I cup

You might be wondering why I took this picture of this man. What is it that he is doing there in the middle of the road? Is he checking the pressure of his tires? Changing a flat? Does he need any help? Should someone be giving him a hand?

No, he definitely doesn't need any extra hands for what he is doing.

This is an everyday scene here in the Philippines. However, usually the guy would be standing next to the wall of a building or in front of a bush. Not, in the middle of some busy street in Manila where this guy decided to take a piss.

Out here it is as if almost anywhere is a public restroom. So for all you foreigners walking around in slippers and who have stepped in a puddle, you'll have to think back if that was really water.

I C-U-P

Holy Week journey

Last week was they celebrated Holy Week here on the island and on last Thursday my uncle had invited me to go on a “spiritual journey”. Despite my usual religious fervor I was kind of reluctant to say yes immediately but after realizing I had nothing else at all to do in my dorm I decided to go along.

The first stop on this spiritual journey was Kamay ni Hesus (Hand of Jesus) in Lubac, Quezon where they have among other things a healing priest by the name of Rev. Joey Faller, a 50 foot statue of Jesus sitting on top of a 20 story hill, and ex-beauty queen. At a glance it looks like an amusement park for Christians with a 20 story hill decorated with statues of the 14 Stations of the Cross. However, as you watch the hundreds of people both young and old make their way up the 200+ steps of the hill bearing the heat and humidity you see that everyone here is seriously devoted to their faith. We'll most of them...



The 4th station, Jesus is adorn with a crown of thorns.



The 7th station, Simon helps carry the cross.



The 8th station.


Where Jesus plays pat-a-cake for the last time.

One of the buckets of coins they pulled out from a pond on the hill.


Religion pays in this coutntry!

Hundreds of candles are burnt for personal wishes.



I was told if you want to bestow ill will on some one you turn this guy upside down and then make your wish.


Alright praying to God to hurt some one. That's a new one to me, but maybe one I'll try.



I believe this is Guadalupe Sanchez. She's a former Miss Philippines who now runs a restaurant in Manila.


Well, you know beauty doesn't last forever.

Though it was already dark and most of us were sweating from climbing to the top of the hill I came to discover our spiritual journey wasn’t over yet. It just began. One of the traditions here in the Philippines is Visita Iglesia which means church visit. It’s a modern day pilgrimage where people go from one church to the next in a physical representation of the Stations of the Cross, minus having to carry an actual cross and adorning a crown of thorns. Although there are some places where they do that. Most people visit 7 churches but others do the whole 14. We sort of got going kind of late so we weren’t able to complete the Visita Iglesia but at least we did give it a go.

One of the places we managed to visit was Tayabas Basilica in Quezon province. Built in 1585 by Franciscan Friars it is one of the oldest churches in the Philippines.



Though it needs a little restoring it is a really nice church.








Oh snap! Jesus is black!

Another church we got to visit before the night was over was Lucena Cathedral, which was completed in 1884.



This was a nice church as well with a lot of decorative wall paintings.


Looks like Cain is about to serve Able a can of whoopass.

We were able to hit up another two churches before everthing started to close down. However, they where just your typical modern churches. So with that our little spiritual journey came to an end.

Case discussion

The case:
While celebrating with a group of friends a 58 year old med student managed to consume 6 bottles of beer and 6 shots of hard liquor. Also on the menu that night was clams, grilled fish and oysters some of which were particularly hard to open. The following day he began feeling the typical symptoms of a hang over including headache, nausea, and myalgia. On the 2nd day symptoms persisted. The 3rd day symptoms were accompanied by severe epigastric pain, fever, chills, and an acute bout of diarrhea. The consistency of the stool was noted to be watery with tiny flecks of debris.

Initial diagnosis:
Vibrio spp. infection

The reasoning:
Vibrio is a gram negative rod that is pathogenic to humans. Typically the body's natural defenses, such as the acidity of the gastric fluid are enough to prevent infection. However, the large quantity of carbonated alcoholic beverages consumed during the party may have increased the normal pH level of the gut. Thus, allowing the organism to survive upon consumption. Shellfish such as clams and oysters are known to be natural host of Vibrio spp. and were served in large quantities at the party. Adequate cooking is normally enough to kill the organism. When shellfish are adequately cooked they will typically pop open to expose their meaty flesh. However, as noted many of the oysters where difficult to open indicating that may have been undercooked. Initials symptoms of Vibrio spp. food poisoning may have been masked by alcohol intoxication. However, the symptoms of epigastric pain, fever, chills, and "watery-rice" like diarrhea typical of Vibrio infection still fell within the normal incubation period of 1-3 days.

The reality:
Once I had taken an aerobics class in junior college where we would have to do situps for a period of 45 minutes straight each session. I still remember the how painful my abs felt after that first week and it was... nothing compared to this. This felt like some one grabbed hold of my intestines and was trying to wrench them dry. On top of that I had made a trip to royal throne so many times that I eventually ended up with toilet paper burn.

Lesson learned:
Don't mix beer and oysters, just drink beer.

The price of cut backs

Now, for some unknown reason I don't have an unlimited amount of money to spend while I'm staying in this country. In fact my budget is quite limited. Luckily for me you could say I've have been born with an innate sense of making my money work. And one of the ways I make my money work is by cutting down on what I spend. And one of the things I have been cutting back is on toilet-tissue. By getting the generic brands I save 10's of pesos. Hey, every cent counts or in this case centavo. Well, at least that's what I thought.

After 7 visits to the John today I've decided that cutting back on the cost of toilet tissue was not such a good idea. Some of this stuff is ruff. My ass now has toilet paper burn.

From now on it's nothing but the softest for me.

The year in review

Ok, so I finally completed my second year in medicine (actually we been done for about a week now) and apparently I have managed to pass all my classes. Amazing. Anyway, it’s time now for my year in review report.

For this second year of medicine I have to say it has been... total crap. Other than out of pure stupidity I can tell you why I thought this year would have been better than the last. I just thought that maybe this year I’ll ignore the fact that the teachers are constantly late and the rest of last year’s problems and try to learn something. However, the teachers that used us as guinea pigs and as personal stress relievers, and the ones that we saw only at Starbuck’s took it to a whole ‘nother level. We had one teacher this year who must have shown up no more than twice for class tell us, “it’s ok for me to be absent but not for you because I know everything and you know nothing”. This had to be one of the stupidest comments of the year. It’s right up there next to DSM’s speech. Ok genius, don’t you think that since you know everything maybe you should be showing up more often so that maybe we might actually learn something? After all you’re suppose to be our $@#%!&* teacher.

As for my grades, they are slightly lower than last year but I don’t think grades really tell you much around here. You got to look personally at what you got out of it. And with that I would say I got the same amount of education as I did last year which was crap. I don’t think I’ve learned much in pharma and definitely not much if anything in medicine. The one thing I did learn though was that if you don’t feel motivated OTs aren’t going to matter much. Don’t get me wrong though OTs are definitely a big advantage. But I would have to say I basically went OT free as one can get this year around and my grades are basically the same as last year, considering the effort. I probably looked at an OT before a regular exam no more than twice but then when finals came around they start popping up everywhere. For some reason it still surprises me to find out who has these things. It’s like everyone has a secret stash. If this was prison OTs would be like cigarettes and you probably could trade them in for sex.

I still have a hard time trying to concentrate on what it is that I came here for, which is an education in medicine. There is still just way too much bullshit that goes on around me that ends up taking most of concentration away. And I seriously doubt that the system at this school is going to get any better so why am I still here?