an eye doctor in a third world country

To cut for a living

I borrowed the title from Bonedoc from his latest post on the economics of medicine.

For the last six months, I have been on my own private practice, no more LandBank ATMs to check if my hard earned salary has some leftovers from all the loans and deductions. I now have to wait for the clinic door to open and excitedly peek if a patient has lost his way to my eye clinic. Yes, it was a patient and he asks nervously how much is the consultation fee? With a bright smile, Marj, my secretary said "150 ra sir" (this was before i join a group practice, well, we charge a little more now). "Sige lang mam, kay mubalik ra ko." There goes my patient, there goes my consultation fee, there goes my secretary's salary. With that promise, 99.9% of them will not comeback. That's how hard life is for a doctor, no patient, no moolah. (So, warning to all the parents who wants their little boys and girls to become a doctor when they grow up, be prepared to be asked for allowance even if their age is past the calendar month.)

Another dilemna. Now you have a patient. Mamser, this is your problem......, we have to this to heal your piskat, buy this eye drop and come to me for check up after one week. Please give your money to Marj outside. Yes! naka-pasyente na jud! Then, Marj, peeks through your door and asks hushly, Doc, pwede ba daw half lang iyang bayaran kay wa na siya ika-plete para uli. Tiwiwiwing! imo pa hinuong sala nga dili sila kauli! Marj, please tell them nga ako lang silang ihatud sa ila. (joke!joke!)

Kani, pasyente na jud! Mamser, kinahanglang jud nato operahan imong catarata para ka maka-klaro pag-usab sa mga binuhat sa Ginoo. Pag-andam ug $$$$$ para sa operasyon. Doc, pwede lang mi muhuwat ug naay cataract mission? Tiwiwwiwing napud. Vision is my mission, literally.

Lain na pud. Sige doc, ok ra mi mag-paopera. hangyo lang mi doc ha kay wa jud mi kwarta, wa na juy trabaho ako bana. She looks sincere and she looks somewhat not well off. Ok, mamser, hangyoon lang taka ug $$$$$. Then I chanced upon her being fetched by a Nissan Patrol, not surplus ha. Tiwiwiwiwing!

But this is not the be all and end all of my life as a medical practitioner. Lest you misunderstood me. I love my job, i love being an eye doctor in a third world country.

The Blog Rounds

BoneMD just invited me to join the The First Filipino MD Blog Rounds. My excitement for the invitation was paired with apprehensions, what can I contribute to the rounds? Am I qualified to be a part of them? Knowing that they are on the upper tier of the Medical seniority hierarchy (im not refering to their age, ha!)

I'm just a simple eye doctor from the provincial islands. What difference would my presence be?

But my little friends are whispering, Game na!

So Bonedoc, Game na!

Sleep and chocos

(BoneMD, this is my first official entry to the blogrounds. thanks for the invite!)

Waking up early is a struggle for a candle burner. It seems that all the emulsified cholesterols are getting their fair share of respite. But these old bones have to get up and be ready for work and all that comes with it. Such an everyday scenario for me.

We live quite far from the hospital and my son’s school, ngitngit pa gud ig lakaw namo, nindot pa ka-ayong iku-ub sa habol. What we do is sleep through the journey to the city with our pillow on board. Mag-lanug-lanug pa gud kuno among hagok ingon pa sa driver, mamukaw na lang na siya kung naa na nami sa Boy’s High. Pilit-pilit pa among laway ig mata namo. Mukalit dayon ug kaabtik akong anak kung abot nami sa iya school , dayon pangutana ” late nako, mi?”

When its my turn to got off, diha pako magkara-kara ug sudlay, pulbos ug lipstick. Dayon dagan sa taas para mag-rounds, dali dali ug ilis ug scrub suit para sa mga kaso. Usahay muhapit pa ug panga-saba sa ophtha interns nga nag kwinanggol.

After all the procedures, adto dayon ko sa OPD. This has been a routine for quite sometime.

You see, im the only resident physician in my department with no applicants in sight. We serve a lot of patients a day and sometimes mag-GGB (gulo-gulo buhay) ka.

Manawagan unta ko kung naa moy kaila nga gusto mo training pagka-ophthalmologist, palihug kontaka dayon ko. Dawaton siya sa among department nga way lisud-lisud.

Pul-an pud biya ko usahay sa akong kahimtang, pero wa na may jud koy mabuhat kung dili sa pag-dawat sa sitwasyon. As in NO CHOICE. The only redeeming thing amidst the fatigue is the smile of the people you have help.

Like what happen yesterday. There was a patient who sought consult. She was not my ordinary clientile. She was a rich looking old woman with an educated bearing. (no offense to my other patients ha, who belong to CDE crowd) She wanted to have a second opinion on her eye problem. (nakalitan pud ko sa iyang tuyo kay kinsa ra man gud tawn ko nga pangayo-an ug second opinion, ni konsulta na ni siya sa usa sa mga ginoo sa ophtha sa cebu who is by far very much experience than me) She said she just came back from the US, where 3 american doctors saw her, they were not able to satisfy her. After examining her, i told her that indeed she had a serious eye problem (total retinal detachment), if she will undergo surgery, there’s only a slim chance that her eyesight could be restored.( this is what the other specialist also said) I was telling her that you should’nt be sad or felt sorry, God is so good to you, your other eye is still good. God gave you a lot of blessings, He gave you a good life, at least you will not worry where to get your next meal, all your children have studied well and you have never experienced anything to being poor. In fact your blessings are way beyond the usual. But I impressed upon her that with all the information that she’s getting about her condition, she and only she can make the decision for herself. Either she will undergo the surgery and all its risks or accept the situation wholeheartedly. It’s all up to her. The technology to treat her will always be here, and she has no financial hindrance to speak of, but the decision to use it will be her’s alone. And that was it.

Then, this afternoon, two girls were looking for me at the opd. I ask them why, they said that Mrs. XXX sent them to give me a bagful of chocolates, one for my interns and one for me. There was also a letter from her, thanking me for the time i spent with her and that technology cannot be compared to truthful and heartfelt explanation. Of course, i cannot deny that I was touch (tao lang po ako). And definitely, Im not sharing these with you so that I can brag ( im not also sharing my chocos, bleh!). Im sharing these because I wanted you to know that there are still people who have good souls, who appreciates what you’ve done to them. These are the things that makes me believe in the goodness of humanity. And for us overworked, government MD’s, this is what makes us keep going.

Piggy Talk

Liar, evil ka!

The Voyage of An Eye Doctor in a Third World Country

Mandaue Host Lion's Club will be having a FREE CATARACT SCREENING on the following dates:

1. January 27, 2008, Garing Baranggay Hall 9 am - 12 pm only, naay pakapin nga Diabetes Screening
2. February 3, 2008, Nangka Baranggay Hall 9 am - 12 pm only, naa ghapoy pakapin nga Diabetes Screening

Qualified patients will be scheduled for operation free of charge after submission of laboratory requirements.

The Little Army

Once a upon a time, there was a little boy named Army. He has no father and mother. He is an only child. When their house was destroyed by a large tornado, he was sleeping. His father brought him to a tree. When he woke up, his parents were lost and was declared dead.

Ten years ago, he was 29 years old, he join the Navy. He fought the American Army for his country. Army was afraid. He missed his parents.

A year ago, he was lucky because he did not die and his five friends died. When they were riding a chopper, it crashed in the deep ocean. He swam for 4 days. He was getting lonely, he did not eat, he did not drink, in the afternoon, he died.

When he died, he saw his parents in heaven and they are happy because GOD is in there side.

from my 9 year old son, rommelrat's journal. in his own little way, expressing himself.

True Urban Legend

"Myiasis" is the medical term for a maggot (fly larva) infestation of a living body. In this case, the patient was a 5-year-old boy treated by U.S. Air Force surgeons in a rural area of the Republic of Honduras. "The respiratory pore of a late-stage larva of the human botfly (Dermatobia hominis) was located in the anterior orbit," says the article abstract. "The larva was gently removed under general anesthesia through a small incision in the conjunctiva." The patient was apparently none the worse for wear in the aftermath.

Of botflies and blowflies

It would appear that the article itself was not consulted when this email tale was composed. Neither "bad dust" nor excessive eye rubbing were cited as causes of the infestation in the 5-year-old patient. According to entomologists, the human botfly lays its eggs on the bodies of other insects (such as mosquitoes), which then transfer the eggs to animal or human hosts by direct contact. When a botfly egg hatches, the larva burrows into the host's skin head-first and begins feeding.

This nasty creature is found mainly in Central and South America, but there are other species of flies known to responsible for cases of myiasis in North America, mainly blowflies. According to an epidemiological study conducted in 2000, most instances of myiasis acquired in the United States are the result of blowflies laying their eggs in pre-existing wounds.

None of which is quite as terrifying as the claim that any one of us could end up with a worm in our eye simply by being exposed to too much dust, which helps explain why the true facts of the case aren't circulating with the photos. In folklore, the story's the thing - accuracy takes a back seat to emotional impact, or, as folklorist Jan Harold Brunvand succinctly puts it, "The truth never stands in the way of a good story."

original from:

urbanlegends.about.com/library/bl-eye-worm2.htm

Mohunong ang taligsik, ig sugod sa uwan......

Sinulog '08, Pit Senyor!

Dili lagi ko mo lansar para pagka-Presidente. Nitan-aw lang ko Sinulog!

Smile dancers!

Pit Senyor! kang Dodong kani!

Senyor Sto. Nino!
Viva Senyor!

Bring my Menudo back....

Here's my menudo. i love you, robby! i love you , martin!

Voted as the worst song in yahoo, i dont care, my heart belongs to the 80's. where's my menudo?

in response to Gamaliel, the twisted rabble rouser.

i don't want myself to be a fodder for fertile minds with idle bodies.
i don't want any remoras to grow on me, feeding on my strength,
delighted with my misgivings.
i don't want to open my email and read some ugly insinuations from a
tainted source.
i don't want to be a part of someone's grand twisted design to assist
in making his day and to help that person practice his prose.

i simply don't need it.
and i'm zipping it.

OTOT! song composed by RommelRat , inspired by Budoy

mangotot ko 2x
gi-sakitan pa jud ko, na ngotot ko sa imong tungod
dako kaayo 2x
ang akong otot, ohhhhh!
mangotot ko 2x, gisakitan pa gyud kooh, ohhhhh!

Goodbyes....

What is good in parting, what is good in being left behind, what is good in waiting for someone to come back, what is good in hoping that you will be remembered.

Old friends, new friends, new found friends, on-line friends, trivial friends, one way or the other, your paths has crossed. Each prose that comes from the keyboard are linkages of your emotions. Some will call it shallow but I call it spiritual. How then can you unravel the connection of minds and thoughts on someone you just read and sometimes feel?

Arianne, we may not have seen each other, but you have touched my soul. Cebu will always be a part of you. I may not be a part of your planeteers but I feel that I am your constant moon, following every revolution that your planet takes. Your everlasting light that follows the tides of your life. Wherever you go, my thoughts will always be with you, as silent as the moon, as strong as the pull of gravity.

Goodbye, my baby Rain. But its really a pseudo-parting, the earth is still round and web is very much expanding.

Hello, again.

she sings in the bathroom, and she rocks!

I have created a lot of blogs inside my head, from my thoughts on food, anecdotes I heard, on funny signs, my bad and nice feelings and some things related with my work.

Pero unsa mang hitabo-a kung, mag-atubang nako sa monitor, mawala man tanan. Is this what we call as blogemesia? (kauban kaha ni sa blogorheaa o opposite?)

God, i wish i could be as poetic as my baby rain or as prolific as the bisdakplaneteers, or as philosophic as paolo, but it will remain a wish as of now.

please GOD, give me the power of the written word.