No Breast Cancer risk after Mammography

Mammogram Radiation Does Not Raise Risk of Cancer in BRCA Mutation Carriers

"Exposure to radiation through screening mammography does not contribute substantially to the burden of breast cancer in BRCA1 and BRCA2 mutation carriers, even when screening begins at an early age, investigators report in The Lancet Oncology, published online on March 22. Because BRCA mutations disrupt the repair of DNA damage, it was feared that DNA-damaging radiation from mammography would increase these patients' risk."

Reference-Reuter's Health

Clinical Experience versus working hours-what is the right balance?

From Medical Student News-

European Working Time Rules ‘Make It Impossible To Train Doctors Properly'

"The European working time directive, which limits the hours employees are allowed to work, means junior hospital doctors cannot receive the training they need to become a consultant gastroenterologist, according to results of a survey presented at the Annual Scientific Meeting of the British Society of Gastroenterology. A survey of Specialist Registrars (SpRs) in gastroenterology found that limits to working hours meant that they missed out on a quarter of the clinics they were supposed to attend and a third of the ward rounds led by a consultant."

Well then what is the solution i have always believed working hours of a resident should be something which allow him to learn and work side by side. How do we strike a balance between gaining work experience and healthy working hours? Comments welcome...

Diffusion Tensor Imaging in Schizophrenia

Diffusion Tensor Imaging
Kelvin Lim is using a new brain-imaging method to understand schizophrenia.
By Emily Singer

"Flipping through a pile of brain scans, a neurologist or psychiatrist would be hard pressed to pick out the one that belonged to a schizophrenic. Although schizophrenics suffer from profound mental problems -- hallucinated conversations and imagined conspiracies are the best known -- their brains look more or less normal. This contradiction fascinated Kelvin Lim, a neuroscientist and psychiatrist at the University of Minnesota Medical School, when he began using imaging techniques such as magnetic resonance imaging (MRI) to study the schizophrenic brain in the early 1990s.Then, in 1996, a colleague told him about diffusion tensor imaging (DTI), a newly developed variation of MRI that allowed scientists to study the connections between different brain areas for the first time. His group has recently found that memory and cognitive problems associated with schizophrenia, major but undertreated aspects of the disease, are linked to flaws in nerve fibers near the hippocampus, a brain area crucial for learning and memory."

Reference

Technology Review (via http://www.medgadget.com )

Gaolinium-Neurotoxicity??

In an article by Maramattom BV et al, Gadolinium encephalopathy in a patient with renal failure in Neurology 2005 Apr 12;64(7):1276-8 authors discuss a case of gadolinium encephalopathy.

"Gadolinium chelates are extensively used in MRI studies. Neurotoxicity due to gadolinium chelates is minimal and uncommon. A 57-year-old woman in renal failure developed a subacute encephalopathy after inadvertent repetitive gadolinium contrast administration. An unusual MRI appearance with CSF hyperintensity due to gadolinium diffusion into the CSF is also shown"

FRCR 1 Sample MCQs and syllabus

First FRCR Examination in Clinical Radiology
Sample MCQs

The bold headings indicate the section of the syllabus that the question addresses.

1.1 Basic Physics
1 In the Compton effect:
(a) There is interaction between a photon and a free electron.
(b) The larger the angle through which the photon is scattered, the more energy it loses.
(c) The wavelength change produced depends upon the scattering material.
(d) High energy radiation is scattered more than lower energy radiation.
(e) The amount of scattering that occurs depends on the electron density of the scattering material.


1.2 Radiation Hazards and Dosimetry
2 Concerning radiation dose:
(a) PA chest x-ray effective dose is approximately 0.02 mSv.
(b) Annual effective dose limit for members of the public is 5 mSv.
(c) Average annual dose in the UK from natural background radiation is 0.1 Sv.
(d) The average annual effective dose to the UK population from medical exposure is 3 mSv.
(e) Effective dose to patients having a radionuclide bone scan with 600 MBq technetium-99m is approximately 4 mSv.


2.1 General Radiation Protection
3 In diagnostic radiology, the following values are typical:
(a) 5 mSv is the annual effective dose limit for classified staff.
(b) 1 mGy for skin dose to the patient in chest radiography.
(c) 2 mm lead equivalence for a lead rubber apron.
(d) 25 mGy per minute for entrance dose rate to patient during abdominal fluoroscopy.
(e) 4 GBq of iodine-131 for a diagnostic thyroid scan.


3.1 Ionising Radiations Regulations 1999
4 An employee must become a classified worker if
(a) they work more than three sessions per week with ionising radiation.
(b) three tenths of relevant dose limit is exceeded.
(c) they are likely to receive a whole body dose greater than 6 mSv annually.
(d) the dose to their hands is likely to exceed 150 mSv annually.
(e) they become pregnant.


3.2 & 3.3 Ionising Radiation (Medical Exposure) Regulations 2000 and Other Relevant Legislation
5 Regarding The Ionising Radiation (Medical Exposure) Regulations 2000 [IR(ME)R]:
(a) Overall responsibility for keeping dose to the patient as low as reasonably practicable rests with the practitioner.
(b) The practitioner is the only person entitled to authorise an x-ray exposure.
(c) Only doctors and dentists are permitted to request an x-ray.
(d) The person performing quality control tests on an isotope calibrator must have training as required by IR(ME)R.
(e) The enforcing authority for IR(ME)R is the Health and Safety Executive.


4.1 Diagnostic Radiology
6 Radiological image unsharpness increases
(a) if shorter exposure times are used.
(b) as the object to film distance increases.
(c) as the target angle decreases.
(d) if a grid is used.
(e) as the focal spot size increases.


4.2 Fluoroscopy and Fluorography
7 In automatic mode fluoroscopy, the patient entrance surface dose rate
(a) usually increases with image intensifier field size.
(b) depends on the added filtration.
(c) is independent of the kV-mA characteristic used.
(d) doubles if the patient-intensifier face distance is halved.
(e) should be less than 50 mGym-1.


4.3 Computed Tomography
8 Regarding computed tomography:
(a) A CT number of 0 is assigned to water.
(b) Image quality is limited by electronic noise.
(c) Axial image resolution is improved with reduction in slice width.
(d) An unfiltered x-ray beam is used.
(e) The typical effective dose for a CT head scan is 10 mSv.


4.4 Patient Dosimetry
9 The dose to a patient may be reduced by using
(a) a grid.
(b) collimators.
(c) additional copper filters.
(d) a high tube voltage.
(e) a small focal spot.


4.5 Radionuclide Radiology
10 Concerning radiopharmaceuticals:
(a) The ideal radiopharmaceutical should have as short a physical halflife as possible.
(b) The ideal imaging radiopharmaceutical should emit only gamma radiation.
(c) The gamma radiation emitted contributes a larger part of the radiation dose to the patient than any accompanying beta radiation.
(d) The effective half-life is longer than the biological half-life.
(e) The labelling isotope should remain attached to the tracer material throughout the examination.

Reference-

First FRCR Examination in Clinical Radiology (RCR)

Google thinking about Healthcare

Google Health, what is it? by ZDNet's Garett Rogers -- It isn't a big surprise that Google is thinking about healthcare -- but now information suggests products or services for that industry are in the master plan.Adam Bosworth, former VP of Engineering at BEA Systems, is working at Google with the title "Architect, Google Health" according to the attendee list for PC Forum. [...]

Using Google pages to create My Online Curriculum Vitae-All About Sumer Sethi

Here is an attempt to create my online CV using Google pages. Check out
Sumer Sethi's Home Page
http://sumerdoc.googlepages.com

Justification for Repeated Radiological Investigations Must

In a very touching letter to medscape a mother talks about her son's leukemia and his repeated CT scans for Head Injury 5 years back.

"After...years, the ordering physician or nurse is gone, the radiologist is gone, and the only one left is the patient, who received x-ray radiation as a child and now harbors a malignancy..."

This encapsulates the issue of the potential impact of CT radiation on children and to illuminate the river of resolve that lies beyond the sorrow over the loss of a little boy. Well somewhere down the line the responsibility for repeated CT scans has to be fixed and potential long term harmful effects should be taken into consideration.

Read the full story here-

March 2006: CT and Cancer: A Mother's Story

Hippocampal atrophy in Alzheimer disease

In an article- Hippocampal atrophy in Alzheimer disease: age matters by Van de Pol LA et al in Neurology 2006 Jan 24;66(2):236-8. Hippocampal atrophy is a marker of Alzheimer disease (AD). It remains unclear whether this holds true for younger patients as well. Hippocampal volume was measured by MRI. Aging and AD were independently associated with smaller hippocampal volume. Both young and old AD patients have hippocampal atrophy abnormal for age. Age-dependent criteria for hippocampal atrophy, suggestive of AD, are needed.

Random Images of Cubao

Ang Nepa Q-Mart. Larawang kuha mula sa overpass sa EDSA.

Isa sa pinakamatandang kainan dito sa Cubao ay ang Nena's Bibingka. Masarap, mura at maganda ang ambyens ng restwrang ito. Ispesyalti nila syempre yung Bibingka. Regular 4o pesos, special 60 pesos, tapos may keso at itlog na pula pa sa ibabaw. Hmmm...sarap... kakagutom no?

Ang loob ng bagong Gateway Mall. Ang mall na ito ay para sa mga mayayaman ng Cubao. Puro high-end ang mga tindahn dito tulad ng Lacoste, DKNY, Esprit, Escada, at iba pa.
Kaming mga nasa panggitnang uri ay kuntento na mag-shopping sa Farmer's o kaya sa mga tiangge sa mga bangketa ng Aurora Boulevard.

bangketa sa Aurora Boulevard. Maraming tindahan dito ng ukay-ukay o mga segunda-manong damit, meron ding tindahan ng mga segunda-manong appliances, relos at kung anu-ano pa. May mga nagbebenta din ng aliw....tuwing takipsilim.

Terminal ng bus patungo sa mga lalawigan sa Quezon, Batngas, Laguna, Ilo-ilo, Bikol, Samar, Leyte, at Mindanao.

Marikina Shoe Expo, isa sa pinakamurang tindahan ng mga sapatos na gawang Marikina. Nakabili ako ng spatos na Rusty Lopez na balat sa halagang 300 pesos lang. Sa ngayon ay hindi na lang mga sapatos ang mabibili sa Expo, meron na ding secondhand bookshop, antique shop, art galleries, at iba pang specialty shops.

Ang C.O.D. ay ginawa ng Puregold Department store. Gayunpaman, ang mga Del Rosario pa rin ang may-ari ng gusali, at ipinauupahan lang nila ito sa Puregold.

MGA PANGGABING LARAWAN

Talagang tuwing hapon, araw-araw ay naglalakad ako sa Cubao. Ito ay parte ng aking pag-eehersisyo. Wala akong planadong lakad, para lang namamasyal. Minsan may makakasalubong na kakilala o kaibigan. Tapos maglilibang ng ilang oras sa loob ng National Bookstore, tumitingin ng mga "sale" na aklat. Pag nagutom ako kumakain ako sa Nena's o sa Bellinis o kaya sa Farmer's Foodcourt. Pag napagod tambay sa Ali mall o kaya video games sa SM. Yan ang buhay ng isang taong walang trabaho.
Narito ang ilang larawang kuha ko kagabi habang namamasyal sa Cubao.

Ang New Frontier Theater. Dito kami madalas manood ng sine nung dati kong girlfriend. Break na kami matagal na. Mga isang linggo na...

SM Cubao. Isa sa pinakamatandang SM departmnt stores. Mas matanda lang ng ilang taon ang SM Carriedo

Ang dating automatic center ay Value Station na ngayon. Tindahan ng mga appliances, damit at laruan ang loob nito.

Isang view ng General Araneta Avenue mula sa tulay na nagkakabit sa Farmer's at Araneta Coliseum

Ang dating Fiesta Carnival ay ginawa na ngayong Shopwise Supermarket.

Full Body CT scans-Risk of Radiation Exposure

"They promise to cut your risk of dying from cancer. Yet full-body CT scans themselves pose a real cancer risk, new calculations suggest. X-rays from a single full-body CT scan give a dose of radiation similar to cancer-associated radiation doses in A-bomb survivors, finds David J. Brenner, PhD, director of Columbia University's center for radiological research.

Richard L. Morin, PhD, chairman of the ACR's commission on medical physics, says that given lack of an established benefit, the risks Brenner identifies raise doubts about screening healthy people with full-body CT scans. "This paper is important in demonstrating explicitly that the risk from whole-body CT or any other diagnostic radiology exam is not zero," Morin tells WebMD. "It supports the thinking that screening whole-body CT scans of healthy individuals is not a wise course of action." "

Reference-CBS News (Via WebMD)

Pwedo Po Bang Mag-Aplay?

Heto ang nangyari sa pag-aaplay ko ngayong maghapon: pudpod ang swelas ng sapatos kalalakad at nanglalagkit ang mukha sa init ng panahon. Natanggap ba ako? Hindi. Malas lang. Pero okey lang.

Ang karaniwang sinabi sa akin sa mga pinag-aplayan ko ay:

1. Iwan mo na yang bio-data mo sa amin at tatawagan ka namin pag may bakante na. Kami ang tatawag sa iyo okey? Sige na. (Sige tutal next week putol na yang telepono ko dahil walang pambayad)

2. Bumalik ka na lang sa isang buwan. Hindi pa kami nag-eentertain ng aplikante. Titingnan pa namin kung pwede kami mag-dagdag ng panibago....(Kahit kailan di na ko babalik dito noh!)

3. Sa totoo lang nag-retrench nga kami noong nakaraang semestre...Tapos ngayon medyo kapos pa ang enrollment..Napakahirap talaga ng sitwasyon ngayon hijo... (Okay, okay I get it, hindi na lang kasi diretsahin na walang bakante!)

4. Maganda ang kredensyals mo iho, kahanga-hanga, pero sa malas ay wala kaming bakante...(Hmmp! pinuri pa ako para lang lalong iparamdam ang aking frustrations..)

Kaya hanggang ngayon, wala pa ring resulta ang aking planong pag-aaplay. Sa totoo lang ayoko na ring mag-aplay. Nakakaasar lang e, dami ko pa namang pinaseroks na resume. Mag-Japan na lang kaya ako tulad ng ginagawa ng maraming kadalagahang Pilipina? Kaso lalaki nga pala ako...

Bumili ako ng pahayagan at binasa ang classified ads...baka sakaling may trabahong pwede kong pag-aplayan...Kahit anong trabaho tatanggapin ko basta marangal at malaki ang sweldo....hehe...

Heto mga nakita kong bakante sa dyaryo at di na kailangan pa ng mga digri digri na yan:

1. Factory workers. Tagabalot ng sigarilyo sa isang pabrika ng sigarilyo sa Valenzuela..(Nyaay. Allergic ako sa sigarilyo at sa amoy ng sigarilyo..)

2. Piano movers. The number one piano manufacturer in the country needs professional men to deliver pianos to any part of Luzon. (Ngwek...kung isang basong tubig nga tinatamad pa akong kumuha sa refrigerator e, piano pa?)

3. Insurance agents. Earn as much as 60,000 pesos in one month! We will train you, attend our free seminar for one week. (Eheheh..Wag na toy. Baka yung one week na yun ay ako pa ang bentahan ninyo ng insurance...)

4. Embalmers. No need for any professional degree. No need for experience. We will train you. Good income. Sure hiring. Free meryenda. (Yaiks!!! Dugo....dugoooooo...Lamang-loob!!!)

5. Professional Purveyor of Environmental Merchandise. In short, Kapote salesman...(Langhiya pinaganda pa ang title tagabenta lang pala ng kapote)

6. Cartoonists for a Danish Newspaper. Applicants must possess a grim sense of humor. We have recently fired two cartoonists for confidential reasons. If you feel qualified, please submit two cartoon figures of Bin Laden immediately.

7. Teachers(yes!!!). High salary(yes!!!). Please bring bio-data, and apply personally at Midok National High School, Basilan (no!!!)

Hay naku..makapanood na nga lang ng V for Vendetta!

Views from a Bus(Novaliches to Sta. Rosa, Laguna)

I had to visit a friend in Sta. Rosa Laguna yesterday. I slept in Novaliches because of the annual family reunion held last friday. Up by ten o' clock, I had to pack a few pasalubongs and try to find a nice bus that would bring me to Sta. Rosa. There are no airconditioned buses in Novaliches so I had to just content myself with an open-windowed bus, and pretend I'm travelling way back during the 1960s when aircon buses were visrtually unknown in the Philippines. As far as I know, aircon buses were only introduced in the country during the mid 1980s. Or so I guess...

Munoz/Edsa intersection. Since the local government built that pedestrian overpass a year ago, traffic had tremendous improvement in this part of Edsa. There are several ovverpasses like these along EDSA and they indeed helped ease traffic situation in Metro Manila.

A view of Kamuning from the EDSA Flyover.

We, of course passed by Cubao, and I cannot just passed my town without taking a snapshot. That green building in the background is the new Gateway Mall.

The Pasig River. View from the Guadalupe Bridge.

Makati near Ayala Avenue Edsa. We took the Alabang exit, of course.

Leaving Manila behind. This is the South Super Highway. It was a nice and bright day. I felt the fresh wind gushing, which makes me relaxed and refreshed. Oh, and I love those clouds!

The bus I was riding seemed very slow. It's like we're just cruising, to the sound of Billy Joel's "I love you just the way you are". Hehe nonsense, just one of my favorite songs that brings memories of my my first love affair. Back to reality. Well, one advantage of slow driving is that you'll feel less in danger of being involved in accidents, and enjoy the views as if they were changing scenes in movies.

A dangerous curve. "Don't go changin', try and please me, you never let me down before uhhhm.... I just want want someone that I can talk to, I love you just the way you are" From Billy Joel's song.

I debarked in the Pacita Complex near San Pedro, Laguna, and I took one of the jeepneys that plied from San Pedro to Sta. Rosa. As usual, I took the seat in front, paid extra for the next available seat, and relaxed as we plied the thirty minute trip to Sta. Rosa.

Thirty minutes later, I arrived in Sta. Rosa. This is the arch of Sta. Rosa, Laguna.

Another view of the arch from the other side. March 17, 2006.

Horseshoe Lung-A Rare Congenital Anomaly

Horseshoe lung is a rare congenital anomaly characterized by the presence of unilateral pulmonary hypoplasia and a midline isthmus bridging the right and the left lung. Almost all cases of horseshoe lung are associated with the scimitar syndrome. The scimitar syndrome, sometimes called the congenital pulmonary venolobar syndrome, is a rare but well-described constellation of cardio-pulmonary anomalies. The characteristic abnormality is anomalous pulmonary venous return from a part of or the entire right lung to the inferior vena cava.

Reference-

Horseshoe Lung Associated With Scimitar Syndrome and Pleural Lipoma.

Journal of Thoracic Imaging. 21(1):73-75, March 2006

Dikensoy, Oner MD; Kervancioglu, Resat MD; Bayram, Nazan Gulhan MD; Elbek, Osman MD; Uyar, Meral MD; Ekinci, Erhan MD

Leading Indian Newspaper reports the demand of security by Doctors

From the leading newspaper-The Hindu

Doctors demand security

Resident doctors at Lady Hardinge Medical College here have written to the Medical Superintendent demanding adequate security for doctors.
The letter comes in the wake of yet another incident of a patient's relative threatening an on-duty doctor at the hospital. "On March 13 around 10-30 p.m., Kalawati Saran Children Hospital's Paediatric-ICU was held hostage by a patient's relative with a gun in his hand threatening to shoot in case his already stable child was shifted from the ICU to the ward. This hostage drama paralysed routine work for about an hour and prevented emergency services. Agitated resident doctors complained to the police in the night but no action was taken. In the morning, doctors talked to the Medical Superintendent who forwarded the complaint to the police,'' said a member of the Resident Doctors' Association of the hospital on Tuesday.
"We are demanding that immediate action be taken against the culprit and that he be charged with attempt to murder. We are also demanding formation of a campus security council. A beat constable should be available round the clock on the campus,'' said the president of the Resident Doctors' Association of the hospital, Sumer Kumar Sethi.

Sumer Sethi opposes violence against Doctors

From the Newspaper Times Of India

"In yet another incident of violence against doctors, a 30-year-old man barged into the paediatric ICU at Kalawati Saran Children's Hospital with a country-made pistol and held the staff hostage for nearly two hours. An FIR has been registered at the Mandir Marg police station. The accused, Pappu, a Shakarpur resident, barged into the ICU at 10:30 pm on Monday and left only after midnight. He was reportedly in an inebriated state. His 18-month-old son, Vinayak, who was suffering from bronchopneumonia had been admitted to the ICU, but was shifted out to the ward after he became stable on Sunday. Pappu, then proceeded to take his son home against the advice of hospital doctors.
"He came back yesterday at night in a drunken state. Dr Navin Butt, who was the senior resident on duty at the ICU, has been left shaken after the incident. Why is that we have to always go on strike for our demands to be met?,"queried Dr Sumer Sethi, President, Resident Doctors' Association (RDA). The RDA has demanded that a beat constable be available round-the-clock in the college campus and that a campus security council be formed with representation of the area DCP, ACP, SHO, RDA, nurses and students. There have been several such incidents in the past couple of months which have even led to strikes at Lok Nayak and Guru Teg Bahadur hospitals. "

This Radiologist is going places!!

Radiologist throws hat in ring

Frank Macaluso Jr. eyes California governor's seat for the second time

"Frank Macaluso Jr. is married with children, lives in Exeter and works in Visalia as a radiologist. And he's hoping to become the next governor of California and has filed the necessary paperwork to run as a Democrat on the June primary ballot."

Source- Visalia Times Delta

Unclassifiable Pelvic masses

Which extrauterine pelvic masses are difficult to correctly classify as benign or malignant on the basis of ultrasound findings and is there a way of making a correct diagnosis? By-Valentin L et al

"Papillary projections, >10 locules in a cyst without solid components, low-level echogenicity of cyst fluid, and moderate vascularization as assessed subjectively at color Doppler examination are found to be ultrasound variables associated with unclassifiable mass. Borderline malignant tumors proved to be most difficult to assess.Papillary cystadeno(fibro)mas, myomas and cases of struma ovarii were also more common among the unclassifiable masses.Borderline tumors cause great diagnostic difficulties, but so do papillary cystadeno(fibro)mas, struma ovarii and some myomas. "

Reference-Ultrasound Obstet Gynecol 2006 Mar 9; [Epub ahead of print]

Leprotic Nerve Abscess-Sonographic Diagnosis, an Article in Applied Radiology By Dr Sumer K Sethi

The case report illustrates the sonographic appearance and management of nerve abscess, a rare complication exclusive to leprosy. Leprotic nerve abscess is an extremely rare manifestation of leprosy. However, in the appropriate clinical settings and with the characteristic sonographic appearance, a diagnosis of nerve abscess should be considered, especially in endemic areas.

Radiological Case Of the Month

Leprotic nerve abscess
By Sumer Kumar Sethi, MD; Ravi Shankar Solanki, MD; Vibhu Mendiratta, MD. Applied Radiology Volume: 35 Number: 3 March 2006 Pg-44-45.

Coffee and Radiologists

As all Radiologists will agree one intregal part of a Radiologists daily life is a cup of coffee, from Helping us concentrate for long hours of work, and fighting off drowsiness to socilaizing with other clinical counterparts; advantages are manifold.

Read this very intersting Editorial from Current issue of Applied Radiology

"I think radiologists consume more coffee per capita than any other population group. I base this on my own personal experience and on the observed habits of a number of radiologists in this center. My control subjects are the other specialists who frequent the same coffee stands, and the other staff and visitors who wander by. As radiologists, we love coffee. We need coffee. We don’t trust those who don’t want it. "

Complete Article by C. Douglas Phillips, MD, FACR

Guest Editorial: I think you’ve had enough…

Medical Education-New Directions

Something i have always wondered is being a genius or a great academics guy sufficient to be a good Doctor.. Is'nt it time that Medical Education looks into developing qualities as Compassion, caring for the patient and communication skills to the medical students.

Examining how medicine is taught - Reading and changing the culture

"Rigorous course work, state of the art laboratories, relevant textbooks and demanding clinical rotations produce technically competent physicians. But surveys say that in addition to highly qualified care givers, we want doctors who are compassionate and know how to communicate well when caring for us and our loved ones, yet the environment in which medical students become physicians is often not conducive to producing these caring qualities"

Read the Full Article here-

Medical News Today

What do you have in Common with American Presidents?

Ok Ok agreed you are not the most powerful man in the world but you might be suffering for the same disease they suffered from.. Yes diseases dont spare even the American President..

"From George Washington's toothlessness (he has no teeth left by middle age), to Grover Cleveland's gout, to Franklin D. Roosevelt's polio, to Ronald Reagan's Alzheimer disease, and finally to George W. Bush's colon polyps, presidents throughout history suffer from the same diseases and ailments like the rest of us. "

For the interested, check the link below

(Link Via http://www.medgadget.com)-

Presidential Diseases

Views from the LRT

A view of Avenida Rizal from the mezzanine of the LRT Carriedo station


A view of Carriedo from the top floor of the LRT


Late afternoon view of the Plaza Sta. Cruz from the Carriedo station of the LRT.

View from a moving train. Blumentritt houses. I am seated at the other side of where the sunset is.

A view from a moving train of the old mauseleums in the Chinese Cemetery, between Abad Santos and R. Papa Stations

Another view from a moving train as it approaches the R. Papa station.

A view as the train approaches the 5th Avenue Station. The lengthening shadows reveal that it is almost sx o'clock at this other side of the sunset.

A view of one of the streets in Caloocan when the train almost nears the end of its journey near the Monumento station.

Debarking the LRT. Monumento Station. March 11, 2006.

Nag-Aplay, Nagpagupit, at Namasyal sa Intramuros

Maaga akong gumising kaninang umaga dahil plano kong mag-aplay ng trabaho sa Maynila bilang isang guro sa kolehiyo. Naisip kong kailangan ko muling magbanat ng buto upang maging kapaki-pakinabang sa aking bansa. Sa pamamagitan lamang ng aking pagtatrabaho ay makapag-ambag ako sa pambansang buwis upang maipampasweldo sa ating mga kagalang-galang na mga pulitiko. Talagang kailangan ng ating bansa ang mga makikisig at poging kabataang katulad ko upang mapaunlad at makipagtunggali ito sa progreso ng mga mayayamang bansa! Malay ninyo ay maging isang tigre din ng Asya ang ating bansa kung ako'y matanggap sa trabaho!

Bitbit ang isang mahabang envelope na kinalalagyan ng aking resume at transcript of records, sumakay ako ng jeepney patungong Maynila upang mag-prisinta sa isang kolehiyo bilang guro. Nakasuot ako ng puting polo, khaki na pantalon, at itim na pares ng sapatos na bagong "shine". Pagkuwa'y nilagyan ko ng konting gel ang aking buhok at hinati ito sa gitna. Sa palagay ko sa hitsura ko at sa bitbit na envelope ay ipinapakita ko ang isang modelong nag-aaplay sa trabaho.

Pagdating ko sa Quiapo ay nagpagupit muna ako sa Lito's Barber Shop sa gilid ng Raon malapit sa overpass. Mura ang pagupit dito, singkwenta pesos lang. Tinanong ako ni Mang Lito kung anong gupit ba ang gusto ko: gupit binata, gupit barber's, o gupit sundalo.

Ang sabi ko ay yung trim lamang, na ang ibig sabihin ay gawin niya akong mukhang presko sa pagtingin subalit hindi mukhang estudyante ng ROTC, o di mukhang mag-aaral sa grade one. Samakatwid ay dapat na may patilya ng kaunti at may nakausling bangs. Gupit Brad Pitt wika nga..hindi Brod Pete!

Naintindihan naman niya ang sinabi ko at ilang sandali pa ay binalutan na niya ako ng puting kumot at pinaupo na sa kanyang ipinagmamalaking Hydraulic Barber's Chair. Ang barber's Chair na ito ay napaka-komportable sa puwitan at likuran. Pagkuwa'y narinig ko na ang pamilyar na huni ng electric razor na "bzzzzzzz". Medyo nangaligkig ang aking batok. Tapos itinaas niya ang gunting at suklay at sa pailang ikot na ginawa niya sa aking barber's chair ay napansin kong pumopogi na ako.

Pagkatapos, hinasa ni Mang Lito ang kanyang antigong labaha sa isang sinturon na nakasabit sa gilid ng salamin, at marahan at buong ingat niyang tinagpas ang mga natitirang mga buhok na di naaayon sa linya.

Hinagod hagod niya ang aking batok pagkatapos, at winisikan ng Million Dollar Green Hair Tonic na siyang pamilyar na amoy ng isang galing sa barberya. Hindi pa siya nakuntento dito kaya binudburan naman niya ng Tonyx Talcum Powder ang isang malambot na brush at ito ay buong paggalang na ipinahid sa aking batok at balikat. Ahhh napakasarap talaga ng pakiramdam ng isang bagong gupit, presko at parang bagong gising ang pakiramdam. Dahil sa magandang serbisyo ni Mang Lito, dinagdagan ko ng beinte pesos ang aking bayad bilang tip. Tuwang tuwa si Mang Lito kaya sinubukan niya akong yakapin subalit hindi ako pumayag. Ilang sandali kaming nagbuno at pagkuwa'y natapos na tabla kami. Nagpasalamat at nagpaalam na kami sa isa't-isa.

Tapos, tumuloy na ako sa aking talagang pakay: ang mag-prisinta bilang guro sa isang kolehiyo sa university belt. Pagdating ko sa gate ng unibersidad ay ayaw ako papasukin ng nakasimangot na gwardiya. Wala daw akong I.D. Sinabi kong talagang wala akong I.D. dahil hindi naman ako empleyado o estudyante doon sapagkat ako ay isang aplikante lamang. Napangiti siya at pinalagda na lamang ako sa kanyang log book...ang mayabang na tanga.

Tumingin-tingin ako sa palibot ng Kampus. Nagkalat ang mga estudyante... lakad dito paroo't parito. Yung iba nagsisigarilyo pa at yung iba mas malalaki at mas malalapad kaysa sa akin. Naisip kong kung ako ay matatanggap sa eskwelahang ito ay tiyak na kailangan kong magpakita agad ng awtoridad upang galangin nila ako. Kung hindi'y magiging kahiya-hiya ako sa buong henerasyon. Samantala ay nagtanong-tanong muna ako kung nasaan ang "Office of the Dean".

Sa wakas ay natunton ko din ang "Office of the Dean". Medyo maliit lamang itong opisinang ito. May ilang mga aplikante ang nakaupo sa isang silyon sa labas ng kwarto. Medyo nanlumo ako sapagkat mukhang mga masisigasig ang mga aplikanteng ito. Alas syete pa lang daw ng umaga ay naghihintay na doon. Sinabi sa akin ng sekretarya na ang dekano ay nasa mahalagang pulong at kung maaari ay bumalik na lang kami makalipas ang isang oras. Tinanong ko siya kung sigurado bang sa loob ng isang oras ay matatapos ang pulong, pero ang sagot ay di daw siya sigurado dahil minsan umaabot pa sa dalawang oras ang pulong ng dekano.

Naisip kong kung hindi pala siya sigurado ay bakit niya ako pinababalik sa loob ng isang oras. At dahil mag-aalas diyes na, kung sakaling matapos ng dalawang oras ang pulong ay tiyak na alas-dose na iyon at syempre ang dekano ay manananghalian na at magsi-siesta.
Sinabi ko na lang sa sekretarya na sa lunes na lang ako babalik, at iniwan na lang sa kanya ang aking ilang mga dokumento tulad ng resume at transcript. Nagpasalamat ako sa kanya pero bago pa ako nakahakbang ay nagwika na huwag daw akong tatawag at sila na lang ang tatawag sa akin. Naisip kong parang mali ang wikang iyon. Naisip kong hindi na lang ako mag-aaplay. Lumakad na ako palabas ng kampus.

Teka, saan naman ako magtutungo ngayon? Madali kong nasagot ag katanungan kong ito sa aking sarili. Naisip kong magpasyal na lang sa Intramuros tulad ng ginagawa ko noong estudyante pa ako. Matagal na rin akong di nagagawi sa Intramuros, mga tatlong buwan na, kaya bakit hindi ko na lang samantalahin ang pagkakataong ito?

Sumakay ako ng Jeep patungong Pier at syempre habang naglalakbay ay kumuha ng mga larawan sa pamamagitan ng aking Sony Super Slim Digital Camera. Dahil sa liit ng aking camera ay di man lang napansin ng aking kapwa pasahero na mayroon na palang kumukuha sa kanila ng larawan. Yung babaeng nakapula hindi napansin yung aking kamera kasi panay ang lambing sa kanyang boypren.


Ito yung kuha mula sa Jones Bridge habang nakasakay ako sa Jeep. Lagi kong kinukunan ang tanawing ito dahil talagang gandang ganda ako.Ganda ng view ng Ilog Pasig diba?


Ito naman yung Ayuntamiento na siyang City Hall noong panahon ng Kastila. Nakakalungkot na ito ay nadurog noong panahon ng pananakop ng Hapon sanhi ng paglalalaban sa pagitan ng mga Amerikano at Hapones. Nung tiningnan ko ang loob ay ginawa na lang nila itong pay parking para sa mga sasakyan. Sana ay muli nila itong maipatayo sa mga susunod na panahon.

Kapag namamasyal na ganito, mas nais kong nag-iisa dahil mas madali kong mapagdesisyunan kung saan saan ako mamasyal. Ako lang, at ang aking anino. Just me and my shadow.

Ang antigo at napakagarang Katedral ng Maynila.

Ang Palasyo ng mga Gobernador Heneral. Noong hindi pa ipinatatayo ang Malakanyang ay dito nakatira ang mga kastilang Gobernador Heneral. Sa kasalukuyan ay isang opisina na ito ng isang ahensya ng pamahalaan.



Tapos naglakad na ako sa Calle Real patungong San Agustin Church. Ito ang pinakamatandang simbahang katoliko sa Pilipinas. Napakatibay ng pagkakagawa nito kaya hindi man lang nadurog kahit ilang malalakas na lindol na sa kasaysayan ang naganap. Ito lamang din ang tanging istruktura na hindi nadurog noong panhon ng digmaan (maliban sa isang bell tower na na nasakaliwa ng facade)


Ito yung isa sa mga granitong lion na nagbabantay sa harap ng simbahan. Ito ay nagpapahiwatig ng impluwensyang Tsino sa arkitektura ng simbahan.


Ang nagtitinda ng rosaryo at estampita sa harap ng higanteng pintuan ng simbahan ng San Agustin. Alas-singko pa ng hapon ang misa kaya nakasara pa ang pinto ng simbahan.

Tapos pumasok ako sa loob ng museo ng simbahan. Pinakita ko ang aking lisensya sa pagtuturo at kaagad akong pinapasok ng libre(ang normal na bayad ay 75 pesos para sa matanda, at 40 para sa bata). Tapos inakyat ko ang granitong hagdanan at humanga sa ganda ng arkitektura nito

Nung nasa ikalawang palapag na ako ng simbahan ay nagtungo ako sa isa sa malalaking bintana at pinagmasdan ang napakagarang Hardin ni Padre Manuel Blanco sa ibaba. Si Padre Blanco ang nagsulat ng makasaysayang aklat na "Flora de Filipinas" noong 1843 na naglalarawan ng iba't-ibang halaman sa Pilipinas.

Tapos binisita ko din yung mga antigong libingan sa loob ng simbahan. Medyo nakakatakot ang bahaging ito ng simbahan, medyo madilim at napakatahimik. Tapos nagkataon pa na ako lang mag-isa ang nandito. Tiningnan ko ang mga lapida ng mga kripto at nabasa kong karamihan sa mga nakahimlay dito ay namatay pa noong panahon ng kastila. Yung ibang lapida mayroong nakalagay na R.I.P na ang pagkakaalam ko ay nagangahulugan sa kastila ng "Requiescat en Pace" o "Rest in Peace" sa Ingles. Kaya lang yung ibang lapida naman ay may nakasulat na D.O.M. imbes na R.I.P. Ano kaya ang kahulugan nitong D.O.M. Syempre hindi Dirty Old Man, diba? Misteryo pa rin ito sa akin hanggang ngayon.

Ang isa sa mahahabang "hallway" sa simbahan. Ang mga dingding ay kinasasabitan ng mga antigong mga paintings ng mga namatay na paring agustino sa Pilipinas. Tiningnan ko ang bawat isa sa kanila at natakot ako dahil kahit saan ako tumingin, ang mga mata nila ay nananatiling nakatingin sa akin na para bang sila'y mga buhay. Kaagad akong naglakad palayo at nagtungo na sa malaking altar ng simbahan.

Sa kanang gilid ng altar nakalibing ang dakilang kongkistador ng Maynila na si Miguel Lopez de Legazpi. Pinuntahan ko ito at nakita ang kanyang nitso na kinalalagakan ng kanyang mga labi. Napaka-solemn ng eksenang ito at para bang nakikini-kinita ko noong mamatay siya at ilibing dito ng mga indiyong tinuruan niyang maging sibilisado. Sa kasaysayan ay maaalalang si Legaspi ang nagtatag ng lungsod ng Cebu at Maynila at siya din ang unang pinunong kastila na minahal ng lubos ng mga Pilipino. Iyon ay sa dahilang minahal din niya ng tapat ang mga Pilipino.

Nag-alay ako ng isang munting dasal sa kanya at dahil hinahangaan ko ay di ko napigil na hawakan ang kanyang nitso ng aking kamay. Palagay ko ay makasaysayan na rin ang aking kamay dahil hinawakan ko ang nitso ng isang dakila at maksaysayang tao. Maaaring ipa-insure ko na ang aking kamay sa mga susunod na panahon.

Pagkatapos humimpil ako ng kaunti sa isa sa mga mahahabang bangko sa simbahan. Pagkuwa'y naglakad na ako palabas upang umuwi. Nasayang ba ang aking panahon sa araw na ito kahit ako'y di nakapag-aplay? Ang totoo'y napakaligaya ko sa pamamasyal kong ito. Ni hindi ko nga napansin na di pa pala ako nanananghalian, at nakalimutan ko ring wala pa pala akong trabaho.