Sunday, February 25, 2007

Experience is the Best

When I was just a "new, out-of-the box, ready to take the world" doctor, I felt that I know whatever there is to learn about medicine and taking care of people. I expected and felt that I can be as good, and maybe "even better" than other doctors (how stupid and arrogant).

Everything there is to learn is in the books, journals, websites and all the places that doctors read to be abreast with the current medical practices.

Until, finally with only more than 7 years of practive and a few hundreds of patients, I realized what I have not learned in the books, lecture halls, workshops, and dissections.
The human face of medicine and treating patients. It's not about science, it about art. Merging the science with the art of "healing patients."

That's what you don't learn and what they don't teach you in school.

Before I use to wonder, how come this doctor has so many patients when you look at their academic and clinical skills, it is at par with everyone else, and yet another doctor who has had several papers he authored appeared in prestigious journals, have flies as his regular patients?

Last few days, I somehow felt that now I know what it was that separated the good doctors from the "popular doctors". The art of talking, reassuring and making sure patients are satisfied with all their concerns while at the same time, using the science of medicine in alleviating the problems patients have,and expecting the troubles ahead of time.

Wednesday, February 21, 2007

Lighter Side of Life

I was explaining to my patients the downside of drinking Coke, specifically how much acidic it is and how much sugar it contains. To further prove my point and make it clear that it is not healthy to drinking this stuff, I told him about how a can of Coke can literally digest the teeth and nails when these are soaked. Moreover, that a can of Coke can unclog pipes.

His reply was: "Wow, that Coke thing is real scary, good thing I drink Pepsi!"

Sunday, February 18, 2007

Lost voices

This is the second time in less than a month where in I have had the opportunity to see 2 patients with lung cancer who have lost their voices. Both of whom are very much eager to gain their voice and be able to be "normal" again.

It must be hard to have a diagnosis of cancer and even harder of not having a voice and be able to communicate what they want and what they want to say to their loved ones.

Just had a talk with one of my previous patient with lung cancer stage IV. She is not walking anymore due to the metastasis to her spine, but she is still strong and fighting. I am amazed at her inner strength and emotional stability. Likewise, the strong family support that she is getting.

This is so opposite the lung cancer patient with brain metastasis, whose wife is so negative and and unbelieving in what we are trying
to achieve for her husband.  Even if she doesn't believe what we are doing, I will understand and accept.
But to see that she doesn't even help with what his husband is going through, that for me is unacceptable.

Cancer support is the most important thing a patient needs. Loneliness, despair, anxiety and worry adds exponentially to an already stressed individual. I have seen time and time again, how the family acts and support their loved ones from a disease, will somehow predict their survival.

My next step is to form a cancer support group. I hope and wish that we can make it happen at the soonest possible time.

Friday, February 16, 2007

Back from Vacation

Just got back from the a well-needed vacation!!! I had a some sun burning issues right now, hahahaha! The Boracay beach is still looking white and clean, though I notice it's not as clean as it used to be. When you see cigarette butts floating, you start wondering what else is there that you can't see or haven't seen. Yucks!

I hope that they will able to maintain its pristine beaches. It's one of the few beaches where I have been that fishes are also swimming beside you eventhough you are not even 5 feet away from the shoreline.

I guess its back to work for me.

Friday, February 09, 2007


Met my friends whom I have been with for the longest possible time. Everyone is now successful in their respective fields. And one of the friend asked me: "Don't you get depressed when one of your patients died, that's why I didn't want to be in the clinical setting." He is a hospital administrator for their hospital.

I suddenly stopped and didn't know how to reply to that question. At that moment in time, I realized: "I think I am, but I am not fully aware of the extent or depth of that emotion."

My reply was, shrinking away from further questioning: "Of course, a little bit." But the truth is, I really don't know, and do I really want to explore that area?

In my med school and I'm sure in almost all the med schools out there, students aren't trained or at least informed of how to handle the emotional and psychological effects of patients' questioning, pestering, pleading, and worse suffering and death itself. WE all were just thrown into the proverbial lion's den and fend for ourselves for whatever physical and psychoemotional asteriods that come into our direction.

Sure there are also psychiatrists, but honestly, how can they treat fellow collegues esp if they themselves suffer the same affliction. And how can you "stay unattached" as much as possible? Only robots and reptilian-based creatures can do that, being cold and steady without emotions.

What will keep the doctors sane after long years of practice?

Wednesday, February 07, 2007


I've been tweaking my blog site lately and I would say that I am a bit amused at how my site looks with all the funny buttons here and there.
Guess, I am a little envious of some of the blog sites that are featured in the "Blogosphere" though for what reason I'm not yet certain. Maybe I want to be famous too! hahahaha.
But I'm happy and contented that I can express myself without fear of reprisal or unwanted criticism from my patients or from fellow doctors.
Until I saw Doctor Anonymous! I said to myself, I don't want to be like him, hounded and all. I feel sorry for him that he is Anonymous no more. Me don't want that, I want to remain anonymous for the longest possible time :)

Monday, February 05, 2007

Lung Cancer with Brain Mets

Its going to be a hard case, this one. I have doubts that the patient and his wife are really going to realize the importance of doing things the natural way. I fear that I might not be able to help them since the patient is still in a state of denial, while the wife is leaning towards chemotherapy. But after the 10 sessions of radiotherapy and the lost hair, isn't it enough to show the wife that her husband might not be able to withstand chemotherapy.
I saw using the SCIO that he's in a lot of stress, not only because of the cancer but more because of the financial difficulties now and waht lies ahead, with the chemotherapy drugs which will cost more than 100,000 for them ($2000) each session.
I hope I can help them at least for the time being.

Saturday, February 03, 2007

Genes and then some

I have seen a lot of my patients who have done chemotherapy, radiotherapy or both. But almost all of them somehow will ultimately fail or failed to finish the course because of poor tolerance to the side effects or tumor doesn't respond or even becomes bigger.
Recently, more and more research have come out about the importance of doing genetic profiling of the tumor to get an overall picture of the prognosis as well as which chemotherapeutic agents willl be effective.

I wish that we here in the Philippines, will adopt that and spare patients from trial and error. Though I know that this will be unlikely in the near future since, all medical expenses will be paid by the patients.

Sad to say, our medical insurance in the Philippines, deliberately or not, excluded cancer for coverage and left people to spend a preposterous amount on chemotherapy. And adding insult would be that chemotherapy drug or drugs will eventually go to waste since the patients will not finish a course. Leaving the patient in pain, frustration and disgust to their fate.

Thursday, February 01, 2007


I can't seem to sleep these past few days. I keep thinking of my past and present patients who I am and have taken care of. It seems that I am rationalizing things that are already been done or things that were inevitable.

Weird, maybe my subconscious is tryng to tell me something!!! I have to know what is it soon, or I go crazy. I can't stop thinking especially of a new patient with lung cancer with metastasis to the brain, that is going to be a bit more difficult. I hope I can help him fast!