15 October 2012

Up Close with Giovanni Manguiat Jr., M.D. Part II

<-- Continued from
On Taking Up Pathology
I learned to love Pathology during my rotation as a clerk in our clinical elective. Course faculty coordinator Dr Felix Marcelo, who was also my UP Pathology professor during second year, was very instrumental in opening my eyes and awakening my passion for this lesser known, not so glamorous and low profile but no less important specialty.

Prior to this, I had my sights set on Internal Medicine or Surgery. I chose Pathology because it cuts across all the other specialties. That is why the pathologist is the doctor’s doctor, the ‘lamplight’ of all other specialties whose doctors are dependent on us to enlighten them so to speak and ‘lift the veil’ on all the mysteries and questions that they have regarding their patients.

We guide their hands and mould their thought processes as they strive to diagnose, operate on and, consequently, heal their patients using the valuable information that we provide them. Even in death and in the solving of crimes – think CSI which deals with forensic pathology – the pathologist is an integral part of determining the cause of death among other things in cases of unexplained or unclear reasons for the demise.

I took Anatomic and Clinical Pathology – as a combined training program – as my residency-specialization also at UP-PGH. I took and passed the specialty boards and became a diplomate of the Philippine Society of Pathology in 2003 and became a fellow of the society in 2010.

I was also under the tutelage of Dr Nelia Tan Liu – Harvard and Massachusetts General Hospital-trained Pulmonary Pathologist and my UP College of Medicine Pathology Professor – during my stint at the Lung Center of the Philippines, where I got to fine-tune my training in the subspecialty of Respiratory/Pulmonary Pathology.

On His University of Virginia Stint
The University of Virginia (UVa) Visiting Fellowship in Neuropathology was arranged for me by one our former Philippine Society of Pathology annual convention speakers, UVa Professor of Neuropathology and Neurosurgery Maria Beatriz Sampaio Lopes, M.D., Ph.D., who was the co-trainee and very good friend of my Neuropathology mentor at UP PGH-College of Medicine, Dr. Edwin L. Muñoz. They were co-neuropathology fellows at the UVa Med Center during the early nineties.


“Philippines? Where exactly is that?” To which I would, of course, point to the huge world map in our dining room and start my Philippine History mini-dissertation on the fifty-year American occupation period in straight grammatical English that, I daresay, was so much better than how they spoke and even better than how some Americans speak.
The program was at my own expense and was the fulfilment of my career wish to train in this particular subspecialty, something that Dr Muñoz was well aware of even during my residency days under him. It was the most amazing life-changing academic experience that I had ever had; largely because of my God-sent Brazilian-American mentor Dr. Lopes. She exposed me not only to the rigours and intricacies of her subspecialty and treated me like I was one of the regular neuropath fellows.

Aside from the comprehensive Neuropathology training exposure, which included once-a-month hour-long trips to Richmond for some forensic brain-cutting at their forensic institute, she allowed me to interact with all the other consultants, fellows, residents and medical students of the University Hospital.

I participated in all of UVa’s Pathology Department’s learning conferences and activities. I also encountered the great Dr. Stacey Mills, the famous pathology book author and editor-in-chief of the American Journal of Surgical Pathology and Neurosurgery. There was also Dr. John Jane, Sr., who operated on the spinal cord of the late Christopher Reeves right after he fell off his horse and got paralysed.

By the way, at that time, there was also the very kind and unassuming but very bright Dr. Kim Sangpyo, who was also a visiting fellow and pathologist sent by his university in Korea. Dr Kim and I did not have practicing privileges and our J1 visas were purely for studying purposes.

My stay in idyllic, charming and breathtaking Charlottesville was simply one of my most unforgettable and memorable stints abroad. Nestled on the foothills of the Blue Ridge Mountains, the University of Virginia in Charlottesville has vast spaces and the green tree-filled beauty of UP Diliman – but is around twice the size! – combined with a rustic Southern laid-back charm and clean fresh air that is more UP Los Baños.

Talk about conducive to learning my subspecialty of choice – I had a blast! I was given this once-in-a-lifetime experience and I savoured every moment that I was there! As an added bonus, I was actually living on-campus in the Lorna Sundberg International Centre, the first Filipino in its sixty or more year history!

Of course, I had to make sure that I represented the very best of being Pinoy because I lived with cumulatively around 30 or more different nationalities during my stay. Double Ph.D. research fellow Moroccan Fadila Guessous, who was the resident manager for around five years already, became a very dear and good friend and we still call and write to each other every so often.

Before she retired just right after I left, Centre Directress Judy Saulle and an assistant at that time, Tanya Reeves, also became my dear friends; and feedback from these two were very heart-warmingly positive. I guess their first impression of Filipinos was good – mission accomplished!

It was a very amusing and eye-opening after-work set-up in my home-away-from-home. Dinner was like a United Nations meeting; and after eating we would lounge around the living room or the terrace interacting, listening to someone play the piano, watching television, reading Time or Newsweek or drinking wine.

Of course, I made sure that I went to Mass on Sundays, sometimes with my fellow Catholics, the Brazilians. This would entail 30-minute walks to St Thomas Aquinas – I got to appreciate the university architecture to and from the church.

Friday and weekend nights were for ‘after-five’ activities and we would go out, ride the free trolley going downtown, bar-hop, listen to live bands or try out a new restaurant. Other times we would just chill out in our own rooms for some private ‘me’ times.

One interesting anecdote happened when I went out for a drink and some dancing with a Swede and a Dane in their early twenties. The bar that we went to asked me for some ID thinking perhaps that I was too young and assumed that the other two dudes were of age.

I was also probably the longest staying at the International Centre during that time period, such that the joke going around was that I should be the unofficial ‘assistant resident manager’ because everytime newcomers would arrive, I would show them around the house and orient them on house policies.

Of course, some of the foreigners would still give the usual comments reflective of preconceived notions and which were kind of discriminatory – racist, even. For instance, “Being Asian and all, why is your English so good?”

“Philippines? Where exactly is that?” To which I would, of course, point to the huge world map in our dining room and start my Philippine History mini-dissertation on the fifty-year American occupation period in straight grammatical English that, I daresay, was so much better than how they spoke and even better than how some Americans speak.

Some of these people, mostly Europeans – seriously – were so clueless and ignorant, or downright condescending that they needed to realize that – excuse me – we don’t live on trees as they might have snootily thought.

So who were the most likeable nationalities? The Spanish, Polish, Moroccans, Germans, Italians, Danish and Brazilians get my vote. Alberto, Marek, Fadila, Adriana, Marcelo, Martin, Caroline and Robert were proof positive that it can be quite an absolute joy to live with them in the same house and to be friends with them despite some cultural and religious differences which, of course, had to be respected.

I was so enamoured with those living with me right before I left that I threw a Fourth of July farewell party. Guests and residents took care of the drinks while I cooked and served them what else but Filipino-Spanish food – lumpiâ, three kinds of pancit, adobo, paella valenciana and sweet plantains a la mode – banana with caramel syrup spiced up with star anise, nutmeg and cinnamon, spiked with rum and brandy and served with a scoop of Vanilla ice cream.

My UVa experience was truly the complete package. The hospital gave out free tickets to a Rod Stewart concert on campus which I saw and enjoyed. I would go around the city and its nearby counties alone and with friends during weekends. Sometimes I would go to the Farmer’s market on Saturdays to buy fresh goat cheese, cherries and peaches.

I enjoyed attending the university graduation with John Grisham as speaker and attended the after-grad party which Dr. Lopes always gave at her beautiful home. I saw and experienced the yearly Filipino community event, the Barrio Fiesta which was attended by Filipino university students and their families from all over the state.

I was even invited by the more mature Filipinos who lived in the vicinity for a block Rosary to celebrate the feast of Our Lady of Perpetual Help. My host family picked me up from the International Centre to attend this and toured me around the Kluge Estate and the vineyards surrounding Charlottesville before dropping me off at International Center at the end of the day.

At the International Centre itself, we would have lectures, film and live musical presentations, mini-after parties, etc. These featured well-known speakers from different embassies and universities and musicians of different nationalities who would play a variety of instruments live.

Of course, the university itself has some cool historical and heritage sites like the Rotunda, the Carillon, the Lawn, The University chapel, etc. This is the university whose founding father is Thomas Jefferson, after all; and two other American presidents studied there aside from other famous names like Edgar Allan Poe and, more recently, TV Anchor Katie Couric.

It was also during my stay when the infamous April 2007 Virginia Tech massacre happened a few kilometres away. I attended the memorial service for the 32 Virginia Tech casualties who were shot by Korean American Cho before he shot himself that fateful Monday.

Everywhere you went, the Hoos (UVa students) would express their sympathies for the Wahoos (VTech students), displaying banners and writing on this school bridge that allowed such graffiti-like messages. Flags on campus flew at half-mast for months.












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