Franz Marie Cruz’s Diary

i did my first evisceration today.  i’ve all my fingers crossed hoping there will be no complications during follow-ups.  it was bloody.  the tissue edges were ragged. i could have done a lot better - next time anyway.  but there’s this feeling of, i dunno, excitement (?), enjoyment (?) basta happy i picked this specialization and i get to do things i am doing now. 

kanina ko lang naintindihan why they would describe evisceration as "parang nagkakayod ng buko" because ganun nga, you scrape out the uveal tissue from the inside of the eye with a spoon very much like nagkakayod ng buko.  though my procedue was blooody heller kanina.  i was blindly scraping the uveal tissue and blood clots out. parang currettage in OB i imagine.   plus i was feeling a bit nervous about my 66/F patient who’s in some amount of pain during the procedure in spite of the pre-op Tramadol and retrobulbar anesthesia.  I’m the RIC and the surgeon, i am responsible not only for her eye but for her life.  i’m sending the patient home tomorrow if she’s without any complication.  hers pala was a case of spontaneous globe rupture secondary to uncontrolled intraocular pressure.  imagine that. pwede pala manyari yun.  the other eye is blind, glaucoma din. so i would akay this patient sometimes in the morning if her relative is not around.  two weeks din sya confined before i finally got to the surgery. 

i also have one patient na sympathetic ophthalmia. ang cool ng case though bad for the patient but he improved after the IV steroids. we sent him on oral prednisone, (yikes!) and all its systemic side effects.

ang ugly pa rin ng pterygium excisions ko! =(

I’m currently hooked to the TV series Grey’s Anatomy. The show and their soundtrack. Been downloading nothing but their music for the past week.
I wanna try the new banana frap from Starbucks!!!! i love bananas.
had a sponsored lunch with my service at Spiral at Westin last wednesday. They have the longest buffet i think. super daming food. I love their dessert selection. Tiramisu! yummy.
Wala lang. i don’t eat at Greenwich if i can help it. Eeeww.
Sarap sunweldo. Gumastos and yet may pumapasok pa rin na money to my account regularly, especially for finally getting paid for something you’ve been doing for the past 2 years as free labor. Not into saving for the rainy days or for my future yet ha.
Funny. Some patients at sentro are afraid to ride the elevator alone. And some who do ride the elevator would go up and down the building so many times without getting to the floor they are headed to. Akyat-baba sila until a good samaritan helps them out with the buttons.
I miss my class and my blockmates and my sisses. Well, at least 2 of my best friends are taking their residency in PGH too, one in IM and the other in OB.
Gusto ko pa rin magbeach! Bitin ang subic beach plus ang daming tao. Di ako nakapagsun-bathe. hehehe, ang arte ko talaga.
i’m in a new service now and please ingat kayo sa mga mata nyo. so many cases of corneal penetrating injuries. don’t let kids go running about with a stick or any pointed object in their hand. all ages and patients ko. kids mostly. swerte na yung mga patients who post-repair can read the E of the E chart.

Gusto ko magbeach!

I did my second solo pterygium yesterday. It’s not as nice as kathy’s demo but it’s a big, big improvement compared to my first. Nakakapressure to do a good job because the patient ahd undergone a pterygium excision on the other eye years ago at PGH and ang linis, no recurrence, you won’t think he had one. But my patient didn’t go for follow-up today! I wanted to see my work on a slit-lamp with a stronger magnification. Still couldn’t do a good keratectomy or complete scrapping of the mass from the cornea. Suturing the conjunctivae close still takes half the OR time but yesterday, I didn’t have to open a second nylon 10-0. I’ve two petrygium excisions next week. I hope the conference finishes early so I have time to do both.
I also did my first YAG-capsulotomy last saturday (thanks to my second year Trina for the procedure and Joran as well.) Super nakakatuwa. As a kid, I enjoyed playing the game in the family computer where I shot down flying saucers and ducks with the toy gun. It’s similar to that. Aim for the PCO and tear it to create an opening at the center. Ang cool! Plus there’s improvement in the visual acuity after. happy and satisfied ang patients when they followed-up kanina. haaaayy… two affirming reasons why I am in ophtha.

It has finally happened to me. Familiar with the particular scene at Bridget Jones Diary where Bridget was invited to dinner with her married friends and she was the only one single female around the table, or an episode in Sex and the City where Carrie was the only single female amongst her “happily-married” friends. I found myself in Bridget’s and Carrie’s shoes when I went on duty last night. I went out to buy my dinner after almost 8 hours of Glaucoma clinic without lunch or a break. Of course, I asked my senior and second year if they want to have food delivered. They already have food waiting for them in the callroom so I went out to buy food for myself. When I got back, there were 3 happy couples around the dining table (made to seat 6 people comfortably) eating their dinner. They actually painted such a pretty picture, I hated to crash their party. For one nanosecond, I thought of eating my dinner all by myself downstairs. But of course, that would be really silly, not to mention pathetic and useless. I had a good laugh about it. They made room for me of course – the 7th man – and I had my dinner.

We finally have electricity back at Sentro after almost 3 whole months. The elevators are working again. We have airconditioning during the day. And they’re bringing out and installing new equipment. We got brand new slit lamps with applanation tonometer or monitors attached to each in almost every clinic, indirect ophthalmoscope each in the general clinic and treatment room, autorefractors in each of the three refraction clinics, projectors, and so many other equipment I have yet to get acquainted with. Kewl!
Spent the whole day yesterday refracting patients, and by afternoon I’ve lost my cool and patience. Majority of my patients yesterday were retina patients and they’re one of the more difficult patients to refract. I sometimes spend a quarter of an hour on an eye alone and I still couldn’t get them to read up to their pinhole VA. By 3pm, the other patients in line are naiinip na and are standing impatiently outside the refraction room and I could here one complaining “nauubos and araw mo dito”. I just had to bang the door close, (eyes rolling). But I couldn’t help but get amused-irritated with one patient who when I asked to read out the letters in front, would shout out each letter as if she was a contestant in ‘Wheel of Fortune”. “Deeee!” “Efff!!!”
I finally saw “Close To You”. I couldn’t at first believe I will be shelling out P120 for that. But then it’s money well-spent. It was a very entertaining movie, couldn’t decide who was cuter (Sam Milby or John Lloyd Cruz), plus good cinematography and beautiful locations where they shot the movie in the Philippines. Ang ganda talaga ng Bohol.
Grrrr. We really have made a mockery of the 1986 Edsa Revolution. First by doing a series of it over the years (Edsa I, II, etc.) and now PGMA has declared our country as a state of emergency and suspended all rallies at the day we should be celebrating peacefully the 20th anniversary of Edsa I. Sigh. Ano ba?

i need a pedicure. i’ve been neglecting my feet for far too long now.

i can’t wait for my new laptop.  i ordered and paid for an iBook last week.

last 6 days as a PL-orbit 1st year.  i am sure to miss some of the consultants, seeing and examining patients with either a proptosed eye or one with orbital wall fractures, doing Hertel’s, MRDs and probing.  but most of all i will definitely miss working with my 2nd year too, mich.  glau, here i come.

There are moments as solo PL-Orbit 1st year when i just want to drop everything i am doing and walk out the door, when there is not enough me to do everything all at the same time.  but there are also moments when i am happy examining patients at the OPD or at the wards. still can’t imagine myself setting up practice 5 years from now.  there are just so many young ophthalmologists in manila, i don’t think i’m ready for the "competition".  taking residency at Ophtha in PGH was just a dream, a vision i had as a clerk. 

i’ve 2 weddings to attend to next month.  the 1st one is of my cousin’s, Kuya Carlo. finally.  the second 1 will be the first wedding amongst my college friends, Maela.  i do hope my sched will permit me to join both festivities.

The cool December wind makes me nostalgic.  It brings back memories of  Christmases past.  I drove by UP Diliman 2 nights ago, I had my windows rolled down, and uninvitingly, memories of ABM Christmas parties haunted to me.  I suddenly missed the company I had back then and the games we used to play come Christmas time.  Dividing into teams of 5 and driving around the campus in search for the next clue, screaming inside the car and running up and down the stairs of the barely-lighted Main Library, and alas finishing only 2nd place in the Scavengers’ Hunt game.   Our big tambio would be teemed full of its members when it’s time for gifts to be swapped hands.  How time flies indeed, these are but memories five years old already.

Fast forward to med school, Christmas season will always be associated with TRP and Phi dance practices for TRP.  The cool night air is like a drink of ice-cold water after hours of practice in a closed room that could barely accommodate the dancing sisses.   I am not a dancer and those steps, however simple they are made to be, are just too complicated for all my 4 extremities.  But I eventually missed those dancing days too, and especially the sisses.

Yet, it was only barely a year ago, when my block and I went to Tagaytay.  We shared a tall pitcher of Margarita to bring our body temp up a notch, as our sweaters could only provide some protection from the biting cold of early January air.  It was one of the very few gimiks we were complete.  We were crazy and we had fun. 

I miss long sleeps, staying in bed til near

noon

, and afternoon naps. For the past 4 weeks, I have been doing my pre-res training at Sentro. Depending on the number of in-patients I have to see in the morning, I usually go to “work” as early as 5 in the morning on weekdays.  During the most toxic days when we had 8 admitted patients in the Plastic-Lacrimal-Orbit Services, I started my follow-up at 430 am!  Imagine too, waking 8 patients up at that yet ungodly hour just so you can examine them.  I am so used to waking up before the sun rises that I immediately know something is wrong if I am still in bed by daylight.  Isang beses kasi, I overslept, did not hear my alarm clock go off and woke up at 830 am! The first thought that raced in my mind was, “Shit! I hope it’s a Saturday.  It has to be a weekend for me to still be in bed at this hour.”  I picked up my phone and saw a message from my first year “Hi! May PL clinic na tayo.”  Boohoo! Took a bath and was in my post 20 minutes later.  Nakakaiyak.  That can NEVER happen again.   Even on Sundays, I have to be out of bed not later than 630 so I could be at Sentro at 7am and I will find most of my batchmates there already seeing their own patients.

There are bad week and good week at Sentro.  There are subspec days when I wish to be literally swallowed up by the ground and just disappear from the kahihiyan and kapalpakan.  Comments as babaw as “very good” or “nahihiyang ka dito…dahil nakakasagot ka” from the consultants do so much to my self-esteem.  There are days when I doubt if I’ll do well in this field.  I have accepted early on that I really can never answer any of the questions posed to me by a one certain consultant (she asks more difficult questions than others) and my ocular exams will always be questionable to her.  Siguro now I am hoping that she will eventually find me improving.  I mean there’s no way to go but up from where I am na diba? Basta, I always feel “tanga” and “palpak” during CO with her.  Nakakahiya.  There is an intense feeling of inadequacy in skills and knowledge lang talaga.

I get so stressed and overworked from work that every time I eat my first meal of the day (usually late lunch) I splurge.  I always find myself with such big appetite, kebs na ang pag-iipon for Christmas gifts.  I need to eat, to reward myself at least. I am also scared of becoming too thin. I still want to look good in my clothes and so I eat.

I don’t know how I will survive PL-Orbit rotation next year when I do officially become the sole first year. 

One day at a food court of one shopping center, I saw a group of 6 gray-haired elderly women, all looking healthy, well-to-do, and not-matronly but quite glam indeed.  They looked a lot like each other, most had short cropped silvery-gray hair, all had a pair of glasses perched at the tip of their noses, and some had a habit of looking over and not through it when talking to the other.  They were all appropriately and conservatively dressed for their age.  One had on a crisp white collared button down blouse, a pair of colored pants and flats.  While they found themselves a table in that mid-afternoon, a guy in his late 40’s (probably a son of one of the women and I imagined assumed the role of the driver for them that day) ordered drinks for them at a store.  When he finished ordering, he took a separate table next to the ladies not joining their circle. He was later joined by an elderly man with a full head of grey hair and presumably the same age as the 6 women.

I keep craning my neck to their direction, unabashedly looking at each personality in the group.  I am very much fascinated by them.  I too am a part of a close group of 6 girl friends.  Three of these people I have known and been good friends with for more than half my life.  And my fascination on these 6 elderly women stems out from my fantasy of seeing us 6 still together and going out for coffee when we do get to their age.  I envision that we too will still look completely glamorous and elegant despite our graying hairs, wrinkles and the puson.  By then we have witnessed so much more in each other’s lives.  More than our own proms, graduations, debuts, and weddings, there will be the birthday parties, basketball games, piano recitals, and graduations of our children.  For it is indeed one of life’s blessings to have a solid set of real good friends you have known for a long, long time.  There is only a myriad of sweet, touching, delightful and funny memories you have growing up with them.    I remember the countless sleepovers, GNOs, and cups of coffee we had together as we discussed “life” (school, parents, siblings, boys, career, etc) and the milestones in life we were there for each other from proms, graduations, planning each other’s debuts, first boyfriends, first break-ups, engagement news, wedding to a birth of the next generation. 

Hopefully, I’ll be able to eventually write more about each of my friends forever for these girls are among the big influences in my life.  Yet, I will start with one.  A piece that I have written no so long ago and had published as a testimonial to this one friend’s great character.

“Just as our friendship has evolved, she too has changed a lot over the 13 years we’ve been the best of friends.  We did not have so many things in common in the start, besides maybe the common barkada, shared passion for theater/musicals and books and the same dream to go to medicine.  She was no-nonsense, serious, sporty, tomboyish, astute, strong-willed while I was giggly, girlish, crazy-impulsive, outgoing and flighty.  She sees the glass as half-empty, I see it as half-full.  Her usual get-up would be a simple T, comfortable blue jeans and Nike rubbershoes while I was color-coordinated and matched from head to toe in skirts and blouses.  My bestfriend.  We later attended the same pre-med course, same med school where we became roommates for 3 years and now we will still  be taking our residency training at the same hospital albeit different departments.  Over the years, she has bloomed and changed.  Shopper na rin sya eventhough she often ends up buying gadgets more than clothes.  She’d sometimes try a different hair style from her usual one-length cut; would go out to get pedicures but no paint.  She has crushes now, a boyfriend and an ex too.  She is a dreamer, a romantic, a Maria Clara beneath that want-to-play-ball/no-fuss-no-nonsense façade and stance.  We’ve become the best of friends.  We may not always see eye to eye on all things, but I’ve always trusted her judgment and objectivity.  She has become one of the strongest influences in my life.  I know I can always count on her whenever, whatever and wherever and she the same way.   I know we will always be at each other’s sides.

But between the two of us, she’s the prettier, kinder, nicer, braver, more diligent, more cultured, more athletic, more talented, the one with the nicer hair (and legs), the better daughter to her parents, the better speaker, a helluva lot better singer and has one million times more admirers.  A major heartbreaker she was.  She is the kind of person who will make you want to become a better daughter/sister/friend/doctor.   This girl is very much blessed in so many ways and yet she has always remained grounded, generous and only willing to share her time, talent and blessings to everyone around her.”