Little Girl in ICU

She was sitting in one corner of the room. With big headphones on her ear, and with an iPad in her lap, she appeared to be preoccupied and was in her own little world.

She was a 6-year-old girl, with beautiful blonde locks, sitting in one of our ICU room. Her back was turned from the door entrance and was facing towards the window. But she was not our patient. Her father was.

A couple of feet away from the little girl was her father, lying in the hospital bed. He was half-awake and half-asleep. He was obviously in distress. Every breath was a struggle that slowly zap whatever energy and life remaining in him.

He was 33 years of age, and for the past 6 years had been battling testicular cancer. And I would say that he gave a good fight. A hardy and courageous fight.

Sadly to say, the cancer was winning this battle. It now had spread to his lungs making it more difficult for him to breathe. His CT scan of the chest which I just reviewed prior to entering his room showed hundreds of big and small masses scattered throughout his lungs. The cancer had spread into his brain too causing him severe headaches.

For the past several weeks he had been in and out of the hospital. He continues to receive chemotherapy, though despite of this the cancer continues to progress. During this present hospitalization, he had been admitted to the ICU twice due to problems stemming from the cancer itself or from the complications of its treatment.

As I entered his room with my ICU team, I spoke to him and his young wife who was in his bedside, about the grim situation. We spoke in low tones, almost in whisper, keeping in mind that their little girl was in the same room.

I relayed to them that in spite of everything we have done, we have nothing more to offer, but one. And that is comfort. Meaning, we cannot cure him or treat him, but we can at least make him comfortable. We can offer medications that can take the edge off from his suffering. Something to numb his pain. Or something to blunt his sensation of air-hunger. Something to lessen the agony as he faces the inevitable.

I recommended that we transition to hospice care.

The patient and his wife agreed, as perhaps they know as well that it was time. The wife silently cried, though not so much, trying to compose herself and trying to show strength so not to upset her daughter, who was oblivious of our discussions.

As a parent myself, I can only imagine the predicament my patient and his wife were in. Oh how we wish that we can protect our young kids from the harsh realities of life. Yet I learned that it was the patient’s wish to have her daughter in his room as much as possible.

As we end our talk, the patient’s wife asked me how we doctors can deal with this kind of situations without crying. I softly answered her, “No, we do.” Or at least I speak for myself. Maybe not in front of our patients, but doctors do cry too.

When I exit the room, I glanced at the little girl. I don’t have the heart to disturb her. She was still quietly sitting in her corner of the room. Her back was still turned away from the bed and from us. She still had her big headphones on. Still busy playing on her iPad. Sheltered from what was happening a few feet away, or so it seems. And at least for now.

Does she know that her daddy will not be able to give her piggy back ride anymore? Does she know that he will not be able to chase butterflies with her again? Does she know that he will not be there to teach her how to throw a baseball or how to shoot a basketball? Does she know that her father will not be able to comfort her anymore when when she falls from her bike and scrapes her knee? Does she know that he will not read her bedtime stories anymore? Does she knows that he will not be able to tuck her in bed anymore and kiss her goodnight? Does she know that her father will not be coming home?

She will.

And I hope she has enough memories of what a father’s love is.

*******

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Post note: Two days after I had the talk with the patient and his wife, he suffered a grand-mal seizure and became comatose. He died a few hours later.

(*photo taken somewhere in Grand Teton National Park)

Crazy Weather

Exactly one week ago, I posted this photo.

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It was taken right after a light shower, with a visible rainbow in an almost complete arc. The brown grass was starting to turn green, and the empty branches were beginning to show their buds. Spring was on its way.

Then two days ago, our temperature went way up to the 80′s Fahrenheit. We put away our heavy coats into the closet. Me and my son played hoops in our driveway basketball court in our t-shirt and shorts. That night it was hot enough that I was tempted to turn on the air conditioner. Did summer arrived already and altogether skipped spring?

Yesterday the heavy rains came and it was gloomy all day. But it was alright, for we badly need the rain. Besides, the saying goes, “April showers bring May flowers.”

But this morning I woke up to this.

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Snow? No! The temperature dipped below freezing again. Needless to say, our heater was on once more, and our winter coats were out of the closet again.

Crazy Iowa weather!

 

Weekly Photo Challenge: Threshold

It’s April. The temperature is rising, specially with the sun shining. The storm clouds are bringing showers instead of snow. The dormant grass is awakening. The naked tree boughs are budding. The flowers are almost peeping. And even the rainbow is appearing. We are in the threshold of spring.IMG_3455(photo taken in our front yard with iPhone panoramic view)

Goodbye Big Brother

It was his last day with us. After spending several years with our family, that feels like a lifetime, we had to say goodbye to him. As we were driving him to his destination, my son, who actually grew up with him, lovingly said, “Goodbye big brother.”

But before you feel terribly sad, I am just talking about our car.

Our family car, a Honda SUV, was getting old. We bought it 11 years ago, and took it home a few days before my son was born. In fact it was brand new when my newborn son rode home in it from the hospital. We were still living in Florida at that time. We rode in it when we moved to Iowa, and kept it all these years.

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In this day and age that many people change cars as often as they change their clothes, it is hard to get attached to a car. But I guess we are different. Though I read a recent article that due to slower US economy, many Americans are keeping their cars longer.

My father, when we were in the Philippines, kept our family car, a Ford Cortina, for more than 20 years. We drove it until it cannot run anymore (see previous post here). Come to think of it, we got it when I was 2 years old, and I even used it to take my girlfriend, my eventual wife, on a date. Too bad my son will not have the chance to take his “big brother” dating.

Back to our Honda, we drove it to parks, markets, church, school, office, hospital, gym, concerts. music practice, birthday parties, weddings, and funerals.  We have taken it on vacations, camping, hiking, and long road trips. From the urban jungle of New York City to the wilderness of Wyoming. From sunny roads of Florida to the snowy highways of Minnesota, and many other states in between. We even drove it out of the US to Canada, from Niagara Falls to Quebec.

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It did not just carry us to places and destinations, but it also carried our stuff, like our luggage, tents, bikes, and other equipments. It even carried our Christmas trees every year from the tree farm to our home. Yes, it carried a ton load of memories.

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But after 11 years of faithful service and with almost 170,000 miles, one day a warning indicator light went off. We brought it to the local car dealer, and after doing diagnostics, they told us that it needed a new transmission and some other parts that need to be replaced. And how much would that cost us? $7000 in total. Ouch!

Then we asked the dealer how much can we trade it in for? We were told that it was valued at about $3000. And the value will not increase even if we have it repaired. Are you kidding me? It would be more expensive to repair it than to trade it in! Where’s the logic in that?

That’s when we decided that it is time to let it go. “Let it go, let it go! Can’t hold it back anymore…(ala Disney’s Frozen)…..Let it go, let it go, you’ll never see me cry.” Sorry I got carried away.

It was cold and blustery that night. We parked it in the dealer’s parking lot. I took a final photo of it with my kids. After doing our final silent “ceremony” with it, we said goodbye to our car.

As we were driving away, I looked at the rear view mirror and took a last glance of it as we left it there in the cold. I felt a certain sadness. I swear, I thought it waved goodbye back.

But the sadness was mixed with excitement, as I hear the roar of the engine of our new playmate. Vroooom!

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Hello there!

 

 

A Pineapple Tale

During my last visit to the Philippines, I had a long talk with my mother. Not trying to be morbid, and in fact she was still in good condition, but with her advancing age I just asked her what her wishes were if in case she would be put to rest. She told me what her wishes were, but also told me parts of a story that I have never heard before…..

Almost 100 years ago, there was young man in Ilocos Norte who joined a wave of Ilocano migrants to Hawaii in search of a better future. It was during the time of one of the largest Filipino migration to Hawaii. Muscular and strong, he was picked to work in a pineapple plantation in Hawaii.

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Hawaii plantation in 1900′s (photo courtesy of Hawaii state archives)

However after a few years of hard labor in the plantation, with long hours under the Hawaiian heat – homesick and longing for the love of his life that he left behind – he decided to go back home to the Philippines. Whether it was a wise or unwise decision, who are we to judge?

Once back home he married his childhood sweetheart. He was determined not to return to Hawaii, but rather try his fortune back in his hometown. He started building a house in Sarrat, Ilocos Norte for his family.

He worked incessantly, and one day while working on the house that he is erecting, he suddenly collapsed. The older folks said he suffered from “pasma,” but the doctor in me think it was something else, though I just cannot be sure what. He did not really recover after that and died shortly thereafter. He was in his mid 20′s.

He left a grieving young widow who was 8 months pregnant with their first baby. That baby was my mother.

My mother was born and she grew up without knowing her father. She did not even know what her father look like. All she had were the stories from her mother of how wonderful and loving her father was.

My mother pursued her own dream despite of their “unlucky” situation, so she made good in her studies.

On the day of her high school graduation, a supposedly happy occasion, she arrived home and found her mother slumped on the floor and unable to speak. She most likely suffered a devastating stroke. She died several weeks later, and left my mother a complete orphan at a young age.

My mother was still able to go to college with the help of her aunt and uncle who unofficially adopted her. She later earned a bachelor degree in education.

After finishing college, my mother took teaching assignments and taught elementary in different provinces. She was assigned in Baler, Quezon and stayed there for a couple of years. When she transferred to Norzagaray, Bulacan as a teacher, she met a handsome young man there. That was my father.

They fell in love and eventually got married. They moved to Sampaloc, Manila where they raised their family, and the rest was history.

I have no photos of my grandfather. Not even a grave to visit where his remains lies, as my mother told me that he was buried in a piece of land that the government subsequently bought and turned into a road. What road or highway was it, my mother was not sure.

We have no memorabilia of his existence. All I have is this story of a man whose likeness I most likely bear, as many say that I am a spitting image of my mother, and who knows, perhaps of my grandfather too.

My grandfather had no idea that one of his seeds will one day make his way back to America. Though not in the pineapple plantation of Hawaii, but settling around the cornfields of Iowa. Not as an unskilled laborer, but as a highly trained physician. He gave up his American dream, but in a happy twist of fate, it led the way for me to chase mine. I have migrant blood in me after all.

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Dole pineapple plantation in Hawaii (photo taken during our visit)

About two years ago, I had the opportunity to visit Hawaii with my wife and kids. We even visited the Dole pineapple plantation and ate some pineapple ice cream there. Never did I knew at that time, that part of my roots came from that place.

Pineapple is one of my children’s favorite fruit. They like to eat it as is, or mixed in a fruit salad, or as fruit drink, or even as a topping in their pizza. Maybe their great-grandfather liked it too. Or maybe he hated it, and hated it so much that he left the plantation.

But I’m glad he left the pineapple plantation and went back home. Thus this story exists. And I exist to tell this story.

Wishful Thinking

I wish that I am walking under these,

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poolside, in one of the hotels in the Philippines

But I am already making my rounds here.

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atrium of the downtown hospital where I work in the US

I wish that I am relaxing here,

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residence complex, somewhere in Manila

But I am already buried with this.

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my office desk in Iowa

I wish I have more time daydreaming here,

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beach resort in Laiya, Batangas

But I already have to do this.

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bronchoscopy room, somewhere in Des Moines

I am not complaining. Just wishful thinking.

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I’ll be back. Hopefully soon.

(*all photos taken with an iPhone)

Flying Home

The other day on my way back from doing some errands, I saw a large flock of migratory birds in a very long V-formation. It was one of the longest perfect V-pattern I have seen for a while. Since I was driving through a less traveled dirt road, I was able to stop and snap a picture of it.

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It was an amazing sight to say the least, with their wonderful flight formation, and all 100 or so of them (yes, I counted them), maintaining their alignment.

Why do birds fly in the V-formation anyway? Studies have shown that they do this to catch the updraft wind created by the flapping of the wings of the one preceding them. This make their flight more aerodynamic and efficient. But what about the bird in the very front? It is doing all the hard work, right? Well, it was observed that they take turns on being the lead flyer. Interesting.

As I was watching them, I have noted that they were heading North. A little more Northwest to be exact, according to the compass on my iPhone. That means this cold winter is finally ending and spring is coming, as the migratory birds are coming back home from their migration down south.

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Another question that comes to mind is how do they navigate their way without using GPS? Research indicates that they employ many techniques like using the position of the sun or the stars, or rely on big landmarks like lakes or mountains. But the most fascinating part is that birds seem to have a built-in compass in their brain, like a magnet, that can sense the Earth’s magnetic field, so they know which way is North and which way is South. They do have GPS after all.

Yet the most intriguing part to me is why do these migratory birds fly back North to the place where they were born (or hatch) every spring? They could have stayed in the South where it is always warm and save them all the trouble of flying so many miles. Do you suppose they do this to earn frequent flyer miles? Every year they come back to the place where their parents raised them, a place where they spend the first summer of their lives. They do always come back home.

I don’t think only migratory birds are like that. I think many creatures including us, humans, long to go back home. There might be innumerable hassles in traveling back. There may be chronic ills pestering the land where we came from. Yet there is something magical to that place where we were born and raised. Something more than mere nostalgia. Something much deeper. And it does not matter how far we have wandered away. It does not matter how long we have been gone. The connection and pull of that place we have once called home is always there.

I was musing with all this flying home subject matter when I was interrupted by an announcement overhead. I adjusted my seatbelt and looked outside my window.

I am nearing home.

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(*photo taken with iPhone)