Gino Gomez

A medical student on his way to becoming a doctor, with photography on the side to keep him sane. All photographs on this site are (C) Gino Gomez unless otherwise noted. Please don't do anything to these photos without my permission. hehe. That includes placing in a video, editing, printing, etc. Except reblog/repost, but don't remove any indication that it came from me :) To view my Project 365 for the year 2011, go to http://ginogomez365.tumblr.com

[gdgomez]

Selective Reduction

As a medical graduate from a third-world country, I have to rely on foreign references to study. Even outside of medicine we rely heavily on the west for our source material. Thats why it really did not feel right when I read about Selective Reduction, which in Obstetrics essentially is choosing 2 out of 3 or more fetuses and leaving only these two to grow the full pregnancy. The logic here being multiple gestations (babies in one pregnancy) could lead to preterm birth and low birth weights because of too little space to grow in the mom. Save two only because as a whole they could all die of prematurity. Of course there is a risk of losing the whole pregnancy in the process of reduction itself. Its "logical" yeah but is it righteous? May the remaining days before our exams and the rest of our careers remind us to protect the sanctity of life always. As they (hippocrates?) say: "To cure sometimes, relieve often, comfort always."

[gdgomez]

Musings

Without my realizing it, my PGH clerkship and internship experience shaped/changed the way i interact with patients.. You find yourself asking "nakakain na po ba kayo?" To the bantay patiently ventilating his mother via ambu bag. You've almost memorized all common lab exam prices because you prioritize the labs. You need to leave enough money for them to eat. You push the stretcher yourself to radiology because the UW has 5 other patients to conduct.. And your patient's only watcher is his very pregnant wife. You ask about the small things.. Is it ok for them to travel far 2x a week for rehab? Whos taking care of the kids? You call CI patients by name when monitoring them, theyre just a few anyway, and they deserve as much. You say "salamat" and "pasensya na" often.. because you know youve sent the watcher back and forth to the cashier, labs, radiology already. Truly, in medical school, books will help you a lot. But as we've often been told, books aren't enough. Not just because they're at least 5 yrs behind. So much is learned through interaction with patients and their relatives. It's the human side of medicine; a side we at times overlook, but is as important as the biomedical aspect.

[gdgomez]

Graduated just a few hours ago..

from monitoring!!!!

[gdgomez]

Service C <3

[gdgomez]

Bagacay Beach, Calbayog City, Western Samar

[gdgomez]

Class 2014 some 5 years ago..

Photo credit: AVMondragon

[gdgomez]

Date #flashbackfriday

[gdgomez]

Sight

Goodbye forever(?) Ophtha.. I will forever be moved by the old lady who was brought to tears telling me the story of how she is going blind and how she fears for the welfare of her children and grandchildren.

[gdgomez]

7 months

I had a young patient today who felt normal until 7 months ago when she had esotropia ("duling") and extremely blurred vision on the right (she compensated with the normal left).  she had already consulted then and was seen to have an mass behind her nose which was biopsied as TB.  Then one day 3 weeks ago she was coming home from a ffup when her vision became total darkness on the left (NLP). A week ago she had decreased hearing on the right and peripheral facial palsy. I can't imagine how scary this all must be for her..

[gdgomez]

Validation came today :)

[cineraria]

[blua]

#IT’S REAL AND LOOKS TINY BECAUSE OF THE SHORT FOCAL LENGTH

[tessaviolet-deactivated20190521]

I can’t brain this. They look like miniatures.

[hot-potato-butter-fingers-deact]

this lens will cost you your arms, your legs, and your grand kids.

[httpneonjelly]

can’t brain this

[gdgomez]

yehey tilt-shift :)

[gdgomez]

Patient Care

Things we do for our patients..

We have a patient in the Trauma ward. There's some aspects of his disease process we need to clarify, so we need to run some labs.

Ok, give him a lab request and a prescription for vials and a syringe.

Already done. No one's here to pay for / buy it though. 900 pesos worth even with the White card (socialized payment scheme). And he doesn't have a cent to his name.

May stash ka naman e. Ano ba naman yung isang purple top. Tapos ipa-MSS mo.

Sure, i'll spare a purple top. then used free washed tubes for the red tops. Thank God PGH still has budget for syringes and gloves, I'll take one thank you.

The thing is, this patient has no bantay at all. When there is one, he's a minor. If you're lucky, you'll get to see the helpful barangay volunteer/official who assisted in conducting him to PGH in the first place.

This patient's mother has passed on, his father is an inmate, and all his siblings are in the province and unreachable. By some twist of fate, he was shot multiple times and needed to be admitted to the hospital, opened up and given a new chance at life.

But right now, he has no one. No one to take care of his papers, needed xrays, labs, waivers for fees, etc.

Nobody but you, that is.

So here I found myself going to the cashier to have the labs priced, going to MSS to a very friendly and understanding set of social workers who had everything ready for me when I arrived, as I phoned in my concern earlier; looking for the Chief Resident of our department or any senior I could ambush for a signature, running to the ADHO..

and finally coming back to the ward to personally extract the blood.

All these made me realize the value of the bantay and the things we take for granted. For most other patients we only get to do the last part, extracting the blood. For these patients the bantay does the legwork for us.

I can only hope they be treated with as much regard as I was, even if they will have to endure the lines I cut (special lanes), wait several minutes for the paper to go from inbox to outbox, or face the wrath of some less than understanding/overworked employees.

The bantays are some of our greatest allies in patient care. 

So even if it takes a little extra effort, it's ok with me to do some work if it means the woman with a 7-month belly can sit instead of going up to the lab to submit her child's labs; if it means the father who hasn't eaten since breakfast can eat at ten in the evening. When you appreciate their effort, they appreciate you -- trust you -- even more.

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Thanks to my co-intern for bringing the samples to the lab. :)

[gdgomez]

Kids

can be so peculiar/cute sometimes..

After you've placed in the IV cannula (only taping remains) and they see spilled blood, they complain "Sakit! Sakit!" (it hurts!) when nothing is actually there to cause significant pain (like a needle).

Then after you splint it and clean up the scattered blood, they suddenly are pain-free. hehe..

[gdgomez]

Heat

wearing our white coats in a couple of days and its still n degrees out there :/

[gdgomez]

Spicy Miso Ramen with grilled beef by Sapporo

[gdgomez]

Chopsticks ala crayola

[gdgomez]

Best ¥2,000 i ever spent :D