Archive for the ‘UP-PGH’ Category

Jokes louder than walnuts breaking, an “H” in a name, and an Ibalon child of tomorrow

September 14, 2008

Each time I look at the pictures of Dr. Ramon Ray G. Rayel and his wife Bessie , I can’t help recall our days in UP Ibalon and Molave Residence Hall in Diliman campus. Things are far better now for my cardiologist-buddy who travelled the world to go to Philadelphia, PA, Nova Scotia, CAN, Iron Mountain, Michigan and a bit later settle to a beautiful place called Clearwater, Wisconsin.

From the Philippines to Australia, to Canada, and the United States, Dr. Rayel has been hot in the business of taking care of the heart. A self-deprecating humorous guy from Polangui, Albay who knows by rigid training the workings of the fist-sized pulsatile organ in the chest, Ray throws jokes louder than the pop of champagne and the sound of cracking walnuts in a charcoal grill. When he plays sports, he shoots the basketball right at the goal to win.

With that stubborn curly hair on his head, Ray watches, listens, and patiently dispenses remedies at the heart’s murmurings. Like a one-man charitable institution, he helps all those who come to him with problems, including those who need treatments and those requiring some baring of the soul.

His best contribution to the world however is nothing less than the cute and cuddly little Bea, Ray’s youngest kid in the brood of three who delights us with her big smile, fashionista sunglasses, and that kiddie backpack (see photo.) It is something we like to see the pixie angel do for her doting parents. By a stretch of imagination, I thought she may look like her loving grandma, the late Lourdes G. Rayel.

Coming to New York a year ago, little Bea proves to be a child of today and tomorrow. Nimble, smart, and delightfully inquisitive the girl with big round eyes and a budding sense of humor is a joy to watch. As I relish looking at her sit comfortably with her parents in their warm and cozy living room, I have to thank God for taking good care of the family who makes me and all Ibalonians happy and proud.

A true friend who taught many to rein over their personal devils, conquer health difficulties, look ahead, and appreciate life’s unexpected complexities, Ray gifted me with a name which to this day I respond to like a poodle. His generous counsel before I took trainings in UP-PGH, SUNY Downstate & NYU Medical Center became part of my decision to be a pathologist—for which I am very thankful.

The only wise advise Ray gave me which I rejected (I’m sorry Ray!) was to put an “H” on the spelling of my nickname. Shown to me in a crumpled paper, I thought it was “elegant” with the concurrence of Drs. Arnel V. Malaya, Mario B. Genio, and Julius A. Lecciones who excitedly insisted it would make the eyes of other Bicolanos spin. They expected the “H” would make me popular and the Ibalon girls would swoon. But there was a hitch. The spelling couldn’t bear the persona of their buddy: the slow itinerant “promdi” (from the province) of Naga, Camarines Sur! =0=

Paying Homage to Community Service

September 11, 2008

The Diamond in the Rough Awards of a fraternity at UP-PGH caught my attention. I thought UP Ibalon Bicol had an excellent candidate-M,D. for the nomination. But there had been obstacles to hurdle. So I wrote a letter to the secretariat which oversees the contest for service-oriented doctors to share my thoughts. Read and you decide.

To the Diamond in the Rough Awards Committee:

I’m elated to know about the Diamond in the Rough Awards. I thought I have a fine candidate in mind, but I was a bit disheartened that it has age and location restrictions. Here’s why.

I have difficulty reconciling that age matters in giving honor to a lofty and admirable endeavor such as community service. In the US, there are a few bases of discrimination that I know. One of them is age. I believe it is also true in the Philippines.

Come to think about it. Isn’t there a shade of injustice if we give a shelf-life (expiration date) to recognize exemplary deeds? I always think honorable work must be for all and for eternity. I believe many of us in the profession feel young way beyond 40 years old. Besides, we’re not thinking here of an award that can prop-up careers, but awards that careers have made.

Also I notice that the contest is for rural doctors. But aren’t there blighted and underserved areas too in the big city which have worse conditions than in the countryside? I believe doing grassroots work in the city can be no less daunting.

I don’t have control over the rules. I humbly respect your age limit of 40 and other restrictions. But in my opinion, in considering a person’s recognition, longevity of work and service gives more bone and credence to a person’s motivation. It will give prestige to your contest. The location of the exemplary work isn’t very relevant as I explained above.

An award such as what you offer is better not restricted for prodigies or upstarts who dazzle us like evanescent dewdrops that may vanish in the cold. How many outstanding young men have gone astray? Who has left the rural areas after receiving honor? How many of them abandoned their cause or tarnished their recognition?

I’m sure there are unsung people out there who in their middle age or in their twilight years got the holy grail of their life passion. They are among the people worth honoring in the contest. I’m pretty sure they’ll inspire us more, just like the young ones to pursue causes greater than their own.

I hope this observation may help your fraternity reconsider the criteria of your award. If there is any change, please tell me and I’ll be happy to try and make a nomination. Thank you so much for your attention.” =0=

The Ferry Tragedy: Lack Of Body Bags And The Dearth Of Forensic Expertise

June 27, 2008

The advice of UP pathologist Dr. Raquel Fortun that “there must be a detailed external examination of all remains recovered while the soft tissues are still intact for documentation and proper identification” seems to be what we know from a pathology textbook. But for those who are aware of how forensic science is practiced in the Philippines, this recommendation is a pipe dream, especially for those who lost loved ones in the Princess of the Stars tragedy.

In spite of advanced forensic technology currently in use today, our investigators are mostly operating on antiquated scientific grounds, very much like the outdated travel guidelines Sulpicio Lines followed which led to the ill-fated ship to its seabed grave. Our forensic doctors may well be 50 years behind in what modern science normally does to deal with deaths of this magnitude.

We don’t have enough freezers and body bags to keep our cadavers. There is no central repository of bodies that’s needed to secure material evidence and specimens for testing. We lack the manpower and logistics to deal with such a catastrophe which upsets all of us. With no time to put up a coordinated team, pressure to bury decomposing bodies builds up. The public is afraid of potential contamination and outbreak of diseases.

Since I left UP-PGH in the 1980’s, little had changed in our way of medico-legal investigation. In those days, as member of the Department of Pathology, I volunteered to help examine remains—a thankless job I did for free, because few pathologists in the academe were willing to do it. I believed it was a calling which I must sustain for those who sought justice. I joined the National Bureau Investigation (NBI,) Commission on Human Rights (CHR,) and some cause-oriented groups perform autopsies and identifications, mostly for victims of violence and killings during Marcos’s time.

The reasons for the dearth of interest in forensic science are largely predictable. For years, the systemic lack of budget has spawned a culture of waiting, inaction, and helplessness on the part of the government. Gruesome and messy as necropsies may be, forensic science is a tedious job. Few doctors go into the specialty for lack of appreciation of its contribution to our society. It appears a sizeable number of medico-legal doctors stick to their jobs as their source of livelihood, not because they gain professional satisfaction in caring for the dead and in seeking the truth behind a person’s passing.

Many medico-legal doctors in the Philippines are trained on the routine crime scene investigation, identification of bodies and autopsy, but they sorely lack support. As basic as a steady supply of gloves, sharp scalpels, or a good morgue assistant, pathologists don’t have standard modern autopsy facilities. Besides, they have only a few credible laboratories with state-of-the-art capabilities which can help put their cases to rest.

The routine death investigations do not usually pose problems. It is the sensational demise, those that hug the news and cause public controversy and pain that bring embarrassment to our medico-legal capabilities. In our ranks, we have forensic workers who are slowed by the endemic problems of the profession: job-overload, lack of facilities, inadequate budgetary support, turf wars, and a dearth in trained manpower.

There are times when we don’t believe what our medico-legal investigators say. Questionable results of past cases make them appear untrustworthy. The question of competence and honesty often crop up, making them cynical and defensive. Burdened by their deficiencies, they end up as apologists and defenders of an institution that needs total overhaul.

Body retrieval and identification disturb us. In mass deaths, our instinct is to ask help from forensic experts abroad, believing that it’s the only way a reliable medico-legal investigation can be carried out. Our unending dependence on foreign assistance makes us lose our drive to learn, work hard, and trust in ourselves.

Who then will do the examination, documentation, procurement of tissue samples that may aid in identifying the dead? Who will provide the freezers that Dr. Fortun asks for (Inguirer, 06/27/08, Uy, J.)—so that the NBI and medico-legal experts like her could do their job to the satisfaction of the grieving public? When will we get the central repository of remains and tissue samples of unidentified victims?

The main purpose of postmortem examination in the tragedy is to recognize the dead as quickly as possible so that their relatives can give them decent burial. Body retrieval and identification will help bring closure to the grief of loved ones. Necropsy is important in the prosecution of case(s) against the culpable. It’s vital in pursuing justice for the victims.

At this time, it is less important to know the victim’s circumstance and manner of dying, for without the ship’s sinking, all the passengers could be presumed alive to reach their destination. Most of those who perished probably drowned.

More than 20 years after I left UP-PGH, I doubt if precise identification could be done on many victims of Sulpicio Lines. An overwhelming number of decomposing bodies, in various stages of decay, at different sites in the islands, some drifting from the shipwreck have been found floating or washed to shore. It appears the manpower and forensic expertise to do a credible job on these bodies, are meager and inadequate. =0=