Sunday, September 25, 2011

Bad eggs

Last week, a few minors hogged the local headlines in what were alarming considering that they committed criminal acts.

The first was a 11 year old boy in Baguio who apparently strangled to death his 10 year old classmate after an argument. News was that he hit by another boy against the blackboard then strangled was strangled by another. What is unknown in this trail of events was what the classmates did while this was going on. While authorities went on the blame game to the teacher, it was odd that the news did not cover what the kibitzer classmates were doing while the older boy was strangulating his classmate.

In Cebu, it was reported that a boy together with an accomplice killed his pregnant mother and 5 year old sister. The boy, a drug addict, admitted to killing his mother and sister because he felt neglected.

Last week at the SM in Pampanga, a 13 year old boy shot his alleged male lover, a 16 year old boy in front of the Astrovision store. After shooting his lover, he turned the gun on himself. Apparently the story trails back to the Facebook account of the 13 year old where he planned the shooting all along. He allegedly was willing to die with his lover. He planned the killing because he found out that there was a third party, another male teenager, involved with his 16 year old lover. After the shooting incident, both boys were brought to the hospital where they eventually died after a few days. A crime of passion. Case closed.

Worst of all is that in one of the pinoyexchange threads, some idiot who calls himself GreenPeas commented "aba violente si atchiii!!! Ayon nga sa kasabihan marz, lokohin mo na ang lasing, wag lang ang bading na nawalan ng booking! etcho" about the incident at SM Pampanga. While the idiot thought it was a joke, the incident poses some critical thinking about the random thoughts and lunacy of a gay boy trying to humor a tragic event. Which shows you the kind of support the community has with an incident requiring empathy and understanding rather than mockery!

The parent of a patient of mine had popped up the question - what's happening to our youth of today?

My expert opinion was sought and I was saddened by the turn of events in the last week.

These were minors. In the words of Etta Rosales, the Commission on Human Rights chair, it is always the parents responsibility on what happens to minors. And while I agree completely with Ms. Rosales on this, I told the mother of my patient - "the youth of today are very different from our generation. I guess the internet age and the technological advancements have made access to information and misinformation much easier to all."

Children do not understand fully the responsibilities of too much information. Parents today are busy juggling between work and career that the child is left to fend off for himself or herself. Many parents think that getting a nanny or having granny take care of the kid is enough. After all, they reason out that they need to make a life for themselves. Most parents today are career-oriented. It's like, the kid or kids they have was the bonus in their relationship. Hence, they're busy making money. Bonding is time shared in a car or in a mall on a Sunday or on a plane and in Hong Kong Disneyland or in a beach somewhere.

I see many patients at my clinic where either the nanny or the granny is the accompanying person. Some of the parents may be reading my blog and if you think you're alluded to, my apologies. It's a personal opinion and I think you need to look at your kids again.

In short, many parents today are not "hands on" with their children. They feel helpless if the nanny isn't around. They need to dump the kids at Kumon because they can't seem to find the time or the brains to tutor their children. And there is always granny to take them to the doctor. They are, sad to say, ambivalent of what is going on in their children's life. The kids are in my waiting room methodically and rabidly texting on their phones or playing with their iPads or DS Lite some violent game. But to the parents, as long as the child is quiet in some dark corner of their house or church or restaurant where in the silence of it all, the parents are not disturbed from their own comfort zone, everything is picture perfect.

Unfortunately, this is not the case.

I've always told parents time and again that there are no bad kids or bad eggs born. We make them. The environment they grow up to is the perfect milieu for either creating a good kid or a bad one. When the milieu is filled with violence, anger, poor supervision, neglect, abuse and a reward system that is altogether wrong, one creates the perfect storm - the product of which is a bad kid. Our children are a mere reflection of ourselves. They mirror our lives and the way we raise them. Kids come into the world without a conscience. The latter needs to get formed. The formation of proper conduct, conscience, and respect actually comes from role modeling. A rotten child does not grow from perfect trees. It grows from trees that are rotten as well.

We cannot and should not keep blaming society or teachers or nannies or grannies for the way our children are today. We cannot and should not keep making our kids happy simply by providing them gratification through gifts and gadgets and money while we are absent in heart and mind. To the young mind, what they grow up with and grow up to during the formative years are what they will grow up to be.

Bad eggs only come from bad breeding.

Sunday, September 18, 2011

The dangers of auto-debit

Why do banks and credit card companies encourage auto-debit for utilities, cellphone bills, country club dues, car loans, housing loans, and the like?

There are pros and cons for both the company and the client.


1. No more hassle of having to figure out when your due date is. This avoids the occurrence of late charges and fines ending up in disputes with the credit card companies later on.

2. The banks/credit card companies get paid in full way ahead! Which means that when we have problems in the statement of account or any dispute arising from contestable charges, we take it up with the utility firm or cellphone company, or country club or whoever is the merchant that is charging you. The credit card company simply sits back and relaxes and waits for the reversal of that disputed charge.

3. You earn points for every peso spent or charged! Which means that aside from the fact that your bills can be paid through either a deferred plan or a later deferred date or a minimum amount, you still get to earn points which at the end of the day can result in a free plane fare or gadget or points to waive your annual dues.


So here's the story. My monthly statement dues for the Palms Country Club is enrolled in one of my credit cards. I make sure that I check the statement of account when I receive it. I don't know how many people actually check their statements of account when the bills arrive. But I do. This month's statement of account charged me for an EAT and RUN event that was sponsored by the country club last August 28, Sunday. I had four charges for the following people - Faisal Amiv, Bianca Velayo, Enzo Chavez, Robert Borjal! I don't even know these people and I don't f*ckng care about them. What peeves me is the fact that I was charged a total of P1850.00 for their participation and meals in the damn fun run!

Golly gee!!

The statement of account has four columns - Date, Reference (receipt number), Description, and Amount. For these EAT and RUN people, there was no reference at all. It was strange that the billing section of the Palms Country Club had decided to charge it to my account. If that isn't stupid, I don't know what being bright is. Why the hell would you just charge it to my account? Was it a matter of guessing game on whom to bill? Who authorized the charging?

Worst of all is the fact that the charges have been made to my card. Which means that any dispute is between the country club and I. As far as the credit card company is concerned (I called to check if I can stop the payment of the charges to the country club), it is a valid transaction. And that I would need to go to the billing section of the country club, dispute the charges, and have it reversed. Of course, I can always go the extreme of just suing the country club for every last centavo it has left. It would throw the Gotianums and Filinvest a bit poorer.

The fiasco with this statement of account led me to checking all the other bills I had.

Lo and behold, I discovered that my PLDT bill had also something new inserted! It's extra P59 a month for the call forwarding, speed dialing, and call waiting inserted into my billing statement! Watdfuk is happening to our bills? These companies just keep inserting things without notifying us! My Lord! They are like the Bureau of Internal Revenue - they think that when we take a shit, cash comes out of our asses!

There was a time I refused to enroll my Globe Telecom bill in an auto-debit scheme. There have been several occasions wherein I have been billed for calls I never made to God knows which country on this Earth or Mars, but for internet charges which are supposed to be free as it comes with my Platinum plan! And yes, my dear Globe, I do turn off the internet when I am roaming. And no, I do not accidentally turn it on. There is usually free wifi abroad anyway so why bother about turning my cellular data of my iPhone on?

I blog about this topic, to warn everyone of the potential hazard of auto-debitting your utilities. While some of the charges may be small in amount (and some of them extremely large), it's not a nice feeling to get these hidden or unauthorized charges in your bills. It's like thieves robbing you of your hard earned money. No matter, how you look at it, it is still a robbery! And it is a crime!

Someone must punish these erring merchants and shut down the business or pay damages to the customers who are inconvenienced. This is only fair to all. They should also fire the incompetent bastards who made a booboo or their bosses who authorized the illegal charges made.

While technology has provided us massive ease in settling bills via a supposedly hassle-free environment, with matching perks to boot, it has also been the very core of cheating and stealing by large companies in connivance with banking institutions.

Be wary, Beware, and Be Careful! Even your next door banking neighbor can be a wolf in sheep's clothing!

Thursday, September 15, 2011

The Twitters

I have nothing against social networking. And while I use Facebook or Twitter, I think that some people have just taken this social networking thing to the extreme.

There is no exact defining principle on how to use social networking. You can Twit the whole day or just look at your Facebook site and keep posting non-sensical things for all I care. After all, some of your friends may be actually interested in what you're doing or what you have to say. That is, if you're really someone popular or worth "following".

I've noticed lately, how some people use their Twitter account to "update" people on each and every step of what they are doing and where they are. While Twitter encourages people or friends to "follow you", it doesn't literally mean that you're followed all the way to the bathroom or to the gas station!

I'll give you an example of a Twit for the day (this is an actual Twit timeline):

24 hrs ago - Good morning! @DeepakChopra: Encourage unity, discourage divisions
24 hrs ago - I'm at ______________________ (Araneta Center, Cubao, Quezon City)
24 hrs ago - I knew I left something! My water bottle! :-(
17 hrs ago - Hangdami lang patients today! Waaahhh
16 hrs ago - I look so haggard already. I'm wearing my best yet surmounted by the amount of patient & d'type of cases. Anobamerontoday? World Clinic Day?
14 hrs ago - Ok since a good friend tweeted about it already, let me announce that I'll be at @dj______________ podcast tonight. Stay tuned!:)
13 hrs ago - I'm at Shell (Kamias Road cor Kasing-Kasing St. Quezon City)
12 hrs ago - I'm at Starbucks (Ground Level, Easton Place, Valero St. cor VA Rufino St. Salcedo Village, Makati City)
12 hrs ago - Didn't get lost. Luckily. Thanks to those who helped me with directions stuff. :-))
11 hrs ago - I'm at Easton Place (Valero, Herrera, Makati)
11 hrs ago - So I'm here!!!! Will start in a few minute... :-)
11 hrs ago - Finally here guys! We're ready to start!
11 hrs ago - I'm at @dj_______________ podcast tonight! Love/Sex/Life probs? Call us! 659-6969
11 hrs ago - RT @mnelizedMD: Watch gwapong-gwapo Dr._____ on GTWM now!!! LOL.
10 hrs ago - We're accepting questions! Call us!
10 hrs ago - That caller sounds like Maria Ozawa. No offense. Hahaha. :))
9 hrs ago - Love/Sex/Life probs? We're accepting more calls with @dj___________ podcast tonight! Call us! 659-6969
9 hrs ago - We're giving away a cellphone! :-)
9 hrs ago - Really had fun with GTWM podcast crew! Waaah! Owell. :-) heading home now
8 hrs ago - Home! I love EDSA traffic during this time/ :-)
8 hrs ago - Oh wow. Now I believe it's really her.
8 hrs ago - Thanks to @dj__________ and @GTWMPodcast crew for the opportunity! I really had fun! TC guys! Gnyt!:)
8 hrs ago - There were a lot of unexpected things that happened today! From the _____ to podcasting...Gosh! thank good Lord for today. Gnyt tweeps!

I thought the guy was going to sleep already and was almost grateful that his narration of his life for the day was about to end....

7 hrs ago - Here's the link about tonight's show.
6 hrs ago - I can very much hear the brother @_______ in the other room listening to the podcast...He missed the show so he'll sleep late for it.

And finally, he went to bed....And I clicked on "Unfollow" because it was getting to be irritating already.

For my readers information, I actually deleted some of the tweets in between because it was getting to be a bore.

Like I said, there is nothing wrong with using social networking, but this is an example of how some tweets can get to the extreme! The interaction between the twitter tapping in wild abandon on trying to update people on where you are, what you're doing, what's going on in your life is left to the fab and famous. We cannot create what we're not. Some people just need to get a life!

And it's sad that some people are simply preoccupied with trying to look famous (image making) than to make a life.

Added to that fact is providing more information than what your followers need to know creates a scenario where you're probably looking for trouble. When parents don't know what their kids are doing or are risking themselves especially when exposing too much of themselves in an attempt of trying to create an image. Parents are the last to know when their kids get in trouble because of a senseless random act of being socially carefree.

Take home message is to use the social network responsibly. And while we are personally responsible for what goes on in our lives, we need to utilize social networking sites to promote the better good rather than the interest of one.

[My apologies to the twitter whose twits was used. For your information, it gets a bit irritating when I'm online as well and my phone just keeps alarming each time I get a Twit message that's non-informative.]

Sunday, September 11, 2011

Denials and Forgiveness (Beautiful Boy review)

On my flight from Osaka to Manila via HongKong on board Cathay Pacific, I had hundreds of movies to choose from on their AVOD. Flipping through the list of films in the catalogue, I read a snippet of the film "Beautiful Boy". I've never heard of the movie nor either seen any announcement of it having been shown in the Philippines, I decided to while the time away with this movie over dinner 36,000 feet in the air.

Winner of the 2010 Toronto Film Festival, "Beautiful Boy" stars Maria Bello and Michael Sheen. It's a gripping drama of a middle class couple Bill (Sheen) and Kate (Maria) Caroll who try to find meaning and explanation in their lives after their only child, an 18 year old son massacres 21 people in his school before killing himself.

The movie is fast-paced and well edited. Directed by debuting director Shawn Ku, it departs from the usual massacre movies where the center of the film are the gore and the debauchery. Rather, it psychologically probes into the lives of the parents of Sam who need to deal with the aftermath of the tragedy rather than the lives of the victims.

In a different take from conventional films, the whole plot of the movie revolves around Sam's parents in the aftermath of his crime. Over the next hour, the movie unravels the many whys, hows and what ifs as a rewind in the minds of Bill and Kate, that eventually led to this tragic incident. Their anguish is hidden deeply to the point of denial.

And perhaps like many parents who try to make sense of the world and the children they rear, this was one senseless act where reasons could not just be swept under the rug. Like the Carolls, many of us try to erase guilt feelings, rationalize our rage and despair, and adapt various coping mechanisms so that we can transform our lives to living the way we want to. It is human nature to want to see things the way we want to and the way it ended. We want a piece of Nirvanah or Shangrila or beautiful endings to our life's journey.

The film leaves more questions than answers. Perhaps it is this compelling feeling of challenging our feelings and experiencing with the Castells the pain they were going through in trying to make sense of the whole tragedy that made this movie a unique one.

It makes us look at life differently and takes the hardest part of accepting and letting go, forgiving and forgiveness to the next level.

It's not one of those "feel good" films. It is powerful enough to make you walk away with a disturbing feeling. It is not meant to make you empathize with the Carolls. It is admirable because it leaves you breathlessly enthralled enough to make one reflect on the many denials we have in our lives.

It's a beautifully disturbing piece of work that everyone must see and change our perspectives on denials and forgiving.

[Rating: 4 1/2 stars out of 5 ]

Sunday, September 4, 2011

Cancer - the in thing?

Another one of my friends had succumbed to Cancer. Another one bit the dust. When I told my partner about this, his reply was "It's the In Thing".

On my trip to Europe last July, I had bought my copy of "THE EMPEROR OF ALL MALADIES: A Biography of Cancer" by Siddhartha Mukherjee at Fully Booked, for the long haul read. The 571 pages (actually 472 pages of an excellent dissertation and approach to the origins and current knowledge of cancer and 99 pages of references and bibliography) provided a radically new approach to understanding the malady that has afflicted humans since time immemorial.

Cancer is not something new. Siddhartha writes with poetic brilliance as he describes his own insight into patients he currently sees and then intertwines the history of cancer to its first documented beginnings. He truly deserved the Pulitzer Prize for the writing of this book.

"Recall Atossa, the Persian queen with breast cancer in 500 BC. Imagine her traveling through time - appearing and reappearing in one age after the next. She is cancer's Dorian Gray: as she moves through the arc of history, her tumor, frozen in its stage and behavior, remains the same. Atossa's case allows us to recapitulate past advances in cancer therapy and to consider its future. How has her treatment and prognosis shifted in the last four thousand years, and what happens to Atossa later in the new millenium?...In 500 BC, in her own court, Atossa self-prescribes the most primitive form of a mastectomy, which is performed by her Greek slave. Two hundred years later, in Thrace, Hippocrates identifies her tumor as a karkinos, thus giving her illness a name that will ring through its future..."

Perhaps the literary ingenuity of Siddharta in this non-fiction novel is how he has pored through voluminous published literature and historical facts on the origins of cancer and managed to write it in a way wherein even laymen that read this book would be highly engrossed in the vivid explanation of cancer diagnosis, treatment options, drug discoveries and outcome.

Advances in cancer have come a long way since Queen Atossa. It has taken centuries to reach where we are in the science of oncology, and we still have a long way to go. While we slowly discover that there are risk factors that eventually cause cancer (some of which was the normal "trend" decades ago, such as smoking and binging on alcohol), we also now discover on which type of patients are at highest rate for cure and who are genetically predisposed to poorer treatment outcomes.

"Cancer, then, is quite literally trying to emulate a regenerating organ - or perhaps, more disturbingly, the regenerating organism. Its quest for immortality mirrors our own quest, a quest buried in our embryos and in the renewal of our organs. Someday, if a cancer succeeds, it will produce a far more perfect being than its host - imbued with both immortality and the drive to proliferate. One might argue that the leukemia cells growing in my laboratory derived from the woman who died three decades earlier have already achieved this form of 'perfection'."

"Taken to its logical extreme, the cancer cell's capacity to consistently imitate, corrupt, and pervert normal physiology thus raises the ominous question of what 'normalcy' is. 'Cancer', Carla said, 'is my new normal', and quite possibly cancer is OUR normalcy as well, that we are inherently destined to slouch towards a malignant end. Indeed, as the fraction of those affected by cancer creeps inexorably in some nations from one in four to one in three to one in two, cancer will, indeed, be the new normal - an inevitability. The question then will not be IF we will encounter this immortal illness in our lives, but WHEN."

And as man fights to survive aging and strive for longer lives and search for the fountain of youth or the drug for immortality, so will the cancer cells that live normally in our bodies, waiting for the time to take us to be part of the next in thing.

This is a must read for all, especially my students and all students and practitioners of medicine. It makes you understand and realize the wealth of knowledge in the discovery and researches in an aspect of medicine that we see in our daily lives.

Thursday, September 1, 2011

Dear PNoy and Kim...

Dear President Benigno Simeon C. Aquino III and Commissioner Kim Jacinto-Henares,

To my knowledge, as a private citizen, I am not obligated to inform the government IF and WHEN I travel outside of the country. You are not my employers and I am not indebted to either of you or any other public servant for that matter. Which means that my taxes pay for your salaries and benefits and other perks which you and of course other public officials and employees enjoy.

In short, it is none of your business when I decide not to hold clinic, when I need to attend meetings out of town or as required by my specialty society or any private legitimate social organizations of which I am a respected member of, when I decide to go on vacation and the like. But you can correct me when I am wrong. If I am, I will publicly apologize.

I am officially informing you through my blogsite (you may not be an avid fan, but neither am I an avid fan of yours, so the feeling is but mutual) that I will be in a meeting in Osaka, Japan on September 7-9 and September 20-22, 2011. I will also be speaking in Iloilo on September 14 and in Bacolod on September 27. Which means that I shall not be holding clinic on those days. In short, it also means that the people from the Bureau of Internal Revenue (particularly the ones from the Muntinlupa district) who do the tax mapping at the hospitals should not look for receipts on days I do not hold clinic or am not in town. I cannot manufacture fake patients just to make you people happy. I am not required to explain to you where I go or why I do not hold clinic.

I am writing this because of an incident that occurred last August when my clinic was tax mapped. The assessor indicated my violation was that I did not issue receipts from July 18-July 31, and was required to pay the fine of P10,000 (for first violation??!?!?). When my secretaries saw the violation form, they informed the assessor that I was out of the country (I was in Greece and in Milan - hindi lang kayo ang may karapatan mamasyal) from July 17-29. The assessor informed my secretaries that I should just write and explain myself and show my passport to the district office!?!?!?! So I had to write to the District Officer and had to spend for photocopying my Schengen visa, passport, dates of entry/exit to Greece and Italy and dates of exit/entry to the Philippines. It was not a matter of having to explain my having to go on vacation or photocopying all documents (kung sabagay hindi ninyo pera at oras yung naperwisyo ninyo. Pag dating sa daming oras na walang ginagawa eh diyan magaling ang mga nasa pamahalaan). It was a matter of being inconvenienced by some moronic government employee who performs the task of harassing common citizens like me.

I know you people have a pet peeve towards doctors and lawyers and other professionals who you think are cheating the government by not properly paying taxes. You said it yourself in your SONA. While there may be some bad eggs among our colleagues, we are not all the same. Let's just say that I give the benefit of the doubt (of course more doubt than benefit) among government officials as well. (Pare-pareho lang tayong may bulok na itlog sa ating propesyon. Sa totoo lang, mas madaming magnanakaw sa inyong sanhi kesa sa amin. Kung tutuusin, eh magkano lang ang suweldo ninyong lahat sa pamahalaan pero sandamakmak ang nagpapakamatay para magkaroon ng puwesto kahit bilang isang kagawad sa barangay! Dahil may kurakot! Dahil may inanakaw! At pera namin ang inyong ninanakaw!.) While you may not all be crooks (I think I'm humoring myself), I certainly don't go around checking who's in town and who's not and who's supposed to be in session in Congress or who's just boxing around the world for a profession and is a congressman on the sideline. Nevertheless, the feeling is mutual. I look upon government officials with an ounce of honesty and a kilogram of ineptness and skepticism.

Being realistic about the scenario, some of the doctors and lawyers who "tax evade" through dubious means are actually small fry compared to the circle of friends who traveled with you to China in your recent trip. We are small fry compared to your circle of colleagues and their wives and children who make a pittance from their government salaries and yet tag along LV or Prada or Hermes bags. In short, your idea of filling in more of tax collection in the Philippines by running after these professionals is but a drop in the bucket compared to the real big-time tax evaders whom the government simply cannot or refuse to touch. Even if you make a case against these people, they have the money to battle it out in court and with the way the justice system in this country works, well, you'd both be dead by the time anything is resolved. So you go after the small fries. (Yun lang naman ang kaya ninyong patulan eh).

But I support you in your endeavor on looking for tax evaders and people paying taxes correctly. What I cannot stand, however, is how even the honest tax payers get the brunt of inefficiency on the part of the bureau. Bluntly speaking, you people are barking up the wrong tree and are totally clueless on how to collect more taxes from the appropriate sources - like liquor, cigarettes, other vices and luxury goods.

Of course, since I'm not the president nor am I the commissioner of the Bureau of Internal Revenue, I will not tell you how to run the country or the bureau. I am, however, informing you that I will not be in town on these days and that if I get a report again from some idiotic tax mapper or assessor within the area, for not issuing official receipts when I am not around or when I do not have patients for the day, I will not hesitate to take the government to court on charges of harassment. There should be no next time around. I am almost about to retire and will have my whole life ahead of me and more time on my hands to see you people in court.

This is not a threat. It is a promise!

Yours truly