A Few Days More....

Malapit na ang compre namin...yun ang deciding factor sa magiging future ko. Good luck!! :)

REFLECTION PAPER

There was a short orientation given by Dr. Solano who was in charge of this Community Medicine Rotation a day before we were actually sent out on our own. A daily routine at the health center was discussed to us. The different papers we had to fill up were showed to us along with a thorough explanation of each item enumerated in the list of skills expected from us. We were also briefed regarding what to expect in the orientation at the Quezon City Hall, the people we were about to meet and the community that may be assigned to us which were frequently Tatalon, Kamuning and Kalayaan. Because of that meeting with him, I had a glimpse of what to expect which somehow alleviated the odd feeling of starting from scratch in a two-week rotation. Therefore, I expected this rotation would be similar to all the other out-patient rotations I have gone through at the Medicine, Surgery, Pediatrics and OB-Gyne department in St. Luke’s where lots of patients seek consult regarding various medical or non-medical concerns. It was then that I realized it was some kind of a blessing for this rotation to be at the end of my internship because I might be in a total loss if it was right after clerkship. I would not be able to confidently diagnose or give appropriate medications to common illnesses if it were so and I’m sure Dr. Castillo will have regular headaches for two weeks having me as his intern.

March 1, 2007: Thursday – It was the first day of a new rotation which we call urban probably because we will be attending to patients in the metropolitan setting. My groupmates and I met at the SLMC lobby and together went to the Quezon City Hall where we arrived just on time for the orientation. It was such a surprise to see familiar faces from last year’s rotation in Mental Hospital. The papers which Dr. Solano showed us were handed to all of us by the person briefing us. When it was time for us to know what health center we were assigned to, I again got surprised because I was the first one called and so I asked the dentist who talked to us where Tatalon was and how I was supposed to go there. When he was giving me the directions, I couldn’t make a map in my head of the places he was telling me bacuse they were unfamiliar except for the Quezon Institute which I frequently notice each time I pass along E. Rodrguez coming from Manila. I just hoped to figure out the place on my own. I didn’t bring my stetoscope that day because I thought it would just be an orientation but when we were informed that we were to join the medical mission in Galas Health Center on that same day, how I wished that I had my stetoscope with me. We rode a van going to the place. When we arrrived, there were so many patients lining up for check-up and then Dr. Innumerable introduced us to our new bosses for the coming two weeks. For me, it was Dr. Leonardo Castillo, who was seemingly a happy person which was proved to be true in the next days that I worked with him. He reminded me of my own Lolo who talked a lot about his life experiences when he was young and how it was in his time. During the course of the medical mission, a lot of things can be observed. It was a dole out activity of the city mayor and vice mayor with a small amount of campaigning for the coming elections in May. The people who went there weren’t really there to seek consult but to ask for free medications even if in truth they had no medical ailment. It is a sad thing because the value of seeking medical consult in that scenario only becomes superficial, which may be deleted. Probably, people may have the connotation that medical consult is only appropriate if they want medical treatment otherwise there is no need to seek consult thus they seek medical attention late or not at all.

March 2, 2007: Friday – It was my first day at the Tatalon Health Center. Lucky for me I found my way easily by recalling the blur instructions given me. When I arrived at the Health Center, Dr. Castillo asked for the endorsement letter given at the city hall and immediately upon handing him the letter, he briefed me about the places that are included in his area of responsibility and the various activities and programs the health center has namely: Maternal and child care, TBDots, Dengue Lecture Series, Immunizations, Family Planning and Environment Sanitation (some of those I remember). He also talked about basically what I was supposed to do which was to see patients and give them advise and medications when necessary. There were many patients on that day and I was not really fast at writing down my SOAP, finding the right drug to give and calculating for pediatric dosages so we had a late lunch together with the nurses and midwives at around 1:30 pm. After lunch, there were a group of girl scouts who were going on a camping and had to have a physical exam done to certify that they are in good physical status. I practiced my physical exam skills on probably 8 girls which I found to be essentially normal except for some who had retained cerumen on one or both ears. The last patient I had was a 36 year old male who smelled alcohol all over and was complaining of abdominal pain which was radiating to the back. I checked if he had CVA tenderness but there was none elicited. I was getting the impression that he was a psychiatric patient because of so many things he was saying which were not connected. I just gave him Mefenamic Acid whenever he felt pain. At the back of my mind, I wanted to tell him “umalis ka na nga, wala ka namang sakit eh” but I tried to appear calm and polite in talking to him. Good thing when he was given the capsules, the nurse convinced him to leave. Later on, I learned that he was on shabu and has lost his mind ever since. On that day, I learned patience in dealing with a difficult patient.

On the days that followed, I was impressed by the competency on how the Tatalon Health Center operated. Everyone had a role to play. The physician, nurses, midwives, aides, sanitary inspector and barangay volunteers all had their own definite jobs to perform and accomplish. There was a well-organized and well-managed system on how approximately 60 to 70 patients each day were admitted, given numbers and triaged to well baby for immunization, pregnant women for speculum exam and all others for general check-up. There was also an organized way on how they manage PTB patients by having someone give them the medication and signing a form for evidence or certification that patients were compliant with their medications.

Because of the Dengue Lecture Series that the Barangay and Dr. Castillo coordinated to implement from March 5-15, I had the rare chance to see for myself the devastating condition of the community and then I realized that Public Health is such a gigantic task to take on one’s shoulders. It demands social concern and social awareness plus so much dedication and zealousness to pursue the dream of the primary health care and “health for all” ideal. What is even more depressing is that we are not even close to it. Even if so much effort has been done and so many resources put to use, we can only hope for people in the community to realize that they have an active part with regard to the future of their health system. As Dr. Castillo blurted out in one of our conversations, the main problem all boils down to poverty which paralyzes and mutates community empowerment. Because of poverty, people develop a dependent and blame-seeking attitude which makes them apathetic to the present health problems in their community such as Dengue. This can be evidenced from the low number of attendees of each gathering for the Dengue Lecture on various sites in the community. People have to be dragged to listen and if they come to listen, there is no assurance that there will be a corresponding action. According to Dr. Castillo, a similar information campaign has been done twice before and yet there are still houses with rubber wheels on their roof which may be serve as breeding site for mosquitoes. There is little we can do about poverty but with a little change in attitude maybe there can be some hope to change what needs to be changed and to do what needs to be done.

All in all, the eleven-day Community Health rotation in Tatalon Health Center was fun and filled with learning experiences that gave me confidence on diagnosing, treating and prescribing appropriate medications. It gave me a chance to feel how the practice of medicine in the country works despite the dark future that it may become. It made me see medicine in a wider perspective not just confined in the hospital walls but rather a social involvement that wakes up our social responsibility to somehow alleviate people’s lives by educating them, by attending to their health needs and by being one with them and wishing that all efforts will not be in vain.

Wait lang...

Di ako yung nagsulat ng Kowts daw, Conversations at yung how do you know if you love someone....galing yun sa mga websites na browse ko nung may kagalit ako. Wala lang gusto ko lang yung mga articles na yun.

March 1, 2007 Thursday

first day of a new rotation..urban!! went to quezon city health office for the orientation..met co clerks na ngayon co interns na. buti na lang di kami late minus pa yun sa attendance grade, hehehe. sabak kaming lahat ng st luke's sa med mission sa galas health center. daming patients pero parang ang tanging pakay lang nila eh humingi ng gamot at hindi magpa konsulta. ang gulo gulo ng lugar may mga batang naglalambitin pa dun sa mga harang na nilagay palibot kung san yung mga mesa ng mga doctor. dumating dun si mayor at vice mayor nakipagkawayan sa mga tao. may libre kaming merienda na siopao at lunch na fried chicken. nakilala ko yung magiging kasama ko sa tatalon health center kung san ako magrereport for 15 days. mabait naman pala si dr. castilllo eh pero matanda na siya tapos hirap na lumakad kase raw may gouty arthritis siya. mga 4 pm na natapos yung med mission kumain kami nina alona at joi sa may gateway ng halohalo at pansit.

March 2, 2007 Friday

first day ko sa tatalon health center. hindi ko alam kung pano pumunta dun pero inalala ko yung instructions na binigay kahapon kaya nakarating naman ako medyo late pero ok na rin di naman pinansin. kinuha ni dr. castillo yung endorsement letter ko galing sa qc health clinic tapos orient na niya ako sa mga dapat gawin dun. madali lang pala parang opd lang. tanong tanong sa patient bigay ng gamot tapos ok na. pinag merienda ako ng coke at pancit palabok tapos naglunch kami nga 1 pm na sa dami ng mga pasyente. ang bagal ko nga tumingin eh parang naka 3 pasyente na na si dr. ako isa pa lang. hehehehe. marami pa raw siyang gagawin kaya ako na raw tumingin ng mga darating sa hapon. may mga batang mag ca camping na nagpa physical exam. ako na lang yung tumingin sa kanila tapos yung form pinirmahan na lang ni doc. bandang mga 3 pm may dumating na mama masakit daw ang likod akala ko lasing kase parang lasing kung umasta yun pala adik siya sabi ni doc. dati raw yung nagtatrabaho sa munisipyo kaso na adik kaya parang wala sa sarili kung kausap. may dumating din na nanay nagtatanong kung pwede dun na lang dalhin yung anak niya para alisan ng tahi sabi ko sige dalhin na lang niya sa lunes. nung pinauwi na ako mga 4:30pm na tinanong ko pa kung pano ako lalabas dun sa lugar na yun kay doc. sabi niya hintay lang daw ako ng tricycle tapos pahatid ako sa may pure gold. nilakad ko na lang pauwi malapit lang naman at para ma exercise na rin ako kaso ang gulo pala at maalikabok. ewan ko kung lalakarin ko pa rin pauwi next time.

wala akong pasok pag weekends eh pero kailangan na mag-aral. good luck na lang talaga. hehehe.

What's Next?

This is a recurrent question when something is nearing its finish line. Malapit na ako matapos sa med kaya yan na naman ang tanong ko. Ano kaya ang magiging sagot? =)

Kowts daw

mahal kita, tagal na… lam ko din na mahal mo siya. pero sinabi ko sayo ang nararamdaman ko, tapos nagkita tayo. lumapit ka… sabay hirit "uy… kami na!"

lam mo, gago ka! bwiset! leche! walang kwenta. manhid! ang laki mong tanga! pero mas naging gago ako kse nagpumilit ako mahalin ang isang gagong tulad mo…

lam mo mhal kta! e ano nmn sayo? la lang dba? kahit na magmuka na kong tanga. ginawa na ang lahat at iniyakan ka. la pa ring kwenta… ako lang naman to diba?!

isang araw, nakalimutan na kita. isang araw, pinabayaan na kita. isang araw, nagmahal ako ng iba dahil sinaktan mo ako ng sobra-sobra, nung iniwan mo ako at pinili mo siya… balita ko mahal mo pa sya? totoo ba? ouch! sensya ka na ha? mahal kse kita. pero pag ayaw niya sayo, dito lang ako kahit panakip butas lang ok na. kahit masaktan pa ko, wag lang ikaw…

sabi nila gago ako kse daw ikaw mahal ko… nasasaktan na cge pa rin ako… dami pa daw iba… lumingon lang ako… tama sila. dami pa nga dyan kaso may problema… mahal ko ba?

may mga bagay sa mundo na di mo maintindihan. may mga bagay na nangyayari na di mo mapigilan. pero kahit ano pang mangyari, gusto kong tandaan mo, nandito lang ako lalo na kung para sayo…

may nagtanong saken kanina kung bakit daw mahal na mahal kita. di ako nakasagot. tumawa lang siya tapos umalis. tsaka ko naisip, wala kseng dahilan para di kita mahalin…

kung alam mo lang kung gaano ako nasaktan. kung alam mo lang kung gaano ako nahirapan. kung alam mo lang kung gaano kita kamahal. kung alam mo lang siguro hindi mo ako iiwan…

pag wala ka na, di na ako iiyak. pag wala ka na, di na ako malulungkot. pag wala ka na, di na ako takot. pag wala ka na, di na ako magmumukhang tanga. lam mo kung bakit? kse pag wala ka na, wala na rin ako…

masakit magmahal kapag binibigay mo ang lahat kahit alam mong walang darating na kapalit para sayo. pero mas masakit magmahal kapag pinaasa ka niya na mahal ka niya tapos malalaman mo na may iba na sya sa buhay nya…

o ano? gusto nyo pa? dame pa me..
post nyo lang email ad nyo ok?


masarap magmahal no?? lagi kang masaya.. lagi kang inspyred.. lalo na, pag alm mo na mahal ka din nya.. pro, masarap bang magmahal kung alam mong balewala ka sa kanya??

lam mo ba na hanggang ngyon hinihintay prin kita? na di pa ako naghahanap ng iba? na ikaw lage iniicp ko? kc hanggang ngyon, mhl parin kita!! kaw lng kc,, ayaw kmong maniwala..

hindi kita nakikita pro ok lng,, hindi kita nakakausap pro ok din lng.. masaya ako khit wala ka sa tbi ko.. pro gusto kong malaman mo, na tuwing wla ka, kulang ang buhay ko, kahit ok ako..

bat ang tao, nagmahal,, iiwan ka?! kapag iniwan mo,, mamahalin ka! pag minahal mo, xa lng tlga.. pro xa, may mahal pang iba,,, skit no? @#%$ kcng pagibig yan! nauso pa!

lm ko mrming beses na akong nasaktan.. pro swerte ka rn dhil dami nagmamahal sayo.. e ako? hehe, ,nasasaktan din.. pro ni minsan,, hindi ko naranasan ang mahalin tulad ng gingwa ko sayo..

kunwari msaya ako.. kunwari,, ok lng ako.. kunwari, lka ako problema..kunwari, nasa langit ako.. ok lng bang icpn kong love mko? kunwari lng nmn eh..

sabi m, dka nanghihinayang na nawala xa sayo.. o nagccc na iniwan ka nya.. pro sa totoo lng.. hindi ako naniniwala.. dhil nakakatulog ka sa tbi ko, lumuluha.. hbang pabulong kong cnsbi, "ako kaya,,iiyakan mo??