Few weeks in Cambodia...

To fellow beloved, I want to tell you about my trip to Cambodia in a few days. Please pray for the team of physicians and I as we work to set up some health programs there. The trip comprises many different facets for caring of the people in need.

Purpose: About 75% of Cambodia is considered rural and medically under-served. There are many villages there without the care of a doctor. I was invited to go on this trip with a pediatrician who has worked to improve quality of child care in orphanages around the world. Our objectives are several: teaching of health aids to take care of villagers, set up an evaluation process that is to be carried out in times to come as way of quality assessment of our program, evaluation of orphanages, and talking with the embassy regarding international adoption issues.

Preparation: I had a lot of experience setting up assessments and analyzing data from studies, however, I haven't had a lot of experience helping to set up health promotion programs on the ground. So, I have been personally doing some reading regarding to information and history of the country and its people, plus additional reading about 'community health program' and other written wisdom of working in countries where there are not many doctors. I have also asked many of you as prayer and support partners. I don't know how many of you have committed to praying, but I know that you guys have already covered more than 90% of the funds needed for me to go. Our F'ather is great! I trust Him greatly and I also trust you guys and appreciate you guys for the prayer coverage. I know that prayers are the most important tool we have in the caring for His beloved.

Follow up: So, I will be keeping a journal with me. I don't expect to have any sort of connection to you for the next month. I may possibly be traveling from site to site and will not have a way to be connected to you. So, as soon as I return, I will try to post some pictures and some results of the trip. For those of you that supported me through this trip, I believe that you are there with me. I also believe that you will see your offerings multiply in unexpected ways. I appreciate your partnership.

What I need you to do: Pray earnestly for my team and I... for unity, for flexibility to learn and to move as He directs, and for effective witness. I will be connecting with you when I can. Blessings!!!

Ventura Interview...

To my faithful friends and family... I've recently finished my interviews for the family medicine residency, with my last one at the program in the Ventura County Medical Center. This is a wonderful program! I am very delighted to have spent some time there and also to be interviewed there. This program is the OLDEST program in CA and possibly the oldest program of family medicine specialty in the country. The program of 'General Practice' started in 1928, and when Family Medicine became a specialty, it was the first to start in CA in 1969. This program is also the largest family medicine program with 14 candidates in each class. Why did I chose this program to interview among other programs? Well, I wanted a 'broad spectrum' training. From caring for pregnant women to deliverying their babies to taking care of both mom and baby and the family. I think this is how medicine should be, and it was the way medicine was done for thousands of years.

With our current healthcare situation of specialty heavy care, I think the ability to provide continuity of care has diminished. Why would anyone want to go to gazillion different specialists for care, with everyone of them just focusing on a part of the whole body and no one tracking how the entire person is doing? I think this is where Family Doctors are important. However, with our current system, family doctors do not get reimbursed very well compared to specialist... hence, the reason why majority of medical school graduates are going into specialties. Unless there are ways to standardize the payments, it is almost not financially feasible for family physicians to pay off our immense student-loans compared to specialists.

However, with much evaluation and temptation, I've realized that being a doctor is about taking care of people, and being a patient advocate. It is about being a resource for patients. It is about seeing what the patients and their communities need before they see it. It is about helping people to being able to adapt to their ever changing environment. We, as physicians, hold tremendous responsibility, and were given the unique opportunity to make our future together better than the past.

I can write like this for another hour, but I'll spare you. Let me just end with my experience at Ventura. In my opinion, I interviewed them as well as they interviewed me. I felt that I did my best in trying to find out where is going to be my home for at least the next 3 years. I've spent over 1 month of time working with their doctors and getting to know their residents. I am very impressed with people's credentials here. I am also impressed with how knowlegeable their family physicians are here. Being a county program and their association with UCLA, as the primary physicians in the hospital, their Family Doctors still run the ICU, still deliver babies, and do C-sections. Being a Trauma Center and a base for paramedics, their family medicine residents still run the trauma codes and follow patients into trauma surgeries with the trauma surgeons. They also have a wonderful clinic where they provide continuity of care for their patients, who they may have delivered their babies or taken care of them in the hospital. There, they also have an Osteopathic medicine clinic, where the D.O. residents can apply their art of OMT to their patients. Being a strong allopathic program linked with UCLA, this is a plus in my book.

So, overall, a program 1 mile from the surfs, sunny California with good weather year round, and a strong broad-spectrum program... I would recommend this program to anyone.

Tail

My time here in Cottonwood/Sedona is nearing the end. I will be parting ways with the natural beauty, the big hooked-up bachelor pad, my favorite fireplace (my constant hangout and companion), and all the great ER staff. I am heading back to Phoenix for a test on Friday, and will be coming home to California. You know, living the way I did for a month, with all my necessities taken cared for... I think I've had enough. I am ready for a new change: a change of scenery, a change of location, and a change of crowd. I am looking forward for Christmas with my lovely family, and also to finish my interviews for residency.

This last few days in Cottonwood/Sedona has been pretty cold and raining... there were even piles of snow in Sedona on my hike a few days ago... and today, there are snow covering the mountain behind my hooked-up bachelor pad. It makes me want to make some trips up to Colorado or Mammoth to go snowboarding... man, I remember snowboarding at the French Alps a few years ago... no experiences before or after has ever compared to how exhilarating that ride was!

Ok, so, I am ready for some holiday family love. Cheerios mate.

(*) Sunday on the Mountain Top

So, I've decided to go another hike again today and spend some quiet time with our LORD on the mountain top. The hike was about 2 miles round trip, ascendning about 300ft. The view was gorgeous. With the sun gently caressing my face, and the wind pushing behind me to help me up the mountain, the feeling at the top was breath taking. As I sat at the edge of the clift, on a 'rock chair' designed for me long ago, my spirit desired to soar like the ravens and hawks before me all over the immensity and expanse of the sky. The air was crystal (not the crystal in the 'castle') as I take a few deep breath to fill my lungs. The crispy morning air brushes over my skin as they rush by as if they were in a hurry to get somewhere. The expanding horizon allowed my eyes to relax. The gentleness of the warm sun rays made me feel as if I am in the forever warm and secure embrace of my heavenly love. In the presence of such stillness and clarity, I cannot help but to think that God so loved us that He had created all this long ago to satisfy the heart of a little creature like me at such a time as this.

A panoramic tour

COME ON, WHAT ARE YOU WAITING FOR?

The trail head... it was actually kinda cold. It stormed last night, so there's even patches of icy snow on the trail.

The red trail, revisited.

Remember this picture? Last time I had my crossbike on this trail and about scare my pants off. I said I'll be back... well, here I am :) Today, I actually finished the 3.3mile Airport loop. The trail is pretty narrow and often made up of slide rocks such as below.

Yikes...

Courthouse Butte and Bell Rock behind the tree...; don't fall!

Where I came from... where I am going to...

It was amazing the wind and the quietness on top of the mountain. I had an Mountain Top experience today. Spent some quiet times with the Lord up on the top. Psalm 19: May the words of my mouth and the meditations of my heart be pleasing to you, LORD. His creations are waiting for the Sons of God to be revealed. Look at them wait...

Recent Residency Interviews

So, I am nearing the last bit of my interview trail for a Family Medicine Residency Program. These last 2 days, I interviewed at 2 programs, Merced and Modesto. They are both broad spectrum family medicine training programs. Broad spectrum meaning that they train resident doctors to do everything from caring for kiddos to elderly, to doing obstetrics and gynecology, and to doing lots of office procedures.

Both of these programs are part of the UC Davis system of family practice residencies. They are both situated in the Central Valley of CA. So, the picture to your left is my summary of the 2 days while I was there. FOGGY! The fog was so thick that I couldn't see more than 50 yrd beyond me.

I've met an attending physicians at each place that really enlightened me with regards to the type of medicine I would like to practice. I'll tell you a little bit about why they are so encouraging. The first one is Dr. K. Dr. K is very passionate about his patients. He made it his career goal to change unhealthy behaviors of the patient. In fact, he says to me that if he does not educate and work with his patients to be healthier, then he has done nothing good for them. He is not satisfied just seeing patients on their visits. He would even go as far as telling them that they would have to find another doctor if they continue to be unwilling to work together toward a better health. He does it so lovingly, that I know he doesn't usually resort to threats. I am sure a large portion of his patients comply. Now, what are the unhealthy behavoirs that he works so hard to change? All these issues are called "Silent diseases," which if can be tightly managed will significantly reduce morbidity as we age and in effect directly increases our Quality of Life!

1. Smoking cessation
2. Diabetic disease management: tight control on the blood sugar
3. Hypertension disease management: tight control on the blood pressure
4. Asthma disease management: proper treatment combinations for the symptoms
5. Obesity management: help patients to reduce BMI as way to reduce long term morbidity

These are just a few things. I believe that if we as physicians could impact patient health in these areas, our world would literally be in a much healthier place. Dr. K relentlessly follow up with patients periodically and re-evaluates treatments and lab results to help his patients to keep tighter control. You see, these are diseases that 'slowly disables us WITHOUT US KNOWING!' That's why Dr. K thinks it is imperitive that we as physicians need to be come patient advocates in educating and helping patients.

Dr. B... He is an inspiring physicians who worked many years to make healthcare available to the underserved. His foresight is inspiring. His passion is to train physician leaders to impact health policy of the community in which they serve and eventually policies of this nation. Simple concepts of policies in community developement: where to put schools, health centers, grocery stores, hospitals, community centers, fast food chains, and other businesses has huge impact in the health of the community. Often, railroads split the wealth of the town. Down wind areas are usually poor. Poor areas have fewer grocery stores, lower literacy rates, higher teen pregnancy rates, fewer access to healthcare, higher crime rates... the disparity is tremendous. Mothers who need to buy groceries, bring children to doctors, work, and all that without a car cannot simply do everything if it takes hours to walk to one thing then hours to take a bus ride to another. So, as a way to serve the poor communities, Dr. B and his team worked together with the community organizers to build a community center that consisted of childcare, medical care, and is right in the shopping center of a major grocery store. A one stop shop! Dr. B and his residents also are required to do home visits, many times at a shack of the underserved family or in the park of the homeless person... these 'home' visits developes deeper appreciation for the underserved and also shows the community that 'we' care as physicians. We care and love those who are down and out to visit them where they are. Home visits also give physicians opportunity to talk to their patients are other pertinent social issues, environmental safety issues, disease exposure and risks, and other topics not typically addressed at the 'sterile' doctor's office.

I'm inspired to incorporate these passions into how I approach medicine!


Lake Yosemite in front of UC Merced; Motto of Modesto: water, wealth, contentment, health

So, the last bit of the blog, I want to tell you about the crazy drive I did last night after the interview... I hope I will not have to do this again. So, the interview finished at around 2pm in Modesto, I decided that I should just drive straight back to Sedona, AZ... That's a 11 hour drive! So, I started thinking, ok, I'm gonna take it one step at a time, may be rest in between. So, crazy me... I drove straight through with just one stop to fill up gas. Yup it took me 11 hours :) The last part of the drive was through the mountains in Jerome, AZ (used to be copper mining town). Have you ever seen Tokyo Drift? That was just like the movie. Imagine, at about 1am in the morning, skinny, slithering 2 lane mountain road, laced with 15MPH and 20MPH 'U' turns... The road was clean, washed by rain... kinda like a car commercial. Darkness all around, shear clift on both sides, guard rail on the right, you can see nothing other than the reflective lines on the road. You are it. No one to compete with you, no one to take a piece of the road. You are the road. The road and you are one. Man, it was so good, I was whipping around the turns at twice the prescribed speed, nearly drifting, sliding, skipping... pulling 'G's' All mine... all mine... I felt like driving a go-kart in the mountain... fresh air... a full hour of exhilaration!

Then, as soon as I got back home... I couldn't resist the sweetness of the pillow...

OMT & Medical Acupuncture

I've just finished the Introductory weekend of the CME course for physicians on Medical Acupuncture. (8 months of self study and 2 weeks of clinical intensive to follow before I am certified to be called a physician acupuncturist) There were about 100 physicians, DO's and MD's alike. The physicians included family doctors, anethesiologists, neurologist, surgeons, physiatrists, psychiatrists, internists, sports medicine doctors, ER doctors, dentists, and podiatrists. We learn acupuncture physiology and philosophy as it was taught in the 2nd century BC in China: the original medical acupuncture taught to Chinese physicians as main ways of treating ailments and maintaining health. The more recent permutations of acupuncture done by non-physicians have been popularized after Chairman Mao took over China and decentralized intellectual education. Various 'schools' of acupuncture became available by the Mao regime to equipe 'common health workers' with 'formulas' of acupuncture to treat village peoples. These 'new schools' do not focus much on acupuncture physiology/embryology/anatomy/pathology like the traditional medical acupuncture as it was taught since Huang-Di, thousands of years ago.
As I was learning about the 'original' way of acupuncture, we went through the fascinating physiology and order to approach diagnosis of disease and health using the 'biopsychotype' make up of the person, doing a physical exam and obtaining a good history of present illness, and examing the tongue and the radial pulses. It was fascinating... way more complete in the way to diagnosis a person than Western Medicine perspectives (which is based on the 'Cartesian' logic of the separation of body/mind/soul).

I have already some experience placing needles in another human being and trying to memorize several hundred other points and methods of treatment... I cannot wait until acupuncture becomes part of how I treat patients, and I also cannot wait until I can incorporate OMT (osteopathic manipulative therapy, which I love) with acupuncture. I would love to offer solutions for ailments of which where Western Medicine tend to sweep under the rug.

I can't wait...

Oh... pictures of the Tempe Street Fair (right next to the hotel):

Medical Acupuncture

So, just a quick status update, I've started 2 days of 4 of my medical acupuncture class... man, it is awesome. I can't wait to actually starting to understand this whole complete different method of treating patients. I think it offers a more complete assessment of a patient's health and deterioration. I will have more pictures and informations to come... stay tuned.

Beauty of Red

So, for the past 2 days I have been working over night shifts at the ER, which gave me time to be up in the morning for some very nice hikes and bike rides in Sedona, AZ... land of beautiful red rocks and weird spiritual things, such as vortex, aliens, and crystals... and also an pretty cool looking church. Sedona is a place I reminesce about. This trip back is some what bitter and sweet. Bitter part is letting go, sweet part is enjoyment of beauty unmatched. If that doesn't make sense, don't ask.


A catholic church build on the side of the red rocks. Sitting quietly in the pews listening to sounds of monks chanting hymns almost took me back to the dark-age France. I remember myself in the monestery of Southern France a few years back, sitting in the old 12th century monestery off of the beaten path... walking by rolls of lavender and grapes... Times of solitude and peace.

A 6 mile hike around Bell Rock and Courthouse Butte . Bell Rock was the center of the universe as thought by some New Agies that the Commet was going to fly by and pick them up. No joke.

WHAT!? No bike... you've got to be kidding me... I can't believe this! This is an out rage! Fines! What! I can't believe this! .... ok, I better simmer down...

Look at those red sand... aww, such a beautiful and serene hike.

Memories... Now looking back... shadows... and a stallion with a small package. Don't ask.

My favorite rock... SNOOPY! A picture of Yours Truly at my favorite dig "The Wildflower Bread Company"... if you are good, you can see Snoopy behind me.

Ahhh... my bike and I and some red dirt makes great romance... or some pain in the crotch from all the rough ridin'

That was scary! See that slick rock path? That was what I had to ride on. I was scared. You see, I am no world class mountain biker and I don't have guts to fall 60 feet... so, I went about 10 minutes on this trail and I had to turn back. NO, I can't do it. Perhaps another day. The view was good though. I will be back!

Hey look... my alien friend! I can't believe that he/or she has been in that tin-can all these years. I can't believe I got to take a picture with 'it' or he or she or ... um... let's go find some aliens.

So, adding on to all the wack jobs that I saw... here is a crystal castle. First of all, it just looks like a broken down house. Then, I heard about these 'awesome vortexes' around Sedona... well, you see many people don't know about these vortexes, they literally will change your life! So, I've decided to interview a few experts... including my green friend above.... here is what transpired, you also have note the nervousness in their voice and the twirling of the hair and head and the inability to look you in the eyes:

• Me: So, what are vortexes?
• Them: Well, they are 'scientifically studied' areas that have 'positive or negative' electromagnetic energies beaming from the earth because of the rich iron or spiritual deposits.
• Me: So, are they marked that I can experience and see it for myself?
• Them: No, they are not, but if you happen to pass through one, you will feel it.
• Me: So, what do you feel?
• Them: Well, one time I was hiking in through the vortex and I decided to take a rest, and when I sat down, I noticed that everything around me and the earth beneath me was sort of humming and vibrating. And, you feel somewhat renewed. It was sort of different for everyone... it was awesome!

Alright, enough of that... if that make sense to you, I don't know what else to say. So, other than all the 'interesting' things I saw in Sedona, I still love the red rocks. I still love the hikes and the biking trails. I love that this environment encourages stillness and quietness. Peace and beamed out.

Thanksgiving thoughts...

Today is Thanksgiving day and I voluntarily worked a 16hr shift in the ER. I remember last year on Thanksgiving Day, I was in New York, off of Broadway Avenue crowding with the several hundreds of thousands of people at the Macy's Thanksgiving Parade. I remembered floating in the streets with seas of people and buying chestnuts and 'street dogs' from street vendors. I remember the festivities of "Christmas in New York," the picture of the dreamy 'American Christmas' depicted in all the movies about Christmas. Christmas in New York is a dream.

I realized that without a dream, without family and loved ones around, it is really easy for me to not celebrate a holiday. What would a holiday mean anyway, if you cannot recall it later and share it with people who actually know what you are talking about?

I remembered festivities of Thanksgiving Day in years past. The extravagant 'mom prepared' dinners with a smorgasbord of food: juicy ham and turkey, yam, beans, cranberry, handmade mash potatoes and gravy, hotpot, special bread roles, fancy salads, homemade dressings, delicious desserts... and much more filled every corner of the table. Around the table would be a gathering of all sorts of characters from grandpa to aunts and uncles to family and friends and guests. The Thanksgiving tradition usually included my dad reading the story of the original Thanksgiving feast with the pilgrims and their first winter at the dinner table. Then, we may get together afterwards to sing songs and share what we are thankful for during that year. We would usually make part of sharing God's goodness to invited guests who were not believers in Christ. Sometimes family games would be involved. Then, the evening would usually conclude with giving thanks to our Lord in prayer and then all our friends and guest and family get a box of food to take home. (Or, it would be turkey for 2 weeks straight for us)

As we have grown up and moved all over on our own schedules, I don't remember having a usually family Thanksgiving feast in a few years. I must have to admit, I really missed that. I miss being able to share special memorable and unforgettable moments with those that I love and those that pour their love on me.

For this season in my life, I am finding myself, a little bit more grown up, and a little bit alone. Holidays and special occasions are merely just a memory and topics of brisk passing conversations in the hallways at work.

Today was an interesting day. We had had a lot of rain up here in Cottonwood and Sedona area. As a result, there was a huge pile of car accidents that plugged up our ER for the entire day. Many people came in with life threatening illnesses are necessarily admitted to the hospital for observation and treatment... and having to miss out on their Thanksgiving family gatherings. Lots of car accidents, car flips, substance abuse, and lots of other sick people... Some we just have to medically clear them to leave the hospital and go on with to rejoin their family for the Thanksgiving dinner. Many people, however, do not get to enjoy the festivities, which included a whole team of doctors, nurses, ER techs, respiratory therapists, radiology techs…

When you are enjoying your Thanksgiving feast, do give thanks for those who continued to work on holidays to provide the rest of us the peace of mind to enjoy special time spent with family. Be thankful for things you don’t remember to be thankful for! That was my new appreciation…

Babies, babies and babies...

CONGRATULATIONS HOLLY AND LARRY! T'is the season for babies, well, I have a few friends with newborns... they are so squishy cute. My friends, well, we are pretty much family... Holly and Larry Baca just had a new baby girl, Jasmine Noelle Baca: born 11/18/08 at 10:55am. I got my hands on the baby just a few hours out of the 'oven.' She's beautiful! Then, I met my other side of the family... Alicia and Tim Lindberg and their new baby, Ellaina born on 9/7/08. Here are some pictures of us:

Isn't Jasmine the cutest thing?!

Jasmine and I; Ellaina and I :) 2 beautiful princesses! What a lucky guy I am!

My new home... Sedona, AZ

After a month in the ICU in Phoenix, I am moving on. I have just moved into a 6 bedroom house in Cottonwood (a small town right next to the beautiful Sedona), and I have this huge house all for myself for this month... Anyone want to join me? Free house to stay. I am always looking for good company :)

This rotation is E.R. I hear that there are some really good mountain biking trails, world class, kinda like the ones in Moab, UT. So, I can't wait to take my crossbike and my mountain bike out for some good ridin'. *Pictures of my new house*

I have a busy year coming up: Medical Acupuncture class in Phoenix in 2 weeks; 2 residency interviews in Northern CA in 2 weeks; 1 interview at Ventura County MC; Cambodia in 1.5 months; 5 weeks in South America in a few months; 1 week of Osteopathic training in Chicago... Well, what else can I add to my itinerary? Oh, graduation from medical school in June...