There's this song I really like listening
every time I'm alone again.
No one to turn. No one to go to.

Joni Mitchell's Both Sides Now

And everytime I listen to that song.
I remember Vanessa.
Those rows and flows of angel hair
And the way her head falls gently over my chest.

She was always looking for something grand
Something I couldn't quite comprehend
And I guess it was of late that I realized
It was meaning she was searching

Not sex,
Not love,
And certainly not addictions

So I dedicate this ode
For her longings
For those moons and junes
and ferris wheels

And for her dream of finding
those ice cream castles
in the air

I tried writing about you Dimsum
Countless times
Changed my stories every single time
Because at first I thought
It was the green CRV
that had me hooked.
Or the free dumplings you gave me at Tomas Morato
Or the fact that you had alabaster skin
Like those pretty schoolgirls of Assumption

But you were never from that school
In fact it was from some fancy school I didn't even know
Which lead me to think
That just because you had a green CRV
And you had alabaster skin
And powerful friends
I thought
You were rich and powerful
And intelligent
And kind

But I was wrong of course
Bad judge of character
So I write today about you
thinking
My God what was that all about

You did not give me anything to write on Dimsum
No idiosyncrasies
No habits
No longings
And certainly no addictions

It is always fascinating to her Dr. Rebosa talk. When I was still a medical student, I remember his lessons on how to escape those kotong cops by mere wit and charm. Of course, I could never be as lawyerly as he is. I mean he rocks.
So anyway his topic was very much alive even at 8 in the morning. While most delegates were busy making coffee, he was actually discussing all the things that I thought I already knew as a physician. Apparently, as I eventually found out, I still lacked exposure with the real world.
Case 1. A doctor was handcuffed and detained by the police for allegedly conspiring to kill a patient in front of the media that is. It was horrible because of the fact that even the NURSES were included. And somehow when Dr. Rebosa talked about it, I can't help but feel the pain of the doctor. Is this how we are being portrayed? Don't we have rights? Are we even aware of our rights as doctors?
Case 2. An anesthesiologist settled with a 7 figure sum for allegedly causing comatose to a patient.
Case 3. A cardiologist also settled with about 4 million for allegedly ordering a treadmill test and while the patient was on the treadmill, the patient apparently died.

I know, those non doctors are thinking but somebody just died. Who is responsible? Isn't it the doctor? Alangan naman the patient pa? Or maybe the technicians who didn't do anything while the patient had chest pain.

Complicated I know. Because the first premise is that doctors are not Gods and second and most important, there is no such thing as 100% in science, even in diagnosis. So it's really tough. And when somebody files a lawsuit on you, it will take its toll. Heavily. Besides the fact that you were not able to save the patient who trusted everything to you, you get to deal with lawyers.

So his answer? Defensive Medicine. And refer. Yes, refer those Pilosopo Tasyo's to those classmates you hated in medicine. I mean he was right is saying it is just not worth it. Four hundred pesos for a lawsuit waiting to happen? Good riddance.

There I was listening to him talk lawyerly about the present predicament of doctors when I suddenly realized, sooner or later those cases that I just read about will happen to my colleagues, or even to me. And soon the Dr. Rebosa's of the world will retire. When that time comes, who will defend me? Do I even know my rights? And my obligations?

Interesting times. Especially with that ABS CBN reporter lambasting Filipino doctors left and right. I do hope she really understands what she is fighting for. Or that she realizes the implications of her actions. Because it is easy to say that you are fighting for truth with just one experience of a loved ones death.

But it is altogether another thing to actually understand suffering and seeing people loose their loved ones magnified thousands of times. From leprosy to Tetanus to HIV. Like what we experience every freaking day of our duties from clerkship, internship, residency to even being consultants. Is she even aware that we are at risk or acquiring PTB, Hepatitis, HIV and a whole lot of diseases she just even reads about?

She does not understand. Like all those before her, she thinks that by spending a segment on Pulmonary Tuberculosis she will know what Tuberculosis really is all about.

She does not comprehend that it takes more than a big mouth to carry the caduceus.

I went to a convention today. You know one of those nice snippets where they get to present all these latest advancement in technology, science and treatment modalities. I actually just went there because I was expecting to get a pillow but there were only these pens and bags and a whole lot of crap.
Then halfway through the convention I got interested. I think because there was all this talk about infections. Oh you know, those sexually transmitted infections. Hepatitis, HIV you name it and they got it. And it was weird. Weird because the speaker seems to be stating statistics and there was no clear discussion on treatment modalities. Does he realize that HIV has become a chronic disease as of 2008? Or that it's not actually a death sentence anymore. Unless of course you don't take those antiretrovirals and we know you'll eventually end 6 feet underground.
So I guess its fine to go unprotected sex once again. I'm kidding of course. Wear those condoms please. Other physicians reading this blog might think of me as renegade doctor. In the same league as those who advertise sillimarin capsules or Athro. I mean I wouldn't want to besmirch the reputation of the Filipino physicians. Besides, those antiretrovirals really cost a lot. I mean A LOT

There is hope he said. I like his last message and the power point presentation. But the weird thing was that he seems to believe that abstinence is the key to preventing the spread of the disease. A for abstinence. It was really like this kindergarten song. A your adorable, B your so beautiful.
Is it just me or are we back to the middle ages once again? What ever happened to condoms?

There's this other thing he mentioned that made me smile. He said the Lewinsky-Clinton thing can also spread the disease. I was smiling because I was thinking if there was really a study done on that. I mean those who prefer Oral sex proceed to Room 1 and those who do not like oral sex to Room 2. Would you choose Room 1 or Room 2? Or both? Assuming of course the real deal is in Room 3. So you know how hard it is to make up a conclusion about sexual practices right? We can't just enumerate all these practices and say, this causes that. It has to be backed by evidence. Everything these days has to be backed with evidence.

Please understand that in the end, medicine is an ever-changing science. And that what we practice today will eventually change. I mean Vioxx used to be very in before but with now we don't use it anymore. Or remember the weight reduction drug Adifax?

To those non physicians who read this blog please understand that doctors are also human beings. Meaning they also get scared of what they do not understand. I mean I got scared when I saw my nth case of Meningococemia few months ago. But we are mandated by our conscience and our laws to show compassion at the very least.

I hope something exciting happens again tomorrow. So at least I can get my 2500 worth of membership dues.

It started with Annie. The sun will come out tomorrow kind of Annie. Although her name was not Annie. And just remembering her, clears away my cobwebs and my sorrow. She really did clear away all my cobwebs, at least for a time when I was alone in Laguna.
When I was alone with nothing but sad letters and pathetic love songs, she introduced me to her family in Alabang.

You see she wanted to take up Medicine and I also wanted to take up medicine. She wanted to conquer the world and I also wanted the world. We were almost the same. Very much the same. Even in our fears.

Then my day begins with simple thoughts of you. Hoping that tomorrow will be me and you.
Sharing dreams with each other. And making them come true.

So I cornered her. That one night in Bioscience. Almost made out with her. But there was also other forces at play. The UP Police roaming and I guess I too was not ready. I was still afraid of what it might do to us. To me. And she was contented with being just friends.

I've known you for so long you are a friend of mine. But is this all we'll ever be. I've known you ever since you are a friend of mine. Babe is this all we ever could be?

So I just told her things she'd never known. But hid the fact that I was in love with her. So she went on and had someone else. Someone who was famous and who also wanted to become a doctor.

All those sleepness nights . All the tears I've cried. All the pain I've kept inside.
Was it just a dream that you said to me. That there was someone new in your life.

There were moments when I wanted to die for such a betrayal. To end my misery. Unrequited love is the worst of its kind. Why couldn't she wait for me?

But when I'm stuck with a day thats gray and lonely. I just stick out my chin and grin and say
the sun will come out tomorrow so I got to hang on 'til tomorrow.

And the sun did. After passing the boards, we saw each other again. We are both physicians now. But there was nothing there. No more butterflies in my stomach.

So while the song still brings that certain low. And the world still sings of love I know. It isn't quite the way it was before.

I suddenly realized I've grown past those Lea Salonga songs.

I understand everything now. The nature of these addictions. How they seduce and control me like a puppet on a string. I always thought that since I never had a childhood, I was merely compensating for it. But like everything else I thought I knew, I was wrong. There is always a deeper meaning to everything. Or so my amazon princess lead me to believe.

You see when I first started with these addictions, everything was new and exciting. Everything was beautiful. Like Chocolait. Like Mango Passion Fruit. Like Apple Berry Freeze. And I guess as time passed by, I realized they were only beautiful because I coveted them. Because I wanted to own them. To taste their every curve, their every scent like they belonged to no one but to me. To torture them until the only name that comes out of their mouth is mine, and mine alone.
But there was always something missing in every encounter. In every secret. Something I could never quite understand. Until now.
When storm signal number 3 ravaged Manila, I was left with nothing but my pen. So I started writing again. About Diana of Themiscyra and her golden lasso. About my grade shool professor and her daring adventures with the Justice League. And even though I failed my teacher countless times as these addictions have started to consume me, I am still grateful. Grateful that she has instilled in me my worth before these obsessions overpowered me. Grateful that I will burn with her like wild fire. Not like Ice. Cold and unrelenting.
Oh yes, Fire. Like my wild things encounter. And with this fire, I will burn the world I know. Like the legendary phoenix. Make it disappear. Remember it no more. Just like that. And change. Perhaps into someone better. Or worst. Someone I will not even know. And soon I will have to find comfort in the fact that these addictions no longer fit my life. No. No more. There has to be something better than these.

I guess my amazon princess already taught me all I needed to know. After showing me her golden lasso, thousands and thousands of nights ago. She already changed me. I simply forgot about our encounter.

Browsing through jobstreet, I suddenly realized I am a rare bred. Honestly now, there seems to be a lot of companies in need of doctors. Even the government is looking for ways to keep the brain drain from becoming well, even more realistic. And its good. Because at least finally we, the young and dashing physicians of yore are aware of our worth.
A few weeks ago I was fortunate enough to be a part of a community far down south. I was actually looking for an adventure. They said I was going to get P1,300 for 24 hours and I was stupid enough to take it. Stupid because I was doing P3,000 for 12 hours in a hospital much closer to my place. Yes, charge to experience. I felt bad afterwards though. I think it wasn't because of the money that I gave up the place but because of those small town people I could never understand. For instance, one patient was bitten by a cat and was given only one dose of rabies vaccine. I was really mortified. What if the cat was rabid? In St. Luke's we usually give rabies immunoglobulin and rabies vaccine in 0-3-7-14-28 days dose plus of course the tetanus stuffs. So really it was difficult for me to adjust. I can't seem to reconcile what I know and how to practice medicine there. And since I was a visitor, I could not say anything. I was practically a stranger to that community.
The quarters was in itself another story. When they showed us where we will live for the next 2 days, I didn't know what to say. It was a small room approximately 4 by 4 meters subdivided into an even smaller room with one ceiling fan located at the center. The entire cast of Ant Bully was also present and I was fortunate to have one in my ears the last night I was sleeping. Apparently, the ants consider me sweet. There is also an exhaust which goes from the hospital (note: dirty) to our quarters (note: dirtier). Where they expecting convicts or child rapists to stay in this place? I was really speechless.
Is this how low they treat us? Are young physicians left with nothing but this cramped place without even drinking water? I was practically dehydrated for 2 days.
I know I'm exaggerating and you may say that well, doctors to the barrio volunteers have it worst and you're wrong. My friend who works in a community in Mindoro for the DTTB program has get this, Centralized Air Conditioning. And he gets to see and advise patients like a real doctor. We on the other hand were made to observe and even ridiculed for our understanding in medicine. We allegedly don't have much experience in patients because we live and breathe in a private hospital. The gall. At least I know there is no stage 3 hypertension. Well, Maybe there was. But that was like before 2004 came.
I was really hoping to know the community since I took my undergraduate degree from there and I still have friends who live there but apparently, I was not cut out for it. When you are moonlighting you are really prone to abuse.
There's this other thing as well. Have you ever wondered why most hospitals in the province prefer that you refer only close friends? I think that is because the cycle of abuse will be easier to propagate. You can't quit if you get a better offer afterwards. Nahihiya ka magquit unlike when no one knows you, you can quit anytime.
It is also a fact that most hospital owners are physicians as well. So why do they treat young physicians like this? Because we are already in the process of becoming their competition. And because they want us to leave the country for good. They want to have monopoly with the healthcare system. I mean who doesn't? Let's keep these young idealistic doctors away and keep the Filipino people ignorant and poor and we'll make more money. Gone were the days when medicine was suppose to benefit the helpless and teach the ignoramuses. O, Who am I kidding? Go to residency at least that way you can earn more afterwards and professors who are there really do teach.

It was perfect when we first met.
Like in the movie Up close and Personal
Or was it the song that I enjoyed the most

You were my strength when I was weak
You were my voice when I could not speak

No, I have to say that she did not belong in the category of addictions.
Nope. Never. She was more than an addiction.

She was my grade school teacher. My light.
Like knowledge. Like truth. Basking in the clear blue sky.

Neither was she like chocolait or my dark cherub
For she did not harbor any of those alluring obsessions.

On the contrary, she taught me control
Before they consume and totally destroy
Like wild fire. Like wild things.
In between the bathroom breaks of those entertainers
in Clowns Bar in Quezon Avenue.

So in return, I offered myself to her. To my beautiful scourge.
I offered my body to do with as she pleases.
And my soul for her eyes to feast upon.

Until morning came and she had to go back to Athens
Or was it Saudi Arabia? Amsterdam perhaps?
I can not remember.

All I know is that there was a country she needed to be
A country she needed to save.

It was my first time in the enchanted forest
So I do remember her very delicate features.

The captivating sprite I met at the Philippine Heart Center.
When I was a young and naive medical student.
She was a radio technologist and back then, I was her first time.
Her very very awkward first time.

That is of course before she saw greener pastures
And left the Philippines Islands
For a much bigger country down under.

You see she wanted to get married.
Probably to settle down with a foreigner
Get rich in the process.
And forget about me.

She wanted to forget about who I was to her.
What I was to her.

So why do I need to write about her now
When she clearly chose to leave me?

Is this about mocking her?
Telling her husband that he will never satisfy her
the way I satisfied her.

Why do I need to speak about her
When clearly she wants no part in me?

Because a long time ago in that enchanted forest
Julia made me fly
Like Peter Pan and Wendy
Like the lost boys of never never land

And because I am afraid

Afraid that if I do not remember her
She will simply stop breathing
And fade like all the other characters of my childhood

This is a tribute
To the man who gave me more than his Y chromosome
To the man who jumped the freezing waters from the Titanic just so he can be with his Rose
To the man who stayed with his family through thick and thin.

Their story was short of a telenovela
Boy meets girl. Boy pursues girl.
Boy and girl get married.
But there was a twist.
Like all stories.
They were related. Far distant cousins I suppose
which probably explains my present psychiatric state.

So there it was, the antagonist. The conflict. The denouement.
To make the story complete of course.

But somehow he managed to survive with his family intact.
Like I said, the freezing waters of the Atlantic
Made me proud to have him as a father.

So I write to honor him
My Gautama Buddha. My Anwar Sadat.

And all the fathers out there.
For bringing joy and life.
For making us more than what we were meant to be.

7:40 pm. Time of Death. 7 year old girl brought in by a relative after being hit by a passenger jeep. Informant is too distraught to give the details of the accident but from what I can surmise, while the jeep went for a U-turn, the driver did not notice that he hit the child dragging her a few kilometers before realizing what has happened. Skid marks all over the torso. Massive internal bleeding. Blood gushes out of the nose while attempting to intubate. No heart beat. Proceeded with giving 3 doses of epinephrine. Still a flat line.

This is not a story. Or a figment of my imagination.
While moonlighting in St. Vincent Hospital in Marikina yesterday, I met her.

An only child, she was suppose to go to school tomorrow after the long holiday. She just celebrated her 7th birthday 2 weeks ago.

Checked her pupils. Dilated. She must have found peace before they brought her in. Good thing she didn't feel the pain anymore. It must have been horrible. For someone so young.

It is in moments like this when I remember Vanessa. My dark cherub. My apple berry freeze.

The one I constantly text messaged when things got bad. When everything was not fine.
I remember telling her to always be careful because I see a lot of vehicular accidents. Drive safe. Be safe. Almost telling her I love her. Almost. But not quite.

No respiratory movements. Performed CPR. More blood gushes out of her nose. Suction please. Still a flat line. The father is screaming at the hospital now and yet she's not even gasping. Or fighting for her life as most children. The pain of being dragged by the jeep wasn't there anymore. She just lay there.

Vanessa didn't understand when I messaged her. Or why.
She must have thought I was another of her pathetic stalkers.

She could never understand these moments.

When I am in my most vulnerable.
When I cannot distinguish myself from my patients
When I get lost in the merry go round.

She could never understand that every time I see a person suffer.
Her face resurfaces. Haunting me and breaking me.
Making me realize how important she is to me.

Close the curtain. Let the family grieve. You have to be in control. Call the necessary people. Police officer. Funeral place. And don't forget to note the time of death.

I was having a bad day. My room mates were all out and I was left alone on a Saturday night.
So I started to take a stroll. Down memory lane of course.
Memory street. I swear there's a street named memory.
Anyway, a car passed by me. Asking for directions. Told her to go ask someone else.
I was not really from there. Just taking a vacation.
That's how I ended up in her bed.

It was early morning when I left her. Couldn't believe what I just did.
Her husband would have called me home wrecker.
If the poor guy knew about us.

Her husband would have killed me.
Knowing he's a police officer of sort.
Or put me in jail for something.

Then again I am always cautious.
Never tell. Never say.
Keep them guessing to the last minute.

Until I saw her again in Greenhills. This time with the entourage.
The kids. The husband. And the grandparents.
And they have no idea.

Of our secret glances.
Of the sweet surrender.
Or the sweet fillings that still calls out to me.
Night after night.

That is how my addiction with tarts started.