An Open Letter to the Mindanao Times

OK, so I am not necessarily a crusader against idiotic bloggers or columnists, but I cannot abide by their idiocy.

On July 20, 2015, the Mindanao Times published a column from Fely V. Sicam entitled, "Are resident doctors really doctors?" The answer of course, is yes, but since she doesn't know that, she went on a tirade about how a friend was recently humiliated during a trip to the emergency room. I'm writing this from my phone and I don't want to type too much, so here's the link to her article: http://mindanaotimes.net/loud-whispers-are-resident-doctors-really-doctors/

She raises some valid points about health care towards the end of her article, but being partly correct shouldn't excuse a "journalist" from basic fact-checking.

This may is may not result in some backlash heading my way, we'll see. Responses to these sort of people usually result in p!ssing matches consisting of ad hominem attacks and claims of "That's not what I meant, you need to educate yourself and read between the lines." In other words, I expect them/her to double-down instead of apologize. I hope to be pleasantly surprised. 

If anyone's interested in sending their own feedback, the Mindanao Times can be contacted at

times.editors@gmail.com and mtimes46@gmail.com.

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July 21, 2015

To whom it may concern,

I am writing in regards to an article that was published in your newspaper and website on July 20, 2015, entitled, "Are resident doctors really doctors?" authored by Fely V. Sicam. (http://mindanaotimes.net/loud-whispers-are-resident-doctors-really-doctors/) Unfortunately I am unable to find Ms. Sicam's contact information, so I am forwarding my feedback to you.

The editors at your publication need to improve their vetting of what is published. Ms. Sicam's basic premise is wrong. Resident doctors are in fact real doctors. In her third paragraph, Ms. Sicam makes a distinction between licensed doctors and resident doctors. One cannot be a resident doctor without becoming duly-licensed first. Even if it was possible to do so, Ms. Sicam does not take any steps to verify her doctor's licensure - she simply makes a blanket statement about resident doctors predicated on her ignorance of this fact as well as assumptions based on superficialities. She's not even internally consistent. The resident said: "I'm a resident doctor," but she says he never spoke in English, which he just did.

In her fourth paragraph, Ms. Sicam gives her opinion of what she deems to be a "real" doctor. This is beside the point. Her primary question is, "Are resident doctors really doctors?" to which the answer is yes.

Because of her wrong premise, Ms. Sicam becomes incoherent. She is against fake doctors and inhumane ones. And ones who don't speak English (but really do). What about real doctors who she thinks are fake? It's unclear because she can't even distinguish.  While Ms. Sicam has some valid points regarding the expediency of her friend's care as well as the law punishing the illegal practice of medicine, the inadequacy of health care is a broad-based multifactorial problem that many people are trying to fix from various angles. Ms. Sicam can help with this fix... But only if she takes the time to check her facts first.

I would be happy to discuss this further if you or Ms. Sicam desire. Thank you very much for your consideration.

Yours,
JB Chong


*Updated on a laptop later at 10:10am, mainly to add text to a paragraph and improve formatting.  The text of the letter itself remains unchanged.

Awesome (C. Diff, Part 2 of 2)

The "alternative treatment" is actually fairly simple and one that homeopaths would probably appreciate.

Since the problem is caused by a dearth of normal gut flora (bacteria), the solution would naturally be to re-populate the colon with good germs.  And where else to get the good germs that normally reside in your colon but... in somebody else's healthy feces.

The procedure is as follows*: take a little over an ounce of a healthy person's poop (about half the size of a large Snickers bar), mix with two ounces of normal saline, and blend on high until nice and smooth.  Run the mixture through a coffee filter twice, and administer the elixir through a nasogastric tube (i've heard of it instilled via colonsocopy as well).  The recipient must have prepped beforehand with a few days worth of vancomycin and a few doses of omeprazole (very important steps, as you don't want to have to do it again because you forgot to prep the poor patient!).

I've never had the privilege of doing this procedure, but i believe some of the Infectious Disease doctors in our institution have had success with it.  Due to the "ick" factor, it's often a treatment of last resort - prior to calling a surgeon and taking the whole diseased colon out.

This is extremely is fascinating to me, as it illustrates important dichotomies in medicine: antibiotics, powerful drugs that can save lives, can also cause horrible disease and death.  And feces, shunned as disgusting and a vector of disease, can actually promote health and life.  Truly, in many things, there are both awful and awesome sides that need to be respected and understood.

Anyway, the mere mention of Snickers has made me hungry enough for a snack...

After a hard day's work of curing disease and saving lives, one has to unwind with a nice snack.

Mmmm, Snickers (a full two ounces worth).

Chocolate milk to wash it down.  

Got milk? 

*Source: Aas, et al. Recurrent Clostridium difficile Colitis: Case Series Involving 18 Patients Treated with Donor Stool Administered via a Nasogastric Tube. Clin Infect Dis. (2003) 36 (5):580-585.  Link to the article.

Awful (C. Diff, Part 1 of 2)

Antibiotics are not harmless.  

This may come as a shock to some people.  After all, antibiotics kill germs, and germs cause disease. So what's wrong with that?  

A lot, actually.  

For one, the antibiotic you're given may not kill all of your bad germs.  The ones that are left can develop drug resistance (essentially, immunity to the antibiotic) and/or cause an even nastier infection.  

One of the bad infections i've come across is from an organism called Clostridium difficile, which is somewhat affectionately referred to as "C. Diff."  In short, if you've used antibiotics recently and have killed enough good germs in your gut, C. Diff can gleefully step in, take over your colon, and obliterate it.  

One of the hallmark symptoms is diarrhea.  Not just in the soft-and-could-use-a-little-more-bulk-poop kind of way, but in the belly-hurting, toe-curling, run-to-the-bathroom, explosive-and-sometimes-bloody kind of way.  Imagine doing that once after an ill-advised trip to the Chinese buffet.  Then imagine doing it fifteen times in one night.  See what i mean by "obliterate?"  

(Interestingly, when i was in the RP, C. Diff struck me as kind of a semi-mythical beast, like PE (pulmonary embolism), which was only typically talked about in CPCs (clinico-pathologic conferences).  Or maybe i just wasn't exposed enough.)  

Left unchecked, this type of infection can kill not just your social life, but YOU.  So it's always important to talk to your healthcare provider about whether or not antibiotics are really needed for your current illness, or if you can fix it with just rest and fluids.  It's not advisable to press him or her for them "just in case it helps."  

Thankfully, there is a treatment for C. Diff, if not a guaranteed cure.  But ironically, it mostly consists of... more antibiotics.  If however this treatment didn't work (or if you just flat-out refused to take any more antibiotics - which i'm certainly not advocating, since they do have their place), there is another way that is near and dear to my heart.  

TO BE CONCLUDED