#GeandMaan: 10 Years!

Because 5-22 will always be a special day for us, 10 years and counting! Happy A babe! #geandmaan #dekada #522 via Instagram http://ift.tt/1i7pZMq
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Glimpse of the Future?

Received this referral personally, via phone. Haha. Joint effort ๐Ÿ™‚ #geandmaan #OOD1 #burnROD @maandecastro

A post shared by Gerald Abesamis (@geraldabesamis) on

It still amazes me how, despite the big difference between the practice of OB-GYN and Plastic Surgery, we could still end up managing the same patient. Hahaha.

We’re both on duty today. Maan’s the 1st OOD (Obstetrician on duty) admitting all charity OB-GYN patients under her care, and I’m the Burn ROD (Resident on duty) seeing all charity referrals to the burn service.

On a previous instagram post, I jokingly suggested that the only time Maan and I could treat a patient together is when she refers to me for wound closure of her CS patients. Hahaha. I never thought that managing a pregnant woman with burns is also a possibility.ย So, when Maan called me up this morning, the last thing that I thought I would hear from her was a referral.

Jackpot. Pregnant patient + Scald burns.

It’s funny how we were discussing this very same topic lengthily just last week! Because of the recent mortality in the burn unit [A 28 week pregnant woman with 30% burns from a blast injury (sumabog ang LPG, tsk tsk) who also delivered her preterm child while in the burn unit!],ย I was asked to report about the management of burns in a pregnant woman in our weekly conference.

While preparing for my report, I told Maan how little literature there was about this topic. The most recent one I found was written in 1998! Sabi ko pa noon sa kanya, maybe we could co-author a research paper about this ‘pag medyo libre na kami. Interesting kasi and at least parehong malapit sa puso naming dalawa.

Little did I know that today, there was this patient we’d see together.

A glimpse of the future perhaps? ๐Ÿ™‚

Birthday Parties

If you know me for quite a long time, you’ll know that I almost always mark my advancing age with a blast. Almost every year, I am lucky enough to have the chance to celebrate my birthday with a party! I don’t know why I always get to have a party on my own. Probably because I’m special in the family (haha, not a special child mind you), since I was born on November and the rest of the family were all born on July. While they celebrated their birthdays together every July, I had the whole month of November to celebrate mine. And almost every year, my birthday wish was to have a party with friends and family. ๐Ÿ™‚

So since today is my birthday, maybe it’s time to take a trip down memory lane and reminisce the best parties I’ve had. ๐Ÿ™‚

The first party that I could at least remotely remember was my 3rd birthday party at Jollibee Greenbelt. I think we had jollispaghetti and a mocha cake. My memory from this party mainly comes from pictures, and the cake figurines of Jollibee and Champ I kept as souvenirs.

The next big party I had was during Grade 6 where my elementary friends came over at our house for a wild and wet water balloon party, hahaha. So juvenile, right? Haha. But we had so much fun! So since then, I had an annual party at my house with friends and family coming over for dinner, and later on for some drinks.

Highschool soon came up and my annual party became the annual inuman of the barkada. Yep, I celebrated my 15th to 17th birthday drunk. Haha. Sometimes we’d climb up our roof, even our water tank. Still so juvenile.

I only missed holding a party on my 18th birthday since I was stuck in Manila, studying for a lab exam in Biology. So the following year, my mom and dad treated me to a BIG party again at our house, debut style, haha, complete with 19 tequila shots!

I had the biggest surprise on my 20th birthday when Maan, Sheng, Sandee and the rest of my med friends organized a surprise party for me at Rob 7th Floor with all my classmates invited! It was the first and only time that I had one, and the feeling was so surreal. I couldn’t believe na naitago nila sa akin yun. Haha.

They later confessed that they would announce the details of the party to the whole class whenever I would go to the CR or outside the lecture room to get food. Hahaha, kudos to all of you! ๐Ÿ™‚

I celebrated my 21st birthday at Ultra Complex during the Palarong Med, an annual sports competition among med schools in NCR. I didn’t have time to organize a party that year, but I got one of the best birthday present I’ve ever received: our volleyball team won 1st place, and so did many other UP Med varsity teams! Championship trumps a party anytime, hehe.

Maan and I had our first joint party when we celebrated our 22nd birthday together. ย We called it The Ge & Maan’s Party, a.k.a. The Priors’ Party since we were both Brother and Sister Prior in the fraternity/sorority that year. We held it in my house, served lots of food and booze, and it was great that our friends, brods and sisses, came all the way from Manila to QC for our party! Saya!

I didn’t really feel like celebrating on my 23rd birthday since we were clinical clerks that year, and well, toxicity got the best of me. Haha. Celebrated my whole day with my blockmates (who surprised me with a chocolate cake!) and Maan (and ate at Cyma Greenbelt). No party again that year.

I was an Intern on my 24th birthday, and since it was my final year in med school, I pledged to hold an all-out wasakan party that year. So I asked the support of my Phi batchmates to celebrate my birthday as a half-way through internship party and called it after our batch name: The Half Life Stag! We rented out a mobile bar, asked them to double the alcohol content of the drinks so people would get really wasak after the party.

Soon found myself to be the one who was the FIRST wasak! Didn’t really remember most of what happened that night, but I’m pretty sure that I was happy. Hahaha. ๐Ÿ™‚

I spent my 25th birthday in Boracay as an island doctor. That was my first time moonlighting (ergo, I finally had my own moolah!), and also the first time I spent my birthday away from Metro Manila. Mam Girlie was so galante and prepared a great seafood and inihaw dinner for all of us! So even if I was away from home on my birthday, I did have a grand mini-party at Boracay! ๐Ÿ™‚

Last year was my 26th birthday and I vividly remember being stuck at the OR for an emergency operation. Unfortunately, I was on duty (kelan ba hindi, haha), ย but after our long OR, I went to Maan for while to find out that a caramel cake was waiting for me! Wee!

But I really didn’t bother to celebrate my birthday last year. I was a first year resident, I had no right. Haha.ย Pero siyempre, I couldn’t resist my batchmates, so I treated them and Maan in Don Henircos (para walking distance lang, pwedeng tumakas, haha!)

And so we end up to this year, my 27th birthday. Well, this I think was the most benign birthday I’ve had so far. I didn’t hold a party, but ย I had a birthday dinner pakain with Bjay ย for surgery batchmates at Yakimix and had fun serving food from Amber Restaurant at the Plastics office for the Plastics and Burn teams (sarap ng Pichi-pichi!). Maan and I had dinner at Opus (thank you!!!), and the food was really really great! Topped the night with a Golden Spoon dessert, and Wreck-it-Ralph movie, where I slept in 50% of the time. Hahaha.

It’s really fun to bring back all these memories of my birthday parties. Makes me thankful to have all these great family and friends to share my birthdays with!

Don’t worry, next year I’m planning to hold one helluva party since it falls on a very special date: 11/12/13! Mazel tov everyone!

Audit

Credit goes to the artist who did this! :-) Great artwork, di ko lang alam where I found it though in the internet...

Surgery

This morning I had my very first audit, and yes, I almost cried. Not because of the sharp, stabbing, shameful words thrown at me, nor the accusing stares, and definitely not out of panic or anxiety. I almost cried because my spirit was crushed and I knew, deep down, that they were right.

Guilty as charged.

In the medical field, an “audit” may bring all sorts of feelings — anxiety, panic, frustration, pity, defeat. For those not privy to the term, an audit is when a doctor, usually one who’s still in training (resident/fellow), presents an interesting case to consultants; and this case is, more often than not, a patient who died on his/her own care.

This has been a long standing academic exercise, more like a tradition, in the medical field, to discuss whether the patient was managed appropriately or not. Others may call it an M & M (mortality and morbidity),or a CMR (case management report), and here is where all the real-life drama of medicine actually happens and not get featured at your favorite medical TV series.

An audit is where all the steps of your management of the patient gets stripped down to all the nits and grits — every wrong detail noticed, every wrong move critiqued, nothing escpes the analytical eyes and ears of the bosses. It’s like seeing the presentor being filleted alive, and then eaten (and then be regurgitated, and again be eaten!) In our native terms, kinarne.

I guess all audits goes the same way. The main reason why you are presenting the case is because the consultant who wants the case presented finds or found something wrong in what you did and wants you to learn a valuable lesson. And well, unlucky you, you just have to learn this valuable lesson the hardest way possible: in shame.

And learn I did.

Yes, I admit that there were lapses in management for this patient, and quite unfortunately, our team don’t have anything substantial to excuse us from these lapses. Most of it comes from wrong attitudes on patient care that were passed-on from seniors to juniors. Part of it is complacency. And an even smaller part of it, dare I say it, is negligence.

This was my first time, and probably not my last. As we climb the ladder of hierarchy and become more senior residents, even more patients become our own responsibility. I know I’ve learned a lot today, and in the end, I think, the most important thing that you must learn is acceptance. Accept that you were wrong, and in all certainty, know the right thing to do when you get the chance next time around.