A Pointless War

Finally. I've overcome my addiction to Rock Legends on Facebook. I've reached the point where I could no longer move forward. Recruiting more powerful band members have become too expensive... and after seeing my credit card bill last month, there's no way I'm buying more "street cred" just so I can have some instant virtual cash. I still tinker with the game every now and then, just to increase my "fame" and therefore allowing me to still level up, but at a snail's pace. But I no longer have the urge to keep playing the game all day. I just play the game when I'm really bored. That's certainly a good thing.

Speaking of Facebook games, if you have a Facebook account, I'm sure you've noticed this game called "Mafia Wars". It seems to be the most popular game on Facebook, and with all the non stop invites I keep getting from friends every day, I finally installed it, just to see what all the fuss was about.

Whoa!

...

What an incredibly boring, totally pointless game.

In a nutshell--- It's a text based role playing game. Wherein you build your own Mafia. It reminds me of those text based PC games from the late 80s to early 90s, back when computers didn't have enough power to wow us with their graphical capabilities. You do some jobs to earn money, and you fight with other people--- with the outcome being shown in plain text. I just don't understand why a lot of people are addicted to this game.Yeah, I know, graphics and animation can't make a bad game good, but they do add to the overall appeal. And personally, if i want to see some text just to entertain myself, I'd rather read a good book than to play a text based game. Honestly, the only way I can see myself getting addicted to Mafia Wars is if I had nothing better to do in my life... and I'd have to be such a big loser if I had nothing better to do than to spend many hours each day playing this stupid game. What's the purpose exactly? You just keep leveling up, with no specific endpoint. The developer (Zynga) has other games based on the same template. That's right, EXACTLY the same template, just differing in theme. Vampire wars--- I guess that would attract the goths and the nauseating Twilight crowd... that would explain why that game is relatively popular. I can also understand how the Pirates game has earned some following. Street Racing---I find that more interesting because I like fast cars, so I don't mind playing through the boring interface. but Mafia Wars? What's the big deal? Why is it the most popular? Does this mean that a lot of people have a secret desire to build Mafias and disobey the law, and they can only fulfill that dream in a virtual world, hence the extreme popularity of this game? I know that a lot of my friends who have been playing this game aren't even remotely interested in Mobs or Mafias... so why the heck is it so damn popular?

And you know what's pathetic? How a lot of people have been adding people they don't know just so they can increase the size of their Mafias. The bigger your Mafia, the greater chance you'll have in winning fights. You can't add people who aren't in your friends list, so a lot of groups have been made where people basically put their urls and their email addresses, asking other people to add them as friends so that they can increase their Mafia. WTF?! You don't just give away pertinent information about yourself to random strangers on the street... how come some people think it's okay to do that in a virtual world? It's basically the same thing! It's okay if you have nothing in your profile, but a lot of people have contact informations, several not so public photos, plus a lot of private stuff in their profiles. I just can't understand the stupidity of these people, how they are voluntarily exposing themselves to possible predators just so they can have an edge in this stupid game. One of my friends even added more than a thousand strangers to his friends list, just so he can increase the size of his Mafia. One of my female friends was ranting the other day that one of the guys that she added in her Mafia kept on harassing her via email, even when she already deleted him in her friends list. I can't say I pity her. After all, it's all her fault.

Also----! All those stupid updates are cluttering up the news feed! People asking for loot every now and then, making them seem like beggars. People proclaiming that they've gotten some award, that they've found a rare item, that they've beaten the shit out of someone, that they've won a fight with your help, that they played the lottery... Jesus Christ... who the fuck cares?! Along with the results from those stupid quizzes, they have been flooding the news feed with useless information, making us miss posts from friends that we actually care about. (those quizzes deserve a post of their own. Which philosopher are you... When will you die... what color are you... which greek god are you... what is the first letter of the name of the person you'll fall in love with... seriously?! people waste their time for such crap?! Those quizzes are so stupid! It would be okay if they were at least even a wee bit amusing as well as stupid... but most of those quizzes are just plain stupid.)

I'm currently at level 50, and honestly... I find that embarrassing. I'm not even really playing the game, I'm just tinkering with it every now and then... but how would that look for someone who just checked out the game? They'd mistake me for someone who's addicted to something so pathetic. I don't have much work these days, but if I had a lot to do, I definitely won't have time for this. I'd rather use the free time I have for something more productive... or at least more enjoyable. People actually derive pleasure from this game?! I can't possibly imagine the lives that those people above level 100 are living. I even saw one of my friends at level 355. Yeesh. I can't believe that the developers have made tons of money from this crap. Before others associate me with these Mafia addicts, I guess it's time to finally use the hide feature and be rid of this stupid game for good.

I should have done that ages ago.

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.

Yo, Joe!

Man, I feel guilty for liking this movie so much. I usually nitpick when I watch movies, yet even with all the flaws I've seen with this movie, I still managed to like it--- a lot.

I wasn't expecting much. The trailers didn't make the movie appealing. All that CG made the movie look like a video game. Clearly, it wouldn't be faithful to the cartoon series that I loved. And all that bad press lowered my expectations even more. I only wanted to watch the movie because I was a fan of the cartoon, and I was curious to see how a live action G.I. Joe movie would be like.

The plot is preposterous. Some of the scenarios presented are downright ridiculous. The whole movie seems silly, and on paper, it's something only a person below the age of ten would appreciate. Also, as a fan of the television series, i found it hard to accept some of the changes made--- most especially those accelerator suits. Yeah, those suits are cool, and they were fun to watch... but that's just not G.I. Joe. I felt like I was watching Power Rangers or something.

But all that eye candy got the better of me. Explosions galore, fast paced action, dizzying special effects--- the whole movie moves at such a brisk pace, one action sequence quickly moves in to another, there just isn't enough room for boredom. Come to think of it, the movie IS faithful to the cartoon series, at least in spirit. It's deliberately ridiculous, just like the cartoon series. Not taking things too seriously seemed like a wrong move at first, seeing the trend for darker and serious superhero and action movies these days--- but for G.I. Joe, it works. One doesn't need to think like a child in order to appreciate this movie. One just needs to accept this movie for what it is, and just go on for the ride. it's not aiming for an oscar after all, it just wants to entertain. As far as mindless popcorn movies go, so far G.I. Joe is the best one that Hollywood has churned out this year.

I can hardly wait for the sequel. :)

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.

Addicted

I've been down with the flu for about 8 days now. Initially, I thought it would be nothing, but towards the middle of the week it has actually become worse than I had expected... i found it difficult to breathe when I moved around a lot. I even had to nebulize with salbutamol while I was on duty at the hospital because this stupid flu seemed to have exacerbated my asthma. I had to give up work for one day, and felt too weak to go to the gym. Basically, my whole daily routine was put on hold. My schedule was messed up. I was in bed for the most part. Looking at the bright side, I figured I would get some serious studying done. I was breaking personal records in studying for one day, but then I discovered this evil entity:

To the uninitiated: that's a Facebook application/ game called Rock Legends. it's a very simple game, and the graphics wouldn't make your heads turn, just the usual look of a java based game... but for some reason, it's incredibly addicting. How addicting, you ask? The first time I played the game, i was playing for 10 straight hours. No meal breaks, no bathroom breaks. That's 10 whole hours that I've wasted, i could have used the time doing something productive. I couldn't help it, i found it hard to turn the computer off. Good thing my laptop ran out of battery and I was too lazy to put the plug in the nearest socket. Unlike the other Facebook games wherein one's energy takes up hours to recharge, in Rock Legends, one's battle points go up by two point every ten minutes--- that's enough for two battles between competing bands. One battle usually lasts for two minutes, so after two battles, i'd realize that if I waited for about 5 more minutes, I could battle more bands... and this cycle goes on and on and on! And when you're offline, stronger bands can continue demolishing your band, therefore depleting your "fame"... so every time i went offline, I had this urge to go online again! There's this consistent need to keep building up your level so that you won't be trampled upon by the other bands, so i kept doing odd jobs just to level up and make some virtual cash so that i could buy more powerful instruments. There's an option to speed things up if you coughed up some real cash (via your credit card)--- and you guessed right... I gave in. I wasted $20 just to build up my band in this stupid game. I had this secret dream of putting together a rock band back in my teen years, so maybe that's one reason why I've grown too fond of this game. But looking at my some of my friends who have been playing this game too, I have to say that's not really the case here.

How am I supposed to get any work done now? It's hard to lock up my laptop somewhere because I'm also using it for studying. The study materials that i'm using are online. And after I log off from Blogger, I'm sure I'm going to log on to Rock Legends again.

Man, this game is probably as addicting as cocaine, it shouldn't even be legal.

Misunderstood

During one casual conversation, a friend exclaimed that as a group, we only watch the movies that I want to see. When they ask me to watch movies that they want to see , i say no if i don't feel like watching it. It was said as a joke, but obviously, it was half meant.

Why is this even an issue?!

Does it create the impression that I'm selfish? That I only want things to go my way? It's either we do it my way, or we don't do anything at all?! First of all, I ask people to watch movies or go on trips, to hang out, or do whatever, based on how I enjoy their company. The first people I ask are those whose company I enjoy the most. For such simple matters, that's how I prioritize. If they say no, that's perfectly fine with me. It's not like I'm FORCING anyone to come with me, and it's not like I'll hold a grudge for something so trivial. I understand that people have different tastes, we can't possibly all like the same things. If one group of friends say no, it's no problem at all. I can ask A LOT of other people. Of course, the next group of people i ask are those whose company I also like, but not as much as the first group. I won't simply just ask anyone I know, even if those people would probably say yes. But yeah that has happened several times... it beats watching movies alone. hehe.

When I say no, why is it such a big deal? Heck, money isn't exactly overflowing these days. Is it a sin to only watch the movies that I really want to see? Yeah, I say no when I'm being ask to do something i don't really want to do, or to go where I don't want to go--- I wouldn't think anyone would harbor ill feelings because such trivial matters, but I understand how some people can get overly sensitive when they have been declined, even for the simplest things. i would say no, yeah... but did they ever try asking me again, in a different manner? Did they ever try to point out that it's not such a trivial matter to them? If one friend asks me to watch a movie I do not like, if a friend asked me to watch a movie i've seen several times, I would say yes if he or she told me that no one else could go with him or her, if he or she would say that he or she just wants my company, or if watching that movie is a big deal to him or her. I've done that many times. I've done a whole lot more for friends, it would be stupid to think I wouldn't do such simple things--- like watching a movie, going to the mall or bar, or just simply hanging out, for my friends... Unless of course, a great deal of cash would be involved. hehe. But if they would offer to shoulder some expenses, just enough for me not to burn a hole through my wallet, then I'd go with them, even to the ends of the world, without even a bit of hesitation. :)

******************

Oh yeah, as an afterthought... that same friend exclaimed that if only I cleaned up my act years ago, I wouldn't be so bitter about that failed relationship three years ago. One thing I am certain of, is the fact that I AM NO LONGER BITTER. I didn't even feel anything when she sent me a private message via Facebook a few days ago. Now what was that about cleaning up my act? WTF?!

Okay... honestly, i can no longer recall every single detail. Those events have transpired three years ago, and because of all the conscious suppression of memories that I have done, i may have missed a few things. Looking back at the past at this point in time may give me a better perspective. So yeah, I tried looking back. But after reading this single entry dated July 14, 2006:

She- Devil

I really have to say... what the f*ck?!

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.

Revenge of the Fallen

One of the cartoon series that I was extremely fond of during my younger years was Dragon Ball Z. I was so obsessed back then, I even watched several episodes that didn't have subtitles nor dubbed in english, even though i couldn't understand a single word of japanese. Even now, I still find the battles amazing. And now that I'm older, I've realized that the battle sequences were the only things the series had going for it. Everything in between pretty much sucked. Preposterous to downright silly story lines, littered with corny jokes and tiresome dialogue. Overextended, boring expositions that only serve to lengthen the running time. Many times, I wished i could fast forward the show when I'm watching it on TV. If only they cut out everything else and just showed one battle sequence after another, then Dragon Ball Z would have been an excellent series.

I know you are wondering... Why the heck am I talking about Dragon Ball Z when this is supposed to be a Transformers review? Because I feel pretty much the same thing with this movie. In typical Michael Bay fashion, the movie is filled with explosions, special effects, hot women, and heavy artillery. A showcase of women, military, and weaponry. The shots during the action sequences are superb, all that eye candy can really overcome one's senses. To put it bluntly, the action sequences are downright orgasmic. As for the rest of the movie? The plot sucks. The characters were written poorly. Some jokes weren't funny, and some were even offensive. Heck, some scenes that weren't meant to be funny were the ones that I thought to be funny. All the cheesy dialogue nauseated me. The scenes in between all the mayhem were overly long and unnecessary, they only made the movie less satisfying. Just when you get pumped up with adrenaline because of all the action you're seeing on screen, it all ends abruptly. You get another boring scene. another failed attempt to portray characterization and to elicit sympathy. If only all the fluff were taken out, if the scenes in between all that noise were shortened... heck, if they only showed one action sequence after another, then we'd have a more cohesive, and ultimately more satisfying movie.

But I still liked the movie... a lot. I know... WTF?!, right? How the heck can I like this movie with all the complaints that I have? Because I grew up with the Transformers. I loved the series to death, and seeing those giant f*ckin' robots for the first time on the big screen two years ago was a wet dream come true. I was a skeptic at first, but as soon as I saw the first robot transform, I was filled with awe. And upon watching another Transformers movie, I was filled with the same level of awe. Yeah I'm incredibly biased with this one. If this wasn't Transformers, I would've trashed this movie to death. But alas, nostalgia can really dull one's senses, and dulled senses made those action sequences even more intense. Nostalgia + Michael Bay signature action sequences = one incredible movie experience. Just throw you common sense out the window and take this movie for what it really is--- a summer popcorn flick (and it's not pretending to be something more than what it is, so critics should give Michael Bay and Co. a break), and you'll walk out of the movie theater entertained. You may not really like the movie as a whole, but to some degree, I'm willing to bet that you'll be entertained.

Dreamscapes

Dreams can be really weird sometimes. At times, dreams are ordinary and believable, sometimes they are completely out of this world. There's this theory that dreams are manifestations of one's subconscious thought, and yeah, some of my dreams do seem to reveal my hidden desires, but some of the dreams I have come out of left field. They don't make any sense at all.

I have always been fascinated with dreams. Way back in college, I even did a research paper on the subject--- but I didn't really get any definite answers. The general consensus seems to be that dreams are manifestations of the unconscious. But that conclusion leads to even more questions, and to many, even doubt. Take this weird dream I had last night:

From what I can remember, it started with me flying through space, but I somehow ended up in an igloo on top of Mt. Everest. Some of my friends and relatives were there, along with a few strangers. It was a rest house of sorts. One of my cousins was skateboarding on the icy ground, he couldn't stop and subsequently fell off a ledge. Then somehow, the place was a became an icy movie theater, i was in a balcony, looking down at the audience below... and there was an event: it was a movie premier. Then the screening had to stop because the stars of the movie have arrived. They apologized for being late, because there was a storm outside. Then the movie started playing from the beginning again. Then my mother was coming up from the ladder along with my aunts, and they were all wet because of the storm. Then I told them I had to go down to get something important. She told me to be careful, the path is slippery. As soon as I got off the ladder, I was no longer in Mt. Everest, I was in some weird town. I sat on the wet ground, and suddenly a truck passed by, which almost ran over me if I hadn't moved quickly. Then suddenly I was in some living room. I was seated on the floor, then a huge dog was all over me. i thought it was going to bite me, but it only sniffed me all over. It then said something, then proceeded to suck my balls.

I'm not kidding.

Just to make things clear, there's no way I'm having thoughts like that, even subconsciously, and never in my wildest, most horribly nauseating fantasies do i even wish for some dog to suck on my balls. Symbolism perhaps? If things in our dreams are symbols, what could they mean? On a scientific perspective, the subconscious theory seems more plausible, along with conscious thoughts, things that we are preoccupied with, manifesting themselves even in our sleep. But I don't really think my conscious nor my subconscious thoughts could be related to that dream i just had. Are dreams merely random images? Do they make sense at all? Are we putting too much thought into nothing? Seeing that there are no definite answers, dreams remain to be in the realm of mysteries for now, and would therefore pique our curiosities indefinitely.

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.

Standstill

It has become a monthly thing.

I got home a little late today. Traffic was bad, and with all the roadwork going on near our house, I had to take a longer route home. I was so tired, and all I wanted to do was sleep, but as soon as a lied on my bed, my aunt told me that my grandmother was finding it difficult to breath again.

*groan*

Not again.

July 2008. September 2008. December 2008. January 2009. April 2009. That's five hospital admissions in a span of less than a year.  It has only been 30 days since she was discharged from the hospital. That last attack was the worst one so far. Whereas before she would be fully recovered after about two weeks, she never fully recovered her strength after the last admission. After walking a short distance, she needed to sit down. She would already be gasping for breath. And when i say a short distance, that distance doesn't even reach a hundred meters. At home, she would occasionally find it difficult to breath, but a few minutes of pure oxygen inhalation would solve the problem. Maybe it was just another one of those episodes. Oxygen inhalation: done. Intravenous diuretics: given. Calcium channel blocker: given. After about thirty minutes, she fell asleep. She seemed to have stabilized. Breathing was normal. Heart rate and rhythm were normal. Everything seemed okay. After a few more minutes, i left her room and went to sleep.

I woke up almost midnight. Everyone in the house is usually asleep at that time so I didn't notice anything that was out of the ordinary. I ate dinner, watched a little TV, surfed the net, took a bath. Then I received a text message from my dad. Apparently, my grandmother was brought to the hospital while I was asleep, and she was again confined at the telemetry unit. She didn't want to wake me up because she noticed that I was tired, so my dad was called instead.

I knew it was inevitable. The fact that she has not yet fully recovered after a month was a bad sign. Hospital admissions have been increasing in frequency, I doubt if she still has long to live. Last month, we had to take her to the hospital right after we had dinner at a restaurant. All of a sudden, she couldn't breath, and she was quickly getting pale. Good thing the hospital was nearby, because that was a close call. That was a week before the exam i took. I couldn't properly do some last minute studying (or should I say cramming) because I had to take part in hospital shifts--- a relative must be present near her room at all times. And because I had the most flexible schedule, i had to take the bulk of those shifts. It was fine, except for the fact that I couldn't get much studying done at the hospital. I'm not saying that was the reason why I didn't get a high grade on the exam, but I guess it was a factor.

Somehow, I'm at a standstill. I can't really make definite plans for the future when she's like this. I have to put everything on hold when these things happen. I HAVE to be always available. Even when it was impossible, my dad pressured me to make it possible--- that was one of the factors that led to my eventual resignation as a surgery resident. That job required me to give all my time, and it wasn't compatible with a family situation that occasionally required me to give my full time also. Just two weeks ago, I found it extremely irritating when my dad specifically told me that when my grandmother has to be brought to the hospital, even when I'm at work, I should still be available to bring her.  He's going abroad and my brother is out of town, and I would be the only one in proximity. Uh... don't we have the family driver for that???? Did he really expect me to do something so irresponsible? To suddenly leave the hospital where i worked when it was virtually impossible to find another doctor to cover for me on such short notice? Yes, I was often pressured. At times I'm given such huge and impractical demands, but I never felt that I was being forced. I'm not obliged to. But as person who cares for someone he owes his life to, I feel that i have to. It's my duty. It's my responsibility. Because of that, I have realized that I can't really go on unless she completely recovers and  stay fit and healthy, or sadly... just the opposite. Yet I can't keep on postponing my plans waiting for such a thing to happen. I can't remain on a standstill for months, even years, or God forbid... even a decade. Who knows how long this will go on? I'm praying for more years ahead of her life, but I can't remain like this during all those years. Eventually, I have to go ahead and carry on, just wish for the best, ignoring all distractions,  and stick to my plans without looking behind...

No matter how uncaring and selfish it makes me look.

No matter how sad, contrite, and pitiful it makes me feel.

Even if I end up hating myself, I have to move on... sometime.

The First Obstacle

Down in the dumps. So f*ckin' depressed. That was how I felt when I received the results of my USMLE step 1. I know, I should be happy that I passed, but I just can't help but feel depressed. A long time friend pointed out that it must be because of my bruised ego. As someone who was viewed as a genius/ nerd a decade ago, getting a below average score is a major downer. Fine. My ego was bruised. It wasn't just bruised. It was crushed. But that's not the reason why I'm feeling depressed. I feel sad because for a fleeting moment I thought I really had the chance of getting into the program that I really wanted. Yeah, it was probably a long shot, but I still had that chance. And just like that, as quick as a blink... the chance was gone.

What exactly am I talking about, you ask? If you manage to read my blog from the very beginning, you'd come to the impression that I'm sort of a morbid creature. I get high with the sight of blood and guts. I get that adrenaline rush when I encounter emergency situations. The most obvious clues would be my entries from the year '07, when i was blatantly ranting about the residency program that I was in. I didn't want to be a doctor in the first place. But here i am now, it would be really impractical to make a sudden and drastic career shift. So if I had to choose a program to specialize in, it had to be something I enjoyed doing. Every incision I make gets me high. Successfully doing an operation, no matter how simple it is, gives me a great deal of satisfaction, a remarkable sense of accomplishment. In order to lessen the bitter taste that this profession leaves in my mouth, to make everything easier to bear... if I had to choose a residency program, it has to be surgery.

When one of my close friends told me I had a shot two months ago, as long as I get an above average score, I was extremely happy. I knew how hard it is for a foreign medical graduate to get into surgery in the US. One needs to have a lot of credentials. US clinical experience. Published research works. Recommendation letters from renowned American Physicians. Exemplary grades in Med school. Exceptionally high scores in the USMLEs. Most of which i don't have, but I still had a chance because my friend has relatives on "the inside", and they could help me out. I just had to get high scores on my MLEs. And when I got my score, that dream vanished instantly.

It's not a big deal really. Crap, I know this would sound selfish, but my main reason for wanting to train in the US is money. Yeah, I know the medical profession is service oriented, and financial matters should not be at the forefront... but I'm just so tired of getting such a paltry some for all my efforts. All those years spent in med school, with all those lavish expenses, those sleepless nights, the mental torture... all for what? For a job that offers salaries that can barely support a single person? Don't get me wrong, I like serving others, I like to help out. But how can I continue helping others when I can barely support myself? So yeah, financial gain is my primary purpose. If that's my primary purpose, then it shouldn't matter which residency program I get into, right? But is it so wrong to dream? To wish that i could get into that certain program that could make this whole profession I'm in a little easier to swallow?

Now reluctantly, I'm exploring other options. First is family medicine. They say it's the easiest program for foreign medical graduates to get into because it's the least competitive. Most American medical graduates choose other specialties, and I can't blame them. Because family practice, deals with primary care, they get the huge patient loads. Schedules can become hectic. On the upside, that means more cash. Plus, the option to take up Sports Medicine as fellowship makes the program attractive to me. And---! I heard that doing minor surgical procedures is part of the program, and sometimes family medicine residents even do major operations when no surgeons are available. i can do something I like, although it would be mixed with rotations that i hate, like obstetrics and gynecology. Yuk. The only problem is, the option to go back to my home country after residency is still an option for me... depending on how things go. In this country, other physicians look down on family physicians and emergency medicine physicians... the "jack of all trades, master of none" stigma... add the fact that family medicine is not a lucrative practice at all back here.

So... option number two would be internal medicine. Since med school i hated this subject matter. Even during clerkship and internship I hated rotating in this department, and now, every time i go on duty at the emergency room, I cringe whenever i have to handle medical cases. I'm also more hot headed when dealing with these patients. It just isn't my thing. At times, I even feel like a fish out of water when I encounter such patients. I know I can learn eventually, but when it comes to this subject matter, I have no urge to learn at all. Would the promise of hefty salaries be enough to make me last for years in a program that I absolutely detest? One upside would be a better private practice back home if ever I decide to go back. And there would be none of that family medicine stigma. And I could take up gastroenterology or pulmonology for fellowship, the two subspecialties that piqued my interest back in med school. But I just can't stomach the other subspecialties. Just thinking about those three years during residency where I have to go through those other subspecialties nauseates me.

The other residency programs are not for me. I just can't see myself as a pediatrician, an obstetrician, a gynecologist, a radiologist, an anesthesiologist... i just can't. So it's a toss up between family medicine and internal medicine... I don't really like both, so it's going to be difficult weighing the pros and cons, which program would be easier to stomach. Man, I hate choosing between two evils. But as they say, beggars can't be choosers. I'm in no position to be choosy.

But it's not over yet, is it? That's just one step, there are three more to go. Maybe if i get a better score on the next one, I might still have that chance again. It's a long shot, but maybe there's still a chance that I won't be spending everyday in residency drenched in utter misery.



Hey, the last time I checked, everyone is still free to dream.

No More Breaks

Caution: THIS BLOG ENTRY IS NOT SPOILER FREE.

Prison Break was my favorite TV show. No matter how preposterous the plot had gotten, the non stop action and sudden twists and turns kept me glued to the screen. It was my favorite show--- until it returned last month after a very long mid season hiatus. I don't know why, but somehow, it did not feel the same. Somehow, I no longer found the episodes exciting. I no longer cared for the characters. In truth, during some episodes, i was already rooting for the villains. Maybe it's bad writing. I hated some of the decisions made by the protagonists. I hated the way they acted. Maybe the extended hiatus made me realize how extremely silly the whole season 4 plot was in hindsight. Maybe it made me realize how the show has deteriorated. Yes, season 4 was exciting and action packed, but looking back, the whole storyline seemed forced. All that excitement only served to distract the viewer from that fact. Obviously, the writers have been milking the series for all its worth, up until the point where they can hardly squeeze anything at all. They should have ended the series sooner, back when the whole story arc still made sense. In truth, I was only watching these last few episodes to see how it will all end. These characters have grown on me through the years, and it will be shameful to cop out as we're nearing the end.

As for the two part finale? There were so many twists and turns that it made the two hour finale very convoluted. It wasn't just convoluted, it was downright silly at times. Each scene jumped to another in a very brisk pace, it left very little time for the viewer to absorb just what happened. And whereas before the viewer is often astounded by the ways Scofield and co. maneuvered their ways around every problem they've encountered, the things they did in the finale was just--- blah. boring. routine. mechanical. And bringing back Kellerman at the very end just to provide an easy way out? Man, I've been impressed by the writers of this show since the excellent first season, and this is the first time they've really let me down. They couldn't think of anything else that would make sense? Kellerman was obviously dead, the same way that Sarah was obviously dead--- until they made up that not so believable story on how her death was faked when the contract disputes were already resolved. And as for the ending? I though it was both believable and fitting that Michael died in the end. No violent reactions from me. Sure, a lot of fans are clamoring for the predictable storybook ending, some have been ranting on how Michael deserved a happy ending after all he's been through, but c'mon. The series has never been about fairy tale endings. That's not even how things go in real life. Kudos to the writers for not going through the predictable path. The ending even gave the series a lasting emotional impact, as compared to an ending wherein everyone is riding happily towards the sunset. So yeah, season four a was great ride during the first half, but everything else pretty much sucked. But as a whole, Prison Break still remains as one of my favorite TV shows, thanks to the strengths of the incredible previous seasons.

As for the direct to DVD movie called The Final Break that's intended to tie up all loose ends? I ask--- what loose ends? Man, this is another attempt to cash in on a series that's on its dying breath! Fox is really milking the series for all it's worth. If they could really expound the storyline, then by all means go for it. But if it would only serve to make the ending even more convoluted, then they better leave it as it is.