Day 14 Cebu City, Philippines

Today was my Grandma and Grandpa's 60^th wedding anniversary! It was also my Dad's birthday! Congratulations Grandma and Grandpa, and happy birthday Dad!

It's always quite the task trying to explain to everyone here what exactly a PA is. As far as I know, PA's are only in the US and have yet to make a foothold in the global job market. I basically tell everyone that I'll be in between a nurse and a doctor.

Anyway, I just celebrated today and met a lot of relatives from my mother's side. I'll be visiting them at their place next time I'm in Cebu, City.

Some of the extended family.

Day 3 Cebu City, Philippines

Today is my Grandma's 88 birthday. It'll be nice celebrating with extended family.

Grandpa said this morning when my sister and I were young, he used to make us chocolate oatmeal, and we'd sit and eat together. He's making some now, and just like when I was young, we will sit together and eat.

It's almost dinner time, and family is starting to show up. It's always strange meeting extended family because they (like all Filipinos) approach American's differently. Not in a hostile sense. They are just very timid. For example, I've been staying in my Grandma's room during my stay here and there is always at least one care giver in the room (which, by the way, they've done an amazing job. My grandma's skin looks great – no skin tears or pressure sores.) They won't speak to me unless I speak first and it's always very polite and formal.

It's a strange culture here. You can see traces of western influence everywhere. In Oregon, most of the places I've worked have fostered a more informal work dialogue. My superiors prefer their first name. Speech is much less formal. Here, in the Philippines, it seems like a throwback to 1950's Americana. Lot's of “sirs” and “madam’s.” I have yet to hear a “yeah” or a “nah.” I'm not saying it's a good or bad thing, just different.   

Day 2 Cebu City, Philippines

It's been my first full night here in Cebu, and already it's intriguing reevaluating my culture through a set of older eyes.

I'm staying in Cebu City with my Grandpa and Grandma for a few days before heading down south to Dalaguete. About a year ago grandma suffered a stroke leaving her in a persistent vegetative state. My mom had me bring a new feeding tube, an oximeter, and a couple of chucks. Grandma's receiving twenty-four hour home care, which is nice, but situations like this always make me think about the difference between extending life and extending the quality of life. It's a controversial topic, no doubt, but it's the first time I've physically sat across the room from a family member with a feeding tube while thinking about it. It's easy to form opinions and judgments when any situation is far removed. Ask any American how to solve the problems in the Middle East, and they'll give you a number of opinions. Ask those same Americans how many of them have lived in the Middle East, or traveled to the Middle East and more than likely they won't have done either. The same logic is applicable to medicine.

Earlier, my Grandpa said to me, “Look at your Grandma, she's awake. Her eyes are as big as the moon.” Compared to my Grandpa, do I really know what she would want? Would any doctor?

In the States, at work, I noticed the growing rift between that idea: What the doctor wants and what the patient wants. It seems the older tradition states the patient must listen to the doctor. Now, there is a paradigm shift the other way – the doctor must pay more attention to what the patient wants. It's definitely an important issue I consider when thinking about my future career as a PA.