Vincent Schubert Malbas ®: 2013

2013 as predicted

i still remember how i wrote a set of prophecies in january like it was yesterday. alas! time flies real' swift now that christmas is 'round the bend. it's high time to look at how our predictions stack up with the events of the past twelve months.

1. manny pacquiao will win his congressional seat this coming elections; however he will lose in his next boxing match yet again, and thus quit boxing for good.

pacquiao did win another term as representative of saranggani last may, but he also won against rios last november, so this unfortunately does not count. 0-1

₰ - ₰ - ₰

2. ms philippines will finally win a title in any of the 4 titles: ms universe, ms world, ms international, or ms earth. successes in the first two will be sweeter since there has been significant drought in those two pageants.

i sincerely did not expect this to happen, but this year turned out to be one of the country's most impressive reapings in beauty pageants, if not the best harvest there ever was. 1-1

₰ - ₰ - ₰

3. some medical school will get 100% in the licensure exam this year; I dare not say which school.

in retrospect, this was a bit of a cop out: any school with less than 50 students will have a better likelihood of getting a 100%. Impressively, there were actually big medical schools that nailed a perfect 100%. 2-1

₰ - ₰ - ₰

4. tv5 will gain significant audience share that it will almost overtake the #2 spot in megamanila currently held by abscbn.

tv5 never had a chance against abscbn, but it did gain ground against gma and overtook the latter in mindanao, gaining significant audience in gensan and cagayan de oro. 2-2

₰ - ₰ - ₰

5. a girl will win american idol season 12 (after a string of guys in the past few seasons).

almost every idol fan hated this season because it was so uninteresting to watch 5 girls shriek out against each other, week after week. this show has gotten old. the award for the best talent show on tv today goes to xfactor and the voice. 3-2

6. Amour (from Austria) will win best foreign language film in the Oscars this year.

this was really a fight between amour, a royal affair, and the intouchables. perhaps the former won because it had the teremity of pushing the plot to a questionable ethos. 4-2

₰ - ₰ - ₰

7. by the end-of-the-year, PSEi will have reached 6000 or more. there is significant resistance at 6500, support at 5500. overall trend is bullish.

the market was remarkably bullish for the first half of the year, compared to the sluggish but solid three previous years. if it were any indication, the index barely hovered the 7000 mark in a span of a month, before quickly descending into massive corrections that never saw the light of day. indeed this bourse was overhyped, and i suspect local buyers were caught in the middle, unable to unload stocks bought at high prices. now it becomes a wait-and-see game, really, as there is no indication that the index will escape this bear territory at 6000 for the next couple of months. 5-2

₰ - ₰ - ₰

8. given the cyclical nature of forex, USDPHP exchange rate will not breach the $1:P40 barrier, but will have strong support at $1:P47.

notice the downhill trend from 2010 to 2012, only to be bucked this year with a 4-peso spread. provided that currency exchange is more volatile than stocks, it's still a shock to see such reversal despite the same country fundamentals as the past 2 years. more likely this was a kneejerk reaction to the fed's decision this year to cut back on the stimulus program. 6-2

₰ - ₰ - ₰

9. nadal will have a strong comeback, my good ol' fed will have a lackluster year, and murray will win wimbledon (after what happened last year).

sometimes i think that tennis players are quite the diva: nadal announced his knee injury last year, and yet he came back this year, winning two grand slams and five world tour masters 1000. murray said he's got back pain, and yet he won the wimbledon versus djokovic. on the other hand, it was djokovic's year to lose, and yes he did. but the biggest letdown was federer. it was as if he might as well have never existed. 7-2

₰ - ₰ - ₰

10. by then there will be more female senators in the 16th Congress than there is now

among the newly-elected are grace poe, nancy binay, and cynthia villar, while miriam santiago, loren legarda, and pia cayetano comprise the three sterling old hags of the senate. hopefully the dose of estrogen brings a more thoughtful perspective to legislation, but more estrogen may also mean more catfights in the senate, but not necessarily among the female species (e.g., santiago v. juan ponce enrile). let's see. 8-2

₰ - ₰ - ₰

11. star trek will hopefully gross higher than man of steel and iron man 3; an animated movie will be in boxofficemojo's annual top 5

star trek only ranked 12th among the top grossers this year: a respectable $400 million haul, but not enough compared to other summer blockbusters like ironman3 and man of steel. among my other favorites this year are catching fire & frozen. oh look, there are actually 2 animated movies in the top 5. so i probably get a half-point, right? well, sadly no. 8-3

₰ - ₰ - ₰

12. there will be at least one storm that will pass through the mindanao landmass again, with maximum winds reaching at least tropical storm status, but hopefully it will be less devastating and the townsfolk will be more prepared by then

there were four cyclones that hit the mindanao landmass throughout the year, but none was as memorable and heart-breaking as the destruction caused by typhoon yolanda / haiyan in the visayas, dubbed by the us navy weather agency as the strongest typhoon to hit land. no one anticipated such scale of wreckage and sadness, and this on top of the damage done by the magnitude seven earthquake that hit bohol and nearby provinces. it's a terribly sad year for the philippines. 9-3

₰ - ₰ - ₰

13. Ateneo will not win UAAP basketball this year, and fans will mourn

Ateneo men's basketball team, for the first time in a long while, has ranked outside the top four. as always, UP has a clean sweep, leading the pack with the most number of losses. Congratulations to the Teng brothers of UST and La Salle for claiming the most number of screaming girls this year. 10-3

₰ - ₰ - ₰

14. UP will remain the highest ranking university in the Philippines according to QS and THE, but DLSU and Ateneo will be a few notches up in the Top500 compared to last year's ranking

Consistently, the premier national university has again fallen short of our expectations. While it can be argued that this is due to so many factors, I believe that this is primarily due to the lack of researches published in internationally renowned journals. I honestly would like to see some genuine effort from university officials into getting local studies published. 10-4

₰ - ₰ - ₰

15. sports dominance in the SEA Games in Myanmar this year will be a toss-up between Thailand and Vietnam; the Philippines will finish lower this time around at a dismal 7th

host country myanmar took second place behind thailand's solid first place finish. sadly, but not unexpectedly, the philippines only took home 29 golds, 34 silvers, and 38 bronzes, the third worst haul and the worst ranking since the country joined the games three decades ago. 11-4

₰ - ₰ - ₰

with a batting average of 73% (11 correct out of 15 guesses), with the rest being nearly correct, i am definitely more than your average nostradamus from quiapo. now, anyone out there who wants their fortunes to be read?

er vs or

ER has always been a very dynamic environment, to put it nicely. one minute you're idly sitting on your chair, then by the next minute you find yourself sweating more than a hundred chest pumps in one minute or else the patient expires.

by contrast, the OR finds its rhythm in the planned unknown. many times, the surgery plan is drawn days or even weeks ahead. even for emergency cases, materials are prepped neatly before the patient gets inside the operating theatre. still, no one knows for sure which outcome will it be.

at the OR, the patient is stripped naked, with only a piece of cloth or two covering the essentials. whether you are under charity or pay, everyone has to be stripped down to their birthday suit up to the post-anesthesia care unit. while there are a few stereotypical telltale signs of income levels, such as skin blemishes or nail hygiene, there's actually little use for us to know whether you have a million pesos in your bank account or you live way below poverty line. we just need you to live through the surgery, and we will do our best to give you that fighting chance.

" ...there's actually little use for us to know whether you have a million pesos in your bank account or you live way below poverty line"

at the ER, especially when in a public hospital, it is easy to discern differences in wealth such as by the kind of garments they wear and by the vehicle they alighted from. although in utopia all patients should be treated nicely regardless of status, in reality pay patients get a much nicer approach from hospital people.

i find all of this unsurprising, though. money certainly begets power, but not necessarily respect. in the end, based on christian texts at least, our lives are judged not by how much we have accrued but in how much we have given. blessed are the people at ER and OR who have willingly dedicated their lives to serve the filipino people.

this post is dedicated to my recent rotations at the departments of anesthesiology and emergency medicine.

future of data

from xkcd

musings of an assist

my whole month of october is dedicated to two things: emergency room (ER) duty and operating room (OR) assists. while at the OR as second assist (or rarely as first assist), i have tons of time thinking about other things: e.g., mulling the prospects of my career after one and a half years, wondering what movie or TV show is on HBO, AXN, or CinemaOne tonight, and looking forward to eating a vanilla sundae with cookies & cream and chocolate fudge after scrubbing out.

as student, i have the luxury of sleeping on my own bed when i'm not on duty, which happens every 3 days. in comparison, the amount of time required from surgery residents is quite ridiculous. there was a time when we did a whipple's procedure for an ampullary mass, and the surgery residents that i assisted at the OR were supposed to be post-duty status, but the procedure went well into 3am the next day. one of them called her husband to say, see you nalang in 3 days, and told her spouse to look after their 5-year old son. i feel sorry for her not being able to cuddle her son as often as she's supposed to, but i guess surgeons are tough like that.

aside from eavesdropping, er, accidentally overhearing results of pre-residency and being able to staple the skin, i also thought about doing a survey on medical students who are or who have been assists at the OR, such as:

which of the following best approximates your feeling about being an assist at the OR?

gusto kong umaakyat para sa OR at gusto ko pang mag-assist sa next case
ayaw ko sana umakyat sa OR kanina, pero since nakascrub-in na, ako na sa next
ayoko talagang magscrub-in kung may choice ako [obviously wala]
none of the above

please rank these locations of hospital duty in order of preference:

emergency room
operating room
wards

do you think about surgery-related stuff during assists?

do you think about NON-surgery-related stuff during assists?

do you intend to train in surgical fields, such as Surg, ORL, ObGyn, Ophtha?

Then, after getting enough responses, I can actually do some multivariate logistic regression, and answer basic questions as to whether our atittude towards OR assists translate to career choices. To take it further, someone can probably do a longitudinal survey and see if such choices are actually realized.

But, of course, instead of doing such tedious stuff, I might be better off sleeping and conserving energy for the next assist.

davao regional

after having worked for 3 months already at the philippine general hospital in manila, i decided to compare a major tertiary referral center in davao, in my hometown, and see if the place is at par in terms of health care.

davao regional hospital, or regional as we the locals call it, is an impressive hospital, it turns out. i actually grew up at a stone's throw from the hospital, roughly around 200 steps away, but without really seeing its insides. yes, because there is still that public versus private hospital mentality.

except for one instance where i went to their chapel to attend mass when i was still a child, funnily this was my first time to actually see, hear, smell and feel the place as an authentic medical center.

the demographic in regional is almost the same as with my dear pgh: poor helpless citizens of the philippines with no money to pay for private health care, although i feel a little more attached to my fellow dabawenos because they speak my language.

from what i gather based on the clusters of happy smiling faces of doctors on the hospital walls, regional has several accredited residency training programs. they have a pretty solid reputation in residencies in internal medicine, pediatrics, surgery, obstetrics & gynecology, anesthesiology, and family medicine. i also heard that they have graduated their first neurology specialist in tandem with davao doctors hospital.

ha! what's amazing with regional is that they seem to have way better infrastructure than what pgh currently has. true, emergency room pa lang, taob na, ang ganda at ang linis kahit madaming patients, parang private hospital.

the hospital has a spanking new, shiny lift! pgh's elevators are put to shame. regional also has several ramps where wheelchairs and stretchers can be pushed and pulled to and from the 2nd and 3rd floor. i don't think we will ever have that in pgh.

the charity wards have the same feel as that in pgh on any normal day, where all beds are filled to capacity. i went to the pedia wards at the back of the main complex to take a look, where patients and watchers have a small playground outside the department.

the hospital is actually very proud of having been cited by the country's president in his annual state of the nation address as the first public end-referral cancer center in mindanao, with a functional linac machine and several specialists on board, e.g., surg-onco, med-onco, and rad-onco.

i was able to write to dr faiqha bagis, one of the few rad-oncologists in davao, although nanghihinayang talaga ako that i wasn't able to meet up with her.

i am really happy to see that regional has evolved into a hospital i can be proud of, comparing it to pgh standards of course. here's hoping that more medical centers like this are put up in other parts of mindanao and the philippines as well.

ted city 2.0

TEDCity2.0 was a day-long event held at the Times Center in New York, in celebration of urban innovation around the globe and in anticipation of emerging issues in population, health, education, architecture, engineering, transportation, environment, and sustainability.

Tweets about "#TEDCity2"

thankfully the goodies are uploaded on livestream for people like me on the other side of the planet. you can watch all the talks in the TEDCity2.0 archive.

session 1 featured redefining what it means to be citizen. i especially liked atlanta mayor kasim reed's speech who was trying to charm the audience into why mayors should rule the world.

session 2 was about reinventing the urban experience.

session 3 was all about reimagining the concept of city.

session 4 discussed how we can redraw geographies and learning from other countries.

career analysis

having enough time to think about the future is probably not a good thing, largely because it makes me worry too much, when in fact, i should be glad that the thought of earning a degree in medicine will open up several opportunities that might not have been possible if i weren't in my state right now.

below is a mckinsey analysis of my possible career options. a mckinsey or GE matrix is a common marketing strategy tool that plots the strength of a product versus the attractiveness of the market. if two or more products are placed in one matrix, then you have a business portfolio analysis. in an oversimplistic sense, it helps identify products with a competitive edge, although we know the real world is full of variables that we cannot control.

let's just say that biostat, pedia and radio are three options out of the many. now i won't deny nor confirm that these three are my top considerations, but i thought that it'd be easier to contrast the difference between pediatrics and radiology doctors, and as well as someone involved in research. also, i know for a fact that these things tend to change, so i'll just cross the bridge when i get there.

the size of the circle dictates the perceived market size, and the size of the pie is the perceived market share. the arrows indicate the perceived direction of each entity in the future.

doing pedia in my province is a no-brainer; there are a lot of pedia patients, and the current inverted demographic pyramid of our population just tells me that more adults in the future will bear more kids.

doing biostat is a different matter, since there are fewer slots in the academe or government, but being good at a specific skill that only 5% of all current medical students are even considering as their future career will expand the market size considerably.

radio is a rather contentious area; technology will likely push the supply-demand curve forward, but will your personal market size increase? probably not, even in the provinces, where even a small number of radiologists are capable of providing their services to multiple hospitals; they're an efficient lot.

i realized that the mckinsey matrix is useful in plotting the complexity and in elaborating the variables involved, but it does not provide a ready answer. this is also true with regards to other market strategy tools. it is always up to the market strategist to decide whether to divest the concept entirely, to focus on a niche market, to further differentiate the product, or to think out of the box and innovate new ideas.

return service ala germany

Barbara is a story about, well, Barbara Wolff, a doctor in communist East Germany in 1980. To be able to understand the film, you must first know a little back story. She previously worked at the prestigious Charite at the capital, but after signifying her intent for an exit visa from the German Democratic Republic to work overseas, she was laid off from work and was instead reassigned to a provincial hospital.

One scene includes Barbara on a train with the local security official saying something like "since the people has funded your studies, it is time that you return their favor". It's a familiar phrase that begs a lot of explanation, but I guess, back then, as it is still now, we don't have the courage to question it.