believed what they were offering. It's one thing to sell these things as part of a cultural system one really believes; to sell these things without believing in them is another and that just seems wrong. It's the difference between a quack doctor and a faith healer. Coming from a family of doctors in Quezon City, I have no prior experience with these things. It's a completely different world from the one I know. And so, authenticity was one of the issues I hoped to investigate.

Ang Tanong ni Kia: Mnemonic para sa Type I at Type II Errors

Dalawang taon na ang nakararaan, may tanong ang kaibigan kong si Kia:

"Anong mas masakit na pagkakamali: Yung Type 1 error wherein you conclude that a relationship exists when in fact it doesn't OR Type 2 error where there is really a relationship but you fail to recognize it."

Isang paghihimay dito ang aking tinangka sa isang pinaglumaang sulok. Babalikan natin ito ngayon hindi upang muling sagutin, kundi upang paghugutan ng hindi bagong distinksyon.

From the Low End of the Bell Curve: Reflections on Medical Education

Two years ago, the release of the results of the my very first exam as a medical student began my disillusionment— not with myself, but with the medical curriculum, as it violates almost every article I've read on the effective learning: that learning should be spaced out, that learning should not be driven soley by exams, that taking frequent breaks are essential in absorption of a material, that the meaningfulness and relevance of a material aids in memory. . . Medical school, as we know it, is fast-paced, exam-centric, stressful, and detail-oriented to the point of meaninglessness.

Confession and Consultation: A Subtle Analogy

A friend comes to you and confesses, "I did something wrong. . ." and this wrong thing may range a wide spectrum: from an unintended neglect to an intentional act, from harming one's self to harming another, from a minor sin (if there is such a thing) to a grave, moral offense. . . What would you say? How would you react? Should your reaction depend on the weight of the offense? Should it depend on who was wronged? Should you consider whether it was intentional or not? Does it matter which friend was confessing?

Before you say anything, I think these things are worth considering:

1. The person is confessing (James 5:16). They have began to recognize and agree that what they did was wrong. They likely already feel remorse. 
2. Confession is hard. It is exposing one's flaws, and insecurities. It is revealing one's heart, rendering one vulnerable. 
3. The person chose to tell you, of all people. They regard you as someone they can talk to. They trust you.

Cure vs. Treat: An Anecdote

Back in college, some of my philosophy classes conducted “objective” exams. That is, they asked identification/enumeration questions, instead of essay ones, but you can protest and defend your answer if it is different from the answer key.

There’s this one particular item that still haunts me to this very day. It’s a question about an analogy between something in philosophy and medicine. I don’t remember the exact question, but I remember the answer: cure the patient. I wrote treat the patient and it was marked wrong. People asked. The instructor reasoned that treating someone is not the same as curing someone. Treating someone was more like how you treat others, she said, and she was looking to the removal of the disease, as what the word ‘cure’ means. This was enough to appease the complainants. But she was wrong.

She forgot to account that a word may have several meanings, and treat does have different meanings. We had been using the word equivocally. In fact, in medical jargon, the word treatment is used a lot more than cure.

I knew this all along, but I never said anything.

A Case for Feelings in Faith and Medicine

A good doctor is not merely someone who can diagnose accurately and cure diseases, but someone who treats the person behind the disease. As the usually quoted aphorism goes, a physician

cures sometimes, relieves often, comforts always.

Medicine is not just the science that aims to eliminate illnesses, it is the art of communicating with people in the manner that addresses their interests. To me, this second part is more than a job. It is a command, the way of life to which I am called:

Do nothing from rivalry or conceit, but in humility count others more significant than yourselves. Let each of you look not only to his own interests, but also to the interests of others. Phil 2:3-4

On Professional Fees and Principles

Conversations with non-medical (former) classmates about my (soon-to-be) profession are usually steered towards a discussion of specializations-- what I want, what they hope I'd be, and/or what they believe is most profitable (hence, I should consider). Sometimes, the people who nudge me towards profit are also those from whom I have heard constant grievances regarding outrageous hospital bills and medical fees. So I'm not quite sure what they're driving at. Are they condemning the system or are they encouraging me to be part of it? Perhaps both?

Aquinas and Fetal Circulation

I stole this from my former philosophy instructor's ancient Facebook post:

  "According to Aquinas, when the angel in Scripture said, 'Hail, Mary full of grace,' it was the first time in the history of mankind that an angel ever saluted a human being with such respect, because more often than not, human beings fell down cringing in terror and fright at angelic beings-- so otherworldly and powerful were they. But the angel said 'Hail,' only because she is higher than angels, higher even than the six-winged seraphim who guard the sacred throne. And when he said she is full of grace, he meant it--because her blood would mingle with the blood of God, who stayed inside her for nine whole months, while their hearts beat in sync in the same body. The heart of the mother, and the heart of the Son, so intimate, as to be One."

-J. Reyes

There are a few things about this that have been bugging me for more than a year now, but I had to make sure I understood them well enough to say something. A few months ago, I finally did.

Medical Ethics is NOT Common Sense

Better view of the letter here

When it's about three major things in your life, you just can't help it.

Almost a year later, this still gets me all fired up. People should know this, and yet they don't. There's still much to say. The vehemence to talk about this more and convince you that this is ethical consumes me.

A Short Reflection on Neurology and Epistemology

Sometimes, med is fun. Last year, Neuro taught us history-taking and neuro exam by making us interact with actual patients in the ward under the supervision of a preceptor. We were, then, individually assigned to write a clinical report. I liked it.

Moments like these remind me why I took this path. I like talking to patients, getting their information and putting together the pieces while figuring out which information I still have to ask. Sometimes, I'd have to discern if they're lying. When I learn enough, I'd have to figure out what illness they have, like solving a puzzle. That's basically what it means to take a patient's history, the most important tool for diagnosis.

If I don’t know what the patient has after I have taken the history, I am in serious trouble.

-Alan Yudelt, MD

A Defense of Samplex

An open secret in the college, it has been passed from batch to batch, under different names for stealth. Its manner of acquisition consists of cooperation within the batch involving discreetness, memory, and exam questions. Its purpose is to help students study for exams. Since our professors, who were once students like us, know about its existence anyway, the concealment strikes me strange. Accompanied by this secrecy is some individuals' condemnation of the system in question as morally impermissible, myself once included.

Reflections on Early Adulthood

It's strange watching what happens after graduation. A couple of graduations have passed and it feels even stranger. Popular student leaders turn into young parents. Delinquent classmates appear in theater, or land teaching positions in your previous school. Classmates who used to bully and be bullied get married. Friends who once conspired with you to write a diary against other friends enter the corporate world. Friends who used to bite and strangle fellow human beings acquire their own screaming fans.