Revision

So maybe i was simply caught up in all that anger when my wrote my previous entry. After almost a month my mood has changed a bit... and i'm capable of thinking clearly one again. But time hasn't changed my disdain of humanity in general. I know there are a lot of good people out there, people who are still capable of selflessness and genuine concern... but they are overwhelmed by the overwhelming majority. I doubt if i could ever regain my faith in humanity ever again. 

i hate driving to work. it burns me up everyday. It takes so much longer to get to work as it should, thanks to traffic mismanagement. thanks to those stupid individuals who make up all those stupid traffic rules, and as ordinary citizens, we have no choice but to obey. and i also have to thank all those stupid drivers who keep clogging our streets with their incompetency. i mean, it doesn't take a rocket scientist to understand simple traffic rules. all it takes is common sense, something that i used to think we were all born with, but i was wrong apparently. take one of my pet peeves: vehicles that block intersections. if they can very well see that there's a traffic jam up ahead and they can't really move that much forward, why the fuck would they continue moving their vehicles and then subsequently blocking the intersection? because they just want everyone else to join them in their misery, is that it? were they secretly hoping that all the vehicles in front of them would miraculously all move forward and give way for them? god, i don't know if these people are incredibly stubborn, selfish, or simply incredibly stupid. i wouldn't mind shooting them in their fucking heads if only someone made it legal to do so. i wouldn't even feel guilty afterward. I'd be ridding this world of stupid people who only serve to bring others down along with them. getting rid of them would be for the greater good, no doubt about it.

And then the grave robbers were at it again. before they just slowly ripped off the metal trimmings outside the mausoleum...i dunno, they would probably melt them and then sell them afterward. then they stole the lights outside. We didn't check on the mausoleum for a month, then when we came for a visit three weeks ago the whole metal gate was missing. Jesus, those bastards managed to take the whole gate. It amazes me how they could have taken that whole gate, carried it out to the streets and not one person saw them carrying it. The street outside is very busy even in the wee hours of the morning, it's impossible that no one noticed them carrying such a big gate. It's either no one cared, or the people in the surrounding area were in cahoots with them. And with the gate gone, the entire contents of the mausoleum was one big free for all. All decorations were gone, as well as the lights and fans. Anything that they could take, they took it. I was surprised they even left the kitchen sink and the toilet bowl. Maybe they just left them for next time, because apparently for the bastards and assholes in the surrounding neighborhood, they have found their new source of income. with shit like that happening, how could i ever learn to trust people again? I keep thinking of just staying there for one night and wait for anyone of them to show up. Then i would shoot them pointblank. I can never go on a random shooting spree without feeling guilty afterwards, but with those people, i could kill them with no apprehensions at all. or maybe put them to sleep with an intravenous medication first, bring them someplace and then skin them alive, very slowly. or maybe burn them alive so that i won't make that much of a mess. their screams would bring such pleasure to me, that's one thing that is certain. These people behaved like animals, and they deserve to be treated like animals. By doing such deeds, they have revoked their right to be treated as humans. honestly, even if they were already dying of hunger, even if they can find no other source of income, would that justify disrespecting other people's graves? how can they eat the food at their tables knowing how they were able to get  food that they were eating? to do so would be to give in to your animal side, to your carnal cravings. and if they choose to live like animals, then they deserve to die like animals as well. they deserve to be slaughtered like cows and pigs in the slaughterhouse. No mercy to those who continue to live by simple necessity. 

So yeah, i wouldn't just kill anyone for no reason at all. i was caught up in rage when i said that, that wasn't me talking at all. but for all the many people who have waived their right to humanity by virtue of stupidity and giving in to their animal cravings? i would gladly kill all of them one by one, if only someone would give me the power and right to do so.

Typical.

Man, that was one horrible weekend. I need a vacation from that vacation. I was foolish enough to believe that it would turn out otherwise. I mean, it was doomed from the very start.

It was early January when my dad called me, telling me not to make any plans on the last weekend of April because the whole family was going to attend my cousin's wedding. And he told me that he was about to buy plane tickets because air fares are cheaper when you book months in advance. Fast forward to a month later. Yup, he hasn't bought any plane tickets by the time i got home. We finally bought tickets two weeks before the scheduled flight. And he had to use my credit card because he had no cash on hand at that time... and by the way my credit card was blocked because he paid my bill with a check that bounced. And what about our tickets for the flight back home? we bought it a week before, and apparently he never talked about his planned duration for the trip with my siblings who can only afford a few days off from work. And what's so fucked up was the fact that i was coordinating things between all of them. Jesus, why couldn't my dad call them instead? and why the fuck did he not talk to them months before? Well, that's my biological father. The word planning is not in his vocabulary. There's minimal amount of responsibility and initiative in his body. I wouldn't be surprised if there wasn't any at all.

The flight to our destination was awkward. He sat beside me and kept on making small talk. The fact that i kept of tinkering with my ipod should have been enough for him to realize that i was in no mood to talk to him. But no, he just kept on blabbering and blabbering. By the time we landed, i asked him about our travel plans. The day after the wedding, we were supposed to rent a van to travel to the beach a hundred miles away. Then we were supposed to stay at some resort. I wasn't surprised to find out that he hasn't made any arrangements. We'll just rent a van when we get there, he says. Find a place to stay when we get there, he says. The two days we were there, he never made any fuckin' calls. He never made any arrangements. Good thing my aunt offered to lend their van when he asked my dad how we were going to the beach. And this happened a few hours before we were supposed to leave. That's my biological father for you. Everything has to be served in a silver platter to him. He can't do anything by himself. For anything to happen, some other person needs to do things for him.

Oh yeah, we got delayed because he just couldn't get up early, even when necessary. And again, he didn't call for any airport transfer service until the last minute. How typical. And we almost missed our flight home because he kept on insisting that we didn't need to leave early because the airport was only an hour drive away. Never mind the fact that we kept on telling him that we should leave early. He just told us to trust him. Jesus fucks, we've known him all these years. Did he actually think that we can trust him? That we can depend on him? And hasn't he heard that there's no way that the time spent traveling by land would be constant. It's either more or less, and when you have to be someplace important it's better to be early because you never know what you'll encounter on the road. But that's my biological dad. He doesn't believe in the saying that it's better to be safe than sorry. His motto in life is just to fix things as you go along. Trouble is, he doesn't really have the capability to fix things. He just has this penchant to consistently fuck things up. And what's worse is the fact that he was shouting at the person driving us to the airport telling him it's his fault that it took so long for us to reach the airport. The same way he shouted at the waitress at the restaurant earlier because the coffee that was served with his breakfast wasn't brewed, even when it says clearly on the menu that the included coffee in his meal was anything but brewed. The same way he shouted at the airport employees, ordering them around as if he ran the place. That's my biological dad for you. He always acts like he's king, like he's such a big deal even though he's not. He's always boastful, he's always bursting with pride even when in truth he has nothing to be proud about. He thinks of himself as everything, always going for the shock and awe approach and he manages to fool a lot of people. But for those people who can look closely, for those people who can see what he really is, they know that he's nothing. A hollow, shallow, empty space filled with nothing but fluff. He's just a huge chamber filled with nothing.

I realize that the main reason i enjoy traveling to different places and why i enjoy going on vacations is because i am far from him. Sure i feel great when i get to explore new and different places, when i get to do different things, when i meet new people... but the location doesn't really matter as long as it's far from him. At home i'm always pissed. At home i'm always sad. It's just either one of those. When i'm far away, i feel content, i feel happy, even when i'm not doing anything at all. A real vacation is something that keeps your mind off the negativity, even for a short while. It's won't be a vacation at all when you bring that negativity with you. In my life, most of the negativity centers on my dad. He's someone that i wish i can always leave behind.

One After The Other

They say that when it rains, it pours. In my case, especially this year... it has been one torrential storm after another.

Talk about rude awakenings. Last weekend, it has been one drinking spree after another. Catching up with old friends while downing down bottle after bottle of alcohol. In the land of my birth, it seems that I am only capable of being happy when I'm not sober. Last weekend, it seemed that all my problems have been blown away, albeit temporarily. And for a few fleeting moments, I was glad.

And then came yesterday. For some weird reason, my sister chose to take my car on her way to work, and she asked that new family driver to drive her there. She could have taken the family car, she could have asked my dad to drive her to work like she usually does, but nooooooo... she had to take mine. Without my permission. Then i received a call from her yesterday morning. She told me that they got into a driving accident, and my car was wrecked. That stupid driver failed to hit the brakes on time. In broad daylight. In an intersection. In a traffic jam. They weren't going fast, and yet he managed to wreck the car. And to add insult to injury, he did some stupid reflex action. Instead of just stopping, he immediately shifted the gear in reverse and he hit the car behind him as well. That's so much worse than stupidity, I can't even think of a proper word for it.

Ever since my grandmother passed away, i have become extra careful when driving. I was really taking care of that car. No more speeding. No more drunk driving. I was mindful of traffic rules. For one thing, there's no way that we can afford to buy another car in case I manage to totally wreck my car again. Like the way I did to the one before. And the one before that. Add the fact that I was aware that we were not able to renew the insurance. We had a lot of things on our minds last May and paying for insurance was the last thing we needed to worry about. And as I expected, being the responsible person that he is, my dad still wasn't able to renew it upon my return. But mostly... I was taking good care of it because it was an expensive gift that my grandmother gave me. It's one of the last few concrete things about her that I can hold on to.

We already have a lot of expenses, and because of my dad's penchant for spending every cent that he gets as soon as he gets a hold of them, I really don't know where we are going to get the money for repairs. it was that stupid driver's fault so we have to pay for the damage that he made to the two other cars as well. And those two other cars were even more damaged than my car. It's a shame that he quit his job immediately after filing the police report. I would have loved to see him for one last time so that I could seriously damage his face. I would have felt such immense pleasure if I could have wrecked his face the way he wrecked by car.

I really can't understand why my dad has zero savings. He's getting the same amount of money that our tenants used to pay my grandmother. My grandma always manages to save more than half of that, yet he can't seem to save any. I know he has to pay for the estate tax plus a whole lot of other expenses, but I have this feeling that he's not using the money to pay for those expenses. How else could you explain the fact that he keeps on borrowing money from me? and why does he keep asking me to write checks from him, even though he knows that the joint account that my grandmother used to share with me is almost depleted? And he can't even pay our bills on time, we have been receiving one disconnection notice after another! I really don't know where all that money is going, and when we ask him, he just can't give any definite answer. I was worried that if an emergency happened... if one of us got into an accident, if one of us got sick, or if, god forbid one of us died... we have no way to pay for such emergency expenses. And true enough, something unexpected happened, and he's at a loss on how to pay for it all.

Somehow, he found out that my grandma left money for me before she passed away. It was meant to fund my upcoming trip. The only people who knew about this are my mom, my sister, and our house helper. And none of them are admitting that they told him, whether intentionally or unintentionally. One of them is lying and that really pisses me off. They know about how my dad deals with money. I trusted these three people and just like that, they broke my trust. I feel incredibly pissed and disappointed. I can't help but feel betrayed. There's absolutely no one in this family that I can trust now. I should be thankful I guess. That just makes it easier to leave everyone behind.

Again I told my dad that I don't have money. He told me he knows for a fact that I had money with me. He called me selfish. He called me a liar. He told me that he couldn't understand why I don't want to lend him money when he will be able to pay for it immediately. Really?! with what?! with the huge fortune that is about to come his way, any minute now? the one that he has been blabbing about for years? Jesus Christ. If he can't understand me, well I can't understand him either! I am a realist. Unlike him, I don't live in a dream world. I know that as of now, I have barely enough money with me. If I lend him as much as he's asking now, I definitely won't be able to leave. I'll be stuck here. With him. With them. My siblings have jobs, why doesn't he ask them to lend him money instead? Oh, that's right. Because they don't want to lend him money either. Then don't want to have anything to do with him either. But they have a steady income, he should direct his words at them instead. Fine, I'm selfish, but he should call them selfish as well. I'm selfish because I have to be. I'm the only one looking out for myself. There's no one left here to help me reach my dreams but me. If I choose to become selfless, I might as well let go of my dreams as well. A few months from now, there will be no turning back. I can keep on driving a wrecked car for a few more months. It's still functional anyway, who cares about that huge dent in the front and in the back. As long as it keeps on running, I don't care. After that, they can do whatever they want with it. I already have a lot of memories of my grandma that I can hold on to that would last for my entire lifetime. A few months from now, they can do what they want with their lives, I would let them handle their own problems, let them get out of the mess that they have created themselves. There's no turning back, and I don't even have to look back. A few months from now, I could stop caring. Because a few months from now, there would only be me.

The Lifelong Stupor

Four years ago, I decided to create this blog so that I could put my feelings into words. I had hoped to experience some form of catharsis every time i create an entry, and usually that's what happens. It works most of the time. Yet sometimes, I just forego everything and choose to keep it all inside. Like when the emotions that I have been feeling are caused by nothing but petty annoyances. Or when the thing that upsets me is something that I experience again and again, that putting those feelings into words every time would only make me sound redundant. If I created a blog entry every time my father upsets me, I’d have close to a thousand entries by now… and that’s a pretty conservative estimate. This blog is already more than four years old. If I wrote about him every time he upsets me, like the way i did a few years ago, I’d probably have more than a thousand entries. One for every day that has passed for the past four years. That's how much he upsets me. That's how often my dad manages to piss me off.

Don’t get me wrong. I know that he loves us. Like most parents, i know that he would do just about anything for his kids. I can recognize the fact that he’s trying to reach out. I can see that he’s trying to make up for all those years that he never reached out. But all his efforts only seem useless, because it’s all a little too late. I never felt close to him as I was growing up, and no amount of effort on his part could make me feel closer to him now. I also recognize his sincerity. All those years, I could see that he really strives hard to provide for us, but he just kept on doing the wrong things... again and again and again. Thus all his efforts to be a good father only seem worthless.

For one thing, he keeps on chasing rainbows.

For as long as I can remember, he keeps on saying the same things. He’s about to get loads of cash. A huge fortune is gonna come his way. All my life, he keeps on saying the same things. I know I should be used to all that by now, but the fact that he keeps on saying the same things for almost 30 god damned years makes it even more unsettling. He’s devoted his entire life to these certain people, with the promise of a huge payback anytime soon. But the thing is, that payback never came. Days have turned into weeks and into years, years have turned into decades, and there’s still no payback in sight. But to him, that payback is already around the corner… the same place that it was for the past couple of years.

He keeps living in a dream world.

And that really pisses me off. Sometimes I wonder if I should hit him hard in the face in order for him to wake up to reality. But with the level of stupor that he’s in, I doubt if that could even be enough. I doubt if anything could even be enough. Nothing could awake a man who's in such deep slumber. He’s an intelligent man, and I just can’t figure out why he’s so entrenched in such stupidity. Before I left last year he told me I didn’t have to look for work in another country. A huge fortune was already coming, and he could build a hospital for me if I wanted him to. I didn’t even look at him as we’re driving to the airport. I couldn’t even acknowledge him. i couldn't even give him that for it might give him a little bit of satisfaction. It might give him the impression that I believed him, that i believed in him. When he was taking me to the airport again last June, he kept saying the same things again. The exact same things. Jesus fuckin’ Christ. And he was deeply entrenched in his dream world that he didn’t even notice that I wasn’t listening. That I didn’t even care. He fails to see that I want to live my own life, and I had no desire to be a part of his life, whether it’s real or imaginary. He never noticed that we have all grown tired.

of his fantasies.

of his preposterous ambitions.

and the fact that he doesn’t know how to set his priorities.

Amidst all the grief that we were feeling when my grandmother passed away, we have managed to make room for another set of emotions. Those emotions were fueled by our hatred towards him. Before my grandpa died, he was given a huge sum of money to fund the mausoleum for my grandparents. When our grandpa died, his coffin was placed within a pile of hollow blocks, but he promised that the mausoleum would be finished in a month. During that time, he ran for a local government position. And as we expected, he lost terribly. In the interim, my grandma wanted to see the mausoleum for herself, because my dad kept saying it was finished, and that it looked beautiful. It looked elegant. But he always told her he was too busy campaigning and he had no time to take her there. My grandma died two months after. She never got to see that elegant mausoleum. We didn't get to see it either. We buried her within a pile of wood and hollow blocks. That was supposed to be the beautiful mausoleum that he kept telling her. Just like the huge fortune that was always coming his way, that mausoleum was also a figment of his imagination.

We weren’t stupid. The money that was given to him was more than enough to build a mausoleum. We believed that he used up all that money for his campaign. He used up all that money to fulfill one of his stupid lifelong ambitions. He wanted to fulfill his quest for wealth and power. Never mind if it was such a long shot. He just had to do it, no matter what. There was no other logical explanation. Of course he denied all this, with tears flowing through his eyes, saying he was deeply hurt that we would even think that he was capable of such a thing. But how the hell could we believe him? He had no job, he had no money to fund his campaign. Where the heck did he get all that money that he used?! If anything, those tears represented all the guilt that he was feeling. He wasn’t hurt because we accused him of such a terrible thing. He felt guilty because he has done such a terrible thing. We didn’t care if he chose to remain in his dreamworld all our lives. He could have easily brought us all down with him, but our grandmother was there to keep us from falling with him. Now he gets all the money from our grandparent’s tenants. He gets a lot of money, yet he never gets to save anything. He gets a lot of money from the tenants, yet somehow he still fails to pay the bills on time, and that me and my brother have to use our own money to pay for some of our household expenses. It’s all gone in an instant, because he needs every cent to fund his expensive lifestyle. He needs every cent to impress the people around him. He needs every scent to maintain the impression that he has a lot of money. He needs so much money to pay for our estate tax, yet he doesn’t allocate funds for that. For someone who is unemployed, he was very lucky that the bank gave him a loan, but that loan still isn’t enough to pay for the estate tax. The deadline is only several months from now, but still he acts as if there’s nothing to worry about. And to add insult to injury, he’s planning an expensive family trip for all of us abroad, and when I asked my mom where the hell is he going to get the money for that, I was surprised by what she said. He was planning to use part of the money that the bank loaned to him… even if that money still wasn’t enough to pay for the taxes. I shouldn’t even be surprised. I’ve known this man for years, and he’s really like that. Nothing should surprised me anymore.

He’s a man with no direction.

He’s a man with blind ambition.

He’s a man who can’t get his priorities straight.

He’s the man that I would never ever want to become.

I remember one instance many summers ago. We were on our way home from our family vacation. 70's music was playing on the radio. My dad was driving the car, talking to my mom. My siblings were asleep, and I was pretending to be asleep. They were talking about us, and I heard him say to my mom that there was nothing he would not do for his children. All these years, all we ever wanted was for him to wake up. All we ever wanted was for him to change. If he would really do anything for us, why the hell can't he even do something as simple as that.

All my life, I've heard so many lies and fabrications from my dad. Plus a lot of wishful thinking in between. I guess it wouldn't come as a surprise that those words that he spoke to my mom many summers ago were nothing but lies as well.

Further Disillusionment

The five stages of grief according to the Kübler-Ross model consists of denial, anger, bargaining, depression, and lastly, acceptance. When it comes to politics in this country, the intelligent people have been resigned to that state of acceptance for the longest time. When history has shown that we as a people fail to make the wisest decisions time and time again, those people who use their heads have accepted the fact that as a nation, we will be heading nowhere.

I however, have been trapped in the stages of denial and anger for so long. Maybe it's about time for me to move on. i should no longer be surprised. i should stop being so hopeful because I just end up being so angry and disappointed in the end. I guess it's about time that I accepted the fact that this country is riding on the non stop train to oblivion.

For you to understand why I am so affected, why I seem to care too much when most of my peers choose to be apolitical, you have to understand where these feelings are coming from. Ever since I’ve started this so called career, save for the few months when I’ve worked at a private hospital (where I’ve felt so out of place), I have been working for government institutions. I know how life is for the poorest of our countrymen, how their lives are defined by hopelessness and despair. I’m not like most of my friends who work at private companies, where all they care about is to pass through each they, and get their salaries bimonthly to support their own needs as well as their families. I don’t do all that work for financial needs. I work because I want to help. A lot of times, I’ve used up my monthly salary just to buy things for those patients who lack the means to buy the necessary supplies. Many times I’ve done volunteer work, where I’ve spent long hours seeing patients without any sort of compensation for my services whatsoever--- because I wanted to help. And there’s an incredible lack of manpower because there were very few people like me who wanted to help without asking for anything in return. And with the present state this country is in wherein almost everyone is affected by these hash times, fewer people could even afford to help. I’m not some sheltered prince who’s oblivious to the ways of the real world. I may have been one before, but for the past few years I have been with those people who are neglected, used and trampled upon. I have seen them with my own eyes, I have touched them with my own hands, and I have shared in their pain.

It was sometime last year that I have finally become disillusioned with it all. Every time I complain, every time I would try and gather our collective voices for change, I kept on hearing the same answer. The system has been rotten for years, and there’s nothing I can do about it. If I hate the system so much, all of my superiors would say that I was free to leave and search for my ideal working environment, wherever that may be. At first I was adamant, but inevitably I accepted defeat. There’s no way I can change things, I am just one man. And the fact that everyone seems to be contented with the status quo that they do not even want to exert any effort to try to change things makes it impossible. I have accepted defeat. There’s no way I can help others, when these very people I want to help refuse to help themselves. And it’s even more frustrating when these people who obviously need help refuse to recognize the fact that they need help.

I resent the fact that some people have called me unpatriotic when I’ve made this decision. Excuse me for saying this, but what have these people done for their country? I’m willing to bet that in the few years that I have served my countrymen, I have done more than what most people in this country would do for their nation in their entire lifetime. So excuse me for finally getting fed up with the system. Excuse me for finally giving up. To continue living a life like that where i am experiencing constant strain and frustration would be a little too much for me to handle. To continue living a life like that is bound to kill me.

The result of this year’s elections further vindicates my decision. Can you blame me if I felt that here was one opportunity when we could finally have some changes? Changes that weren’t possible if I tried to do them on my own? That’s why I find the results so frustrating. Here was a glimmer of hope, but it turned out to be nothing but a mirage. Here was another chance to turn things around, and we blew it, yet again. Contrary to what others think, I do not hate specific candidates. I’m not convincing people to vote for a specific candidate either. I just want people to use their heads. That’s it. It’s the way people vote that really pisses me off. They say they think about their decisions, but once you ask them further, they are at a loss for words, which completely negates their statement that they make informed decisions. When asked, may people say one liners, similar to those campaign slogans used by candidates, as if it ends there. They say we should just respect each other’s decisions? Well forgive me for saying this, but just like trust, respect is something you earn, it’s not just given away for free. I may not agree with your choice, but say something that makes sense in defense of your choice and I will respect your choice. I just want to hear something that makes sense so that I may believe that you have made an informed decision. But if you can’t say something sensible to justify your choices, at most I could be civil with your decision. Asking for respect is a little too much.

Some have commented that I was so negative, that I resorted to bashing specific candidates instead of just pointing out the positive traits of my choices to convince others. First of all, I wasn’t trying to entice people to vote the candidates that I preferred. I want to open their eyes, I want them to be open to other possibilities so that they may make informed decisions. And let’s face it. I posted positive things before, and I didn’t get any reaction. but when I started my bashing spree, that’s when people took notice. Some people agreed with me, some people took offense. But hey, I got reactions. That’s one fact of life. Talk to people in a nice manner, and you’d be completely ignored. It would take something extreme to get people’s attention and hopefully knock some sense into them. And hey, I managed to open the eyes of at least three people. And save for the few who blew their top when they ran out of things to say in defense of their candidate, I’ve had several meaningful conversations with some people, I got to hear sensible answers, something that would never have happened if I chose to stay silent.

Some saw me as arrogant. Thinking that I was too stubborn, thinking that I was the only one who was right, and all others were wrong. Some even say that I was so narrow minded. How can I be narrow minded when I reviewed each candidate’s platforms for months, when I kept on watching those debates and discussions again and again so that I can reach a truly informed decision? I doubt if those fanatics ever considered what the other candidates had to say. They are the ones who are narrow minded, and I find it laughable that they would label me as such. They’ve completely bought the marketing strategy of one candidate, that it’s a battle between good and evil, and he alone leads the forces of good, and that he has a monopoly on integrity. I didn’t buy all that bullshit because I know for a fact that other candidates could offer what he’s claiming to offer, plus a whole lot more. And anyone who claims to have analyzed each candidate’s platforms would realize that only two candidates have made promises that they can actually keep. The others just kept on spewing whatever the people want to hear, and no one realizes that all those words are nothing but empty promises. I’m a realist. I’m not a fan of blind faith. Miracles don’t happen everyday after all. I need to look at a candidate’s track record and I need to see if he is capable of doing the things that he says he can do. And to choose the leading candidate is tantamount to giving blind faith. There has to be something that I can hold onto, and he offers absolutely none. This is not a progressive country, and at the depths we’re in now, we can’t afford to keep on praying for miracles, we can’t afford to put our trust on something that isn’t realistic and attainable. As a nation, we can’t afford the luxury of blind faith.

I’m not saddened that one candidate won. I am saddened with the results of the elections as a whole. I thought it was impossible to sink into further depths of disillusionment, but that’s where I am now. I’ve completely lost faith in our people. Just by looking at the winners in most positions, and looking at the runner ups… it only proves that people are still dumb enough to buy all that propaganda. It only shows that people do not learn from the past. One man used to say that our people are worth dying for. I doubt if he would say the same thing now. Would you give up your life for a nation that doesn’t care? Nothing could be more stupid than to give up one’s own life for a nation of imbeciles.

Two of my friends got it right. I asked them why they are supporting a certain candidate, who obviously pales in comparison to all the others. They told me to get real. They pointed out that even though I’m a realist, I kept pinning on the ideal. They pointed out that I am a study in contradiction. If I am really a realist, I should accept the reality--- THAT I LIVE IN A NATION OF MORONS. It’s always about charisma, it’s all about popularity, it’s all about the right kind of propaganda. They turn a blind eye to one of the most qualified candidates because he speaks harsh words, because he speaks the truth. He makes no lofty promises, only those that are attainable, but apparently realistic goals are too boring for most people. He makes no attempt to woo the voters with sweet words because he means business, and because he believed that voters are now mature enough to look past all the fluff of propaganda… and he was so wrong to put that much faith in our people. These people do not want to hear the truth because it is so offensive to them. All prefer to hear what’s nice to hear, no matter how surreal, no matter how absurd. People wouldn’t know what’s good for them even if it’s already right at their faces. The ideal is not an option in a country full of morons. The intelligent people have no choice but to choose the lesser evil, because that's the only choice available, as dictated by the overwhelming moronic majority. When the ideal is not an option, the best that the thinking class can do is to choose the less stupid choice. Those are very harsh words indeed, but I have to agree with my friends. In the case of this pathetic excuse for a nation, nothing hurts as much as the truth.

So I’m sorry for contradicting myself. I apologize for thinking reforms are possible in a country so content to lie down in mud and grime, that any form of change is impossible. By actually thinking we can change things when it is clear that we cannot, I was thinking like most people in this country. By believing in the impossible, I WAS ALSO THINKING LIKE A MORON.

But everyone deserves a chance right? I don’t want this country to sink further into the depths of mediocrity after all… there’s nothing more I can do about it, we should just learn to deal with the repercussions. All I can do this time is hope for the best, and that everyone proves me wrong. But for now, there’s really nothing to hold onto, is there? When all you’ve got are lofty dreams that would need miracles in order to fulfill, I can’t help but feel so pessimistic. In a few years, we will know if our people have finally made the right choice, or made another stupid mistake like they always do. Although most signs point to the latter, anything is still possible. In a few short years, we will all know. But by that time, I wouldn’t even care anymore. I’d be so far away, that I wouldn’t even care whatever happens to this god forsaken country... even if I wanted to.

The Sick Cycle

The carnival has started. In fact, it has already reached fever pitch.

I’m not really a fan of elections in this country. It all seems so pointless. It’s nothing but an exercise in futility. Because no matter who wins, nothing changes. People keep making the same mistakes, they keep on making the same stupid decisions. People don't use their heads when they cast their votes, they are easily swayed by emotions. They are easily swayed by the popular sentiment. Their emotions cloud their capabilities for logical thinking, that they often think they are making the right choices--- to the extent that they would fight for these choices with such conviction. And then after a few years, people keep on blaming each other, even though they are part of the blame themselves. It’s funny when you think about it. In fact, I would be laughing out loud if the consequences weren’t so depressing.

Fine. We can blame the masses. Most of them are uneducated and since they make up the majority, they can dictate the outcome of elections. To solve this problem, we should educate the masses, that’s what they say. But with the mess that this country’s educational system is in, all I can say is good luck with that. As long as they are uneducated, we can’t really blame them for making stupid decisions. What pisses me of more are so the so called educated people. They keep on blaming the masses when they themselves keep on making the same stupid decisions. They keep on voting for the wrong people. What’s the use of all that education when they can’t even use a bit of common sense.

Take one leading candidate for example. He has gained a lot of support from the educated and the elite. For the life of me, I can never understand how anyone who’s even using half a brain could support such a candidate. He has a long political history, I’ll give him that--- but he has done close to nothing despite that long political history, and that’s just so pathetic. Arguably, he may not be corrupt, he may be honest--- but is that the sole criteria for choosing someone to lead our country? He lacks the necessary skills to properly lead a nation of millions. Heck, he can’t even stand up for himself. Up until now, every word that comes out of his mouth obviously came from someone else’s. And the reasons that I hear from my peers just leave me dumbfounded. These are doctors, lawyers, businessmen--- they are all educated. Yet the reasons they give for supporting such candidates just leave me scratching my head.

I asked my friends out of curiosity why they are supporting a certain candidate. The most frequent reason--- he has integrity. He’s honest. He’s not corrupt. I doubt that anyone can say for certain that he’s not capable of corruption, but for the sake of argument, lets say he isn’t. Is integrity the sole factor for choosing the right candidate? Shouldn’t he have leadership skills? Shouldn’t he possess intellect as well? Watching the presidential debates would be enough to see how incapable he is, yet most people choose to turn a blind eye. Can’t we choose someone who has both the necessary skills as well as integrity? If you’re going to say that there’s no such candidate, then I urge you to please look again. If you still can’t see that there are such candidates, then I’m sorry to say that’s there’s no hope for your stupidity. What’s the use of all that education when you’re not even using the things you have learned.

Another stupid argument I hear from the “educated”? They have grown tired of intelligent leaders. We’ve already had intelligent and capable leaders in the past, and look at where they have brought us. Of course there are other factors to be considered. Many factors have brought us to where we are now, we can’t just blame it on our capable leaders. I can say that given our situation, they’ve probably handled it the best way they can. Can these people imagine our condition if some of our past leaders weren’t as capable? Well, I guess they can’t imagine such a scenario, they lack the necessary brain power to visualize hypothetical scenarios. After all, they’re saying that integrity alone can make us soar higher.

Some even say that they won’t vote for an intelligent and capable candidate because our present leader is intelligent and capable yet that leader is very corrupt. Way to go! I find it remarkable that adults can think as such. I thought only children generalize. All intelligent people are corrupt. Then I guess all people with integrity are stupid. With such narrow minded reasoning, it’s no wonder these people are supporting whoever it is they are supporting.

The other frequent reason that I hear? Because his parents are considered heroes. They were great leaders. They were people of integrity. Even a kid who is only in third grade knows that such traits aren’t inheritable. Children can be very different from their parents. And again, anyone with half a brain can recognize that he is far from his parents. I just can’t help but wonder why people fail to recognize the stupidity of such line of thinking.

Another reason? He’s the lesser of two evils. Whoever said that there are only two choices? The problem is, even the educated people are swayed by surveys. Sure these surveys have a scientific basis, but we can never be really sure of their accuracy. And let’s admit that sometimes they can be used as a tool for mind conditioning. Still, most people just look at the leading candidates, and then choose between them. As I have mentioned above, the uneducated can greatly influence votes, so it’s no wonder the leading candidates are always those who lack the necessary skills. They just make up for it with charisma, eloquent words, with flashy ads, with celebrity endorsements--- the stuff that the uneducated go for. They keep on saying stuff that the masses want to hear, who cares if these are empty promises, who cares if what they are saying are downright lies. That’s what it takes to win, and the masses are buying it. It’s always like this. And then years after, the elite would bitch and complain, forgetting the fact that years ago they voted for the very same candidates that they are loathing now. Because he or she was the lesser evil. Why are the educated being influenced by the uneducated? Shouldn’t it be the other way around? We don’t have to choose between two evils since there are better candidates who deserve our support. If only the educated would vote for the deserving candidates even though all surveys show that they are unlikely to win--- who knows? Maybe sufficient votes would be reached, giving those deserving candidates a shot. But alas, most people don’t want to take such risks. They don’t want to waste their votes on a losing candidate. With the way the uneducated people keep influencing the votes of the educated, then it’s no wonder that this country is as fucked up as it is. It’s a vicious cycle, and the end is nowhere in sight. The masses keep on making stupid choices. And the so called intelligent people keep on making decisions that are just as stupid. What’s worse, their pride and arrogance prevent them from seeing how stupid their choices are. They are educated, so they are making the right choices. Some of them know how faulty their arguments are, they realize how stupid their decisions are, yet they still make such decisions for whatever selfish reasons that they have. That’s even worse. As long as the educated keep their brains in its present state of dormancy, then there’s just no hope for this god forsaken country.

Pervasive Animosity

Whereas before i still had some doubts... whereas before there was this pervasive sense of uncertainty that kept on lingering... Now I am sure. I don't want to stay in this place. I absolutely hate everything about it.

From the very moment the plane landed, I immediately reverted back to my old self. My old self made up of negative emotions. I was anxious. Sad. Angry. Miserable. Full of angst. When I was away from this place i was full of energy. As soon as I got back all that energy dissipated. This place brings out the worst in me. If that's not a sign that i do not belong here, then I don't know what is.

I easily get pissed, even with the littlest things--- those things that are of little significance. I hate the stupid weather. I hate our unreliable Internet connection at home. I hate how certain stuff that I want aren't available here. I hate the smell of the water coming out of the faucet. I hate our eternally busted toilet and how no one can ever get it fixed. I hate how every hour seems like rush hour because of the traffic. I hate all those stupid traffic rules, they make no sense at all. I hate how people can't obey simple rules. I hate how a lot of people still cling to superstitious beliefs. I hate the stuff i eat at home. I hate the sloppy service in restaurants. I hate how every local show seems to be exploitative. I hate watching the news because all I see are people who have this penchant for hurting one another. I hate reading the newspaper because it only brings more bad news. I hate the crowd. I hate the fact that almost everywhere i go, it's too crowded. I hate how everyone seems to lack discipline. I hate how most people seem to lack manners. I hate how people bring each other down. i hate the dirty surroundings. I hate how cops use their authority to milk you for money. I hate the government and how crippled it seems. I hate how celebrities and politicians seem to have a penchant for grandstanding. I hate how the catholic church has such a great influence on everyone in this country. I hate the fact that the church can dictate upon people's lives, and I hate the fact that everyone just lets them. i hate how church leaders speak as if they are more powerful than the government. I hate all those politicians who keep on insulting our intelligence with their empty promises. I hate the masses for being gullible enough to believe those promises, and I hate the educated individuals even more for being as gullible as the masses. I hate how the whole country could serve as a model for inefficiency. I hate the fact that it's so hard to earn a living here. I hate the glaring divide between the rich and the poor, and I hate the lack of support from the government. I hate how everyone think it's okay because that's just how the way things are. I hate how everyone seems to have an ulterior motive. I hate going out because everywhere i look, there is no order, all i see is chaos. And i hate the fact that I keep on nitpicking just because I am so sick and tired of this place.

And let's not forget how much I hate my dad. I am so pissed right now, I think i could burst. It's really amazing how he never fails to piss me off. I hate the fact that we could never get along, but that's just the way it is. It's already too late to make amends when the animosity is this deep. He shouted at me, awaking me from sleep, saying i don't care for my family because i can't accompany my grandfather to the doctor's clinic. He said I should be ashamed of myself plus a whole lot of other stuff. I don't need to be ashamed because I am already ashamed. I'm almost 30 years old and my life still accounts for nothing--- I'm a ashamed of the fact that i could be like him... a guy who's almost fifty and he can barely support his family's needs. A guy who's almost 50 and yet he still relies on his parents for most of his financial needs. A guy who's life accounts for almost nothing, yet he's so full of himself that he can't seem to realize that. He thinks he's such a big deal when in truth he's made up of nothing but hot air.

I do not care about my family, that's what he said. Never mind the fact that I only had two hours of sleep, never mind the fact the I had a killer hangover. That's not an excuse. Sure that wasn't responsible of me, but I had to drink to numb all the pain that this place is giving me. Never mind the fact that there were already three of them with my grandfather. I still needed to go for whatever reason, I do not know. Apparently, being the designated family driver ever since I got home accounts for nothing. The number of times i accompanied both of my grandparent's during their weekly check-up accounts for nothing. Being the only person they could call immediately whenever they needed someone accounts for nothing. I'm the grandchild who spends most of his time with his grandparents, and unlike my siblings, I cancel my plans when they say so, and that accounts for nothing. He doesn't scold them for not giving a shit about our family, because apparently to him, I'm the only one who doesn't care. My grandparents are part of my dreams, and they are one of the reasons why I want to be successful in life so that i could pay them back somehow for everything that they have done, and that also accounts for nothing.

I've put my entire life on hold for them, and that still accounts for nothing.

I still do not care about my family. I still do not know how to set my priorities. I'm still nothing but a source of continuous disappointment.

But you don't have to worry, dear old dad. When I finally get a job elsewhere, I am never ever coming back. When I say goodbye, we might as well take a picture for posterity's sake, because that would definitely be the last. When i leave home on that fateful day, i swear you'll never ever see my face again for the rest of your god damned life.

When I finally leave home i can breathe a sigh of relief. I can finally move forward, and I will never ever look back.

Men of Dishonor

I'm so fuckin' pissed.

There I was, on the way to my med school to get some required documents for residency application. i was stuck in a traffic jam for about two hours, and i was in a hurry because the office would be closing in a few minutes. Just when i was within the vicinity of the university, some cop made some hand gestures, signaling me to stop the car.

What the fuck?!

I was completely aware that I did not commit any traffic violation, so I had no idea why he was asking me to stop. When he approached my car, I immediately asked him what was the problem.

He said I made a right turn while the traffic light was red, and there's a sign by the intersection that clearly said "no right turn on red signal". Was he blind?! The light turned yellow as I was making that turn, and it only turned red after he asked me to stop. I argued with him that I did not commit any traffic violation, and i refuse to hand him my license, and I refuse to accept any ticket stating a violation that i did not commit.

Then he said I also violated traffic rules by "swerving". That was another what the fuck moment. I transferred to the lane beside the rightmost lane as I overtook the public transport in front of me because it was still waiting for passengers. That was barely a few seconds. When i passed it, I immediately returned to the rightmost lane. Since when did that constitute swerving?!

This is a typical scenario when times are hard. These vultures masquerading as cops wait for unsuspecting drivers that they can milk for cash. No wonder most people don't trust the police---- because a huge number of them are corrupt, a lot of them are opportunists, many of them use their power to fuel their selfish needs. Majority of drivers would offer cash even when paying the actual fines are cheaper, just to avoid the hassle of going to the police headquarters or lining up at the city hall where queues usually stretch for several miles. I'm wise to their game, and I refused to offer any cash. Screw him.

Using the excuse of a "doctor responding to an emergency" did occur to me, but I did not want to make up excuses for a violation I did not commit. Police officers exercise leniency when it comes to traffic violations committed by physicians as long as they are responding to emergencies, but i did not commit ANY violation, so why the heck would I ask for their leniency? It was evident that i would not give in. He then asked me for my driver's license. He said he would just like to see it because driving without a license is another violation. Stupid me. He got my license, then proceeded to give me a ticket. That asshole! He then told me that i could pick up my license at the city hall the next day, as soon as I pay the fine.

Fuck him! There's no way in hell I'm paying for the penalties that he accused me of. There's no way I'm paying for a violation that I did not commit! I'd rather make a scene at the city hall when I get my license than to let these assholes take advantage of me! There's no way I'm backing down!

Man, I'm so fuckin' pissed!!!!

In this state of mind--- If i had a gun, would've shot him in the head! Opportunists like him do not deserve to live.

Toying With Lives

I have always said that I prefer working at government hospitals because that's where I can reach out to a greater percentage of people who need our help the most. But at the place where I'm working now, even when I know the right thing to do, the utter lack of facilities makes my profession futile, and downright pathetic.

First, there are stupid hospital policies, that the administration cooked up from God knows where. Blood glucose meters are not allowed in the emergency room because the department of health allegedly came out with a directive saying that CBG monitoring should be handled by the lab department, along with other blood works. Since when did the Department of Health come out with such a stupid directive? I know for a fact that this is not the case in other hospitals. It just boils down to common sense. There are many instances wherein a patient's blood sugar level should be taken immediately--- when an unconscious patient comes in for example, hypoglycemia should be one of the conditions that should be ruled out at once. But since there are only a few lab personnel on duty at a given time, they can't respond to such cases immediately. Things would be much simpler if we had a blood glucose meter in the emergency room. We had one last year, until the department of health allegedly banned such devices from the emergency room. Honestly, I can't think of a logical motive behind this policy. They even went as far as saying that they are only implementing orders from the Department of Health, when in truth, they are not.

Want to hear another stupid policy? Intubated patients cannot be admitted to the wards, or even in a private room unless they are connected to a mechanical ventilator. This means that if a patient cannot rent a mechanical ventilator, they are stuck in the emergency room until they are extubated, or worse, until they have expired. Staying at the emergency room is more expensive since patients are charged by the hour. We even have the tendency to neglect stable patients when a critical patient comes in. It would be understandable to impose such rules when the patient is to be admitted in the intensive care unit... relatives are not allowed to stay inside, so continuous ambu bagging by the relative is not an option, but to require mechanical ventilators in the wards even when the relatives can provide positive pressure ventilation via ambu bagging? They even have the tenacity--- or should i say enormity to defend themselves, saying such a directive is a standard protocol in all hospital. Christ, give me a fucking break! I wasn't born yesterday. I have worked at other hospitals, and I know for a fact that's not the case in other hospitals! I can't help but feel that it's just another ploy to milk these patients for more cash, just like that directive about the glucose meters. One such case was a patient with a "do not resuscitate order"--- basically we were just waiting for the patient to die. His life could no longer be saved. The family managed to get a private room, and yet the administration wouldn't allow them to be admitted at that room unless they would rent a mechanical ventilator. What the hell for?! The patient only had a few hours left to live, and the relatives only wanted to share their last moments with him in a private room, away from the chaotic atmosphere at the emergency room--- and they were to be deprived of that right because they had to rent a ventilator, of which the payment was non refundable?! Such practices may be acceptable (but arguably unethical and stupid) in private hospitals, but most of the patients we encounter cannot even afford to buy their own medicines, and most of them definitely can't afford to rent a mechanical ventilator. The fact that the administration proclaims that the hospital is a government hospital (even going as far as promoting the hospital as such in local papers), yet imposes such directives that would compel each patient to cough out more cash even when they are obviously unable to--- that's not just hypocrisy to the highest level, it's downright unethical.

And then during my last tour of duty, the only laboratory exams that were available were electrolytes, urinalysis, and fecalysis. That's right, even a complete blood count was unavailable. All other blood works had to be sent out. Good thing we still had paper for ECG tracings, and we still had x-ray films... there were many times that we ran out of both. Yes it's understandable that government hospitals do run out of these things due to budgetary constraints, but such degree of ineptitude is laughable. I would be laughing out loud if it weren't for the fact that the hospital charges exorbitant fees for such procedures, even comparable to the rates charged by some private hospitals. With the rates that they are charging, one would expect a little more quality in terms of services. If they could not deliver, then they should just slash their rates to prices that would be proportional to the pathetic services that they can offer.

And what about the laryngoscope with the busted lamp? We've been complaining for all eternity, practically begging for a replacement, and yet we still see no action. How many times do we have to insert an endotracheal tube blindly, hoping that we have inserted the tube on the airway, and not on the esophagus? And the worst part of my last tour of duty? A patient with a stab would on the abdomen came in dyspneic and very hypotensive. 2 Liters of IV fluid couldn't even raise his blood pressure to normal levels. The abdomen was rigid and slowly expanding. Breath sounds were clear upon auscultation, his dyspnea was probably due to an internal bleeding in his abdomen pushing his diaphragm upward. An emergency exploratory laparotomy was indicated. And as expected, no surgeon was available. Jesus Christ, in that fucking hospital, if it's not the surgeons who are not available, it would be the anesthesiologists. And if by some miracle both were available, the operating room doesn't have all the required materials for emergency operations. It's a NO WIN situation! As I've said before, with regards to these physicians--- if they can't make themselves available for emergency operations, why would they even allow themselves to be decked in the first place?! The surgeon on deck wouldn't answer his phone, and the others had something else to do. I can't really blame them since they were not the ones on call that night, but would it hurt to show even a little bit of concern during our conversations? They all sounded indifferent, some even sounded a bit peeved. We had a life or death situation, wherein every second counts, and I couldn't do anything. If I could operate on the patient in the emergency room, I would have. This has happened many times before, we should just put a huge sign at the emergency room entrance saying "Trauma patients cannot be accommodated in this hospital" to save all of us from trouble. Maybe something as explicit as "Trauma patients die in this hospital. If you want to live, just go straight to another hospital"--- yeah, that would effectively drive the message across.

So what did i do? I called up friends from where I used to work. I told them about my dilemma, and we all agreed that the patient was non transferable (obviously) because he could die any minute, but what else could I do? My hands were tied. i was working at a place that had the gall to call itself a hospital. In truth, it's only a hospital on paper, it's just a hospital by name. It's just a building that's pretending to be a hospital. So yeah, we agreed to transfer the patient as soon as possible... because I had no other choice. We were talking about a patient's life that could be saved. I had to transfer the patient personally because he could die any minute. When we arrived at the place where I used to work, they immediately recognized how critical the situation was, everyone worked quickly and efficiently... a far cry from where we came from, wherein only two of us seemed to recognize that the case before us required immediate action, wherein very few people genuinely seemed to care. Man, I couldn't help but reminisce on how things were more than two years ago, when I was the trauma resident on duty at the emergency room. We also lacked a lot of facilities back then, often we didn't do what is ideal and we often improvise, but we always managed to get things done, somehow. I miss working in a place where i can really help people. These days, on each tour of duty I'm still overwhelmed by feelings of altruism... but I can't seem to put such feelings into action. I genuinely want to help, but because I'm working in such a fucked up place... I just can't. It wouldn't matter if there were no doctors on duty at the hospital, because it wouldn't make a big difference at all. Tears are shed, lives are lost, and no one seems to care. No one seems to do anything about it, and it would seem that not one of those people who are in the position to take action would want to do any action. Patients are just sources of income. For them, lives are dispensable. For them, life just goes on.

Now I'm counting the days until my last tour of duty. I only have until next month, and this is one phase of my life that I couldn't wait to get over with. A person can only go so far before the sense of futility breaks him down. Even though I'm not doing it deliberately, I've had enough of toying with people's lives.

Public Disservice

Roadwork has started on the northern end of our street last April, and it was nowhere close to being finished. That's why I had to pass through the side streets and take the longer route home for the past few months. They said the old pipes need to be replaced, and since the pipes on our street are located right smack in the middle of the road, they can't do repairs one lane at a time. The entire width of the road has to be smashed up, hence making that section of the street inaccessible to vehicles. I wonder what's taking them so long. Limited supplies? Budgetary constraints? Not enough manpower? Or too much time off for the workers? and I wonder why they have to start doing their repairs at the start of the rainy season. Everything was fine before their work started, we weren't experiencing any problems with water drainage. I wonder if repairs were really needed to be done, or if this was just another opportunity for incumbent politicians to show that the taxpayers' money are working for them since elections are going to be held next year. Heck, ever the cynic, I suspect that this also gives those politicians a chance to siphon more of the tax payers money with their under the table deals with construction companies.

When I got home from work this afternoon, there were a lot of people outside, but i didn't really mind them. I was so tired, and all i wanted to do was lie on my bed and sleep. When i woke up several hours later, I heard the sound of trucks outside. And--- I swore i could have been wrong at first, but i was hearing the sound of jackhammers. I went outside to take a look.

F*ck. Just like that, someone had the bright idea to do roadwork on our part of the street, even when the northern end was far from being finished! Now the entire length of our street was closed! My dad and grandparents were pissed, because apparently we weren't informed beforehand! Even our neighbors weren't informed beforehand, and everyone was angry! My dad and my brother had to park their cars on some side street a mile away, while my car was trapped in our garage. Who wouldn't be pissed? For the next few weeks--- or god forbid, MONTHS, knowing how road work crawls at a snail's pace in this country... I'm back to using public transport. Our other cars would be exposed to possible theft. And then there's my grandmother, who has already been rushed to the hospital several times this year, most often in the middle of the night. How the heck are we supposed to carry her all the way to our car that's parked a mile away and reach the hospital in time when the road outside our house resembles a demolition site?! At its present state, it looks as if an atomic exploded!

My dad has talked to the mayor (who's my grandfather's friend), and he said roadwork would be done in a few days. It's possible--- on another city, roadwork was done in only two days... but then again, the house of the mayor's mother was on that street. The same thing cannot be said with regard to the other streets in this country though. That's too bad, because having VIPs within the vicinity seems to be the only way to make people work both quickly and efficiently. A little over a week, let's see. That's what the mayor said. We're just hoping nothing bad happens within the next few days... nothing emergent, nothing critical. No life or death situation. because if something does happen, you can bet on it... our family will SURELY raise HELL.

Of Least Concern

Another day in the emergency room. Usually exhausting, at times benign. Always unpredictable.

It was around 9 PM when those two stab wound patients came in. I've encountered a lot of trauma patients, and I have been trained regarding the proper management of such cases. Both Patients were hypotensive, but one of them already has parts of his intestines eviscerating from the stab wound on his abdomen. And he had a lot of other stab wounds on his back, which could account for the probable massive blood loss. On ausculation, his lungs didn't appear to be injured, but I ordered an immediate chest x-ray just to be sure. An emergency exploratory laparotomy was indicated. The other patient only had a single stab wound. Auscultation revealed a possible pneumothorax, but since he was more stable, i first administered fluid resuscitation and ordered an immediate chest x-ray.

While waiting for the results, i referred both patients to the surgery consultant on call. I was surprised by his response. First he asked me if there was a vacant room available. I told him there was none. He said how can the patient be admitted at the hospital when there's no available room. He reminded me of the "no room, no admission" policy. i told him in such emergency cases, a patient can be admitted even if there's no vacant room. Then he told me we lacked supplies at the operating room, and I said I already checked the supplies at the operating room. The hospital did not lack the necessary supplies. Then he said that he would need blood for the operation, and without waiting for my response he told me that's it's better to just stabilize the patient and transfer him to another hospital as soon as possible because we cannot operate on the patient. WTF?! Good thing one of the nurses had the foresight to check if we had available blood at the blood bank, so I told him that blood was available in case a blood transfusion was needed. Then this surgeon sounded irritated. Even more when I told him that I could do the operation for him if he would allowed me. He ran out of excuses, so he just told me he'll be at the hospital in thirty minutes.

Searching for an anesthesiologist was another problem. I already called all the anesthesiologists on deck at the hospital. Some said they had an ongoing case, others said they were out of town and that they wouldn't make it in time for such an emergency procedure... but i doubted if these anesthesiologists were telling the truth. It has always been such a chore finding an anesthesiologist in a government hospital. The others simply didn't answer their phones. I had no choice, so I just called their department chairman and told him the situation. I told him bluntly, if he can't find an available anesthesiologist, he had to administer anesthesia to the patient. I didn't care if he found me disrespectful. A patient's life was at stake, I've had about enough of these consultants and their stupid excuses.

The x-rays were done after that. The patient's chest x-ray was unremarkable, but the other patient had a massive pneumohemothorax on the left side. And whereas previously he didn't find it difficult to breath, after the xray he was almost gasping for breath. So I did an immediate closed tube thoracostomy without referring him to a consultant. It was an emergency and I've done the procedure dozens of times, so I didn't bother informing any consultant. Several supplies were not available, but miraculously, I managed to improvise. Afterwards, the patient became comfortable, although he complained of pain in the left lower quadrant of his abdomen. Palpation of the area elicited tenderness. Since the stab would was on the lower ribs, an abdominal injury was possible. I could have done an abdominal ultrasound to rule out an intraabdominal injury, but it wasn't available at the hospital. The chest xray didn't show any signs of pneumoperitoneum, so I decided to just observe the patient. An exploratory laparotomy could also be indicated if symptoms progressed.

And then Mr. Surgeon on duty came. He ordered the nurses to bring the first patient to the operating room ASAP. I mentioned the other patient to him, and that I already inserted a chest tube. He didn't seem to care, but when I told him about the abdominal findings, he told me to transfer the patient to another hospital while it was still early, because there's no way he could do another laparotomy. Christ. Is he aware of how difficult it is to transfer such a patient? Especially when the mentioned patient lacked sufficient funds? I can't just transfer a patient when I have already managed his immediate concerns. Most government hospitals already have their hands full, and they would not be inclined to accept a stable patient. What the heck. Screw him. I chose to continue with my present management. I knew what to do anyway.

The patient was stable when I endorsed him to my reliever. Ultrasound was still pending, but all abdominal symptoms have disappeared. Before I left, I referred the patient to another surgeon, who was more amenable. When he saw the post thoracostomy xray, his words were "perfect placement". He looked at the patient's chart and commended my management. He then asked me if I was already done with general surgery residency, and if I was just moonlighting while waiting for the results of the exam administered by the board of surgery. i told him no, and he seemed surprised. He told me that I more capable than a lot of doctors who have already finished surgery residency. I couldn't help but smile. I was extremely pissed a few hours earlier, and all those miserable hours seemed to have vanished suddenly. It's great to end one's tour of duty on a high note. It makes the whole day seem fulfilling, even when it's not.

I understand why a lot of consultants don't really want to accept patients at the hospital where I'm working. For one thing, they are not adequately compensated. Most of these patients don't have money, and I guess they often get promisory notes as payment for all their efforts. i understand where they are coming from. Of course I want to receive just compensation as well. But these consultants are aware of this fact when they signed up. They are aware that it's a local government hospital, therefore majority of the patients that they would receive won't really have sufficient funds. If such patients would always be the least of their priorities, or worse--- if such patients won't even be a priority at all, they shouldn't have signed up in the first place.

I. Saw. Red.

Went home intoxicated, with a glimpse of sunlight already on the horizon. Only slept for two hours. Had to force myself out of my bed. My day wasn't starting out right. And from the moment that motorcycle hit my car from behind as I was on my way to work that morning, i knew it would be a horrible day. It just wouldn't be my day.

I know how irrational patients and their relatives can get in times of emergencies... or more often, in times that they mistake for emergencies. Back in 2004, the year of my clinical clerkship, I experienced first hand how a patient's relatives showered utmost hatred towards the medical staff when we failed to revive their relative. Expletives were shouted, and they had the look in their eyes that screamed murder. In times of grief and despair, people tend to become incapable of rational thought. That's human nature, I guess.

There are a number of times that I behaved unprofessionally while at work. I can't help it, so sue me. I work at a government hospital, and although I like the fact that the patients we encounter are those who really need our help, one drawback is that most of these patients and their relatives are uneducated, some may say even uncivilized. They can't understand simple instructions, and they fail to grasp simple reasoning. I'm aware of this fact, and often I can show patience. But the workload can sometimes limit the extent of how this patience can be stretched... especially when these patients don't treat you with the respect that you deserve, I can't help but to retaliate at times. Respect begets respect, one does not need fancy education to grasp such a simple concept.

Often, patients demand to be admitted at the hospital even when they have no basis for admission. They just think they need to be confined at the hospital because of the subjective symptoms that they feel. To be admitted just because you want to be admitted is acceptable at a private hospital, but not in a government hospital wherein we save beds for those who really need to be confined. Most the time all beds are full because the bulk of patients in the general population seek consult at government hospitals. It would be both foolish and impractical to admit patients because they want to. Or how about those patients who go to the emergency room to seek consult for such simple and benign illnesses that could obviously wait until the next day? Do they not understand the meaning of the word "emergency"? It's fine when there are only a few patients. But when we are dealing with a lot of patients, most of whom are really in emergency situations, these patients can really be a waste of time and manpower. And it even gets more irritating when they demand immediate attention, saying they were there first, even when the patient who came after them is already gasping for breath. At times I can't help but shout at these patients. If they refuse to wait, then they better transfer to a private hospital. Their non- emergency complaints along with their money, would be fully appreciated there. It even gets more annoying when they start to namedrop, saying that they know the hospital director, or someone from the government. D-oh, as if those people can really do anything. So what if they are from the government? We can't just discharge patients randomly just so we can admit their patients. Often, all beds are full, all rooms are full. There are even makeshift beds and stretchers along hallways just to accommodate the huge patient load. If those people that they know can add rooms or beds just to accommodate them, then fine. But if they can't, then they better just shut the f*ck up.

There was a time last year when I actually challenged a patient's relatives to a fist fight. Highly unprofessional behavior, i know. There were a lot of patients coming in, and seeing that the patient only had a simple laceration, I asked him to wait. After about an hour, I fully explored the wound, and I saw that a tendon was transected. I couldn't find the proximal part, I had to extend the would longitudinally to find it. A local anesthetic wouldn't be enough. Such a procedure can't be done at the emergency room, and since the operating rooms were full, the patient had to be transferred to another hospital. I called another institution and they were willing to accept the patient. Our ambulance was available, so the patient was ready to be transferred. But then the patient's brother started rapping about making them wait. If I couldn't do something about his brother's condition, I shouldn't have let them wait that long. i explained the situation again, but he refused to listen. I was getting exasperated. I haven't eaten yet, and there were more patients coming in. i couldn't waste any more time explaining. Then I heard an expletive. My patience ran out. I shouted at him. I exclaimed an expletive as well. He answered back. he pointed a finger at my face, and I pushed his hand away. Then I challenged him to a fight outside to settle things. He then said something like what aprofessional I am, challenging him to a fight. I told him that was the way I am and he couldn't so anything about it. I was about to kick his sorry ass when the hospital's security guards grabbed him and brought him outside. Such unreasonable people can really bring out the worst in me, especially when I am stressed.

The last time I went on duty, things were going smoothly at first. I've managed to keep that stupid motorcycle driver who scratched my car out of my mind. From morning until the afternoon, the patient load was tolerable. Then that patient with two gunshot wounds to the head came it. He was brought in by the local rescue team. They said they found him by the road, so the exact time of injury was unknown. Both pupils were already dilated. On my assessment, his Glasgow Coma Scale was only 4... definitely not a good sign. But the patient was still alive, so we had to resuscitate him. I inserted an endotracheal tube, started fluid resuscitation, and after a few minutes, his vital signs began to stabilize. The patient was stripped as i searched for other injuries. His pockets were emptied, which had a small bag of marijuana among other things. I knew the outcome wouldn't be favorable, and an operation would be useless, but as per the hospital's protocol, I referred him to a neurosurgeon. Just as I suspected, the prognosis wasn't good. But an immediate CT scan had to be done just to see if an immediate operation would be of benefit. If there was a subdural or epidural hematoma causing a compression or herniation of structures, then immediate craniotomy would be of benefit. If there was none, then a craniotomy would be useless. The location of the bullets had to be known too. If the bullets were only superficially located, they could be excised. If the bullets were located deep in the brain though, excising them would mean dissecting the whole brain, which would only do more harm than good. That was when some relatives came. Since the hospital had no CT scan, the patient had to be transferred temporarily to another hospital. Good thing the relatives had sufficient funds. The CT scan was done immediately. One bullet did not penetrate the skull, but the other was at the center of the brain. There were no subdural nor epidural hematomas, only intraparenchymal hematomas around the bullet's trajectory. Based on my initial assessment, I figured that an operation was useless. The CT scan affirmed my presumption. When I relayed this to the relatives, that was when all hell broke loose. The patient's mother grew hysterical. She demanded that the patient be transferred to a private hospital because we weren't doing anything.(WTF?!) To appease her, I tried to call the hospital where they want to transfer the patient. The physician at that hospital told me that they could not accomodate the patient. The patient's mother grew even more hysterical. She screamed at me and told me that I was a liar. She said the hospital would accept them because money was no object... never mind the fact that that hospital had no available rooms. Obviously, she knew nothing about patient transfer protocols. I let that pass. I knew that she was grieving and she was still in denial. Then they wanted to transport the patient by themselves, which we cannot allow because the patient was intubated. Now the other relatives were also shouting. Why wouldn't we let them go, they ask. Jesus Christ. To appease them, I called another hospital--- one that I was sure had available rooms because of their exorbitant rates. And true enough, they can accomodate the patient. One of the patient's relatives, who was a doctor herself, asked me questions. She understood the fact that transferring the patient to another hospital was useless, that it would only incur additional expenses, and yet she wouldn't help me make her relatives understand. No amount of explaining could make things clear to people in denial. But she could somehow provide the voice of reasoning. When I asked her to explain everything to her relatives--- because maybe they would listen to her... she just remained silent.

Another half hour of crying and screaming. The mother shouting that her son was a good person, he had no enemies, he did not deserve what happened... i just wondered how good he really was, when illicit drugs were found in his pockets. He had two shots in the head, one on each side... a person must really be consumed with anger in order to do that to another human being... More crying. More shouting. It was a madhouse. I was glad when they finally settled their hospital bill. A few more minutes, and we were off. When we arrived at the other hospital, a few more relatives arrived. The patient's brother, who was crying and begging me earlier to let them transfer their patient to another hospital said something that really made my blood boil. He told his relatives that the doctors at our hospital weren't doing anything. He told them that we were stupid and we did not know what we were doing. And the he turned to me and said that all the years i spent in med school was a waste, because look at the way I turned out.

I wanted to punch him in the face.

I was trying so hard to control myself. I knew that they were in grief, and that's why I remained incredibly patient all that time. But to say something like that, to personally attack my and my profession?! That comment was way below the belt. It's bad enough when patients accuse you of not knowing what you are doing--- but when you are 100% sure that everything you've done is correct and they still question your management, it's even more offensive. I know I'm not perfect, and I know I'm not a great doctor. I've made a lot of mistakes in the past, but on that patient's case, I did everything right. I tried so hard to control my temper, simply because I wasn't at my home turf. I was at another hospital. If we were outside and I wasn't on duty, I would challenge him to a fight, punch him in the face, I don't care even if he's bigger than me. We weren't doing anything?! whether they brought the patient to a private or public hospital, it wouldn't have made a difference. We followed resuscitation protocols by the book. The treatment would be the same even if the patient was brought to a private hospital. And he calls us stupid?! They're the ones who can't grasp the reality that their patient was brain dead to begin with, that he wouldn't survive anyway--- and in the unlikely event that he does survive, it would only be in a comatose state. They kept on demanding that the patient undergo operation no matter how hard I explain to them that an operation is useless. If there's anyone stupid in the emergency room, it's their whole family, not us. I wanted to tell him that only a blind person would say that we were not doing anything. Only an imbecile would tell me that i don't know what I was doing. Only a moron would tell me that the things that I did were wrong. But what could i expect from a family that can't grasp the simple fact that their relative has no chance of survival? What could I expect from a family that keeps on insisting on an operation that isn't even needed? Mark my words, if the neurosurgeon at that hospital recommends an operation, he or she would only be milking money from them, knowing very well that an operation is not indicated. But what could I expect from a family that's drowning in denial? What could I expect from a bunch of know-it-alls? Stupidity must really be genetic. Their family is the living proof of that.

But i stayed silent. I tried to symphatize, i tried to understand their situation. But I was really offended, and that feeling rises above all others. It doesn't dissipate... it lingers. I kept all that anger inside, instead of finding a way to release it. And now... two days later, I'm still pissed. Really f*ckin' pissed.

I should've punched that asshole in the face. Who gives a f*ck about consequences. I could deal with all that later. At least punching him would have immediately made me feel better.