Puto Rounds

Sometime in the year 2000, in the heart of New York, New York. In the hallways of the intensive care unit (ICU) of Memorial Sloan Kettering Cancer Center, a world-renowned hospital, and one of the best cancer center of the world, if not the best. Five doctors – four were fellows-in-training and one young attending physician with a specialty in Critical Care – were in a huddle, making their rounds on the critically ill patients.

The doctors were scholarly in their discourse of each case, deliberating what the best management approach was for each individual patient. There was nothing really special in their rounds, especially given that it was a regular occurrence and practice in an academic center. Except that they were all speaking in Tagalog – deep in the bowels of New York City, a thousand miles away from Manila.

Of course English is the official language of the academe and of this country. And those Filipino doctors were discrete not to talk in their native tongue in the presence of other people. There were several other doctors-in-training as well as consultants of other races aside from Americans in that institution. But in this opportune time, with all of them Filipinos, they felt comfortable speaking in Tagalog. Who says Tagalog or Pilipino cannot be the language of the learned?

All of those young doctors finished their medical education in the Philippines. They came from different schools though: one from University of the Philippines, another from University of Santo Tomas, one from University of the East, one from Lyceum-Northwestern University  in Dagupan, and another from Saint Louis University in Baguio. That they  ended up in one place, at one time, is a happy twist of fate. And here they were all now, in an Ivy-league-affiliated hospital of Cornell University. Who said Philippine schools do not produce world-class graduates?

After a demanding few hours of rounding and working in the ICU, those Filipino doctors took a break. They did not go down to the hospital cafeteria for an american doughnut or for an English muffin. Instead they headed back to the fellow’s call room, and snacked on home-made puto (rice cake), brought by one of them. No one asked for dinuguan (blood stew) to complement the puto. I guess the gory sight of some of the ICU cases were deterrent enough to make dinuguan unappealing. So you’d think puto is only found in the streets and markets of the Philippines?


Was the puto special? Does it have cheese on top? Or salted egg perhaps? Did only the Tagalog-speaking doctors eat the puto? Or did they share them to other people?Did the puto made the medical rounds noteworthy? Did the puto made the doctors more brilliant? Did the puto help cure the sick patients? Was puto prescribed to the patients to be taken at least once a day?

Is the puto even the focus of this story? I don’t know.

Twelve years have passed since those puto rounds. What has happened, you may ask, to those young Filipino doctors? The young attending physician then, is now the chief or Program Director of the said training program. One of the doctors after completing her training, went back to the Philippines, where she now practices her profession. She is also an elected congresswoman.

The other three physicians-in-training then, found their niche in different areas of the United States, where they are now specialists, involved in private practice as well as in some academic institutions.

How do I know this story as a fact? Because I was there. I was the one who brought the puto.


(*image from here)

(**compliments to my wife for making the puto, and the story it inspired)


Post script: This piece was later published in Manila Standard Today, on Oct. 2, 2012.

New York’s Higher Learning

“If I can make it there, I’ll make it anywhere. It’s up to you, New York, New York.” …….Frank Sinatra

New York City. Arguably the center of the world. Many people from every part of the globe would like to make it their destination, and find their luck there. And like in Sinatra’s song, “I want to be a part of it, New York, New York.”

And it was.

I had so many experiences and lessons learned during my few years of stay there. First, was the educational and post-graduate specialty training that I received in the top medical institutions there. This became the foundation of my professional career, from which I draw my livelihood to sustain my family. Somehow, I still feel proud, unwarranted or not, to claim that I am New York-trained.

Second, it was in New York, that my first child was born. It was here that I first experienced the joy of fatherhood. With that though was the realization of the responsibility beyond just fulfilling my own dreams, but also providing for the future and dreams of my children. For this reason, I learned to strive even more harder.

It was also in here that I learned to tap on my apartment’s ceiling at 2 o’clock in the morning, to stop my neighbors’ dance party, who lives above me, so my wife and I, and my newborn baby can sleep. I guess you need to learn to fight for your right and speak up your mind, if you “want to wake up in that city that never sleeps.”

waking up in a city that never sleeps (image from http://www.dailymail.co.uk)

This is where I chased an intruder who was able to enter my apartment, out of my door, down the stairs of the apartment complex, and through 2 blocks of crowded streets. On hindsight, I should have never run after that thief, for I could have been killed, especially if he was carrying a weapon. But when the adrenaline was pumping through you, I guess it bypasses your brain and your better judgement. It awakened my territorial and survival instincts.

It was in New York City that whether you are at work, commuting in the subways, or walking in the streets, people have learned to: mind your own business; rely solely on yourself; trust no one; and don’t walk, run. And so did I.

But it was in the last few months of my stay in New York that I received my greatest education. After changing my decision to stay in the US for my children’s sake, instead of going back in the Philippines after my post-grad training, I had to switch my visa from an exchange visitor (needed for the training)  to a working visa (needed for a real job). A process that can take some time. And in my case, it did.

After completing 6 years of specialization, and armed to the teeth in training, I was all gung-ho to start work. But I was put on hold……Suspended animation….. As I cannot work without a change of visa, I had no choice but wait. Days of waiting turned into weeks……and weeks turned into months……and months into several more months…….

In a place that is always hustling and hurrying, a place where it only takes a fraction of a second from the time the traffic light turns green to time the car behind you honk its horn, a place where times ticks a little faster like in a New York minute – is where God taught me patience, and the virtue of waiting.

With no work, no income, and with a 5-figure amount in dollars of credit card debt, that was increasing by the day, I was forced to leave my apartment because I plainly cannot afford it. My family became one of  the hundreds of homeless people in New York City. Our only difference from the other homeless people who wanders in the streets, was that a caring family took us in and let us stay in their home, without paying rent, and even fed us for free.

homeless in New York (image from http://www.dgrin.com)

During the several months that I was jobless, we moved from one family’s home to another, relying solely on their goodness and mercy. It was here that I experienced complete helplessness in providing for my family. I realized that in life, diligent and hard work may not be enough, for we all need grace.

Then every week, when we went to our church, church members and friends who knew our predicament, will quietly hand me $10, $20, or $50, telling me to buy something for my daughter who was 2 years old then. I knew these people were not rich. They too have barely enough and just trying to make both ends meet, but they shared the little that they have. It was a touching experience. And it was a humbling experience.

From being independent, to becoming fully dependent. From minding my own business, to others caring and looking after my own business. From trusting no one, to fully trusting and having faith. It was a complete turnaround. It was in New York City that I found renewed confidence in people and a stronger reliance in God. It was here that I received a course of “higher” learning.

After more months of waiting and still out of work, my family and I finally flew to California and stayed with my sister-in-law to escape the harsh winter. I left New York City with a heavy heart but thankful, humbled but not defeated, broke but hopeful. I admit, I was also wiser, more enlightened and insightful.

Three  months after we left New York, only then did I received what I was praying and waiting for.

New York, New York. Yes, I made it there (though barely). And I believe, I can make it anywhere.

There Are Places I Remember

Here are the pictures of places where we used to live, and hospitals where I did my training. It’s hard to believe that it has been more than 10 years since then. (Photos taken during our recent trip back to New York and New Jersey area.)

Color My World

When I was in kindergarten (in one of  my neighbor’s driveway turned into classroom, run by NFWC), one of my prized possession is a new box of crayola. 2 rows of 8 crayons, 16 different colors, in 1 box. I like it more than my scissors, ruler, pencil, and sharpener. Though I love my eraser very much too, because it smells like bubblegum (I wonder what kept me from chewing it). I used those crayons to color my art projects, my books, our wall, and everything that I think needs some color.

Then, when I started my residency training program in Internal Medicine in New Jersey, colors took on a  different meaning. In our program are medical graduates from different countries of the world. I was privileged to work with people from Russia, Romania, Guyana, India, Israel, Greece, Burma, Nigeria, Vietnam, and of course Americans, and fellow Filipinos. We got along alright, once you learned to pronounce their names. Our group  had a problem with one in particular, Hoia-nghia Nguyen, so he was unofficially given a new name, Bill Smith.

When I pursued my subspecialty training, we moved to Queens, New York. Not only are the  resident doctors diverse, but the patient ethnicity became very diverse too. In fact the zip code 11373, where the hospital where I trained was located, was even featured in the National Geographic a few years ago, as the most ethnically diverse neighborhood in the whole world. In one of the studies we conducted about tuberculosis in our hospital, we have counted more than 70 different ethnic background in our study population. We do have problem sometimes of understanding our patients, but we always find an interpreter who can assist us (now I feel for the veterinarians who has to interpret the “arfs” and “meows” of their patients), or we get by with gross sign language; besides pain and suffering is a universal language you can read in their faces even without them telling you in plain English.

When we moved to Manhattan where I further my training in another hospital, there was an instance, when my wife entered a store; it was dead of winter, so she was wearing a coat, muffler and a hat. The store clerk looked at her and tried to determine her ethnicity: “You don’t look  Chinese, you don’t look Japanese, are you from Tibet?” (Tibet? Maybe its the hat she’s wearing.) My wife just smiled and proudly said, “I’m a Filipino”. Then the store clerk who was an American, greeted her “Keymustah kah?” (Who knows, he probably can greet in Chinese or Tibetan too.) Yes,we may be sometimes mistaken for another, but we never deny our origin.

Over the years I have learned to work, be friends, and live peacefully with people of different race, culture, and background. I may still sometimes gravitate with Filipino friends, but I have embraced the diversity, for I believe it is our differences and diversity that makes our world beautiful and more colorful. As the different colored crayons all in 1 box, but each color  stays the same, in the same token, I have maintained my identity and proud to show my color – ako’y Pinoy (“di ako nahihiya kung ang ilong ko ay pango”).