After heart disease cancer remains the second leading cause of death in the US. There was very good news that came out today that revealed that death rates from cancer have been dropping by an average of 2.1 percent a year recently, a near doubling of decreases that began in 1993 when they began decreasing by an average of 1.1 percent a year.

The biggest drop belongs to the number of colorectal cancer deaths which is still the number 2 killer after lung cancer. This is personally gratifying because I started screening aggressively for colon cancer in 1996. I have also been nagging my patients to quit smoking and for my female patients to get their mammograms.

There is still a lot of work left. Patients who get a screening colonoscopy remain the minority. The challenge is how to convince these patients that the procedure is painless, private and rapid.

This entry will be brief because I am going back to work.

Saturday night, we Filipinos in Guymon were complete. Medical doctors, registered nurses and their overqualified unemployed spouses, medical technologists, X-ray techs. After a repast of native dishes we gathered by the flat screen to watch and cheer Manny Pacquiao. We were totally united and throughout the fight, all our personal stories about our American journey were set aside because Pacquiao was representing us all. And he did a fine job.

It seems wherever we are, we keep together for these events. I remember being amazed at how Bacolod City ground to a halt while Pacquiao disposed of another opponent. Might be because we think of ourselves as a weak people and every demonstration to the contrary is cause for unity and celebration. Might likewise account for our sensitivity towards denigrating comments.

It doesn’t have to be this way. We Filipinos can be just as good and we can also be just as bad as everyone else. One reason why living in another country makes for a good educational experience is you get to feel the barriers that humans naturally create whenever strangers are in their midst. You get to realize that there are parties and places and societies that are off limits, at least initially. With familiarity some of these barriers might come down but there will be bound to be some permanent ones.

You become tougher, more resilient as an overseas Filipino. Slights and slurs that you encounter often enough lose their sting. And this happens when you begin to understand that you yourself are capable of this behavior when you’re on homeground, which may be a specific place or where there are many of you.

So for the respite, Salamat Manny Pacquiao.

My fellow Filipino physicians in the US are in an uproar over an episode of Desperate Housewives where Teri Hatcher's character (Susan) sees her male Caucasian gynecologist:

MD: Well, everything seems normal. But, you say you've been having irregular periods?
Susan: Yeah, you know, one month off, two months on. That happens, right?
MD: Have you ever experienced night sweats? ....
(few other lines here)
MD: How about hot flashes?
Susan: OK, whoa. I'm gonna stop you right there. I'm way too young for that, please refer to your chart.
MD: Susan, I know for a lot of women the word menopause has negative connotations. They hear aging, brittle bones, loss of sexual desire...
Susan: Before you go any further, can I check those diplomas? I would just like to make sure that they're not from some med school in the Philippines

Boom. Immediately calls were made to boycott the series, write letters to ABC executives, demand an apology, file a class action lawsuit….. I totally understand the outrage considering all the racial, academic and financial obstacles we all had to hurdle. But let’s examine this closer. Do I expect to lose a single patient in rural Oklahoma as a result of this comment? Are we Filipino doctors irreparably harmed? I don’t think we Doctors worked and studied very hard just to become excessively threatened by insensitive and mediocre scriptwriting. We should have a fair idea of how much we are truly worth.

I admit I used to be awed by Harvard and company. Not anymore. I now know it isn’t all in the school, no matter how plush their classrooms are and how much cutting-edge technology is available in the laboratories or even in faculty members brimming with degrees. A physician’s competence ultimately depends on one’s capacity to learn arising from a deep compassion to care for our patients.

So while I am not happy about the comment I will continue to be at the endoscopy unit at 6:45 am and see patients the whole day and get on with my practice and give the best patient care that I can. I don’t intend to be bothered by those who will allow DH to influence their choice of physicians.

So, the Elections Commissioner Benjamin Abalos just resigned amid allegations that he brokered a telecommunications deal in exchange for a substantial kickback. “Broker” meaning dutifully distributing criminal loot among government officials responsible for approving the project including consolation bribes to the losing parties. He was pretty familiar with the song and dance routine, having been in politics for a long time. He was so familiar he got cocky and went down for the count.

Not that we all didn’t know the top counter of votes was simply being rewarded for past disservices rendered. Perhaps in the ultimate order of things this crooked transaction was in partial payment for the zero votes I received in Maguindanao. Point is, we all knew, somewhat. Yet we were all eyes and ears during the senate hearings as we were regaled by some of the very politicians Abalos caused to represent you and me. And, let’s admit it, we all harbored some secret longing for an on the air conversion from one or more of these absolutely top of the line genuine products of our corrupt political system.

Abalos did not start as a bad guy. He was at the forefront of the Marcos opposition when the only requirement for membership was raw courage. Like most traditional politicians, he overstayed. And he even has his little dynasty to prove it. “Sic transit gloria“, a slave would whisper into the ear of the parading conqueror. We never learn.

One day soon we will fully learn about the excesses of this administration. Like all else, it is only a matter of time. Part of our human weakness lies with the fond hope that we will be that one, singular exception.

I met a young physician yesterday who has his heart set on producing safe and effective generic medications for the 80% of the population who are unable to purchase medications for hypertension, diabetes, asthma, peptic ulcer disease and infectious diseases.

Throughout the campaign, I had advocated for Filipinos producing their own medications. Why resort to importation from other nations when we can produce these drugs in our own country? Most people are not aware that drug prices in the Philippines are more expensive anywhere in Asia except for Japan. This is because we Filipinos have very little say when it comes to multinational drug companies dictating prices. Here in our country, drug companies are reaping great profits essentially because they can get away with it . Our government does not encourage competition and would rather let the majority of our people go without their essential medications rather than tangle with the wealthy and powerful drug industry. In no way is this an indictment of pharmaceutical companies because these entities are simply pursuing their stated business goals which is to manufacture quality products and realize as much profit that is possible. It is a miserable reflection of our weakness that we have always appeared powerless to determine our destiny.

Medications do not have to be as expensive as they are in our country. Even if we still have to import all the raw materials needed to compound these drugs, the actual cost of producing these drugs is relatively negligible because once we stop subsidizing enormous marketing expenses (which includes the vast amounts of money spent convincing prescribers to stay with brand names and not give generics the opportunity to prove themselves) and immorally immense profits, we can expect a steep price drop.

This young doctor is the research director of a start-up company that will produce, or more accurately compound raw material originating in Europe to make antihypertensive like amlodipine and losartan; drugs for diabetes like metformin; antibiotics like cefuroxime and even anti-obesity agents like orlsitat. In no way am I endorsing his company. I would like to give him the opportunity however to prove to all of us that a local company can produce effective, safe and affordable medications. They are already very busy warding off several legal challenges and conforming to expensive government regulatory procedures. This is the least we Filipino physicians can do, give these entrepreneurs a chance to profitably capitalize on a perennial problem that will benefit the greater good.