Hope · Life = Hope · Life Rx · Med2Love · TandeMD

The SOAP of UERM Class 2016

THE SOAP of UERM Class 2016

By Jerald Pelayo

 

I am truly honored and humbled at the same time to receive this award today, knowing my limitations as a post-graduate medical intern. To everyone who believed in me, and in what God can do through me, from the deepest recesses of my heart, thank you so much.

I will not be referring patients to my residents or to any consultants present today. Instead, allow me to refer Class 2016, with whom I have, in so many ways, braved the rigors of 4 years in Medical School and 1 year of medical internship. Allow me to present our Class SOAP today.

 

SUBJECTIVE

Class 2016 is a 5-year-old, multicultural group, who has come together from all parts of the world, with different co-morbidities and personality traits. The Class came in for thoughts and feelings of anxiety of 6 months duration.  Life was apparently well for the class until…

5 years prior to graduation, we accepted the challenge of a lifelong education, entering with a naïve but energetic spirit. We were lost in our own anxious thoughts, and were culturally shocked in the new environment we were immersed in. We were faced with the complexities of Anatomy, Biochemistry, and Physiology. From the ground emanated budding emotions of love and hatred, successes and failures. During the process, some left, some were left behind but still many survived.

4 years prior, more paper works were added to the already long list of subjects to study. Our time was consumed by preceptorships and interviews, thus studying had to be left in the crevices wherever they could fit.

3 years prior, the amount of paper works escalated exponentially to the point of neglecting the need to study or even listen to lectures. We kept on chasing deadlines that we forgot what really mattered – the very long examinations. For some, this was probably the most academically challenging year of all. If we recall, we were all instructed to attend clerkship orientation, clueless as to whether we actually made it or not. The rest was history, until…

2 years prior, we came to the end of classroom education and we were residing in the hospital as junior interns, living in a far different world where we slept in a cramped up or a make shift “lungga”. The class had its fair share of being addressed as “Ate/Kuya/Nurse/Miss/Mister/even worse simply a ‘Psssttttt!’”. We had endless duties day in and day out, sleepless nights because of bedside monitoring, referrals which were either torn or accepted, paper works, rounds, codes, OR/DR assists, labor watch, sleep-wake monitoring and the like. We weighed diapers, drained urine and colostomy bags, inserted and re-inserted IVs/NGTs/foley catheters and so much more. The time we spent together may even be longer than the time we spent with our own families, hence we got to know each other at a deeper level, allowing us to see each other’s good and bad sides during those good and bad times. These varied experiences shaped us and our perspectives, and with these, some inevitable twists and turns transpired along the way, where some old relationships and friendships were made stronger, some new ones formed and some old ones unfortunately came to an end. Nevertheless, we journeyed as one family until…

1 year prior, we had to be matched to our hospitals of choice, some of us were lucky with first matching, while the others were not, who were matched only until the first day of our official duty. Whether we were wrongly matched or not, we all went our own ways, separated by our choices. And here are the few that remained in our home base – whether chosen, forced, or left with no choice at all, who were ever ready to stand by the idea that we made the right decision when we chose to stay, ready to be enslaved once more! And finally, we got to wear the white coats, now as senior interns. We received referrals from our JIs and taught them what we learned from the previous years. Some of us enjoyed the blessing of authority through suggesting demerits and merits, crossing them out in their attendance logbooks, giving them quizzes, and sometimes doing midnight rounds with them. #ForYourLearningPurposesOnly #WalangPersonalan. This time, it was less physical work and less monitoring, but we had more censuses to edit and more responsibilities. We were actively involved in patient care under the supervision of our residents. It was a steep growth curve, but the class survived! And together, we conquered PGIship.

On the day of graduation, the class experienced ambivalence with a heightened feeling of anxiety hence this SOAP.

Review of systems revealed irritability, palpitations, muscle tension, sleep disturbances, and polyphagia.

 

PERTINENT OBJECTIVE DATA

                …showed that the class is awake, alert, conversant, coherent but restless, not in cardiorespiratory distress. Vital signs are relatively stable, save for tachycardia. Other pertinent findings include cold clammy extremities and diaphoresis. Mental Status Exam revealed that the class is in a state of heightened anxiety as verbalized. PE findings of other systems are unremarkable.

 

ASSESSMENT

Generalized Anxiety Disorder secondary to pending PLE 68 days from now

s/p 4 years of Medical School, s/p 1 year of Medical Internship

 

PLAN

  • Give BOLUS Signatures for clearances STAT. Please DO NOT DELAY!!!
  • Diagnostics:
    • ECG to check for residual heartaches and fears that need to be dealt with or resolved before the boards
    • 2D echo to check for emotional abnormalities that need to be stabilized
    • Electrolytes – to check for imbalances in doubts and self-confidence
    • CBG – to check for acute spikes of panic attacks
  • Treatment:

Allow me to share my treatment plan for Class 2016.

The first prescription is FAITH. “We have nothing to fear for the future, except as we shall forget the way the Lord has led us in the past.”* Remember, “man’s necessity is God’s opportunity.”**

The second prescription is DISCIPLINE. We are to discipline ourselves by gathering up every jot and tittle of knowledge and experience. Discipline also entails temperance and focus. Prioritize! Remember that the time we spent can never be brought back or re-lived.

Hence, remember this formula: FAITH + DISCIPLINE = EXCELLENCE

Do not settle for mediocrity. If best is possible, then better is never enough. God requires of us nothing but our best. Let us then strive for a rock-solid 100% passing rate. Class 2016, are you up for the challenge?

Excellence, after all, is not a skill but a habit; it’s not a destiny but an attitude; it’s not a seasonal aspiration but a way of life. Keep the faith, exercise discipline and achieve excellence.

Then lastly, follow-up with God. Make Him your FIRST, LAST and BEST in everything!

As difficult as it will be for any of us, I will miss and treasure the beautiful memories that we have spent together as a class. As we go on our separate ways, let us remember to look back to where we once were and move forward with greater hope that we can live the reality of our greatest potentials. Now, go and #LiveTheDreamUERM2016!

 


 

*Taken from EGW Writings, Life Sketches, p. 196, paraphrased

**Taken from EGW Writings, Testimonies for the Church, volume 4 p. 530

 


This was delivered by Jerald L. Pelayo at the UERM PGI’s Graduation (July 4, 2017) at the UERM Physio Auditorium. May this ever inspire our dear classmates, colleagues and friends!

With much love,

Jerald and Ardys

Your newly graduated Post-graduate Interns

 

Advertisements
#APieceOfJoyADay · Faith · Hope · Life Rx · Sabbath Joys · TandeMD

Bend to Ascend

 

Bend to Ascend 1

(by Ardys)

Bend to ascend. Does this make sense to you in any way? How will you ascend when you’re stooping low? This phrase is what we call an oxymoron. It is an incongruous and contradictory statement, purposely weaved together to create a stronger message. Examples include cruel kindness, freezing fever, defeaning silence and bittersweet. These are commonly coined together to create or describe a whole new contradictory but complementary statement to express a powerful thought.

Today we will be focusing on Romans 12: 1-2. “Therefore, I urge you, brothers, in view of God’s mercy, to offer your bodies as living sacrifices, holy and pleasing to God – this is your spiritual act of worship. Do not CONFORM any longer to the pattern of this world, but be TRANSFORMED by the renewing of your mind. Then you will be able to test and approve what God’s will is – His good, pleasing and perfect will.”

With transformation, we shall be bending ourselves. Only then can we learn to ascend. Now allow me to share 3 methods of bending. Let’s have  some spiritual exercises, shall we?


BEND DOWNWARDS: HUMILITY

Bending Downwards 2

  • Naaman (2 Kings 5:1-19)

Naaman was the commander of the army of the king of Aram. He was a great leader of the army, rich, famous and strong. But Naaman had a problem; he had a then incurable disease called leprosy. Through the SERVANT of his wife, Naaman heard that there was a PROPHET in Israel (Elisha) who could cure him.

If you were Naaman, being the rich and famous army leader that you are, would you even listen to the advice of a mere servant and prophet?

Or let’s make it more modern. Imagine you were a CEO of your own company and your company is about to go bankrupt. Then a janitor of your company comes up to you to tell you that he knows someone who can help you regain your company’s status. Would you even spare a minute to listen to his advice? Would you bend downwards to at least try and see if his advice would really help you ascend back to where you were?

Jordan River

Had Naaman not listened to the advice of his “lowly” servant, he would not have immersed himself in the seemingly dirty waters of the Jordan river seven times. He hoped for healing but it was presented to him in the most unusual of ways. Had he not swallowed his pride and bent downwards to heed the advice of the servant and the prophet (who in perhaps almost every aspect was lower than him in position and wealth), he would not have received healing. He even gave God honour for healing him. He knew that God was the only god who should be worshipped.

Now, think about it. How many times have we rejected the wisdom of those a little lower than us just because we think we are of higher status than they are? Have we even bothered to listen? Naaman was humble enough to bend down and be healed.

Matthew 23 12

  • Mark Zuckerberg

In today’s modern times, we perhaps know the person who created Facebook. Mark Zuckerberg, at a young age, has earned himself a huge company that generated jobs and enabled us to restore connections with our old friends and helped us create new ones.

He once said, “I feel that the best companies are started not because the founder wanted a company but because the founder wanted to change the world…”

Sure he is some big shot who now owns a multibillion dollar company but if we are to examine his lifestyle and his philosophies, we will be amazed at the humility of this man. He would meet with religious leaders and people in the community not to give them a sermon, but to listen to them. One of those who had an encounter with him even claimed that he talked 10% of the time, and the rest of the 90% he spent on listening to them. A modern Naaman perhaps?

Mark Zuckerberg

He even wears the same style of clothing every day. When asked why, this was his answer: “I really want to clear my life so that I have to make as few decisions as possible about anything except how to best serve this community… I feel like I’m not doing my job if I spend any of my energy on things that are silly or frivolous about my life, so that way I can dedicate all of my energy towards just building the best products and services,” he added. It is in being humble that made him stand out among the world’s influential. He not only bent down. He listened while bent. And that made him ascend!

Romans 12:3, “For by the grace given me I say to every one of you: Do not think of yourself more highly than you ought, but rather think of yourself with sober judgment, in accordance with the faith God has distributed to each of you.”

  • Personal Encounters

Perhaps my best example of humility is my father. He has always put our own needs above his own. Whenever I am confined in the hospital, he would stay awake at night to watch over me that even in the wee hours of the night when his eyes fail him, the slightest movement from me would wake him and he would stand to check if I am okay.

Then, I remember a friend of Papa’s working as an OFW who gifted my Papa 4 pcs of branded shirts. He would simply choose one to keep for himself, one which he liked most and he would give the remaining 3 to whoever he thinks needs it more, usually my lolo’s workers. One time my lolo bought him a cellphone. He didn’t want to receive that big of a favor from his own dad, he refused it. Then my lolo bought us a television set. He also refused it and gave it to his sister. And that left me with no reason to rebel for his overprotectiveness towards his only child, me.

And I would imagine God in my Papa. He is that concrete example of humility and I will always thank God for a very selfless father like him. His humble demeanor I have always sought to emulate. And to me, he stands out because he treats others better than himself.

Lesson on Humility

BEND SIDEWAYS: RESILIENCE

Resilience

  • Esther (Esther 1-4)

Esther was a fair young Jewish lady who was faced with the uncertainties of life early on. Her parents had died. She was raised by a male relative, Mordecai. So essentially, she did not have a woman in her life as she was growing. She was also a Jewish captive. The challenges she faced at such a young age has allowed her to be resilient, ever ready to face far greater problems ahead. Perhaps her difficult life as a young lad must have prepared her for the royalty, and even helping her to be strong enough to be putting her life at stake to intercede for her people. She was able to rise to the occasion strong and ever more steadfast in her faith in the Lord simply because she stayed resilient.

Queen Esther

  • Abraham Lincoln

Lincoln suffered from horrible losses while he was taking responsibility for the Civil War. His generals failed him. And it did not stop there. His 11 year old son died, triggering events that deprived him of much support from his wife, who instead demanded that he direct his personal resources to helping her get through the pain and distress, when he must have had few resources to spare. He also suffered from severe depression. Still, he continued to make effective and responsible decisions. He exemplified an important aspect of resilience: we are not ruled by our moods and emotions. We can let ourselves be aware of them yet still know that they are not the arbiters of reality and we are not enslaved by them. His resiliency in trying times has set for us an example that as long as we bend sideways and keep ourselves rooted in our values and beliefs, we will rise to reach our own pinnacle, like Abraham Lincoln who served his country well as President.

Abraham Lincoln

  • Personal Encounters

I’ve had my fair share of bending sideways too. To have started medical school miles away from home for the first time in my life was a struggle in and of itself. First year medical school happened. Finding healthy food was hard. Getting good grades was harder. But living miles away from home was the hardest. I also happened to start medical school when we were a little bit financially unstable. But you know, if you persist and persevere and trust that the Lord will provide, He will send you the help that you need just at the right time when you need it most.

UERM

He sent a classmate’s mother who was very generous enough to pay in full my first semester of 2nd year medicine, when I lost my full scholarship. By this time, my parents had enough time to financially prepare for the next few years ahead of my med school. Before I knew it, I was already marching down the aisle up to my graduation as a medical doctor. And up to this day, I could not believe that I have actually graduated while all those years doubting whether I would actually really finish this race. I have even prepared my heart for perhaps the greatest disappointment in my life. But no. God saw me through. I am a living proof that when you bend sideways, when you stay resilient in the Lord, He will finish what He has started in you. He will definitely see you through until the end just like He promised because He is able.

Lesson on Resilience


BEND UPWARDS: ASPIRATION

Aspiration

  • Barnabas (Acts 11:21-26)

“And the hand of the Lord was with them, and a great number who believed turned to the Lord. The report of this came to the ears of the church in Jerusalem, and they sent Barnabas to Antioch. When he came and saw the grace of God, he was glad, and he exhorted them all to remain faithful to the Lord with steadfast purpose, for he was a good man, full of the Holy Spirit and of faith. And a great many people were added to the Lord. So Barnabas went to Tarsus to look for Saul, and when he had found him, he brought him to Antioch. For a whole year they met with the church and taught a great many people. And in Antioch the disciples were first called Christians.” Acts 11:21-26

Barnabas was known as the “son of encouragement” because he was constantly encouraging those around him. As the apostles worked to spread the good news and grow the church, Barnabas played a large role in encouraging and connecting people, aspiring for the church to grow. He put his reputation on the line to encourage the apostles to accept Paul after his conversion. He mentored the young apostles when others didn’t want to give them a second chance.

Barnabas

Barnabas aspired for the church. Like a bamboo shoot growing upwards towards the Sun, he kept his ardent aspirations for the church to grow by encouraging others and dedicating his life to teach and preach about God, that despite the fact that others may not accept his teachings, he persevered and befriended them, gaining them back to God.

God will use others to encourage us as well as using us to encourage others. We should always be aspiring and looking for ways we can bless someone with our words or actions. It involves bending upwards to seek for help as we aspire to touch lives. In turn, we can be thankful when God uses someone to say or do something kind or helpful to encourage our hearts. There is great power in encouraging each other.

  • Steve Jobs

Steve Jobs was born to a college undergraduate who put him up for adoption. The first disappointment in his life was perhaps when the couple who promised to adopt him gave him up because they wanted to adopt a girl. His mother had high hopes for him, putting him up for adoption only to parents who were college graduates and were willing to send him to college. But then again, a midnight call gave his mother hope, and he was adopted by the less-than-expected undergraduate middle-class working parents. They did promise to send him to college, so his mother consented that he be adopted by this couple.

His life wasn’t smooth sailing. Until his school age, Steve Jobs struggled. From his early days in elementary school, he grew frustrated with formal schooling as his mother had already taught him early. In college, he decided to drop out after just one semester, thinking his middle class parents’ money ought not to be put to waste to be spent for his expensive tuition. He did continue listening and attending in some of his classes. He dropped IN in the classes that interested him, without a fee in the same school he dropped out of. So to make ends meet, he slept on friend’s dorm rooms, he returned coke bottles for the 5 cents deposits to buy himself food. This allowed him to focus on learning the things he deemed essential for him to reach for his aspirations. He was bending upwards, mentoring those who worked with him.

Steve Jobs

Not finishing his education didn’t stop him from becoming CEO of Apple, one of the world’s most innovative technological companies. Starting in his garage, the first apple computer was born. However, it was not without any struggle as well, as with the other aspects in his life. He was initially kicked out of Apple, his own company. But that did not stop him from innovating and aspiring. He later created another company that, a few years later, saved Apple from bankruptcy. He simply aspired and did not for a second think about giving up despite his pitfalls.

Jobs preached that “You can’t connect the dots looking forward. You can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future… Jobs bent upwards with his aspirations and that led him to ascend.

  • Personal Encounters

I’ve bent downwards, sideways and upwards to somehow get to where I am now. It wasn’t an easy path, and I’m sure you’ve bent yourselves in many ways than I can ever imagine. There were days when I’d cry myself to sleep because I failed in an exam while my parents and grandparents are making ends meet at home, struggling financially, and I am nowhere near them at all to assure them that I am doing my bestest best to repay their hardwork and sacrifices for me. Their ceaseless encouragements kept me going up until now. There were days when they’d call me to ask if I still have money, and even though I only have 50 pesos left to spend for the month, I would tell them I still have enough to last me the month because I understood how hard it is for them to acquire money to get me through Med School.

i

There were nights when the only comfort I found was in the floor just beside my bed where I would bend down to pray. There were months when I would bend sideways to cheer my patients on with a whispered prayer to lift their spirits and it would break my heart to see them suffering and all I could do for them was pray. There were hours when I would bend upwards, hopeful for the victories that are ahead, when I would look up to rest my head, for days when I have done what I could and all that’s left to do is to trust God to finish what He has started in me.

Lesson on Aspiration


Deuteronomy 28:13

“The Lord will make you the HEAD, not the tail. If you pay attention to the commands of the Lord your God that I give you this day and carefully follow them, you will always be at the TOP, never at the bottom.”

Bend to Ascend 2

Disclaimer: Some photos and phrases were sourced from the internet. We do not intend to take credit for the hard work of those who published these but we thank them for giving us enough resources for our ministry. God bless!

#tandemd

As Pilgrims · Life Rx · Sabbath Joys

Frozen

The cold December breeze fills the air and what better word to associate it with than this –

Frozen 2

Now, perhaps the Disney movie crossed your mind before anything else when you read the word “Frozen”.  We remember our cousins singing the movie’s songs at the top of their lungs almost every day for about a month, as far as we could remember. They especially loved the songs from this movie. But we go beyond the frozen movie and understand the word in a different context.

Here’s a trivia first. We’d like to see who believes the word FROZEN appears in the Bible (NIV and KJV)? If it does, then how many times? Go ahead, take your guess and see if you guessed it right in the next paragraph.


To answer you, we did our own research. Thanks to digital copies of the Bible today, searching for a word in the Bible is made easier!

The word actually appeared twice in NIV in Job 37:10 and 38:30 and once in KJV, in Job 38:30. In total, only 2 verses.

1. Job 37:10 (NIV) “The breath of God produces ice, and the broad waters become FROZEN.” and in

2. Job 38:30 (KJV) “The waters are hid as with a stone, and the face of the deep is FROZEN.”

This tells us that the frozen concept appeared even in the Biblical times!


Now, there was a very, very rich and greedy yet sickly old man who spent most of his money and time finding a way to immortalize himself. He was suffering from an incurable disease at present. Greedy as he is, immortality to him was the answer to keeping his riches all to himself beyond his supposed “lifetime”. To him, beating death was never beyond what his money can’t buy. And there was one particular method being extensively researched which he thought was the answer – cryonics. This method was meant to keep his body FROZEN to an indefinite time in the future. However, his waking up in the future depended on whether advances in technology will learn how to bring back life to his FROZEN body and hopefully, the cure to his disease would have been found- an ambitious and impossible quest isn’t it?

Cryonics

Cryonics in medicine is being used in the operating room mainly to preserve a particular organ’s function during an operation like a transplant yet this was never meant to freeze man to immortality. This rich mortal’s quest simply cannot be. However, there is one thing we’d like for us to learn from this man. Even while he was still alive, he lived the last few months of his life as if he was already frozen. His greedy heart, though slowly failing by the minute, was undeniably already freezing cold towards his wife, his friends and to everyone around him. His selfishness somehow froze the life out of him. Terrible isn’t it? Freezingly FROZEN!


Now you may wonder, why talk about being frozen when we’re already suffering from global warming? Well, it seems to us that though global warming is happening, people are getting colder, like the rich yet cold man we knew. It’s pretty ironic that this global warming resulted from cumulative efforts of FROZEN people.

Global Warming under Frozen Hands

Looking back at history, as far as the 1920s or even way before that, we seem to have embraced much of this frozen concept. Throughout our existence, we’ve found a way to freeze things to prolong their usability. Much of today comes in frozen packages. Fresh frozen plasma, frozen chicken, frozen veggies, even frozen body parts ready for transplant! (or frozen bank accounts perhaps? haha)

Frozen Goods

We are in the age of FROZEN goods – goods kept frozen in the hope that their value might last a little while longer than they’d normally be when not. For most of us, freezing somehow proved to serve its purpose quite well.

But much more than frozen goods are frozen words, frozen characters and even frozen relationships. Just how much of this frozen age are we embracing in our lives?

Frozen words, when we keep speaking of them, become our character (frozen character at that). With a frozen character, we become frozen to the needs of others and start entering frozen relationships. All too freezingly cold isn’t it?


 Frozen words

What do we make of frozen words? How does it affect others? It breaks people rather than build them. It hurts their self-esteem.

“The words of a gossip are like choice morsel; they go down to a man’s inmost parts.” Proverbs 26:22 

“A gentle answer turns away wrath, but a harsh word stirs up anger.” Proverbs 15:1 


Frozen character

It freezes. It ceases to grow. It becomes cold, indifferent to the needs of others. It is selfish. It is nothing close to empathetic. It demands. It destroys.

Ezekiel 32:2 like the pharaoh “You are like a lion among the nations; you are like a monster in the seas thrashing about in your streams, churning the water with your feet and muddying the streams.”

Many who profess to be Christians become excited over worldly enterprises, and their interest is awakened for new and exciting amusements, while they are cold-hearted, and appear as if frozen, in the cause of God. {1TT 231.3}


Frozen relationships

Proverbs 25:18 “Like a club or a sword or a sharp arrow is the man who gives false testimony against his neighbor.”

Let not our relationships be buried in the face of the deep as in Job 38:30 (KJV) “The waters are hid as with a stone, and the face of the deep is FROZEN.”


Now, imagine an ice sculpture. Have you ever noticed how fragile that frozen sculpture is?

Now imagine yourself to be like that of an ice sculpture. What happens when you remain in a frozen state? Medically, our bodies work optimally only at certain temperatures. Anything below freezing point at a longer duration of exposure, our bodily functions start to gradually cease. In freezing conditions, our bodies try to shunt blood into the vital organs – our brains, our hearts and our lungs. Less blood goes into our skin and what happens is that our extremities start to become cold, then becoming necrotic. Eventually, this becomes gangrenous. It’s like getting a frost bite in a generalized sense.

At some point in your life, or maybe even now, you must have been or must be FROZEN! We admittedly have been a little frozen for awhile. But how do we defrost ourselves? Or unfreeze our frozen hearts?

Learn about how we defrosted ourselves in our next part.

God bless everyone and thanks for stopping by!

Stay #TandeMD with God to keep from being frozen – that’s definitely one of the ways to defrost ourselves! But there’s more in the next FROZEN article so keep posted!

(And by the way, your computer screen’s not broken so don’t worry, it’s just snow flakes falling – to give you that frozen feeling! 😉 Enjoy!)

With much warmth and love,

Ardys and Jerald

Copyrighted

© TandeMD