modern-day alienism

an alienist, in 19th century medicine, is an asylum doctor, one who specializes in finding cures for the illnesses of the mind. in the film stonehearst asylum, we see the adorable jim sturgess suit up as a would-be alienist-in-training from oxford, only to find out that the asylum he visited is overrun by the patients themselves. at first glance, we see how preposterous the situation has become, but flashbacks to the cruelties of the real asylum doctors make us wonder: who is more insane?

a more modern take on mental illness is the film the babadook. it presents a mother & son story confronted with the coming-to-life of the titular book character. at first the son presents with paranoid delusions & visual hallucinations of the babadook, and then the mother begins to develop auditory hallucinations as well -ba ba ba dook dook dook. while the son takes the pill regularly at the urging of his psychiatrist, the doctor misses out on seeing the illness of the mother as well. her crazies begin to take its toll, and the babadook begins to take over their lives.

both films are definitely weird, but it is this wonderful weirdness that endears a psychiatrist to this specialty. it is easy to see how a person suffers with a physical illness, but an illness of the mind is one that takes forever to treat, a suffering that is greater than any one can imagine.

perhaps it's not in my genes to become an alienist - i have the attention span of a cat - but i certainly would want more individuals with mental illness and their families to stand up against the stigma and actively seek help.

admittedly the facilities of the national center of mental health is farthest from ideal, and here i am asking for your help to sign up for the petition to lobby for the passage of the national mental health act. the website for the online petition is at https://www.change.org/p/mhactnow. bendakt, en goedendag! (thank you, and good day).

gilead's fall-off

a few days before christmas, stock prices of gilead sciences (NASDAQ: $GILD) tumbled on news that competitor pharma company abbvie (NYSE: $ABBV) has inked exclusive deals with express scripts holdings (NASDAQ: $ESRX) on hepatitis C regimens to be claimed by scripts's network of patients. the movement was drastic & bleeding red.

the lessons to be learned from gilead's stunning drop from $110 to $86 in just two days can be summarized into two: have a definite price target, and know your psychologic support. in this case, gilead's immediate support came at around $85, as this was the trough of the two previous cycles this year.

another lesson i learned from this movement was, even if dangerous, averaging down can still be profitable. but i was just lucky maybe. there was a 50% chance that the downward momentum will break the $85 barrier, but i reckon a movement of $10 (from 95 down to 85) down in just two hours is crazy and big institutional investors would not let that happen. thus, i bought a lot of it at around $86, and it surely went up from there.

as for gilead's future, i'm pretty sure that the competitor deal will hardly make a dent on gilead's sales, since firstly the deal only concerns scripts's market in the US, and not with europe or elsewhere, and there is a clause in the deal that patients can still use gilead's hepC drug if the competitor's won't work on a case-to-case basis. so obviously it was an over-reaction, and honestly $85 for this pharma giant might be a good bargain; but i'll leave it to you to make your own informed guesses.

digital disaster responders

even when you're away from the scene of a calamity, there are many ways to help. one can provide basic goods such as canned goods and clothes to relief repacking centers, or one can give his or her time in doing manual work in these centers. if that's still not possible, e.g., you're stuck inside a hospital in manila like me, on round-the-clock duty while strong typhoon winds bear down on several provinces down south, technology can bring you closer to relief operations than you might think possible.

enter micromappers.org, a growing community of disaster reponders in the digital age. tapped by the UN humanitarian office for help during typhoon haiyan (pagasa: yolanda), it once again opened its doors to netizens for typhoon hagupit (pagasa: ruby).



the platform of micromappers.org is pretty simple: digital volunteers determine if the tweet / image is relevant to humanitarian response. classification is verified by getting at least 5 people to classify each tweet or image. the output is then relayed to humanitarian organizations thru the united nations office for the coordination of human affairs (OCHA).



this year's typhoon project aims to replicate the usefulness of last year's haiyan efforts. already the ongoing project has generated encouraging numbers, but it still needs more volunteers to segregate the tweets and images.

so, if you want to become a digital volunteer, please help us in this project. visit micromappers.org for more information.

basic rules of trading

here are some ground rules in stocks trading based on my 4-5 years experience of watching and playing with market prices. while i think the following are prudent strategies in terms of investing, other traders might want to be more aggressive and allow riskier moves; in the long term, however, wouldn't you want a more stable investment portfolio?

1. ON SPECULATIVE TRADING: never enter a trade on the premise of premarket or after-hours valuation. aside from having wider splits, these prices are exagerrated and are not written in stone - exactly why they're just mere speculations outside trading hours. it's best if you do transactions during trading hours.

2. ON DIVERSIFICATION: always split eggs in different baskets. better if you have mini eggs than large ones, so as to split the risks. there will always be that one or two positions that will lose, so it'll be better if your losses are only a small percentage of your overall portfolio. trust me.

3. PLAN YOUR TRADE: enter a trade with an EXIT price in mind; that way you won't unjustifiably greedy on one hand or hopelessly wishing on the other.

4. CHECK THE FUNDAMENTALS: never buy stocks of a company on the verge of bankruptcy. sure it may trade in a range but it will be difficult to get out of the rut.

5. MARKET NOISE: buy the rumor; sell the news. it seems that no matter it's something positive or negative, people will more often sell. it's like the news is an afterthought, a bygone opportunity. perhaps you should research a few days prior which stocks are due to move in the next few days, be it due to a selloff, the release of its earnings report, a buyout, or whatever.


6. ON COST AVERAGING: it will be difficult, but not impossible, to minimize losses via simple cost averaging. by experience, 25% of the time i do make a profit, however 75% of the time i actually lose money, maybe because my hasty temperament gets the better of me. maybe there's that: if you're an impatient trader, you might not like waiting for too long for a stock to regain its previous price, and you'll be stuck at the bottom for a long time - a week or two perhaps?.. or maybe even a month and still not back to original prices. thus it's best to stay away from cost averaging losing positions.

so there; surely in the next few months i'll be adding more input regarding prudent investing. for now, keep safe!

vaginas for a living

the department of obgyn of pgh is never perfect, but it tries to be.



this is a collective observation by my colleagues from 2 months of rotating in the department:
* the opd clinic is a hotspot for robbery, and the thieves are never caught. many have lost their ipads and mobile devices. it makes us wonder who really is the culprit - might even be an inside job, and how come the security guards are not doing anything significant about it
* the ob admitting section is cramped and tiny, and it does not have its own supplies. interns still buy their own stash - crystalloid fluids, cannulas, macrosets, foley catheters, blood containers, syringes - from bambang for use on patients; where did the 2 billion pgh budget for 2014 go? and where will the 5.1 billion budget for 2015 be spent?
* the labor, delivery, and recovery rooms serve as a humid holdover hotel for pregnant and postpartum women, and when it's filled way over capacity (think 300% the ideal), it's a nasty sight - and a nasty smell as well, the scent of poop, blood, urine, vomitus, and vaginal discharge combined.
* a manong's work of conducting pregnant patients to the ultrasound/perinatology section becomes an intern's responsibility and at times you get to push 2-3 preggies atop the transporter gurney from the 1st floor to the 2nd floor - it gets worse: at times it's already 11 in the evening and you haven't even eaten lunch (have experienced this misery at least 3x this year)

but for all its flaws, the department manages to sell itself well:
* daily summary rounds mean your bound to get called to endorse patients, and you better study your cases well - an effective impetus for the stubborn and the case of lazies
* consultants are scary, and that's a good thing!, 'cause there's no other way to survive preop conferences, gyne onco rounds, and tropho rounds other than by studying
* postduty days are relatively light (you get halfday off most of the time) - that means more time to study!
* the rhythm of duty every 3 days is a blessing to your body clock, as compared to other departments where my nonexistent sleeping pattern is much more messed up.
* some residents get terrible mood swings, probably having menses, and they're occasionally spreading bad vibes, but i can name several whom i am eternally thankful for always being nice to us even when the situation gets ugly.

some of the memorable events i had during ob are:
* when chax & i had to call an acls code for 25mins for god-knows-what kind of cancer in a very young patient at the ward;
* a young primi at the ward who did not know if it's her bag of waters that broke, or if it was just her urine - she seemingly cannot control her bladder;
* a 45-year old young lola squeezing my hand to tell that her apo delivered via CS died after 2 days due to multiple organ failure at the NICU;
* our 12-year old primigravid who had an abortion - i don't know what to make of it.

for 2 months, i've looked at vaginas day in and day out, at the opd, obas, lrdr, and a few times at the ward, so by now i'm pretty oblivious to the sight. i'm also elated to have bid goodbye to the daily toxicity of ob, but here i am, formally saying my earnest thank you to my nice residents and fellows in ob. thank YOU!

medical carpentry

the thing about orthopedics is that it deals with disease and disability in the most mechanical manner. there's nothing wrong about it, really, except that only a few gifted ones are capable of reciting anatomy like the back of their hand. so it becomes a specialty that you'd love dearly or regard with indifference.



in my case, i always remember jesus when we use carpentry tools at the OR. jesus was nailed multiple times to the cross, skin oozed with blood, and all His energy drained. in comparison, an ortho patient with a fracture undergoes multiple pinning, which is done by trial & error to see if gets reduced properly, while he loses a liter or more of blood. he has become indifferent to pain, just like how Jesus responded, thanks to modern-day anesthesia.

i will probably not enter orthopedics as a preferred specialty because the time & dedication required from every orthopedic surgeon is crazy - i'd rather give the slot to those willing to take the job wholeheartedly. but i'm glad that there are people who would still serve and pay for the poor patients in pgh who can't even buy OR needs, or pay the OR fee moreso, because apparently, the end referral for fracture cases is either pgh or poc. but the dole out system in pgh by its doctors to its poor patients - a majority of its clientele - deserves a whole new post, as it is an inherent anomaly that will not disappear overnight, akin to a tradition that the oldtimers would want the new generation to experience.

but for tonight, i'll resort to brushing up on my carpentry knowledge to be able to help other people fix themselves.