Warm Thoughts on a Cold Day

9 February 2019

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Last Friday, I drove to our new satellite clinic. This was the most distant one so far compared to our other outreach clinics, as it takes an hour and 40 minutes to get there from our main office. I go to an outreach clinic at least once a month.

It was a very cold day for a drive. The outside temperature was -2 degrees Fahrenheit with a wind chill factor of -20 degrees. The wind was brisk and it was blowing the snow that was already plowed to the sides of the road back into the road.

The whole surrounding was white as we had fresh snow that had fallen the past couple of days. There was also a shiny glaze on the branches of the bare trees as in addition to the snowfall, it was preceded by a freezing rain that coated everything with ice, including the roads, which layered underneath the snow. This made the travel more dangerous.

In fact one of my partners cancelled his trip to another one of our outreach clinics a day before mine, due to the snow, sleet and ice.

But on the day of my travel, though it was very cold, it was sunny. Thus I decided to press on. Besides, there were many patients that were waiting and expecting to be seen. Plus, I felt confident in my driving and in my trusty vehicle.

I felt warm though while I was cruising along the wintry rural highways of Iowa. My favorite feature of my car on a very cold day like this was the heated seats along with the reliable heater. In some countries, like in the Philippines, a car airconditioner may be a luxury to keep you cool on a hot day. But where I live now, we can survive without an AC but not without a heater. It is a necessity or we’ll freeze to death.

But there was something more that was keeping me warm besides the heater, the heated seat, and the heated steering wheel. It was the warm thoughts and happy memories of a tropical place I still call home.

Playing on my car radio was streaming music sync from my iPhone from an on-line radio station. What was the radio station I was listening to? Pagudpud Beach Resort Radio Station! (Pagudpud is a place in Ilocos Norte, Philippines with a year round temperature of 70 to 90ºF.)

photo taken few years ago in a beach resort in Ilocos Norte

I could almost hear the lapping waves as they break into the sandy shore and the rushing breeze bristling through the palm trees. A stark contrast from the view of a slew of ice and snow surrounding me. They say that you could take away the boy from the island, but could never take away the island from the boy.

It’s true, I was feeling homesick. It has been three years since I last visited my motherland. Perhaps it is time for a journey back to that very familiar place.

I know I’m not the only one missing home. Most of us, in one way or another, have wandered away and left our comfort zones in pursuit of a dream. And many times in our quest, the path we crossed was not easy, for it was uncertain and unfamiliar.

I was deep in this thought when a familiar song played on the radio:

Hawak-kamay,

Hindi kita iiwan sa paglalakbay,

Dito sa mundong walang katiyakan,

Hawak-kamay,

Di kita bibitiwan sa paglalakbay,

Sa mundo ng kawalan.

That was all I needed to hear, a reassurance that we are not alone in this journey.

I glanced at my car’s GPS. It indicated that I still have 70 miles to go, and an hour more before I reach my destination.

Well, I still have an hour to enjoy this “beach.”

(*lyrics from Hawak Kamay a song by Yeng Constantino)

Mud (Mad) Runner

3 February 2019

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I am glad that January was over. For many, January is when they intensify their excercise activities as part of their New Year’s resolution of living a more healthy lifesytle. Not for me.

I was practically sick all January. I caught a bug that brought me down on my knees (see previous post) just after New Year’s Day. Then when I was recovering, I caught another virus that put me into another tail spin.

I lost my voice that made me talk in whispers. I am thankful that I did not totally lost my voice as I was still able to blog loudly and clearly. I was also coughing so hard that I think I pulled a muscle, or contused or even broke a rib. Coughing became a nightmare that made me double up in pain. I used a small pillow to push it against where my chest hurts whenever I cough. Breathing was literally painful.

But I am better now. I hope.

Besides me being sick, the weather here in Iowa last January was just plainly awful. Three days ago, our wind chill was – 40ºF. This they say was due to the Polar vortex. In that extreme cold, you can toss boiling water high into the air and it will turn into ice particles before it hit the ground.

However, today is different. Our outside temperature is 50ºF. That is almost a hundred degrees swing in temperature in a matter of few days! You barely need a jacket on.

So what did I do when I got the first chance to go outside? I ran!

Due to temperature way above freezing, all the snow that had accumulated in several weeks have melted and all that was left were a few patches.

The snow was rapidly melting that this created a small rushing spring from snowmelt at the side of this road here.

It was just not me enjoying this warm break. I saw a herd of deer roaming around in the distance. I don’t know where they take refuge when the weather is brutally cold. But no, I am not inviting them in inside my home.

Since it was my first run after about a month of inactivity, I chose to run in the gravel road which is a relatively flat terrain rather than the more challenging up and down hills in some part of my running route.

Yet the moment I stepped into the dirt road, I felt the ground to be soft and soggy from all the snow that have melted. In other words, it was muddy.

It probably was a mistake on my part to run on the dirt road, still I was determined to finish the loop back to my place. I literaly plowed through the mud. I just thought that it was one of the muddy obstacle courses in those Spartan races.

I finished a 2 mile loop albeit my pace was somewhat slow, perhaps due to my deconditioning. But I’m not admitting that, I am blaming the mud that caused me to run slow.

Perhaps I am a little crazy or mad, but I am also now a mud runner.

(*photos taken with an iPhone during my run)

Antarctic Freeze

31 January 2019

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Yesterday, while sitting in my car when I was parked at the hospital’s parking lot that I took this photo of my dashboard.

The outside temperature was -18ºF (-28ºC)! No wonder I was really cold. But at least it was sunny and it was already warming up. It was -26º F before the sun rose. The wind chill though made it feels like -40º F.

It was dangerously cold that most schools including colleges here in Iowa was closed yesterday. Even the postal service was shut down. Of course hospitals stayed open and I still had to go to work.

Do you know where else had -20º F yesterday? At the South Pole in Antarctica. North Pole was a balmy 5º F!

I should be on the look out for penguins that may be crossing my path anytime soon.

Bracing for Snow

27 January 2019

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There’s no question that snow is beautiful. It blankets everything in white. But shoveling and clearing your driveway, and worse yet, driving on it is something else. It is at the least treacherous, especially during a major snowstorm with more than a few inches of snowfall.

Iowa State Capitol Building (photo courtesy of KCCI)

However if you live in a place that has significant snow accumulation in winter, like here in Iowa, you need to deal with it. Driving in snow is a skill that you need to develop through experience.

Last week, we had consecutive days of heavy snowfall. There was a lot of cancellation in our clinic appointments as patients decided not to come as they deemed the roads were not safe.

I went home early and sure enough as I was driving down the interstate, there were several cars that were abandoned as they had fallen in the ditch. There were several reports of collisions too. Oh the joy of slipping and sliding in winter driving.

When I arrived home, the snow was still falling. With about 4 or 5 inches on the ground already and no sign of letting up, I called my son down. I told him that we were going to drive in snow.

My son got his driver’s permit a few months ago. He cannot drive alone, but only when there’s an adult in the car. Yet he needs to gain experience to drive in snow. He needs to develop the skill. I thought, this was the perfect opportunity for him to do so.

I am far from being the most expert driver or the most skilled in driving in snow. But I have several years of experience in driving in this weather, and my best qualification to teach him is that I am his father. I know what is best for my kids. Plus our car is an all-wheel drive with high ground clearance, built to play in rough terrain.

First we drove around our neighborhood. I let him slam the brake when we were going downhill and let him feel the car sliding. Of course nobody was on the road except us, so we were never in danger. When my son gained some confidence, we went out in the highway to let him experience real driving in snow with cars tailing and passing us.

After almost an hour of driving, we went home.

Yesterday, I received a phone call from my daughter who was in college a couple of hours away. She said that she was supposed to go somewhere but snow was starting to fall. I sensed some alarm in her voice and she was not feeling confident in driving in snow. She was asking if she should go or not.

My daughter has been driving for a couple of years, but have not driven in snow by herself. If I could only go to where she was, I would, but she was far away. So I did what I think was best. I advised her to drive slowly and carefully. I told her that sooner or later she would have to drive in snow but she should be fine. Besides the snow was a couple of inches only.

Even though I sounded convincing when I talked to her, in my heart I had some fear. But I know I had to let her fly on her own. I know she needs to build her confidence. I know she needs the experience to be independent.

I was relieved when she texted later that she made it to her destination safely.

As parents, we don’t stop parenting even if our children are grown-up. Their challenges may be different now. It’s not about the big spider on the wall anymore, or about a difficult math equation, or a bully in the playground. But their challenges may be bigger. Would I pass this college course, or would I find a job, or would my salary be enough, or would I find a niche in this world?

I hope I have equipped and prepared my children in facing the snowstorms in life. And I don’t mean just driving in snow.

Dinosaur Technology

24 January 2019

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Not too long ago, these things roam and rule the earth. But like dinosaurs, they are now extinct. I don’t think the millennials or the younger generation have any idea what they are.

I will give you a snapshot if you will, of my normal day employing the current technology of the time when I was still in college:

One evening, I wanted to call my classmates so we can meet up in the library before our late morning class to work on our school project. But I had to wait for our party line to hang up before I could use the phone. An hour later, I finally was able to make the call. I dialed the number (not punch in, mind you; this explain why we say “dial”) using this device:

The next day, after taking a shower, I dressed up and was heading out the door when I happened to glance at this big “box” and checked the weather forecast. The talking box said no need for an umbrella today.

On my way to the university, I boarded a jeepney plying the Balic-Balic route with loud music blaring inside. The driver was proudly playing an expensive music console system using this:

The jeepney driver probably was an ex-OFW and bought this console when he was still in Saudi. What made me think that? Because a sign in front of his jeeney says “Katas ng Saudi.”

Though I wish I had my own portable music that I could choose what songs to listen to. Then I noticed one passenger in the jeepney who was rocking to a different rhythm than that of the music we were hearing. Of course he had this:

I know it’s kind of cool, but it makes you a hot target for snatchers especially if you’re walking in the streets of Metro Manila.

After meeting up with my classmates for an hour, it was time to attend a lecture in a big hall. Our professor was using lecture aids and was projecting it on a wall using this gadget:

While our professor, who was also a practicing physician, was giving his lecture, he asked to be excused for a minute to make a call at a payphone outside the hall. He was responding to a message he got from this:

Later that day, we started writing our paper for submission. We could have gone to Dapitan or Recto and had it done for us, but we decided to do it ourselves to save money. So we worked on this:

Of course we needed duplicate copies so we had to use these:

This explains why even in our e-mails now, we call a copy to a different recipient a “carbon copy.”

After a while we had noted that the letters we were typing were getting faint. So we had to replace this:

We also had several mistakes, but we were able to correct them thanks to this:

We had to work on the presentation of our paper too. During our brainstorming we decided to make our exhibition fancy and we planned on having photos or slides. So we had to borrow this gadget for our presentation:

However we had to take photos first. Our group chipped-in some money and they handed them to me. They asked me to go to Raon near Quiapo to buy this:

And for better picture-taking, just in case the lighting is not good, I bought these as well:

We wanted to make sure that we only take good photos so not to waste any film. But can you imagine taking a photo and not seeing the picture until after a few days?

Before going home I passed by a friend’s house. I heard they just got this gadget called a “computer” that would be the future of all technologies. I even tried it and I was able to do some of our school project on it. My friend was kind enough to have me save my work and transfer it to this:

Maybe it was just an excuse for me to use their home computer. For what I really wanted to do was to play some games with my friend in their other “computer:”

The end.

*****************

Can you name all of them? Do you have an idea what they are?

If you know all of these gadgets and have used them before, then you are probably “old” like me.

(*photos from the web)

9 Years of Blogging

18 January 2019

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Nine years. Like any span of time, nine years can be relative.

It can be short. If you are a giant tortoise and can live more than 200 years, nine years is just like taking a long breath.

Nine years could be long too. For the blogging world it is a long time. Considering that an average life span of a blog is less than 100 days, nine years is like a mountain of time.

Nine years was so long ago, that in fact here are nine things that are not yet present or have not yet developed when I started this blog. Now we cannot live without them.

  1. iPad
  2. Lyft
  3. Pinterest
  4. Snapchat
  5. Instagram
  6. Facebook Messenger
  7. Selfie stick
  8. Captain America movies
  9. Ed Sheeran songs

Over the nine years of blogging, I have authored more than 800 posts, and this site had been visited more than 400,000 times. The last year had been the most successful yet with regards to readership, with visits of more than 90,000. Most of my readers are non-bloggers.

Here are the 9 top posts of this blog based on my readers:

  1. Question and Answer: Sakit sa Balakang
  2. Usog, Gayuma at Anting-anting
  3. Mamang Hilot
  4. Alaala ng Luneta
  5. Debunking Folk’s Medical Advice: Part 1
  6. Debunking Folk’s Medical Advice: Part 2
  7. Kwentong Palengke
  8. Ebolusyon ng Wika
  9. Homecoming Speech

As for me, here are my 9 personal favorites, so far. I want to believe that I have not constructed my obra maestra, and my best compositions are yet to be written.

  1. Alaala ng Luneta
  2. Pagbabalik sa Norma
  3. Bahay sa Norzagaray
  4. Catching Fireflies
  5. Once Upon a Starry Night
  6. Tag-lagas
  7. Divisoria Suit and Recto Resume
  8. Time Under Heaven    
  9. Leksiyong Pang-Grade One

The aim of this blog stays the same through the years. It is not to make money, so this site remains ads free. This blog is maintained mostly and primarily for the inspiration and happiness of one and one person only – me. But if I have made any of you, my reader, be inspired, or laugh, or cry, or be touched in any way, I am deeply humbled.

Looking ahead to a grand horizon of more years of blogging. And thank you for joining me in this wonderful journey.

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(*first photo was taken at New Paltz, New York; second photo was at Grand Canyon, Arizona)

Calendar Boys

10 January 2019

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I was rounding in the hospital with my team when we came to a room of one of our patients. The patient was a frail woman in her 70’s, who had significant lung disease and was oxygen dependent. She had improved on this hospitalization and we were discharging her home.

When we were heading out of the door, I overheard the patient told one of my team members, “I want a copy of that calendar.”

I have no idea what they were talking about, and not trying to be nosy or maybe little bit, I asked my resident, “What calendar was the patient talking about?” Since it is a new year, perhaps the hospital is giving away new 2019 calendars, I thought.

Then my medical resident sheepishly smiled and told me the whole scoop.

I learned that this patient thought that our team was “hot” and she was calling us the “Dream Team.” I have been in this teaching hospital for 15 years and have rounded with hundreds of medical students and residents that came and went, but I have never heard my team referred as such before. Or maybe it was, but I was just not aware of it.

So this particular patient, the elderly woman, suggested as a jest to my resident, that “we,” or my team should put out a calendar featuring our team members as models. Whether it’s a white lab gown edition or dress suit edition or a swimwear edition of this calendar they were thinking about, I dared not ask!

I then looked at my current team, and agreed that the old lady had a point. My team appears “hot.”

One of my new resident is a blue-eyed gentleman of English decent, clean-cut and handsome. Now that I think about it, he really looked like a much younger version of the actor Mark Harmon.

The other new resident is a young good-looking French guy with well-trimmed mustache and beard, with hair slickly combed back. He always dress very neatly too.

And then there’s the attractive and muscular Asian hunk of a guy. But before you think I was referring to myself as the Asian hunk, I was not. I was talking about the 4th year medical student I have on my team.

Of course I don’t consider myself as chopped liver. I can definitely hold my own. I deserve to be in that calendar too!

We have women medical residents and students as well in this hospital but it just so happened that this month’s rotation, I have all male house staffs.

But seriously, I never consider much the appearance of my residents. When I evaluate them during their rotation in our service, it is mostly based on their performance, their knowledge, their willingness to learn, and their emphathy to our patients. But of course we don’t want them to appear like hoboes or dress like gangsters. They need to look professional too.

I understand that our patients get well mostly due to our comprehensive care stemming from our intelligent decisions, skillful procedures and emphatetic support. But if our good looks help them heal faster, then I am fine with that too.

Would I put out a calendar featuring my team? Don’t count on it.

(photo is from the show Grey’s Anatomy)

A Battle Within

6 January 2019

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There is a raging war inside of me. The resulting blaze and smoke of this battle is evident while I am shaking and crouching under my blanket.

It all started a few days ago when the enemy gained unwelcome entrance to my domain. Perhaps these intruders escaped from another territory by a sneeze in which they could travel up to 20 feet at 100 miles per hour, and they usually travel as a mob with 40,000 others of their gang.

They got a foothold on my borders through my nasal and airway passageways. It’s really difficult to close all the entryways unless I quit breathing all together. The invaders then broke through my barriers and overwhelmed my sentinels. I should build a border wall and have Mexico pay for it. Hah!

As soon as there was a breach in my initial defenses, my border guards alerted the headquarters and radioed for back-up. They have identified these infiltrators and relayed their profile to the central intelligence.

The headquarters searched the database if I have a pre-fabricated artillery specific for this certain enemy. But lo and behold this “common” enemy is not so common after all, as it probably continues to change its appearance and structure to outwit my defenses. So my system staged an all out war to fight this common cold.

The first to arrive into the battle field are the big boys, called the macrophages. They are the biggest soldiers among my army of white blood cells. These big boys are like Pacmans as they hunt and engulf these viral invaders.

a macrophage in action (image from the web)

But the enemy has hijacked some of my manufacturing plants. They infused their DNA into my own cells and they are replicating themselves using my own factories and resources. The Pacmans cannot eat them all as they are too many now and they continue to multiply. Good thing my defenses have more tricks under their sleeves.

As soon as the macrophages got an exact profile from the captured intruders they send signals to the headquarters, my bone marrow, to have the rest of the cavalry released.

One of the most effective fighters are the B-cell lymphocytes. They are part of a line of my white blood cell army. These cells uses the information of the enemy’s profile and they start building specific missiles, a protein called antibody, to fight these particular intruders. Once these virus-seeking missiles are constructed they are launched into the system to seek and destroy every infiltrators.

antibodies attacking a virus (image from the web)

Some of these specific antibodies are stored into memory cells. So the next time this specific virus intrudes again, my body already has the pre-fabricated missiles ready to launch to fight them back.

Another important battalion of my soldiers are called the T-cell lymphocytes. These are elite fighting machines, like the SWAT or the Navy Seals. They don’t just track and kill the enemy but also destroy cells that harbor them. With some named as “natural killer T-cells” you know that these are badass soldiers.

Go, go, go my army and defend the motherland! And die you infidels!

There are also some foot soldiers that are deployed to the area of the breached wall. They have fortified the defenses there, and as a result the lymph nodes around my throat are swelled up, a sign of an ongoing battle in that area.

Besides the chills and runny nose, so runny I can’t keep up, I also started having this paroxysmal cough. I got out of my bed and went to the bathroom. I hacked up a phlegm into the sink – a nasty purulent and rusty mess. Then I realized that part of that purulent mess are dead bodies of my white blood cell soldiers. They have laid down their lives for the cause.

So before I flush down the purulent mess deep into the sink, I thanked them for their sacrifice, and as a grateful nation I fired up the canons and gave them my 21-cough salute.

After hearing my cough, my wife suggested that I should take some medicine to relieve my symptoms so I can have a better night sleep. Being hard-headed as I am, I said no to the medicine and just trusted that my body will take care of itself as I crawled back under the covers.

The next morning, I don’t feel as awful as the day before. Perhaps my army is winning the war, and they are rounding up the remaining stragglers, and cleaning up the residual wreck and ruins of the hard-fought battle. I guess I will live.

This is another victory for my immune system. But I’m not ready for a victory march and parade as of yet. I think I’ll take it easy and still stay in bed today.

Grateful to see another morning (photo taken with an iPhone)

(*Credits to my immune system and also to the Immunology class in my medical school)

A Day in New York

2 January 2019

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New York City has such a pull on my heart. You probably know it already that we lived there for a few years, long time ago. It was there where I received my training for my career, a medical specialty that I am now practicing for the past 20 years.

As the song New York, New York goes:


If I make it there,

I’ll make it everywhere,

It’s up to you,

New York, New York.

Anytime is a good time to visit New York City. But the holiday season is even more noteworthy. Especially on New Year’s when it becomes the center of the world’s celebration.

My family spent the last few days of the year 2018 in New York City. Here are just some of the places we visited:

We passed by some swanky restaurants, but we did not dine there.

Instead we were taken by our friend to a quaint eatery that was more quiet and subdued.

The ambience in this place was homey, relaxed, yet festive. The food was excellent. This is not a paid post, but if the management of this restaurant wants to give me a free meal next time, I heartily would accept it.

Then we went to Midtown Manhattan. Of course we used the iconic New York subway to get there.

Our kids together with some friends’ kids went ice skating.

There are several ice skating rinks in New York City. Perhaps the most famous is the one in Rockefeller area, but that is too small. Then there’s also one in Central Park.

We went to Bryant Park. This is near the New York Public Library. The ice skating rink is surrounded by New York’s skyscprapers. You could even catch a glimpse of the Empire State building from there.

The skating rink was very crowded though. There was a long line of people waiting and it took more than two hours to get in. But our children did not mind, as they chatted away with their friends while waiting in line.

I did not join them and was just satisfied watching the skaters go. Though there were some skaters that fell on the ice, but who cares, at least they were enjoying themselves.

I probably would be included in those falling a lot on the ice if I skated. I tried ice skating before, at least twice, and I would say that I could glide over the ice. Whether I was standing, or I was on my or knees or worse on my butt, but at least I could glide.

Besides watching people skate, the best part for me was watching this big machine sail through the ice.

This is the Zamboni machine, named after it’s American inventor and engineer. This machine smooths the surface of the ice.

I also spent time talking with our friends, catching up with them, while our children skated. Including an old friend, a classmate back in elementary and high school days. He now lives in Massachusetts.

We were in this place for several hours and my fingers and toes got numb from the cold. I had to walk around to keep warm and many times went inside the market stalls surrounding the place where there were heaters.

It was already dark when we call it a day.

We went back to our hotel which was located across the Hudson River, so technically it was in New Jersey. But you cannot beat the view from there – a view of the New York City skyline.

From New York, I wish you all a Happy and Prosperous New year!

Pinoytransplant

(*photos taken on the eve of New Year’s Eve)