Making the Rounds with the Kirk Kerkorian School of Medicine at UNLV

Making the Rounds

August 31, 2021 Issue 293

Friends & Colleagues,

In today’s newsletter, we feature third-year medical student Paul Matthew Manno Cabugao, who immigrated to the U.S. with his sister and parents in 1999. For those of you who’ve read Making the Rounds over the years, you know it is not unusual at the Kirk Kerkorian School of Medicine for immigrants to be an integral part of our school’s culture. We have both faculty and students -- men and women reaching for the American Dream -- continually strengthening the medical school through their contributions of immense dynamism and talent. We hope you enjoy this written snapshot of Paul and his family, individuals who show us yet again that we should be proud to be called a nation of immigrants.

Marc J. Kahn, M.D.

Dean, Kirk Kerkorian School of Medicine at UNLV

Medicine By The Numbers

Kidney Disease

Kidney disease, also known as chronic kidney disease or CKD, causes more deaths than breast cancer or prostate cancer (according to 2018 data).

Kidney disease affects an estimated 37 million people in the U.S. (15% of the adult population; more than 1 in 7 adults).

Approximately 90% of those with kidney disease don't know they have it.

1 in 3 adults in the U.S. (approximately 80 million) is at risk for kidney disease.

Kidney disease is more common in women (14%) than men (12%). But for every 2 women who develop end-stage kidney disease (ESKD), 3 men's kidneys fail.

Approximately 1 in 3 adults with diabetes and 1 in 5 adults with high blood pressure may have kidney disease.

COVID-19 is targeting people with kidney disease, kidney transplant patients, and those at risk for kidney disease.

Source:

www.kidney.org

Medical Student Aims To Provide

Holistic Approach To Medicine

Paul Matthew Manno Cabugao, shown here in Red Rock Canyon, is set to graduate from the Kerkorian School of Medicine in 2023. Seeing how much he enjoys interacting with patients furthered his interest in primary care.

As a young boy, Paul Matthew Manno Cabugao, now a third-year student in the Kirk Kerkorian School of Medicine at UNLV, rode with his physician-father in a little red VW Beetle to visit patients who lived on the outskirts of the small Filipino mountain village of Kapangan.

Cabugao remembers that the VW, owned by the government of the Philippines and the only car in the village, was usually met with smiles and warm greetings, even in the monsoon season when dirt roads turned to quicksand-like mud.

“I always remember how happy the people were to see my dad,” says Cabugao, “Seeing his interaction with people, how they remembered him for happy things like deliveries of babies, was what initially got me interested in medicine. I saw people who really cared for one another.”

For the first six years of his life, Cabugao spent much of his time playing in creeks and catching small river crabs, eating guavas under guava trees and getting into mischief with his older sister. “In many ways, it was idyllic,” Cabugao says.

Paul Matthew Cabugao

Class of 2023 Medical Student

Today, as Cabugao thinks about what medical specialty he’ll pursue, he always recalls the give and take his father had with patients. While he enjoyed the surgery section of medical school, Cabugao realized what he enjoyed even more, was interacting with patients during their recovery, the way his father did.

“With one particular patient, who had been operated on by a UNLV physician, I talked at length with him before the residents arrived to round and see patients one day. We talked as we walked around the unit about his fishing trip and his days as a sushi chef. I learned that fish don’t necessarily taste better the fresher they are. Talking with him furthered my interest in primary care, where you can actually get to know a patient like my father did.”

On their trips to the Filipino countryside, father and son Cabugao often talked, in their native language of Tagalog, about how the livestock on their farm, including cows, pigs, and chickens, was faring. At one point, Cabugao wished his father, as well as his mother, didn’t talk so much about his interaction with chickens.

It seems Cabugao and his sister decided they wanted to make a chicken coop for baby chicks inside the house -- pillows were placed around the baby chicks who were chirping away as they sat on a bed. “That was fine,” Cabugao says, “until the chicks relieved themselves and dropped, shall we say, natural chicken nuggets all over the bed and pillows.”

“My parents weren’t happy with that,” Cabugao says, laughing. “My sister and I had to wash the sheets and everything and we got some spankings and were told not to do that quite a bit.”

To date, Cabugao is the only Kerkorian School of Medicine student who has been punished for allowing chickens to dispense their nuggets on a bed. He also appears to be the only medical student who has suffered a scratch on his face from a mother hen who wasn’t happy with someone moving a chick from her coop to another coop.

Be that as it may, Cabugao obviously survived both the displeasure of his parents and the mother hen. He is currently working on a research project with Dr. Anne Weisman that is scrutinizing opioid overdose autopsy procedures, “seeing if we are able to streamline the process. This would allow families to begin their grieving process sooner by having the body of the deceased returned at an earlier time. This would also ease the burden on coroners and medical examiners who are overwhelmed with numerous autopsy procedures.”

How Cabugao got to this time and place was far from streamlined.

“My clinical experiences have taught me that treating a patient holistically involves both listening and treating their concerns while being cognizant of their environment and situation. I aim to embody this mindset as I pursue a career as a physician.”

Paul Matthew Cabugao

While his parents both practiced medicine in the Philippines -- Cabugao’s mother was a dentist -- they thought the educational and professional opportunities for their two children were lacking in their island country, so they decided to immigrate to the United States.

At the age of six, Cabugao moved in 1999 with his family to California. Other members of the family, aunts and uncles, would move to Las Vegas (which Cabugao visited frequently). To take advantage of educational opportunities in the U.S., Cabugao had to learn a new language. “Elementary school was a struggle for me because I had to take extra classes to learn English,” Cabugao says.

The struggle was worth it. Cabugao became such an exceptional student that he received scholarships to the University of California, Berkeley, one of the country’s finest universities. He graduated with honors with a bachelor of science degree in molecular environmental biology.

Paul Matthew Cabugao at the

White Coat Ceremony, August 2019.

“It wasn't until I got older that I realized the profound sacrifices my parents made for their children (Cabugao’s sister received a PhD from UT Knoxville in biochemistry and molecular biology and is currently doing research at UC Berkeley),” says Cabugao, an avid hiker. Because of U.S. license restrictions, neither of his parents could practice in the U.S. in the medical fields they had worked in for years while raising a family. To help support the family in the U.S., his father initially worked as a certified nursing assistant and then a phlebotomist before becoming a clinical lab scientist, and his mother worked as a dental assistant prior to becoming a registered nurse.

At UC Berkeley, Cabugao developed a fascination with Kendo, a Japanese sword fighting martial art, and spiders -- he caught 100 of the creepy-crawly things for a spider biology class. In the same conversation, he’ll tell you that some male spiders just want to be eaten and that Kendo can be quite noisy, with lots of shouting and foot-stomping. “I practice my strikes with my bamboo sword at home but I don’t yell because I don’t want to disturb the neighbors,” he says.

After graduation from UC Berkeley, Cabugao worked as an emergency department technician in the Bay Area. He liked helping patients and seeing how his work improved an individual’s situation. He also worked as a volunteer at the San Francisco Health and Wellness Center. In both positions, Cabugao became further convinced that the practice of medicine, which he already leaned toward because of his father, was for him. He would apply, and get accepted, to the then UNLV School of Medicine, which his girlfriend from Berkeley already attended. He began his medical studies in 2019.

At the San Francisco health wellness clinic, he says he learned something that he plans on using in the future.

“A doctor at the center pushed me to consider the root causes of a patient’s chief complaint. One example occurred when a patient came to our clinic with trouble breathing without any irregularities in his vital signs or physical examination. After I assisted the patient by carrying a box of belongings back to his apartment, I discovered that it was suffocating to be inside. The window was too difficult to open so he kept it closed and the fear of theft meant he could not leave the door open. I fixed the window and helped get the air out of the apartment. When I saw the same patient the following week, I was relieved to hear he was no longer having any trouble breathing. My clinical experiences have taught me that treating a patient holistically involves both listening and treating their concerns while being cognizant of their environment and situation. I aim to embody this mindset as I pursue a career as a physician.”