“There were teachers, and there were mentors. We all knew there was a difference. Whether it was your basic medical science lab professor or it was the department chairman, we had our favorites.

On the other hand, there were those who loved to torture us. Why do they create greater impact? Deeper wounds, maybe? Or do they really?

The theme is your favorite mentor and/or tormentor during medical school and training. They may be the same person, or not. You may have several favorites. Most importantly, share your experiences with these people, and the reason why they have created an impact on you as a doctor and as a person.”

One person stands out for me. See, medical school and residency hardly even count. Much like practice and play before the real business of treating patients, committing mistakes, breaking the news of an unexpected death of a close friend and patient to a distraught family who will never understand, getting slapped with lawsuits, having to be available every hour of the day, every day of the week and spending many sleepless nights wondering if any patients will show the following morning to pay for the nurse, the receptionist, the rent, the utilities, the insurance premiums, the medical supplies, the equipment lease.

There is no practice involved in private medical practice. It is a painstaking process that requires total commitment and focus. Required anatomic equipment include nerves of steel and a cast-iron stomach. Rewards may be great but certainly no country for the faint of heart.

I was a newly-minted gastroenterologist who had to work in a medically underserved area in the Oklahoma panhandle, population of 10,000. He was a blue eyed surgeon who spoke impeccable Spanish because his father was from Puerto Rico. Even if his expertise was in laparoscopic procedures, he saw them all and did them all. He delivered babies, took care of neonates, set fractures, removed cerumen and excised ingrown toenails, circumcised, took x rays, met patients with migraine headaches at the clinic at midnight and gave them shots of nubain and promethazine. His patients loved him.

He owned two planes, one of which, the Cheyenne picked me up in Dallas for that fateful interview. His well appointed home was perched atop a cliff, his wife was strongly protective, ever-resentful of the little amount of time her husband had for his family on account of his vigorous work ethic.

He had a way with patients, he made them feel as if he spent an inordinate time with each of them even if he would get to see close to a hundred patients in a day. Naturally, others got envious. He was accused of being too aggressive, performing unnecessary procedures and downright unethical behavior. Even then, working closely with him, I found all those charges baseless. I tried hard to get him back to the local hospital where he had been barred from practicing. I drew the ire of many of the old white guard here especially since I was a young, foreign upstart but it did not matter. Here was an injustice that needed to be corrected.

After close to 10 years, he was able to perform an operation at the Guymon hospital. The clinic was doing very well, I was working seven days a week and would never complain if there was an endoscopy that needed to be done in the evenings because my salary was based upon my productivity. I don’t remember taking a day off in 2 years.

We found a discrepancy in how the collections were being tallied. The irony is, I never really got to talk to him because he became strangely defensive and hired lawyers to placate me. One of them became the head of FEMA and the other lawyer came from the firm of the Attorney General of the State of Oklahoma.

I was eventually sued for libel for a million dollars and I had to counter-sue and he ended up being ordered by the court to pay me a large amount of money, not a single cent I would get to see because he filed for bankruptcy and he left town.

Talk about pure torment--but to this day, I am grateful to him. He showed me the ingredients of a successful medical practice: availability, compassion and competent medical care.

I continue to hope that I can one day coax him out of his self-imposed exile and return to the tiny town in the panhandle where your best dreams come true.

My Tita Inday died today. A wonderful person who graced our lives when we lived in Brooklyn. I would pick her up in Astoria in Queens at 5 in the morning on Mondays and make our way through the Brooklyn-Queens Expressway and drive her back on Friday evening. Throughout those exceedingly busy work weeks, she stayed with us and cooked unforgettably delicious meals and took excellent care of our first child.

Long before her cancer and her dying made it easy for us to gloss over her failings, I would tell my relatives that the Tita Inday I knew never uttered an unkind nor an uncharitable comment against anyone despite having endured her own share of unfaithfulness, disloyalty, ingratitude. I am grateful I had the chance to tell her last Christmas that I did not have a single unhappy memory of our time together in New York.

We would make our way to northeast Philadelphia on weekends every chance we got to scour the magnificent clearance racks in what was then the largest outlet mall in the US. Most, if not all of her salary went towards thoughtfully made purchases for her family. It made me and my wife very happy to know that she was happy to be with us. We would have been privileged to have let her continue to stay with us but taking care of her own grandson naturally took precedence. Tita Inday had a clear understanding of what duty was all about.

When she was diagnosed with colon cancer, I could not help speculate how easy it would have been for me to screen her in my clinic and how much my other children would have learned from her kindness and how obese my wife and I would have become if only she remained with us but that is the way life is. You make your choices and for the good ones among us, you live your life for others.

Tita Inday was an Assumptionista. Her father was a talented golfer from Bacolod who helped establish one of the first law schools in the Philippines and who was also a successful publisher. Her mother was a prominent leader of the Catholic Womens League in its formidable days. At her wedding, Judy Araneta and Precy Lopez were part of the entourage. My Tita Inday may never have attained the early promise of her bright social stature but at the end of our lives, who really cares?

She was gentle, she was kind, she was generous and she kept her Faith. Rest now, Tita Inday. May we meet again.

Do we physicians practice what we preach? Do we eat little saturated fats, exercise regularly, stay away from nicotine? The average life expectancy in the US is 78 years. It is 70.5 in the Philippines. The difference is mostly due to the scandalously high infant and maternal rates prevailing in our country. In other words, a Filipino physician in his or her 40’s has roughly the same chances of living up to 80 as anyone living in the US. If we could only provide more potable water, vaccinations, inexpensive antibiotics, anti-tuberculosis medications, prenatal care, obstetric support we would be able to live as long as those who reside in Andorra.

What is my point: anyone reading this entry is statistically set to live beyond the age of 75. Of course it would help to lose a little weight, keep an eye out on our lipid profiles, glucose and PSA levels, submit to Pap smears, mammograms and colonoscopies but the important consideration remains that we live lives that are fulfilling and meaningful. How often have we seen nursing home residents with advanced dementia, abandoned by their relatives and totally oblivious to what is going on around them?

It is not simply a matter of living long. What is more important is living well and being able to share our blessings with others. Much like passing the baton in a relay, we must strive to lengthen the lead we bequeath to those who follow us.

If we should preach any particular message, it is that we neither live nor die for ourselves alone.

The topic for the blog rounds this week is why we continue to love the Philippines and what our reasons are for staying.

From a purely material perspective, there is very little to stay behind for. Educational opportunities are dwindling, security is tenuous, wireless internet service is spotty, the cleanliness of bottled water is suspect, gasoline will only become more expensive, there is a looming rice shortage, traffic and its twin children, pollution and waste of time is ridiculous, the beaches in Thailand are less costly, shopping in Hong Kong and Singapore is infinitely better, Haagen-Dazs is more expensive in Manila compared to Tokyo!

You leave our country and find that much of the world has left us behind. You leave our country and your desensitization to poverty and bad governance disappears, you begin asking questions once again. It does not have to be this way and this is the fundamental reason why we can’t leave our country like this.

We need to love our country and give as much as we can because of those we leave behind. We become a nation only when we recognize our responsibility to help these desperate millions of Filipinos who by the looks of it, have no chance to improve their lives.

We need to keep this love for our country burning because we are the last hope, or so must we frame it in these dramatic terms because if we give up and cede our country’s future to all these politicians who have been presenting themselves all these years, then all becomes lost.

We will be telling our children we had a country once.

In a very disturbing development, the Philippine Supreme Court upheld the disqualification of an elected mayor because he is a United States permanent resident as shown by his possession of a green card. In a glaring display of ignorance, the Supreme Court ruled that US permanent residents are deemed to have abandoned and renounced their status as residents of the Philippines.

A few facts rankle. First, the disqualification emanated from resigned and disgraced elections commissioner Benjamin Abalos. While the elected mayor chose to return to his country and participate in rebuilding it, Abalos was busy sealing the deal that would have allowed him a big portion of a $135 million kickback.

Second, the Philippine government strongly encourages Filipinos in the US to send money back home, invest in real estate and business ventures and return frequently as tourists.

Finally, in order to work in the US and become productive Filipinos who can potentially contribute to our country, we need to legally adjust our status by becoming permanent residents. There is not an iota of love lost for the Philippines in this process. Every remittance reconnects us to our communities. Unless our government prefers us to hang around the corner store and drink beer and gin and sell our votes to all these traditional politicians who control the political process from whence they make their livelihoods.

In all seriousness though, I think this is the preference of the government.