Entertaining the Intellect

**This is not a review 

Back in college, I learned in my Humanities subject about the difference between a movie and a film. My kind (she gave me 1.00) professor said that the former is a motion picture created purely for entertainment while the latter (in addition to entertainment) has artistic and technical excellence plus intellectual stimulation. This definition of a film was more appreciated last week after i have seen Christopher Nolan's Inception. 

The film totally gripped me and got me glued to my seat in excitement and anticipation. From start to finish, the film was pure visceral and intellectual entertainment. I honestly think that Inception has brought cinematic experience to a different level for it required its audience a heightened focus/concentration on details without taking away the thrill and fun in following the film's progression.

Basically the film is all about the idea of breaking in through a person's dream to enter the subconscious mind. The access to the subconscious mind  opens the gateway to valuable information which can be stolen for whatever purpose it may serve. Stealing info was initially the only service given by the lead character extractor Cobb (diCaprio). But when Cobb was offered by Saito (Watanabe) a hard-to-refuse proposal  (wiping out his criminal record), Cobb agreed to do more than just stealing - the dangerous planting of an idea inside the mind of Saito's closest business rival Fischer (Murphy). The planting of idea (inception) is meant to convince Fischer to dissolve their empire and pose lesser threat to Saito's business.

The process of inception calls for the induction and penetration of multiple dream sequences. And to achieve this, more potent sedatives must be used and more complex dream architectures must to be built. The extra measures used to achieve getting into lower levels of dreams pose greater risk and danger of getting stucked in 'limbo' where one can remain dreaming for an indefinite amount of time. 

Christopher Nolan is a brilliant director I must say. He was able to stitch all the different fabrics of the movie into a tapestry of various designs and intricacies. I think the real beauty of this film lies in the fact that besides the top notch story, great artistic and technical merits, the film made moviegoers discuss and share intellectual notes long after they have left the cinemas.

welcome back to myself!

It has been a long time since i posted an entry in this blog. And finally am glad that i have found the time and initiative to start posting again here on secondmanonthemoon

welcome back to me!

 

Wounded healer

My workplace is a host to a myriad of interesting personalities. 

Well I guess it's also true for every other workplace. 


The characters that roam where i work comprise a unique group of individuals that range from being annoying to being humbling. Yet all of them are colorful enough to paint a rainbow of  vivid hues. And these hues do make my workplace a little more exciting. :-) On one end, there is a green eyed monster, an orange (read: hazardous) terrorizing goblin, a gray energy sucking vampire, a cyanotic feasting parasite. We also have a fresh white affable angel, a golden altruistic Buddha, a purple gentle fairy on the other end. There are many more characters of various shapes, colors, sizes but I only mentioned  the outstanding ones.

Earlier this year, the colorful set of characters welcomed a new comer. It was me who discovered that in our midst, we also have a rusty badminton playing zombie. And the funny thing is that this badminton playing zombie makes use of twin sites to make a smash, instead of a shuttle cock. The badminton playing zombie even taught me how to play! We made use of transducer cable lines as our net and wore heightened emotions as our uniform. And all of these happened in the sterile environment of the operating suite. For the badminton playing zombie is a doctor (an anesthesiologist who for anonymity will be referred simply as “the doctor”)

So what am I really writing about? Well, to the uninitiated, I will come across as someone who visually sees colors through individuals and then post his thoughts on line. So to start it right, I will give a  quick background of what happens during a bypass surgery. And also of what transpired at the time of the discovery of the badminton player.

If you have read the posts in this blog, you will know that this author works as a perfusionist in a cardiac center in the Philippines. My work as a part of the surgical team is to support the cardiac patient through the use of a heart lung machine.

The open heart surgery starts with the patient being put into deep sleep by the anesthesiologist. Then the surgeon cuts open the sternum to reveal the heart. After the heart is made visible and ready for cannulation, the surgeon asks the anesthesiologist to give heparin systemically. This is done so as to make the atraumatic insertion of the cannula to the patient’s heart possible. During cannulation, the perfusionist collects the blood in the operative field through his green suction and into the reservoir of the oxygenator (the lung substitute). With all safety parameters checked (gas source, ACT count, occlusion check, power supply secured) the surgeon then commands the perfusionist to go on bypass. The roller pump (heart substitute) is slowly turned on up until it reaches an acceptable flow based on the patient’s temperature.

At the initiation of bypass, the anesthesiologist hands over the support lines (a set of sterile, thin lines from which medications pass through). These support lines deliver the agents that will make sure the patient is relieved from pain and memory.  In the particular operative case I am writing about, the doctor did a new manner of handing over the support lines: by THROWING it - right in front of me. 


I was taken by surprise. For the life of me I was not able to see the need for the support lines to be thrown towards me. The patient was stable. There was also no toxicity that may cause pressure to act eccentrically. So why throw the lines? Can it not be handed over nicely?

The support line skidded down to the floor. My mind struggled between the choice of keeping mum about the rude behavior and/or voicing my thoughts about it. In the splittest of seconds, I opted to go for the second choice. I called the attention of the doctor and said:

“Doctor, unsterile po yung support line. Hindi niyo po kasi inabot ng maayos” (the support line is unsterile. For you did not give it to me properly.)

“Hindi unsterile yan!” (that is not unsterile!) the reply of the doctor to me.

“Tignan ninyo nga ho. Nasa sahig yung dulo ng line” (Look at the line. The tip touches the floor)

The doctor shot a slashing look at me. If only looks can really slash, my face would have been hacked in two instantly at that time. I guess my reaction and confidence to stand up against the rude behavior caught the doctor by surprise.

The doctor opened the push cart to get a new line to replace the unsterile one. After the sterile line was connected, the doctor got the dirty line. Since it was already a trash, I was expecting the doctor to throw it to the trash can which was just nearby the push cart. The doctor did throw the dirty line. Where? In front of me. Yup. In front of me, on top of my oxygenator. What a professional and ethical act! :-).

My mind processed the newest stimulus. Will I flee or fight? Again, I chose the second option. I got the unsterile line. What did i do? I threw it back to the doctor . Then I shot the doctor the “my-area-is-not-a-trash-bag” menacing look. The doctor just needed to make a half turn to face the trash can, but that is not what the doctor did. The doctor bent down to pick up the unsterile line, then faced me and threw the unsterile line back again to me. Amazing isn’t it? We were like in a playing ground! Hehehe. It was at that time when I realized the doctor is playing badminton with me. "And so shall you see my badminton skills", i thought. I got the unsterile line shuttle cock. And with much gusto (as if playing in an international meet), I served the unsterile line shuttle cock back to the doctor cross over the transducer cables. The unsterile line landed on the doctor’s feet. 


The doctor was taken aback. The doctor paused as if to decide what next move to do. Then the doctor asked me:

“Wala na bang ibang perfusionist?” (Is there another perfusionist?)

“Wala ho” (There is none) I answered.

“So ikaw ang hahawak ng kasong ito”(So you will handle this case?) the doctor asked again.

“Yes. And I will finish this case” I replied.

For some reason, the other members of the surgical team seemed not to mind us. Although each of us are just an arm’s length from each other, my exchanges with the doctor seemed unheard and the flying in the air support line seemed invisible.


The surgery went on. The surgeon applied the cross clamp. The heart was arrested. And while all of those were happening, the doctor nonchalantly stood on top of the foot stool while observing the events happening in the operating field. After I gave the cardioplegia, I updated my patient data sheet. The doctor was still on the foot stool I observed. When I was about to finish writing on the PDS, I saw in the corner of my eye the doctor got off from the foot stool. The doctor approached the monitor screen and calibrated some parameters. Then the doctor went down again to pick up the unsterile line. And for the nth time, the doctor again threw the unsterile line towards me! It was already becoming irritatingly comical I thought. We were like preparatory kids playing during recess. To again reiterate my stand that the proper place to put the line is in the trash can just nearby to the doctor, I picked up the line and thew it back to the doctor. Twice the force. The doctor quick as lightning picked up again the line and threw it. Only at that time farther than I could reach. 


Then the doctor looked at me fiercely in the eye and said:
 “Bastos ka!” (You are rude!)


I was stupefied. “Bastos ako?” (I am rude?) Then if I am and was rude, what does that make the doctor then? Uber bastos? Unethical is a better word i think. 


Upon the advise of my colleague wyner (who came in to circulate for me), I did not answer the doctor back. I sat on my chair for i know i need to relax. I took deep breaths and concentrated on relaxing thoughts like the beach, my latest Baguio trip, the Christmas season etc.

At the end of that day, I realized two things:

1.        The doctor is just like me - a perfectly imperfect person.

I too have my own share of weaknesses and deficiencies. I also commit misjudgments and lapses. So why did I blew my top and showed unkindness to the doctor in return? Why did I not extend my patience further? I could have just opted to talk to the doctor after the operation when emotions are not heightened anymore but I did not. I chose to feed my ego and act solely on what is pleasing to my logic. 

2.        The doctor is just like me – a work under progress.

I am still continuously being molded by God to become the updated version of me. Things are not yet finished for and within me. So much of me is yet to happen and so much of me is yet to become.. and so is with the doctor! Maybe the doctor hasn’t gotten over a hurtful past or a traumatic issue. Maybe the doctor is carrying a heavy load.. And if ever the thought that I am progressing faster than the doctor holds a grain of truth, who am I to act superiorly?

Before retiring to sleep, and after saying my prayers, i became aware of the fact that the doctor is a part of my world. The doctor is one of the many colors in my world. And these colors collectively make up the spectrum of light that illuminates my world. In a way, the doctor is a part of the light in my life.

Come to think of it, the doctor was instrumental for me to become enlightened on an area where I am blinded. So wherever you are doctor, thanks to you.

Hackneyed  it may seem, but i believe it's true that everything happens for a reason.

Even the falling of a leaf has its own reason.

And so is the throwing back and forth of unsterile support lines.. 

Be blessed. and be a blessing :-)

Taza de amor

A good friend of mine, Tope recently finished medicine school with honors. He bested his classmates to become cum laude of his batch. Tope and I both bear the common Filipino surname. And now it’s clear, we just don't have the same surnames, we have the same intelligence too. Just kidding. :-)

Last Palm Sunday, Tope texted me. He asked if we could talk. I said yes. Normally this person does not initiate a talk unless he has something important to vent out or discuss with. He has a problem with a girl in school. So we talked while we walked at the banks of the marikina river. From the many things he shared: the cum laude honour, the girl he befriends, the upcoming internship, he said he feels there is something missing, “parang may kulang pa...” ("something is amiss") he confessed.  Since I know the issues and history of my friend, I asked him “do you want to hear my thoughts about it?” he said “ok”. Then I proceeded to discuss with him about the “love cup”. After hours of sharing, Tope concluded, “So you're trying to say that love is the answer.” I said “Exactly!” And then I quipped: “Let me ask you, if love is the answer, then what do you think is the question?” To which Tope gave me a what-on-earth-are-you-asking stare. (He never answered actually)

Before we parted ways, I reiterated to him the importance of the love cup.

What is the love cup anyway? In the midst of my “elocution piece” to Tope, I used a cup as a metaphor to represent the amount of love a person has within. I have long held the belief that each and every one of us has his own love cup. Being products of love, we have pre-filled cups when we were born. Then as we grew up, the pervasive emptying and refilling of our cups have also started. When we have great bonding moments with loved ones or when we are in a state of bliss etc, our love cups are filled... Likewise, our love cups are withdrawn of its contents when we get envious, when bitterness or revenge takes over us etc.

So what is the essence of this love cup? The love cup is a measure of how much love we can share. Remember, as Christians we are mandated to love. A drying love cup will not be able to sincerely love. Because the cup has not much contents to give. How can love flow out of a cup that is on the brink of drying up? What is there to share if there if the cup is bereft of load?

The point is one can not give what he does not possess. One has to experience first how it is to love himself before he can be able to love others.

Psychoanalyst Bernard Berkowitz wrote and I quote – “people who don’t love themselves can adore others, because adoration is making someone else big and ourselves small. They can desire others because desire comes out of a sense of inner completeness, which demands to be filled. But they cannot love others, because love is an affirmation of the living, growing being in all of us. If you do not have it, you cannot give it.”

Kudos to you Mr. Berkowitz! Excellently worded  I must say. :-)

But of course, the great liar devil will always pipe in and whisper a distorted thought: 

"Why bother to love when nobody loves you?" 

Or the devil may opt to character assassinate and say: 

"Can a porno addict like you be given a chance to find love?"
"So you think a loser like you who appears semi-orangutan will be loved?

Friends, be always on guard with these lies. These deceptive thoughts will never prosper in the presence of prayers. 

Now i ask, if love is the answer, then what is the question?

In my own words the question goes like this:  What was taught by Christ that we Christians must always be full of?

The answer? None other than  L O V E. 

For ourselves.

For others. 

And for God.

Be blessed. And be a blessing :-)      

Inside the Heart

Blood. Chambers. Valves. These are what one will see if he cuts open a heart. But one early morning a few years ago, i got a whole different view point of  what is inside the heart.

I was new then in the Philippine Heart Center. And as the most junior among the cardiovascular perfusionists, i am the one who gets in the earliest and gets out the latest. One Monday morning, I came in very early. As there was not much yet to do that morning, i watched patients get wheeled in to the operating room.

A patient scheduled for bypass surgery was brought  to the receiving area. The entourage included the nurse, orderly and the relatives. My attention was caught by a gentle looking woman with a very concerned countenance. Through the conversations, i was able to deduce that the woman was the patient’s wife. When the patient was about to cross the sterile area going inside the operating room, the wife  held the hand of her husband and spoke these words: “Nasa puso kita. At nasa puso mo ako. Lalaban ka ha.. babalik ka sa amin..”  (You are in my heart. And I am in your heart. Please put up a good fight.. And come back to us..) To which the husband replied “Nasa puso ko kayong lahat.. Babalik  ako sa inyo.. Lalaban ako”. (You are all in my heart. I will come back to you.. I will fight.)

The short exchange of words hit me. On a cold Monday morning, i felt the warm affection the couple shared. There were no tears, no wails or whatever intense emotional scene, just pure sincerity in the expression of their sentiments. 


As i joined the group bringing the patient into the operating suite, i pondered on the "heart" conversation i over heard. Then I realized one thing: our hearts are big. We all have cardiomegaly! :-)  For besides the blood, the chambers and the valves that it contain, our hearts also accommodate priceless treasures : Our family. Our hopes.  Our aspirations. Our faith. Our love.

My thought analysis sub branched to another thought: If our hearts are big vaults of treasures, then how about God's?  I could not fathom  how to find the answer to my query. I searched my lexicon and  i could not find any appropriate adjective to use. Then i came up with an answer. The word is immeasurable. God's heart is simply immeasurable. For inside His heart is the vast, colossal, immense love that God has for ALL of us. It is a love that transcends time and surpasses conditions.  The wife’s love may have boosted the morale of her husband, but it is God’s love that masterfuly guided every stroke of the surgeon’s hand, every decison made by the anesthesiologist, every move of the clinical perfusionist, every work done by the nurse.. God arranged everything to fall into its right places so that the heart surgery would go well. (and it did)

Such is the love of God. It knows no boundaries. It has no limits. It has no prejudice. No matter who we are, no matter what we have gone through, no matter what we have done or was not able to do, GOD LOVES US. And that is a truth that will always remain true. No stain, no shortcoming, no flaw can make us unworthy of the love that God has for us.

If for any reason or circumstance we may feel unloved, let us banish that thought. Because it is a lie. A subterfuge fabricated by the devil. In his greatest effort, the devil will always cloud our thoughts and inject the notion that we are unloved. Or that we are unworthy to be loved.  But by all means my friends, let us avoid subscribing to that idea. For the truth is, we are all loved. We are all products of love. And we are all born to love.

A popular Grammy award winning song by the Blackeyed Peas threw this question “Where is the love?” 
My  answer: Love is in the faithful heart. For where there is God, there is love.


Be blessed. And be a blessing :-)

Noble job

Any job when performed in the best way possible, for me is a noble one. In connection to this, i find it very fortunate that i have not just a noble job, but also a fulfilling one: clinical perfusionist.  The work that i do (together with the cardiac team) creates ripples of effetcs and changes in the lives of many. The easily fatigable child who can not engage much in play because of a congenital heart defect can fully maximize his potentials once a corrective surgery is done on him using cardiopulmonary bypass (CPB). Then that once sick child can go on with life and become anybody he wants to be. (Reminds me of an olympic energy drink advert) :-)

Just like what i have written earlier, I work as a part of the surgical team that do cardiac surgeries. Together with the surgeon, anesthesiologist and the nurse, the perfusionist makes it possible for an open heart surgery under cardiopulmonary bypass (CPB) to be carried out. I am currently employed at the premiere cardiovascular training center in the Philippines, the Heart Center.

My main responsibility is to support the physiologic and metabolic needs of the patient undergoing CPB. I achieve this by utilizing the heart-lung machine and its components like the oxygenator, arterial filter and tubing lines. The heart lung machine contains the roller pump that substitutes for the heart while on CPB. The oxygenator (as the name implies) is the substitute for the lungs of the patient. And the tubing lines act as the blood vessel extensions. All of these components form a sterile, closed system circuit in which blood and medications pass through to allow the surgeon to operate on a non-beating heart.

Above is an example photo of how an open heart surgery is being carried out. The anesthesiologist is on the head part of the patient (making sure that the patient is sufficiently paralyzed and asleep), the surgeon/s and the nurse/s are directly in the operating field and the perfusionist is nearby, behind the surgeon and/or assistant surgeon. In front of us is the heart lung machine set up.

Below is the group shot of the perfusionists of the Philippine Heart Center. We are inside the operating room in this shot.

Wish granted

As i was browsing through my photo library, i came across photos of the Bohol Medical Mission I participated in almost 2 years ago. It was an open heart surgical mission. I became nostalgic seeing the faces and places in the pics.

My participation in that medical mission was almost cancelled out. I had a misunderstanding with one of the doctors who made up the organizing committee. "If am not welcome to join the medical mission, then i will beg off from it", so i said. What is the point of volunteering (i did so) when someone wants you out of the mission? i thought.

But God has another plan for me. He really wanted me to have my wish of being able to ride a plane. (a friend of mine joked me that i can just take the plane in the carnival hehehe) So a workmate of mine "lobbied" for me and talked with the committee member.The ending: i took the Philippine Airlines flight the next day going to bohol. I kept thanking the Lord for the granted wish/answered prayer. Not only will i be able to give free service to chosen Boholano patients, but i will also get to see interesting sights like the Chocolate hills, Loboc River, Tarsier habitat, Man made forest etc. 

\

Aboard the plane, my seat was beside the aisle. But i asked my friend to have his seat which was beside the window for I wanted to see clouds and over head views of terrains and seas. When the plane took off, i was smiling! hehehe. I could not believe i was flying. :-) Everything was good. The sights, the sounds and the feel. The turbulence? i longed for it! hehehe. Well it is not something i usually experience everyday so i kept on waiting for some turbulence while on board.

Snacks were served and broadsheet papers were given to us. Ditto with the headsets to be used for music listening or movie watching. I kept awake (unusual for me) for the rest of the trip. I made sure that i keep it all in within me - the experience of the first plane ride.

Someone told me that one of the things i should definitely try to do aboard a plane is to pee. At my seat? Of course not, at the comfort cubicle. (well it is not a room to me) And so i did. There was nothing new or remarkable about using the CC except for the fact that the space was really consumed well. A fully functional restroom, toilet is built in such a cramped space.

After an hour and a half, the plane we boarded touched ground. Then when i got out of the plane, i saw a band marching and playing nearby. I was delighted to see that we are being given a warm welcome. Then after a few moments, it dawned on me that the band was not playing specifically for us. It was playing for the ambassador of Australia who then at that time also arrived on a private plane. Hehehe. So much for wishful thinking.