Open Letter to Noynoy Part 2
Beyond the Wang Wang: Fixing Road, Traffic and Pedestrian Discipline
Has Ancillary Effects

Mr President,

When one visited Gordon's Subic in the mid 90's, it was like entering
a different world far removed from the chaos of road discipline found
in urban and provincial Philippines: We would actually stop at
intersections, observe speed limits, walk in the proper lanes. We knew
we would be flagged and caught for noncompliance. It came to a point
where even when there were no Subic cops physically around, we
followed these internal road rules anyway. Why is our road and
pedestrian behavior in Subic and in other countries exemplary, only to
horribly deteriorate when we step out of these places? It is simply
discipline and enforcement, stuff that the "common tao" should see,
observe, feel, internalize, comply.

When we see law enforcers corrupting themselves with "tong" and
"lagay" in our very streets, we permit road chaos. Jail these errants.
Replace them with young, idealistic incorruptibles.

Mendicants and hawkers on public roads? They are jaywalkers and pose a
road hazard to us and impose a health hazard on themselves. Apprehend
them and their "business managers" who allow them on public roads
which are for motorists and pedestrians, not for them.

When we see motorists making "lagay" and giving "tong," jail them.

Jaywalkers? Apprehend them. Apo Ferdie in the 70s made them trim grass
as their fine for all to see. That was a good thing, right? It should
be made shameful to jaywalk.

Smokebelching public transport? Give our Vice President who rode to
his June 30 inauguration on an e-jeepney something worthwhile to do.
Have him electrify or solar power ALL urban and provincial buses
jeepneys and tricycles. They have solar powered tuktuks in Thailand
already, don't they?

Buses, jeepneys, tricycles that don't avail of their stops and keep to
their designated lanes? Suspend their licenses. Reinstate them when
they show evidence of compliance in our streets.

Public conveyance stops are to be situated in places AWAY from thruway
traffic flow. Eliminate bus, jeepney and tricycle stops that impede
thruway traffic flow. Forever. Pedestrians walking a bit longer to
their destination will be good for cardiovascular health anyway.
Mallowners and building permit issuers should be prosecuted for
building their "traffic magnets" in proximity to major roads.

Remove vendors and physical obstructions from public sidewalks and
conveyance stops. Please.

When the common tao sees and feels the effectivity of enforcement of
road, traffic and pedestrian rules on our very streets, they will
learn to comply with their other civic duties and responsibilities as
paying their taxes and not breaking the law because they will realize
that the State will not let them get away with it.

We need to feel your changes first on our streets, Mr President,
beyond the wang wang. The State must impose order to the War in Our
Streets. This war is ongoing, the enemy is the lack of discipline and
law enforcement, and the State must win this war QUICKLY to make our
streets the FIRST visible, palpable shining example to the world of
your resolve.

ENFORCE DISCIPLINE ON OUR ROADS. IT WILL HAVE EFFECTS FAR BEYOND THEM.

Open Letter to Noynoy Part 1:
Improving Universal Health Care and Heath Security Has Ancillary Effects

Mr President-Elect,

When he inherited his young island nation from the Malaysian
Federation, and faced with a raging, gargantuan communist insurgency,
Lee Kuan Yew of Singapore told his 200 "best of the brightest"
associates in 1965 that "whatever the Reds offer, WE HAVE TO OFFER
SOMETHING BETTER."

We can learn from Singapore by simply starting with health care.

Doctors are sorely needed in 90% of the Philippines. Medical students
after passing Medical Boards are to be issued certificates of medical
licensure AFTER they have completed 2 years of national medical
service in the provinces. As with Singapore's public servants, doctors
in provincial service will have to be paid INSANELY WELL. If this
works well with doctors, pay the rest of our government public
servants similarly. The best and the brightest of Singapore were
recruited to serve in government, and it helps that they were paid
better than the private sector. With fiscal discipline (clamping down
on corruption) and stern justice (Internal Security Act), they made
Singapore First World in 20 years. Try it here in the Philippines.

To improve access of Filipinos to healthcare facilities especially in
acute situations, a nationwide interisland and road/port/bridge
infrastructure has to be started. Employmemt in this giant nationwide
infrastructure project will generate jobs for millions of Filipino poor.

A national health identification system ID card should be issued to
all citizens containing their past and current medical status. This
will also improve domestic security and enhance revenue collection. No
compromise.

In Cuba there is a hospital for every 5 barrios. This can be
replicated in the Philippines. An economically viable model should be
a 100 bed hospital. Building 90,000 such hospitals (1 hospital for
every 1000 Filipinos) should cover the whole population. Hospital
building generates businesses and jobs.

Doctors need to be secure to practice in the remote barrios.
Increasing the military and police budget to enhace sustained security
will encourage doctors and rural people to stay in their areas. Our
fathers brought down Taruc from the Huk boondocs in the 1950's using
the successful Magsaysay-Landsdale model of dealing with insurgency, a
model we should revisit.

There must be a research hospital in each province and region to
specifically identify and address solutions to public health problems
unique to each province/region and to create practical technologies
and health care models unique and appropriate to each area.

Taxation will need to be improved to fund the Philippine Health budget
from its current 2% share to 15% of the national budget.

Enforcement of taxation on Filipinos will require a revamped justice
and law enforcement system to ensure compliance.

Funding will be assisted by encouraging the "oligarchs" (the term
Ferdinand Marcos and Ninoy Aquino used to describe the Philippines'
super rich) to moving their overseas funds back to the country's
local financial institutions, like the Indonesians.

PhilHealth, currently underfunded, should be expanded to include FULL
coverage for every service, including big ticket procedures like organ
transplantation, coronary bypass, and chemotherapy (kaawawa-awa talaga
ang Pilipino). Current shortfall in Philhealth budget is due to the
overwhelming failure of remittances by companies of their employees'
Philhealth contribution. If the justice system and law enforcement
will be consequently revamped and improved this can happen. Revenue
collection has to be improved and this will not happen with poor law
enforcement and a slow justice system.

Telecommunications have to be upgraded to allow Filipino MDs here and
abroad to help local experts in remote areas via telemedicine
encounters and remote (robotic) surgical procedures. This must be made
ubiquitous as we can have the best expertise without having our
overseas and local urban experts physically present.

Public sanitation infrastructure development to the barangay level
quells disease and generates employment.

Vying to beat India, Thailand and Singapore in Medical Tourism
promotes jobs and generates income. The Filipino, because of his being
"mapuso" (heartfelt, genuine and caring concern for another), is
undisputably the world's best service provider. We have to complement
this trait with world standard technical proficiency, and we will be
unbeatable.

Pollution control and going green promotes health and employment.
Improved law enforcement and a justice system will aid this.

Local pharmaceutical manufacturing (our drug prices are one of the
world's most expensive) promotes jobs and research.

Initiating Sports Development Infrastructure generates jobs from
barangay to national level while promoting health. By focusing on
certain sports and being competitive in the international sports
arena, these endeavors will serve as an example to our youth to aspire
for sports excellence and sustain a healthy lifestyle. It is also a
natiomally unifying factor as you can observe from the Manny Pacquiao
experience.

To the masa, hunger is alleviated first before he thinks about his
health. Corporate agri and aqua and animal culture steeped in
mechanization and technology are anti hunger and promote food security
and productive land redistribution.

Distill Ghandi, Ho Cho Minh and Mandela and formulate a unifying
national vision. Distill Lee Kuan Yew and be tough and incorruptible
and LOOK, not WAIT for the best and the brightest to help you. Distill
Fidel Castro and emulate a relevant health care plan that will be the
world's envy and the Philippines' pride.

More open letters to follow, Mr President.

Wilhelmina Schuck Montemayor Eulogy
01 June 2010

My family wishes to express our appreciation and gratitude to all
those relatives, friends and colleagues who came by to visit our
mother at her wake, sent over flowers, mass cards, emails, Facebook,
Twitter and text messages, phone calls, not to mention your valuable
prayers. We hope that you continue praying for our mom beyond today,
as these are indispensable to assure us of her smooth transition to her
place with all the other saints in Heaven. Though her body is
physically with us her soul is now in that particular place where she
no longer can pray for herself, so it is up to us to
continue these petitions and supplications to assure her entrance into
the arms of our Lord, His Mother and all the other saints at the
soonest possible time.

How can one even begin to describe the incredible 95 years of one
Manna Schuck Montemayor? Born at the outbreak of World War 1 of
industrious German immigrants and fierce Tausug-Samal nobility in the
paradise of islands that was and still is Tawi-Tawi, she was a product
of the American initiated public school system and Pilar College in
Zamboanga. Returning to Jolo, Sulu to teach Math and English at public
school, she met a persistent young clerk of court, a newly UP
graduated lawyer from Alaminos, Pangasinan. Though she had her fair
share of suitors in Jolo, Mamerto Ruiz Montemayor eventually won the
first dance with the beautiful Manna Schuck at the weekly Saturday ball
and a bit later, the heart of this feisty German mestiza, marrying her
73 years ago. Being Moslem,
she converted to Christianity much to the consternation of her Tausug-
Samal mother. They were together for 37 years through war and peace.

Her courage and industriousness first manifested itself when the
Philippines went to war with Japan, as she relocated to her husband's
hometown of Alaminos, Pangasinan still pregnant with her 3rd child
Marilyn and with her 4 year old son Michael and 2 year old daughter
Minnie in tow. She sold gasoline and made dresses to keep herself and
her 3 children alive with nary a clue whether her young husband
Captain Montemayor was still alive or dead fighting the Japanese along
the Abucay Line in Bataan with the 41st Division. After almost 6 months
of not seeing him she finally collected him in
the Capas concentration camp in the summer of '42 bald, emaciated,
lice ridden but alive, and they were a family again.

After Liberation Mamerto Jr came along, the first of three more baby
boomer Montemayor children: Monina 12 years later, then myself. She
made her home at Agno Street, Quezon City, designing dresses and gowns
mostly to friends, augmenting the income of her
husband, by then a military lawyer and trusted associate of Ramon
Magsaysay. In the 50s and early sixties she saw her first three children
graduating from college and obtain further schooling abroad, marrying
and settling both here and in the United States, happy with their
successful professional and family lives.

With her husband retiring from the military and joining Atlantic Gulf
and Pacific, she moved us to the house in Magallanes Village she herself mostly
designed 45 years ago, still sewing dresses, and raising her three
remaining children. Mert, Mona and I saw how she struggled when Papa
passed away unexpectedly 36 years ago with Mert still searching for his
professional roots and Mona and myself still in high school. She
invested in rental apartments and real estate from what she earned
from dressmaking, rented rooms in our Magallanes home, and maintained
a tight budget, eventually completing the mortgage of the Magallanes
house. Her younger children Mert, Mona and I never felt want and
deprivation as she made sure we were schooled well and led a quality
of life unaffected by Papa Dear's demise.

She was there for us in our problems and triumphs. She was there,
unquestioning and unfailing when we needed her. She was there as we
broke out and went our own ways in work and family life, remaining a
beacon in our troubled seas, worrying about our health, our loves, our
work. Through it all she remained beautiful and elegant, active with
the AFP Retired Officers Wives Association and Catholic Women's
League. Her time with her friends were spent on weekly luncheons and
mahjjong sessions which were socially sacred events.

As she aged she saw Mert and I married and Mona professionally
accomplished, complaining constantly about her failing eyesight,
missing out on her favorite Mills and Boon novelettes, gradually
withdrawing from her social circle as she did not want to be viewed by
her amigas as becoming eyesight deprived and socially irrelevant. She
was incessant in seeking a solution for her failing eyesight for which
there was no known cure. She chose not to engage in her usual social
activities. She still managed to be there to go to the US to stand
witness to her granddaughter Maia's wedding at the ripe old age of 83.

As her children themselves started to grey and the grandchildren and
great grandchildren came along she would say that she had nothing more
to live for as she had done her job as a mother. We would always
counter her death wishes by claiming, rather correctly, that she was
German built and was healthier than any one of her children, failing
eyesight and memory notwithstanding. She chose to pass on 72 hours
after her 95th birthday with her last wish having Mona provide her
with a son in law ASAP.


Then as now, Manna Schuck Montemayor defined love: tough and tender,
caring without expectation of compensation, a love ever forgiving when
we her children disappointed her and caused her extreme heartache she
so rightly did not deserve as she was as human as all of us. We forever will
remember her as forthright, God fearing and an ardent lover of our
Blessed Mother, as she was never without a rosary in hand. We pray
that our Blessed Mother will accept Mama Dear in her loving embrace
and eventually take her to that big mahjjong parlor up in the sky
where Papa Dear, Minnie, Anna Felici, Grandpa Billy, Ina, Uncle Pandy,
Tanti Caroline await expectantly. Her name Manna comes from the
Biblical word for “bread from Heaven”. Rightly so, she was our Manna,
our sustenance, our sign from Heaven that God indeed cares for us all.

We promise to honor you and your life
by being the best person we can be, full of love, unconditional,
unfailing. How can we possibly forget you, Mama Dear? You simply live
on in each of us.

Again, we thank everyone in helping us celebrate our
mother's wonderful, wonderful life.

Commencement Address to the Class of 2010 De La Salle College of Medicine

Br. Gus L. Boquer – President of the De La Salle Health Sciences Institute-Hermano (San) Miguel Febres Cordero Foundation, Members of the Board of Trustees, Vice Chancellor Dr. Ramona Luisa P. Santos – (Academics), Vice Chancellor Dr. Mel Victor G. Frias (Research), Vice Chancellor Dr. Charles Y. Yu (Mission and Linkages), Vice Chancellor Dr. Alvin D. Crudo (Shared Services), Vice Chancellor Sr. Francesca San Diego (Hospital Operations), Associate Dean of the College of Medicine Dr. Josephine Carnate, Mr. Reynaldo G. Cruz our Registrar, Executive Director of the De La Salle Alumni Association Mr. Benjie Uichico, Esteemed Members of the Faculty of the College of Medicine and Non Medical Staff, Distinguished Graduates of the Class of 2010, alumni and alumnae, parents, friends.

Twenty-one years and many many pounds ago when I was a 2^nd year surgical resident I was asked to deliver the Main Remarks as Guest Speaker of the High School Honors Assembly of La Salle Greenhills, my elementary and high school alma mater. There I met my old grade school principal, the late great Brother Rafael Donato, who was I believe President of Greenhills at the time. Upon mentioning that I was a surgical resident he informed me Emilio Aguinaldo College of Medicine had recently become part of the La Salle system, and that I should visit Dasmarinas, Cavite sometime. Well, two decades later, here I am Brother Rafe, not only visiting, but addressing De La Salle’s College of Medicine Graduating Class of 2010. I could not ask for a greater privilege.

How did I deserve to face you, the Class of 2010 as commencement speaker? I cannot fathom any reason except that I, too, swore to the Hippocratic Oath just as you will a few minutes from now. What wisdom can someone surgically trained in private hospitals, engaged in purely private practice, teaching formerly and currently at private medical schools and at the cusp of middle age possibly impart to medical students graduated by their school a few minutes ago? Nothing profound, I assure you; just simple, practical tips from a not-yet-so-senior medical practitioner.

First, you cannot thank your parents enough for what you are and what you have accomplished today. When I was in fellowship training long ago and far away, aside from surgical residents I would handle medical school students as part of their clinical training. These bright, incisive young people from Ivy League pre medicine programs would castigate me no end when they learned I was an overseas medical school graduate. They would first ask me how I paid for my medical school education. When I would tell them my parents paid for medical school they would tell me: “you are too fortunate, Doctor Montemayor. We had to take out a bank loan just to pay for medical school.” I did not know how to react; whether to feel guilty Filipino medical students such as I never had it so good - and how different the resulting motivation to study hard, to learn as much, to make the most of one’s medical schooling would be between someone who had to borrow money versus someone given money to become a doctor. How fortunate we all are indeed. The perception is true. Most of us had our medical education served to us on a silver platter. These last four years, dear graduates, how did we manifest our gratitude to our parents? How did we translate our thanks for this tremendous sacrifice they made into something palpable or valuable or worthwhile? How did we for our part honor their sacrifice and effort to allow you to sit where you are today in your toga and masons cap? Never forget what they had to do by being the best you can be. As a parent myself it would not be as much expected as appreciated.

Secondly, help La Salle--the school that educated you. The La Salle physician is both a teacher and healer, as the DNA of a La Salle School is education for the least fortunate. St. John Baptist De La Salle made it his commitment to teach the poorest of the poor, without compensation. He taught others to become teachers in the same way, without compensation. As a La Salle medical school graduate do not forget not only to heal, but to educate as well. Remember St. La Salle’s commitment to the poor. Teach your patients both rich and poor as you doctor to them. Teach them not only what to do when they are sick, but more importantly teach them how to be well. Promote concepts of wellness, for that is the springboard of preventive care.

Your school and its teaching hospital is expanding to enhance the ability to connect with our intended market --- the most deprived and unfortunate of Filipinos who cannot or barely can pay for their medical care. When you are financially fortunate enough, do not forget La Salle. The physical environment you immersed yourself in the last 4 years is a lot different from whence you started your medical schooling; it has become, by leaps and bounds, a better environment for you to learn: new buildings, new library, new facilities. For the institution’s expansion to proceed we need financial help and we look to you our new alumni to help La Salle and its teaching hospital serve all the more patients.

Thirdly, know right from wrong, the truth from the lie. As a Filipino citizen we see our environment clouded all the more not in black and white but in a gray haze of untruths and distortions of reality. You must stand your ground, and ferret out the truth. As recent history shows, the La Salle community has emerged as one of the very few beacons of truth, calling corruption by its very name, protecting the truth tellers and whistle blowers, demonstrating to Filipinos who still care that political stability should not rest on a bedrock of lies and untruths.

As for the medical field, further the truth by considering research for those of you inclined to it. Research confirms and reveals truths. Your school is committed to research. Research is sorely lacking in Philippine Medicine. Enhance Philippine medical research; organize it, lead it, fund it. Not all western medicines work well with Filipino patients, not all western algorithms can be applied here in the local setting. Our economy cannot support too many currently emerging but expensive diagnostic and therapeutic technologies. Local research injects more relevance in patient care, resulting in better patient outcomes for Filipinos at more reasonable cost.

Fourth, fulfill the needs of your country. When I graduated from medical school 24 years ago, we had just deposed an overstaying president. We as 4^th year medical students were part of medical teams stationed at Mendiola Bridge that fateful February night. We cut our hands feet and legs pushing away the barbed wire as we inched closer to Malacanang upon news of the flight of its long time occupants, first as a hesitant walk, later graduating into a giddy run as others scaled the once forbidden gates. I will never forget the feeling of being part of history. People were not only happy, they were euphoric. As I contemplate the past, examine our tumultuous present and pray for our nebulous future as national elections near I sense that great change is afoot; we must stop betraying each other, work together and echo our desires into productive action.

How do you as young physicians help your country? Being helpful certainly is embedded in doctoring anyway, you so rightly may claim. What do we need to do as physicians aside from doctoring? Will you be less patriotic if you treat foreign patients if you decide to relocate overseas, or if you decide to confine your practice, as I, to pay patients in an urban setting, knowing well enough that large numbers of our countrymen reside in rural areas and barely have or do not have access to a physician? The short answer to this difficult question is that there is none. There are thousands of permutations to helping our underserved countrymen. Choose a path that works for you. If living and working abroad would become your chosen path realize that because of technology the world has shrunk to the size of a town hall, a barangay, and the physical boundaries of the Philippines have forever dissolved in the face of email, social networking, SMS and cellular phones. The Philippines because of its citizens and new technology has become a nation without borders—a worldwide nation. We will technically never leave our country anymore. The sooner we realize this and get our act together as a worldwide country, the better things will become.

Fifth, you will not be happy in work you do not love. There is a world of difference between aptitude and passion, about knowing what you are capable of doing from what you enjoy doing. Some of you are already decided what they want to do, others not so. Discern what your passion is early on, and follow it. What particular aspect of medicine are you most passionate about? You are currently at a crossroad – many paths lie ahead but you have to choose one. Unfortunately as you advance in your medical career one will definitely encounter more crossroads, each become busier and busier, making one’s decisions harder and harder to make. Choose something that ignites a fire within you, a fire that burns brighter with each day.

Sixth, as you further your training and start your practice, the tried and tested qualities of availability, affability, affordability and being amiable will always be desirable. However, know also how to properly sell yourself. Everyone is a salesman. Somebody always sells something. It may be a physical product, a technology, a service, a skill, an image, a perception, attitudes and values. Doctors are not exempt from selling their skill. I do not mean this in an unethical way. Connecting to your intended audience lies not merely in the non-medical realm but is totally relevant in your future medical practice. Learn the concept of differentiation. Ask yourself: what will make a patient choose you as his physician? What will differentiate you from the other doctor with the same skill set?

Seventh, be fearless. Success they say is a series of mistakes. Mistakes are for the learning. Do not be afraid to err, as long as you learn from them. There will be mistakes you will make, mind you, in the course of your medical training and practice that will result in the unintentional injury and death of those under our care. These situations will happen and will be difficult to bear, but that is the stark reality. To honor these patients we must learn to be the better and wiser for the errors we unintentionally make. The climate in Philippine medical practice is not as litigation happy (yet) as that of other countries. It may very well become so, but as long as you appraise patients of all the possible complications of tests and treatments, when you allow patients to take part in their medical care and communication lines are always open, you will be spared the bane of litigation. Take good care of your patients, and your patients will take good care of you. Fear, though a great motivator should not make us cower, but soar to greater heights. Observe Manny Pacquiao when he climbs the ring prior to a fight. Observe his face and countenance…absolutely fearless. Stay clear up here--supratentorially; never allow people or situations to get into your head and affect your actions and thinking.

Eighth, learn to handle politics, especially in the medical workplace. The sooner you realize politics is everywhere and in everything you do even as MDs, the better you will be able to handle what I term “people situations.” As you further your training and glide into your practice you cannot avoid being associated with people younger and older who share your goals and respect your ideas. You will as well encounter people or groups of them that disagree with you or do not share your ideas. This is a reality, so one must deal with it, as it cannot be avoided. Be solid with your beliefs, stick to the truth, seek the happy compromise. You cannot please everyone, so at least try to get along with everybody.

Ninth, your patients are children of God just as you are a child of God. Behave like one and treat your patients accordingly. Respect their dignity, their humanity. This we must do always, even in the face of Medicine’s commercialization and the degradation of the doctor-patient relationship by businessmen and corporations. When we were graduating medical students twenty-five years ago I read an article in the New England Journal of Medicine foretelling the invasion of health maintenance organizations and managed care into medical practice and how it would affect the doctor-patient relationship. Indeed it is upon us, and twenty-five years later, the value of the care you give your patients has been commoditized into price schedules that doctors have to subscribe to. Doctors are no longer as independent as they once were, as they rely on patients provided by these HMOs for sustenance. With this reality what are you young doctors to do? Becoming financially savvy is not a sin to a doctor. If corporate middlemen have taken over medicine, doctors can just as well take it back from them. Become medical entrepreneurs. Organize yourselves. Get into business courses. Learn accounting. Learn how to read a financial statement. Doctors are inherently trusting people, and this is taken as a motivation for their deception by marauding businessmen. Your clinical-technical knowledge, skills and attitudes should not only be your equity on the business table when dealing with corporate medicine. One must be adept at finance, accounting, and management as well.

Tenth, let Jesus live in your heart forever. La Salle students implore this at the start and end of every classroom session. The answer to the question “What would Christ do if He was in this situation?” should animate your everyday life. Pray and desire Jesus always remains in your hearts, despite the humdrum, the everyday routine, the stress, the challenges, the sorrows and joys of doctoring.

Congratulations to the Class of 2010. Enjoy the rest of the evening. Thank you and Animo La Salle!