Our God is a Perfect God -Conversations over Lemongrass, Herbs and Passion Fruit Soda

A couple of weeks ago, Lance (who blogs at www.bottledbrain.com) and I were privileged to receive a grant from ESMO (European Society of Medical Oncology) to attend an advanced course in prostate cancer. Lance is my fellowship batchmate whom I’ve probably had the most conversations with -not only because we both live in Ortigas and take the train ride daily together, but we also have the same waking hours (up by 4am, asleep by 9pm). So yes – when everyone else is still in bed, there’s a high chance you’ll see us both sipping our coffee at some nearby café.

 

During this trip, we were blessed with free time to visit Muji Café at Plaza Singapura where we tried the lemongrass, herbs, and passion fruit soda. It was sophisticatedly good, and was able to quench our physical thirst and desire to try out the place.

 

Lance and I talk about almost everything -from petty things like the couple fighting behind our table, to life when we were kids, how we both managed to survive medical school and residency, me sharing to him how it feels to be an only-child, him sharing to me how it feels like to have a younger and older brother and their amazing stories with his beloved tatay and nanay, to stories about times when we had triumphs and defeats.

 

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At MUJI Cafe: Lance enjoying his lemongrass, herbs, and passion fruit soda and me trying out the red shiso.

 

We realized that despite all of the challenges and difficulties we are currently facing with our personal and professional lives, we are still blessed beyond what we deserve. And we both agreed with the fact that “Our God is a Perfect God.” -He does not fail. He does not fail to provide for our needs. He does not fail to protect us from harm. He does not fail to make sure that we are headed to somewhere good.

 

Psalm 18:30 says “As for God, His way is perfect: The Lord’s word is flawless; He shields all who take refuge in Him.”

 

Our God is a Perfect God. I pray that you take comfort in this truth, in the same way that Lance and I do.

 

God bless you.+

 

HARRISON’S Principles of Internal Medicine 20th Edition

 

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Hi there!

Below is the link to a pdf copy of the new Harrison’s Principles of Internal Medicine 20th Edition book. I got this copy from my former Chief Fellow (Dr. Vergara) in the hospital where I am currently doing my Fellowship Training in Medical Oncology (UP-PGH).

I am sharing it with you, for the sake of the hundreds of patients we see in the hospitals everyday. May this book and God guide us always in all our decisions and actions in providing our patients the best medical care possible.

Enjoy, and God be with you always!

Download on this link: Harrison’s Principles of Internal Medicine 20th Edition

 

10 Things We Were Reminded at the ESMO Head and Neck Preceptorship

Last weekend (April 13-14, 2019), I was very fortunate to have had the opportunity of participating at the European Society of Medical Oncology (ESMO) Head and Neck Cancer Preceptorship Programme held at Kowloon, Hong Kong.

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Program Packet and ID

This program was chaired by the leading experts in the field -Dr. Anthony Chan from Hong Kong and Dr. Jean-Pascal Machiels from Belgium; which included the following speakers: Dr. Melvin Chua (Singapore), Dr. Brigette Ma (Hong Kong), Dr. Sandra Nuyts (Belgium), Dr. Christian Simon (Belgium), Dr. Joseph Wee (Singapore), And Dr. John Woo (Hong Kong).

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Program Schedule

 

Here are the top 10 reminders I got from the program:

  1. The best approach in treating head and neck cancer involves a multidisciplinary team.

With the rapidly changing advances in the management of head and neck cancers, it is always best for the patient to be offered treatment options discussed by a multidisciplinary team which includes but is not limited to: Head and Neck Surgery, Medical Oncology, Radiation Oncology, Dentistry, Speech Pathology, Rehab, Dietary, and the Nursing Team.

 

  1. Human Papilloma Virus (HPV) tumoral status is a validated positive prognostic factor for oropharyngeal cancers. However, the treatment of HPV-positive oropharyngeal cancer should still be based on the TNM staging.

Although it has been validated that early stage HPV-related tumors have a 5-year overall survival (OS) of 90%, the new staging system incorporating HPV or p16 positivity is only used for prognostication as of this time. There are currently ongoing trials aimed at treatment deintensification for this subset of patients, but treatment decisions should be based according to the TNM staging as of the moment.

ORO HPV +Oro HPV-

 

  1. Intensity-Modulated Radiation Therapy (IMRT) is preferred when doing radiation treatment for head and neck cancers.

IMRT uses advanced technology to focus the high radiation doses on the targets and avoid irradiation of non-involved tissues. Several randomized controlled trials (RCTs) have shown that IMRT (compared to conventional RT)  causes less chronic side effects such as dysphagia and xerostomia which have been proven in some studies to improve the patients’ quality of life.

 

  1. I will consider using neoadjuvant chemotherapy in carefully selected patients who need “debulking.”

Induction chemotherapy followed by radiation therapy (compared with definitive concurrent chemo-RT) for patients with hypopharyngeal and laryngeal cancers is associated with better long term survival but a lower organ preservation rate.

For head and neck cancers other than these subsites, we were reminded to use neoadjuvant chemotherapy with extreme caution (preferably in the setting of a clinical trial) as this treatment approach is considered investigational. However, it may be applied in specific cases where locally advanced tumors pose complications related to RT or in patients who need “debulking” due to local complications.

 

  1. I will consider using Epstein-Barr Virus (EBV) DNA testing in patients with Nasopharyngeal Cancer (NPCA).

In high-incidence regions such as Asia, the undifferentiated type of NPCA is prevalent and highly associated with EBV. The close association of EBV with cancer is presently being exploited to develop diagnostic tools based on detection of EBV material in tissue (EBER) or in blood (EBV DNA or antibodies). Currently, the most important application of EBV DNA in blood is to detect residual disease after treatment and recurrent disease on surveillance.

 

  1. I will use Gemcitabine – Cisplatin in treating metastatic NPCA.

A phase 3 RCT by the Sun Yat-Sen University group showed that Gemcitabine plus cisplatin (versus cisplatin with 5-Fluorouracil) prolongs progression-free survival (7 vs 5.6 months) in patients with recurrent or metastatic nasopharyngeal carcinoma. The results establish gemcitabine plus cisplatin as the standard first-line treatment option for this population.

 

  1. I will use Cetuximab with cisplatin-fluorouracil chemotherapy in non-nasopharyngeal head and neck cancer patients with recurrent, unresectable, or metastatic disease with no surgery or RT option.

The addition of Cetuximab to cisplatin-FU is the standard first line treatment, as it resulted in a 2.7 month increase in median survival and a 2.3 month prolongation of progression-free survival (PFS), thus its designation as a Category 1 recommendation by NCCN in these particular subset of patients.

When using Cetuximab, it is important to remember the following associated grade 3/4 side effects: skin toxicity, hypomagnesemia, and infusion-related reactions.

 

  1. I will not use Cetuximab as first line in NPCA patients.

Present data shows that cetuximab does not improve outcomes when added to concurrent chemoradiation with high-dose cisplatin nor does it have any advantage when replacing cisplatin in combination with radiation therapy.

 

  1. I will consider using immunotherapy as second line treatment for patients with head and neck cancers with recurrent, unresectable, or metastatic disease with no surgery or RT option.

Nivolumab and pembrolizumab are Category 1 and 2B recommendations as subsequent line treatment for Non-NPCA patients with disease progression on or after platinum therapy and previously treated NPCA patients respectively.

 

10. Improving the patients’ quality of life is an essential aspect of treating head and neck cancers.

Treatment of head and neck cancers involves both acute and chronic side effects (eg. xerostomia, mucositis, dermatitis, pain, dysphagia, loss of taste, osteoradionecrosis) and it is important that these are addressed.

In managing patients with metastatic head and neck cancer patients, it is important to remember that combination chemotherapy is associated with higher response rates than single-agent therapy, but has not produced better survival outcomes compared with monotherapy.

 

My bonus but probably the most essential reminder for clinicians taking care of cancer patients: “Always take time to nourish the soul.”

After the conference was concluded, I was very fortunate to personally thank Dr. Anthony Chan, one of the chairs of the program and definitely a leading expert of head and neck oncology. As we exchanged our goodbyes and well wishes, he randomly mentioned that he was “crossing the street to attend church service” and that “it’s very important to always take time to nourish the soul by prayers.”

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Dr. Sabando (St. Luke’s Medical Center) Dr. Lim (University of Santo Tomas), Dr. Balolong-Garcia (St. Luke’s Medical Center), with Dr. Jean-Pascal Machiels, Dr. Anthony Chan, myself, and Dr. Brigette Ma.

Happy Easter, everyone!

 

*The statements here are the personal views of the author.

Two Monks and the Bees by Sir Joey

Yesterday during one of our conferences at the UP-PGH Section of Medical Oncology, our chairman Dr. Jorge Ignacio reminded us to never get tired of serving the Filipino people especially the poor, the sick, and the dying.

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UP-PGH Section of Medical Oncology Consultants and Fellows 2019

No matter what the circumstance is and despite of all the unique pressures and challenges we encounter in taking care of the poorest of the poor cancer patients in the Philippines, it is essential that KINDNESS and HUMILITY should still prevail.

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Our chairman, Dr. Jorge Ignacio

Sir Joey concludes by retelling his story about the two monks and the bees.

“Two monks were walking down the road on the way to their temple. Every time they see the bees struggle, one of the monks would always help the bees. After that monk helped the bees, this was their conversation:

Monk 1: I’m sorry if I’m walking a little slower. The bee stings hurt.

Monk 2: Can I ask a question? Why do you still help the bees every time you see them, when all they do is sting you in return?

Monk 1: It is the nature of the bees to sting. It is our nature to help.”

 

Have a Blessed weekend, everyone. =)

 

 

Maintaining the Passion in Compassion

Cancer Institutue

UP-PGH Cancer Institute. Photo by Dr. Christian Tagal (UP PGH Rad Onco)

 

It has been a while since I’ve written an article  -partly because of the work load as a Medical Oncology Fellow at the UP – Philippine General Hospital, but mainly because everytime I try to sit down in the very rare moments of peacefulness my current schedule provides me, I do not know what, why, or how to write. It is as if my endeavour in learning to battle the emperor of all maladies left my body and soul not only scourged, but empty.

I remember before I left Bacolod for fellowship, one of my dear consultants reminded me as I was about to step out of the hospital where I did my residency training, “Fred, I know that you are about to venture into a new field which will give you an abundance of new knowledge, but remember that the most important thing is that we never lose compassion. When we lose it, we lose everything. Never forget that.

I’m treating cancer patients, it’s impossible to lose compassion -these were my thoughts back then. But after long, draining days of seeing patients from different walks of life -people with different masses from different social classes, people whose tragedies became worse because of various herbal remedies, I realized that the discipline can not only lead to compassion fatigue but may even suck the life out of me -sometimes leaving me empty, but happy.

Empty because as I walk into Room 107 (our clinic), I can sense the tension of the different emotions I will be facing for the day which are mainly brought by the wrath cancer has caused an individual, not to mention the pains of parents and spouses seeing their beloved in anguish.  Empty because in filling up your own patients’ emptiness, you give a part of yourself -sometimes just enough, but more often than not, maybe a little too much.

But I guess having compassion puts in some happiness. Happy because no matter how many patients showed up at the OPD for consult, we will all be able to finish seeing them with or without their results. Happy because our patients showed up for chemo, even if looking for their charts is like finding Nemo. Happy because no matter how hungry we are while doing consults, we can always go to Norman’s area and get some chicheria. Happy because no matter how devastated our patients get every time we tell them they have a recurrence, they still feel thankful just for our mere presence. Happy because despite the emotions that we encounter on a daily basis -denial, sadness, anger, and even depression, we try our best to make them leave loaded with some hope, a renewed faith, tons of love, and most importantly, the realization that in the battle against the emperor of maladies, family is of utmost priority.

So I think this is what compassion is all about -how we react to the feeling of urgent distress in connection to another person’s agony, with the goal of helping them out through their difficulties. And as the Dalai Lama once said, “Compassion is a necessity, not a luxury.”

May it always be our prayer that we, as the guardians and warriors of health, never tire of maintaining our passion in compassion.

 

 

Successful PSBIM Passers 2018

Below is the post from the Philippine College of Physicians (PCP) website showing the list of the successful passers of the recently concluded Philippine Specialty Board of Internal Medicine (PSBIM) Exam held last March 4, 2018 at University of Santo Tomas (UST).

IMPORTANT: To be a Member of the Philippine College of Physicians (PCP), you are hereby advised to email a Letter of Intent on or before March 31, 2018  (please click to  download a proformaLletter of Intent, print, sign, scan and email back to application@pcp.org.ph) . Use LOI_<LASTNAME>, <FIRSTNAME> as subject of email. (Eg. LOI_Dela Cruz, Juan).

PHILIPPINE COLLEGE OF PHYSICIANS
PHILIPPINE SPECIALTY BOARD OF INTERNAL MEDICINE
04 MARCH 2018  –  UST College of Medicine Bldg., España Manila
LIST OF SUCCESSFUL EXAMINEES
Abanilla, Kathleen Joy C
Abarquez, Anna Francesca S
Abasolo, Herlyn C
Abdallah – Jovero, Magdalena Jone B
Abdullatif, Mohamad Alisar A
Abella, Avegail A
Abella, Lea Farrah D
Abraham, Oliver John O
Absalon, Marie Antoniette F
Abubakar, Sitti Sophia R
Abungan, Michael V
Adriano, Cheryl Grace Y
Adtoon, Jonah A
Agapito, Marie Menette I
Aguila, Enrik John T
Alamban, Lani Marie N
Alcantara, Michelle Joane E
Alcoriza, Neil Jnart L
Aldaba, Christine Victoria C
Aldovino, Cynthia Kristina G
Alegado, Niña Carissa L
Alegre, Michelle R
Alicando, Ezekiel John A
Alindog, Webster S
Alipio, Sheena S
Almajar, Maxine Georgette R
Alvarez, Jose Maria O
Amaya, Bryle Simon L
Ambor, Nasroden B
Aming-Sala, Rofaida E
Andalahao, Edzele Marie F
Ang, Blake Warren C
Ang, Gretchen S
Ang, Kerwin S
Ang, Kevin Francis U
Ang, Stephanie Rachel C
Angala, Kristoffer Ted M
Angeles, Roland Reuben B
Antolin, Angelie May S
Antonio, Ethel V
Aoanan, Glice Michelle C
Aranilla, Jestoni V
Aribon, Pamela Ann T
Arnado, Maximo Isidore L
Arrabaca, Roski Alexis T
Atienza, Celine Anne G
Atutubo, Bjorn Karl N
Avila, Meryll Adreanne O
Aviles, Ednalyn D
Awing, Arlyn G
Ayes, Marc Edsel C
Ayuban, Allan Pierre R
Bacasno, Mylene B
Baclayon, Joel C
Bactol, Israel B
Badar, Daryl R
Badere, April L
Badillo, Nicolo Andrew V
Badron, Abdul Wahab L
Bagon, Aldin C
Bagsic, Mery Grace D
Baiya, Janet D
Balanga-An, Kristoffer T
Balboa, Rocky C
Balderrama, Ana Francezca R
Baldovino, Christine Jew V
Balino, Everly Joy T
Balmes, Maureen B
Banania, Mary Joy Angelyn C
Banares, Karla Kristel A
Barbon, Carla Emille D
Bariuad, Irene Kei N
Barrameda, Lara Mea T
Barranda, Krystill Joy B
Baulos, Pol Dennis I
Bautista, Callen Marie P
Bautista, Jose Antonio L
Bayogan, Jennifer Theresse C
Belleza, Roderick M
Bello, Mary Hyacinth A
Benjamin, Cherry Lois M
Berbano-Saini, Claire R
Berceles, Sheryll B
Bermudez, Anna Maree J
Bernardino, Hannah Mae T
Beron, Emilia Gracia M
Bibera, Christine Joy C
Bibon, Jennnifer B
Bigol, Janella Marice B
Bolinao, Antonio R
Bonavente, Katrina Q
Bool, Kathleen Z
Boquiren, Sharon C
Borbon, Alvin Christian C
Bordones, Maria Carmela D
Borja, Maureen Faith T
Boseta, Marites R
Bruno, Racquel G
Budimutiar, Felix A
Bueno, Kevin Cham A
Bulaclac, Julian Patrick L
Buno, Susana V
Cabilao, Stephanie Mae R
Cabrera, Carmen Carina G
Cabrera, Ma. Margarita G
Cabus, Charles Erwin A
Cagurangan, Raisa T
Cahyadi, Alius N
Camenforte, Jameel Kristine L
Camua, Melanie D
Cania, Virgilio Dave O
Canseco, Lariza Marie L
Capucion, Shena Jo A
Caragos-Merin, Leilani Rosalind P
Carbonel, Martin Carl C
Carlos, Conrad Avednego R
Carolino, Lei Anne C
Carrascal, Bea Barbara C
Carreon, Aileen S
Casem, Pejy Arce C
Castillo, Christa Carmeline D
Castillo, Christel Lynn G
Castillon, Jeffty C
Catedral, Lance Isidore G
Catibog, Isabella Bianca D
Ching, Cheryl May C
Ching, Maria Elizabeth C
Chiu, Kristela A
Chua, Abigail G
Chua, Winnie Andrea T
Chung, Philippe Ryan K
Clarion, Charlie A
Comilang, Arnellie T
Coraler, Tc May L
Corpuz, Dianne Grace S
Cortez, Kristle May R
Cruz, Angela Beatriz V
Cuaño, Carlos Rolando G
Cuatriz, Tanya Rae O
Cunanan, Romulo M
Custodio, Agnes L
Dabalus, Jude D
Dalmacion, Allen Yentyl V
Damalerio, Alta Gracia B
Danganan, Marie Dominique Cezanne M
Dantes, Ma. Angelle Lalaine D
David, Jamaica Ross B
Dayo, Alfred Matthew R
Dayot, Stephanie D
De Guzman, Adrian Joseph D
De Guzman, Boris – Jruing J
De Guzman, Leah P
De Guzman-Pamplona, Aleli Y
De La Cruz, Kathryn B
De La Paz, Janine Kae A
De Leon – Naredo, Madelle D
Dela Calzada, Maria Joscel M
Dela Cruz, Allan Jake C
Dela Cruz, Jeremiah John G
Dela Cruz-Bariuad, Anna Lisa D
Delos Reyes, Ma. Kristina J
Demot, Bernard A
Dewi, Cyntia N
Dideles-Sandifer, Luanne Rose E
Diez, Brian Cesar V
Dimaporo, Johaniya M
Dionora, Ariel Patrick P
Dipantar, Najmah D
Dizon, Troy Michael P
Dolorso, Toni Mar B
Domato, Tahir A
Domingo, Cristina G
Domingo, Norbert Drustan P
Domingo, Ruth E
Domingo-Palacio, Katherine Joy G
Doria, Ursus R
Dueñas, Kevin Clifford B
Dumangas, Marlowe T
Dungca, Pia Pamela P
Dy, Chris Albert N
Edulan, Vaughn Caesar L
Embuscado, Jessa Christine C
Encarnacion, Margaret C
Enriquez, Jhon Ryan G
Erum, Cherrie Kaye G
Escalona, Charlyne Mae R
Escaño, Mark Collins R
Escasura, Gladelyn C
Esguerra, Jerica Cristel A
Esguerra, Kevin L
Espino, Joseph Niño A
Estalilla, Jan Raymond M
Estepa, Lilybell Victoria E
Esteves, Joy V
Estrellado, Joyce Angeli P
Evangelista, Arriane P
Evangelista, Lisa Angelica V
Fajardo, Maria Janelle M
Ferido, Ma. Genela C
Fernandez, Sime Raymond B
Festin, Mark John F
Figuracion, Julie Ann I
Flores, Alfredo H
Flores, Eloisa L
Flores, Karen Marie G
Francisco, Mark David D
Francisco, Phorenice D
Ga-An-Castigador, Arlyn G
Gabitan, Marvic Raymond C
Gabuat, Harry M
Gaerlan, Tee Jay Kristoffer G
Galang, Danille Emerald P
Gallego, Kristainne R
Gallemit-Dy, Apryl G
Gampong, Earl Revo P
Ganangan, Sheila Grail J
Gapasin, Princess Michelle V
Garcia, Doris M
Garcia, Lyka Kymm E
Garcia, Marjo Florizzell C
Gato, Nonita P
Gaw, Jenelyn T
Genelsa, Rainiel S
Gernale, Gerlane Lyn L
Gimena, Mary Yolanda L
Go, Beatrice Delynn D
Golez, Mary Diana Z
Golong, Karen M
Gomez, Federico C
Guadarrama-Arriola, Ana Ma. Nanette L
Guades, Floryanne Y
Guanzon, Crystal Hope D
Guevara, Daniel Y
Guevarra, Eric Ranniel P
Guillermo, Sheryl V
Gutierrez, Alfonso L
Gutierrez, Caesarianette S
Gutierrez, Ian Lordeo A
Handi, Adriel H
Heidari, Marjan O
Hermo, Christine Jane G
Hernandez, Kriz-Ann R
Humarang, Jeffrey M
Hung, Paul Aldrin Y
Ibarra – Dadez, April Rose C
Ibrahim, Fatima Amina H
Idio, Kenneth Junel P
Imperial, Clarisse May R
Inciso, Pinky Precilla A
Ingco, Paul Andrew C
Ismael, Shereen L
Israel, Sylvernon C
Jalipa, Francis Gerwin U
Jao, Marelyn N
Jao, Suzanne U
Javier, John Joel H
Javier, Rhea Cez B
Jorge, Jenina Joy E
Joson, Ara Crissele M
Juson, Alexander D
Kalaw, Reginald Paul Joaquin V
Karim, Halima J
Kho, Kathleen Rae M
King, Rich Ericson C
Kusain, Maisura K
Labadan, Genalyn B
Labriaga, Roy Justin G
Lacaden, Sherwin Joseph R
Lacanin, Mary Rose Anne E
Lacasandile-Sanchez, Kareen Alna M
Lagade, Leo Alejandro Miguel A
Lagos, Timothy Bjorn M
Lajara, Bryan C
Lamorena, Karina Ann
Langilao, Salimah M
Lao, Bryan Christopher C
Lapuz, Emilita S
Lat, Karen Loise P
Latawan-Danasen, Abegail B
Laxamana, Frances Lorraine M
Lazaro, Ma Aurora E
Lazo, Reynaldo C
Legaspi, Mishell Kris S
Leones, Louis Mervyn B
Leuterio, Jade E
Libo-On, Dyann Dolour M
Lim, Anne Kimberly K
Lim, Djarnell Ashley T
Limcaoco, Mary Rose Celerina B
Limos, Honey Jane B
Listanco, Olivia Faye J
Liu, Marie Krisca D
Lopez, Benny A
Lopez, Joyce D
Lovendino, Anna Rose P
Luce, Yvette P
Luceño, Vincent M
Lumanang, Leslyne V
Lumaque, Shake G
Mabao, Angelyn Grace I
Macailing, Jurina Joy P
Macapagal, Justin Romeo J
Madamba, Bernadette Meifel Joyce D
Madarcos, Dennis C
Madera, Monica Kristine L
Madla, Ma. Mercedita G
Madrid, Joie Merriel V
Magbanua, Ana Sabrina S
Magbojos, Jayson John L
Maglonso, Therese Anne S
Magtoto, Alvin Harren B
Mala, Princess Jasmine A
Malazarte, Maricel B
Manalili, Christine P
Manalo, Carlson C
Mangrobang, Jan Patrick C
Maniri, Cosnifah A
Manuel, Marielle Lois M
Maranan, Maria Luisa D
Marapao, Jessa Marisse E
Marasigan, Anne Clarisse Mae G
Marave, Raiza S
Mareta, Lily
Margaja, Ryan Joseph A
Mariano, Evanelle G
Mariano, Lorbenjie P
Marquez, August Oliver A
Marquez, Mary Grace A
Martinez, Jared Manuel P
Mascardo, Yancel Donna L
Mason, Jackie S
Matibag, Rhenz Martin L
Medina, Marco Luciano R
Medina, Noel M
Medrano, Kristin R
Mejia, Evelyn P
Mendoza, Avianne Krystle S
Mendoza, Josiephine C
Mendoza, Kristine Joy L
Mendoza, Ramon Christopher T
Mendoza, Reina D
Mertola, Oscar Paulo C
Metmug, Anwar M
Miralles, Julie Ann Stephanie R
Miranda, Kenneth Kay Lee N
Mislang, Francis Xavier F
Mondragon, Karen Anjela M
Montemayor, Jan André S
Montes, Cristina Camella P
Montevirgen, Richultz C
Montoya, Lionel B
Morales, Shayne Julieane L
Morrell, Miriam Ruth S
Muharram, Sharijane D
Mula, Bethlehem C
Musni, Orson M
Nadong, Jasfer Neil B
Nagera, Airene V
Narisma, Maria Aurora N
Narvas, Nicy F
Navarro, Marc Julius H
Ng, Anthea L
Ng, Jan Patrick O
Nuñez, Ma. Clarissa B
Obay, Shirley Cecilia N
Obuyes, Ernie P
Ochia, Joanna Loren J
Olivar, Francisco U
Omaña, James C
Ombao, Genevie R
Ong, Laureen Claire Y
Ong, Nicodemus L
Oriola, Ronnie Allen D
Ortal, Abigail Z
Ouano, Oscar I
Ozaeta, Maria Kristina Cecilia P
Pabelico, Christie Anne I
Pableo, Rachel Liwliwa M
Padilla, Samantha Faye M
Palec, Jesilyn F
Palencia, Frances Ina B
Palmero, Vina Florentina P
Palo, Kathleen Leigh J
Palogan, Christopher P
Pamintuan, Carlo Franco Philippe L
Pañares, Chiara Christine N
Pañares, Kathleen Ann B
Pangan, Efrea Lyndee G
Pantas, Jim Paulo P
Panugayan, Krislyn G
Pasco, Charisse Amor F
Pascua, Marc Ryan N
Patio, Antoinette Twinkle G
Pelayo, Blessa Marie H
Pellazar, Charisse Honeylette R
Penserga, Grace G
Peralta, Rafael Jose M
Perez, Maria Cristeta B
Perez, Maria Erica Mae S
Perez, Tamica L
Pesayco, Ma. Jeanette M
Pescador, Antonio O
Piansay, Lylle Angelica F
Pilit, Ma. Belen B
Pineda, Sabrina V
Piodos, Vernie M
Pizarro, Dean Marvin P
Planilla, Cyril Jonas M
Platero, Marieldo S
Po, Christopher John S
Pornillos, Maria Charissa Thalia M
Pragados, Carmela C
Presto, Julius Ceasar E
Puentespina, Jan G
Punzalan, Samantha S
Purnomo, Inosensius A
Quinon, Jewel Mae M
Quintero-Penaranda, Fern Lyse G
Rada-Llenaresas, Clarin M
Rama, Ardie S
Ramirez, Bryan Paul G
Ramos, Everly Faith P
Ramos, Hazelene Joyce G
Ramos, Nicole Rose B
Ramos, Sittie Zulaipha A
Ramos-Manalaysay, Amanda Mae L
Rances, Oliver T
Raymundo, Nikko Theodore V
Razote, Michael Rey L
Rebana, Marisol B
Regpala, Naomie F
Rejante, Sofia Carla D
Relente, Maria Ricci Elearhina S
Relleve, Dara Diana D
Revelo, Renamar N
Revilles, Jeraldine D
Reyes, Jed Cedric S
Reyes, Kristine P
Reyes, Roman Niño R
Ricalde, Baby Kristianne U
Rimando, Sheena A
Rimando-Valera, Kimberly A
Rivera, Josephine Encarnacion M
Rivera, Lorelie Ann C
Rivera, Ramon Miguel M
Roberts, Stephen R
Rodil, Dennis C
Rodriguez, Ben Joseph P
Roldan, Marie Kristine R
Roman, Christine Ysabelle G
Romines, Lucille G
Roque, Jether M
Rosales, Edison O
Rosales, Virra Teresa L
Rosete, Margaret B
Ruaya, Amy G
Saberon, Keith Moon Q
Salcedo, Karl Martin Q
Saliendra, Glethe Hanzel A
Salvador, Joanna Luisa Z
Sancha, Carlo Henry A
Sanchez, May R
Sanchez, Melanie B
Sandejas, Joanne Carmela M
Sanedrin, Lea A
Saniatan, Jay-Lord S
Santiago, Aivind Gabrielle G
Santos, Faith Y
Santos, Joanna Margarita S
Santos, Joel B
Santos, Maria Kathleen C
Santos, Maria Regina C
Santos, Ronald F
Sarabosing, Moneen Magdalene D
Sarita, Mabel Angela T
Sarmiento, Sherwin Joseph P
Sayson, Joberly D
Selodio, Evan F
Serenina, Ann Kristine S
Sevilla, Denise Ayn B
Silva, Kervin Jake B
Simbajon, Maryvic Izah S
So, Rizza Antoinette Y
So-Cabahug, Jacklyn M
Soeryaatmadja, William N
Solaña, Renato Q
Soldivillo, Lynne Michelle B
Sollano, Ma. Hanna Monica Z
Soria, Arriza Kryssan M
Sotta, Laarni Lou M
Suero, Joyce Karla S
Sulaeman, Marshall S
Sulit, Juxerez Maria B
Suñe, Therese Anne M
Susi, Fiel Marise S
Sy, Darleen M
Sy, Marianne Linley L
Tadios, Maricris Anne I
Tagayuna, Kimberly A
Tagayuna, Rafael A
Tagomata, Karl Babe G
Taladua, Kristy Michelle S
Talavera, Eric Royd F
Tamayo, Maria Theresa H
Tan, Ailie C
Tan, Anthea Virginia G
Tan, Claire A
Tan, Dan Lester U
Tan, Jayne Sari D
Tan, Katherine Ann N
Tan, Lynnette Marie C
Tan, Randall Isaac F
Tan, Ron Michael M
Tañada, Carlo Benjamin Z
Tanengsy, Debbie Rose U
Tang, Hervin Damler A
Tanseco, Vicente P
Tanwani, Albert C
Tayao, Lotgarda N
Tecson, Gina Y
Telan, Judith U
Tentativa, Elaine M
Teus, Merry Ann S
Tibayan, Christoper  John N
Tiglao, Angelique Love C
Ting, Frederic Ivan L
Toledano, Bryan Rene F
Tolentino, Joy Melchora
Tongo, Marco Angelo D
Torres, Pia Katrina G
Torres-Morado, Danilyn Rose Q
Tripole, Kathy Jane S
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Tuplano, Romelie M
Ubaldo, Onion Gerald V
Ugale, Maria Yvez Erika P
Ulit, Lea Marie M
Uy Choa Khao, Shair Aris D
Uy, Angelique Bea C
Uy, Anthony Earl C
Uy, Fanny Marian P
Uy, Gladys A
Uy, Glenn Darryl D
Vallente, Jeremiah R
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Velasco, Rogelio N
Velasquez, Jhoanna Rose H
Ventanilla, Glen T
Ventic, Vehement Jay G
Viernes, Jonathan S
Vigo, Kristine Dyan C
Villamar, Anna Maureen R
Villamor, Ralph Raoul A
Villanueva, Allen Richard D
Yabut, Vince Leenard M
Yamamoto, Julianne Marie E
Yap, Annabel Joy D
Yap, Ma. Krizia Camille C
Yap, Ralph R
Yau, Tommy D
Yoro, Ofelyn T
Yu, Brigitte Aiza D
Yu, Sherry Coleen C
Zamora, Mithi Kalayaan S
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To God be all the glory. +

What Your Doctors Always Promise You (But probably don’t tell you)

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RMC Department of Internal Medicine Residents with their Chairman and Training Officers.

 

As early as medical school, it has always been emphasized to never promise anything to patients –otherwise, we might just be giving them false hopes. For the science of Medicine is never stagnant and ever changing. Its art sometimes more philosophical than logical. And with the advent of modern technology and new discoveries, its practice has never been this sophistically complicated.

 

Medicine has its glorious moments, and it has its gloomy days. We’ve had patients who came in dead, but went home walking. We’ve also had days when we admitted a seemingly well patient accompanied by his wife in the morning, who unfortunately ended up a widow in the afternoon.

 

But no matter what condition your patient has –be it benign or toxic, simple or complicated, rest assured that we are doing everything we can. From the moment the very innocent-looking, young, and vibrant intern gets your medical history and examines you, to the time the tired and famished resident redoes all the things the intern did and makes your admitting orders, to the time your attending physician visits you, it doesn’t stop there. We prepare for each and every patient we see -from the usual late night readings, to the constant case discussions made during our regular conferences, to the daily rounds we do, until the day you are sent home.

 

So no, you will never hear us promise you a good outcome. But to tell you honestly, here’s one thing we, your doctors, always promise to do: that in every patient we see, in every case we encounter, no matter what the outcome is, we will always give you our best. That’s what we are trained to do, and that’s what Medicine is all about.

 

To burn all candles, exhaust all efforts, and explore all possibilites –all for the care and comfort of those who entrusted their lives to us. This is our promise to you. It has always been, and will always be.