Squaring Off: The Hospital Detention Law

I just came home from guesting on ABS-CBN News Channel (ANC)'s debate program, Square Off.

The proposition: Resolved, that Republic Act 9439 (Hospital Detention Law) should be repealed.

A backgrounder: Last April, President Gloria Macapagal Arroyo (PGMA) signed into law RA 9439 also known as "An act prohibiting the detention of patients in hospitals and medical clinics on grounds of nonpayment of hospital bills or medical expenses", or the Hospital Detention Law for short.

It prohibits hospitals or clinics from detaining charity patients who have recovered (or corpses) but still have financial obligations or unpaid bills. It allows for these poor patients/families of deceased indigents to execute promisory notes in lieu of payment, for the former to be released from the hospital.

The Private Hospital Association of the Philippines (PHAP) is strongly against the law and is calling for its repeal, citing financial losses that private hospitals will allegedly sustain due to charity patients freely leaving the hospital without payment in cash.

For the program, I chose to side with the negative to the proposition. The proposition being to repeal the above law, my position thus translated to being pro-charity patient, anti-private hospital as far as detaining patients is concerned.

Want full details? Please watch Square Off's replays of the episode on any of the following: Thursday (May 31), 1:00 pm; Saturday (June 2), 7:00 am or 2:00 pm; and Sunday (June 3) 1:00 am. I sparred words with Niko Tuazon, an incoming 4th year BS Computer Science student at DLSU-Taft.

The Power of a Lie

In the town of Tarnopol lived a man by the name of Reb Feivel. One day, as he sat in his house deeply absorbed in his Talmud, he heard a loud noise outside. When he went to the window he saw a lot of little pranksters. "Up to some new piece of mischief, no doubt," he thought.

"Children, run quickly to the synagogue," he cried, leaning out and improvising the first story that occurred to him. "You'll see there a sea monster, and what a monster! It's a creature with five feet, three eyes, and a beard like that of a goat, only it's green!"

And sure enough the children scampered off and Reb Feivel returned to his studies. He smiled into his beard as he thought of the trick he had played on those little rascals. It wasn't long before his studies were interrupted again, this time by running footsteps. When he went to the window he saw several Jews running.

"Where are you running?" he called out.

"To the synagogue!" answered the Jews.

"Haven't you heard? There's a sea monster, there's a creature with five legs, three eyes, and a beard like that of a goat, only it's green!" Reb Feivel laughed with glee, thinking of the trick he had played, and sat down again to his Talmud.

But no sooner had he begun to concentrate when suddenly he heard a dinning tumult outside. And what did he see? A great crowd of men, women and children, all running toward the synagogue. "What's up?" he cried, sticking his head out of the window.

"What a question! Why, don't you know?" they answered. "Right in front of the synagogue there's a sea monster. It's a creature with five legs, three eyes, and a beard like that of a goat, only it's green!"

And as the crowd hurried by, Reb Feivel suddenly noticed that the rabbi himself was among them. "Lord of the world!" he exclaimed. "If the rabbi himself is running with them surely there must be something happening. Where there's smoke there's fire!"

Without further thought Reb Feivel grabbed his hat, left his house, and also began running. "Who can tell?" he muttered to himself as he ran, all out of breath, toward the synagogue.

[From A Treasury of Jewish Folklore, Nathan Ausubel, Ed., 1948]

Guazon Hall

This is how we med interns look like every 7:00 am of Monday to Saturday.

This is how the residents look like when they don't get the right answer from us.

And of course, this is the bust of Dr. Potenciano C. Guazon, for whom the PGH hall where morning endorsements are held is named.

Kartagener's Syndrome

...is what I'm going to be reading on for tonight, in preparation for morning endorsements (aka Intern Breakfast Combos for Medical Residents) tomorrow.

Don't get me wrong - I AM TOXIC.

It's just that writing this Blog entry is my way of telling the Hospital - I still have freedom to do what I want, when I want! Of course, so long as my schedule permits it...

Darn. I'm not so free after all.

Proof of Participation

I just came home from Parish Pastoral Council for Responsible Voting (PPCRV) Medic/Pollwatching Duty at our voting center in BF Homes Multipurpose Hall Phase I, Barangay BF Homes, Paranaque City.

Patient Census: two (2). One who came in due to "palpitations", and another due to fatigue. Turns out that both were stable and just tired of the morning heat.

With nothing much to do on the medical aspect and the "action", so to speak, being more at the voting center front lines, I decided to double up as a pollwatcher.

Lucky for me that my home precinct's Board of Election Inspectors (BEI) were courteous and of the peaceful kind, as were many others. The image of teachers out to cheat is so unfair to these men and women who slave away from 7:00am to midnight or even past, just to facilitate our democratic exercise.

When it came to the counting, our precinct finished somewhat earlier than the others, thanks in part to the BEI's third member being a college student perhaps a few years younger than me.

In all, it was an experience that was more relaxed than in 2004, maybe because back then I was Voting Center Manager (VCM) for NAMFREL, a job with more responsibilities than those expected of me this time around.

I hope and pray that the inconvenience and sacrifice felt by BEI members, pollwatchers, and support staff nationwide were all not in vain. Still, as one of the BEI members quipped (and to which I agree) - the cheating is not done in the precinct level. It's at the Canvassing where the likes of Garci do operate.

How to Vote

Are you a first time voter? Or veteran who wants to review the steps in voting? In any case, knowing in advance how to go about the process will save you time by making your visit to the polling place more efficient and orderly.

This has been adapted from the Pollwatcher's Handbook of the Parish Pastoral Council for Responsible Voting (PPCRV).

Pointers:

- Find out what your precinct number is preferrably at least a day before the elections. The PPCRV offers a free and fast computerized search at your local Parish Church. For non-Catholic Filipinos, the same may be done at your local Barangay Hall. (Tip: Your precinct number will not be far from your family's or neighbor's precinct number.)

- Voting starts at 7:00 am and ends at 3:00 pm on Monday, May 14, 2007, but if there are still voters in queue within thirty (30) meters from the polling place, they will be accommodated. (Tip: Avoid the Filipino tendency to procrastinate. Vote in the morning for your convenience.)

- You are encouraged to list down on paper your preferred candidates/choices even before election day, and you're allowed to bring this list with you to the polling place. Unless you have a photographic memory, it is hard to remember 12 Senators, 1 Partylist, and a whole bunch of local city/town officials.

- Bring at least the following: Ballpen, Your list of candidates/choices, Identification Card

- From the moment you are handed a ballot, keep your eyes on it until it is finally dropped into the ballot box

- If you have any questions, do not hesitate to ask any member of the Board of Election Inspectors (BEI), PPCRV, or NAMFREL. While there will also be helpful pollwatchers from political parties in the area, be wary of their advice as it may be biased towards their candidates.

Steps in Voting

1) Proceed to your polling place (usually a public school or government building, may be a public basketball court/gymnasium sometimes). If you have not yet done so, look for your name in the alphabetized and posted Computerized Voters' List. Take note of your precinct number.

2) Go to your precinct (denoted by an alphanumeric combination, such as "523" or "523-A"). There will be three COMELEC-appointed officials (known as the BEI) seated directly in front of the ballot box. Ask who the BEI Chair is, and then give your name and address to him/her. (Tip: There may be some instances when someone will "challenge" your identity. Simply present your ID card to the BEI and there will be no problem.)

3) Present your right index finger to the BEI. They will check (NOT yet apply ink) if it is already stained with indelible ink. The BEI Chair will then announce your name and ask you to sign in the Election Day Computerized Voter's List (EDCVL).

4) The BEI Chair will then process your ballot. He/she will a) announce the serial number and sign behind the ballot to authenticate it; b) write the ballot serial number in the EDCVL; c) fold the ballot before giving it to you; and d) make sure you have signed in the EDCVL.

5) With ballot in your hand, go to the designated area where you can find COMELEC Ballot Secrecy Folders. Write down on your ballot your choices. Just like using an ATM, do NOT ask for help from anyone while casting your vote, unless you are physically challenged (in which case the BEI or your relatives may help you). Do NOT make any stray marks anywhere else on the ballot. (Tip: You are allowed to abstain. To do so, simply mark the position you're abstaining from with a line or an "X". Do NOT leave any positions blank.)

6) After writing, fold the ballot in the same way that you received it. Go back to the BEI of your precinct. You will be asked to affix your thumb mark on the ballot coupon.

7) Return the ballot to the BEI Chair (he will be the one to drop it in the ballot box later). He/she will check if the serial number of your ballot matches the serial number issued to you.

8) The BEI Chair will apply a drop of indelible ink at your right index fingernail. You MUST allow your right index fingernail to be inked; if you will refuse, your ballot will be marked as spoiled (it won't be accepted) and you will be asked to leave (shame!).

9) The BEI Chair will sign in the EDCVL, remove the coupon from your ballot, and drop your ballot into the ballot box compartment for valid ballots.

10) Quietly leave the polling place. Unless you are a pollwatcher or authorized by the COMELEC, you're not allowed to loiter in the polling place.

You're done!

Sample Ballot Update

Election Day is already on Monday. I've been updating my sample ballot. From the last time I posted it, I took out Alan Cayetano (sorry, but Sen. Pia's already there - no to dynasties!) and added Sonia Roco.

Three slots left to fill-in, or maybe leave blank. Ang Kapatiran's candidates seem to be a good choice, but I'm not yet fully convinced. They are, at this point and in medical parlance, "to consider".

For Senators:
1) Kiko Pangilinan
2) Joker Arroyo
3) Ping Lacson
4) Manny Villar
5) Edgardo Angara
6) Ralph Recto
7) Noynoy Aquino
8) Sonia Roco
9) Chiz Escudero
10) -undecided-
11) -undecided-
12) -undecided-

For Partylist:
Akbayan

For Congressman (Pque 2nd Dist):
Roilo Golez

For Mayor (Pque):
Jun Bernabe

For Vice Mayor (Pque 2nd Dist):
Gus Tambunting

For Councilors:
-undecided-

Dermassage

This morning I was posted at the PGH Outpatient Department's Section of Dermatology.

From a medical intern's standpoint, interviewing and examining patients with skin diseases is like a highly intellectual game of show-and-tell: the patient shows you what's on his/her skin, you tell the resident what the patient has.

It would not be worth blogging a daily encounter if there was nothing special, of course:

One of my patients was a 27 year old female who, to fast track, was diagnosed with something akin to skin darkening after using too much skin whitening products and then exposing yourself to the sun.

She came in, very particular about these black macules (spots) on her face.

Yes, she was thorough in telling me everything - down to the last detail about her concerns on bad breath.

Being the compassionate student physicians that we are (or are supposed to be?), I listened.

After taking down her disease's history, I invited her over into the examination cubicle for better positioning and lighting. Inside was a recliner chair similar to that used by dentists, draped with green hospital linen and lighted well, as it should be.

On seeing the set-up, my patient's eyes light up. She looks at me with great expectation, and asks...

..."Wow Doc, may libreng massage?" (Wow doctor, there's a free massage?)

It was an "oops, ay..." moment. Oops, because she saw the shock in my face; Ay..., because I tried to be most tactful in telling her that a massage is not part of my job description.

But wait, there's more!

In the course of presenting her case to my resident, the patient is told to use sunblock lotion every morning as part of her prescribed regimen. Training institution setting as it is, the detailed advice is expected to be delivered by me, while the resident moves on to check other patients.

I told Ms. Massage-me-Doc that she should apply sunblock lotion of any brand, so long as it is at least SPF Factor 30. The lotion was to be applied in the morning at least 30 minutes before going out into the sun.

I was expecting the usual follow-up question "Doc, ano yung SPF?" (Doc, what is SPF?) When, perky as ever, she asks me:

"Ah, thirty minutes ilalagay ang sunblock bago maarawan sa umaga." (Oh, sunblock should be applied thirty minutes before sun exposure in the morning.) She understood. Then... "Eh paano siya gamitin sa gabi?" (Umm, how do you use it at night?)

Arrghh... she was serious in asking me.

I just had to look around and check for hidden gag show cameras.

Quotable Text Quotes

Look at the world as a big fruitcake.
It would not be complete without a few sweets and nuts...
Sweets like me, and nuts like you.

-----

Host: Ms. Philippines, what is your stand on premarital sex?
Ms. Philippines: Ladies and gentlemen, the question is easy.
I do NOT stand... I lie down. Thank you, thank you!

-----

Why do you want to be a Doctor?
Here are some reasons...

1) You don't like sleeping
2) You love caffeine
3) You like to play with dead bodies
4) You love hospital food (yummy!)
5) Your handwriting sucks
6) You want to stay in school forever!
7) You look good in white
8) Your parents have an extra million bucks lying around
9) You like to memorize without understanding
10) and of course... You want to help mankind! (Awww...)

-----

Mga anak (triplets na lalaki): Itay, itay - bili mo kami ng baril!
Itay: Wow naman! Paglaki niyo palagay ko sundalo kayo.
Pagkabigay ng baril...
Mga anak: Get ready girls, Charlie's calling!

-----

Let us maintain a balanced life:
Be strong, but not rude
Humble, but not weak
Kind, but not timid
Confident, but not arrogant
and best of all...
Gorgeous, pero kungyari hindi aware!

-----

It's sad how busy we can get sometimes
and forget to keep in touch with each other.
But I want you to know that nothing's changed...
I still look great!

-----

My nights are becoming sleepless,
my days are becoming restless,
So I asked God, "Is this love?"
and God said,
"Love? Anak, it's your Finals Week."

-----

Alone walking, I slipped and fell
not noticing a hump on the way.
Naiiyak na ako... kung kasama sana kita,
may magsasabi...
May humps, may humps, may humps,
Check it out!

Doctor, Doctor I am Sick...

...call the Fellow very quick!

My first day as a medical intern was overrated. Too much hype. It's either that, or it's my so-called "benign powers" at work.

There was this plump, pregnant cat lounging around the intern's area (more of an intern's window with a view of lush green vegetation in the form of mango tree branches). The way she lazed around the callroom is akin to how I was doing. No one was "codeable", and the steady stream of procedures became routine after a while.

Still, everything felt comfortably weird. This newfound responsibility accentuated by a red nameplate - cool in that it says "Dr. Albert Francis E. Domingo" for real, gave me a sense of guarded authority: confident that medical rank was conferred upon us already, but humble enough to realize that we are still students under the direct supervision of licensed physicians.

The way the Cancer Institute was endorsed to me can be summarized by this statement: "You're the only MD in the building, and the nearest code team (dedicated team of senior resident physicians tasked with advanced cardiac life support) is around 10-15 minutes away at running pace. Be prepared to take charge and do tracheal intubation, CPR, and initial steps in life support."

Gray's Anatomy? Somewhat.

Intership Begins

In exactly one hour, my nameplate shall henceforth be color red.

Along with several of my classmates, 7:00 am of today marks zero hour - that time wherein the outgoing interns of UP-PGH Class 2007 shall endorse their patients (for the last time as interns) to the incoming interns of UP-PGH Class 2008.

No more excuses of blissful ignorance. Well, in a lot of instances maybe there's still our option to "refer" to a doctor higher up in the medical food chain. Still, unlike medical clerks, tolerance for mistakes will not be so high.

I feel queasy. Or maybe this is just overrated?