Sunday, July 27, 2008

Car Dunce Seeks Car

one of the models i'm considering: a mitsubishi mirage

I admit it - I am the quintessential lady driver. You know, the kind that most (chauvinistic) males drivers roll their eyes about and in whose presence they wonder (aloud) why women were ever allowed to get behind the wheel.

I have a fairly stuffed sense of direction complemented by an occasional tendency to be indecisive about what route to take. I do know (in theory) how to change a flat, but I know absolutely nothing about the mechanics of a car. Frankly, I don't really mind that I don't, as long as it runs when I put the key into the ignition - awful, I know.

It's quite easy to understand why, as I am beginning my foray into the world of second-hand car hunting on a budget, I feel like I am jumping off the deep end into water teeming with sharks.

Sometimes I wonder if I really do need a car, specially since I am thinking of staying only a year (for the moment). To be fair, I've been getting on okay with walking and public transport.

On the other hand, weekly grocery shopping has become a bit of an Olympic sport for me - a hybrid of long-distance walking and weight-lifting every time. I've also been drenched fairly regularly by motorists cruising down the highway, as I, the lone pedestrian, plod to work in the rain. And, since walking along the fairly deserted highway late at night is hardly a wise idea under any circumstances, I've had to endure taxi waits of over 2 hours from the end of my shift.

In an ideal world, a car dunce like me would be best off buying brand new, regularly bringing the car in for prophylactic servicing, and then selling it off before it has any serious problems. Unfortunately, I don't live in an ideal world - but I need a decent car on a very modest budget that won't cost me more to service it than the price of buying it.

I'm not really looking for anything fancy - just a fairly well-maintained little hatchback that won't kill me with fuel expenses and car repairs. I've been doing a bit of research, and I've already zeroed in on certain makes and models that may suit. However, given my current automotive know-how, anyone could hand me a lemon of a car and I'd probably drive it away with a smile on my face - until it refuses to take me anywhere and needs to be towed to the nearest service station as soon as I've bought it.

Frankly, I can't think of any solution around this dilemma at the moment. While I have made a few acquaintances here, I'm still a bit wary about dragging any of them car shopping with me - not only because I wouldn't want to impose, but also because I don't know who might have the best amount of know-how to help me out. Short of taking a crash course in appraising cars, I'm not sure what else I can do. Of course buying anything that pre-owned always comes with risks, but despite my desperation, I wouldn't want to throw away my money on a dud.

If there are any natives out there reading my blog - I'd love to hear some suggestions. (Or maybe you have trusted friends who are considering selling off their cars!) As for my readers from back home and elsewhere, let's just all cross our fingers together and hope I don't get gobbled up by the sharks alive.

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Tuesday, July 22, 2008

Not Cooking for One

Adobo on rice *sigh*

This photo by River Rats

One of the things I miss the most from back home? Hot, homecooked meals.

I may be living in a house with a kitchen, but it just takes too much energy to cook for one.

I have done my best over the past few weeks not to fall into the trap of eating too much "take away" (a.k.a. "take out" back home) - which is both horrendously unhealthy, not to mention expensive. I've mostly succeeded, but gastronomic options become quite limited when you don't want to be bothered with cooking.

Don't get me wrong, I can cook. I actually even enjoy it under different circumstances. But the idea of having to take out the pots and pans, prepare all the ingredients, then putting everything away and washing up after - it's just too much effort to make for a meal just for one person. Whereas when you nuke a frozen meal (invariably a meat pie or a box of Lean Cuisine) in the microwave or prepare a sandwich, you only need to wash one plate after. Peeling an orange or biting into an apple means you don't even have to wash anything at all... a good thing when you're dead on your feet from work and walking the three or so kilometers home.

As for a full, hot breakfast? Out of the question. I barely have time to eat my cereal in the mornings as it is! When I get out really late, I have breakfast on the go - walking to work while munching on an apple.

Maybe when I've saved enough money and settled into the rhythm of things, I may get one of those electric skillets on which I can do a little bit of grilling (would you believe I've been here a month and not have had a bite of steak?) and a stir-fry every now and then.

I will only consider whipping out my culinary skills only if I'm going to be making food good for more than one portion. In the meantime, I'm sticking to bread, fruit, cereals, and frozen food. And if I get the urge to eat rice - there's always Indian or Chinese take away, which I indulge in once a week.

Can anyone here think of other alternatives? I'd love to hear them.

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Friday, July 18, 2008

Nosebleeding in English

Yes, I have been raised bilingual. Yes, I have been instructed in English since I've been old enough to read. Yes, I have used it in academic discussion for just as long and everyday conversation for even longer. And, yes, I probably read and write better with it, maybe even express myself with it, than I do with my native tongue - and I have a body of work, a thriving blog, and academic IELTS scores to prove it.

But my first month abroad is quickly teaching me that despite my background, I am, as someone who uses English as a second language in an English-speaking land, still prone to frequent "nosebleed*" moments.

Despite having fair command language, I often find myself suddenly bereft of words to express certain thoughts or questions quite unexpectedly. I find myself stopping at mid-sentence when I would frantically grab for an English word in my otherwise good vocabulary only to find Filipino words floating to the surface instead. At times, when my mouth is running faster than my brain, the occasional Tagalog integrates itself into my stream of thought, only to be met by puzzled glances.

In fairness to me, I've been complimented quite often at how fluent I am in English relative to how long I've actually been living here. My English has been good enough to get me through the basics of day-to-day interaction - asking for directions, following instructions, striking up conversations with complete strangers at bus stops (yes, this actually happens quite often in Australia). This country has become such a multi-cultural place that Aussies take my occasional grammar and pronunciation flubs in stride - and are often way more forgiving than many people are back home would be if they heard me.

But the biggest adjustment so far has been in my interaction with the patients I see at work - something other overseas-trained doctors who work in English-speaking countries probably grapple with as well. Although I was taught medicine in English and my conceptual understanding of medical knowledge is in English, I have gotten used to conducting interviews and asking questions in a way that would be better understood by the patients I used to see back home. All of a sudden the metaphors and the analogies that have served me well for so long no longer work. Explanations of common conditions I've used for years quite effectively must now be reworked for my English-speaking audience. New subtleties and nuances have to be relearned.

I don't think that makes me a worse doctor than I used to be. It just means that, for now, I have to make more of an effort to be understood and to understand. Knowing that I have to keep on my toes works in my favor, and it's that effort that I put in that closes the gap. It's slow going, but I like to believe I'm getting there and getting better every day I come into work, every patient that I interview. It's all just part of the growing pains of practicing medicine in a foreign country.

Nonetheless, no matter how fluent I get at speaking English, I know the nosebleed moments will probably remain a fact of life. And while I may have no real, formal knowledge of Filipino and my actual Tagalog vocabulary is shallow at best, not speaking it for long spells has made me realize that a heart-deep connection with it exists - and I miss using it, in a major way.

(*For people not in the know, the term "nosebleed" is Filipino slang for something exceedingly difficult or takes so much effort that it makes your nose bleed. It is often used in the context of someone trying to conduct a conversation in straight English and struggling mightily with it. I don't know how widespread the term's use it and how accepted is the term's use is in this context - so please free to correct me by posting a comment if I am wrong. :))
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Tuesday, July 15, 2008

Walking the WOC

See one, do one, teach one.

There is only so much medical knowledge that you can glean from reading the books. An internist's clinical eye can only be developed by actually seeing. A surgeon's hands can only gain their skill by actually doing.

And for doctors just at the beginning of our journey, the quality of practical knowledge often rests on the guidance of our teachers' wisdom and expertise. Our mentors spend time every week to see our patients with us, and share valuable clinical pearls with us - and many of them WOC - without compensation.

Having worked only in a training hospital and been reared in a culture where teaching is the norm all my years as a doctor, I admit that I never fully appreciated the time and the effort that our consultants put into our rearing.

It boggles the mind how these doctors, now leaders in their fields with busy practices, give precious hours of their time to teach despite the lack of financial return. How surgeons who charge a hefty fee for each procedure serve as first assists to surgical trainees doing a complicated procedure for the first time - and do it for free.

What's in it for them? Cynics will say that the prestige of being associated with a university with such a well-established reputation is motivation enough - but given how easy it is to get the hospital tagged to your name without having to give anything back, it cannot be the explanation. Maybe there are just people who simply love to teach. And then there are those who believe in paying it forward.

Whatever their reasons, these teachers continue to inspire and spur on struggling trainees to reach the standards they have set. And in doing so, they pass on their love of medicine and of teaching, so that despite the many challenges of a medical career, there will always be those who will walk the WOC with them.

* * * *

This is a contribution to The Blog Rounds 16 - Unsung Heroes hosted by Doc Gigi.

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Monday, July 14, 2008

A Rainy Taste of King's Park

Any fine day in winter is too precious to be wasted, especially on a day off. So, undeterred by a dysfunctional camera, the lack of a car, and my growing pile of laundry, I decided to spend my Friday exploring one of my adopted city's most famous landmarks - King's Park. Between going outlet window shopping in the city despite not having much cash versus gorging on photo-ops despite not having a proper camera, there really was no contest.

Armed with my trusty folding umbrella, the Perth guidebook I brought from home, and the bus and train schedules, I was all set. My inner wanderlust was looking forward to a great day drinking in some serious natural beauty in the gargantuan sprawl of genuine bushland and manicured gardens that remains outstanding in this city where parks and open spaces seem to be a dime a dozen. At over 400 acres, it is reputed to be the third biggest inner-city park in the world.

Even without a car, King's Park is quite accessible by public transport. There are buses you can catch around the city that can take you straight into the park - Bus 37 - and all hop-on-and-hop-off guided bus tours will also take you around. But for people with a limited budget and no aversion to walking, the Red CAT bus - one of three bus services going around the central business district which you can ride for free and can catch right outside the Perth Underground train station - works just fine. Just get off at the Havelock Street stop and follow signs pointing the way.

Which is what I did. But as I was walking down Havelock Street, my fine day suddenly took a turn for the worse - and I had to scramble for my umbrella to keep from being drenched by a cold winter shower. Undeterred and commited - there was no point in turning back now when almost half the day was gone - I plodded on, my lesson on fickle winter weather and having a sense of humor when traveling well learned. The bone-deep chill of walking in the winter rain was quickly forgotten, though, when I found myself under the canopy of Fraser Avenue's magnificent lemon scented gums as I walked into the park.

From its perch high above the city on the western side of town, the park offers magnificent views of the Perth CBD skyline, the mighty Swan and Canning Rivers, and all the way the hills of Perth in the horizon. Bemoaning the loss of my camera, I took a couple of photos with my camera phone for posterity. I even got a nice old gentleman, who was decked in full raingear with his wife in a matching set, to take my picture against the backdrop of Perth city in the distance.

Under the shelter of my little umbrella, I oohed and ahed over the lush greenery, the magnificent old jarrahs and breathed deeply of the smell of rain and the hint of eucalyptus. I followed the walkway and marveled at the strange, exotic looking plants whose names I didn't know but were pockets prettiness that warranted a picture. The wide open spaces were nearly all mine with the exception of a smattering of fellow tourists.

There are volunteer guides who take interested visitors around the park at certain times daily for free - anyone can get a brochure with the schedules in the park tourist information center. There are different kinds of walks - some which go through the botanic gardens, others going as far as the heart of the park's bushland - lasting about an hour to two hours depending. The kinds they offer also vary on the season, with more lengthier walks offered in the spring and summer when the park is alive with people.

I wanted to the visitors' center with the intention of joining a group doing the walk on the scheduled time - only to find myself all alone in front of the sign announcing the guided walk schedules. Apparently everyone else must have known about the weather forecast and were sane enough to stay in the warm indoors instead. Torn between cutting my losses while the rain had ceased temporarily and sticking to my guns, I was forced into a decision when the guide for the afternoon - a lovely lady named Inge, who must have been about 65 at the least because she says she has memories of what Perth looked like 50 years ago when she first came over - asked me if I wanted to go on the guided walk. Unwilling to deprive her of her solitary audience, I agreed and was glad that I did.

Inge took me around the botanic gardens and told me many interesting tidbits about the highly specialized native flora of Australia planted through the garden. Australian plants have had to develop unique survival tactics in order to exist in the continent's poor soil and harsh conditions, and my inner nerd really enjoyed hearing all the interesting factoids about them. There were also many pockets of prettiness that just begged for a picture - like this one, at the Water Garden section of the walk.

One of this guided walks' highlights was going on an elevated walkway about 60 meters above the ground, which cuts through the trees and lets you see the canopy at eye level rather than from the ground. The vantage point is amazing, and it literally offers a gorgeous bird's eye view of part of the park.

There are certain tree-lined streets within the park which have been made into Honour Walks. All the trees along these streets have been planted for or dedicated to young Australian soldiers who have died in both World War I and II. There are small plaques in front of each tree in remembrance. I think it's a wonderful kind of living memorial that goes on after you have passed. I would love to have someone plant a tree in memory of me when I am gone, too.

There's a section of the botanic garden dedicated to the memory of the pioneer women of Western Australia. (Did you know that WA was the second place in the world where women were allowed to vote?) In the paved walk going through it, there are inscriptions and replicas of sculptures made by prominent Australian artists that represent what women have given to their society over the past two hundred years and more. Among all of them, this one was my favorite.

My guided walk with Inge lasted about an hour and fifteen minutes, and at the end of it, I knew one thing for sure - I am definitely going to be back. Inge says the best time to go will be in spring, when all the wildflowers are in bloom and everything is gorgeous and even greener.

Anyone who comes to Perth should not miss a visit to King's Park. A day spent under the wide, vividly blue sky, surrounded by open spaces in this oasis of green in the heart of the city is just what one needs to refresh the spirit and make one realize just what a wonderful world it is we live in. Seriously. Rain or no rain.
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Sunday, July 13, 2008


For some weird reason, all of my gadgets have started acting up on me ever since I flew them over here. Just last week, my CD drive suddenly disappeared from my laptop... my Palm PDA refuses to hot sync with my computer at the worst possible time... now, to top it off, a traveler's worst gadget nightmare has happened.

My digital camera has apparently kicked the bucket.

I got my Cybershot as a medical school graduation gift from my parents, and it's been a constant travel companion eversince. It's been with me through far and wide, high seas and mountains (not a lot of these, though), good and bad weather, drunk and sober times (yes, this is relevant). I've never had much trouble with it over the past three years and change I've had it - so its demise has come as a complete shocker.

Well, maybe not a complete shocker. It's been doing that flickering LCD thing ever since Aman - which I initially put down to overexposure from the blinding white sands of the beach. I thought it had had it when we were in Anawangin after it got caught in the rain - after my last sunset shot, it flickered and died. Thankfully, it came back to life after I charged it back home, so I thought it was probably just the battery.

I've been going around my adopted city these past two weeks with it in tow, but being a traveler alone makes it tricky to take too many pictures. It seemed alright the few times I brought it out - I was even able to get a picture of me and my landlady at the bed and breakfast I was staying at last week. So imagine my dismay when I tried it out right before I left for a day exploring King's Park the other day (more on that another time).

When I turned it on, I was treated to a laser light show complete with hissing sound effects instead of a functioning LCD and zoom lens. I took out the battery and put it back in, then turned it on - and the retractable lens just peeked at me, moved out halfway, then died. I plugged it into the wall, in an attempt to charge it, but when I turned it on, the anti-red eye orange light blinked several times, the flash went off once - then it died.

It has since then refused to switch on since. Not even for a flicker.

Given labor and repair costs here - which are atrocious - it may be cheaper to throw it out and get a new one. You can imagine just how distressing this is for me - I'm living in a foreign country and just itching to take photos as I explore it for posterity, I am trying to save up and my first paycheck is already accounted for by expenses even before I get it... and this happens! I wasn't planning on a new camera until after a year... only then, I was planning on getting an SLR. So much for that!

Besides that, it feels like I'm saying goodbye to a really good friend. *sigh* (Now you have an idea why I am such a pack rat.)

So long, my little Cybershot! :(

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Wednesday, July 09, 2008

Lucky Country

the healing hands fountain in front of the hospital where i work
(photo from flickr)

I've been working here just a over week, and I still can't get over how lucky "public" patients here are. I know that all medical systems have their flaws, and Australia is no exception, but compared to back home, they don't know just how fortunate they really are.

I work in a public hospital (government funded) in one of Perth's outer suburbs, a fairly small one relative to my old medical home. It's a 200 bed hospital that's just inching its way towards secondary hospital status - by Australian standards that is. We don't have an ICU and as a rule (strictly enforced) we cannot have intubated patients or toxic patients here. We don't have complete specialist cover and have to refer some of our patients to the bigger centers in Perth who need consults.

Despite this, in this little hospital, we have access to diagnostics and resources that my fellow co-residents and I would have killed for. All you have to do is order them, arrange for a schedule, and most of the time you get results within 24 to 48 hours. For blood work, you can get them as fast as half an hour. I know this must sound routine to someone who works in a first-world insititution or even a private hospital back home, but for us, it was all but a wistful dream. To top it off, puiblic patients don't have to pay a single cent.

And the drugs! All you have to do is write it in the chart, and it's all provided for. Antibiotics are given regularly, without fail. No need to run around looking for donors, worrying about where you are going to find your patient's next dose. And this covers discharge prescriptions as well. No need to wrack your brain cells and make up unconventional combinations looking for the cheapest option.

I'm often given amused smiles by my fellow residents when I'd give a delighted, "Oh, you have that (can do that/can give that) here? Wow! I've never seen that done (given to a patient) before!" Believe me, I've said it so often, it's become almost embarrassing.

On the other hand, they can't wrap their head around the idea of relatives who ambu-bag patients who cannot afford a mechanical ventilators, let alone patients who ambu-bag themselves. The concept of young patients dying simply because there are no medications to be had is unthinkable to them. And treating empirically based on a clinical diagnosis is almost akin to a joke. Yet these are realities that I and fellow doctors who work in government hospitals in the Philippines lived with every single day.

Being exposed to all this excess, I can't help but being a great deal envious in behalf of the many needy patients back home. And sad, because given the place health is given in our national budget, to have something like this back home is something of a pipe dream. As it is, the government cannot even pay trainee doctors a decent wage for service hours rendered; it is never going to have enough to cover the health expenses of even just the Filipinos who find their way into the hospitals across the country. The ever-upward spiraling prices of health care in the world makes the unlikely almost impossible.

Whenever I hear someone here griping about how lousy their health care system is, I'm always tempted to make the retort, "How about I send you to the Philippines in place of one of the patients we have in the wards?" Just a day in, and I'm sure they'll realize what we all know to be true - they're still pretty damn lucky.
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Monday, July 07, 2008

Blue Monday

those i'm friend-sick for

People warned me it would catch me unawares. And just like that, it did.

I've had a bad day at the hospital today. I can't go on a comfort shopping spree because there's nowhere open after five. I can't watch a movie because I don't have a car and it's not a great idea to commute at night. I can't even drown myself in ice cream because I missed the last open grocery - which closes at six.

But most of all, it's hit me that there is no one here I can just ask over to whine to... to have some retail therapy with (besides, the shops are all closed!) or have a soothing coffee with or get wasted with. No one to gripe with about the unfairness of life over lunch or dinner. No one to make unsubstantiated and totally unlikely scenarios of vindication with.

I've been in constant communication with my parents - and that had helped a lot - but there are many things about my job that my non-doctor parents will never understand, and bad days at work are among them. Besides, I'd never try to get wasted with my Mom - got to keep up appearances, after all.

My other workmates try to be supportive, but it's early days yet. Nowhere near "Let's-get-drunk-so-all-this-can-go-away" or the "let's-shop-and-comfort-ourselves-with-the-joys-of-materialism" just yet.

I miss my batchmates. And just like that, I suddenly miss home.

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