Slow Run

It’s summer here in our place. Well, not quite officially, as the summer solstice is not until June 21 which marks the official start of summer in the northern hemisphere. Yet the mercury is rising, as our high temperature for the past few days and the coming week will be in the 90’s to even reaching 100 º F.

But this morning, it was a comfortable 74 º F, so I went out for a run. It is also about this time of year that I should start preparing for the half marathon, if I should decide to join again this coming fall.

As I was approaching the small pond in my running route, I have to stop and let the family of geese get off the road before I could pass. The mother goose was already hissing at me as I was approaching them. They can be very territorial you know. But that’s fine, I can share the road with them, and I have no plans on swimming in their pond.


When I came to the wooded areas, I also saw a deer. But it bounded quickly away before I could take out my phone out of my pocket to take a photo. It might be sneering at me that I am too slow.

Same thing happened when I came to an area where a couple of wild rabbits were on the side of the road foraging for food. They also scurried away at the sound of my slow feet, before I can get near them. They may also laughing at me for being slow.

I admit, I am getting slower. Maybe my age is catching up on me. I have no match for the swiftness of the deer and the hare. They seem to dash so effortlessly and yet so gracefully. While me, I push for every step of my way to get to a pace that runners would even consider “running.”

Maybe all of us can relate in one way or another, and in different endeavors, that we feel we are no match to the “competition” we are going against. Whether it be in sports, or in school, or in our work, and in life in general.

Then as I was fighting my way uphill, I saw this guy.


Yes, that is a snapping turtle. And I was “quick” enough to take a photo of him.

They are called snapping turtles not because they snap their fingers as they go, rather they have the ability to snap, as in bite an attacker. That’s why I kept my distance.

The pond, or any body of water that I know in this area, was hundreds of meters away. I don’t know how long it would take him to get there, if that was where he was heading. But I’m sure his slow pace does not stop him from continuing, for that’s who he is.

It gave me a good insight for the day.  Life they say could be like a race. But it is not always for the swift, but to those who kept on running.

 

Conflicted

What do you do when you see a sign that says Caution:Wet Paint?

Are you like many people, which includes me, that can’t help but touch it? Just to see if it’s really wet! Maybe because we have been lied to so many times, and we don’t believe anything unless we prove that it’s true.

The other day, since we were having some construction in our office to add more examination rooms, I saw this sign. I know it’s a mundane sign, but it caught my attention.

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Do you suppose I touched that wall? Of course I did.

But there’s more to this sign. Is it wet? Or is it dry? I think the wall is conflicted. Is that an oxymoron, a wet drywall? Do you still call it a drywall when it is wet? I’m confused.

I believe the caution here is like that wall, some people today are conflicted and confused. We are lost in our identity. We are neither wet nor dry. Neither hot nor cold. Constantly riding the fence, and compromising our beliefs.

 

 

Sheep Crossing

When we we’re traveling in Jordan, our tour bus came to a sudden stop not because of traffic, nor stop sign, nor because of a bus stop.

It stopped because of this.

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I am not sure why the sheep cross to the other side, when the grass is greener where it came from. Maybe the grass always looks greener when we look at it from the other side.

Discontent, can put our lives in peril.

(*photo taken in rural Jordan)

Not Bound for the Promised Land

During our trip to the Holy Land, we visited  a place known as Mount Nebo, which is located near Madaba, Jordan, or the land of the Moabites in Biblical times. It’s pretty high that it provides a panoramic view of the surrounding areas around it, including the land known as the Biblical Canaan.


On Mount Nebo’s highest point, the remains of a church and a monastery was discovered in 1933. Today a Christian chapel stands on its site.


As we were enjoying the view beneath an iron cross, the tour guide was giving insights and explaining the significance of this place to our group.


While another group near us was having a devotional and they were singing the hymn “I am bound for the Promised Land.”

You probably know or heard that song:

I am bound for the promised land,
I am bound for the promised land
O who will come and go with me
I am bound for the promised land.

But the irony of this is, historically, here in Mount Nebo was where Moses stood and God showed him Canaan, the Promised Land from afar. But here also in Mount Nebo was where Moses died and was buried, without reaching the Promised Land. Moses was not bound for the Promised Land.

Moses, even though he was chosen by God to lead the Israelites out of Egypt and to go to the Promised Land, was not allowed to enter it. All his life work – including 40 years of top-notch Egyptian education, including military tactics and operation, and another 40 years as a lowly shepherd just to learn patience in preparation for his mission, and finally 40 mighty years of leading God’s people out of Egypt, and into the wilderness, on their way to the Promised Land – yet he never set foot to that land.

Was Moses a failure then? Not at all!

Sometimes we are assigned something to do, but we may not see the conclusion of that work. We may have started something that we are not able to finish, not because we are a failure, but because it is not planned for us to fully fulfill that. For God has some other plan for us, or He had appointed another one to finish the work we have started.

More importantly, when Moses stood there in Mount Nebo, while looking at the Promised Land from afar, he did not complain to God why he was not allowed to enter the land that is “flowing with milk and honey.” A land that was promised to his ancestors, Abraham, Isaac, and Jacob. A land he probably dreamed of claiming all his life. He humbly submitted to God’s plan for him.

He may have not entered the Promised Land here on earth, yet God had a better plan for him. For he was taken up to the Promised Land in heaven.

So we may not be able to achieve the dreams or goals we set for our lives here on earth. We may never live a life so rich that it is “flowing with milk and honey.” We may not be able to claim the “promised life” we hoped for here on this world. We may not be bound for the earthly promised land.

But may we set a higher goal, the one God had promised for us. To live in heavenly Canaan with Him.

(The sign under the cross reads: “Just as Moses lifted up the serpent in the desert, the Son of Man must be lifted up, so that everyone who believes in Him may have eternal life.” John 3:14-15)

 

Don’t Take Your Valuables

Last summer, we took a long road trip that took us from the cornfields of Iowa, to the mountainous wilderness of Montana, and to the concrete jungle of Los Angeles California. As we were pulling up into a parking lot in Los Angeles, we saw this sign that said, “Please take your valuables with you.”

I think that is a fair warning, as they don’t want you to lose something that is important. Or perhaps they just don’t want to take responsibility of any theft that will happen. Or perhaps they don’t want you to tempt others of bad thoughts by displaying something valuable, or something that they would think is valuable, inside your vehicle.

I don’t think this warning applies in Los Angeles only, as it is true in many parts of America and the rest of the world.

I remember when we were still living in New York City, somebody tried to break in into our parked car, and in the process broke the door lock of our car. And there’s really nothing of value inside, except maybe the car itself. They took my tire hub caps and antenna instead. Then we had some friends whose car windows were shattered just to get some change of coins and some barely valuable things inside their car. Maybe the thief needed coins so badly for a cup of coffee or for a ride on the subway.

Same in the Philippines. When I was still living in Manila, there’s an instance that me and my dad witnessed a car theft while we were parked near Binondo. It happened in a blitz, and they acted so smoothly that we think these guys were “professionals.” Bad use of their skills and talents, I guess. With dexterity and quickness like that, they could be show-time magicians. On second thought, they were already magicians, making things disappear!

Back to the parking lot in Los Angeles, we kind of chuckled when we read the sign. Not because it was funny nor it was an unreasonable or unusual sign. To us it was just interesting that few days before that, when we were in a national park in Montana, we read several signs that contain a completely different warning.

The warning sign when we were in the wilderness of Montana states, “Please take your trash with you.”

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It was just sensible that they don’t want you to litter in such a pristine place. Plus the wild creatures, like bears, can get attracted to your trash and rummage through them. This may endanger their well-being. More so, your well-being and your life may get endangered as well, if the bear cannot find what it’s looking for (a jar of honey?) and is not happy with your trash and attacks you.

It was a totally different perspective. In one, “take your valuables with you.” In the other, “take your trash with you.”

Yes, there are places in this world that they don’t care about your valuables. It does not matter whether you’re lugging a Louis Vuitton bag or a DSLR camera with an ultra zoom lens. Just don’t leave your trash too!

This made me think, in this life, there are things that we consider our valuables. Like our fancy jewelries, our expensive toys like our cars and gizmos, our pricey wardrobes, our houses and estates, our bank accounts, and other worldly treasures. And it’s not only that there are places that they will not matter, but there will come a time as well, that all of these will be deemed worthless. Rubbish. Garbage. Trash. For you cannot take them forever with you.

I do hope that we discern what really are the important things in this life. The “valuables” that no thief nor anybody can take from you.

(*photo taken last summer in Montana)

 

Intern Blues

The other day, I let our medical intern in the ICU place a dialysis catheter on one of our very sick patients. It is a minor surgical procedure of placing a thick catheter in the patient’s jugular vein using ultrasound for guidance. Of course she had lots of supervision, as one of our senior resident was assisting her, and I was around as well for support.

The intern was not able to place the catheter that quick being inexperienced, so it took a little longer doing the procedure. Though that is nothing out of the ordinary. This is normal for a teaching hospital, as interns and doctors-in-training has to start somewhere.

While we were doing the procedure, the patient became unstable, and then went into cardiac arrest. We called a Code Blue (a call for help on a patient having cardiac arrest). Moments later the whole room was teeming with hospital personnel responding to the code.

The patient survived and was stabilized after several minutes of furious cardiopulmonary resuscitation.

The intern was visibly shaken to what just happened. I saw her later in the workroom crying. One of the senior resident told me that the intern felt that it was her fault that led to the cardiac arrest.

However after extensive work-up, we found that patient has a weak heart to start with, and in fact was in congestive heart failure and kidney failure, and that was why he was in the ICU. Then he suffered a heart attack, that caused the cardiac arrest. It was just coincidental that it happened while we were placing the catheter. It was not a direct complication of the procedure.

I reassured the intern that it was not her fault, and gave her some words of encouragement, that this is all part of our work. Besides, this intern is good, intelligent, comes prepared on rounds, and has initiative to learn. I see a great potential in this young doctor. Her only fault is that she is new and inexperienced. But we all have been there.

I have been an attending physician in a teaching institution for a long time now. In fact five of my partners in our practice, who are now full pledged Pulmonary and Critical Care doctors are once my medical interns in the hospital. So at some point in time, I showed them the ropes. And now they are probably better than me, and once in a while I asked for their opinion in difficult cases.

I remember when I started my medical internship in a Columbia University-affiliated-hospital, I was not a “good” intern. At that time, I was a new arrival to the US from the Philippines, was new to the American system of medicine, and definitely not the sharpest among our batch. Compared to our star intern, a graduate of Johns Hopkins University, I was like a kindergarten. I was really lost and I struggled in the beginning. But I am thankful for my seniors and attending physicians who saw the rough potential in me. Though I would be lying if I tell you I was not lectured on at times, or even chewed and spewed.

At the graduation ceremony of my Internal Medicine Training, they gave me the “Tabula Rasa” award. It took me a while to figure out what it meant. But I guess I was really like a “blank slate” when I started, which what the Latin “Tabula Rasa” means. I must also had that blank stare like a deer in the headlights, that goes with my blank mind.

But as I said, we all have to start somewhere.

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hospital teaching rounds, circa 1940’s

In some academic centers they have a very defined hierarchy. Even one year of seniority feel like a world of difference. The attending physicians act like demigods as they would climb up their high horses when they do their rounds. The attendings treat the medical residents as dirt. In turn, the senior residents treat the junior residents as dirt. The junior residents treat the interns as dirt. The interns treat the medical students as dirt.

It may be hard to admit, but I witnessed this hierarchical state of thinking when I was in my medical school in the Philippines. And being the medical student, I was at the bottom of the totem pole.

But I don’t buy into this old-school hierarchical philosophy and system that treats our inferiors like dirt. I adopted a philosophy of providing a more collegial environment which I believe is more conducive to learning even for the least of us. A resident, or an intern or even a medical student can approach me freely without fearing of being chewed on.

Back to my intern, I hope she’ll learn something from that difficult day. I know someday she will become a good, experienced and a well-rounded doctor too. And if someday she becomes the chief of the medical staff in this hospital, as she has a great potential, or becomes the head of a big-shot medical corporation, or even becomes the US Surgeon General, I hope she remembers me and the words of encouragement I gave her during one difficult day.

(*photo taken from reddit.com)

 

Chasing Sunrise

Today is winter solstice. That means here in the northern hemisphere, this day has the shortest daylight hours, and tonight will be the longest night. Where I live right now here in Iowa, it will be almost 15 hours of darkness tonight. Though in Barrow, the northernmost town in Alaska, they don’t see the sun for 67 days in the winter. I’m sure the next sunrise will be much-anticipated after such a very long night.

I like to see the sunrise. Many people do. Somehow for me, there’s something magical to this daily event. There’s something more than just a spectacle.

Few summers ago when we went to Grand Canyon in Arizona, we were told not to miss the chance to see the sunrise there, as it has a peculiar appeal. That entails we have to wake up before four in the morning (sunrise during summer time is just a little past 5), drive to the advised “best” viewing area, which was almost an hour away from where we were staying, just to capture the grandeur of the sunrise.

Was it worth it? Definitely!

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watching the sunrise

When I was young, my father encouraged me to take running for my exercise and as a form of sports. If you know Manila, with its heat and smog, the only tolerable time to run is early in the morning. That is just before the sunrise.

So my dad and I would weave our way in the dark streets of Sampaloc, running in the morning, while the rest of the neighborhood were still snoring. It was not a long run, perhaps 2 kilometers or so. Though the roosters were already crowing, and some dogs may already be up and would bark as we pass through.

My father told me that during this time of the day, the only people we would encounter in the streets were good and hard-working people, who were trying to get a head start of the day. Sure enough, we would see newspaper boys delivering their stocks, vendors preparing their goods, and other folks scuttling their way to work even before the sun rises.

Back when I was in highschool, my family ventured into the business of bangus (milkfish) farming. We leased a small area in Laguna de Bay, where we have erected a fish pen to raise the bangus. Though that business of ours only lasted less than 2 years as we barely broke even, just enough to pay what we borrowed.

During one occasion, I accompanied my father to buy the bangus fingerlings from a fish nursery somewhere in Pasig or Pateros, I don’t really remember. I was 13 or 14 years old at that time. These fingerlings were what we would place and grow in our fish pen.

We left our home in Sampaloc, Manila around 3 o’clock in the morning to commute, so we could be at the fish nursery way before the sunrise. After purchasing the bangus fingerlings, which were smaller than my pinkie, we then travelled with our hundreds of fingerlings aboard a large banca (pump boat), via the Pasig River into Laguna de Bay.

As we approached to enter Laguna de Bay in our rented banca, the sun was just peeping in the horizon. It was one of the most glorious sunrises I could remember. And it’s not that we were even vacationing or sitting idly on the beach. In fact, my father and I were working.

I know there are more hard-working people, like the taho vendor who have to get his supply around 4 or 5 in the morning so he could sell them that day. Or the baker who needs to get up in the wee hours of the morning to prepare and bake the bread, including our favorite pan de sal. Or the flower vendors of Quiapo who have to get their merchandise from Dangwa, way before the crack of dawn. Or the palengke vendors of Divisoria and Baclaran, and other markets for that matter, having to haul their merchandise very early in the morning. Or the jeepney drivers already plying the streets of Metro Manila before daylight. These people are continually chasing sunrise.

And it’s not just in the Philippines, but all over the world, there are men, women, and even young kids, who are already up and working before the first ray of sunlight appears in the sky. To them greeting the sunrise is more than just a spectacle. It is their means to survive.

To all sunrise chasers out there, I salute you. May all your labors bring you what you’re pursuing in this life. And may you all have a very good day!

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view of the sunrise from our place

 

(*written after reading an entry of a fellow Filipino blogger)

Harvest Time

This morning I went for a long run, in preparation for the half-marathon that I would be participating in. The event would be in 2 weeks.

My long runs have been getting longer, and sometimes it can be tedious and boring. Maybe I should play Pokemon Go while I run to make it more exciting, and capture those fleeting critters.

I did not capture a Pokemon, but I captured these photos while I was running:

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Yes, it is harvest time in this part of the world I’m living in. The fields are golden brown, the days are getting shorter, and the wind is getting colder.

In this particular field, they were harvesting corn.

Why are they harvesting corn? Because they sow corn! Shouldn’t it be that way, we harvest what we sow?

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Maybe some cynics out there may disagree with me, for I know we are living in a world where so much injustice abound. People seems to reap what they did not sow, or have been harvesting in fields that are not theirs.

In my home country, we even have a proverb for that: Ako ang nagtanim, ako ang nagbayo, ako ang nagsaing, pero iba ang kumain.

Loosely translated, it says, I was the one who planted, I pounded, and I cooked, but somebody else ate it.

Yet I still believe in justice.

Lady Justice may seems to be blindfolded (I don’t know why it is portrayed that way) to the unjustness and repression happening all around us. And I’m not blind to that. But I know it as a fact that in the end, justice will be served.

That day of reckoning will come to all of us, when we will harvest what we sow.

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(*photos taken with an iPhone)

Life Can Be a Lonely Highway

A few weeks ago we embarked on an ambitious summer drive that took us from farmlands and prairies, to mountains and valleys, to deserted areas and busy metropolis, to rivers, waterfalls and ocean.

We started off from our home in Iowa and drove to Glacier National Park in Montana where we stayed for 3 days. Then we continued our trip to California where I attended 3 days of conference and my medical school’s grand reunion at Long Beach, but we passed by Yosemite National Park first, where we stayed for 2 days.

The sceneries that we passed have been so varied that it changed drastically: from barren lands of South Dakota to lush forests of Montana, from farm lands of Idaho to deserts of Nevada, from wilderness of Yosemite to concrete jungle of Metro Los Angeles.

It was the drive from Glacier National Park to Yosemite National Park that we passed through very lonesome country roads. Though I would take the lonely highways anytime than dealing with the heavy traffic of Los Angeles.

Passing through Nevada on our way to Yosemite, we passed Route 50, a transcontinental highway, which is also named as the “Loneliest Road in America.”

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Indeed it was a lonely road. You probably can set camp in the middle of the road and not be bothered by a passing car for hours. While we were driving through Route 50, I was afraid we will run out of gas and nobody will come to our rescue. Until we saw this….

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Right in the middle of nowhere, is a sort of an oasis. They have a bar, a restaurant, a small motel, and a gasoline station – all in one.

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Notice the sign posted in the motel? It said, “Route 50: The Loneliest Road in America.”

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They even have an old phone booth, which of course is now obsolete in this age of cellular phones.

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So we pulled up to this place and filled our gas tank. We also took the opportunity of taking a bathroom break. Though in reality, I wonder how many travelers in Route 50 when they felt the urge, just stopped and took a leak at the side of the road?

We also check out their small restaurant, and we found that they have plenty of supply of ice cream! Who knew?

Life they say is like a road trip. Sometimes the journey is exhilarating as we go through scenic byways. Sometimes it feels boring as we go through mundane yet major highways. Sometimes we feel we are not going anywhere as we are stuck in traffic. And sometimes we feel alone as we go through lonely roads. But there’s always surprises and unexpected turns.

In the last leg of our trip, after the medical conference and reunion, we also took time to visit our friends and family in California, including my wife’s mother who was staying in Los Angeles area.

Sadly to say,  my mother-in-law got sick and was hospitalized while we were there. Her condition quickly deteriorated and was even transferred to the ICU. So part of my vacation was visiting the ICU, not as an ICU physician but as a patient’s relative. I can’t seem to get away from the ICU.

Despite the medical efforts, my mother-in-law did not improved. She died shortly after a few days.

It was not the vacation we imagined. But at least we can comfort ourselves that we were there during her last moments and we’re able to say our goodbyes in person.

Our family is surely going through a lonely road right now. Yet, we can find solace that even in the loneliest road, there’s always an oasis, a refuge, or a sanctuary if you will, waiting for us where we can find rest.

Lastly, an important thought to remember, that even though it seems we are passing through a very lonely road, we are never alone.

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P.S. Nanay, thank you for the love and the memories. From you “favorite” son-in-law.

(*photos taken at Route 50, somewhere in Nevada)

 

 

 

Serendipity

Serendipity: the occurrence or development of events by chance in a happy or beneficial way.

Several days ago when my family and I were driving to Glacier National Park in Montana, while we were in a middle of nowhere in a lonely highway, we came to a site that was unexpected, at least for us. We had to stop and enjoy the view, for just a little longer.

Of course we were expecting great views in Glacier National Park, a wilderness in Montana’s Rocky Mountains, known to be one of the most picturesque landscapes in North America (I’ll make a separate post about Glacier National Park later, I promise).

However, while we were still hours away to our destination, we serendipitously saw this field full of bright yellow flowers with the snow-capped mountains seen from the distance. It was  just us and some bees on that field.

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a field somewhere in Montana

Later on we learned that they are canola plants, the source of canola oil, and are commonly farmed in this part of the US. We were just not familiar with them. But still, I think you’d agree that it was such a beautiful sight, right?

Sometimes in life, there are things or events that we are not expecting, but happen as a pleasant surprise. Of course the opposite is true as well, when we have such high expectations and then we become extremely disappointed by the turn of events. We even have a law for that – the Murphy’s law: “If anything can go wrong, it will.”

Well, back to the positive side of things, there are also “mistakes” that turned out to be just right. The discovery of Penicillin and the development of Post-it are prime examples.

Are there really fortunate happenstance?

When I was applying for Internal Medicine residency training program after I graduated from medical school in the Philippines, I sent out more than 50 application letters to different universities and hospitals in the United States.

A classmate of mine who was also applying, gave me a list of US hospitals and universities that would likely accept foreign medical graduates like us. I am not sure where he got this list, but that was an era before the heyday of the internet, whereas now you can “google”just about anything.

The list that he gave me was scribbled in a hospital’s pad paper with a letterhead. So I sent applications to all those on the list. And for good measure, I also sent one to the hospital on the letterhead, even though it was not on the list. How did my friend got the stationery? I have no clue.

Out of more than 50 applications I sent, I received only 8 or 9 invitations for interview. I needed all those invitation letters to apply for a visa to enter the United States.

You know that traveling from Manila to USA cost a fortune, not to mention traveling to different States where those hospitals were located, and so with limited resources, I was forced to choose only 3 hospitals to go for an interview – all were in New Jersey and New York, and all within a train or a bus ride away from each other.

After all the interviews, each applicant would rank their preferred hospital or training program, while every hospital would also rank their chosen applicants out of the hundreds they interviewed. Then the National Resident Matching Program matches all applicants to training programs by using a mathematical algorithm. There’s always a chance that an applicant won’t be accepted nor matched.

Where did I end up matching and doing my training?

I matched at a hospital in New Jersey that was an affiliate of Columbia University. Though this hospital was not on the list that I was given. It is the one on the letterhead of the stationery with the list!

Serendipity? Maybe it is destiny.

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(*Photo taken with an iPhone)