Lots To Be Thankful About

Had 2 patients today at U__ (1 was HMO) and zero patient at S____. Frankly, I do not feel bad. I felt kinda relieved actually. In the next few days/one and a half week, we’ll be preoccupied. There’s my repeat pure tone audiometry test and ENT consult (4th opinion!) that’s long overdue. Plus our moving in to our new home is happening sometime next week. Hooray! Praise God.

We’re going to be busy, busy,busy… just thinking about the packing and fixing and cleaning makes my tinnitus even louder. But everything seems to be a small price to pay for a beautiful home that is all our own and the quiet, peaceful surrounding that comes with it. Not to mention my commute that is about to be remarkably shortened to 15% of my usual daily commute. Hooray ulit!

Things like enrolment and uniforms and black shoes and school supplies and school service have also been on my mind and will continue to be on my mind for the next couple of weeks. I am excited for the kids. They will be going to schools that have been prayerfully picked for them by their dad and me. They will be making new friends and immersing themselves in new things that are good for them – fresh air, and big spaces for running and playing. I am determined to drastically cut down their TV time.

I am also making some plans for myself. I plan to make myself busy. To spend my time and energy in things and activities that will be good for my health (both of body and of mind). I am planning to start learning how to wake up earlier (never too late to change!) and to do some walking (and running, maybe… who knows?). I will call up my cousin about the yoga classes she’s been going to in Sta. Rosa. Though I occasionally have been doing my yoga, I am not so sure if my technique has been right. My muscles are tooo tight still and having an instructor will probably help me push myself a little and make myself a little limber.

I am preparing myself for a lot of fixing and working around the house in the next few months. I am also looking forward to starting a little bit of gardening with a lot of help from Mommy and Tio M.

Plus there’s my needle work that has been shelved for months. Will start working on them again as soon as I can. The designs I’ve picked (beautiful windows, meant to be displayed in groupings) will be perfect for our new pasilio outside of our bedrooms.

Life is great. Things are looking up. God has been generous and with all my heart I thank You, Lord.

Dear Lord,

Today I’ve met with some of my colleagues. Some were much older and ”senior”. A handful were quite younger but have started their practice way before I started mine.

As I spoke with hubby about how my day went, he noticed that I was making comments about how ‘big-time’ so-and-so already is. That is, ‘big’ enough such that their hotel accommodations for the convention have been graciously sponsored by pharmaceutical companies. When I made those comments, it didn’t occur to me that I was comparing myself to others. To hubby, it appeared as if I was whining about how slow my career was going and he remarked that maybe I should reconsider my decision re choosing not to practice in any of the big hospitals in the metropolis.

It was also today, as I came home after a long day, that the yaya welcomed me by saying that this hospital called and was reminding me about my contract re their acceptance of my application as visiting physician.

Lord, can You please help me out? I am a bit confused. When I made the decision to concentrate on the hospitals that were relatively near our soon-to-be home, I felt confident that it was the right decision. I justified it by telling myself that in limiting my practice like so, I was making the decision to make my family, especially my little kids, my number one priority.

You, oh Lord, know the inner workings of my heart best. Did I really make these decisions because I really held my family important above all else? Or was it a decision borne out of my laziness and my fear of failure? Was it only because I am too scared to step out of the boundaries of my comfort zone? Did I choose this path not because I thought it was best but because I thought it was the easiest?

I search my heart yet cannot find the answers. Only you, my Creator, know best.

You know that I long to have some degree of success in my professional life. That I desire to be of help and comfort to as many patients as possible is already a given. But I also long for a career that would afford me and my family some of the comforts I dream of. I look at some of my colleagues with a little bit of envy as they tell stories of which hotel they were billeted in, or of how the other one did not need to fall in (a really long) line just to get a free copy of the MIMS because the med rep delivers it right to the doorstep of her clinic. Two words. Big. Time.

Yet I also long for a life that will enable me to attend PTA meetings, to help kids with their homework, to exercise and run around our village or do yoga, to spend time in my little joys like working on crossword puzzles or doing cross-stitching, or a future activity that I hope to learn and enjoy – tend to our little garden.

Is it possible? Or do I need to give up this very idea of fence-sitting and make a firm decision re which path to take?

Help me, Lord. Please enlighten me. Hold me by the hand and lead the way. Right now I pray for patience and let You do Your work and unfold the life that You’ve always meant me to live and enjoy. Let me live a full life, oh Lord. Bless me and my family always. Bless me and my work. In Jesus’ name. Amen.

Happily Swamped

This week, I was swamped by referrals and new patients. Okay, okay… ‘swamped’ is an exaggeration. But they were plenty enough to keep me busy. It left me no time to whine about my tiniest troubles and left me scrambling about with a smile in my heart. Every day I drive 80 to 120 km. Every night, my sleep is interrupted by updates and lab results. One doesn’t mind and instead, chooses to be grateful for the busy-ness and for people (nurses and residents) who bother to call and SMS.

I whined. Heavenly Father heard me. I am such a spoiled brat. Thank You, God.

Of Taxes and Anchovies

I am pissed off. Really pissed off.

I received a text message from my accountant, asking if I filed my ITR for 2008. She is in the process of registering my clinics. Without skipping a beat, I said I didn’t because I had been in training for the past four years with no pay. What she said next annoyed me to the max. She asked whether I didn’t practice during that time. What irked me the most was that it seemed like she herself doubted whether I really did not. Like she couldn’t and wouldn’t believe it. Is this the first time she’s met someone who’s had to train for many years before finally being able to start practice? I wonder.

For the past 6 weeks, I have been doing my best effort to get an accountant who can register me so I can have my receipts already. I had to give up on the first because apparently he was too busy and took days before he returning my text messages/calls. (He was a CPA/lawyer). Finally, I was referred to this one, a very nice lady, soft-spoken and efficient. But she doubted me and I’m pissed.

After years of toiling with no benefits, and working long hours, caring for poor patients with no decent wage, I get accused of tax evasion?! Ako ang mandaraya? C’mon! All I really want and need is to get those darn receipts and start my paying taxes already. Kaya wala tayong asenso. Instead of running after the big sharks (and there’s lots of them), people waste their time fussing over tiny anchovies like me.

But now that I think about it, can I blame her? Pag naglipana ang mga magnanakaw at mandaraya, ang hindi gumagawa ng masama ang nagmumukhang suspechoso. People are jaded. Siguro sa dami ng mga negosyo-slash-doktor-slash-establismyento na dala-dalawa ang libro e nagmumukha nang norm. Bwiset talaga. How do I prove to her/them na wala talaga akong trabaho at pinapagkakitaan noon? Na for the past so many years ay palamunin ako ng butihin kong asawa (actually hanggang ngayon). Dapat bang idineclare ko ang kakarampot na stipend na pinaghirapang ipamalimos ng mga boss para sa amin mula sa mga drug company? Karampot na stipend na inaabot ng 4 hanggang 8 buwan bago namin makuha? Stipend yun e, sabi ng mga kasama ko, therefore tax-free. Pathetic. Grrr...

Fruitful Day

I am up early because hubby had left very early for the airport for a business trip. Nawala antok ko so I decided to say my prayers and a rosary for his safe trip.

Yesterday was a good day and napahiya ako kay Lord kasi pinagbigyan N’ya na naman ako matapos kong ngumawa nang ngumawa. Tinuturuan N’ya talaga ako to be patient and to put my full trust in Him. As I awoke yesterday to the smell of breakfast cooking in the kitchen (care of hubby), I felt mild pain on my right temple. At that moment, I decided to lie in bed and nurse that headache, possibly the whole morning. I’m guessing that headache was because of the multitude of things that I have been worrying and fretting about (needlessly, as usual).

Mid-morning, I received a text message from my would-be secretary (naks!) and was told that the accountant… THE accountant is at the hospital today. Wow! Nawala ang sakit ng ulo ko. Thankfully, hubby was willing to bump off the plans he has made so that he can come with me and teach me (again) the directions to the hospital. So we bundled our three kulits and I drove to Laguna, leaving our yayas behind to rest.

The accountant was very pleasant and her rates were better than most I’ve heard of. Medyo malaki lang nagastos ko initially because I had to register all three clinics so times three yung initial gastos. I had to rush to two nearby ATMs but all were off-line. She was gracious enough to accept a check as payment and hubby was very generous enough to take care of the payment for me (more than 5 thou). Yehey! Thanks to hubby and to God. The accountant says my registration should be done within a week and she says my receipts should be available before I start my clinic at their hospital next month.

The drive to Laguna was relatively easy and it didn’t take too long. I think I can do it on my own. I mean, on a regular basis. Kaya naman. The toll fees were considerable though. One hundred and ten (65 for skyway plus 45) to and then 76 pabalik.

While I was settling things, hubby was able to get a car sticker from the security guard for me. Nakita ko na lang dinidikit na nila. Ang bait nung mga tao doon. Very accommodating sila. I was surprised that the guard, though he initially asked daw for papers to show that I was indeed affiliated, took hubby’s word for it.

After the stint with the accountant, I was very, very happy for having accomplished that task that has been bugging me for weeeeks. We drove off to the nearby Pavilion Mall and had lunch at, you guessed it… Jollibee! We availed of the BPI promo so nakatipid nang konti. The kids were happy; it was their first time at the Pavilion. I was feeling quite pleased, too. Hubby and I can imagine living our lives there, parang nakaka-at home doon. Later, the Little One had to poop so she and I went upstairs to the mall restroom and, thankfully, I had some wipes left in my bag.

After we had finished lunch, the Little Girl said it was her turn to poop. I ran out of wipes so I left her with hubby and dragged the Little Boy to the supermarket to buy some. While we were at it, I was very pleased to find the kids’ shampoo which was not available at SM nor Shopwise. It was very cheap and smelled great on the kids’ hair so I grabbed two big bottles. In the meantime, hubby was texting because the Little Girl was badly in need of the wipes already. Rush, rush, rush… wash. Ah, the little stresses and inconveniences of parenthood. Instead of giving in my to tendency to be irked, I thought these are what make parenthood an exciting adventure.

After some dessert at Dunkin’ (coffee for hubby), we drove around the place to scout for some schools for the kids next year. We were quite pleased with a couple of schools we saw. One was particularly impressive and I was awed by the beauty of the surrounding scenery. Their soccer field was nestled right amidst beautiful, lush mountains. What a blessing it would be if our kids can grow up in such a beautiful surrounding. For a while, I worried, too about the kids coping to this big change of moving to a “big” school. Their school right now is such a small community, almost everybody knows everyone else.

After that, we visited our lot at V____. It was a very quiet and peaceful Saturday afternoon. We let the kids play at the playgound/clubhouse for a while. The Little One was tearful as we climbed to our car. She so wanted to swim in the pool but we did not bring any extra clothes. We then drove around a bit, admiring the pretty houses and just taking in the calm of the surroundings.

The whole experience reminded me of the suburbs in the States (based on my friends’ pictures and on what I see on TV, at least). I felt very grateful that we were on our way to achieving this dream. I thanked God for such a blessing and prayed that He would continue to bless us with this gift. I was particularly thankful that hubby and I need not leave our country to be able to enjoy such blessings. We were right at home.

We then braced ourselves for the trip back home. The traffic was heavy and the kids, particularly the Little One was getting irritable and began looking for her yaya. Good thing she fell asleep. I realized it was not easy driving in bumper-to-bumper traffic and my right quads hurt. I did not complain. Silently, I told myself that this was something I had to learn to contend with for the next half-year. Twice a week wouldn’t be so bad. If I needed to go more than twice a week, it would mean having referrals and that would be something to be thankful for.

I’m supposed to start my other clinic next weekend but since my reciepts aren’t ready yet, I hope to be able to ask the secretaries if I can start by December instead.

Oh, I forgot to tell you that the layout for my prescription pads and business cards have been finally sent to me. They looked okay. I can’t wait to get my hands on them.

Baby Steps

Today I ordered my first batch of business cards and prescription pads. I can imagine how thrilled I would be when the delivery comes in tomorrow. I grew up putting name tags on everything… notebooks, books… later when I started going to my high school dorm, things you did not dare imagine being labeled were labeled by my mother dear… sandos, undies, palanggana. You name it, it’s got my name on it!

Sorry sa pagka-OA ko about this. These are teeny-weeny things. Baby steps, I admit. But still steps TOWARDS my dream of starting my own practice so kebs kung OA. Di bale nang nakatunganga muna sa clinic para magbilang ng butiki o maghanap ng agiw.

Kailangan ko na lang maayos ang sa accountant… aaaargh! Para makapagpaskel na ako nung 'Please ask for Receipt'. At mag-ensayo pa sa pagmamaneho ng mag-isa nang hindi naliligaw para di mapadpad sa Pasay or elsewhere dahil sa wrong turn. Hindi madali but i'm slowly getting there. Ajaaaah!

I consider it nothing short of a miracle, finding the clinic place and schedule that I wanted a day after hubby and I went to St. Jude to pray for guidance and much-needed help.

On the eve of my first day of practice

I sit here in my room. A room once shared with my one and only sister. The room of my childhood. Much has changed compared to how it was some 25 years ago. There is less clutter. None of the countless pillows that our beds used to have.

Funny how lonely I feel being here by my lonesome, quiet self. As I sit here amidst the stillness, I realize with much amazement how big my world has grown. Whereas before I had nobody but my parents, my sister, and my school (and all the people that came with it), I now have a husband and three children. People who are now four hours away from me. People who mean the world to me.

God has been very generous. I am on the verge of the realization of a life-long dream. Tomorrow is the first day of my private practice. The anxiety, even nervousness, that I feel is real. And yet I find comfort in the white coat that now stares back at me as it hung on my bedroom door. It bears my name and the field that I’ve chosen. It bears witness to God’s generosity. Proof of how one’s dreams, once so distant and almost out-of-reach, can slowly come true.

Thanksgiving to all patients

Truth be told, I feel a considerable amount of nervousness and anxiety at the prospect of starting my private practice. That’s on Monday, if all things proceed as planned. I try now to ‘cram’ my Consultative H--------- and T--------- book into my tiny brain. I worry about having forgotten my IM.

I remind myself that I can do all things because Jesus strengthens me. He has never failed me. I tell myself that I have been preparing for this for years. I turn my thoughts to the hundreds of patients and cases that I have seen during my training. My training amounts to thousands of hours of exposure to the clinics, to diagnosis, and to answering referrals from all specialties. I think of my mentors who are truly the best of the best. (Believe it or not, I also thank God for mentors who have yelled at me during the earlier years of my training. They contributed to my fortitude and determination, no doubt). And I think of all the hematologists who have long gone before me, now pursuing each of their own paths.

I thank God for books. I thank God for my mentors. Above all, I thank God for all my patients… from my first ‘patient’ (read: cadaver) in anatomy class… to my physical therapy spinal cord-injured patients at the Philippine Orthopedic Center… to my surviving anemia/leukemia/lymphoma patients. As the song goes, “some are dead and some are living…” In my life and training, I loved most of them and, I learned from them all.

Ayayay!

After I had passed my subspecialty diplomate exam, I was very eager to start my practice. I felt like I was ready to take on the world. I described the day after I learned I passed as the “first day of the rest of my life” (Aug. 17 post). After 13 years (that’s post-college) of non-stop study and training, it felt like I have finally reached the finish line.

Then reality set in.

First, hubby and I scouted for prospect clinics south of Manila. We then learned that one needs a considerable sum of money to be able to start holding clinic at most hospitals. If you think your credentials are enough… you’re mistaken. Show them the money! Borrow from your spouse or your folks! Only then can you start earning your own.

But that was reasonable. Natural lang that they ask money from me first. Parang negosyo, di ba? Kailangan mamuhunan. Labas ka muna ng pera para magkapwesto sa palengke, bago ka pa makapagsimulang bumenta, tapos saka kikita. Fine.

And then I got entangled in one big mess of requirements.

The most difficult part, at least for me, is the fulfillment of the different things required by the government. PTR. TIN card. Not just TIN, the number ha. TIN card. And to get this, one must go back to the branch where one first got the number. Only then can I get my recently renewed S2 license card (for prescribing regulated drugs). And only then can I start applying for Philhealth accreditation as a specialist. It also requires numerous certificates of good standing from different societies. Because I live in the metropolis and cannot, as of yet, drive our car (that’s an entirely different story), I would have to take the FX, MRT, LRT, Taxi to get all of these. Pera pa din. Not to mention, oras, effort, at pawis.

I am also quite overwhelmed by the sheer volume of numbers that I would have to store (memorize?!) and back-up. I am no longer defined by my name alone. Gone were the days when I could just present my complete name and occasionally, my mother’s maiden name. Let’s see… how many numbers do I have? There’s my PRC, S2 license, PMA, PTR (which, by the way, will have to change every year), Philhealth, NBI, GSIS, LTO, TIN, GSIS, Passport, Community Tax Certificate. Whew! Not to mention all the different usernames and passwords for my different internet accounts/social networks and gadgets. Tapos meron na tayong isang tambak na phone numbers. Dalawang mobile, 1 landline, at 1 prepaid wireless broadband. Grabe na ito.

There’s no use complaining. All my colleagues who have gone ahead and are doing their practice have gone through the same. I just have to laugh at myself when I go back to ages ago, when I was a young girl and began to dream of becoming a doctor. Those days, I thought it only entailed studying and then I would have my very own black medicine bag and start making home visits. Parang lumang sine. Simpleng simple.