Quality of Life

An 80yr old lady comes into the clinic. She's strong (for her age), sharp mind, good hearing, good eyesight, can walk fairly well with a cane for assistance. She's had a good life - her children have their own families and are doing well. A son is taking good care of her.

She has cancer - a big one in her neck. But otherwise she's fine. She wants to get an operation because, well, it's cancer...

How can I make her understand that it's not that simple a decision? A few years earlier, it would be an easy decision.

She might not survive the surgery. If she does, she might not fully recover and wish she didn't get the surgery in the first place. If she does survive, she might not survive the radiotherapy and chemotherapy that has to come after the surgery. If she does survive, she might not fully recover. If she does fully recover... that's a lot of "IFs".

How can I make her understand that the extra time the surgery MIGHT give her could be spent bedridden and totally dependent on her relatives?

How can I tell her that if she doesn't undergo surgery, she might even die of old age before the cancer kills her?

But then again, I'm not even sure of any of the above. They are all just possibilities.

And yet, I know more than she does. And I know once she undergoes surgery, there is no turning back. The end of her life is inevitably near and the cancer might not even have an effect on her lifespan. And surgery could.

Timed Out

It took 5 years before I finally pushed myself to start residency training. I hated the fact that I would have no time of my own once I started training.

Now, after almost 2 years into my training, I am being coaxed to plan when and where to spend the 15 days vacation leave given to us every year. Reality is I can't afford to go anywhere. What's worse is I don't really feel like going anywhere. Maybe things would be different if there was that "someone" I could spend time with.

I was always afraid that residency would rob me of time for myself. I never expected that I would have some time off and yet have no desire to use it.

More Than Words

I blogged about this person from my past at least 2 times before (here and here).

He was the one I let go.

This year, 5 years since we last met, our paths crossed again thanks to social networking sites. I couldn't help but feel excited about meeting again and catching up on the years we spent apart. And I couldn't help but feel this tiny spark of hope that maybe we could give "us" a try again.

The years had been kind to him physically. He still looked as good, even better than he did before. We've both grown and at the same time so much has stayed the same. He asked me why I left. That took me by surprised. I couldn't explain something that wasn't tangible. I felt like I was trying to describe "sound" to someone who couldn't hear.

After a few hours together, it was obvious that the things that drew me to him were still there - That he appreciated the smallest of things was the one that always caught me off guard. Unfortunately, the things that made me leave were also still there. And what we had years ago was really as good as it would get.

"…Now that I've tried to talk to you
and make you understand
All you have to do is close your eyes
And just reach out your hands
and touch me
Hold me close
don't ever let me go
More than words is all I ever needed you to show
Then you wouldn't have to say
that you love me
'Cause I'd already know..."

Enter the Dragon

I was on hospital duty when the humanity welcomed 2012 and now I'm on duty again as the Year of the Water Dragon will engulf the world. That's 2 New Years. I'm feeling hardpressed to come up with some new years' resolution that should make a better me. So far I've come up with nothing.

It's not as if there is nothing I have to change. It's more of, "where should I start?" I should start showing gratitude and for what I have and stop looking for something I think I want. I have to let those around me know that I appreciate them instead of pretending not to notice. I've got a lot to be thankful for and not a lot to be angry about but yet I act the opposite. My perspective has to change.

Enter the Dragon

[PS: Years of the Dragon should be lucky but the Chinese Zodiac isn't as simple as it sounds. Apparently there are several kinds of Dragons (2012 is the Water Dragon) and every Dragon Year is some body part of a dragon - 2012 is the tail of the dragon - which is the unluckiest of all the dragon years.]

Sleepless

It was by accident that she saw the sign to the clinic and by compulsion that she decided to come in for consultation instead of going to her usual doctor. She looked as if she had the whole world on her shoulders, and maybe she had. She appeared in her 60s even though she was just in her early 40s.

I haven't been able to sleep for the past couple of days.
I conducted the usual history taking and she admitted that she was going through a tough time for the past couple of weeks. We never went into the details but it seemed to involve her grandchildren. She was fighting back tears when she admitted that it was her worries that prevented her from getting much needed rest.

It was one of those rare instances where sleeping pills were needed. But I told her that the best remedy was to get away from the problem for a couple of days and gain a new perspective on how to deal with what was troubling her.

She took the prescription for the pills and left.

After 2 weeks she was back. Her face was brighter and she didn't appear as tired as when I first saw her.

I stayed with my sister these past few days and I'm sleeping much better even without the pills.

She felt she had gathered enough energy to go back to her home and deal with the same problems as before. There were still the same problems and she still didn't know how to solve them. But she had a more positive outlook now.

Those few days away gave her some breathing room to think and reassess how she could deal with things.

But just in case, she asked for another prescription for the sleeping pills, just in case...

The Filipino Isn’t Stupid

… but it seems we still don’t know how to properly address our concerns.

On May 10, this country will be having it’s National Elections. It will also be the first ever automated elections the country will (maybe) have. During the past months, the media has reported on the PCOS machines provided by the group Smartmatic, the printing of ballots and everything else about the planned automated elections.

And yet, there have been several problems along the way, problems that an IT group like Smartmatic should have seen… problems that seem impossible to have been overlooked by the company [unless it was intentional].

The Commission on Elections [COMELEC] is the government agency in charge of the elections and yet they don’t seem to have an idea of what is going on, except what Smartmatic tells them.

Same goes for the media – for all their claims of unbiased, fair coverage, none of the major networks have provided their own independent IT expert to point out or at least explain to the people why we should or should not believe Smartmatic and/or the COMELEC.

And today, just 6 days before the elections another problem has been found – the Compact Flash cards of all the PCOS machines are not properly programmed so they all have to be replaced.

1. This should have been seen weeks ago during testing.
2. It can be seen as a way of manipulating the results
3. why does a machine with so many supposed security features have to use REMOVABLE memory cards to store its programming AND results???

And now they say that it’s to late to ask the COMELEC and Smartmatic to be responsible; and that all we can do is to be vigilant during the elections…

Good luck with that! At least during the manual counting, people cheated with brute force by bring guns and goons… and Filipinos died (in vain) trying to protect those ballots. But how are we going to try to stop electronic cheating?

The media is the only organization I know who can actually try and do something about this. And yet they’re spending their time bragging about which network provided the most ‘unbiased’ news coverage (which no one really cares about). I wish they’d actually use their brains and resources to make a difference.

I’m tired of this government. We need a change. Now.

Cruises to Haiti Ethical?

Issues have been raised about certain cruise lines continuing trip stops at areas in Haiti unaffected by the earthquake but near the affected area where thousands of people already have died.

This article in CNN presents the sides of those against the cruise stops as well as the defense of the Company that operates the cruise.

To what extent are we, as moral beings, supposed to share in the sufferings of others? Are we even obligated to? Is it wrong to enjoy what we have worked for while others are suffering? What if we've donated something in cash or kind already - can we then enjoy what we have without guilt?

Isn't this a case of "misery loves demands company"?

Fireworks and the New Year

Over here, it is a tradition of many families to buy their own fireworks/firecrackers and light them up on New Year’s Eve. Unlike other countries where there are certain places that are designated for  firework’s displays, here everyone makes their own show. You have to see it to understand :D

The intensity of fireworks here in Metro Manila on New Year’s Eve is a pretty good gauge of how the year went. The worse the year was, the more intense the fireworks. While the duration - how many minutes or hours before midnight the fireworks start - reflect the state of the economy.

Based on last night’s fireworks, it’s obvious that 2009 was a bad year for most. You could almost feel the determination and impatience of the people to put 2009 behind by blowing it up with fireworks :D

Usually, about 2 hours before midnight, there were already lots of fireworks and firecrackers, but this time, it was relatively quiet up until 30 minutes to midnight, and then everything erupted. Just goes to show that there really wasn’t that much extra money to buy them so people were reserving using their fireworks and firecrackers until close to midnight... and then they let it all go.

If you think about it, December 31 - January 1 is just another day. Nothing will change overnight. But it gives us hope that it will be better this time around. Just as the sunset signals the end of the day and a promise of another sunrise - another beginning - the start of the New Year somehow gives us the motivation to try to start anew, the drive to improve,  and courage to change.

Happy New Year! Happy New Decade!

Listen To Your Gut

Gut feeling, gut instinct, gut, intuition, conscience, small voice, or even the Holy Spirit - call it what you want but we can't deny that there are times when we have this feeling that something is wrong (most of the time) or right. I've had my gut warn me... well actually made me feel that what I was planning wasn't such a good idea. Most of those times I didn't listen and regretted it. [read one explanation of gut feelings]

Every instance I recall being told something it was about the timing of plans of going somewhere. Often I've ignored it and ended up with all sorts of misfortune like loosing stuff, not having a good time, etc.

Just this weekend it happened again. I planned to go out in the afternoon and buy some stuff for an upcoming trip. But when I woke up the morning of that day, I had this 'feeling' to move my plan to following day instead. I almost listened but instead just moved it to a later time in the evening. BIG mistake.

The whole evening was a mess. Tempers (mostly mine) flared and what would have been a great evening christmas shopping became a stressful waste of time. I have this feeling that I missed out on something good because I didn't follow my gut.

I'm reminding myself again - pay attention and listen to my gut feeling because I never know when it'll speak up.

Have you had similar experiences?

Mahogany

Kansas Bob’s post, On Life Space, & Priorities, he posted the story of an astronaut who was space-walking when his daughter was born (back on Earth). Bob commented,

“...I wonder how often the rest of us miss important life events because of work or other seemingly important things.”

When I finished my medical degree, I didn’t go into specialty training because I was burnt out from the many years of school. What I said would be just 2 years has already become 4 years and counting. I could be a specialist by now.

But...

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