Feels surreal that this is our last full week at the hospital but here it is! We continued this week caring for patients in the chemotherapy unit. One of the main patients that I cared for this week had a diagnosis of epigastric cancer with metastasis. I was told he got a positive result for HER-2 so his drug given was trastuzumab, usually given for breast cancer. There was another patient who came in to receive the same drug but she got it in as a sub-q injection. Something interesting that Nurse Ika was telling me was that that injection is made by a drug company that the hospital has a business agreement with where they get money back when they use their drugs. It’s much more expensive for the patient as well. Nurse Ika told me that if the doctor has the option, they will choose the branded injection for the patient to make money. Mia and I also got the chance to observe Dr. Parra assess a patient in the pantry room. It was a 34-year-old getting chemo for breast cancer. Her right breast was so ulcerated, that it looked almost moldy and crusty yellow. The patient had it bandaged up and almost didn’t show us because she was very shy. Then the doctor thanked the patient for showing Mia and me because he said the likelihood of us seeing someone’s breast at this state is very unlikely because of the available interventions we have in the U.S. He also noticed a new left mass on the patient’s left breast. The patient is not able to afford a CT scan, so the doctor ordered an ultrasound for the lump which is much cheaper. The patient also was not able to afford targeted treatment for bone metastasis that was going on but luckily her current chemo regimen helped the metastasis. The patient went from being wheel-chair bound to now being able to walk and not having to take any pain medications. She also told us how she lives on a different island 2 hours away but comes here to Cabrini to get treated. This conversation between the patient and doctor really was eye-opening. It shows the reality of how expensive healthcare is. But the doctor is willing to adjust the treatment to help the patient out financially, even if it means they might not get better. Dr. Parra also asked Mia and me the routine questions about where we are from and turns out he is familiar with Chicago as he often goes to oncology conferences at Northwestern. He is actually one of the best oncologists in Luzon.

We had a very fun weekend hosting our work party with the Cabrini staff that became good friends of ours. We had a great time eating good food, having some local drinks, playing party games that we showed them, making tik-toks, and listening to music all night. Sir August also brought balut for us to try before we leave because apparently no trip to the Philippines is complete without balut. Shoutout to Jake and Mia for eating it. I unfortunately could not go beyond cracking open the egg without throwing up. Other than that, a super great night and great end to our week!

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