Hope · Life Rx · TandeMD

My Journey: Further and Higher

(Delivered at Taal Vista Hotel during the First Annual Adventist Medical Evangelist Network – Philippines Conference, June 10, 2018)

They say that a journey begins with a single step. But in my case, I believe that my journey began before I even took my first step. My journey started with God. Let me quote Jeremiah 1: 5 to clarify my point. “Before I formed you in the womb I knew you; before you were born I sanctified you; I ordained you a prophet to the nations.”

I hope I am not that too ambitious to claim that text as ascribed to Jeremiah. But I hope that when you listen to my story, I might convince you that it could be well applied to this lowly colleague of yours, as I believe that this text also applies to all of you.

Let me begin my simple story in line with our theme, “further and higher.” In our personal and spiritual journey, how far is further, and how high is higher? Considering our humanness, limitations, incapacities, incapabilities, and worst, our sinful human nature, how can we even think of proceeding a step toward that mark? That would be too ambitious, if not impossible. But before we get discouraged, let me bring you to an example of a journey- low, low behind, and far, far behind.

I was born third of us 4 siblings. Low, low behind our family’s humble past, we had meager funds for our expenses. Although my father was a public teacher, and my mother a midwife, it was not easy for them to provide us 4 siblings of our needs. But far, far behind us, we felt that the Lord was already leading us into a higher level of growth, further into a brighter future.

After graduating from my elementary education in my homeplace in Masbate, I followed suit to East Visayan Academy in Cebu for my high school education, after my two older sisters. Challenges became bigger, but somehow the Lord provided me with enough strength to hurdle those tests and grew better and stronger, but more dependent to God.

Off I went to Mountain View College in Mindanao to take up nursing. Of course, my personal mountains became bigger and steeper, paths rougher and bumpier, seas stormier and wilder, and I felt smaller and weaker. Sometimes, I felt that gloomy days seemed longer, and happy days seemed shorter. That was during those transitional days.

But in that mountain, I get to know God closer and deeper. There, God made me get acquainted with my self better- weak, inadequate, unready and unprepared to confront the sinfulness of the world. There I found that my real strength is outside of myself- It’s found in Jesus Himself, and the only way to have that strength is to welcome Him in my heart, which I did with all faith.

God’s gift of making me top the nursing board on 2011 was a major point in my life. My heart was swelling with joy and gratitude to the Lord for giving me more than desired, and covenanted with him where to pursue my medical training. That’s why I went to UERM.

Yes, with honest modesty, I felt good in achieving high academic honors since my elementary years until my college years. I thank my parents for that. But I found out later that unless God would let me receive those awards and accolades, I would not have those. Therefore, I concluded that these achievements are His ways to prepare me to do something worthwhile and special for Him- in a different capacity and level from the traditional ways that we normally know. Let me proceed further to emphasize this point.

It was already my childhood dream to become a doctor. And in my childhood innocence, or maybe some childish thoughts, I just want to be different from my other relatives and siblings- and be the first physician in the family. And I am glad that God worked on me even in that immature mind that I had. And now, I am a medical doctor.

Let me orate to you a poem composed by me and my girlfriend who is also a medical doctor who knows this medical journey by heart and by soul.

The Covenant Fulfilled

It started with a prayer from his childhood dream,
Commenced by a late application which he sent to UERM
And by God’s intervention the journey started unfolding,
The poor little boy was granted full scholarship for studying.

Burdening his heart were everybody’s expectations,
Obliging him to top the board, exams without objections;
He carried these all his own thinking he’ll be alright,
But he later realized that God was his partner in this plight.

In class, as an Adventist, he belonged to the minority,
With a day less to study, was disadvantaged, thought by the majority;
But he knew better than that, that he was not disadvantaged,
For great is his God, and having His wisdom, that was his advantage.

Asking for help from a classmate for Biochem laboratory,
That classmate turned his back, and said, sorry, for my group only;
His heart was broken but his will God had strengthened,
With his faith unwavering, He stood firm and was determined.

He busied himself not only with academics,
But also shared the gospel even with the atheists and agnostics;
He taught the discipline of prayer to his unspiritual roommate,
And invited to the church his distraught and troubled classmate.

God sent an anatomy student for him to mold,
And blessings from Him came back a millionfold
Her grade from 69, it rose up to the line of eighty,
And an unexpected reward came back worth a semester’s fee.

From doing all these he shared his time,
He learned from them a love so sublime
And more than teaching others, he was also taught,
That God is faithful and true, so His presence he sought.

The five grueling years of education finally came to a close,
And he ultimately faced the challenge that mattered the most.
He partnered with his God in every step of the way,
In every answer which he shaded, God had a say.

The board exam result was released, and God’s power was manifested,
With a mere 0.17 percentage, God put him in the lead,
Ladies and gentlemen, if it isn’t so obvious I am this lowly lad,
Relating to you all the journey I have just had.

Through the prayers of His people for my colleagues and me,
God granted His people this most assured victory!

When I passed and topped the medical exam board, and was interviewed left and right, I remembered that college realization I had- God is bringing me to this level because He has some job for me to do in this world’s stage. And the more I think about it, the more I shrink in humility because what I have now and where I am, is never ever because of me, nor because of my ability, nor because of what I have and nor because of my genes- it’s all because of Him. The farther and higher I get into, it’s because I am under His divine wings bringing me higher and higher and farther and farther into success which I have hardly known and expected.

This is confirmed by the stories of Joseph- the governor of Egypt during the regime’s golden years; of Daniel- Babylon’s governor, too, during it’s glorious days; of David and Solomon- making Israel a great kingdom during their times; and a lot more. Today, we also have our modern lay ministers in higher and extensive capacities- Ambassador Tejano, Major Espinedo, chaplains in the US Senate, government leaders in Papua New Guinea, and many more.

Contrary to my dream and expectations, being in the limelight is a challenge itself for me and I don’t know how to handle the situation without my God, without the support and guidance of my family and loved ones, and of course prayers of the entire church community. As there was a fourth person in the burning furnace, a companion of Daniel who shut the lions’ mouths, an Angel who was with Gideon in his victory, I believe that my God is my companion in all my undertakings from here and beyond.

With my few yeas of knowing, experiencing and sharing God within my sphere of influence, I have learned several countless lessons in life. I learned not to strive for recognition in this world. The Lord taught me to strive for significance in His vineyard. God impressed in me that topping the board exams is not an obligation; it is a gift from Him. I have also learned that true success is being who God wants us to be, doing what God wants me to do and finally hearing Him say “well done good and faithful servant”. Because for me, excellence is living out the best that I can offer according to the talents, skills and mental capacities that God has gifted us with and making it our way of life. Excellence is not only found in the result of the board exams. It is the result found in the lives of the people whom we have touched and changed for the better.

As your ordinary colleague in the medical field and in the medical missionary work, Joshua 1: 9 is my armor in my spiritual and professional journey going further and higher for the Lord. “Have I not commanded you? Be strong and of good courage; do not be afraid, nor be dismayed, for the Lord your God is with you wherever you go.” Let this be your strength, too, as you journey with me further and higher for the Lord. God bless us all.

#amensdaphilippines

Advertisements
Hope · Life Rx · Med2Love · TandeMD

A Message We’ll Never Forget & Always Remember

So we just heard a very inspiring message from our consultant in UERM and we, with Dr. Locnen’s permission, wanted our fellow physicians to also find inspiration in her message. This was given during the Testimonial Dinner for the New Board Passers last 02 May 2018. It was so inspiring that we can’t help but share this to you here, just so we’d have something to read again when we get fed up with life.

Each time we read this, we are always left with wet eyes and matted eyelashes but altogether feeling comforted, inspired and ready to take on a few more challenges when we go on duty. Read this when you feel down or lost or just simply worn out from the daily grind.Read on and be blessed, Doc!

(But if you’re not a doctor, this will still inspire you! Or at least you get a glimpse of how it is if you’re aspiring to be one someday. Or if you know someone, at least you could understand them better.)

(Emphasis by #tandemd)


Vice Chairman Young, Dean Uy, Secretary Quinones, ,VPAA Dr Aligui, SVP Carmelita Valdez, VP fro Treasury Ms Iris Militar, VP for Research Dr Nailes, my fellow teachers, my mentors, beloved staff of UERM and to the newest physicians in the room, who in all likelihood are also the happiest people in Cubao at the moment, a very good and warm summer evening to all of you.

To say I was surprised with the invitation to speak before you on this wondrous occasion is an understatement. After the initial emotion was the realization that I am indeed getting old. Wala na rin po kasing kumukuha sa akin mag ninang sa binyag. Puro na lang kasal…..But in truth, I am equally honored and horrified beyond words to be on this podium. I have spoken before graduating residents and fellows previously, so some of the things I will say are similar to what I told them. In spite of that fact, I felt that I have been unusually preoccupied the past days about this task primarily because during my graduation/testimonial ceremonies, the inspirational speakers were always individuals whose resumes were kilometric, whose wisdom were deemed unparalleled and whose characters were of solid repute. And also a bit older than I am. How would I measure up to that? How does one become inspirational? I think the best way for me to earn my keep this evening is to look back.

One September night in 1996, my best friend and I learned that the results of our Physician’s licensure exam will be coming out the following day. Unlike the present, we had to wait for a month to learn about the outcome of the boards. So, just before midnight, we drove to the Manila Bulletin Newspaper Offices in Intramuros, to get a copy of the paper hot off the press. As soon as we entered what seemed to be then a cavernous and imposing building, a security guard, who was standing at a corner with a pile of newly printed newspapers, asked us, in a bored monotone: “Board exam? 10 Pesos” and handed us a copy. We proceeded to nervously look for our names and began shrieking like high school girls when we saw that we made it. I can still vividly remember the feeling of joy and relief, the same way you are feeling right now. Finally, I am done after 5 years of grueling work. Or so, I naively thought.

Afterwards, as some of you might do, I moonlighted as a general practitioner while I studied for the USMLE. I went on duty in a small lying in clinic where I delivered babies and knew I could never be an obstetrician, sutured wounds and discovered I did not have a surgeon’s hands, did circumcision and looked at various medical cases. And during those times, I brought around my books for reference in case I would not know what to do. Walang internet, UpToDate or You Tube. I even taught chemistry to nursing students for one semester in the Philippine Women’s University. After passing the USMLE, I got letters for interviews in some US hospitals but as I was lining up to apply for a visa at the embassy, I received a message in my “Pocketbell beeper” (Yes, there was a time when we did not have ready access to a telephone) that I got accepted to UERM’s Internal Medicine Program. At that crossroad in my life, I made a split second decision to stay in the Philippines and pursue residency and fellowship here. What followed were several years of rigorous training — sleepless duty nights, endless preparation for conferences, specialty board exams, missed family reunions and Christmas or New year Eves in hospitals. This will also likely be your life for the next years. Do not be worried. For even if the road will be full of challenges, the joy and fulfillment of being a doctor will easily eclipse the hardship. During all these years, I have certain practices that I endeavor to remember. I may not succeed all the time but I try my hardest. I share them with you tonight.

One is to always strive for excellence.

Pour your heart and mind into everything that you do in work and in your personal life. When seeing patients, exhaustively look for answers to their problems. Ask for help when you need it but develop critical thinking. Challenge your peers and mentors when you have a different opinion. Just be certain that you do it respectfully and that your opinion is based on facts. Fake news are quite abundant these days. Developing excellence needs focus and attention to detail. Oftentimes, when I go on rounds with trainees, one or two of them would be looking down on their phones while I talk to the patient. The beauty of the digital world is that information can be easily handed but it sometimes removes us from pertinent human interaction. You learn a lot by observation. I remember a mentor telling me once that “diseases do not read books”. Ordinary illnesses may present differently and serious illnesses may seem initially mundane. So beyond reading, you have to hone your powers of observation. I remember as a CCU fellow, after consultants have done their rounds for the day, I would sit inside my patients’ cubicles and observe them quietly. I would just stare at the rise and fall of the chest, the steady or changing rhythm of the heart in the monitor, feel the strength of their pulse and collect a lot more tidbits of information that make the whole. During those brief yet important moments, it was just me and my patient.

Secondly, persist beyond adversity.

You will commit mistakes. That is a hard, cold fact because you are human. Show me a doctor who tells otherwise and I will tell you that he has not seen enough. What is vital is that you learn from your mistakes and you do not repeat them. The world of medicine can be seemingly cruel to those who occupy it. You will have mentors who are exacting and may have a small tolerance for mistakes. As a first year resident, I remember being told: “you are giving the right medicine for the wrong disease” in front of the clerks who were under my supervision. My service consultant was asking me whether the heart murmur was diastolic or systolic. I answered incorrectly and as such received a dressing down. Pagkatapos nga po ng rounds, sabi ko sa mga JI’s, pahingi ng tabo babanlawan ko muna ang sabon. I had several of similar encounters during fellowship, when I trained under one of the most demanding mentors I have ever met. But it prodded me to study even harder and take time to talk to and examine patients thoroughly. Honestly, I never developed any ill feelings against those who expected that I give my best. In the contrary, I thank them for having had faith in me even when sometimes, I have stopped believing in myself. I distinctly remember that incident in the medicine ward about that murmur as if it happened yesterday.

Exactly 20 years hence, I stand before you as a cardiologist. Of all the professions, I think medicine equates most to delayed gratification. I know most of you grew up and studied during an era when answers are found in a split second, when you do not need to go to the library for your research, when you can get a ride by a push of a button. Unfortunately or not, medicine isn’t like that because humans are much more complex. It is a test of your patience and resilience. Though your intellect matters a lot, it is your emotional quotient that will sustain you in medicine and mostly in life.

Thirdly, I try to always remind myself to be kind.

People are inherently good and I would like to believe that doctors in general are inherently kind. Patients come to us because of discomfort and pain so they are anxious and afraid. In the face of their suffering, their loved ones may become belligerent and turn to you in anger and frustration. Be patient. Answer questions objectively and in a language they will comprehend. Never, ever engage them in a fight. Walang papatol sa pasyente. There will be times when you would want to answer back but exercise that superhuman effort to keep your patience. When you feel that you do need to defend yourself, do it with class and with quiet strength. And not over social media, please. Stay above that fray. The world still needs kinder people. And kindness should not only be extended to patients. We try to be kind to our fellow doctors, nurses, other hospital staff and even to strangers. Kindness should not be equated with weakness. We can be just and kind at the same time. One of the most important people you have to be kind to is yourself. In a profession where expectations may become unreasonable, you have to get out of the pressure cooker occasionally. Stop and smell the flowers. Recharge. Watch a movie. Go out with friends. Sleep. Rest makes you better physicians and allows you to appreciate the work that you do.

Fourthly, doctors take a front seat in the face of human suffering and human joy.

You will have patients who would seem to recover miraculously and leave you heady with satisfaction but you will also lose a few in the most unexpected of ways and leave you broken hearted. To keep your grace in all of these, learn to laugh and pray. When the timing is appropriate, laughing with our patients brings the relationship to another dimension, something akin to friendship. Learn to laugh at yourself, too. It induces endorphin production. One of the best pieces of advice I received from a senior consultant was to pray for my patients. I do not consider myself very religious but I do ask help from above. It always gives me a sense of peace especially when I have to make very difficult clinical decisions. It emboldens me yet at the same time it humbles me into accepting that we too, are just human, that I could not make patients’ hearts beat forever, no matter how hard I try.

Now before I close, I wish to remind or reassure the honorees of certain truths. One is family is always the priority. When you have to choose, choose family. If you are not on duty, no matter how tempting sleep is, attend family reunions. Just bring a prescription pad. You will for certain conduct a med mission there.

On the practical side of life, I know you are concerned about making a living. For those going into further training, that is a big challenge. Makikitira pa kayo sa mga magulang ninyo.. Kasama sila sa delayed gratification. For those who will go into practice or a different path, I assure you that you will lead a comfortable enough life as long as you do good by your patient. I always tell my mother that I will not go hungry with the amount of food I receive from patients. You see what they are forbidden to eat, they will give you. Now if a fanciful life is something you wish for, you may not be in the right profession because the essence of medicine is truly service. Being a doctor does not entitle you to any privilege, only to a lot of responsibilities and accountabilities. But that can make your life profoundly meaningful.

Remember also where you came from, your old schools and mentors. Knowingly or unknowingly, they helped shape what you are today. And if you have the chance, teach. It will help ensure the future.

On this occasion when most of your sacrifice has come into fruition, I warmly congratulate you, your loved ones and most especially your parents, who if they are not doctors, never had any idea of what they were going into when you chose to go to medical school.

For all my self doubt and imperfection, I must have done something correctly, for you invited me here today. For that, you have my undying gratitude. Know in your hearts that wherever your fortunes may take you, you will always have a home in 67 Aurora Blvd, Brgy Imelda, Quezon City where one of the best medical schools is proudly located.

Go follow your bliss and Godspeed. Thank you.

Sue Ann Locnen, MD


Need we say more?

Just perhaps stay #tandemd with the Lord!

❤️

Ardys & Jerald

Your #tandemdDuoctors

Hope · Life Rx · TandeMD

The Case of the Dreamer’s Dream by Dr. Jerald L. Pelayo

Given during the UERM Testimonial Dinner at Novotel

May 2, 2018

Today is a celebration of the dream for which we were meant to live—a dream that was once but a figment of our imaginations. Today, we will finally #LiveTheDream #UERM2016. We are no longer medical students, clerks or interns but we are already conquerors of the Physician Licensure Examination. I would like to request my dear colleagues to please stand to accept my warmest and most heartfelt congratulations! Ladies and gentlemen, these were my co-warriors who shaded boxes, cried streams of tears, ate tons of food, gained and lost weight, gained and lost boyfriends and girlfriends, but fought the battle with me during the recent board exam. And they all deserve a round of applause. To our school administrators, mentors, teachers, consultants, residents and friends here in UERM who prayed for and with us, thank you! You deserve our utmost gratitude through our warmest round of applause. You have taught us to become 5-star physicians and rest assured that you have taught us well. This victory is also yours!

Last year, I spoke about the SOAP of the UERM 2016 class. Today, please allow me to share “The Case of the Dreamer’s Dream”.

The dreamer is a 20-something year old man from Masbate who once, as a child, looked up at the stars in the provincial night sky dreaming about becoming a doctor someday. He had seen his mother going about the barangay helping mothers deliver their babies. He mistook his midwife mom to be a doctor. And from that emanated the seed of his dream to become like his mom. He pictured himself—just like any other typical grade schooler would—as a doctor wearing a lustrous white coat with a fancy stethoscope harnessed around his neck.

About 2 decades ago, the dreamer, with his backpack, trod to his elementary school in Masbate through the muddy puddles with his drenched black shoes and almost-browned white socks. Rain fell and run down his face, clearing his tear-soaked eyes only to realize he only had slippers. He wished they were shoes though. He went on to take just a few more steps through the 9-km journey down the unpaved road. Halfway through, his teacher saw him walking alone and offered to bring him home because classes were actually suspended due to a storm. That day, he wasn’t only drenched from rainwater but he was soaked with ardor of living the dream.

After a few years, he went to Cebu independent from the care of his parents for his secondary education. In the stillness of the night, a thief broke in and stole all his clothes, (and by all, I mean including his underwear). The next day, he found himself wearing an ill-fitted uniform and shoes, both of which he borrowed from his cousin. He also had to study with just the flicker of an oil-trimmed lamp. The soot filtered by the vibrissae of his nostrils would collect, so he had to make sure to clean them before going to school. However, left in a shock from the incident the night before, he forgot to clean his nose. And he went to school ridiculed for the black soot in his nostrils and his ill-fitted suit. Despite these, he held onto the dream.

He spent his college years in an Adventist institution tucked in the verdant mountains of Bukidnon. He endured a month-long intermittent fever and chills because he refused to miss even one day of school. Only did he succumb to being hospitalized when he felt very ill and could no longer make it to class. Nonetheless, no atypical pneumonia could stop him from reaching for the dream.

Years later, he found himself shading the last number for his NMAT. Who wouldn’t remember the day they took the NMAT, how eager they were like this dreamer, to finally kick start their journey to the white coat? And not long after that, he was applying for medical school. As a late applicant coming from an unknown college in the mountains, he was grateful that he got accepted as a university entrance scholar in UERM. Finally wearing the white uniform of his dreams, he felt jocund at the thought that he can finally commence to live his dream. And even more so when he knew that the school is one of the few medical schools that didn’t hold any classes on Saturday Sabbaths, because he is a Seventh-day Adventist. This was one of his primary considerations when he chose to enroll in UERM. This dreamer was indebted to UERM for all the favors extended to him especially when academic activities fell on a Saturday. Because of this, he hopes to encourage more Adventist dreamers to experience UERM and how she respects freedom of religion.

As a medical student, he remembered going to the biochemistry laboratory for the first time not knowing what to do. He had to ask a classmate (not a groupmate) to teach him because during his college years, biochemistry was removed from the nursing curriculum. However, his classmate, belittling this space-occupying lesion, unidentified foreign object, simply looked at him from head to foot and turned his back on him, exclaiming “I’m sorry. I will only teach my groupmates.” The dreamer’s heart was broken but his dream never flickered even a single second. So he survived the first long exam simply memorizing some mind-boggling concepts without understanding them.

He also remembered sitting down that examination chair as he took the PLE. Several of his classmates had already conquered it ahead of him. He obviously had more time to prepare and great was the burden squatting on his shoulders. Everyone was expecting great things from him. He had no other stronghold but the Lord. He was his constant, his refuge. And the Lord was true to His promise, He never failed this dreamer. It wasn’t an easy a task as walking drenched through muddy puddles in the middle of the storm, or wearing ill fitted suits with black sooted nostrils, or enduring month-long fever and chills.

Ladies and gentlemen, the dreamer stands before you tonight in this podium ever grateful for the lessons that he was taught from the life experiences he gained. It must have been obvious to you from the very beginning that I was the dreamer. And coming to UERM to finish med school and becoming a licensed physician was the dream. More than classroom knowledge, UERM has taught me valuable life lessons that I will carry with me in my practice. And my sentiments of gratitude echo that of the rest of the newly licensed physicians present here tonight. To the UERM community, thank you for training us to be the kind of doctors we are today – with much empathy, skill, attitude, knowledge, competence and compassion.

To my colleagues, you may all have your own experiences and I may not know all of your struggles, but we share one thing in common, we now #LiveTheDream.

So what now?

From the time we held the pencils as we shaded our answers for the NMAT to finally holding the plastic cards with our names and license numbers, we’ve been taught priceless lessons. Our varied exposures in the hospital and community sharpened our vision and enabled us to have that acuity to see the needs of others and to act upon them. We’ve seen life in its beginning and in its end, and the more we witness these, the more fueled our desire is to make a difference.

Allow me to continue with discharge instructions and home medications.

Nurturepressin (instead of Torturepressin)

Bullying can take many forms and can happen irrespective of place and time. Unfortunately, bullying exists even amongst us in the medical profession and the culture is seemingly becoming a norm. The act becomes so customary that it attenuates our ability to recognize its harmful effects.

Dr. L.N. Dyrbye et.al, in her work entitled, Medical Student Distress: Causes, Consequences, and Proposed Solutions, mentioned student abuse as one of the many sources of stress and burnout among medical students especially those in their clinical years. Verbal abuse, in particular, profoundly affects students’ confidence and renders the learning milieu non-conducive. This adversely affects patient care, erodes mental health, and leads to depression, so to speak. But the gravest endpoint of all is suicide.

It’s ironic how much we try to save our patients’ lives and yet we turn a blind eye to the ordeal of those whom we share our calling with. This profession is too noble to be regarded as a mere platform for competition. So let us be catalysts by changing this bullying culture. Let us cut through the vicious cycle and replace torture with nurture.

Influencezosin (instead of Eloquencezosin)

The famous expression, “Do as I say, not as I do” is pretty much the motto of many health professionals—physicians included. The statement reveals the reality that humans are subject to err and thus shouldn’t be the basis of another person’s practices. But whether we like it or not, our patients look up to us and they associate us with healthy living. But it’s also a fact that many practicing physicians have indulged themselves into intemperate ways of life and have suffered the consequences brought about by various lifestyle-related diseases and even death. This kind of practice clearly misrepresents the profession we are bound to uphold. Our patients now are as keener as ever and our actions and practices pass under their scrutiny from which they also pattern their lifestyle. I think we need to be more responsible of taking good care not only of our patients’ health, but our health as well. It’s high time that we “walk the talk”. Seek to influence not by words but by actions.

Healazole (instead of Hurryzole)

Man is a composite of both physical and nonphysical elements. His physical entity makes him a tangible being subject to sickness and decay, while his nonphysical entity makes him a spiritual and rational being subject to evil and distortion. A person is beyond what our senses can perceive. With all of man’s complexities, a lifetime is not even enough to understand him. Hence to offer healing to a sick soul by talking to him for a few minutes would only give us but a glimpse of his true suffering. We must seek to heal the person instead of hurrying to our own appointments and neglecting to properly evaluate our patients and their needs. Quality still weighs greater than quantity.

But more importantly, before we are able to heal, we must seek healing from Him whose streams of mercy and life floweth freely and ever so abundantly. We cannot heal others until we seek to heal ourselves.

Hence, I leave you with this question:

Beyond the dream of wearing a white coat, what else do we #LiveTheDream for?

While you may dream, dream bigger dreams

And seek to live it, building streams

Of influence, healing and nurturing

To live the purpose of the white coats we are wearing

To our dear UERM mentors,

This glorious victory is for you

Your years of labor for us, now bid adieu

Gracias from the deepest recesses of our ventricles and atria

We’ll follow your footsteps, Pro Deo Et Patria!

To my classmates,

We’ll soon part ways to find our niche

And in our practice, extend our reach

I’ll surely miss our yesteryears

But let’s find joy despite our tears

Great are the tasks and challenges that lie ahead

We’ll sometimes be enfeebled and defeated

But in God’s guiding hands we must have confidence

For higher is His calling and greater is His providence!

Thank you!

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

 

#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