BOREDOM 101 Lesson1- Learn a Song

After unsuccessful attempts to put myself to sleep, I've found myself in front of my laptop, my camera, and my guitar. I was bored.

To address this annoying issue of unused time, I decided to learn a song (find out the whole thing for myself- no aids, no tabs, no sheet music- just the song.) on my cheap-ass electric guitar. I came across Jinky Vidal (a Filipino pop/rnb artist) on youtube and she sang a nice rendition of Angela Bofill's "Tonight I Give In"...Cheesy? Yes. But screw it, the rhythm simply captured me I had to listen to it multiple times. I love this song!

THIS IS NOT AN IMMACULATE RENDITION OF THE SONG. YOU WILL ENCOUNTER UNPLEASANT SOUNDS AND OFF-NOTES. It's just practice playing, after all.

Welcome to the first of many lectures in my new class, BOREDOM 101. I am your professor. Enjoy.

Can't Go To Sleep

This is killing me
3am and still awake.
Tomorrow, I intend to flee
Things to do. I can't be a flake.
Procrastinated during the break.

Melatonin might help me
Taking it won't kill me.
Eights hours I'll be down.
But wait, 3-11?
I planned a long day, and so I frown.

Whatever. I wanna sleep now.

Needlestick

"Bro, go back to bed 16. I'll cover you here."

"Yesss!" I told myself. I haven't seen a chest tube insertion before and It's time I learned to how to assist in one just so when the rare occasion arises, I'd be ready.

Our patient, a gentleman in his early twenty's, has pleural empyema (accumulation of pus in the pleural cavity). It is important to drain the pus via chest tube drainage. If it doesn't work, then surgical intervention is necessary- a thoracotomy (yes, open the effin thorax!).

The tray was set-up and Melissa was already assisting Dr. X, one of our respected Cardiothoracic Surgeons. Shiet. Now what? I was hoping I'd get to do it this time. I wanted the action! And it seems like I missed 1/3 of the procedure...dammit. The patient has already been anesthetized. At least the surgeon hasn't stuck the tube in yet. Oh well.

Luckily though, I wasn't assisting him. As Dr. X was looking for a smaller scalpel, he buried his hand into the tray, and bam! Lo and behold- the syringe he used for anesthesia-was stuck to his right thumb. He threw the damned syringe. Picked up another instrument and slammed it into the tray. Picked up another. Slammed it into the tray. My face turned pale. The guy was mad. I hope I don't have a scalpel stuck to my forehead.

Melissa shrugged. And the beast in Dr. X. was unleashed. "That wasn't funny. I'm on Chemotherapy!". The crowd went silent. "Order an HIV antibody test!". The nurses scrambled to kiss his ass.

Oh holy snaps. The poor surgeon is recovering from cancer. Hence the absence of his hair. Hence his long absence in the hospital. Hence the absence of his temper control. Wow...

Worse, a 28 and a 32 size tube didn't drain anything. He scheduled an emergency surgery right away. This guy has to work against his physical condition, the pleural empyema that the young man is suffering from, and the uncertainty of this potentially fatal mistake.

I hate being philisophical at work but this is one time where I had to step out to the smoking area and ponder the severity of the circumstance. What's gonna happen to Dr. X? Now that he's immunocompromised, a potential opprtunistic disease is within the horizon. More importantly, I thought of myself. I thought of the risks-including my own life- that comes with this chosen profession. I thought of the challenges that one has to undergo, especially that of foregoing important personal issues to be able to address a stranger's immediate needs. It seemed too much. It seemed too taxing. It seemed very heavy.

I stepped back into the ER. After a brief conversation with myself, I thought...

"It's just a needlestick. It happens...This cannot stop me from keeping my calling. This cannot stop me from saving lives. This cannot stop me from getting my MD".

Nine more hours and it's time to go home.

"The One That got Away": Hmmm...Does This Sound Like Bull?

Ciara, a friend of mine, sent me this. Thought I'd share it to everyone.
Credit goes to whom it is due.

People, feel free to tear this apart. My comments section are open.

My take: a great literary piece. Very catchy and well written. No wonder it became popular. The ideas of the author are clear, concise, and well-developed. A great thing to read in the office or when you're bored.

Oh, and the message? Hmmm...whatever.

The one that got away

In your life, you'll make note of a lot of people.
Ones with whom you
shared something special, ones who will always mean
something. There's the
one you first kissed, the one you first loved, the
one you lost your
virginity to, the one you put on a pedestal, the one
you're with...and the
one that got away.

Who is the one that got away? I guess it's that
person with who everything
was great, everything was perfect, but the timing
was just wrong. There
was no fault in the person, there was no flaw in the
chemistry, but the
cards just didn't fall the right way, I suppose.

I believe in the fact that ending up with someone,
finding a longtime
partner that is, does not lie merely in the other
person. I can actually
argue that an equal part, or maybe even the greater
part, has to do with
the matter of timing. It has to do with you being
ready to settle down and
commit to someone in a way that goes beyond the
little niceties of giddy
romance.

How often have you gone through it without even
realizing it? When you're
not ready to commit in that mature manner, it
doesn't matter who you're
with, it just doesn't work. Small problems become
big; inconsequentials
become dealbreakers simply because you're not ready
and it shows. It's not
that you and the person you're with are no good;
it's just that it's not
yet right, and little things become the flashpoint
of that fact.

Then one day you're ready. You really are. And when
this happens you'll be
ready to settle down with someone. He or she may not
be the most perfect,
they might not be the brightest star of romance to
ever have burned in
your life, but it'll work because you're ready.
It'll work because it's
the right time and you'll make it work. And it'll
make sense, it really
will.

So that day comes when you're finally making sense
of things, and you find
yourself to be a different person. Things are
different, your approach is
different, you finally understand who you are and
what you want, and
you've become ready because the time has truly
arrived. And mind you,
there's no telling when this day will come.
Hopefully you're single but
you could be in a long-term relationship, you could
be married with three
kids, it doesn't matter. All you know is that you've
changed, and for some
reason, the one that got away, is the first person
you think about.

You'll think about them because you'll wonder, "What
if they were here
today?" You'll wonder, "What if we were together
now, with me as I am and
not as I was?" That's what the one that got away is.
The biggest "What
if?" you'll have in your life.

If you're married, you'll just have to accept the
fact that the one that
got away, got away. Believe me, no matter how fairy
tale you think your
marriage is, this can happen to the best of us. But
hopefully you're
mature enough to realize that you're already with
the one you're with and
this is just another test of your commitment, one
which will just
strengthen your marriage when you get past it. Sure,
you'll think about
him/her every so often, but it's alright. It's never
nice to live with a
"might have been," but it happens.

Maybe the one that got away is the one who's already
married. In which
case it's the same thing. You just have to accept
and know that your
memories of that person will probably bring a nice
little smile to your
lips in the future when you're old and gray and
reminiscing.

But if neither of that is the case, then it's
different. What do you do if
it's not yet too late? Simple...find him, find her.
Because the very
existence of a "one that got away" means that you'll
always wonder, what
if you got that one?

Ask him out to coffee, ask her out to a movie, it
doesn't matter if you've
dropped in from out of nowhere. You'd be surprised,
you just might be "the
one that got away" as well for the person who is
your "the one that got
away."

You might drop in from out of nowhere and it won't
make a difference. If
the timing is finally right, it'll all just fall
into place somehow and
you know, I'm thinking, it would be a great feeling,
in the end, to be
able to say to someone, "Hey you, you're the one
that almost got away."

Looking Back- The King-Drew Medical Center Closure

I remembered writing this for one of my classes. This was my take on the chaotic turn of events for King/Drew Medical center. It has been a while since this has happened, but it's worth pondering. Now, what is the aftermath? What did our health authority do about this?

Feel free to refute, verbally abuse, condemn, or commend me.


To Close King-Harbor or Not

After a series of management mishandlings, clinical practice errors, unmet minimum care standards, and a lot of unhappy people, Martin Luther King Jr. - Harbor Hospital had to be shut down for an indefinite period of time.
The Los Angeles Times editorial article on August 15, 2007, a few days before the finalization of the closure, commented on and justified the then-impending closure of the said institution. It seemed that the Los Angeles County Board of Supervisors has failed to use its wealth of resources and extreme capability to save King-Harbor Hospital and the needing communities of South Los Angeles. The people in charge of the ill-fated center demonstrated poor competence in running hospital operations. Clinicians and practitioners have been practicing below good standards of care. This unfortunate chain of incompetence leads down to the patients and the community- the ones who will end up suffering most of the blow.
The persons who possess the power to close the hospital were not even able to exercise this authority totally when it seemed fit. “They instead play games with the very definition of "to close." Half the staff of 1,600 remains on-site, on the job, at outpatient clinics and an urgent care center. Capacity to perform surgery is being expanded”(“Close King-Harbor”). In essence, the said medical center still operates even though it is doing a lot less than it used to- and probably committing the same mistakes on a smaller scale. The county supervisors are now looking for a private purchaser with strong hopes of coming back as a full medical center in less than two years. Technically, King-Harbor is not really closed at all.
Dealing with the internals of the institution, particularly concerning patient care, there have been a lot of accounts pertaining to poor clinical care, medical malpractice, and staff incompetence. “Just walking into the building, inspectors saw that patients were in immediate jeopardy. Further probing showed that staff failed to track records, properly mix medicine and sterilize equipment”.(“Close King-Harbor”). There was also one incident as specified in The Los Angeles Times that during one of the hospital’s major inspections, a patient who at that time were writhing on the floor for almost an hour was just ignored by the nurse. There also have been numerous accounts of misdiagnosis and maltreatment of patients that have occurred in King-Harbor’s “treatment” phase.
On management issues, the said article presented its concerns on the hospital executives being more focused on corporate issues rather than the much-needed medical care the institution have originally stood for. “It is painful to say it, but the truth is that preserving an African American-run institution took precedence over providing competent care. The interests of staff came before the needs of patients.”(“Close King-Harbor”).
The points seem to be convincing and rhetorically powerful. However, in reading the article, one may find that some, if not most, of the arguments point to very particular instances that are existent in other successful medical centers- which doesn’t really back up the argument for justifying the closure of the institution. Concerning the patient lying on the floor for over an hour and the nurse ignoring him/her- did the inspectors know about triage (where patients are seen in order of the nature and urgency of the disease/injury)? Probably the patient was just having abdominal pains without other severe symptoms accompanying it- digestive problems fall on the lower priority on the triage. On medical malpractice and errors, King-Harbor is a teaching hospital. Errors like these are a commonplace in the medical community, and these clinicians are not robotically perfect. There are disciplinary actions for these incidences that are hidden behind curtains to the commoner, such as Surgical Service Reports, Morbidity and Mortality Conferences (M and Ms), and attending physicians putting the erring clinician in the hotspot, constantly testing its knowledge and skills, known in the medical community as “pimping”.
Concerning management issues, the point that “…preserving an African American-run institution took precedence over providing competent care” is really ambiguous. Are they implying that the corporate ladder took precedence over patients or are they implying something else with regard to a particular ethnic background?
Thomas Scully, then-administrator of federal Medicare and Medicaid programs and presently a Washington law firm senior counsel, contradictorily thought about the issue. In the June 15, 2007 issue of the Los Angeles Times, he claimed that closing the medical center is not the answer.
The problems that King-Harbor Hospital was facing were no different than any other inner-city hospital. Economics, being one of the major problems, would be very difficult to run in a medical center serving mostly uninsured and Medi-Cal patients. “The LA system is almost totally funded by the federal government, and, with that support, L.A. has to deal with the hand it has been dealt — and make the most of it.”(Scully) Given the ample financial capability of the government, successful operation of the hospital is really possible. It just seems that the said medical center does not receive the amount of funding it deserves. Scully also pointed out that King-Harbor Hospital should try to pattern itself to various city hospitals in similar-situation places. “There are many different big-city models to look at… Jackson Memorial in Miami and Grady in Atlanta are huge public hospitals in very poor neighborhoods that do a pretty good job of saving lives, and I would feel confident there as a patient. Philadelphia has no public hospitals yet serves at least as tough a population through private hospitals that get public support and provide great care.”(Scully) King Harbor has a lot of “mentor” hospitals in this case then, and it seems fit to have its administration imitate or at least seek help from these thriving systems. The mere fact that if these big urban medical centers- with situations similar to our dying local hospital- can handle the work, then so could King-Harbor too.
Keeping King-Harbor is extremely important since it is, unfortunately, the only best health care access for the urban underserved in the area. Although Saint Francis Medical Center, a level II trauma center, in just in nearby Lynwood, King-Harbor is a public hospital and it thereby caters more to the uninsured and the poor. The medical center is also significant in medical and allied health population, housing the prestigious Drew-UCLA medical program and the Charles Drew University training programs for allied health. Shutting down the hospital means shutting down a great community resource.
“The best thing for patients is to stop looking for blame, apply the best ER Band-Aid available to King-Harbor and get back to fixing the whole L.A. public hospital system.”(Scully) By saying this, Scully made recommendations-channel more of Los Angeles County’s financial resources to the medical center, downsize the Hospital more hence making services more controllable and efficient, and stop pointing fingers.
Analyzing Scully’s perspective on the issue brought an optimistic light to the matter. As empowering and hopeful his arguments seemed, his points, in general, are vague and somewhat introduces red herrings. How could King-Harbor possibly model itself to other big urban underserved hospitals when those mentioned are operated by different leaders with different objectives, located in different environments with possibly an entirely different underserved population, and enjoying financial and community resources different from what we have in Los Angeles? How does him bringing up what he did to Greater Southeast Hospital in Washington help King-Harbor if that very idea has not been tried out in this problem? What did he mean when he said “Given the situation, the best the federal government can do is to poke, prod and push the hospital — and the county — to improve.”(Scully)? His recommendations were not really specific- they would of course apply to similar hospitals with similar conditions. None would cater to the particularities of this chaotic situation that is King-Harbor Hospital.


Understanding and analyzing both sides of the issue helped me shaped my prior convictions into an educated and well thought-of stand. Empathically reading and actively doubting the articles gave way for a deeper analysis of the issue at hand, especially with the intricate particularities in each perspective.
Taking a stand on the matter, as blunt as it may seem, considering the harsh and chaotic situation King-Harbor Hospital is in, it would be reasonable to close it. Completely cease operations. Period.
Defibrillate the chaotic cardiac rhythm in the Los Angeles County Public Health system that is the Martin Luther King Jr.-Harbor Hospital. Why? The institution has humiliatingly failed inspections and supposed “makeovers” over and over again. This just implies that the hospital just did not improve and implementations for renovation were simply ineffective. It became a total waste of resources. The same people trying to make desperate changes are the same ones that have been part of the demise. Same ideas will be surmised, and they are the same nonproductive ones. There has to be some new, better light in the administrative heads hence shedding fresh, effective, and more responsible planning and implementation. Current operations are causing more harm than help to the community. Much needed services are being provided ineffectively and inefficiently. Medical education and patient care in the institution is becoming counterproductive, jeopardizing quality physician and health care professionals’ education and experience and straining community access to public health services.
Closing the hospital does not necessarily mean curtailing the much-needed health access for the local urban underserved population. There are a lot of things to do for this community in dire need of quality health care, and there are myriad ways to deal with the transition period between the closure or King-Harbor and opening a new institution.
A good recommendation would be to start fresh with a new culture, a total rebirth. “It would be ideal to create an independent committee outside the bureaucracy to assess what really went wrong and to oversee the construction of a new policy to minimize medical errors, improve patient care and to restructure the operational system. Hence, a better medical institution” quoting Omar Hernandez, a UC Irvine pre-MD/ pre-MPH student. It would be a really wise move to learn from successful and experienced models and integrate them for a while in the system, just like what the county is planning to do- find a private partner institution and take the new King-Harbor under their wing. Or if it would be feasible, have administrators from other hospitals get together and re-form a new medical institution. Another part of the solution, concerning patient care and clinical standards, would be to hire and get more faculty appointments from accessible top-tier medical schools like The David Geffen School of Medicine at UCLA and The Keck School of Medicine of USC to advance and to further residency training programs as well as push patient care to its optimum.
As for the moment, an urgent care center is just enough to temporarily provide basic family medicine and public health services. The county should also develop a better transport system to channel needing patients to nearby hospitals for more specialized care, and it seems also necessary to increase emergency medical system access to the area- more ambulances, more paramedics, and more stations- in order to provide for prehospital emergency care in a trauma-abundant community. Probably another good community resource would be active student-run clinics from Charles R. Drew University of Medicine and Science, UCLA, USC staffed with enthusiastic soon-to-be doctors and allied health professionals who would be more than happy to provide care for free. It would also be good to have more frequent and more comprehensive health fairs.
Simply put, close King-Harbor. Build one that would be better able to address the needs of the urban underserved community.

Sound Bits

Clair Marlo's 'Til they take my heart away...enjoy

Sound Bits

I learned this song when I was at Guitar Center Cerritos. There's this bossanova guitarist that happened to be there, and I played along with him. He probably enjoyed the mini-jam session and he ended up sharing jazz guitar techniques, including this song.

Sound Bits

The way you look tonight...enjoy!

Sound Bits

I was drunk and I had my guitar around...So I played part of "Someone to watch over me".
Want to hear the entire song? Good luck.

Enjoy!

What's Up With Liquor?

What is up with liquor? I'd like to look at it from a physiological perspective...Yes I am fucking drunk while typing this. So understand if I make errors. Or go F yourself.

Take for instance the substance of my choice, Jack Daniel's. In what way(s) is it similar to a neurotoxin? I have noticed a slight paresthesia in my laryngopharynx upon consuming 3 12oz. glasses of heineken and my first shot of JD with iced tea (there's no Coke in my fridge, so fuck off) alongside the compromised balance and noticeable drop in respiratory rate my fucking midbrain should be concerned about... let's wiki the contents of this absolutely wonderful liquid....

Wikipedia has no uselful facts about it! I need the chemical composition! Let's try something else...

So it's 40% alcohol by volume. If you know what that means. Vol by volume, idiot! Learn general chemistry!

Let's check this site...credit where it is due: http://chestofbooks.com/food/beverages/Adulteration-Origin/Composition-Of-Whisky.html

So whiskey has more than ethyl alcohol in it- it has aldehydes (excess of this are the prime cause of hangovers) and....FUCK I'M TOO DRUNK TO THINK...I gotta SLEEP