June 2002 Vol. 2 Issue 11

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


Dominador Ong, M.D.
Maida Antigua, M.D.
Dolores Lao, M.D.
Epifania Aranas, M.D.
Clem S. Estrera, Jr., M.D.
P. R. O.
Anita Avila, M.D.

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 Coordinator:
Rise Faith E. Dajao, M.D.
Portsmouth, VA


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

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

Drive Safely!

Editor's Column

    "Life has a bright side and a dark side, for the world is composed of light and shadows. If you permit your thought to dwell on evil, you yourself will become ugly. Look only for the good in everything, that you absorb the quality of beauty." - Paramahansa Yogananda

A Second Chance

Questions, Questions, Questions…
    Just for a moment, take a look at your life and give it a thought. Then ask yourself these questions: If you could do it all over again, if you could live your life differently, what would you do? Or if you could just live the last fifteen, ten, five or even the last two years all over again, would you do anything differently this time? Some of us would probably plan to do nothing differently at all. But most of us, if we could - if we were given another chance to live a lifetime, or ten, or five, or even the last couple of years again, we would do things differently.

     So if we have a second chance, is there any reason to believe we would get it right this time? Is there any reason to believe that we would have a more positive attitude and thus would be a lot happier, kinder, gentler, or nicer to everyone? Is there any reason to believe that we would be giving consideration as to how we want to be remembered by our family, friends, and other people we care about and know of, before we run out of days? Is there any reason to believe that we would be more proud of our CIM roots and thus look at our alumni association on a different perspective and become proactive, not reactive, making suggestions and participating with our association's activities?  

    But what assurance would we have that things would go any better for us if we had a second chance? We still do things the same way, think the same way, still have the same attitude, and we still see the world pretty much the same way today as we saw the world yesterday. Most of us would probably make the same bad mistakes or decisions the second time around as the first. We would probably still be too preoccupied with professional and personal matters and thus still have no time for extracurricular activities like attending our alumni reunion to renew friendship and fellowship with our fellow alumni.

    The problem, however, is not whether or not we get that second chance because as long as we are still alive and kicking, we've still got second chance left. The problem lies in what we will do with the second chances that are in front of us. We may have learned from our mistakes in the past, and we may even avoid making some of them in the future, but there are other mistakes that just seem to be waiting for us to make them. We may have wanted to come to our alumni reunion, but there are so many compelling reasons and excuses that are just so convenient and tempting to choose from, just as there are so many priorities and schedules to follow, promises to keep, demands to meet.

    Life involves choices. Choices and decisions are the molders and shapers of who we are. It's because of the choices we've made that we have become what we are, we feel what we feel, and we do what we do. Choices lead to actions and the actions we take clearly indicate the persons we are becoming. They define our characters and shape the quality of our life. Each life is a struggle between the opposing forces of good and evil, right and wrong, optimism and pessimism, hope and despair, vision and blindness, etc. Choosing is a privilege, but it is also a responsibility. The choice we make today could have a consequence far into the future. A Spanish proverb says: "Choose what you want in this world and pay for it."

    It's our choice to make our life more meaningful and fulfilling. It's also our choice to keep our life boring or less fulfilling, or to keep it just the way it is, not boring and not fulfilling either. It's our choice to make conclusions and pass judgment on the basis of assumptions and prejudices or on the basis of the words and opinions of others. But we should be aware that many relationships have been ruined, ambitions lost, potentials untapped, plans not carried on, all because we chose to assume and to listen and follow the opinions of others without thoughtful consideration that assumptions are not facts, and that opinions and truths are not the same. When someone tells us that a friend said something bad about us, we can choose to ignore it or confront that friend, find the truth and keep our friendship, or we can choose to assume it's true and then shun our friend or fade away from the friendly relationship. When someone tells us that we don't have the talent for writing and thus cannot write good essay or article, we can choose to assume and believe we can't, or we can choose to ask ourselves these questions: "Is this really true? Is this what I believe? Is this what I think? Or is this what someone else wants me to think and believe what I can or can't do?"

    Now that we are aware that we've still got second chance left, would we still make the same choices that make us feel the way we do and keep us what we are? Would we still choose to react the same way to every mistake we make? Would we still choose to look for more convincing reasons or excuses not to attend our alumni reunion and continue to stay away and maintain distance from our CIM roots? Would we continue to promise ourselves every time by saying, "Maybe next year, I'll attend." Yet how many "maybes" have we made so far? And how many more would we have to make? Of course, it's none of anyone's business. It's our choice.

Becoming Better
    There's an old story about the preacher who was called upon the funeral sermon of the meanest man in town, a character whose dying was his only act that ever won popular approval. The good preacher usually had some kind words to say about any corpse who required his service, but this occasion presented a major problem. As the service began he rose slowly, wiped his glasses, cleared his throat and said: "I know some of you think this townsman of ours was a mean man. Perhaps he was. But in all fairness you ought to admit that there were times when he wasn't as mean as he was at other times."

    This kindly minister also might have come right out and said that none of us is perfect. And it might have been encouraging to his listeners if he pointed out that there are times when most people are better than they usually are. Probably we - most of us that is - are not that bad, but all of us could be better if we tried. So how does one set about becoming better? Marcus Aurelius, the Stoic philosopher, told us not to waste time worrying about the answer. "Put an end at once and for all time to this discussion of what a good man is," he said, "and be one!"

     So how do we want to live the future - a second chance - that we have in front of us? Do we want to live the rest of our life rehashing the painful, unpleasant, or unfair events of the past, or would we rather do something right now and be more optimistic, kind and understanding? It is our choice to look backward and live with the pains, failures, frustrations and disappointments of the past, or to look forward and try to create the circumstances of our future so that when we reach the future, it's not chance or luck that got us there. It's our own best efforts through our own clear understanding of our own responsibility.

    We've got to let go of the past that keeps upsetting the present. If we have a disappointment or disillusionment with our alumni association, misgivings and prejudices with its officers and a grudge with our fellow alumni in the past, we can choose to dwell on them and continue to stay away from our association's activities. Or we can choose to move past them, rejoin and have fun with everyone. If others don't like us because they consider us as aloof, arrogant, stiff or insensitive, we can choose to try to be kind, nice, helpful and considerate. But we can also choose to simply say: "So what? Who cares?" Yet we do have a chance to try to become a hell of a lot better person. We do have a chance to change the way we live and behave in such a way that one day written on our tombstone could be this: "Here lies Clem, he tried. He really did." Rather than this: "Here lies Clem. He never cared."



     Nenita O. Estrera, M.D. of the class 1973, is now a diplomate of the American Board of Psychiatry and Neurology. She passed both the written and oral parts of the exam. She took the oral part of the exam in May 7, 2002. She is presently an Assistant Professor in the Department of Psychiatry of the Medical College of Virginia in Richmond, Virginia.


ASOCIMAI Potpourri

     We have three new members of our e-mail community.
       Lowell Taclob, M.D. Class 1967
       Edgar Alonsozana, M.D. Class 1987
       Gladys Alonsozana, M.D. Class 1987

    New members, welcome! It's still not too late to join with us in our alumni reunion at the Grand Hyatt Hotel in Washington, D.C. on July 10-14. Everyone would love to see you there. But if you are unable to attend this year, next year will be in San Diego. Please don't hesitate to make any inquiry about anything that bothers your thought or anything that makes you unsure of regarding our alumni association, e-mail community and newsletter. Feel free to send your suggestions, contributions, recommendations, comments and even criticisms. If we don't like them and we're frustrated with them, don't worry. We'd just punch the wall in our garage. Just kidding.

Reunion Attendance
     Our alumni reunion this year could be one of those reunions in which the attendance could be impressive if not stellar. For sure our association will never have to worry about being unable to reach the quota for the hotel rooms reservation. All rooms reserved are taken and a substantial number of alumni have already paid their reunion dues especially for the culminating event - the Grand Ball. So we, the officers, board members and CME coordinator, would like to express our heartfelt appreciation to everyone of you who are coming to our reunion. You just don't know how much pleasure it gives us. Your attendance or participation means so much to us, for we consider it as your way of approving what we've done and are doing. It strengthens our faith not just in ourselves but also in all of you, and toughens our resolve to continue doing our best because we believe that every member deserves nothing less than the best. Nothing could enrich us more and give us more encouragement and satisfaction than seeing every one of you at our reunion. It's like having been on many fights and finally won the most important fight - the fight that counts most. We can hardly wait to see your lovely smiles that would surely light up our reunion like the rising sun.

    For those alumni who are struggling with the decision until now about attending our reunion, is there something we can do to make you join with us? We'll do anything...well, maybe almost anything…just to see you. It doesn't matter whether you smile or frown, laugh or complain. Your presence is enough to give us pleasure, for it will surely add more flavor and savor to our reunion even if it's sweet and sour. Anyhow, there is a gap that stands between decision and action. Please tell us what we need to do to fill that gap and make it easier for you to act and have fun with us. There is no guarantee that we can do it but we can promise to give it our best shot to fill that gap. Come on. Try us. Name it and we'll figure it out.

Work and Love
     Theodor Reik said: "Work and love - these are the basics. Without them there is neurosis." Work is good for us, for it is in work that we create ourselves by expressing our spirits in muscles and joints. It is also in work that we deserve to have more of what we need and what we want. It's only natural to want what others want from time to time. It's often the reason why we work so hard to keep up with others especially with our friends. Thus it's not uncommon to have the feelings of envy and jealousy over our friends' success and fortunes. It's not always easy to be happy for what our friends' have achieved and accomplished, or what our friends have gotten or are given that sometimes we harbor a secret desire to see our friends fail in some small way. Sometimes we derive pleasure from our friends' failures. Although these feelings are not uncommon, they can impact not just on our work by aggravating our frustrations and irritability, but also on our friendship by building a wall of tension between our friends and us. It would not take much but a very minor misunderstanding or unfavorable words from someone to break a friendly relationship.

     So work alone is not enough. We need love. Without love, who wants to be a friend? Without love, who could appreciate life? So we've got to learn to love what we are, who we are and where our professional roots are from, and we'll be loved. The best way of affirming that love is to celebrate with our friends and others who, like us, have the same professional roots and who love to have some fun together with us. Celebration is our way of expressing our love for life and for our distant friends. It reminds us that we deserve to live and we deserve friendship. A Thai proverb says: "God respects me when I work, but He loves me when I sing." Now please allow me to paraphrase a song:
           "For all we know, we may never meet again;
           "We come, we go …like a ripple on the stream.
           So have fun with us this year, for next year's another year;
           Next year may not be there, for all we know….."

     As far as the hotel is concern, you may still be able to get a room at the Grand Hyatt but as a regular guest and thus no longer get the lower rate under CIM alumni name. If Grand Hyatt has no more room available, the nearby Mariott Hotel probably has vacancies. One of the alumni made her reservation at the Mariott Hotel two weeks ago. Although you may stay at Mariott, you can bring your luggage to one of your classmates' rooms in Grand Hyatt to change dress. Sorry that the Lincoln Bedroom in the White House is also occupied. We would be willing to ask George Bush for the room just for you.

Name Badges
    Name badges are all done of those who are definitely coming to our reunion. Our Vice-President Maida Antigua has been on fire meticulously checking and rechecking for spelling and making sure that the names must correspond with the class the alumni belong to. She single-handedly printed the names, put every one of them in a plastic case to be hanged around our neck. Those who sent old pictures that were supposed to be in our souvenir program ads last year will have the pictures this year because there was no souvenir program last year. Maida, with her artistic and computer skill, aided with a sophisticated graphic software program, had to manipulate the pictures to remove wrinkles, improve the contrast, remove the red eye, adjust the brightness, etc., so the pictures would look a lot better if not beautiful. Don't worry. You all in the picture will look the same except perhaps a little bit more handsome and pretty like elegant-looking politicians, not shabby-looking morticians.

     We'd like to thank those of you who sent pictures for our reunion intermission presentation. Once you see these pictures on power point, you'll be glad you sent them. Those who still want to send pictures of the days in CIM and of the past reunions, send them now. Maida may still be able to accommodate them. I think she will as long as she doesn't have to do a lot of manipulation. Faded and wrinkled pictures are not that easy to restore. Well, it maybe easy but it takes time.

    Our special thanks to Edwin and Ayen LaRosa, M.D. both of the class 1978, for donating a tote bag for everyone of the alumni who is coming to our reunion. It's one of the most inspiring gestures. No, it's not an act of charity. It's a plain and simple old-fashioned act of goodness and kindness.

     Our CME program should be a lot more professional this year with the state-of-the-art audio visual equipment, not to mention interesting subjects and interesting speakers. We have power point, laser pointer, etc., but no Torsades de Pointes. We'll also have a never-ending supply of coffee, tea, bottled water, soft drinks, fruits, sweet foods, etc., but no poto, biko, bodbod, tinula or inun-unan. Moreover, Pfizer and Pepsi companies are offering us free supply of their new drink laced with lemon-flavored Viagra liquid shaken and stirred. But it's no longer considered soft drink. It's stiff drink. And it's called Mount and Do. It would probably keep at least most men awake while listening to the lecture. Those who want to try this drink, it maybe better if you wear a coat in case you have to get up and go to the restroom. It would cover the obvious unless you want to become a walking advertisement.

     Attendees who paid for the CME will have their CME certificate immediately after the program. Rise Faith E. Dajao, our CME coordinator, worked hard for it. She means business. She and Maida are coming early on Wednesday of the reunion to check the necessary equipment and make sure they're in top shape. Although we don't expect any radioactive temper to detonate from anyone, we don't want to take any chances. We don't want any equipment to malfunction, let alone obey Murphy's law. From now on, we will not allow our association to settle anything less than the best. Our association has enough money to buy everything or anything that it needs to facilitate its activities for the satisfaction and enjoyment of its members. As they say, there are only two things that money can't buy - true love and homegrown tomatoes. I've got the later. Anybody wants some?

The Visionaries
    There are four visionaries: Dr. Jacinto Velez, Dr. Benito Antigua, Dr. Uldarico Bacay and Dr. Renato Espinosa. Dr. Velez and Dr. Bacay are no longer with us in this world but they left a legacy that not only lasts but also endures the test of time. For all these years, these four visionaries have maintained their modesty and a low profile that even their own families have not been aware of their great accomplishment. Their accomplishment never made the headlines, and was not even mentioned to the students of CIM, at least not when I was there. But the mission that these visionaries had accomplished was an awesome challenge - a challenge that was toppled by a perfectly simple plan beautifully executed with professionalism armed with persistence, prudence, passion and determination. Its accomplishment is an inspiration to everyone. For it shows and proves to us that we too can reach our goals, accomplish a mission, or make our dreams come true if like the visionaries, we have got "what it takes."

     These visionaries could have easily bragged about their accomplishment, but none of them chose to. Perhaps age has finally penetrated the conscience of one of them that he found it hard to hold it any longer and so he told the story to his own daughter that should have been told long time ago. Outstanding achievements, whatever they are, fill us with awe and admiration especially the kind that these visionaries had. For it's a meaningful contribution to the medical profession that has made and will continue to make a difference in so many lives, not to mention yours and mine.

     Our Vice-President Maida Antigua has been tracking down the families or children of the three of these visionaries to invite at least one of these children to come to our reunion and receive the award for their father. Like the Israeli intelligence that stopped at nothing to find the Nazi war criminals, Maida had pushed all the buttons and exhausted all her connections to locate and contact the family of these visionaries. She located some of every one of them. But there may not be anyone from the family of Dr. Espinosa who would be able to come and receive the award. However, his friend and co-visionary Dr. Benito Antigua would accept the award for him.

The Importance of Teamwork
    We will have a program that could be full of pleasant surprises for our Grand Ball. Eppie Aranas, our delightful secretary, is at least trying to make our Grand Ball to be an affair to remember in a positive way hoping that the alumni would leave the reunion taking with them home some fond memories. Thanks to those who are willing to share and show their talents. Your talents will definitely double our fun and triple our joy. Maida made the template of our reunion souvenir program that started with a plan of only four pages, and ended up with twenty pages. Eppie is now in charge of having this template printed in a way that it could become something worth keeping. Lolit, our kind-hearted but incorruptible treasurer, who used to dread the headaches that seemed to punish her more during every reunion, has now gotten headache-free. Cards have been done for the seating assignments and every one of us would like to thank every one of you for sending your seating preference earlier.

    To run the program smoothly, we will have an EMCEE but we'll not give you his name yet because we are still negotiating his demands and charges. Actually, he is not asking for monetary compensation. After all, he is a member of the team. He just wants a good functioning microphone with a good sound system. He wants to be reassured that the microphone is sensitive enough to pick up what he says and transmits it to a sound system that would not alter his voice but sends it to everyone's eardrum as it is, loud and clear. He has already reviewed the many previous OSCAR awards in TV to pick up some quips or gibes. It will be interesting. No kidding.

     As you can see, teamwork is very important in an alumni association since each one's job is purely voluntary. No compensation. Our President is in charge of the wheeling and dealing for our association. The rest like Mike Espiritu who is eager to help but nothing much to do for him, still participates by sending his undying moral support and encouragement as well as an occasional suggestion to the team. He is not even aware that he helps provide the team with a wind beneath its wings. Now what about me - Clem? What's my role? Well, I'm the messenger with the message. I make everyone look good. Just kidding. I'm probably what you call an agitator or the worst nightmare for those alumni who have not attended or are not attending our alumni reunion. I'm giving them a run for their conscience, making them examine where their love and pride of their professional origin really are. But we can't really blame them.

A Gardener's Way of Looking at Our Association
    I happen to be an avid gardener and I often compare the growth of humans to that of the trees or plants. To me, there is not much difference. Like humans who need food and water regularly to maintain growth if not life, trees need fertilizers and water. Like humans who need spiritual energy and encouragement to keep them in balance and endure through the tension and turmoil in life, plants need sunlight for their energy and spray preferably organic spray, to keep the bugs away. They also need the soil aerated and the weeds pulled around them and the placement of mulch to encourage and facilitate their growth, foliage and bloom. Like dormant trees that stop growing and bearing fruits not because of old age but because of the lack of water, nutrients and sunshine for years, many of the members of our association lost their interest and faded away from our association because of the lack of periodic communication, information, knowledge and excitement. For years our association has not provided them regularly with enough of something to be proud, something that could make them feel important and excited about. Instead, it has continued to rely on the Four Olds - Old thoughts, Old ways, Old issues, and Old ideas. The Olds had dulled its glory and produced the same old frustrations, disillusionments and disagreements.

     So we, the officers, board members, CME coordinator and the staff of Brain Waves have been doing some kind of restoration, renovation and beautification. Like a house that hasn't been touched by a woman for quite a while, we are doing some cleaning, patching, re-arranging and putting some new paintings in it so everyone will get excited to come when invited. We are doing our best to put style and class in our association to hopefully make everyone feel proud and important so that our association would spread and grow in all its glory, luscious and luminous. We hope, not expect, for such a lovely growth. It's all up to the members now to ignore or resist our best, turn down our sincere invitation and let our association lose its glory from the lack of cooperation and participation. In other words, the ball is now in the members' court.

Scholarship Update
     Somehow our CIM scholars are oblivious to our new requirement of making them write a report regarding their school progress. For the second time, Maida had sent another message or letter to Dr. Poblete about a month ago asking her to remind the scholars regarding their written report. Perhaps the report is in the mail but if it won't come before our reunion, we need to take action because if we don't, no one will take us seriously. I don't think anyone of us wants to be involved in an association that is spineless or toothless. We need to bare our teeth when necessary, and bite, not just bark. So we'll surely put this in our agenda for the business meeting.

Let the Countdown Begin!
     We look forward to see you soon. Those who are not coming for whatever reason, please keep in mind that we are going to miss your lovely smiles. And those few alumni who sent their sincere apology for not being able to join with everyone this year, your apology is accepted. And thank you for taking the time to let us know. But we'll hold you to your promise to come to our reunion in San Diego next year. I've got your e-mail message saved in my hard drive. And remember that our integrity depends on the promises we keep.

     Drive safely. We love you. The next issue of Brain Waves will be a week or two after the reunion. But between now and the reunion, if there is any important development, we'll notify everyone through an e-mail message. Now let the countdown begin!



    "No matter what you've done for yourself or for humanity, if you can't look back on having given love and attention to your own family, what have you really accomplished?" - Lee Iacocca, Retired Automobile Executive

    "The easiest kind of relationship is with ten thousand people, the hardest is with one." - Joan Baez

    "Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around." - Leo Buscaglia

    "Wherever there is a human being, there is an opportunity for kindness." - Seneca

    "Life is merely the canvas for which you as the artist are able to create whatever you can imagine!" -Ian Boe

    "Motivation is what gets you started. Habit is what keeps you going." - Jim Ryun

For Laughs Only

     An old man was sitting on a bench at the mall. A young man walked up to the bench and sat down. He had spiked hair in all different colors: green, red, orange, blue, yellow.
    The old man just stared at him.
    The young man said "What's the matter old fart, never done anything wild in your life?"
    The old man replied, "Got drunk once and had sex with a parrot. I was just wondering if you were my kid."


    A minister sold a mule to a priest and told him that the animal was trained to obey two commands. "Praise the Lord" to go and "Amen" to stop. The priest climbed on board the mule, said Praise the Lord" and the mule set off. The mule began to go faster and faster and the priest began to get worried. He wanted the animal to stop but he couldn't remember the key word. He kept saying "Whoa" but it had no effect.
    Finally he remembered and said "Amen." The mule stopped immediately. The priest looked down and saw that the mule had come to a halt right on the edge of a huge cliff with a 500-foot drop. Wiping his brow in relief, the priest sighed: "Praise the Lord."


    Two men were watching a Western on television. As the hero rode on horseback toward a cliff edge, one of the men said: "I bet 50 dollars he goes over the cliff."
     "You're on," said the other man.
    The hero rode straight over the cliff.
    As the second man handed over the money, the first man looked at it and said: "You know, I feel a bit guilty about winning this because I've seen the film before."
     "So have I," said the second man. "But I didn't think he'd be stupid enough to make the same mistake twice."


Buffalo Rhapsody

Ernesto Yu, M.D.

CIM Class 1973

Stolen Moment

    If you leisurely browse through the English language, there is an excellent statistical probability you’ll score a hit that keeps on throbbing in the words “Stolen Moments”. This lovely pair could bog you down in predictable sentimentality if you equate the catch phrase to an unrehearsed chirp of love in the afternoon or a coincidental whistling of the same cooing serenade in the park. On the other hand, the two words can tap into the upper limits of your fear threshold and manufacture a quivering jelly out of your manic energy if you are abnormally susceptible to spine-tingling terms like “hijack” and ransom notes”.

    At any rate, depending on the mood swing of your hormone clock, stolen moments is an inseparable duo that is here to linger and be an active terminology particle in our daily vocabulary. Unquestionably, it is a byproduct of fresh lingo that currently floods our new millennium psyche.

    Our annual alumni reunion is a downright model of such harmony between an adjective and a noun. For those of us who love to pine for the exuberant remnants of the CIM past, the wondrous yesterdays that we temporarily shove off the shelves due either to diverse personal goals or good/cruel circumstances, our convention soups up a pot of stolen moments for everyone to soak into and sigh, “Yes, this is the life I have been missing!” It is the tantalizing flash in time when we can sieve the charred ashes of wonderfully charming tales under the CIM banner of shimmering sun and glowing moon, to learn to cherish the rhythm in the rain, to distill poetry and melody out of the plain verses and lyrics of genuine handshakes and hugging hellos, to affix back into loveliness the vital ingredient “love” that makes breathing worth the cycle of inhale and exhale. It is the day in the sun for the bored-to-the-bone-with-daily-little-deaths who harbors an unflagging craze for memoirs.

    Personally, it is a marker in my life where I revisit the old heavens for the army of angels I left behind: mentors, heroes, buddies, sweet pals and drool-only inspirations who intermittently inject social dazzle and infuse healing warmth to my reveries of the last 29 years. It is the ultimate “now” to extend to each of these remarkable souls, while time stands still, the singing rainbows that they composed and sprinkled into my skies, and the difference they implanted into my orbit that molded me into what I am today. It is a segment of a daydream where I can amble with species (endangered, extinct and never mind) of the Stone Age along the ancient familiar marching echoes that, once allowed to pulsate, would invariably saturate the airwaves with cracking noises of arthritic joints and smokers’ coughs. Furthermore, it is an encounter where I can trade intro remarks with a breed of younger alumni who populated the CIM campus just when I evaporated from the smooth jazz clouds of the Bee Gees and the Carpenters. Likewise, it is the click of a new beginning to accept welcome whispers from the crawling babies who later inhabited our alma mater when I was already engrossed in cadaver dissection in Manong Ogay’s building.

    For the privilege to be exposed to such stolen moment, I can only wish that a chance meeting like this just doesn’t melt away without imprinting enduring footprints. Traces that will make me yearn, against anything else in this world, to make a habit of flying to our designated yearly July rendezvous even if such remote region (Next year, San Diego) demands almost a day of tormenting hops from one airport to another coupled with nauseating doses of motion sickness. After all, traveling back to a site where old gang regroups, huddles and revives the once-upon-a-time is not registered in my book as a mere summer vacation trip.

    It is a stolen moment to be home.


Did Hippocrates Swear His Oath?

By Wilmo C. Orejola, M.D. Class 1974

    Sometimes I wonder if Hippocrates, the Father of Medicine, really swore to the Oath attributed to him. Some of our modern colleagues swearing to this Oath may find it indefensible and disturbing, especially on the issue of abortion, surgery and euthanasia. But let us study this document that we all pledge with raised hands or hands on our hearts upon induction to the practice of our noble profession.

    Our lives are invariably influenced by the dichotomy of science and religion. Both teachings claim the way to Truth and Enlightenment. Religion is founded on Faith and its truths cannot and should not be diminished and need not be proved. On the contrary, Science arrives at the truth by Doubt, a dogged investigation and critical debate of proof. Nevertheless, mankind from ancient to modern times has become enlightened either way.

    Science is a systematic knowledge of the physical or material world gained through observation and experimentation. In its simplest definition, it is our knowledge of nature. The laws of nature follow order and regularities that the human mind observes and draws conclusion from. While the human mind reflects the outside world, it is in itself limited to what is perceived by the five senses. These observations are subject to pitfalls of interpretations. By and large, man is able to accept what is real or substantive and reject what is not by trial and error. This approach of learning embodies the knowledge of nature upon which man came to rely more accurately for survival.

    Medicine is an art variedly practiced and constantly improved and modified with adroit and sophistication. The science behind it has evolved from dogged didactics and critical attitude of polemics, in order to arrive at the truth. Ideally, medicine strives to achieve results with precision and not giving up to chance.

    Disease has been present even before man appeared in this planet. Evidence has shown inflictions in fossil remains of dinosaurs. Man at first accepted death and disease as part of existence. As life became placid, pain and suffering from disease draw natural and, in more serious cases, supernatural explanations, caused by spells cast by enemies, malevolent incursions by demons or bad spirits, or punishments from an offended god. This required counter spells, potions and incantations to lure back errant soul. At the same time, he also noted the order and regularities of things around him. He could apply certain observations to his advantage and chances for survival.

    Primitive cultures gained knowledge of nature that dictated their way of life. They learned to hunt based on the migratory pattern of birds and animals and plant according to the changes of the seasons. While they looked up to the heavens for wonder and inspiration, they invented some form of calendar for practical and religious reasons. Solar and lunar eclipses and appearances of comets were heavenly phenomena that inspired awe and alarm.

    About ten thousand years ago, Mesopotamia was a tilled, fertile land between the great rivers of Tigris and Euphrates. Five thousand years later they left a legacy in a system of writing called cuneiform by the Sumerians. This cradle of civilization is the origin of the wheel, the arch, uniform weights and measures, the clock dials and the sexagesimal system, which we come to know as present day sixty-minute hour. Later civilization centered in Babylon, Hammurabi set his code of laws which included the practice of Medicine with severe penalties like cutting off the hands of a doctor who kills a patient in the process of opening an abscess and in some cases, if the patient was a slave he was simply obliged to supply the master of another slave.

     Astronomy was the first science to emerge. However, like the Egyptians, the Chinese, the Indians, the Mesopotamians and the Mayans, astronomy was welded to religion. Religion had the answer to all vicissitudes that fell upon the people. The Babylonians believed that order exists only when the capricious gods supported it. These people described nature and use it, but religious proscriptions prevailed upon critical thinking.

     While theology attained its highest importance among these cultures, the Greeks had their gods and goddesses in foolish childish flings with mere mortals. The Mycenaean values and events, while passed along by poets like Homer, did not attain the highest esteem accorded to the Egyptian God or Jehovah. This became a fertile ground for the Greeks to seek reasonable explanations of natural phenomena not merely arbitrary will of the gods.

    In 6th century BCE (Before Current Era), the Greeks supplanted theocracy of other civilizations with teleology – the doctrine that phenomena are guided not only by mechanical forces but that they also move toward certain goals of self-realization. The first of these natural philosophers, notably Thales of Miletus, predicted a solar eclipse in 585 BCE and invented the formal study of geometry. He named water as basic element of all matter but was quickly criticized by his disciple Anaximander, who argued that water is essentially wet; therefore it cannot be a basic element because it contradicts itself. Two hundred years later, natural philosophers accepted four basic elements: earth (cold and dry), fire (hot and dry), water (cold and wet), and air (hot and wet). All bodies were made from these elements. This critical thinking and the art of disputation laid the fundamentals of science we know today.

    The Hellenic tradition of science peaked during the time of Aristotle and Archimedes. A biologist, Aristotle studied marine organisms and its teleological existence. This work was the framework of the science until it was challenged by Darwin’s On the Origin of Species by Means of Natural Selection, or the Preservation of Favoured Races in the Struggle for Life, published in 1859. In living organisms it is easy to understand the doctrine of teleology, since the organism has its primary function of self-preservation and self-perpetuation. In physics, this is not so obvious. To impose the doctrine to the cosmos, he had to borrow from his teacher Plato, the theological proposition that heavenly bodies are literally divine and, therefore, perfect. They all moved in eternal, unchanging perfect circles. In the divine schema of the universe, the Earth, being inert and imperfect is at the center. At various levels of concentric crystalline spheres are the moon, the sun and the cosmos. Outside the cosmos is prime, unmoved mover God, the ultimate cause of all motion. This philosophy obviously borrowed from the Greeks epitomized the religious teachings adopted by the Romans and subsequently Constantine’s adoption of Christianity, notwithstanding the critical Greek thinkers that constantly challenge the dual nature of Jesus Christ as God and Man.

    In the 5th century BCE, Greek natural philosophers, notably Hippocrates and his school at Cos, established precepts from the treatment of diseases to professional conduct by physicians. They insisted that disease was a natural, not supernatural, phenomenon. It challenged the practice of casting spells, prayers and propitiatory measures to a malevolent demon or offended god. The art of healing was elevated to standard of care that has been adapted even to the present times.

    The Corpus Hippocraticum embodies the practice of Medicine during this period. In 4th century BCE Ptolemy assembled at the Library of Alexandria this collection of about seventy-two books and fifty-nine treatises by different authors from Cos, Cnidos, Sicily and elsewhere. It is virtually impossible to determine authorship. Hippocrates, historians argue, refers to Hippocratists or Hippocratics, who by their written contributions shared their knowledge of Medicine for generations.

     The Collection dealt with varied topics that may be difficult to classify as one would browse through the pages of a scientific journal. However, general beliefs could be categorized into different fields of study like anatomy, physiology, general pathology, therapy, diagnosis, prognosis, surgery, obstetrics and gynecology, mental illness and ethics. Most famous in the Collection is the testament that affirms and prohibits certain norms of conduct of the physician. 

    Like the rest of the world for centuries, I as a graduating medical student swore to the provisions in the Hippocratic oath though in a modified and abridged version. Some of the provisions including abortion and surgery have become less relevant in our times. However, the substance and the spirit of the pledge remain sublime.

    An English translation by Ludwig Edelstein from the original text of the Hippocratic oath states:

    I swear by Apollo Physician and Asclepios and Hygeia and Panacea and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

    To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art – if they desire to learn it – without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but to no one else.

    I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

    I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

    I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

    Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief, and in particular of sexual relations with both female and male persons, be they free or slaves.

    What I nay see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must speak abroad, I will keep to myself, holding such things shameful to be spoken about.

    If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

    Scholars have questioned the relevance of the Oath even during the time of Hippocrates. It is at variance with some teachings of Hippocrates like abortion and surgery, which were widely practiced. Thus, it was unlikely that physicians at Cos swore to such untenable interdictions. It is believed that the Oath was Pythagorean in origin but was incorporated to the Collection centuries later. Pythagorean philosophy abhors taking of life within or outside the body, and advocated against any form of surgery, even bloodletting, for they desecrate the soul.

    The earliest reference to the Oath goes back to the first century CE (Current Era, formerly referred to as A.D.) when Christianity prevailed upon religious ideals of the time. Christian doctrines even today incidentally are consistent with Pythagorean philosophies in abortion and surgery. This probably explains why this non-Hippocratic document has remained firmly the symbol of a physician’s pledge to his calling.

    In a present scenario, a pro-Choice health care provider may find swearing his Oath quite untenable and unsettling. While this debate is fueled by a dichotomy of conscience and reason, ergo Religion and Science, we tend to be influenced by the prevailing forces of the time, exemplifying a non-Hippocratic Hippocratic Oath. Did Hippocrates swear his Oath? Maybe not. Yet this document has been sworn to innumerable times and innumerable times it has been breached.

    The most notable part of the Oath is the pledge to act in purity and holiness. The pledge to conduct oneself in a way considered appropriate behavior of a physician is in essence the Hippocratic Oath. Invariably this speaks of humankind transcendent of national identities and religious following for all times. The incorporated interdictions on abortion, surgery and euthanasia are variables in the changing practices of the art of Medicine. 

Suggested readings: 1) AS Lyons and RJ Petrucelli, Medicine, an Illutsrated History, Abradale Press, New York, 1987; 2) Science and Religion, Macropaedia, Vol. 27, The New Encyclopedia Britannica, Chicago, 1992.



Friends and Friendships…

by: Marie Belen C. Flores-Rosales, MD MPH

    Some few months ago, for some unexplained reason, I had the compelling urge to tidy up my closet, rummage through boxes that were tucked away for years, went through old photographs all yellowed with age, and high school and college yearbooks all covered with dust. I must be getting old, I thought, for becoming this sentimental, feeling the need to reminisce my youth and the friends I knew.

    Each photograph I looked at told a story and my time machine brought me to as far back as I could remember. I saw the faces of friends, a few are still here, but most are long gone. Along the way, I saw some disintegration of alliances, not romantic relationships, but simple clean ordinary friendships. I know the sound of friendships breaking as I have heard its lonely echo quite a number of times. For a great number of them, the drift was smooth and casual; but for some special ones, the drift became debilitating that cut through the core of my being.

    I had a friend in my childhood I was so particularly close. As we were growing up, I was busy building my life and she was with hers. Our individual growths brought us to different vibrations and by doing so, we crossed psychological boundaries where choices begin to assert themselves. As I pursued a career different from hers, there was a natural shift in my interests and my priorities. While I did not feel the need to explain myself to her, I felt the pressure of a friendship where expectations, though unspoken, were thrust to your face like the sword of Damocles. I met her again, after 38 years. I was genuinely happy to see her, and I think she was, too. Both of us made the effort, but it just wasn’t the same. For a while, I tried to sustain the friendship and keep the calls going – but the expectation that I had to reshape myself to where I was 38 years ago became exhausting. Unfortunately, or maybe fortunately, I have changed and have expanded in several directions, and it has become a monumental struggle for me to change myself back in order to accommodate this friendship. I still cherish her in my heart, I still cherish the fun memories, but the friendship has to end, and it hurts. There is a different kind of sadness inside, but there is no guilt. I just needed to let go.

    On the other hand, I developed a friendship that started in a refugee camp in Kompong Som, in Cambodia in 1973. It is a friendship born without heavy expectations, a friendship so genuine, so true that survived 29 years of intermittent interaction. Communication between us is very sporadic as we are constantly geographically on different sides of the globe. He was in Egypt when I was in Thailand, he was in Lebanon when I was in Peshawar, he was in Angola when I was in Kermanshah, he was in Russia when I was in Haiti, he was in Baltimore when I was in Yuma. Now he is in Khyrgystan and I am in San Diego. I talked to him last month, after 4 years, when he called from Pakistan. That conversation was very fluid and so spontaneous, no gaps as we just took on from where we left off the last time we talked. That, to me, is friendship.

    There are friends who journey with us the entire way. There are also friends who fade in and fade out of our existence., and are better left behind. I have friends from yonder whom I remain close with in spite of the years and distance, in spite of changes in spiritual direction and personal philosophies. These are the friends who remain my friends, who I respect for what they are, and who respect me for what I am. In a friendship, there is no bad or good. In a friendship, there is no right or wrong. In a friendship, we are all, and we should be, where we need to be.


    Editor's Acknowledgement: Thanks to Dr. Ernie Yu of the class 1973 for sending the beautiful pictures above of the tulips and the windmills he personally took when he went to Holland few months ago. Looking at the windmills, initially I thought I've heard a background song, "To dream the impossible dream..." I began to wonder that perhaps my good friend, Ernie, was looking for the armor of Don Quixote to carry on his fight. It would have been nothing more that a piece of cake for Ernie. All Ernie would do is pass some gas and put the enemy to sleep. Thanks again, my friend.