Thursday, January 26, 2012

When Amihan Makes Me Wanna Move

The new day brought weirdness to mind. It was 9 am and it was still dark! Why? The sky that poured the early morning rains, which flooded the front of my house, hasn't cleared yet. 

The creeping heat and humidity made it  so ironic though. But the realization of the irony came an hour later when the sun peaked and brought full on its heat! Must have risen to nearly 35 C and 90% humidity! Yikes!

Wiping my brow as I entered the ICU. I immediately checked one of my two patients there. And what I saw in his lab result confirmed my worst fears - Weil's Syndrome. That is a severe form of Leprospirosis. It was just so saddening that they were too poor to buy their meds, which though minimal at best, could still be life-saving. 

The other patient was improving despite the new xray results which seemed worse. I am hoping this is just radiologic lag please. 

Off to my ward patients then. Sad news then hit me. One of our patients worsened overnight with decreasing platelet and hemoglobin now only at 22,000 and 42 mg/dL. I had to update her family and advise transfer to Tacloban where platelet transfusion can be done. Sadly, we can only do whole blood transfusions here. Prayer will be their greatest weapon now. 

As to lunch, it is well-toasted corned beef over toast with light mayo. Yum yum! Made in less than 20 mins to boot!

The afternoon was spent with evaluating some more patients for the surgical mission and giving advise on some difficult thyroid patients they had. 

The ideal next agenda should have been badminton. But the rains and winds stopped me...not to mention my unfinished laundry. Better pick it up early tomorrow. 

It was a typical and slightly unsettling day, but at least I was able to write some stories that brings me heartaches and pushes me to challenge the norms already set. 

I dream of a medically self-reliant Eastern Samar. That dream takes root today and I will try everything in my power, moving heaven and earth, even hell if need be, just to make it happen!

More to come...

Tuesday, January 24, 2012

The Day The Patty Went Rouge And Raw

What greeted my open eyes this morning? Nothing fascinating but the darkness of the NGCP-induced now 26-hour blackout! The only amazing thing was that my rechargeable fan which was already on for 8 hours was still going strong...thanks Dra. Apita and family for that particular raffle prize. 

As I got up and prepared for my day, I was surprized by the pittle-pattle outside my bathroom window (which was the only window in my room). It was raining, the first drops of rain in about a weeks time. The weather here is truly fascinating...rain throughout nov-feb and sun from may-oct. Parang di Pinas. 

As I finished my rounds, I realized I had  a few new cases that were medically simple but clinically befudling as to how many doctors missed the diagnosis from out patient to admission. Note to self: make a lecture series for doctors and health professionals on basic medical conditions with odd presentations. 

As for lunch I decided on a local home-made siomai from Cabana, the best in Borongan, not to mention the best home-made chili garlic oil I have ever tasted! Then for take-out I got myself a calorie splurge with a cheeseburger extra cheese and patty. 

As I headed out, I had my first real laugh of the year. The guy handed me my order and an extra bag. What' in the extra bag you ask? The extra cheese and extra raw patty! Bwahaha! I had him redo my order and I headed out. 

My main schedule in the afternoon is to do a cardiopulmonary evaluation on indigent ptients set to receive surgical care from American surgeons in partnership with the local diocese of Borongan. It was a tough job but I finished with a smile (and a siopao with C2 Apple to boot) because I know what I was doing will make a difference in the lives of those indigent people. 

Then off to badminton. I played 3 games, where I won 2. Since I just started, I am assuming the other guy did all the job. Hehe. Kudos to Florina of Philhealth! Great game!

Went home with a longing for more exciting things. As I upload this, I am still chuckling from the raw patty episode earlier. Dreams be sweet because I need you to. 

More to come...

Monday, January 23, 2012

The Irony of Black Outs and Pen lights!

In contrast to yesterday's sluggishness, I woke up briskly at around 630 AM. Since it was a holiday, I was expecting another lazy day. I tried lying back down and sleeping, but my body refused to accept two lazy days in a row. 

I decided to make breakfast, which today is canned tuna and toast. I felt like a walk so I brought my sandwhich out and made rounds in the hospital at 730 AM. 

I then made warm coco (as opposed to the scalding coco of yesterday) and walked to the ER. And the year of the water dragon greeted me - wet with sweat and a dragon-load of patients to see! 

Then by sheer stroke of pure magical misfortunes brownout came and the hospital ran out of diesel. Pure freaking hell! Especially when you have 2 asthma exacerbations, one lung cancer and a heart disease patient in the ER. Water dragon sure aint looking up just yet. 

Diesel was provided by the governor (thank you governor Nicart) and power was restored by 1pm. The only good thing that came after was me eating a plate (small lang) of tuna pasta and 5 matchbox-sized tikoys! Kung Hei Fat Choi!

After clearing the ER, I decided to finish the guidelines I was making for oxygen use in the hospital. I finished around 5 pm. I then got dressed for badminton, which I will play when light comes back on at 6 pm. 

On my way home, I met a good friend who I have not seen in a while. After a lengthy update, we parted ways. First smile of the day. Thank you Jerryver Cinco!

Six PM breezed by, then seven, then eight. Still no light! After a tart message to NGCP in fb, I decided to get out of my badminton attire and eat the remaining pasta from lunch.      

Having left with nothing much to do, I opened my laptop and typed a questionnaire for an upcoming study on pneumonia, which I will be doing. I finished it in no time at all. 

This made me wonder, if it takes the destruction of my entire day's schedule to make a seemingly productive day for me. Hmmm...maybe a Chinese New Year resolution - throw out scheduler! 

As I finish this blog, the whole province is still cloaked in the darkness that is night (fueled by NGCP's miscalculation), I thought how odd...it took a black out to light my pen! 

Sorry but no bangs for the water dragon year's start. At least there is no where to go but up from hereon. So it might still work out just fine!

Hitting the sack or the bar, whichever cradles me first! Ha!

More to come...

Sunday, January 22, 2012

Of Pantries on a Lazy Day

Pantries on a Lazy Day

Sundays in the province can really be depressing at times. Take today for example, I woke up at the very late hour of 9 AM! But I never got out of bed until 10ish. Come to think of it that might be the herald of my lazy day ahead. 

I made myself a hot cup of swiss miss classic marshmallow. Yum! That is until I took my first sip and the warm humid morning air hit me as I opened the windows. Boom! I immediately cooled it in the fridge and took a glass of cold water. So hilarious, I literally felt like I was in a Mr. Bean movie. 

I then started reading a book on infectious diseases and drank my now cooled down cup of coco. I was so engrossed by the book I forgot lunch until my gut made a loud gurgle, which even I can't deny. I was too lazy to go out so I made instant yakisoba. Another lazy point of my day. 

I then checked for dessert and lo and behold, there is a half-consumed (or half-full, depending on your point of view) tub of ice cream. I was so happy, I just ate it straight out of tbe tub! Only to realize later I have no idea who the ice cream belonged too. Note to self, replace ice cream 'coz I'm sure it aint mine. 

Back to my book then. Then another gurgle of the hunger kind. Hmmmm.... I then went and opened the pantry and found Graham Honey crackers and started eating it. 

One pack later (about 8 full crackers) I decided to leave the house and play badminton. But before that I updated my fb status about raiding my pantry. And boom instead of saying I was about to eat all that was inside my pantry I mistyped and said panty! So embarassing for me and shocking to all my friends thinking I would eat all that was inside the panty! Immediately typed a disclaimer and headed to badminton. 

Boohoo! When I arrived in the courts, it was empty with lights out to boot! I had to wait 30 minutes for another guy to come and play. After 30 minutes only 5 players showed up. I decided to play a doubles game even if I was the only novice. Pant pant!

I went home and decided to grab a cocktail in honor of my best friend who took the Specialty Boards for Internal Medicine. As I tipped my glass, I realized even a lazy day could bring out good. My blog is back up. 

Samar has changed me and it is starting to show. For good or not? Only those who know me can judge but for me, I am happy, so that is all!

More to come..

Thursday, March 17, 2011

Of Pebbles and Tides

Sorry for the long hiatus but I hit a rough patch of time management here and it was just recently that I noticed I needed to write some more to share what I am enjoying here.

So as a start (or better yet, re-start), I would like to share a wonderful lunch I recently had.

First of all, this was not my first time in this place. But the first time was at night and I never really felt the need to write anything about it that time. This time though, with the sun shining high above and the tide gently coming in, I felt that this place is wonderful enough to tell tales about. 

This place is called Pebbles and Tides. It is a beach front property in Barangay Bato, a 5 minute tricycle-ride away from Borongan Proper. It is easy to find and most drivers know where it is. It is really a resort where people can stay in and enjoy water activities with good eats.


I could say that this place has the best Lechon Kawali I have ever tasted here in Samar, maybe even ever! It is cooked just right with a thick layer of fat, enough to retain the flavor of the marinade and to add its own juices to the taste of the meat. The skin is crisp like chitlings and is not as salty as one would expect. It is dipped in a local vinegar that is smothered with cracked peppers, red chili, garlic and onions. But believe me, one does not need the dip to enjoy the dish. It is also very cheap at less than 200 bucks for 3 people! Sinfully good (but not for cholesterol).

 
   (Picture of Lechon Kawali...minus some pieces I can't help but eat before taking a pic)

The other dish I enjoyed was their version of chicken and pork adobo. The chicken pieces were small and bite-sized but ample and evenly cooked through. The pork on the other hand was similar to the cut of the lechon kawali but cooked in a very different but nonetheless delicious way. The pieces of meat were cooked in its own juices with some expressed fat, then cooked again with the soy sauce-vinegar mix until it is soft and juicy. The mix contains whole pepper and bay leaves with crushed garlic to highlight the local taste. It wasn't the best one I've tasted ever but definitely in my top 5.

(Picture of Chicken Pork Adobo...again minus some pieces of meat...dunno where it went)

But to me, what made the place so great to eat in is the ambiance. We stayed in a small beachfront cottage where we can eat and see the beach while listening to the lull of the waves as the tide comes in (must be where the place got its name). From where I was, I could see two of the three main islands off the coast of Borongan. Looking back I could see the estuary where a local river meets the sea. And off to my side in the farside beach is Lalawigan, where most boats dock to go to the off-shore island. I call it my little vantage point, an overview of a sliver of life that is Eastern Samar.

It was nice to see the tranquility of the sea even if it rained hard and the wind blew crazy the night before. I'd say the place made me melancholic and think of friends and family in Manila but in the end I still felt like smiling. Now that is a little piece of Eden right there.

 
                        (view from the lunch cottage with Ando Island to the Left)

        (view from behind the cottage as the sea meets the river and form an estuary)

One little quip though, DO NOT expect quick prompt service like the harried food servers in Manila. Remember this is a province and people here are known to take their time eating and thus service takes a languid pace unknown to city people.

I made the mistake of wanting to hurry it up. The result, my meal still came in 20 minutes but I was fuming. So to enjoy the local culinary experience, learn to wait and relax a bit. Believe me the food tasted way better this second time around because I was just patiently waiting and enjoying the view from all around.


                                       (view of Divinubo Island in the center)

        (Barangay Lalawigan in the far beach...a take off point to the off-shore islands)

After a successfully satisfying meal, I have realized that in my 2 months here, I have discovered the joys of local life. I suddenly found out that the part of Borongan in my heart is growing bigger without me noticing it. Just want to share it with you all guys! Hoping you get to taste it too. Hopefully with me.

Sunday, January 16, 2011

Day 6: Of Steps and Sensibility

Another bright day of sunshine greeted me as I woke up, you guessed right at 7AM sharp. I was thinking that the day would be a relaxing day because in Manila it usually is. People usually sleep in late after partying hard the previous Friday night. Well either people here don’t party as hard or they just wake up early on weekends – I had my first consult at 730AM! I was barely out of the bathroom when I was called.  Checking myself to be fully dressed and decent, I attended to my first consult.

It ran on for many hours and I ended up seeing the most number of patients I had here so far. They later on informed me that it was really busy Saturdays here simply because this is the only time people working and studying the whole week to seek consult. Which would also explain why the cases are usually several days on already and are seeking the first consult after days of having symptoms.

Lunch was ground pork with tomato sauce and an abundance of diced carrots and onions. So obviously I didn’t eat it, what with vegetables and all. Maybe I have time this year to work eating vegetables in to my goals here...maybe. I had to go to the mall to eat a hearty lunch which I deem Rodel-friendly. Turns out it was a great mean of sweet and sour fish, 3-piece dumpling and spicy garlic rice. Ha!  Feeling fully sated, I headed back to the hospital. Walked there, I might add. Nothing better to enjoy two straight days of sunshine than a little stroll through the City’s main thoroughfare. I arrived after about 7 minutes of walking and I felt invigorated and energized.

Tonight was another sight-seeing night for me. I was still with my OB friend here but we were joined by 2 younger nurses this time. We ate in this local grill house called Kandaga and I had my fill of Sinarabsab. A hearty dish of thinly sliced grilled pork cut like liempo mixed with a vinaigrette and topped with onions, green mangoes and bagoong. Ten stars here so far. And apparently they also have a 3 liter beer tower. Quite a feat I must say for a place so far away.



The next stop is local watering hole called La Cabane. This is a night spot with a live band. And of course being the newbie in town, I was asked to sing a song with the band. Sort of an initiation to the city I guess. I requested the song Faithfully by Journey. After the song, the people asked for a second song. Either it was a custom I know nothing about or they actually enjoyed it but I obliged. I sang Sweet Child of Mine by Guns and Roses. The people shook my hand and told me I was good but I wasn’t really able to hear myself cause apparently there were no monitors facing the stage so I really couldn’t hear myself. After one of the nurses hurled on my OB friend,  we went home a bit later than usual here (1230AM) but had a great fun.



Yet at the day’s close the little steps I took to get myself and the city integrated made more sense to me than I ever wished. This adventure is really on!

Day 5: Discovery Shores

I think the idea that says a habit is developed after 21 days only applies to highly urbanized cities. Because here in Samar I think I’ve already acquired the habit of waking up early only after 3 days. I am now an early waker. My mother would be so proud.



This is the first day of full sunshine here in Eastern Samar this past 2 weeks. It was as if I was really meant to go out and explore the city today and the weather was cooperating with a smile on its face. But first I have got to work. Friday signals a rise in out-patient consults here because before people head to wherever far places they reside in, they want to get consults for their complaints first. I am also beginning to settle in my clinic routine. Add that to my few in-patients so far and I have made a breakfast-morning care-inpatient-outpatient-lunch-outpatient routine.

I have also discharged 2 patients today and I am appreciating the smiles as they leave my care only to return for a follow-up check-up in two weeks for me to assess their compliance to medical care. Patients here, I have found out, need to be constantly educated about their conditions and emphasize the need for compliance. This is also true for Manila though. This makes me think that patients are all around the same – difficult to convince out of their old ways and craves education as much as the next person.

As the sun (yes the sun actually shone hot and bright today!) come down to rest its life-giving rays, me and an obstetrician friend decided to have dinner in one of the nearby restaurants located near the shore by the seawall. But before that I had to admit another patient. Dinner was a well-deserved treat for me. I had a platter of crispy spicy calamares, sweet and spicy pork ribs with spicy garlic fried rice. Yum yum yum. All of the food was even more than what the three of us (a chief nurse went with us as well) can consume, and all for only 500 bucks. I am loving this place more and more.

Next stop for us was a hotel lounge with a videoke machine. According to the nurse with us, it is one of the more decent places for videoke in the city, plus it had a wider selection of songs for the 3 of us to sing our hearts out. I ended up singing 11 songs including Mr. Brightside of the Killers, The Prayer of Josh Groban, All Out of Love by Air Supply, Don’t Stop Believing by Journey, Peabo Bryson’s If Ever You’re In My Arms Again, Lips of An Angel by Hinder, Angels Brought me Here by Guy Sebastian  and Go The Distance by Michael Bolton. Had a blast! And what made it more enjoyable is that the song list is similar, if not the same as the one in the videoke place I frequent in Manila. Easier for me to adjust and find songs! Whoopee!

As we left the shore side, the staff people there wanted me to go back soon so they can sing along with me. I said, as long as there are no patients, maybe I can keep on going back every so often. Yet, without the luxury of time my hands are tied. Despite the fact that we left quite early for a night out (11PM), I still enjoyed it immensely, being my first here in Borongan.



As we head away from the shore, I will have fond memories of this day as my first night out of town. As I head to sleep this day, I realized that there may be more in store here for me to discover, enjoy, cherish and make my own.