01 / THE PERSON BEHIND THE NOTESPAMPANGA → PLM → MEDICINE
THE PERSON BEHIND THE JOURNEY
Hello, I’m Aemie Cruz.
Every experience has brought me here.
A Physical Therapy graduate, a small-business owner, an eldest child—and a future first-generation physician.
I am a BS Physical Therapy graduate from Pamantasan ng Lungsod ng Maynila, Class of 2026, originally from Pampanga. My journey has always involved balancing different responsibilities.
During the pandemic, while I was still a Grade 12 student, I started a small baking business while also working as a call center agent. These experiences taught me discipline, communication, patience, and perseverance.
As the eldest child in my family, I learned early to be responsible and independent. Today, I am continuing my journey in healthcare as a Year 1 medical student, working toward my dream of becoming a first-generation physician.
During Grade 12, I started a small baking business and worked as a call center agent. Baking taught me patience and consistency; working taught me communication and resilience.
02
Learning to see function.
At Pamantasan ng Lungsod ng Maynila, Physical Therapy taught me patient-centered care. I graduated in 2026, carrying that foundation into my next chapter.
03
Learning to look deeper.
Now a first-year medical student, I am working toward becoming a first-generation physician. Biochemistry is helping me connect the science with the person who needs care.
A CHANGE IN PERSPECTIVE
From “What do I need to memorize?” to “Why does this happen?”
At first, Biochemistry felt like unfamiliar molecules, pathways, and terminology. Then the chapters began to connect. The symptoms and diseases we encounter clinically have molecular explanations.
Six chapters that began as separate topics and slowly became one continuous story.
Showing all 17 entries
01
CHAPTER 01
Biochemistry & medicine
The molecular foundation of care.
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What I learned
Chapter 1 introduced me to Biochemistry as the molecular foundation of medicine. Biochemistry studies the molecules and chemical reactions that allow living organisms to function. More importantly, it connects basic science with health, disease, diagnosis, and therapy.
What stood out to me
Medicine does not begin only when we see a patient. It begins much deeper—with molecules, reactions, enzymes, and processes occurring inside the body.
My reflection
As a future physician, I cannot only recognize what a disease looks like. I also need to understand what is happening underneath it.
Connecting the dots
Molecular changes → cellular changes → tissue or organ dysfunction → clinical manifestations → disease.
This connection helps explain laboratory findings, disease mechanisms, diagnosis, and treatment.
Core memory
“Every clinical manifestation has a story happening underneath it.”
02
CHAPTER 02
Water & pH
The balance that makes life possible.
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What I learned
Something as simple as water is fundamental to life. I studied its unique properties and the interactions that make biological processes possible.
Hydrogen bonding and hydrophobic interactions
Salt bridges and van der Waals forces
Acids, bases, pH, and pKa
Buffer systems and physiologic buffers
My reflection
Before this chapter, I mostly thought of water as simply the main component of the body. Now I understand that its chemical properties allow many biological processes to occur. Water provides the environment where biochemical reactions happen, while proper pH allows proteins, enzymes, and other molecules to function correctly.
Why pH matters in medicine
The body cannot allow its pH to change drastically whenever acids or bases are produced. Bicarbonate, phosphate, and proteins help maintain the conditions necessary for life.
This helped me appreciate why acid-base balance is important in conditions involving respiration, metabolism, and organ dysfunction.
Core memory
“Water enables life, but pH keeps life in balance.”
03
CHAPTER 03
Amino acids & peptides
Small structures. Significant consequences.
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What I learned
Amino acids are much more than simple building blocks of proteins.
Unique R groups influence their interactions and properties.
They can be acidic, basic, aromatic, aliphatic, or sulfur-containing.
They participate in metabolic pathways and join through peptide bonds.
Their sequence influences the eventual properties of proteins.
pKa, ionization, electrical charge, peptide structure, and L- and D-amino acids describe how they behave.
Connecting structure and function
The structure of a molecule determines how it behaves. When amino acids are connected into a specific sequence, that sequence influences the structure and function of the resulting protein.
My reflection
Even a small change at the molecular level can potentially have consequences for the entire body. Diseases can arise from changes in molecules that seem extremely small but have major effects.
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CHAPTER 04
Primary protein structure
Reading a protein’s first story.
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What I learned
Proteins are not random chains of amino acids. Their primary structure is the specific amino acid sequence. I was introduced to methods used to study and analyze proteins.
Edman degradation
SDS-PAGE
Mass spectrometry
DNA cloning
Genomics and proteomics
Bioinformatics
My reflection
What surprised me was how Biochemistry connects with modern technology. We are not only learning what proteins are—we are learning how scientists identify, analyze, and understand them.
From structure to disease
Amino acid sequence → protein structure → protein function → normal physiology.
When something goes wrong: altered protein → altered function → cellular dysfunction → disease.
Core memory
“Structure gives us clues about what a protein can do.”
05
CHAPTER 05
Higher orders of protein structure
It matters how the pieces come together.
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What I learned
Primary structure: the amino acid sequence.
Secondary structure: α-helices, β-sheets, bends, and loops.
Tertiary structure: the three-dimensional arrangement of a single polypeptide.
Quaternary structure: the association of multiple polypeptide subunits.
These structures are stabilized by hydrogen bonds, ionic and hydrophobic interactions, van der Waals forces, and disulfide bonds.
When protein folding goes wrong
A protein must fold properly to perform its function. Disrupted folding can cause loss of normal function or harmful aggregates. This helped me understand the relationship between protein misfolding and disease.
Clinical connection
The chapter introduced conditions involving abnormal protein folding, including prion diseases, as well as disorders involving collagen structure.
My reflection
The body does not only need to produce the correct protein. It also needs that protein to fold and assemble correctly.
06
CHAPTER 06
Myoglobin & hemoglobin
The chemistry behind every breath.
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What I learned
This chapter felt especially clinically relevant to me. Structural differences explain the different functions of myoglobin and hemoglobin.
Myoglobin
Monomer, found primarily in muscle
Stores and facilitates oxygen availability
Hyperbolic oxygen-binding curve
Hemoglobin
Tetramer, found in red blood cells
Transports oxygen throughout the body
Sigmoidal oxygen-binding curve
Cooperativity and the Bohr effect
Hemoglobin shifts between the T state, with lower oxygen affinity, and the R state, with higher oxygen affinity. This allows oxygen loading in the lungs and release where it is needed.
In tissues, increased H⁺ and CO₂ promote oxygen release. Oxygen delivery depends on how the biochemical environment influences hemoglobin—not simply on having enough oxygen.
From hemoglobin to disease
2,3-BPG regulation and the Bohr effect
CO₂ transport
Hemoglobin variants and sickle cell hemoglobin
α- and β-thalassemias
Molecular defect → abnormal protein → altered red blood cell function → impaired oxygen delivery → clinical symptoms.
My reflection
A change in protein structure or synthesis can affect something as important as oxygen delivery.
C01
CLINICAL CONNECTION / SGD
A case that challenged my first assumption
When Iron Is Not Enough
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The SGD “When Iron Is Not Enough” involved Henry, a five-year-old boy with pallor, easy fatigability, decreased exercise tolerance, and exertional shortness of breath.
His initial laboratory findings showed anemia with low hemoglobin, hematocrit, MCV, MCH, and MCHC. His anemia persisted despite a month of oral iron supplementation.
C02
CLINICAL CONNECTION / SGD
Reading the findings together
When Iron Is Not Enough
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At first glance, Henry’s microcytic anemia could suggest iron deficiency. Additional findings made me question that assumption.
Persistent microcytosis
Normal ferritin, serum iron, and TIBC
Increased reticulocyte count
Mildly elevated indirect bilirubin and LDH
Target cells and abnormal hemoglobin findings
These findings pointed toward a disorder involving hemoglobin synthesis rather than simply iron deficiency. A laboratory finding should never be interpreted in isolation.
C03
CLINICAL CONNECTION / SGD
Chapters 3–6 became one story
When Iron Is Not Enough
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Amino acids build proteins. The amino acid sequence determines primary structure, while folding and higher-order structure influence function. A defect affecting globin synthesis can ultimately cause anemia and impaired oxygen delivery.
α-globin gene defect → reduced α-globin synthesis → globin-chain imbalance → abnormal erythropoiesis or hemolysis → reduced effective red blood cell function → reduced oxygen delivery → pallor, fatigue, exercise intolerance, and dyspnea.
The SGD required us to relate α-globin defects to globin-chain imbalance, ineffective erythropoiesis, hemolysis, reduced oxygen delivery, and reticulocytosis. Biochemistry can explain the journey from a genetic defect to a patient’s symptoms.
C04
CLINICAL CONNECTION / SGD
Family history tells a biochemical story
When Iron Is Not Enough
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Henry’s father had significant microcytosis and anemia, while his mother had relatively normal findings.
Biochemistry is not isolated from genetics and inheritance. A molecular defect can pass through generations and produce different clinical manifestations depending on the inherited changes.
This connected with applying the inheritance pattern of α-globin gene deletions to genetic counseling.
C05
CLINICAL CONNECTION / SGD
One subject, many systems
When Iron Is Not Enough
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Water and pH → amino acids → proteins → protein structure → hemoglobin → oxygen transport → clinical manifestations → the patient.
What once looked like six different chapters became a continuous story.
R01
PERSONAL REFLECTION
How my understanding changed
Looking back, connecting, and moving forward.
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Before
Biochemistry felt like memorization. Proteins were just building blocks, hemoglobin was an oxygen-carrying protein, and anemia was mainly a CBC finding. The chapters felt separate, and I focused on passing.
Now
Biochemistry is about relationships. Protein structure determines function. Hemoglobin’s structure and regulation determine oxygen delivery. Anemia can be traced to molecular and biochemical abnormalities. The chapters are interconnected, and I am beginning to see their importance in patient care.
I am no longer asking only “What is it?” I am learning to ask, “Why does it happen?”
R02
PERSONAL REFLECTION
Biochemistry × Physical Therapy
Looking back, connecting, and moving forward.
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My Physical Therapy background helped me appreciate Biochemistry from a functional perspective. In PT, I learned to observe movement → muscle → nerve → function. Biochemistry takes me deeper: molecules → proteins → cells → tissues → organs → function.
Understanding myoglobin and hemoglobin helped me appreciate that muscle activity and exercise tolerance depend not only on the musculoskeletal system but also on oxygen availability and cellular processes.
My PT background taught me to see function. Biochemistry is teaching me to understand what happens underneath that function.
R03
PERSONAL REFLECTION
What I still need to improve
Looking back, connecting, and moving forward.
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I can understand a concept individually, but connecting several concepts at once can still be challenging. When studying hemoglobin disorders, I need to consider genetics, protein synthesis, protein structure, red blood cell function, oxygen transport, and clinical manifestations.
My difficulty is not necessarily understanding individual concepts; it is integrating them quickly.
My plan
I want to continue using concept maps, diagrams, clinical cases, and active recall to strengthen these connections.
R04
PERSONAL REFLECTION
From molecule to medicine
Looking back, connecting, and moving forward.
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A small molecular change can have a much bigger clinical consequence. An alteration in a gene can affect a protein. A change in protein structure or synthesis can affect a cell. A cellular problem can affect an organ. Eventually, the patient experiences the result. That is why understanding Biochemistry matters.
R05
PERSONAL REFLECTION
Thinking as a future doctor
Looking back, connecting, and moving forward.
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Biochemistry is teaching me to think beyond the obvious. When I encounter a patient, I want to look beyond the symptom and ask:
What is happening at the cellular level?
What molecular process explains this finding?
How does this biochemical abnormality produce the patient’s symptoms?
How can this understanding guide diagnosis or treatment?
These questions are slowly shaping how I want to think as a future physician.
R06
PERSONAL REFLECTION
Beyond the exam: still becoming
Looking back, connecting, and moving forward.
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Medical school has reminded me that I will not understand everything immediately. Some concepts take multiple readings, discussions, diagrams, and clinical examples before they make sense. I am learning not to measure progress only through grades, but through the moments when something complicated becomes connected.
Biochemistry is not simply about molecules, reactions, amino acids, proteins, or hemoglobin. It is about understanding why the human body works the way it does—and what happens when something goes wrong.
My journey from Physical Therapy graduate to medical student has taught me that healthcare requires both compassion and scientific understanding. Biochemistry is helping me build the scientific side of that foundation.
A baker: patience.
A call center agent: communication.
An eldest child: responsibility.
A PT graduate: patient care.
A medical student: understanding disease.
I am still far from the doctor I hope to become, but every lesson brings me one step closer. Molecule by molecule. Concept by concept. Patient by patient.
03 / A CASE THAT CONNECTED EVERYTHINGSMALL GROUP DISCUSSION
WHEN IRON IS NOT ENOUGH
Behind every finding, there is a story.
Henry, a five-year-old boy, presented with pallor, fatigue, reduced exercise tolerance, and exertional shortness of breath. His anemia persisted despite a month of oral iron supplementation.
THE TURNING POINT
A finding should never be read in isolation.
Normal iron studies, persistent microcytosis, target cells, and abnormal hemoglobin findings challenged my initial assumption of iron deficiency. The case pointed toward a problem involving globin synthesis.
04 / BEYOND THE EXAMSTILL LEARNING. STILL BECOMING.
Progress is when I can say, “Now I understand why.”
Medical school has reminded me that I will not understand everything immediately. There are concepts that take multiple readings, discussions, diagrams, and clinical examples before they finally make sense.
But I am learning not to measure my progress only through grades. I measure it through the moments when something that once seemed complicated suddenly becomes connected.
My journey from Physical Therapy graduate to medical student has taught me that healthcare requires both compassion and scientific understanding. Biochemistry is helping me build the scientific side of that foundation.
Connecting the concepts. Not just collecting the notes.
Integrating several ideas at once is still challenging. I want to keep using concept maps, diagrams, clinical cases, and active recall to strengthen those connections.
Concept mapsClinical casesActive recall
BEFORE MEDICAL SCHOOL
The experiences I carry with me.
Snapshots from the baking and call-center chapters of my journey.
Baking taught me patience and consistency.Working taught me communication and resilience.
My Biochemistry journey is only beginning.
Understand the science. Remember the patient. Connect the two.