| Wednesday, August 24, 2005 | |||||||||||
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When I was in high school, my cousins teased me that I was fat. They even called me and my brother "The Two Little Pigs". Consequently, I spent my days hopping from one diet to another (the one that worked best on me was the no-rice diet), joining all sorts of sports despite rigorous CAT training (basketball, badminton, and pingpong), and even working out furiously on the stationary bicycle for up to an hour each day. My parents and friends told me that my figure was fine and in fact a little skinny, but I didn't believe them. I was almost suffering from a mild form of anorexia nervosa at the time. I'd look at the mirror and see this pudgy girl. Yet, I weighed just 98 pounds, with a waistline of 24 inches. Ah, the good old days, only I didn't realize it at the time. I was like that all the way through college. And then, just before I entered Med school, romance struck. I'd always credited my weight gain to all the coffee and junkfood that I obsessively consumed during my endless nights of studying, but now I realized that being involved with someone at the time also contributed. Current evidence supports that relationships can have this effect. A Cornell University study of 1,980 married people found that women are more prone to gaining weight during the first year of marriage than men. My ex used to be fit too, but somehow, once we got together, our diets fell apart. It didn't help that he was huge with a matching appetite; when he was in his early teens, he got a hairsbreadth away from acquiring Diabetes Mellitus type 2 because of his weight and unhealthy eating habits. His doctor put him on a healthy kind of crash diet and ordered him to work out. A lot. That way, he was able to control his weight for several years. However, dining out, fastfood, and spare hours reserved for study changed all that, for us both. There was another factor. In many long-term relationships, the motivation to stay thin fades, explains Edward Abramson, a professor of psychology at California State University-Chico and the author of "Marriage Made Me Fat." Part of the attitude shift is a waning interest in conforming to a strict beauty ideal that the male species is supposedly drawn to -- a woman in a relationship has already found a partner to love her. (excerpts from IS LOVE MAKING YOU FAT?) We've always said that love is blind--that if you really love someone, factors such as shape and size shouldn't matter. But this doesn't give us the license to let ourselves go just because we think that our partners shouldn't care. (I still hear from him every now and then, and he supposedly lost all that excess weight again. Figures.) Fortunately for me, Tomato happens to be a work-out buff. He said that a few years before we met again (long story), he gained so much weight that I wouldn't have recognized him. He also had a girlfriend then. Fortunately, he recognized the danger in time (maybe the ribbing he got from his friends had something to do with it too), and enrolled himself in a good gym. Within a few months, he was trim, fit, and proudly wearing form-fitting shirts everywhere. When we got together, he dragged me along with him to the gym, to my mother's delight. I was embarrassed to go alone before, but his cheerful and encouraging presence made all the difference. So now, I'm slowly but steadily trying to lose the accumulated cellulite of eight years, not because Tomato wouldn't love me anymore if I didn't get thinner, but because I enjoy it and it's good for me. That, I think, is the best reason to do it. Now if I can only stop snacking on those darned ubiquitous scrumptious potato chips... This sounds as sweet as love (but not quite as fattening (I hope):
This would make a heavenly first course for a summer supper under the stars--or a refreshingly light dessert. A luscious tribute to the sweet melons ripening now, the recipe calls for only four ingredients: melon, mint, lime juice, and a dollop of honey. You don‘t have to cook it at all--just whiz it in a blender or food processor. The results are pure poetry.
Prescriptions (2) The bill
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| Monday, August 22, 2005 | |||||||||||
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This is how I look like when I'm simultaneously updating my blogs (8), browsing my friends' blogs, trying to keep up with the 10 RPG's (Harry Potter, Star Wars, and miscellaneous Fantasy/Sci-fi/Reality stories) that I'm currently a character in, reading/answering my email, and chatting to 3 people on the Yahoo Messenger, just when I'm running out of prepaid internet.
This is my new baby. Tomato's already jealous of it. It's a shiny black Yamaha upright with 88 keys and 3 pedals. We bought it just a few days ago, on August 18. I wasn't asking for a new piano (although our old one, which I've been playing on for 18 years) has been sounding more and more metallic as of late. The old one was a Yupangco--a local version of Yamaha, and yet we were only able to sell it for 25K! (Imagine a piano being sold for 25K. That's just the price of a midlevel mobile phone!) Still, it was traded in for this new one, which I'm absolutely ecstatic with. It sounds gorgeous, with unbelievable sound and resonance. On the afternoon that it was delivered, I played for 4 hours straight, until my back, shoulders, and wrists were aching like hell. I've bought a lot of new pieces, and I'm planning to review my 7 years' classical training even for just a few months before I re-start residency. I'm mostly besotted with lyrical pieces like Canon in D and arrangements by Jim Brickman or George Winston. For local arrangers, I recommend JonJon or Boboy Bagayaua, as they're the ones who seem to be able to capture the spirit of the songs best. Can man and woman still find Paradise in the world outside the Garden of Eden?
By the time I arrived at the last page, I was bawling like a baby, with tears of triumph and joy. And books don't make me cry easily. Nothing of Nicholas Spark's ever really moved me. In short, I highly recommend this book. It won the Manila Critics Book Circle Awards (did I get that right?). It's one of those Filipino works that I would proudly tell a foreigner: "This was written by one of us!!"
This is the finished game of Scrabble that I played with Tomato last week. I won, but just barely. We had a lot of fun tossing each other weird words, just to see if the other would accept it, since we didn't have a dictionary handy. Next time I'm going to tell him that there are new rules: medical terms will be allowed. He won't even know if I'm bluffing harharhar...
Lastly, here's something I really have to internalize: (from Fortitudine Vincimus) State of Mind If you think you are beaten, you are; If you think you dare not, you don't! If you'd like to win, but you think you can't, It's almost certain you won't. If you think you'll lose, you're lost; For out in the world we find Success begins with a fellow's will; It's all in the state of mind! If you think you're outclassed, you are; You've got to think high to rise. You've got to be sure of yourself Before you 'll ever win the prize. Life's battles don't always go To the stronger or faster man; But sooner or later the man who wins Is the person who thinks he can! Author Unknown
Prescriptions (2) The bill
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| Saturday, August 20, 2005 | |||||||||||
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Everyone listen up! If you want to know exactly why so many doctors are leaving the Philippines and heading elsewhere for greener pastures, even if it's just to work as a nurse, look up the prescriptions section of FAKING IT, HARD, where you'll find the very informative comments of The Doctor. He has graciously been answering my questions back and forth regarding the situation of Medicine in the States, and I feel that his insights should be shared with the world (This is dedicated to my friends who are wondering what to do with their lives--like me). This is his reply when I asked him about the compensation of physicians in the US, social medicine (which I'm not even familiar with, but maybe that's just me), the starting salary for a GP MD in a government hospital, and the starting salary in private practice: "Well, as most of the world knows, MDs in the US are the best paid. Our licensing requirements are also the most strengent. First, a 4 year BS or BA is required to enter. Then you have the 4 years med school, where you must pass the NBME Parts I (end of 2nd year), II (4th year). Residence is from 3 to 7 years depending the area you choose (mine was 5) and the school. I have yet to see a 3 year Res, but they are out there. Then you must pass the NBME, Part III, and pass it every 5 years too! Then each state requires its own exam. The pass rate for US graduates is around 95% for step 2 and 3. Where as the pass rates for foriegn graduates for each step is around 50% which translates into a total of 12.5% of applicants. I have met a number of filipino immigrant nurses here that went to med school or pharmacy school in the phillipines, but couldnt pass the required exam, but they say they dont mind as the nurse's salary of $40,000 is so much nore than the MD's salary in their country. (how far would 2.24 million pesos/year go in your country?) You are paid during residency depending on the place you choose (or chooses you) the minimum was $2o,ooo when I graduated University and U of Michigan paid me $35,900. Now, the residencies pay about $40,000. When I finished, the starting Salary was about $125,000/ year for a Government Job and about $150,000 in the private sector (90% are private here). Last year, a Cardiogist started around $200,000. IM is much lower, at about $125,000. Social medicine is free medicine. It is not based on income. Here we have both private as well as government sponsored health care (for the poor). If you meet poverty levels, your health care is free, but generally of lower quality (not the practioners, but this health care is acute, not preventative)." This is my reply. I bid my Filipino/non-Filipino friends to share their own thoughts, opinions, and experiences. "Wow. The requirements are stringent indeed. In our case, we have to go through a 4-year Science-related course, although i know some med students who graduated from extremely unrelated courses, like Hotel and Restaurant Management. They had to take extra science subjects, of course, but still... Anyway, the most popular pre-med course is still BS Biology, though I have no idea why since it appears to be the most useless! The only skill I learned that I was still able to use in Medicine was how to operate a microscope--duh. Like that's such a big help. That's why I tell my younger friends who want to go into medicine to take up either Med Tech or Nursing, as these are lucrative fallbacks, with emphasis on practical expertise. After Pre-Med, there's four years of Medicine, with the fourth year being mostly clinical rotations. The fourth year culminates with an Integrated Test encompassing all three years, and an Oral Revalida. This oral revalida is the killer, and it's only given now in the university where I graduated from, as it's been shown to be subjective and unfair (the admi in our university just feigns ignorance of this, I guess). Consider: if you're an honor student and you don't get the required marks, you don't get your award. If you don't pass it at all, you don't graduate with your batch. Last year, the panel failed a student who was supposed to graduate MAGNA CUM LAUDE, so she wasn't even able to graduate with everyone else. That student took a leave of absence (If that were me, I might have tried to kill myself). She and about five others who thought that they had been unfairly failed eventually sued the university just before graduation, intending to postpone the commencement exercises. The court quickly denied their claim so the graduation was able to proceed as planned, but I think it was because the court was afraid of the uproar that the other 400 graduating students could create. Anyway, there's one-year internship after that, then 3-6 years of residency depending on the field. Here, IM can be taken for as short as 3 years. The funny (sad) thing is that residents are generally paid so poorly that they still have to rely on their parents (like I mentioned before, the salary can be as low as P8,000/month or $142 dollars a month! Pathetic!). Of course at this point, a lot of them (us) are already old enough (too old!) to start their own families (Biological clock ticking!!). Imagine how hard it is to marry, rent/buy a place, raise a kid, and go through residency at once, all the while relying on your aging parents. That's why a lot of would-be doctors hesitate at this point, and go on to nursing instead (thus foregoing all those years of hard work), or study for the MLE so they can work in the States. Why? That salary you quoted for nurses--$40,000.00 a year or P2,240,000/year (translating to about P186,000.00/month!!) is already the salary of a well-paid cardiologist/cardiac surgeon here!! Imagine! That's a lot; more than the average person here could dream of! If a Filipino nurse didn't intend to stay away forever, she could just work in the US for 10-15 years, save up, and come home a multi-millionnaire. Or if she did intend to stay, she could petition for the rest of her family to join her, and so ensure a good future for them. (This conversation is making me faint. Maybe I should just go over there...dear, dear...) Your figures for specialists are even more staggering. A cardiogist starting out at around $200,000 and an internist earning about $125,000?? I want to be a cardiologist, as it's one of the most lucrative fields, but I'd only expect to earn as much as...A NURSE working there in the US! I don't even want to convert the figures that you quoted into pesos anymore. I might go into hysterics. Social medicine...well we have government hospitals here, but they're extremely underfunded, understaffed, under...everything. Oh, my mistake; they're overcrowded. That's why if you're not that sick, it's a mistake to get yourself confined because you might just contract something really virulent. The state of the "free" government hospitals are pitiful. And pathetic. Our foremost government hospital--PGH or Philippine General Hospital--is always crammed with patients. And when I say crammed, I mean crammed, like two patients per bed, etc. And they reuse equipment that are supposed to be disposable because of lack of funds. When you walk in there, it's like you're walking through purgatory, or hell. The patients stay in the emergency room for three days and die there of neglect--because the doctors are too few and at the point of collapse! The government allots so little funds to healthcare that it's laughable. More money goes into the pork barrels that just disappear into the pockets of corrupt politicians. Sorry. Am I ranting? Of course I am. When I think of how this country used to be before we ended up with such thieving and inept leaders (whom we ourselves voted into position, don't forget)-- *Sigh* To think that I'm already one of the lucky few who has a good chance of a future. I wonder how everyone else feels? Prescriptions (2) The bill
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| Thursday, August 18, 2005 | |||||||||||
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I used to think that doctors all over the world--as long as they came from a technologically advanced or updated country--treated their patients the same way. I thought that they used the same references, the same standards, and the same diagnostic techniques. I thought that they gave the same drugs, in the same doses, in the same formulations, using fail-proof algorithms that pinpointed exactly who needed that drug and who didn't. I thought that Medicine is one frontier where evidence-based knowledge and principles made sure that patients were treated as scientifically as possible so that there was a minimum of conflict among the caregivers. I was wrong. In fact, disagreements are routine among physicians in the same team, much less the same hospital. Even longtime partners bicker over what to order or not to order for a patient that they had been co-managing for years. This is made official and a little less barbaric in a formal presentation staged supposedly to educate us younger colleages: the Grand Rounds. But listen closely, strip off the courtesy, and you'll realize that it sounds just like a trial, with a prosecution and a defense. Thus it's no wonder that physicians from differing countries can manage their patients so differently, each thinking that they are doing the best for a certain condition even when they're using contradictory methods. Cases in point:
And yet, the people who live in America, England, Germany, and France have equivalent life expectancy rates, meaning that even some widely divergent medical treatments don't significantly alter the course of disease. It appears that there is a wide margin for error. Our systems are actually pretty resilient. Prescriptions (5) The bill
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| Tuesday, August 16, 2005 | |||||||||||
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One traditional casualty of diving into Medicine is sleep. When you're a student, sleeping in becomes a luxury. When you become an intern--and beyond--sleeps becomes synonymous with wishful thinking. When I was a med student, I slept at 4 hours max during ordinary days. If we had an exam the following day, that would be cut down to 2 hours. If we had finals, well...I'd mix up a batch of strong coffee, buy sacks of junkfood, and probably not sleep at all (you can now understand while I gained so much weight at this time). On the day before the Med boards, we all had to wake up at 5:00 a.m. so we could get to the testing center as early as possible. I slept at almost 3:30 a.m. that night, and grudgingly at that. I kept stuffing my brain desperately with tidbits of information that I hoped I wouldn't forget once I woke up, even though I knew better. It's actually better to study sensibly and then sleep adequately, than continue cramming long past the point of exhaustion. Our brains continue working on problems even after we have gone to sleep. In one study, a group of people was allowed to sleep for eight hours before tackling a problem that had been described to them. Upon returning to the problem, the sleepers were almost three times as likely as the non-sleepers to find a solution to the problem. Getting 6 to 8 hours of sleep per night can also make us 3 years younger than our biological age. Sounds like a lot of benefits for doing something we'd want to do in the first place, right? But if I ever had to take an exam again, I have no doubts about what I'll do. Bring out the latte, Mom. Prescriptions (3) The bill
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| Sunday, August 14, 2005 | |||||||||||
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Have you ever laughed so much that you couldn't breathe? Not because you couldn't catch your breath from excessive mirth. But because your chest tightened, your throat closed up, and you started to wheeze like an amitious cat trying to sing the opera. Yes? I see. Like me (and about 70% of my relatives), you must be asthmatic. There are dozens of triggers for asthma attacks, and a lot of them don't have anything to do with allergies at all. Some examples: a change in temperature. Exercise. And, as I've mentioned, laughter, especially the uncontrollable giggle and the belly laugh. It's actually funny. Picture this scene (which has happened so many times during family gatherings that I've lost count): A dozen French Fries, mostly women, gathered around the living room. Excuse me; I meant Potatoes, or scions from the maternal side of my family. Someone tells a hilarious anecdote. Everyone breaks out into hysterical laughter. Within 30 seconds, someone begins to impersonate a cat. Seconds later, someone else chimes in. Within five minutes, more than half of the people there are coughing, wheezing, and yet laughing at the utter ridiculousness of the situation. It's almost sounds like an orchestra. To a doctor, this might look like a scene of potential disaster. The probability of status asthmaticus (a continuous asthma attack that could become fatal) seems frighteningly high. But everyone acts with aplomb. As one, the afflicted members of the family reach into their respective purses and fish out their Albuterol inhalers. They puff twice, wait a few minutes for the medicine to take effect, then continue on with the enjoyable conversation. Another ordinary event the lives of the Potatoes. I don't know why the medical world took so long to latch on to this phenomenon. I guess it sounds ludicrous that laughter could set off something as potentially dangerous as an asthma attack. But we've been dealing with it all our lives. It's all a matter of preparedness. That's why when you go to one of our family reunions, it's no big deal if you've forgotten your inhaler at home. Someone else is bound to have brought theirs. Prescribe! The bill
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| Saturday, August 13, 2005 | |||||||||||
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Had a full day yesterday, which was why I didn't get to post until the afternoon. I accompanied my Tomato to the the Rizal Hall of Malacanang Palace where he was given the Outstanding Writer/Reporter of the year award by the Volunteers Against Crime and Corruption (with members such as the tragically stricken Vizconde and Cervantes families). Hosting the glittering, nationally televised ceremony (it was live on Channel 4; unfortunately, we only realized that after the affair was almost over) was Cory Quirino. Also there was Rosebud (who turned out to be friendly with my sweetheart, and even commented favorably on my appearance), and some other generals and personalities whose names I have already forgotten. Guess who gave the award? It was President Gloria Macapagal-Arroyo herself, resplendent in red and tall(er) in stiletto heels. This was one complication I did not expect, and it explained the tight security around the place. She looks exactly the way she does on television. It was pretty ironic the way she stood there and smilingly handed out plaques and trophies to the awardees, a lot of whom were working actively against her. Near the end, she gave a long speech regarding her administration and the state of the country, punctuated by expectant pauses and rather reluctant applause.
Unfortunately, you will not be able to find much about that affair on today's Inquirer except for a small footnote about PGMA saying something aboutjuvenile delinquents (link may not function after midnight). Trust her to steal the occasion by saying something controversial. Oh well, I guess it was too good an opportunity to pass up.
Accompanied Tomato to an internet cafe afterward, so he could type up his stories for the day. I just clowned around taking pictures of him from all angles, then gave up and surfed on my own (while bugging him through the YM).We didn't stay for lunch. We had another engagement to cover: a press conference at Makati Shangrila hotel regarding drug counterfeiting and Viagra. Hmm. Interesting combination. If you want to read about my reaction to that affair, just read my previous post (Smiley here). After briefly strolling around at a nearby Powerbooks (and drooling at the gazillion books there that I didn't have the money to buy--sniff), we drove home tiredly through the typical EDSA rain and traffic, where I continued my penchant for taking pictures of the ordinary with my cellphone camera. Prescription (1) The bill
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| Friday, August 12, 2005 | |||||||||||
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Hi guys. Sorry if I'm a little late in updating today. I just came from a very interesting product presentation and WHO forum. The topic? The Science of Better of Sex: Viagra (Sildenafil Citrate). I can just see the guys clucking, shaking their heads, and wishing they'd been there. Actually, the presentation started out with ominous updates regarding the counterfeiting of medicines, which is on the rise. According to their estimates, 6-10% of drugs nowadays are fake, especially those bought from unreliable sources such as peddlers, small stores, and websites. Actually, that's a very conservative number, as I once read in a Reader's Digest article that the actual figure may be as high as 40% in some third-world Asian countries. This may account for several instances of so called "therapeutic failure", when the patient's condition doesn't respond to the drug. Maybe the "resistance" of several microbes to several stock antibiotics (which has been causing panic in medical circles) can actually be attributed to fake products. We can't be certain, of course, because this problem is rather hard to track. In any case, we are certain that this widespread counterfeiting has already cost many lives. The majority of fake drugs don't contain any active ingredients at all, while others contain too little. Others may contain the right ingredient in the right amount, but may be expired or mixed with toxic impurities that can be carcinogenic (cause cancer) or mutagenic (cause mutations). I once read of an instance when a drug counterfeiting laboratory was found to be run by individuals who had AIDS and Hepatitis B. A horrified shudder at this point would be appropriate. So how does this all connect with Viagra? Apparently, Viagra is one of the most faked drugs around. There are many reasons for this, namely:
Okay, so drug counterfeiting is a legitimate problem. It robs patients and their families of both health and income. It should be suppressed as much as possible, not just for the sake of lost revenue for drug companies, but also for the trusting consumers whose lives are on the line. However, I don't think that Viagra should represent the forefront of this campaign against counterfeiting. It is still mostly just a lifestyle drug; hardly as important as the vaccines and the antibiotics that are also being bastardized in the market. I found it disturbing that despite such emergent issues as burgeoning epidemics, worsening health-care and widespread poverty (which admittedly were not discussed in that forum), the host (an MD) seriously called Erectile Dysfunction "The Scourge of the Century". Even more disturbing was the fact that everyone actually nodded, laughed, and generally agreed. I would think that we have more important things to worry about than a threat to good sex. I guess the MD's there had no choice, as they were supposed to be representing the drug company's interests, but still... Prescriptions (5) The bill
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| Thursday, August 11, 2005 | |||||||||||
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Okay, let's get off the boring subject of humans for a while. Let's talk about...dogs! Yup, man's best friend. I just learned something very interesting about them. For the longest time, I thought that a dog aged 7 dog-years per man-year. Thus, a 7-year old dog is 49 years old. However, according to my cousin, (who cites a doggie digest): A dog's life increments by 12.5 dog-years for the first two human-years, then increments by 4 dog-years per human-year thereafter. For example: a four year-old dog is actually 33 dog-years old. I'm vastly relieved. In an earlier post, I mentioned that we had our 1 1/2 year-ol dog mated, and that she cried and whimpered all over the place. If you calculate her age the usual way, that would make her way too young, right? (I guess a lot of you are snickering right now. I don't know much about dogs!) But using the new formula, that would make her about 18, which is obviously more acceptable. Whew. Lastly, check out this page by Herb, concerning pets. It's soooo funny. Prescriptions (4) The bill
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| Wednesday, August 10, 2005 | |||||||||||
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Another myth busted. According to Jeffrey Kluger of Time Magazine, it is actually possible to be fat and fit at the same time. Apparently, being overweight may not be as dangerous as being inactive, according to Holter, Miranda, and Park of Time. We all know that inactivity leads to obesity, and obesity leads to a slew of other health problems, such as diabetes, stroke, heart disease, sleep apnea, joint problems, and even cancer. "It's not the number on the scale or the size of your khakis that will kill you, after all; it's the elevated blood pressure and cholesterol...that come with moving to the relaxed fit rack." (Time) Being fit and fat isn't quite as good as being fit and lean, of course. The fat itself, especially the 'visceral fat' around our middles which encapsulates our internal organs, releases inflammatory substances that contribute to diabetes and hypertension. Logically, the more fat we have, the more predisposed we are to cardiovascular problems and related diseases. The good thing is, exercise helps combat some of the negative effects of this fat, making it possible to attain normal blood pressures, normal cholesterol and sugar profiles, and even normal aerobic capacity. In layman's terms, that means that some active plus-size people out there might actually be healthier than slender and sedentary model-types. For someone who is active but has yet to lose a lot of weight (like me!!) that's really good news. Exercise Tips for the Oversized (From Time) SAUNTER OVER TO DOC EMER'S FOR THE 46TH MEDBLOGGERS' GRAND ROUNDS, AND SOME 40+ OF THE BEST HEALTH-RELATED POSTS AROUND. ENJOY!! Prescription (1) The bill
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Blogroll Me! ABOUT ME: ![]() Just trying to: ![]() Visit my other pages ![]() I Live: long and prosper. I Work: Awww...do I have to?. I Think: therefore I get headaches. I Laugh: even when I don't get the joke. I Hide: and Seek. I Write: when I'm bored/inspired. I See:...Dead People? I Sing: in the shower. I Can: cross my eyes. I Can't: whistle. I Watch: Disney. I Daydream: in church. I can't help it!. I Fall: when my heels are too pointy. I Want: potato chips. Lays, Sour Cream and Onion. I Cry: when I chop onions. I Read: the instruction manuals that come with gadgets. I Love: Tomato. I Sometimes: talk to myself. Joke. Oh, wait... I Fear: Doctor Go. I Hope: to be him someday. Another joke! I Quit: and so did three others.... I Miss: College. I Forgive: mostly everyone, except Kris Aquino for publicly confessing she had an STD. I Drive: a red Mazda 3. In my dreams. I Dream: when I sleep. Duh. I Remember: when I had a smaller waistline. *sigh* I Don't: have a sense of direction. I Believe: that I should be in Hogwarts. I Know: who was killed in the Half-Blood Prince. I Hate: Snape. I Feel: restless. | ||||||||||||||||||||||||||||||||||||||||||||||
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