In the media, doctors in the philippines are making headlines due to their mass exodus to work abroad as nurses. In this particular article which I read in the Inquirer, a top surgeon who was making P100,000 a month still saw it difficult to stay in the country and decided to work abroad as a nurse. Sorry, but I don’t believe the pathetic BS about his decision not being about the money. It is always about the money. Why even bother to mention the amount, anyway? $4,000 a month is a lot if you convert that amount to pesos. But if you live in the States, you will spend dollars – like everyone else. It’s the standard of living in the country and one’s personal lifestyle that dictates how much one can save.

Can’t say I blame the doctors at the lower end of the food chain, so to speak, for wanting a higher pay and better life for themselves and their loved ones. But what’s this so-called “top” surgeon who’s earning 100k a month, and still wanting to leave? I don’t get it. Why is it that inspite of the unique opportunity to serve his countrymen, to become great by making the ultimate sacrifice of forsaking his dreams in order to serve his countrymen, the lure of the great American dream ultimately proved to be too strong to resist? I can almost understand if he were to move elsewhere in order to improve his status, like to be the best surgeon in the best hospital in the world. But to be a nurse? No offense to our great Filipino nurses, but for a top-rate surgeon to give up his status in the country, and to take on a job which he is clearly overqualified for is evidence of how low our morales have sunk. Where is the striving for greatness? Is this the kind of legacy we would like to leave to our children and our future?

When I was about to graduate from high school, I had to make the critical decision of what course to take. My family was not rich, and if there was any straightforward way that I could help alleviate our condition, it was to take a course that would ensure the biggest economic gains after graduation. Back in the latter part of 80’s, the high demand for nurses abroad was already in full swing. And indeed, most of my female classmates eventually took up nursing, a fact that to me now is really ironic, given that we were educated in science-based curriculum. Of course I do not know their personal circumstances, like if they were pressured by their parents or peers. What I do know is that I myself had been through a similar kind of pressure. I was strongly advised to take up nursing, or even physical therapy or medical technology. I knew that if I did so, I would be ensured of a high-paying job, however not in the Philippines, but abroad. But deep inside I knew in my heart that I had to strive higher, to dream, to aspire for greater things. I knew in my heart that money could only get me so far, and even if in the eyes of my family I would be great because of my economic contribution, I would be denying myself the opportunity of harnessing my fullest potential. I knew from the start that I wanted to be involved in the sciences. I decided to take up Physics, although at that time I thought that the most I could be was to be a teacher or lecturer in a university after I got my degree. I didn’t know that it would actually be my stepping stone for a lot of other things that happened in my life. Fortunately, although my Dad could barely comprehend this obscure subject, he was all-out support for me. He trusted my judgement. He could barely put me through college, but not once had he told me that money was to be my ultimate goal for my education.

As my favorite columnist, Conrado Dequiros, once wrote: “…the role of education is to educate.” It is to expose our fertile minds to the rich, vast knowledge that has been accumulated by man since the dawn of time. It gives us a chance to stand upon the shoulders of the great thinkers of our time and look out toward the infinite possibilities ahead.

And most of all, it gives us a chance to conquer mediocrity and strive for greatness.

“SPVC,” the doctor said. “Supraventricular, ahm…contraction. I’ll go look up what “P” stands for,” he added in Japanese. Actually, he didn’t have to. I knew what the word was. I have already done my homework. Cautiously I suggested that the word was “premature.” Still, he left the room and came back with a dictionary. “Ah, here it is. Premature. Supraventricular premature contraction. Esu-pee-bui-shee.”

Long before I went back to the hospital for my last and what I had hoped to be my final consultation with the doctor, I have already made my self-diagnosis. Since my so-called “attack” last month (Oct. 2), I have been acutely aware of my heartbeat, and I could feel every heart flutter, every day. Some days are quieter than the others, some days are marked by just too many flutters. It feels like a pause in my heartbeat, followed by a sudden flop feeling. If I feel my pulse, it would seem as if my heartbeat stopped, followed by a rather heavy beat. There are no other symptoms whatsoever.

Premature ventricular contraction on ECG.

All the tests came out normal. W. N. L = within normal limits. Aside from the ECG, blood test, x-rays performed at the ER, during subsequent visits I also had the 24-hour Holter monitor and heart ultrasound. The holter monitor is actually a cool gadget which records the heart’s electrical activity, a 24-hour ECG on-the-run. I wore the recorder on my belt as I did my daily chores. As it turned out, based on these tests, my heart is structurally sound, with really nothing to worry about.

Premature contractions may either be classified as atrial or ventricular in origin, hence the acronyms “PAC” for premature atrial contractions, and “PVC” for premature ventricular contractions. I couldn’t quite find enough resources on “SVPC”, but I could only suppose that it is also ventricular in origin, the term “supra” involving an area further up the ventricles. Here is a good description I found on the internet:

Ectopic heart beats are common but they are abnormal only when they occur at a frequency of more than 1 in 10 beats. Premature contractions may be of atrial (much more common) or ventricular origin. Immaturity of the conducting system may be the origin. The diagnosis is made by passing an M-mode cursor through one atrium and one ventricle. Premature atrial contractions are spaced closer to the previous contraction than normally and may be transmitted to the ventricle or blocked.

Premature ventricular contractions present in the same way but are not accompanied by an atrial contraction. Premature ventricular contractions are often followed by a compensatory pause due to the refractory state of the conduction system; the next conducted impulse arrives at twice the normal interval, and the continuity of the rhythm is not broken. Premature atrial contractions are usually followed by a non-compensatory pause; when the regular rhythm resumes, it is not synchronous with the rhythm before the extrasystole. The distance between the contraction that preceded the premature contraction and the one following it is not twice the distance between two normal contractions but a little shorter. Another approach to the sonographic diagnosis is to evaluate the waveforms obtained from the atrioventricular valves, hepatic vessels or inferior vena cava, which demonstrate pulsations corresponding to atrial and ventricular contractions.

I asked the doctor many questions, if only to annoy him because I waited for too long to have his final diagnosis (it took a month, by golly!). During my first consultation with him he actually said that my condition might be “WPW,” or Wolf-Parkinson-White syndrom, based on the ECG results taken earlier. I was mulling this new acronym over while waiting for my papers at the lobby when he called me back again to his consultation room. Well, he took back everything he said earlier, apologizing for unnecessarily making me worry. Apparently he consulted a cardiologist in the hospital and was told that my ECG was normal, and “WPW” was just “kangeinikui” = unthinkable. I heaved a sigh of relief.

Anyway, most of his replies mostly confirmed what I already knew, from my readings on the internet. I guess I just wanted to be reassured. But there are a few hard facts to swallow:

1. This condition is untreatable. I could take beta-blockers if I wanted to, but I don’t want to f**k with my heart, not if I can’t help it.

2. Once diagnosed, it’s here to stay.

3. I was probably born with it. There are no known causes, except that which is already inherent in the heart’s structure. I know that Daddy also experienced irregular heartbeats. But the doctor assured me that it’s not always hereditary.

4. I am still trying to verify this, but a lot of my readings tell me that caffeine is one of the triggers, among other things like stress, alcohol, etc. I’ve been purged of caffeine for almost a month now, and still I get the flutters. I am still unsure of whether to shun coffee for the rest of my life.

PACs and PVCs have not been associated to a higher mortality rate among healthy individuals. Interestingly, the doctor mentioned that feeling the premature contractions could actually be psychological. He pointed out that while I reported feeling the flutters mostly at night, my holter results showed that most of the premature contractions occurred during the day, when I am mostly busy with other matters. At night, when I lay down to sleep, that’s the time I feel the contractions more because I am not preoccupied with anything else. It’s much like saying, it’s all in my head. Well, that’s what I’ll try to do from now on – try not to think about my heart too much. Ok, I’m writing a blog about it, but it’s a different thing. 😛

A wake up call? Maybe. It’s easy to relegate health down the bottom of our priorities, until it gives us a tug (at the heart, in my case, har har har) But it is definitely high time to start taking care of myself better.

I’ve been attending ISS (International Symposium on Superconductivity) since 1998. This symposium, organized by ISTEC, is held annually in Japan. This year, though, happens to be a rather special year, because for the first time, members of the CMPL (Condensed Matter Physics Laboratory) in NIP (National Institute of Physics), UP Diliman, had also participated. One of them happens to be my former adviser, Dr. Roland Sarmago. Somehow I knew that sooner or later we would meet in one of the scientific meetings on superconductivity, but never did I think that we would actually “converge” right here in Tsukuba. The first time I met a fellow Pinoy in ISS was way back in 1998 — some guy who was taking his PhD in Hokkaido University. Funny, I never saw him in the succeeding years. I envy the Indians, Chinese, and Koreans, who always manage to find their fellowmen in conferences like this. For the longest time I thought that I would be the only Pinoy representative. Until this year, of course. And I am so proud of them!

Anyway, Dr. Sarmago was surprised when I told him, “Do you realize that it has already been ten years since I left UP?” Has it really been that long? One thing I know, though, is that hadn’t been for CMPL, I would not be here. Dr. Sarmago was very instrumental in the shaping of my career path. My first ever paper, published in 1995, was the result of our efforts on the combustion method of preparing bulk superconductors. If that first paper had not been published, I doubt very much if I would still be working on supercon. I doubt it very much that I would even get the opportunity to come to Japan.

Reunited after 10 years. This photo was taken while touring the cleanroom (hence the Boysen-paint outfit), where I showed them our PLD systems. From grinding oxides to depositing thin films, yes, boss, I’ve come a long way!

One particular highlight of their visit to Tsukuba, aside from the ISS of course, was to actually listen to Prof. Alex Muller’s lecture at AIST. Alex Muller, to those not familiar with the name, is a Nobel Laureate. He was awarded the Nobel prize, together with George Bednorz, for discovering high-temperature superconductivity in the La-Ba-Cu-O system. It was their work that spurred the fervent research on superconductivity in the latter part of the 1980s. In the poster prepared by the organizers, his photo bore the caption, “Kouon Choudendou no Chichi,” which literally means, “The Father of High-Temperature Superconductivity.” But I guess that is only half-correct. The other “father,” Bednorz, seems to have abandoned superconductivity altogether and is probably working on a different field. So I guess there would not be any opportunity to see him in any supercon-related conferences.

The first time I saw Prof. Muller was in Vienna, where he delivered a special plenary talk during EUCAS. In a later session, finding no other seats readily available (it was difficult to get into the seats in the middle because those sitting near the edge had to stand up), I saw an available seat which happened to be right next to Prof. Muller, who was sitting at the second to the last seat. Well, I thought, it wouldn’t hurt to sit beside him, after all, I’m a nobody, he could go right ahead and ignore me, haha. However, as soon as the current speaker was finishing his talk, Prof. Muller turned to me and said, “You can go and sit inside (gesturing to the empty seats towards the middle)…I will disappear in a while.” Then he stood up and allowed me to pass. I smiled at him and sat maybe three seats away from him. I’m pretty sure that he would not – ever – remember that incident. But for me, I will always have that anecdote treasured in my heart. Frankly, I was “this close” to asking him for an autograph. I had to try very hard to contain my Pinas-bred fan-feelings for the man who was responsible for the field I fell in love with.

Interesting trivia: Muller was 60 years old when he was awarded the Nobel prize in 1987. Right now I’m just about half his age then. Kaya may pag-asa pa ako sa Nobel! 🙂