Finally, licensed to heal!

Our PLE journey was very different from what most doctors encountered. Ours was in a time of crisis that brought another whole new level of ordeal. They say you have all the time to focus and prepare for the examination but maintaining our mental health state was another thing to take into account knowing that year 2020’s cataclysmic events in slow motion have disrupted thousands of people’s lives and disseminated a sense of uncertainty. Some of us were blessed to have good health and intact family but some had to deal with grief for the loss of their loved ones, the loss of family’s work, the loss of their home stricken by the typhoon. It was not easy. Certainly, there were “highs” of excitement and the enjoyment of learning. Things will start to make sense as you connect one concept to the other. But there were also “lows” of frustration with your pace, feelings of inadequacy, and unpreparedness. There were more of those the-more-you-know-the-more-you-don’t-know moments. But in spite of it, I am proud to have witnessed my batchmates’ PLE success. What great joy it is to see one rise up from the ashes.

In emphasis, my PLE success story was more of God’s faithfulness and the unbending support of my family and friends that played a crucial part in my journey. Because of them, I never allowed those down moments to define me. My family most especially Papa and Mama was my pure motivation to persevere and cross the finish line. They were the picture (second would be my crush JK) that I always put in my head when I am having those “bad moments”.

To my parents, thank you for your unyielding support and unconditional love. I am now a licensed physician and I wouldn’t be where I am right now if it weren’t for you both. To my sisters, my brother-in-laws, nephews, relatives, and friends! This is also for you guys. How blessed I am to have numerous people to count on. Thank you for taking the time to encourage, motivate, comfort, and help me in this medical journey. Thank you for spoiling me with your love and care.

To my mentors and CIM community, thank you for imparting to us all the knowledge you possessed to aid us and to prepare us for the board examination. As the days went by, we never felt alone nor neglected with your continuous support.

Most of us studied 15-20? hours per day (question mark because hahahaha I don’t study that long and the hours are varied) just to cover all 12 subjects. Despite all those efforts to prepare for the big battle, it did not seem enough. But I rested on the promises of God and that gave me hope during those moments. I am certain that He did not accompany me all those years of struggle in medical school for nothing. I held on to His every promise, and that the only thing I needed was to have faith in Him. Let go and let Him do His wondrous works.

Indeed, God is faithful for granting the deepest desires of my heart to become licensed to heal. He is the God of covenant and of faithful promises. And that time and time again He has proven that He who began a good work in me will bring it into completion. With conviction, there is no such thing as a lucky red ribbon empanada, red underwear/clothing, lucky pencils nor charms. No superstitions nor rituals will help us pass the exams. It was the amazing grace of God. I just brought with me my faith and grit- the most powerful weapon you must bring in the testing site.

Congratulations to the newly licensed doctors for this milestone! After years of sleepless nights, all the high-pressure exams, all the missed birthday parties, and weddings, anniversaries, and reunions, the hard work we endured have all come down to this single moment, and it seemed like we simply could not contain it. Continue to cherish and give time to your family and loved ones. Continue to live with purpose, stay humble, and don’t forget the true reason why we chose this path- to become physicians with a heart.

Fifth year a.k.a Postgraduate Internship

You survived senior clerkship! (4th year)

Congratulations! You’ve graduated and earned your Diploma. You now bear the title of a doctor.

…and yay, you still have a loooong way to go!

The 5th year of Medicine is the Post-Graduate Internship year, as most Philippine Medical schools give their diplomas at the end of the 4th year. This is the year you’re no longer a student per se. You will become the Post-Graduate Intern, the “apprentice doctor”.

This is the year you will rotate one last time in all the different fields of medicine – you will be a surgeon, internist, a pediatrician, an obstetrician-gynecologist and a community doctor.

A GLIMPSE OF PGI LIFE:

Every postgraduate interns’ responsibility: Updating the Census

Updating the census means doing patient rounds during and before shift ends

Obligatory picture in the operating room 😂

Milestone: Performing a Spinal Anesthesia Block

My favorite day of the week is having to wear a comfortable pair of sneakers

From clerkship to internship, I have always loved apposing and suturing wounds. I am thankful for our surgical residents for allowing us to suture wounds on our own.

Debunking false ideas about vaccines

“Why are there doctors still encouraging parents to get vaccinated when it can cause harm to our children?”

“My baby died because of the vaccine injected to her.”

“Vaccines can cause autism.”

It has been a while since I remained silent about my thoughts with regards to this current hot issue in the Philippines. I try to ignore the rants of every citizen that happens to be irrational because it’s just giving me another headache. However, I realized that as part of the healthcare team, instead of staying quiet, I will try to do the best of my ability to make people understand what’s vaccine before their minds are polluted by negative opinions of people. Note: these people have no background knowledge with what vaccines do in our bodies, so they can just say things that aren’t even evidence based.

Just recently when I was scrolling in my Facebook feed, there’s this news that caught my attention. It says that a 10-year old girl died due to the dengue vaccine. It’s not a different article that I read a month ago saying that there were 2 kids who died when they were vaccinated with anti-measles.

First of all, why do I find the media over-exaggerating things? It seems like they’ve been spreading lies to thousands of netizens that this vaccine did killed the child. Can they do more research before implying that this vaccine really caused the death of the child?

For everybody’s information, the child died due to her sickness that was triggered by the vaccine. Any vaccine could have triggered her sickness and not only dengvaxia. She had an underlying autoimmune disease that’s called Systemic lupus erythematosus (SLE) where the body’s immune system mistakenly attacks its healthy tissue. The disease is characterized by a variable clinical course with periodic episodes of inflammation and damage to the joints, tendons, other connective tissues, and organs as heart, lungs, blood vessels, brain, kidneys, and skin.

What is a vaccine?

Vaccines are classified into two groups. The first group, live attenuated vaccines, comprises weakened versions of the pathogens; these mimic the kind of protective immunity induced in people who survive live infection. The second group includes inactivated vaccines, subunit vaccines, toxoid vaccines that consist of inactivated toxins, carbohydrate vaccines and conjugate vaccines. (Source: CDC)

How does it work?

Vaccines help develop immunity by imitating an infection. This type of infection, however, does not cause illness, but it does cause the immune system to produce T-lymphocytes and antibodies. Sometimes, after getting a vaccine, the imitation of infection can cause minor symptoms such as fever. Such minor symptoms are normal and should be expected as the body builds immunity. Once the imitation infection goes away, the body is left with a supply of “memory” T-lymphocytes, as well as B-lymphocytes that will remember how to fight that disease in the future.  (Source: CDC)

Why did it cause the child’s death?

The dengvaxia is an attenuated virus to trigger the immune system to produce antibody. Therefore, if the immune system of the patient is weak due to its illness, how can her body make her immune system work to produce antibody when it is being attacked by its own? While most vaccines are effective and safe in SLE patients, in certain cases immunogenicity may be sub-optimal and vaccination can trigger a flare. So, instead of causing good, it posted more harm on the child. Bottom line is, there should have been thorough assessment.

Is vaccination 100% effective?

No, vaccines are never 100% effective. But close. Maybe 95% – 97% – and what that level of efficacy is really doing is building what’s known as herd immunity.

Herd immunity or herd effect, also called community immunity, describes a form of immunity that occurs when the vaccination of a significant portion of a population provides a measure of protection for individuals who have not developed immunity. Herd immunity theory proposes that, in contagious diseases that are transmitted from individual to individual, chains of infection are likely to be disrupted when large numbers of a population are immune or less susceptible to the disease. The greater the proportion of individuals who are resistant, the smaller the probability that a susceptible individual will come into contact with an infectious individual.

Let’s take the smallpox vaccine as an example. It was estimated to be about 95% effective for each individual. Once the majority of people were vaccinated, it became so hard for the virus to find new targets. Viruses can’t survive without infecting something. By denying the virus access to hosts, it died out. Even though the smallpox vaccine was not 100% effective in terms of individual humans, it is 100% effective in practice, because smallpox doesn’t exist anymore.

If a vaccine is close to 100% effectiveness in individuals (let’s say >90%), then 100% effectiveness can be achieved in practice on the large scale through herd immunity.

Does it cause autism?

No. Some people have had concerns that Autism might be linked to the vaccines children receive, but studies have shown that there is no link between receiving vaccines and developing ASD. If you want, you can just google it or visit CDC.

Due to these news about how vaccine can affect children, it has grew concerns about “vaccination hesitancy”. What is “vaccination hesitancy”? Simply put, it as a psychological state where parents are unsure about whether or not to vaccinate their child. Some hesitant parents will fully vaccinate. Others will leave-out or delay certain vaccines. Hesitant parents are different from declining parents who never did or no longer vaccinate at all. Declining parents have often made their decision and are less likely to change.

So, what to do now?

I’m encouraging doctors and nurses to discuss issues of concern about vaccination with parents and carers. By doing this, it will make vaccination decisions more informed and more satisfying for parents. It also move them towards vaccinating; increase parental satisfaction and build trust in health professionals.

Take-Home Messages

• Although the history of vaccination in SLE patients had been controversial, the risk benefit balance is in favor for vaccination to reduce the risk of infection as compared to the risk of flare.
• Educate yourselves. Always do research before posting things online about vaccines because this is an alarming effect for parents and carers.
• As a supporter of vaccination, I want to see children protected with safe and effective vaccines. For the parents, I understand the challenges of raising children. It’s easier said than done.
• I’ll say it again, even if it’s not 100% effective, even if there are mild side effects, I believe that the benefits of preventing diseases through vaccination outweigh the risks.

 

 

Physician with a Heart

Hello, friends.

To describe my week, it has been nothing but very dragging and exhausting. All because of the incoming holidays, my mind can’t keep up with the school responsibilities. I’m always tardy, I nap during lectures, I am forced to go on duty and make my clinical formulation and the worst is, I haven’t been studying the  number of chapters to read because I find it so lengthy and boring. I feel worthless and all the more I feel ineffective because of the rainy weather. I guess my brain is already on vacation mode. Of course, I do feel guilty of not studying but I shouldn’t only be studying just to pass the exam, I should be studying to learn, to help my future patients and become a good doctor.

Because of my deep reflection which happened a while ago, I remembered this certain doctor who had a memorial lecture on our school. I can remember so well his encouraging talk. He said that the path we chose on becoming a doctor is not an easy one and that it is difficult to defy. And on our daily journey as doctors, there will be challenges that are difficult to face and our character will be tested. However, we shouldn’t be worried when facing such challenges because day by day this will sharpen us to be a better version of ourselves. However, I realized that the more I am almost done with medical school, the more I feel so inadequate and that my brain has 0% information. I feel like I have become a monster: so lazy, complacent and undisciplined. Well, not all the time. Haha.

Being a medical student means we are always struggling just to get through the year after the other especially on the never-ending reading and studying that this profession requires. “Cover to cover, over and over.” But I realized that studying will be more hard beyond the four walls of my school, especially when I am left on my own to deal with my patients.

I realized that I should complain less with the number of books to read or study for the upcoming exam because there is a far more difficult test waiting for me in the real world, and if the power of five books is already too much for me to handle, then maybe, I am not fit to face the real challenge.

From the thick medical books to the thinnest of journals and papers. They are there to constantly update us with the new research discoveries, may it be new diseases, new equipment or new procedures. A doctor myself must be equipped with the essential tools as to not cause unnecessary harm on my patients, and by tools, I mean knowledge, updated knowledge.

Medicine has not been and will never be about the grades. It is actually the passion to help and care for others that will be the measure of one’s ability to become a good physician. That passion will be the driving force for every medical student to strive in school, not because he wants to get good grades, but because he wants to learn all aspects of human health in order to deliver the best care he can for his future patients. In that way, we will never get tired studying and reading. Of course, we do get tired but if our thoughts are sync with this idea then no matter how tired we are, we will still be happy and contented at the very end of day.

 

Medical student feels

“The more I read, the more I feel so inadequate. I’m not good enough. I’m not smart enough. Can I still do this for the next years to come?”

Yet despite this internal battle I face daily while learning in medlical school, almost always when the tears just barely begin to well up in my eyes, a feeling of peace overwhelms me. Maybe I’m inadequate. Maybe I’m not good or smart enough and maybe I can’t do this…

BUT..

With my God, nothing is impossible. And with Him, all things are possible. The things that were only asked of me to do is to just take up my cross daily, follow and love Him, which right now, as much as I don’t like some of the things that I am doing- missing important events, staying up late to complete paperworks and read tons of chapters, getting stressed out with clinics, etc., means I need to do my part and try my hardest to learn this material to the best of my ability. All I can ask of myself is my best effort, and God will take care of the rest.

In a world and a life with so much uncertainty and unexpected challenges, I find comfort that my worries are irrational in light of a God that will see me through any and all circumstances and will never abandon me.

And so, I press on, trying to replace my worries with God’s love and grace, which, no matter what happens, will protect and carry me wherever this crazy life should take me.

When a good God allows adversity

Have you experienced the most painful and faith-rattling circumstance in your life? A circumstance that left you anxious, desperate, frustrated and disappointed?

2 years ago, I was struggling in my studies. It made me so down like it hit me rock bottom ’cause I felt like God wasn’t answering my prayers. The struggle was hard to bear and it took me quite a while to accept the things that had happened because never in my entire life did I struggled in my academics (well, not until I studied medicine). The pressure’s really real especially when you are currently studying in the country’s #1 medical school. However, I realized that the Lord taught me to be humble and to rely on Him because I was too proud of a person. The situation also taught me a lesson about the scope of the human’s ability to choose acceptance over denial and faith over fear.

Just this week’s reflection, little did I know that what had happened to me was not as destructive as I thought it would be. I have always thought that my problem was worse than everyone else’s. I was very self centered and only cared about myself. I have not thought about the thousands of people who had experienced worse situations than me, just like Joy Mendoza, whom I knew from her personal blog and book. She was an innocent and beautiful lady of God. She had parents who were very active in church and all out to share the gospel, she lived a happy life but unexpectedly their house was ransacked and she was raped by 10 people in her bathroom and bedroom. Naturally, we always ask the Lord, “Why did this have to happen? I am a good person, I have always followed You, God? I have been a good child meanwhile the bad people are living in relative happiness. Why?” We question God’s goodness and fairness. Sometimes we even doubt His existence. How can an all-good and all-powerful God allow good people to suffer and bad people to prosper? We are tempted to think about these negative things.

But, there were 4 pillars of non-negotiable truth that I just learned that would help us all in turning each adversity into victory shared by Peter Tan-Chi:

GOD IS SOVEREIGN

Psalm 115:3 But our God is in the heavens; He does whatever He pleases.

Our Father in Heaven is omnipotent, omniscient and omnipresent. And with that, He is in full control of everything; that nothing in the universe occurs without God’s permission. He has the power and knowledge to prevent anything He chooses to prevent, so anything that does happen must be allowed by God. Yes, He could have prevented us from any adversities, tragedies and even problems but He allowed it to happen, then we must trust that it is ultimately for our good.

Therefore, the only way to survive is to turn to the Lord, not away from Him. What option do we have? To give in to the despair or would we choose to look at the possibility that divine orchestration was involved? Let’s just cling to the verse Romans 8:28 “And we know that God causes all things to work together for good to those who love God, those who are called according to His purpose.” A sovereign God makes no mistakes. Tragic circumstances are ordained for a reason. While this is difficult to comprehend in the midst of suffering, it doesn’t change the reality that God desires our greatest good.

GOD KNOWS EVERYTHING

1 John 3:20 in whatever our heart condemns us; for God is greater than our heart and knows all things.

Like I said earlier, our God is omniscient. He knows the number of strands in your hair, He has counted and even named each stars in the night sky, He can count every grain of sand and before there is a word on our tongues He knows it all. And because He knows everything, He was not caught by surprise when the adversity stroke. We may never understand His wisdom, but we have to simply trust His will.

GOD LOVES US

Thankfully, I found my hidden container with handful of encouraging notes and verses from my youth camp days inside. Here are some of the verses inside that reminded me of the Lord’s love for us. First, God loves us unconditionally. His everlasting love for us was demonstrated at the cross through His Son, Jesus, when He died for our sins and suffered for our sake. He showed His love through action and not just emotional feelings. James 1:17-18 says “Every good and perfect gift is from above, coming down from the Father of the heavenly lights, who does not change like shifting shadows. He chose to give us birth through the word of truth, that we might be a kind of first fruits of all he created.” He has given you many scriptures that overflow with illustrations of His love, giving us assurance and promise.

God assures you in Psalm 100:5, “For the LORD is good and his love endures forever, his faithfulness continues through all generations.” This verse not only tells us of His goodness and love, but says that it is for us today, generations later. God is faithful through all generations.

GOD IS GOOD

We must firmly believe that God is good ALL THE TIME. Wait, but what about the bad things that just happened to me? Yes, while the bad things may happen to any of us, bad things don’t have to define who we become or whom we choose to be. We can still choose to believe that God has a divine plan. We can still choose to love and forgive. We can still declare God’s victory in our lives to bless others and glorify God.

The reality is all of us go through trials, difficulties and hardships. Some are temporary illnesses, while others are long term, even incurable. When we cannot understand the why, we must look to the Who. So, despite the unimaginably hurtful circumstance that we may have experienced, our relationship with God, strengthened by God’s sovereignty and Word, should shine like a rainbow after a storm.

Always try to turn every adversity into victory. Remember that there’s a purpose why we were given such adversity; that there’s always beautiful surprises that can bloom from painful seeds.

Are you discouraged by circumstances? Are you broken by sin, by tragedy? Are you trap by chains of shame, unforgiveness and bitterness because of the trauma that you experienced in your life? You know what, Jesus can set you free, Jesus can heal you. All it takes is a prayer to surrender everything to him. Your life, that pain, that trauma and He will set you free. It’s only the Lord who can heal us, who’s going to make us precious. He is The One who makes us whole again.

You can pray with me if you like 🙂

Does this mean I will be problem-free from this day forward?  I don’t know. I do not know what trial we may still encounter in our lifetime. But God still affords the same bountiful grace He has supplied. He has given the assurance of His presence with us in times of trouble.

Fasting from Social Media

Going to medical school, in some ways, is like going back to high school with school every day again. It’s a change from the style of learning you’ve become accustomed to. Additionally, you may have more classes at once than you had during college.  However, the amount of information you have to know (and the detail to which you are expected to know it) makes college seem like it was a walk in the park. However, we are encouraged to look for activities that will help reduce stress other than studying and I can’t deny that social media is on top of my list. It’s one of the most effective stress-reducing activities for me. When I’m too tired to function and then try to scroll my feed on Instagram, I become awake and energetic instantaneously. Haha. Amazing how it can also save you from dozing off. But, I didn’t realize that social media was also one of the reasons why I always compare myself and still feel inadequate in my abilities as a friend, sister, classmate, and daughter.

Social media was also one of the reasons why I’m so addicted to beauty products (nothing wrong with trying to look good and feel good) because I love hearing people compliment me especially my eyebrows (Lol! Sanguine problems.), and I hate to admit that it’s the reason why I’m so addicted to online shopping. I always purchase clothes and things thrice a month and wouldn’t mind if I’m carrying an empty wallet. Other than that, I was surprised to know that I can survive eating once or twice a daily for a person who really has a big appetite. All of these things are the work of the enemy. I knew what I did was unhealthy but I still continued doing it.

Thank God for Your neurons

Lord Jesus,

I thank You for my neurons. For my well functioning dendrites and axons.

You created my brain for the purpose of bringing glory to Your name. I do not want my brain to be conformed to the patterns of this world, instead I ask You to enter all areas of my brain that You might give me the ability to process academic and spiritual wisdom from your Holy Spirit.

I believe that you created my inner most being and that my brain is fearfully and wonderfully made by your hand.

Lord I repent of all the times I have not regarded my brain and my learning abilities as a gift from You. I ask you to forgive me for the negative thoughts and words that I have spoken against my own brain and learning abilities.

I repent of trying to solve my learning problems through my own efforts rather than turning to receive your love, grace and healing touch first.

I pray that I will not have a Spirit of fear about learning new things. I accept your gift of the spirit of power, love and self-discipline into my brain.

Give me the Spirit of wisdom and revelation that I might succeed in school and to know You better.

Thank you, Lord, for using me. For choosing me.

Thank you for blessing me with Your bounty. Your favor. Your love.

I feel more peaceful and fulfilled than I ever have in my entire life.

I am learning so much. Growing so much.

You are so good to me, Lord Jesus.

I don’t deserve Your love, Your grace, Your favor nor Your blessing.

Yet, you still love me.

Your little doctor in the making,

Delbeth

I’m going to be like him someday!

 

Dad,

I could start this letter by thanking you for many things but I would like to say first that there are no words to actually describe how much I love you and how thankful I am for your life. I am so blessed to have you as my role model, hero and father.

Thank you papa for providing shelter to cover our heads, food to feed us, things we actually need and for allowing us to have good education. Thank you for loving, leading and guiding us. Thank you also for loving mom because from you, I’ve learned what it means to love your spouse. Thank you for sacrificing for us-waking up in the middle of the night to respond to emergency calls, making rounds, going home late and for always waiting patiently for your seven daughters plus wife to get finish from dressing up every occassion. Even until now, dad, you chraracter amazes me and that’s the reason why I respect and look up to you.

Even though you are a busy man, you still never as in ever fail to give time for us, you ALWAYS give time for us like how you also give time for treating your patients. Papa, I can never fully express my gratitude to you. You will always be the first man I will ever love. I would be completely lost in this world without you and Mama. God knew exactly what He was doing when He chose you to be my father!

(Don’t mind my stressed face, please. Haha.)

Mondays get me down

If you are like me, you probably start the week a bit slow. I used to hum a song that says Mondays get me down. Perhaps it’s because of the hangover from the weekend’s gimiks with friends, activities you joined from church or school or probably, your past time at your house. I had to force myself out of bed and take a shower. Mondays find me lazily preparing for school in the morning and yawning through the professor’s lectures the rest of the day. I usually can’t concentrate. No brilliant ideas surfaced, and my schoolwork was so-so. I’d finally get perked up in the afternooon but, by then, the day had practically gone by. One cup of coffee from the nearest coffee shop should do the trick.

Later, I realized that it’s not Mondays that get me down. It’s my attitude. If I truly wanted to honor God with my studies, then I would pursue excellence no matter what. I won’t write term papers, answer exams or listen to the professor just so I would pass the course. I would do all these because I am serving the Lord.

And here’s what’s encouraging. Even if we should not expect something in return, God promises us a reward for serving Him. To get the highest grade or a teacher’s commendation or our classmates’ admiration or an exemption from the finals are perhaps some of those rewards. But the joy that our accomplishments bring to our parents and the honor it gives God are the best returns for our hard work.

Do your work willingly, as though you were serving the Lord himself. In fact, the Lord Christ is the one you are really serving, and you know He will reward you. Colossians 3:23, 24

(Devotion: Real time)