On Your Graduation

For my endocrine fellows who graduate today.

I was pleasantly surprised to receive a book from you yesterday. A parting gift as you graduate today. From the Eyes of A Healer, an anthology of medical anecdotes. I saw what you wrote on the back of the front cover. Consider this my response.

Last night, as I sat in the car on my way home, tired but strangely content to finally have some cash in my pocket (I had been away from clinic for a week) – I thought of giving you a thousand peso bill as my graduation gift. I wondered if I still had some crispy ones, like what grandparents give out on Christmas.

It is not an original idea. Because someone had done the same for me, more than a decade ago. Though I don’t remember now how much cash that was.

Everyone loves graduations. I’m sure someone will tell you that today is the beginning and not the ending. How many graduations have you had as you pursued a career in medicine? Too many perhaps, but this is probably your last. Now, you will start an endocrine practice. You’ll be on your own, finally.

The one thousand peso bill. For me it evokes that ad which asks, Saan aabot ang 20 pesos mo? What is it for? My small contribution to the days ahead when you will no longer receive a fellow’s stipend.

Enough to buy a few cups of coffee as you sit waiting for patients in an empty clinic. They will come, eventually. And someday, you might wish you had time to drink coffee when the line at your clinic is long. No worries. A grateful patient will buy you coffee, and more.

Enough to buy load if you needed to call me to ask something. Once I had to call her to ask, How do I give endocrine clearance for gynecomastia? Sure, I knew the endocrine workup. But I also knew it was expensive. The guy just wanted to be a waiter in the Middle East. Surely, gynecomastia was the least of his worries.

Enough to pay for a few minutes of surfing online. You might need it to go on Pubmed to search for answers to an all important clinical question, for your very first confined patient. Enough to make phone calls to the nurses station hourly, to adjust an insulin drip.

So what will you do with this one thousand peso bill? It’s all up to you. Graduation is about possibilities. Someday soon, I’d like to hear how you spent it and how you’re doing. Good luck!





Is There Another Me Out There in a Parallel Universe?

My contribution to the inaugural call for #theblogrounds.

Aileen asks If I were not a doctor, I would have been … If I were not a [insert specialty here], I would be a … When I retire from my medical career, I would. She conjures an alternate universe. But how about a parallel universe instead?

Ethan Siegel asks, Is there another you out there in a parallel universe?

In other worlds, would it be possible that there’s a Universe out there where everything happened exactly as it did in this one, except you did one tiny thing different, and hence had your life turn out incredibly different as a result?

It certainly feels like I’m switching between parallel universes most days of the week! This morning, I’m a medical educator. This afternoon, an endocrinologist. Always a mom. Tonight, a wife. Sometimes I inhabit social media until dawn.

I look back on my life so far to find those tiny things I did different that led me to here and now.

I went to an all girls Catholic school where most graduates go to the Pontifical University for college. Instead, I went to the University of the Philippines.

I had a long-distance relationship. We broke up. I married someone who was always there for me.

The popular choices for a master’s degree was either clinical epidemiology or health professions education. Instead, I took health informatics.

I was a board member of our specialty organization in endocrinology. I gave that up to be Chair of the Medical Informatics Unit.

I blogged, tweeted and became the Endocrine Witch. Later, Dok Bru.

I wandered into a Women in Endocrinology forum at the Endocrine Society meeting. They said we all need mentors and at all stages in our career. I looked for mentors online.

Students were sleeping in my class. Instead of letting them, I experimented with new ways of teaching to get them to listen. I won a prize.

I wanted to attend the Endocrine Society meeting abroad, but had an informatics class with Dr. Alvin Marcelo. He told me to live tweet the conference. From there, I built a personal learning network on Twitter.

I wanted to attend Doctors 2.0 in Paris. I did eventually speak at this conference. But first, I co-founded #HealthXPH.

I was already Chief of MIU, but she asked me. I said yes. I’m concurrently Director of the UP Manila Interactive Learning Center. I share my teaching journey with a wider audience.

Finally, to answer Aileen’s questions. I can’t imagine not being a doctor. But if I weren’t, I’d likely be a teacher. If I were not in health informatics, I’d still be a practicing endocrinologist. When I retire from my medical career, I’d still be the Endocrine Witch online. Typing on my keyboard with arthritic fingers.