Moments of Craziness

Or moments of irrationality if you prefer the more formal term. Anyway, I believe everyone has them and contrary to belief; I actually have moments like this. Foremost would be the decision to enter medical school. So far the greatest irrational decision I've ever made. Still waiting for the results of the promotion boards and well, still seeing what would be the results 10-20 years down the line. And the other moments, well again, you would be shocked. 

1. Got crazy-drunk in the middle of a public field in school during high school. (I didn't get caught officially).
2. Pined for someone with the song, "Officially Missing You" by Tamia for 1 whole year *insert snicker here*.
3. Wrote this on my Facebook wall. 
4. And 1 year later, after getting friend-zoned by the person in no. 3; cried in a coffee shop. It didn't help that "A Thousand Years" by Cristina Perri was being played on repeat. Not to mention, was studying Cardiac Pathology.
5. Wrote and staged my own monologue with a partner. Oh and said partner was the same person in Nos. 3 and 4. (Shhh no one but friends from that event knows about this one).
6. Drank many vodka-laced shots and smoked an entire pack in a party staged during the night. It was a school night but the finale was making out with someone. (Hey, at least it wasn’t on-stage where every people can see; oops a different event and time).
7. Finally, cried my entire being on the side of a sidewalk at approximately 2:00 am in the morning.

No. 7 was during the last year of college. I was getting crazy enough to go to parties. And, to put it simply, I was dumped. But we're getting ahead of ourselves.
Semi-last year of college and I was walking along the SEC-B foyer when I saw a poster of a certain someone. A person sliding alongside a motorcycle or it seems to be because of the photograph. It didn't help that "Sexy Bitch" by David Guetta feat. Akon was playing. I was drawn to the figure wearing a red dress and sliding on top of a red motorcycle. Maybe it was the pose or the expression but it seemed to me, the person was sliding or maybe melding with the red motorcycle. Red happens to be my favorite color; something about red representing bravery, audacity and passion. It got to me. 

Funnily enough, it was a "human auction" or an event to bid the highest to win a date with said person. Whoever was the brainchild of that smoldering poster is an effective marketer. It was effective on me! I bid the highest on "Red Dress" and had the audacity to use my YM id (Facebook wasn't "in" during those times or maybe I was ignorant). My rationale during that time was that if "Red Dress" didn't like me then I could be messaged and I'd abandon my bid.

Classmates cheered me and "Red Dress" didn't message me. So I was feeling jittery and thinking this could be the start of something.

During the Bionight which was the event wherein the winning bid would be announced, I was so excited. I even wore something nice, shaved and gelled my hair. Things I would only do on very rare and special occasions then. However, an unexpected twist happened. Someone bid against me. Doing the very crazy thing, I bid more and even borrowed money from my friends.

Unfortunately, he had more money. I kicked myself then for spending my spare money on online games. And the knife-thrust to the gut and the arrow straight to the heart happened: it was Red Dress's boyfriend who bid against me. My illusions were shattered. Imagine an atom suddenly imploding inside and, all at once, exploding. It was a sudden release of all the tensed energy and for one night, I embraced craziness. I drank all the available alcohol and smoked all the available cigarettes.

“So why’d you bid for Red Dress?” asked someone as he was driving me and my friend home. I just smiled and brushed it off but inside I was slowly imploding and embracing that rush of melancholy like a long-lost friend.

And we finally get to number 7. While walking to the town house, my college residence then, I broke down on the side of the road. Cried. I let the tears explode. Suddenly, I was reminded of how insignificant I was. How deluded I was that a human person would actually fall for someone who was ugly, a bit on the thin side, someone wearing glasses and having a brownish complexion. At least I wasn’t making noise and waking anyone up with my inconsequential breakdown.

And 3 years after no. 7, I’m reminded of a comment a groupmate/friend made about my behaviour. “People actually find you weird and creepy”. Yeah, I know. It was all an elaborate defence mechanism to make me an unattractive person. And it worked. If my classmates are reading this, well here is a psychoanalytic explanation for my crass behaviour falling under Axis 4 of the DSM IV TR guidelines. Damn you Psychiatry!

Yes, the fact that I’m writing this online instead of saying it in person is pathetic but hey, I’m getting somewhere. The mere fact I’m writing about it and posting it on a platform wherein anyone can see it is progress enough. Or who knows, this will stay buried here. Maybe it’s all for the best. Maybe this will serve as a notch, as a mark, that I’ve moved on.

If anything at least I have a very strong reason, among many, to have a work-out routine even during the rigors of medical school. 

Brain or Heart

It's a given that physicians are smart. However if given a choice what should be the number one trait that a physician must have. Should a physician be so intelligent and wise hence have a well-developed brain? Or should a physician have the drive, the passion and the empathy for patients hence have a big heart?

Well according to Neuroscience, we live and feel with our brains. Our feelings and emotions are found in the limbic system of the brain. Our hypothalamus releases chemicals that influences the rest of the limbic system. For instance, you have an exam and you need to get a very high grade. The limbic system gives the necessary drive for you to study all-night. In addition, the hypothalamus releases a signal to the pituitary gland. The pituitary gland, in turn, releases a chemical signal to your adrenal cortex. The endpoint of which is a release of cortisol. Cortisol now gives you the energy to study all-night albeit for a short while.

So really, the graphic representation of our feelings into a heart is a mistake. The better representation would be our brains with all its gyri and sulci. But it is not completely wrong to represent our feelings and emotions with a heart. The brain influences the heart rate through the autonomic nervous system. The heart makes manifest what we feel in our brains. That increased heart rate and sweaty palms when your crush passes by that's your autonomic nervous system making its effects on the body. However, I highly doubt that people will shift to representing emotions with a brain.

At this point, it was all a long-winded explanation to get to the point that the brain and heart are interconnected. In terms of what should a physician have, it's not far off from the truth. A physician must have both Brain and Heart. One cannot become a physician if one aspect is deficient or not in synergy.

Because a physician with only a Brain will only see the patient in terms of his/her organ systems. If said patient is suffering from a cancer then that doctor will only see the cancer and how it is disrupting the organ systems of the patient. The brainy physician will ignore the signs of distress evident on the patient's face. How his/her family members are holding back tears. And if said patient is a parent, how his/her child is suffering in school. The patient becomes Homo sapiens but not anymore a human being.

Conversely a physician with only a Heart will see the patient as a human being but will ignore the disruption in the organ system brought about by the cancer. The physician will then forget about making differential diagnoses and cry with the patient. The hearty physician will not know which drugs to prescribe or when to refer to a surgeon. Or if the physician is a surgeon, he/she may not be able to perform surgery on the patient. So in this situation, the patient is a human being but the physician is helpless.

The Brain now refers to the physician's arsenal against disease and disability. The Brain supplies the medical knowledge and pharmacology of drugs. The Brain is a reservoir of many specialties enabling the physician to make a scientific and economical choice for treatment. And if the disease is beyond the physician, the Brain enables the physician to know when to refer to another physician. The Heart is the physician's drive and motivation. It is his/her humanity. The Heart enables the physician to remain motivated to keep updated with the latest medical advances. Medicine, after all, is an ever-changing Science. The Heart keeps the physician grounded with his/her patients. The Heart motivates the physician to serve his/her patients because service to others is the ultimate manifestation of the Heart.

So Brain or Heart? The answer is Brain and Heart, in synergy, together.

A Soon-To-Be Tax Evader and Burden

An ad courtesy of BIR, Bureau of Internal Revenue, the tax collecting agency of the Philippines. 

I should be studying for Microbiology-Parasitology but every time I finish a class transcription this
BIR ad comes to mind.

A soon-to-be tax evader and burden. I let that sink in. Now before anything else, I'm not denying that some doctors do not pay their taxes. However, in this ad, it clearly states DOCTOR. So all doctors are tax evaders and burdens? What about those who chose to go to the barrios, to those who chose to go to the under-served provinces of this country and to those who work in government hospitals? And on a personal level, how about my personal reasons for going into Medicine. I certainly didn't do it for
the hypothetical income found in this ad which amounts to approximately P1,000,000.00 and the paltry tax.

I went into the noble profession of Medicine to serve and to learn. But according to the BIR, I'm a soon-to-be tax evader and burden. I let that sink in again. 

And I had to read the comments in this Rappler Facebook thread. 

It's full of the entitled Filipino mentality and ignorance. "Bakit ang PF ang taas! (Why is the professional fee high!") says one commentor. "The truth hurts eh doctors," says another. On and on again, the same entitlement, negativity and selfishness permeates this thread. It was as if all the life-saving functions of doctors are forgotten. The sins of a few doctors becomes the sins of all. Now, I am numb and speechless.

These are the people who I decided to serve upon having a revelation at the Rizal Library! This will be what my future Filipino patients will say to me and what hurts is that they'll say it behind my back. They'll generalize that my lifestyle is funded by my very high professional fees; never mind if I chose to do a medical mission or get involved in a community. Never mind if I do pro bono work.

The idea of a doctor charging a moderate professional fee is sacrilege. All things should be free. Never mind if the doctor has expenses and wants. 

I now have a sudden urge of re-thinking my original consideration in taking the USMLE and then getting an ECFMG certification which will then allow me to practice Medicine abroad. Any place far away from the BIR and these entitled Filipinos who might I add will have the audacity to ask for a discount from their doctors. How these Filipinos can face their doctors after deriding them online is beyond me.

Maybe it was a mistake in being adamant about staying in the Philippines to serve my fellow Filipinos.