May 2002 Vol. 2 Issue 9

An Internet Newsletter publication of the American Society of CIM Alumni, Inc.

THE ASOCIMAI OFFICERS:

Dominador Ong, M.D.
President
Maida Antigua, M.D.
Vice-President
Dolores Lao, M.D.
Treasurer
Epifania Aranas, M.D.
Secretary
Clem S. Estrera, Jr., M.D.
P. R. O.
Anita Avila, M.D.
Auditor

Board Members:

Horace Cabasares, M.D.
Perry, GA
Ramiro A. Cadag, M.D.
Kings Point, NY
Mike Espiritu, M.D.
Okeechobee, FL
Elie Gonzales, M.D.
Oswego, NY
Cecilio Delgra, M.D.
Charleston, WV
Rosario B. Gonzaga, M.D.
Cumberland, MD
Teresita Varona, M.D.
Oakbrook, IL

CME Chairperson:
Rise Faith E. Dajao, M.D.
Portsmouth, VA

BRAIN WAVES STAFF:

Editorial Board:

Maida Antigua, M.D.
Boston, MA
Horace Cabasares, M.D.
Perry, Georgia
Eli Estabaya, M.D.
Yuma, Arizona

Editor and Technical Adviser:
Clem S. Estrera, Jr., M.D.
Petersburg, VA

Staff Correspondents:
Roland Pasignajen, M.D.
New Jersey
Henry L. Yu, M.D.
Cebu City, Philippines
Ernesto Yu, M.D.
Buffalo, New York

Wilmo C. Orejola, M.D.
Pompton Plains, N J

Marie Belen F. Rosales, M.D.
San Diego, CA

Send news, articles, pictures, announcement, obituary, etc., to:clems3ra@rcn.com

Editor's Column

    "When I was a boy of fourteen, my father was so ignorant I could hardly stand to have the old man around. But when I got to be twenty-one, I was astonished at how much he had learned in seven years." - Mark Twain

Children - Pride or Personal Properties?

(Part 1)

Personal Experience
     When our older daughter was in first year high school in a catholic school in Petersburg, Virginia, her teacher and the principal called my wife one day to have a conference about our daughter. Assuming that it was not a good idea for me to come along, my wife went alone and she was told that our daughter was depressed and needed a therapist. Being a psychiatrist, my wife suspected the same because she would sneak into our daughter's room and read our daughter's poems. And she thought that the poems were depressing. Also, my wife always has a very high regard on nuns, and the principal of the school was a nun - a mother superior. Of course, there was no question about the nuns' honesty and integrity, but this was not about honesty and integrity. This was about interpretation, understanding and common sense. But my wife provided me examples that she used to have depressed patients who wrote poems about their depression, and it seemed like she would just accept our daughter's fate imposed upon by her teacher and school principal.

    So I sneaked into our daughter's room and read her poems and my perspective was a whole lot different. To me, depressed kids don't write good intellectual poems, and so, instead of confronting our daughter, we encouraged her to talk by listening to her calmly and carefully. She was bored at school. She stopped participating with the class discussions because a couple of her teachers were upset of her intellectual arguments. She was not challenged, but put off. There was nothing more to learn for her. She did not talk to us about it because she didn't think we cared and we might only get upset particularly that the alternative school is in Richmond which is an hour drive from home. During that time, the public schools in Petersburg were ranked at the bottom among the public schools in Virginia. Indeed before this incidence, our reflexes were hyperactive while our reasons were comatose. We easily got upset when kids had problems at school. And instead of finding out what happened, we found it easy to blame the kids. It took us this incidence to reconsider our attitude and behavior toward our children and made essential changes since then. We became focused on understanding rather than on being understood.

     So in our daughter's second year high school, we transferred her to St. Catherine School, the best school for girls in Richmond driving an hour one way every day because that's where she wanted to go. She became the only student in the history of the school who transferred in the second year and graduated valedictorian. She went on to graduate magna cum laude from Duke University and is now going to be a third year medical student at the University of Virginia this June 2002.

Personal Views
     Now how many kids like my daughter out there who could have been understood easily instead of being misunderstood as having mental problems, if only they are provided with an emphatic mind and a sympathetic ear? How many kids don't talk about their problems not only because their parents take them for granted, but also because they often end up being blamed for such problems or being castigated with the insensitive I-told-you-so guilt tactic? How many of us still remember as a kid going to our parents complaining to them that our stomach is hurting and our parents would react and say: "Kay nagpalabi ka man ug ka-on!"( Because you've been eating too much!)?

    How many kids rebel or run away from home because all they want is to think for themselves and to have some freedom to make their own choices? How many kids haven't been able to develop enough self-confidence because they are often criticized rather than encouraged for their failures and rarely if ever appreciated for their successes? How many kids simply give up trying their best because no matter how hard they try, their best is never good enough for their parents? I believe there are many of these kids and it's a real waste of brainpower. A lot of times, all the kids ever really want is for us, parents, to listen to them and understand, or just listen and be quiet. After all, they rarely turn to us when the going is easy. It's when the going gets tough that they call out to us. But it is also during this occasion when we often tune them out because we merely assume that it's not important or it's one of those cry-wolf episodes. Yet what's not important to us could be very important to them.

     Children, particularly teenagers, need more patience than reason. We've got to be patient to listen to them. But the problem is, children don't know how to ask us to listen. Many of them would shout, yell and make demands, and so, we tune them out, often with a threat or a warning, the same way our parents did to us when we were kids. Then there are needs that go unspoken and we could not recognize them. They sometimes just sulk and not say anything. When kids behave this way, it's time to look inside, not time to look around, and start listening to the language of noises and silence so we can understand and respond appropriately before serious problem develops. The longer it takes for us to detect the problem, the more difficult it is to resolve, and the longer it is for the children to recover.

Values, Vision and Variations
    These days, children are exposed to so many different cultures that vary from piercing their tongue to tattooing their butt, from shaking hands to slapping hands, etc. Their values are often different than ours. Their vision of the future rarely if ever goes beyond what they see in the present. Their idea of life is what's now, not what will it be a year or so from now. Furthermore, they listen to different kinds of music and songs that are loud and noisy like an artillery bombardment that would assault your eardrum and numb your brain. Being in a car with them, if you can't adjust, you'd have a hard time driving, and conversation inside the car is almost always impossible. With my children, I decided to learn to enjoy and sing with them, their kinds of music and songs. My wife could not tolerate the songs in particular. She wanted peace and quiet. The songs seemed to get into her nerves and thus our trip was often miserable and boring particularly to the children. So I told my children to think of something. They came up with a couple of earplugs for their Mom to put in her ears when we were going for a long drive.

    But as our children got older, for whatever reason, they started going back to the cultures and values we tried to show them. Even the kind of songs and music they listen to has changed. In fact, my teenage son has now started listening to jazz, the kind of music I listen to, and he switched his guitar lesson to jazz few months ago. My two daughters, too, who, used to play classical piano music and used to tease me that jazz is not for intellectual and sophisticated people, changed their taste to jazz music and songs. Somehow the four of us have come down with the same favorite jazz song artist - Diana Krahl. And we burn CDs for each other.

     So we really don't need to have headaches and heartaches quarrelling and arguing with kids about things they believe in and the varying cultures and different values they follow because they change from one stage to another. I found it effective that for kids to notice our values, we have to learn to respect and nurture theirs. If we force our values to them, they would only resist as much as they can in order to prove to us that our time is gone. No matter what we do, and whether we like it or not, our kids will not be kids forever. They'll turn out to be whatever they can be and certainly, they'll turn into adults. We might as well enjoy with what they are enjoying because what they are to us now they can never be again. If we don't find joy with what they are and what they do, then one day all we will have left from them are faded photographs of memories filed away in photo albums. Also, we must understand and keep it in mind that the kid that challenges us today may be our closest friend many years from now.

Bending for a Middle Ground
    When our younger daughter was still in high school, at one time she came home with a ring pierced on her left eyebrow. My wife cried all night. She sobbed and sobbed to have the ring removed because to her, it was a sign that soon our daughter would join with her peers who are on drugs. When my son and I came home from the movie that night, I thought someone had just died. I had a hard time pacifying both my wife and daughter. But I remembered what Jack Wells once said: "Learn the wisdom of compromise, for it is better to bend a little than to break." So I negotiated and compromised with my daughter that may be she could transfer the ring to her navel and Mom probably would not mind it since it would not be seen. After few days, she decided that the only good place for a ring is her ears. But during those few days, my wife and daughter never looked at each other, let alone talked to each other. Bedrooms were closed and locked when both of them were in the house.

    Many parents like my wife often consider every problem particularly with their teenage kids a catastrophe, and every dilemma a crisis. Yet it doesn't have to be that way if we only learn to consider and respect our children's individuality. There are so many ways to change children's mind. Demoralizing them or making them feel bad about what they have done or what they are doing is not one of them. When kids want to pass through a door that we believe would lead to no good, closing that door won't help that much. The tighter you close it, the harder the kids would push and pass through. The best thing to do is to open another door. Or as Woodrow Wilson puts it, "The thing to do is supply light and not heat."

Where are the Clones?
     When it comes to children, we can drive ourselves mad pondering on the rights and wrongs, but we've got to come back to one thing in the end. They are individual beings just like us, and just like us, one day soon they'll have to make their own decisions and follow their own dreams and desires. By what right, paternal or maternal, divine or infernal, do we have to prevent them from claiming their own individuality? By what right do we have to bend them into living as our alter ego or into living the way we want them to? Many of us may be well informed to attack questions of family and parenting, but are ill equipped to deal with issues about children's right to live as individuals. But being a kid once, we all know the truth and that is, the more we run the children's lives, the more desperate they'll be for a taste of freedom. Yet even if we succeed in chaining our children to our philosophies, binding them to our beliefs, and making them slaves to our principles, we will still lose them. It's because they'll become parrots, not humans, who simply repeat exactly what they've heard us say, and will never have the ability, let alone the confidence, to think for themselves.

     So every now and then, we have to remind ourselves that our children are not us, even if they have our eyes, nose, ears, tempers and mannerisms. They are different. They have different hopes and dreams, concerns and considerations, and fears and priorities. Thus we have to examine our expectations of them as often as we can. Are we measuring them up to the goals they have set for themselves, or to the goals we have set for them? Are we using them as a way to give us a second chance in life, to fulfill our empty lives, to find success that eluded us, to live a life we wish we could have lived, or to fulfill our own misplaced dreams? They are not here in this world for any of that.

    Children are not clones of ourselves, and we don't own them. They are not our personal properties. We did not give them life as what most of our parents made us believe they did for us. They did not choose to be in this world. We did. But even if we may have given them life, we do not have the right to live it for them. Only when we learn to see them as separate beings that we can completely let go of the power of control and seek instead cooperation and compromise. Their mistakes, failures, and weaknesses become more tolerable, and we would find it comfortable to allow them to go at their own pace. We would then understand that they are trying their best to carve a path for themselves like we used to do for ourselves, and not follow us. When they are ready to leave home to be on their own, we would be happy to see them go, not because we are finally free from obligations and responsibilities, but because we trust them to follow their own path. No matter what they have become or what their profession is, we can smile at the thought that they are individuals who are now ready to face the world by themselves. We would miss them but we'd be happy to sing:
       Isn't it rich? Isn't it queer?
       Losing my timing again, in my career,
       But where are the clones?

     Well, at least to me, in having a good, harmonious and loving relationship with our children, we would not have to worry about having a future Attack of the Clones when we're old and weary. Instead, we are likely to have the Return of the Jedi to comfort us when we are sick and lonely. (To be Continued) - Clem

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IMPORTANT ANNOUNCEMENT!

PROPOSED AMENDMENT TO THE CONSTITUTION OF ASOCIMAI

     During the regular business meeting of the association on July 13, 2002, to be held in Washington, D.C., the undersigned will propose an amendment to our Constitution and ByLaws:

The constitution as it currently reads

     Article IV, Section 5: An elected or appointed officer can only hold the same office for a maximum of two (2) consecutive terms.

PROPOSED AMENDMENT:

     To completely eliminate Section 5, Article IV and replace it with Section 6 of Article IV.

     The above proposal is being submitted to the regular members at least 30 days prior to voting, in accordance with our bylaws.

Respectfully submitted:

HORATIO V. CABASARES, M.D. Class 1971
Perry, Georgia

hcabasares@hotmail.com

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Obituary

    We regret to inform everyone that one of our own, Lito Evangelista, M.D. of the Class 1966, passed away on May 8, 2002. Sorry that we don't have any other information. Accordingly, he was fighting some kind of malignancy for 3 years. He was planning to attend our reunion in Washington, D.C. in July when he had some complication and did not make it. 

     Sometimes death reminds me of some of the lyrics of one of Joan Baez's songs: "….you don't get to choose how you're going to die, or when. You can only decide how you're going to live. Now." I believe Lito had lived his life fully. May he rest in peace. 

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The Reunion, Let's Make It Better

- from the Officers and Board Members

"What's in a name?"
    Someone said that middle age is when you still recognize your classmates and colleagues, but they no longer recognize you. Frustrating, isn't it?….when you have a hard time remembering the name of your classmate or colleague in front of you whom you used to hang around with during the medical school days? The face still has the trace of familiarity, but your mind lost the name to associate it with. How embarrassing to ask the name again. Now stop scratching your head. Your classmate might think you are using the wrong shampoo. Or you have kagid or kaspa on your scalp. It's time we do something in our reunion to make it easy for everyone to call each other using their name or nickname that we used to call each other in the medical school. But we need your cooperation.

Name Badges
     One of the things we came up with during our officers' previous meeting in Philadelphia on May 18 was to do something to make it easier for everyone to recognize and call each other with their names, not just "Dong, Bay, Day, Si Ku-an, Ooy! Si kinsa kadto ka?" So we decided on a name badge that you hang around your neck when you are attending our reunion activities during the days in particular with letters big enough so that one can read your name even if one's vision is no longer 20/20. We decided against the tag to stick on your shirt because many of us change shirt or dress daily or twice a day or three or four times a day. But for us to be able to make your name legible and a little bit artistic, we want to make it through our computer and then print. So what we need from you is for you to pre-register and pay the required payment for the reunion on time. Once you register, we want you to list the name or names of the guests or members of your family who will be coming with you so that we can put their names too in the computer and print. We want to be ready to give you the badges when you come to the reunion. If you wait till you get to our reunion to register, we may have to simply hand write your name because we may not be able to set up a printer there. But keep in mind that we are doctors and we'll be writing your name the way we write prescription. As a father once said about his eight-year old son, "I think my son is going to be a doctor. He writes like one. I cannot read his handwriting." However, if you have a better idea as to what we should do, we are open to it.

Program Activities
     Have you ever wished that our reunion activities would move smoothly like being caressed by a lover's hand?…. with grand, grace, charm and charge? No? Do you still consider some chaos and confusion, roughness and frustration, as parts of a normal CIM alumni event? But don't you want our reunion activities to run smoothly, or better than it used to? Of course, you do, unless you enjoy seeing others in frustration. We, officers and board members, definitely can tolerate frustrations, but we don't enjoy seeing any of the members getting frustrated. We want everyone to enjoy and to make our reunion a happy event, not a disappointing one. Thus we want to move our activities as smoothly as we can and handle them like professionals so we can have more fun together. But we need your help.

     Here is what we have in mind. We would like to make our reunion nights entertaining nights. We are fairly sure that we have talented members in our association or members with talented children and perhaps talented cousins or friends they can invite as their guests. If you're one of these talented individuals, please share with us your talent in singing, dancing, or other musical rendition, etc., in the name of fun, friendship and fellowship. Come on. Help us make our reunion provide more variations. If you have some idea, suggestion, or opinion on how are we going to run the entertainment program, contact us. If you want to run it, then that would be great and we'll just coordinate. We, officers and board members, can do some thinking, can make decision for our association, can dance a little bit during our reunion, and some of us can write a little bit for our newsletter. Beyond that, nothing more, no extra talent, except perhaps singing in the bathroom loud enough to disturb everyone in the house like someone is being murdered or choked to death. We would be doing it ourselves if we only have the talents. But even if we have, we would still need you. So please help us.

Business Meeting
     Our charming secretary Eppie Aranas is going to make an agenda for our customary business meeting on the Saturday morning of the Grand Ball. If there is something you want to bring up for discussion, please let Eppie know or anyone of the officers, so that Eppie can put up a good meeting agenda. Eppie knows her job like the back of her hand. She puts up minutes of the meeting like a real executive secretary. Sometimes she makes me wonder whether she graduated secretarial course before she became a doctor. If you need a good secretary,.. Naah!… don't even think of it.

     We don't want to be bogged down with the same old issue that could not be resolved because we are not in a position to do so. It doesn't serve any purpose beating around the bush. We want our meeting to produce results and resolutions, not create problems and frustrations, so that our association would come up with something new, something we all can appreciate and be proud of, not something we have to argue and end up with nothing new. With an agenda to guide us, we are hoping that we would not be going off course, and we would be able to allow reason to prevail so that we all can have a meaningful discussion, not meaningless argument. We are also hoping that we all can relate to each other, think and behave like one big collective sphincter that keeps the cream and squeezes out the crap, not a bunch of individual assholes that blows away the grain and grits but circulates the grudge and gripes.

Scholarship Program
    We are still waiting for the written progress from our CIM scholars. They are on vacation at this time of the year but that should not make them ignore writing their progress to our association. Our Vice-President Maida Antigua, M.D. had sent a message to Dr. Poblete a while ago informing her that our association has now required our scholars to write to us about their progress as a way of saying that they appreciate our scholarship. It is also our way of knowing that we are not giving something for nothing. We will follow up on it because we believe that every member has the right to know.

     We believe that in any alumni association like ours, it is our responsibility as officers, board members and coordinator to promote whatever program or project our association has decided upon, and follow-up on it until we get result. Even if our job is only voluntary and we have to spend our own money to attend our board meetings in particular, we feel that whatever the result of our association's program or project is, we are accountable. Otherwise if we attend our meeting only to sit and babble, and hold our position mainly in the name of prestige, not principle, then we would become nothing more than pricks without balls. But more essential than the meetings, however, is our frequent communication to help, support and coordinate with each other what needs to be done to achieve a desirable result.

    Thus our scholarship program is one of the issues we want to bring up for discussion in our business meeting during the reunion in July. If you, as a member, are in favor of requiring our scholars to write about their progress at least twice a year, what action do you think we should take if the scholars don't fulfill their requirement? Now this is my personal opinion. If any of the scholars doesn't write to us about their progress as required, then we will stop paying for his or her scholarship. Writing about their progress is not much to ask for. We are providing financial scholarship, not entitlement. Our association provides real money and thus it should demand from real scholars with real names a written note about their real progress. We don't want to play tough and rough, but we should not put up with any crap either.

ASOCIMAI Potpourri
    The orchids pictures in this issue were taken by no other than our artist Vice-President Maida Antigua when we went to Longwood Garden during the weekend of our recent board meeting in Philadelphia. They are beautiful. Aren't they? The picture of the new version of tartanilla was sent by Dr. Helen T. Yap of the CIM class 1978. Thank you, Ladies. And thanks also to our President, Dr. Dom, for being a superb host, making the weekend of our meeting worth the trip. It was not only enjoyable, it was also educational having gone to places that added sophistication to our life, and to restaurants that provided sophisticated variations to our taste buds.

     As of last month, 50% of the hotel rooms reserved for our association have already been filled. This is more than it used to. So please decide soon and make your room reservation because our association's reserved rooms are limited. Again, let us not give anymore headaches to Lolit Lao by sending your request for your seating preference now. Lolit deserves a lot more than just a headache relief, but it's the least we can do. Lolit is the most diligent, dedicated and diehard treasurer an alumni association can ever have, and she is also incorruptible. She doesn't just reimburse you for any expenses you incurred for the association unless you come up with the receipts. So we don't have to worry about any audit as long as we have Lolit. The cut off date for sending your payment for our reunion activities is June 10. After that, there is a surcharge. If you don't want to pay the surcharge, then register now. Otherwise you have to deal and negotiate with Lolit, and it's not going to be easy. Lolit is not tough, nor rough, but she is the kind who doesn't put up with any crap.

    CIM Brain Waves has now more than 600 readers all over the world; many of them are not CIM alumni and are non-physicians who are grateful of being included in our circulation. We will continue to welcome and include anyone who is interested to receive a free subscription of our newsletter. After all, since the beginning of time, humans have always learned from one another. Thus the more candles we light, the brighter the world is going to be, and the easier it is for everyone to follow their own "yellow brick road." Thanks to Belen Rosales and Wilmo Orejola who are joining with the staff of Brain Waves. And thanks also to my good friend Ernie Yu of Buffalo, New York who is now sending his article regularly making me wonder that perhaps he is again inspired by the change of the weather, by the bubbling water of the Niagara Falls and by the migration of those Canadian geese away from his backyard swimming pool back to Canada. If you want Canadian geese eggs to make baluts, give him a call. These fellow alumni make me a lot more optimistic that our newsletter will only get a lot better and last a lot longer. If you are still hesitating to send what you have written for our newsletter, the longer you hold it, the more you're going to find something wrong with it, and the less likely you want it published. As the Nike slogan says, "Just do it!" You can always write another article for another issue of Brain Waves. So send it now and we will find a place for it in Brain Waves, although the next two issues are just about ready for the layout. We have few new members of our alumni e-mail community, but we will welcome them formally in the next issue.

    Please pay attention to the proposed amendment to our Bylaws above by Horace Cabasares, M.D. of the class 1971. It's a bold proposal that could come only from someone who knows what he is doing - someone who says what he means and does what he says. Horace is one of the board members of our association who never hesitates to give his support to whatever we have come up with for our association that he thinks is the right thing to do even if it means going to where others dare not go. But if he thinks it's not the right thing to do, he would tell it to you straight. Like our Vice-President Maida Antigua, M.D., he is no-nonsense. When they both work on something, they focus on getting result so that if you work with them and you want result, then result is what you get.

    Below is a reprint of our annual CME program now complete with speakers. This is the final version. Changes have been made already. Rise Faith Dajao has done a great job in making our CME program and in saving our association a substantial amount of money. Applying for accreditation is not easy and it used to cost our association a lot. With Rise Faith's hard work and of course her charm too, the cost was significantly reduced. Anyway, if you are interested in being a speaker for our CME program in our next year's reunion in San Diego, please contact us. The earlier we lined up our speakers, the easier for Rise Faith to make the program and apply for accreditation.

     For those who want to donate something like books, used medical equipment or instruments, computers, slides, or other teaching materials, etc., please contact Dr. Ramiro Cadag at ENGKAK@aol.com. You can discuss with him regarding assessing the value of your used equipment for tax deduction purposes. If you can make someone happy with something you don't need anymore, and at the same time, help others, then by all means, do it. It will make you feel good about yourself. 

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The Annual ASOCIMAI CME Program

Grand Hyatt Hotel, Washington, D.C. July 11-12, 2002

THURSDAY, July 11, 2002

7:30 - 8:00 A M

Registration and Breakfast

8:00 - 8:05 A M

Welcome Address
Dr. Dominador Ong, President

8:05 - 9:05 A M

"Ultrasonography in the Management of Breast Diseases: An Office-Based Experience"
Dr. Horatio Cabasares
Chief of Surgical Services, Houston Health Care - Perry Branch, Perry, Georgia

9:10 - 10:10 A M

"Update on Breast Imaging"
Dr. Celia Yap
Chair of Radiology, Lutheran Hospital, Cleveland, Ohio

10:10 - 10:30 A M

B R E A K

10:30 - 11:30 A M

"Spinal Anesthesia: Old Myths, New Tales"
Dr. Ernesto Yu
Clinical Associate Professor, UB Medical School, Buffalo, N.Y.

11:35 - 12:35 P M

"Using ASOCIMAI Foundation to Create a Family Legacy"
Joseph Matson

12:35 - Afternoon

LUNCH, courtesy of Mr. Matson, and Free Time, courtesy of ASOCIMAI

FRIDAY, July 12, 2002

7:30 - 8:00 A M

Registration and Breakfast

8:00 - 8:05 A M

WELCOME
Dr. Rise Faith E. Dajao, CME Coordinator

8:05 - 9:05 A M

"Uveitis Diagnosis and Therapy: A Recommendation for Change"
Dr. Stephen Foster
Professor of Ophthalmology, Harvard Medical School, Boston, MA

9:05 - 10:05 A M

"A New Millenium for Peripheral Vascular Disease"
Dr. Nelson Bernardo
Director, Cardiac Catheterization Laboratory
Veteran Affairs Medical Center, Salem, VA

10:05 - 10:20 A M

B R E A K

10:20 - 11:20 A M

"Innovations in Arthritis Management, from Logical to Biological"
Dr. James C. Roberson II
Faculty Chief, Section of Rheumatology, Providence Hospital, Philadelphia, PA

11:25 - 12:25 P M

"Diagnosis and Management of Migraines"
Apollo Arenas, M.D.
Practicing Neurologist, Temple University Hospital and Parkview Hospital, Philadelphia, PA

12:20 - Afternoon

LUNCH and Whatever You Want

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FOR LAUGHS ONLY

    Two doctors opened an office in a small town and put up a sign reading "Dr. Smith and Dr. Jones, Psychiatry and Proctology"
    The town council was not too happy with that sign, so the doctors changed it to "Hysterias and Posteriors". This was not acceptable either, so in an effort to satisfy the council, they changed the sign to "Schizoids and Hemorrhoids." No go.
    Next they tried "Catatonics and High Colonics" Thumbs down again. Then came "Manic-depressives and Anal Retentives" Still not good. How about "Minds and Behinds"? Unacceptable again. So they tried "Lost Souls and Ass Holes." Still no go.
    Nor did "Analysis and Anal Cysts" "Nuts and Butts" "Freaks and Cheeks" or "Loons and Moons" work either. Almost at their wit's end, the doctors finally came up with a business slogan they thought might be acceptable to the council:
    "Dr. Smith and Dr. Jones, Odds and Ends."
     Approved.

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    A young reporter was covering a story about an escapee from a mental asylum. To accompany the story, he sent in headline. Woman Raped, Mental Patient Escapes. But the editor asked for something snapper. So the reporter suggested: Nut Screws and Bolts.

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     A busload of politicians was speeding along a country road when it ploughed into a tree and overturned. There was blood and glass everywhere. An old farmer saw the crash and was first on the scene. Within two hours he had dug a huge hole and buried all the politicians.
    A few days later, the local sheriff was passing through when he saw the wreckage of the bus. The farmer explained what had happened.
     "Were they all dead?" inquired the sheriff.
    "Well," said the farmer. "Some of them said they weren't, but you know how them politicians lie."

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     Few Weird Signs:
     On an electrician's truck: Let us remove your shorts.
     Outside a radiator repair shop:The best place in town to take a leak.
     In a hotel: Ladies are requested not to have children in the Cocktail Room.
     In a Finnish washroom:To stop the drip, turn cock to right.

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INSIGHTS

    "It is better to light a candle than to curse the darkness."Chinese Proverb

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    The conventional view serves to protect us from the painful job of thinking." J.K. Galbraith

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    "It is easy to believe that something must be true because everyone else believes it. But the truth often only comes to light by daring to question the unquestionable, by doubting notions which are so commonly believed that they are taken for granted." Floyd Maxwell

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    "Children require guidance and sympathy far more than instruction." -Anne Sullivan

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    "One often learns more from ten days of agony than from ten years of contentment." - Merle Shain

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    "Anyone can blame; it takes a specialist to praise." - Konstantin Stanislavski

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    Do you know that spider silk is stronger than nylon, rubber, and even stronger than high-tensile steel? One hundred times more energy is required to break spider silk threads than carbon steel strands. It makes the movie, Spider Man, believable in the way Spider Man could swing from one building to another with the use of its spider silk he shoots out from his wrists. The only problem is that the average household spider produces only a minimal amount of silk in its lifetime. And one could easily cringe with the idea of arachnid silk farm with billions of creeping crawling spiders.

     Dr. Richard Basel, president of Lebensmittel Consulting and Dr. Glenn Elion, president of Plant Cell Technologies have worked together to produce commercial amount of spider silk. Dr. Basel developed the techniques which allowed the spider silk proteins to be cloned. Dr. Elion contributed his expertise in such areas as DNA sequencing, expressing genes in plants, and testing for tensile strength. They took some risks and suffered through hundreds of failures. But now they have so many clones they don't know what to do with them. As a result, they have been ready since 4 or 5 years ago to transform bugs to body armor.

    Pretty soon modern-day combatants will be protected if not already by arachnid silk in the form of bullet-proof vests. Spider silk is stronger than Kevlar, the main component of bullet-proof vests - and it weighs 25% less. The silk can also be used as an absorption agent in protective suits worn to ward off the more heinous biological weaponry. Obviously, the military is extremely interested, for it will make its fighting forces safer and more efficient. Furthermore, its supply can easily be replenished since its source is under domestic control.

     Spider silk has other applications, too. It can be used to reinforce fibers in composite materials, climbing ropes, and seat belts. It would be strong enough to function as a safety net for jets that miss the arrestor wire when landing on the deck of an aircraft carrier. But the primary use and market for spider silk are in silk-woven fabric for dresses and garments. The silk can be cloned with natural color to eliminate the dyeing process. It's possible that some of us have already been wearing shirt or dress made of spider silk. So reach to your pocket carefully. There might still be a spider in there. Ahaah! I got you!

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Buffalo Rhapsody

Ernesto Yu, M.D.

CIM Class 1973

The White Coat

    Doubtlessly, the crumpled expression on her face and her calculated steps bespeak of the obvious collection of gnawing pain and discomfort that she has rehearsed for years. Her sunken eyes and shallow breathing seem to beg for miracles, even transient, to gather some rainbows out of another gloomy skies...

    I ponder on this dime-a-dozen doctor-patient clinic encounter that is replicated day in and day out, and distill the reflected symbolism of our white attire: Mine representing the knowledge and skill to ease that ailing something in her system and hers stands for the myriad of symptoms that discolor a blurred world; mine is a constant thirst for scientific know-how and compassionate care, hers an amplified plea to rebuild herself into whole again.

    Back in my early breaks in med school, I recall how my white coat speaks of faith and purity, of purpose and pursuit, of professionalism and empathy, and the tons of dualities that henceforth wiggle ceaselessly at the center of my life. This is synonymous to the twin serpents of knowledge and wisdom in the caduceus where both complement each other to render a soothing symphony for the senses; one is a discordant music scale without the other. During this phase, my white coat was an ultimate prize for all the sleepless nights endured digesting lengthy lecture notes that trained my brain to absorb better than high-quality sponges, the lonely shadow chasing and mental torture in the wee hours, the pathetic overtime lab works on weekends, the nauseating smell of slow death after dizzying exams. In addition, the jacket doubles as an excellent repository for pens, percussion hammer, handbooks, papers...pride. The frequent inescapable dirt and stains splattered on its starched whiteness were medals of the trial and error maneuvers against bewildering illnesses, of the miserable tales in the wounds I dressed, of the many educational sessions on suffering from its very root- the eyes of the debilitated, of the miles I traveled to refine the art of attentive listening and mellow whispering back to the heart and soul of the tormented person, of the realization that what transpired on the patient's bedside is not just an exhibit of what I know but of what and who am I.

    With maturity and a good volume of experience on the fragility of life and death, I have discovered that occasions abound where sometimes the ideal way to auscultate the chest is to free your ears of the stethoscope and just see, feel and understand the dreadful corners of fear and ache, scars of agony that are visual imprints of a patient's muffled bark for help. Moreover, I've discovered mechanisms to renew and nurture my own body, mind and spirit as I would to those diseased mortals whom I selected to serve. Gone are my monochromatic perspectives of life. There is a bounty of enriching beauty outside medicine when you rest the white coat at day's end. One is music that vibrates with one's inner harmonies. Another ones, art and medical journals which give you fresh vision of life. The wisdom generated from such sources spray new insights which you eventually channel into the patients.

    Sensitive writers have aired the need for physicians to be priests also. This is not to be confused with having a sacred site to kneel before God or an altar to observe religious rituals. Rather, it is about the summon to remedy the soul as you would attempt to drain the body of toxic impurities. Doing so, one bumps into the fulfilling richness of his calling.

    As such, the white coat is a privileged access to a bedside of moans and groans. It's what makes doctors stay humane, not reluctant to propagate the embers of tenderness and empathy which are at the core of the instincts which made doctors dedicate a lifetime of healing and loving.

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Marriage, and the choices we make….

By: Marie Belen C. Flores-Rosales, MD MPH CIM ‘ 70

    May 10, 1936 … This was the day my parents made their vows, for better and for worse, in sickness and in health, etc. etc. etc.... Sixty-six years is a long time, a very long time, for two people to stay married. My parents, celebrating their 66th wedding anniversary this month, this year are still so in love and as devoted to each other as they were on the day they wed. My mom, frail and deaf at 87, is still solicitous with my dad, as ever, and my dad, at 89, is still as protective (even more so now) as he was years and years ago. Looking at them with their simple gestures of caring make me cringe with envy as I reflected and looked back at their life together. Theirs was not a bed of roses. They had more than their fair share of joys and sorrows, sorrows and joys. After 66 years, their faces still glow from the battles they’ve won. The same faces also bear the scars of the wars they lost. Today, they have emerged triumphant because they did not let the tears, the fears and the years wear them down as they held on to each other, provided anchor to four headstrong children and remained a family. This was their choice.

    Then, I reflect on how I am doing with mine. The choices I make are mine and mine alone. The mistakes I make are mine, too, and no one else’s. Life is a colorful interesting collage of the choices I made and the mistakes I committed. No ifs.., no buts.. Either I savor the glory of my good choices, or sulk over the hurting consequences of my mistakes. In my marriage, it is both.

    I fell in love with a vision of the man I was going to marry. I fell in love with the thought of being married. I never married the man I dreamed about. Through the years, I fell in, fell out of, and again, fell in love with the man I married. After all these years, I still am in love with the thought of being married. It couldn’t be otherwise.

     Thirty years of marriage is a long time, too. And, not easy. Time was when I grieved for broken dreams, broken promises. Time was when I grieved in anger as I desperately clung to and refusing to let go of useless promises. Time was when it could have been a lot easier to throw in the towel and call it quits.  Time was when it could have been a lot simpler to pack my bags, leave and not look back. Sometimes I wondered where God was during those times. Then, one day, like the proverbial glow in the dark, I made the conscious decision to stick it out and make the marriage work. Not for myself, not for my husband, not for my children.. but for the simple reason of standing by my choice and taking responsibility for it whether right choice or wrong choice. Then, and only then did I recognize the real meaning of marital bliss.

    I learned that there is no such thing as a perfect marriage. I learned that there is no such thing as a perfect couple. I learned that there is no such thing as a match made in heaven. I learned that I couldn’t change my husband according to how I wanted I him to be, according to the vision I have of him. I learned that, I, too, couldn’t change what I am according to how he wanted me to be – because we are two individuals, distinct and different, bonded by love and commitment, who should be willing to accept each other’s idiosyncrasies and frailties. He is far from perfect as I am, too. Two imperfect individuals thrown into the sea of life could either sink or swim. These two imperfect individuals did not want to sink; these two imperfect individuals chose to swim… and swim together. Thirty years, and four children later, in spite of the storms, these two imperfect individuals made it to shore.

    As I started to take stock of life, I started to count my blessings. As I counted my blessings, I started remembering the sadness and the pain that came with the marriage, and counted them as blessings. Overall, the sadness and the pain in the marriage became a wonderful memory, one memory that I wouldn’t want pushed aside to oblivion, because this is one memory that makes me smile.

    Looking back, I feel a sense of victory realizing that my husband and I chose to accept each other as we are. We have come full circle in our marriage. We are back to where we started, just the two of us, together, as the children left the nest to venture with life on their own. We still have dreams, and we indulge in these dreams… but our dreams, now, are nowhere close to the ones we dreamt thirty years ago.

    Who knows … another 36 years might just be around the corner.

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TIME….PRECIOUS TIME

by Maida Antigua, M.D. CIM Class 1971

    “Oh, those school year days…”
    I am sure we all remember our school days when the school year seemed to yawn ahead of us interminably. Yet summer vacation always went by in a blinding flash. Where did it go? Why did it go so fast? Now that we have “matured” we face Mondays like we did when we were school kids at the beginning of the school year and weekends whiz by as fast as our summer vacations did. And even worse, I have found that my grandmother and my mother were so annoyingly right on target when they told me when I was a kid that time would fly by faster as one got older. Undeniably true is the saying that has recently resurfaced as part of e-mail “truisms”: Life is like a roll of toilet paper. The closer it gets to the end, the faster it goes.

Time is relative….
    We all have an equal allotment of time in a given day. It does not matter where you are in the world or what time zone you are in. There are twenty- four hours in a single day, seven days in a week and 52 weeks in a single year. But isn’t it amazing how we all manage it so differently! We all have varied priorities. But on whatever and however way we spend our time, we must never forget that each second that goes by is time spent and there is no such thing as time refunds or time loans. There are people who continually astound me at what they can do in such a short time and on the other hand, there are people who go about their business in a manner not unlike the speed of very thick molasses being poured out of a jar. And why is it that when we are doing something we hate, time drags on. But if we are doing something we absolutely love, time is over too soon…. much too soon.

Life happens…
    As physicians, our lives are filled with managing the health and illnesses of our patients. Our times are broken down into 15 or 30-minute segments of patient office encounters and segment hours allotted to surgery and repairing, fixing, healing, enhancing broken bodies (or minds). And yet further hours are spent making rounds, completing charts and records, following up Pathology reports, Radiology reports, answering phone calls and queries from patients and their relatives, renewing prescriptions, and listening to drug representatives who insist on spelling out every minute detail of their company’s latest drug du jour. And there are the obligations attached to being an active staff member to various hospitals and organizations. Those CME requirements have to be met so our licenses can be renewed.

    Then we go home and start working on our second jobs as husbands or wives and parents or grandparents. Unlike Harry Potter’s world, food does not appear magically on our tables without it being cooked or bought first. As a testament to the shortage of “time” in two career marriages, I am hearing more and more advertisements for “home replacement meals”, the latest euphemism for fast food. Whoever cooked up this new phrase must be the same person who glamorized “used cars” as “previously owned vehicles”. So the hours are eaten up with food shopping, laundry, helping kids with homework, chauffeuring them to their myriad activities of sports, music lessons, dance lessons, attending recitals, school meetings, this and that practice. And for the grandparents, there is the new role of babysitting. And yet another segment of time has to be used for dealing with that relentless pile of mail and bills, bills, bills! I am sure I am not alone when I stare guiltily at those dust collecting medical journals piled up in one corner waiting so patiently for our promise to read them one day…one of these days.

    The place we call home also makes its own demands. Why can’t somebody invent a self-cleaning house? Pipes break, walls need repainting, roofs leak, light bulbs replaced, fixtures fixed (somebody please invent self-fixing fixtures and appliances), garbage has to be dealt with. Grass needs mowing, plants need water, fertilizing, trimming, and gardens need endless care.

    And we continue to wonder as we flip those calendar pages month after month, year after year, “Where does the time go?”

Spiritual Nourishment…
    There is no question that we spend a lot of time meeting our own physical needs, not to mention that of our family’s and our patients’. Aside from Sunday or Saturday church (for those who have kept up the practice) how do we nourish the spiritual facet of our existence? Do you ever give yourself your very own block of time? Time that is yours and yours alone? Time to do what you want and not what your spouse or children or boss or friend wants. Time spent to do whatever you want to do so that the life force is energized. We all have our own soul-nourishing activities. Some find it in actively participating in sports, others in watching it. And there are those who try to fill that bottomless gaping hole inside with a shopping spree, some do it by eating. Others devote that time to hobbies. Some love to do “nothing” and find it wonderfully energizing. Does it matter what we do, as long as it fills the need? Is time ever wasted?

Questions Posed…
    There are two questions that have come to my mind over the past seven years as a result of some personal life-threatening and life-changing events:

     1.“If I had all the time in the world, what would I do?”

      2. “If I only had 24 hours to live, what would I do?”

    If I posed those same questions to you, what would be your answer?

    Time, alas, waits for no one. If the answers to the above questions are things you have not done yet, what are you waiting for?

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