Life’s Worries

A couple of weeks ago, I took care of a patient who was admitted in the hospital for shortness of breath. She has COPD (CDOP if you’re obsessive-compulsive), a disease due to smoking, and went into acute respiratory failure.

The patient was really struggling to breathe thus the Emergency Room doctor placed her on a non-invasive positive pressure ventilator (NIPPV), a device similar to CPAP used by people with sleep apnea, to provide assistance in her respiration. She was then transferred to our ICU.

On the first day that I rounded on her she was still on the NIPPV and unable to talk much, as it was almost impossible to talk with that mask on, for it’s like having a blower in your face. I would not be able to hear her clearly anyway even if she wants to speak. Though I examined her thoroughly, I limited my history-taking to questions she can answer by yes or no.

The next day she was much better and we have weaned her off the NIPPV. She was sitting in a chair, breathing much easier and looking comfortable.

I pulled up a chair and sat beside her and talked. She admits she has been diagnosed with COPD for years, and has even been on oxygen at home. But sadly to say she continues to smoke. Damn cigarettes! I guess old habit never die.

I told her that it was vital that she quit smoking. Yet in the back of my mind, she has done quite good despite of her bad habits, for she was 84 years old after all, and she still lives independently, all by herself.

Then when I asked her how can I help her quit smoking, she relayed to me that she smoke because she was stressed out.

What? She was eighty-four years old and still stressed out? She should be relaxing and enjoying life, or whatever is left of it, at this age.

That was when she told me that she has not gotten over from the death of her husband, whom she was married for sixty-one years. He died three years ago. I suppose the heartbreak never heals when you lose somebody you love and lived with, for that long.

If we only peel off our prejudgment and peer behind the puff of cigarette smoke, we will learn that these people are hurting inside.

Then she said that she was also worried about somebody she knew longer than her husband. She was worried about her mother.

Her mother? What?!!!

Wait a minute, was my patient confused? Too much medications maybe? Was she having ICU delirium? Or does she have the beginning of dementia perhaps?

But as I talked to her more, I ascertained that she was very lucid and of clear mind. She was indeed worried and stressed out about her mother, who has been in and out of the hospital for the past several months.

Her mother was 103 years old!

I came out of the ICU room with a smile. I was ever so determined to help my patient get well. And maybe if I can get her to relax and convince her to quit smoking, she will live more than 103.

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view from the hospital’s corridor

(photo taken with an iPhone)

Bugtong Kurikong

Matagal-tagal na ring panahon nang huli akong makarinig ng mga bugtong. Naalala mo pa ba ang mga ito?

1. Baboy ko sa pulo, balahibo’y pako. (naka-spikey mohawk si Miss Piggy?)

2. Ako’y may matapat na kaibigan, kasama ko kahit saan (utang?)

3. Sa araw ay bumbong, sa gabi ay dahon. (binilot na marijuana?)

4. Malaking supot ni Mang Jacob, kung sisidlan ay pataob. (supot ba kamo si Mang Jacob?)

5. Hindi hari, hindi pari, suot ay sari-sari. (Drag Queen?)

6. Isang butil ng palay, sakop buong bahay.  (mabahong utot?)

7. Nagtago si Pedro nakalitaw ang ulo. (butas na brief? huh?)

8. Bumili ako ng alipin, mataas pa sa akin. (unanong may alipin?)

9. Isang magandang dalaga, hindi mabilang ang mata. (dalagang maraming pigsa?)

10. Nakatalikod na ang prinsesa, mukha niya’y nakaharap pa. (doblekarang prinsesa?)

11. Dumaan ang hari, nagkagatan ang mga pari. (Vampire na pari? “Vam-pari!”)

12.  Hayan na, hayan na hindi mo pa rin makita. (duling?)

(For the right answers, see comment section)

Shoeless Party

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Not too long ago we held a gathering in our home. Though the above picture is not a typical image of a Filipino party, the photo below is.

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I really did not demand my guests to take off their shoes when they enter into our home, but since almost all of them were Filipinos, it is a kind of unwritten rule in our culture, so they just did without being asked.

Filipinos and shoes have some kind of notoriety, when Imelda Marcos was found to have more than 2000 pairs of shoes that she left behind in Malacañang Palace during the People Power Revolution in 1986. But that is a different subject altogether.

Not just in the Philippines, but many Asian countries have this common custom of taking off their shoes when entering their own home or somebody’s home. The practice is more cultural rather than religious. It also has a practical reason for it, like in Japan, where they sit, eat, and even sleep on the floor, so keeping street shoes off would maintain the cleanliness of the floor.

I have read that other European countries also have this practice of removing shoes when entering one’s home, like Switzerland and Scandinavian countries.

Though in some culture, like here in America, it may be deem rude to order your guest to take off their shoes when they enter your abode. Unless they do it without being asked.

I remember when I was growing up in the Philippines, it is almost a must that we leave our shoes, street slippers, or bakya (wooden slippers) at the door when we enter a house. It is not that our floor is considered a holy ground, but it is considered the polite way, when we take off our shoes.

Whether the floor is concrete, hardwood, bamboo slats, or carpet (though I cannot remember entering a home with carpet floors in the Philippines), I took my shoes off just the same.

I have even heard of an old woman from the province who boarded a bus to go to the city. She left her bakya at the foot of the bus stairs when she boarded, only to find them not there when she got off.

So it does not matter whether you came from the market or a palace, or from playing tumbang preso, where you throw your slippers around. It does not also matter if your shoes are muddy or clean or even covered with antiseptic solution, or if you’re wearing a cheap footwear from Ukay-ukay, or a Manolo Blahnik or a million dollar shoes. Please take them off when you enter a Filipino home.

Except if the host told you “Huwag na, huwag na” which means it is alright to keep them on.

Lastly, a word of advice to our friends, when you are going to a Filipino house party, make sure your socks are clean and not stinky, or has no holes in them.

Unless of course, you want to be the talk of the party.

I’m Writing a Book

After lengthy deliberation, I am finally taking the plunge.

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photo taken at Grand Canyon

 

No, not that plunge.

It’s time for a change. I am quitting my day job!

I am going to be a full-time writer!

I have decided that I will write a book. I have already in contract with Visprint, Inc., the publisher of the widely successful Bob Ong, author of “ABNKKBSNPLAko” and “Stainless Longganisa” among others.

Besides the articles that I have already written on this blog that will be adapted into a book (title: Ang Pagbibinata ng Butiking Walang Dingding), I will also venture on writing fictions.

Why fiction? What qualifications do I have to write this genre?

Consider my resumé:

1. Wrote a book report in high school about an obscure and unheard book, which of course I completely made up. I got an A for the report. Not bad, right?

2. Wrote a case study in Social Science while in college. It is about the struggles of a social deviant in our society, that I interviewed and followed. Except that, that person is non-existent. A fictitious character! I also got an A for it.

3. Published a research paper in medical school about the ill effects of holding a fart, and the benefit to health of letting your gas out unabashed. Of course, the science that back this study is full of air! Sorry for the pun, it is intended. The study was published in a major scientific paper.

So there, I’m fully qualified to be a fiction writer.

And lastly, this article is a just figment (though some may be true?) of my wild imagination.

Happy April Fool’s Day!

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photo taken at Madame Tussauds Wax Museum, Hollywood

 

Up on the Wall

People hang pictures on their wall. It could be art photos or beautiful landscapes. Or it could be pictures of themselves showing their achievement, like graduation or wedding photos. Or it may be photos of someone we our proud of and like to remember, like our children or our parents, or even our pets.

In the corporate world, they hang photos of their founder, or top executives, or model employees. Maybe you have your photo posted as the best employee of the month. Or as the boss’ pet perhaps?

In the old days, especially in the wild west, they also post photos of persons on walls but for a very different reason. It has the words “wanted” and “reward” on them. That’s not what I am talking about here.

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(photo taken at Cody Wyoming)

In the company I am with now, they have a tradition, that after a doctor is with the group for 10 years or more, they would hang a photo of you up on the wall on the clinic’s main hallway. It is like an honorary gesture, that the organization is proud of, after that years of service you dedicated to them. It is like the wall of fame. Sort of.

Sure enough, since I am now with this organization for 10 years, they told me that its time for me to get up on their wall. No, they will not hang me! Just my picture.

Then I thought which picture of me would they hang? When I asked them, they told me it is a photo that they have taken when I joined the organization more than 10 years ago.

Wait a minute. Yes, I may look much younger then, and my youthful image would be immortalized on the clinic wall, but that photo does not look like me anymore. I got lots of hair then. People would pass by and see that photo and wonder, who is that doctor?

So I asked our office manager, to schedule me to have a photo session with the organization’s official photographer, so I could have my picture taken. I want a photo on the wall that has full resemblance of me.

In this day and age of photoshop, you can airbrush your image, or altogether alter your appearance to make you look more beautiful, or younger, or thinner, or more glamorous perhaps. Except that, it is not you anymore.

My take on this is, the closer to the reality the photo is, the better. If we cannot accept the truth about our own appearance, then what a sorry state we are in.

Never been more proud of the result of my new photo. And I can vouch, they did not have to retouch it much.

As I pass on that main hallway, I saw my picture up the wall. It certainly look like me. And there’s no “wanted” or “reward” underneath it.

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our wall of fame

 

Doctor’s Report

We were sitting in a waiting area of a posh Cancer Center building. This time I was on the receiving end of this business. I was not a provider (doctor) but rather a consumer (patient). I was accompanying my wife for her follow-up appointment with the Hematologist-Oncologist doctor.

It was a day of reckoning. We were going to get the dreaded results of her bone marrow biopsy.

Have you ever waited on a report before? A semester’s grade perhaps? Or a qualifying examination? Or a job application? Or a tax return? Nothing can compare to the anxiety level of waiting for a biopsy report.

As I looked at the people in the waiting room, I can easily identify the patients. To lighten up her mood, I told my wife that I look more as the patient than her, for I am the one with the thinning hair. Though I am not poking fun of the chemotherapy patients at all, for I only have admiration for their courage and resolve as they undergo this difficult treatment.

When we were called inside, we met with the cancer specialist. He reviewed the results of the bone marrow biopsy with us, including some fancy genetic tests that he obtained.

The doctor went into detailed medical description, for he knew I am a doctor too and speaks his language. He then concluded that the test did not show any evidence of Myelodysplastic or Myeloproliferative disorder. In simple terms, no evidence of badness to worry about. It was a good report overall.

It was such a relief!

For the past several days, we experienced silent and unspoken fear about our future. For my wife, for me, and for our family. But now, we will grow old together after all.

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my wife and I (photo taken last summer in Vail Colorado)

If there’s something good that came out of this, is that it made our bond stronger and our faith more steadfast.

As we were leaving the doctor’s office, I glanced once again at the people in that waiting room. One elderly woman who was in a wheelchair, was wearing a colorful bandana but looking glum. Another not so old lady who was wearing a fancy hat accompanied by few friends or family. One middle-aged man who looked frail and sitting alone. And some other ones I failed to describe.

What would the doctor’s report on them be? Would it be very good like ours was? Or not so good perhaps? Or would it be downright heartbreaking? I can only hope and pray for each of them.

Life. So unpredictable. Live it to the fullest. And celebrate it while you can.

Today we will.

 

Peace Be Still

A few days ago, while I was in my clinic seeing patients, I received a phone call. It was another doctor who wanted to discuss with me the results of a patient’s laboratory exam.

It is not unusual to have another doctor call me to discuss about a mutual patient. Except this one was not about a mutual patient. On the other line was the Hematologist-Oncologist (Hem-Onc) doctor. The patient he was calling me about, is my wife.

It started with a regular annual doctor’s visit. After having routine test, my wife’s Primary Care physician was alarmed by the results of the complete blood count (CBC). This prompted a referral to the blood and cancer (Heme-Onc) specialist.

After the evaluation by the Hem-Onc doctor and having the exam repeated, that’s when the specialist called me. He said that he was concerned about the elevated count of a blood component, and for some “funky-looking” cells. He recommended a confirmatory test, a bone marrow biopsy.

Bone marrow biopsy is not a very dreadful procedure but its not a walk in the park either. It can be done as an outpatient, usually under “conscious sedation” (meaning, light sleep). It entails drilling a long large bore needle into the hip bone down to the marrow, and aspirating and scraping a “sample” contents inside the bone.

The problem of being a doctor, is that you know “too much.” Too much than needed. So in my mind, I already ran down on the possible differential diagnosis. I started to play the different scenarios, their treatments and outcomes. And even though I know that it can be nothing or something benign, I couldn’t shake off the idea that it can be a myeloproliferative disorder. In layman’s term, leukemia.

My spouse’s family history was not reassuring either. Her father died of cancer in his 60’s. She has two brothers that died prematurely, one was barely 50, and the other one in his 40’s. Then her sister who was a little older than her, was diagnosed with cancer in her 40’s.

I tried to be nonchalant and positive about it when I spoke with my wife, but I think she can sense that it can be something serious. For the succeeding days prior to the scheduled biopsy, both of us were feeling the uneasiness, as if there’s angry storm clouds hanging over our heads ready to discharge their fury.

The fear of the unknown is one of man’s greatest fears. It terrifies us. It consumes us. It kills us even before we die.

Two nights before the biopsy, we both cannot sleep. My wife asked me point blankly, “Am I going to die?”

I don’t know how to answer that question. Or perhaps I don’t want to answer that question.

She told me that she’s really afraid. So in the middle of the night she asked that we kneel down in prayer.

As we prayed, I asked God to be with us as we go through this storm.

Suddenly I was drawn to the story of Jesus and his disciples when they were caught in a great storm* while crossing the Sea of Galilee. I saw myself struggling with the oars and the sail with the disciples. We were trying our best to keep the boat afloat……

The winds are howling. The billows are rolling. The thunders are cracking. The storm is raging. And I am terrified and trembling.

But where is Jesus?

He is asleep! How can he sleep, when we are about to be swallowed by the storm and the sea?

“Master, do You not care that we are perishing?” I cried.

When Jesus arose, he looked at me lovingly, yet he asked me why do I have so little faith.

Then he spoke: “Peace, be still.”

I looked around me. The winds are howling. The billows are rolling. The thunders are cracking. And the storm is even more raging.

But I am still.

image from here

(image from here)

(*Mark 4: 37- 40)

Kwentong Kindergaten

Noong makalawang araw, habang ako’y nagbibiyahe patungong trabaho, ay aking napakinggan sa radyo ang isang report tungkol sa mga leksiyon ng buhay na natutunan natin sa Kindergarten. Isa na rito ang simpleng pagpasok at magpakita sa eskwela. Ano nga naman ang matututunan kung lagi kang absent?

Bigla tuloy akong napabalik-tanaw sa makulay kong mundo noong ako’y isa pang kindergarten.

Ako ay nag-aral sa isang munting Kindergarten school sa Sta. Mesa na patakbo ng NFWC. Dalawang kalye lang ito mula sa amin. Ang aming klase ay sa isang garahe ng bahay na ginawang classroom. Maaring hindi ito kasing tanyag ng Montessori, pero maganda rin naman ang turo dito.

Naalala ko minsan, matapos ang sunod-sunod na ulan, pinasok ng baha ang aming classroom. Kaya mga ilang araw kaming sa simbahan ng parokya nag-klase. Nabulabog kaya ang mga Santo sa aming ingay?

Natatandaan ko pa ang aming guro, si Ms. Genova. May nunal siya sa noo, na parang “red dot” sa noo ng mga bumbay. Siya ay mabait at bihirang magalit kahit kami ay makulit, at hindi siya kagaya ni Miss Tapia sa “Iskul Bukol.”

Tanda ko rin ang ilan sa naging kaklase ko. Si Yaren, na taga kabilang kalye. Siya ay naging matalik kong kaibigan. Si Big Boy na makuwento. Pero hindi ko alam kung bakit iyon ang palayaw niya, dahil patpatin naman siya. May kaeskwela rin kaming kambal na nakatira sa likod bahay namin. Alam ko kung anong inalmusal nila, hindi sa dahil amoy ulam sila, kundi kadikit ng bahay namin ang bahay nila kambal, kaya amoy namin pati niluluto nila.

Sabik din ako sa mga gamit ko sa paaralan noon. Tulad ng krayola, kahit walo lang ang laman ng aking kahon ay masaya na ako dito. Iba sa aking kaklase ay hale-halera ang laman ng kahon ng kanilang krayola. OK lang naman dahil hanggang red lang ang alam ko noon at hindi ko pa maintindihan ang fuchsia.

Gusto ko rin yung pambura dahil amoy kendi. Kulang na lang ay nguyain ko ito na parang Bazooka bubblegum. Nandiyan din ang lapis. Iyong ibang kaklase ko, magagara at may borloloy pa ang lapis. Iyong sa akin, ay simpleng Mongol lang: yung may nakasulat na eberhard faber, tapos number 2.

Maiba ako, alam mo ba ang ibig sabihin ng eberhard faber at number 2?

Si Eberhard Faber ay isang German na nagtayo ng kauna-unahang lead pencil factory noong 1861 sa New York. Kaya nakapaskil ang pangalan niya sa lahat ng lapis na gawa ng kumpaniya niya. Iyong number 2 naman ay grado kung gaano katigas ang graphite core ng lapis. O ayan, may natutunan ka sa akin na hindi mo alam noong Kindergarten ka pa.

Marami rin masasayang karanasan sa Kindergarten. Natutong magbasa: a-e-i-o-u, ba-be-bi-bo-bu, Bobby is bobo. Ano kamo?

Natuto ring sumulat, mag-drawing, mag-kulay, at kumanta. Isa sa natutunan kong kanta:

“Pusa ko’y may nahuling daga, mukha niya’y nakakaawa,

Meow, meow, meow, ang sabi ni Muning, di na kita patatawarin.”

Ang maging walang-awa ba sa daga ang itinuturo ng kantang ito?

Paborito ko rin ang recess noon, dahil nakakapaglaro kami. Dito ko natutunan ang larong Dr. Quack-Quack. Kahit muntik magkapilay-pilay kami sa pagkakabuhol-buhol sa larong ito ay maaring natututo rin namang mag-isip at mag-solve ng problema. Pero maniwala ka, hindi si Dr. Quack-Quack ang naging inspiration kaya ako nag-duktor.

Gumanap din ako bilang Joseph sa aming dula noong Pasko. May pintang balbas ang aking mukha, tapos may dala-dala akong tungkod na mahaba. Pero mas gusto ko iyong role ng aking kaibigan bilang wiseman, dahil mas magarbo ang kanilang costume tapos may bitbit pa silang regalo. Bakit ba hindi ako naging artista?

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Christmas program, circa 1973

Sa Kindergarten rin ako natutong tumula. Sa katunayan ako’y tumala noong graduation program namin. Makaraan ang apatnapung taon, saulado ko pa ang aking tinula. Tungkol ito sa ibon na nakakulong. Ito ang dulo ng tula:

“Bagong pinta ang kulungan, may pagkain araw-araw,

Ngunit ibon di man lamang, umawit kahit minsan.

Ibon ay aking pinalaya, umawit ng tuwang-tuwa,

Tao’t ibon pala kapwa, maligaya kapag malaya.”

Tunay naman na kahit nasa Kinder pa lang kami ay ipinamulat na sa amin ang kahalagahan ng kalayaan.

Pero meron ding masasaklap akong karanasan noon. Tulad nang ako’y tumambog sa kanal galing sa paaralan at napuno ng burak ang aking buong braso. Pingot ang inabot ko sa nanay ko. Nasa Kindergarten din ako nang ako’y nabalian ng braso. Nakasimento ang aking kanang braso nang halos dalawang buwan. Kaya sa maikling pagkakataon ako’y naging ambidextrous, dahil natuto akong sumulat sa kanan at sa kaliwang kamay.

Tunay na pinahahalagahan ko ang edukasyon, lalo na ang mataas na antas na aking narating. Sang-ayon sa aking magulang, edukasyon lang ang maipapamana nila sa amin. Pero naniniwala ako na maraming mahahalagang bagay sa buhay, ay natutunan ko sa pinaka-mababang grado ng edukasyon – sa Kindergarten. Tulad ng:

Pumila ng maayos (siguro yung mahilig sumingit bagsak noong Kinder). Makinig sa turo ng guro. Huwag kunin ang hindi sa iyo, o magpaalam muna sa may-ari bago hiramin ang gamit. Mag-share. Huwag makipag-away. Huwag mangopya. Maging patas sa paglalaro. Huwag kainin ang baon ng iba. Huh?

(Oo naranasan ko na may ibang kumain ng baon ko, pero nasa Grade 1 na ako noon.)

Isa pa sa aking naalala ay mabilis maubos ang aking pambura noong nasa Kinder pa ako. Dahil nginangata ko ang eraser. Dahil burara ako. Dahil marami akong mali sa pagsusulat, kaya’t pudpud agad ang aking eraser.

Isa sa mahalagang leksiyon na natutunan ko sa Kindergarten ay ito: ang pagkakamali ay bahagi ng buhay. Hindi lahat ng ating sagot o gagawin ay tama. Ang mahalaga ay natututo tayo sa ating karanasan, at ituwid natin ang ating mga pagkakamali.

At kung ika’y nagkamali at ika’y naihi sa salawal noong Kindergarten? Hindi ito katapusan ng mundo.

(*This article is lovingly dedicated to Kindergarten teachers, and all other teachers, who showed us the way. Thank you.)