Ang Paglipad ng Butiking Walang Dingding

Paano nga ba nakakagapang ang butiki sa dingding? Bakit kaya nitong maglakad ng patiwarik, kahit na sa kisame? Siguro hindi nila kilala si Isaac Newton at ang kanyang “Law of Gravity.” Hangga’t merong dingding, kaya nilang akyatin.

Ngunit paano kung wala nang dingding? Kaya bang nilang lumipad?

Naalala mo pa ba noong musmos ka pa? Tinanong mo ang mga tanong na ito. Marami ka pang ibang tanong, na hindi mo alam ang sagot, at hindi ka rin nila mabigyan ng sagot. Nagsawa na nga sila sa pagsagot sa makukulit mong tanong.

Naalala mo rin ba noong bata ka pa? May gusto kang maging, ngunit sabi ng iba ay imposibleng mangyari. May mga bagay na pinagarap mong gawin, ngunit sabi ng iba ay mahirap tuparin. May mga lugar na nais mong marating ngunit mahirap daw abutin.

Sa aking munting silid noon sa aming bahay sa Sampaloc Manila, ay maraming butiking bumibisita sa aking pag-iisa. Madalas ko silang pinapanood. Naaaliw at namamangha ako sa kanilang paglalakad sa dingding at kisame.

Doon din sa loob ng apat na dingding ng silid na iyon ay marami akong mga pangarap na hinabi. Ilan sa mga ito ay tunay na matayog. Hindi ko pinangarap na umakyat sa dingding. O sa kisame. Higit pa doon. Marami sa aking mga panaginip ay lagpas-lagpas sa hangganan ng aking maliit na kuwarto.

Isa sa mga poster na nakapaskil sa dingding ng aking silid noon ay ang larawan ng Grand Canyon ng Amerika. Sa larawan ay may isang tao na lumilipad (hang gliding) sa gitna ng kalawakan ng malalalim na bangin. Nakasulat sa poster na ito ay: You are only limited by the bounderies of your mind.

Ito ang naging hamon ng aking buhay. Walang kisame. Walang dingding.

Pagkaraan ng panahon, ay pinaglayag ko ang aking mga pangarap. Tunay nga na walang dingding ang hindi natin kayang buwagin. Walang kisameng hindi natin kayang abutin. Walang hangganan ang kaya nating marating.

Kaninang umaga, makalipas ang mahabang panahon ng paghahabol at pagsasakatuparan ng mga pangarap, at pagkalipas ng dalawampung taon kong paninirahan dito sa Amerika, ay narating ko rin sa wakas ang lugar na nagdulot sa akin ng malalim na inspirasyon.

Ako ay tumanaw sa kalawakan. Pumailanglang sa himpapawid. Walang kisame. Walang dingding.


photo taken while soaring at 6000 feet above the canyon

(* More photos and stories of my visit to the Grand Canyon will be on a separate post.)


Pac-Man Invades the World of Medicine

“There’s nothing good that will come from playing video games.”

That’s what I heard some older folks say when I was still young. Well, I beg to disagree. If you’re a parent who don’t like your kids to play video games, please don’t hate me for this.

My first exposure to video games was in the early 1980′s when Game and Watch, a handheld electronic game, was introduced by Nintendo. I played games like, Octopus, Chef, and Donkey Kong. I did not own a Game and Watch as my parents would not splurge on these. But near our school was a store where one can rent Game and Watch. They were chained to a wall, and for 25 centavos, I can play for 10 minutes.

Later on I occasionally played video games in the mall arcades, like the classic Space Invaders and Pac-Man.

classic Pac-Man (photo from the web)

classic Pac-Man (photo from the web)

For home video console back in those days, there was Atari. Again we don’t own one, I just played in my friend’s house. I remember one instance when I was still in College, my friends and I spent one night playing video game till the wee hours of the morning.

The next generation handheld video games had more advanced graphics. Game Boy launched a handheld version of Tetris which was a huge success in the early 90′s.

One time after I finished Medical School, I joined a Medical Mission trip to Batangas. I sat beside a girl whom I recently met at that time, and she played Tetris the entire trip that she barely talked to me. But at least she let me borrow it for a few minutes.

Nowadays, I still play Wii, once in a while, with my kids, and I have a few games in my iPhone as well, that I play when I am bored. Though I don’t consider myself a serious gamer, nor do I wish to play some of the newer games today, as they are far too violent than Super Mario beating up fungus and turtles.

Last week I attended a seminar in Minneapolis to learn a new way of doing bronchoscopy (scope to look inside the lungs). This method borrowed technology from video games and thus it turns bronchoscopy into something like playing one. It is called Electromagnetic Navigational Bronchoscopy (ENB).



By the way, I have known the term “electromagnetic” since I was in grade school. Yes, you read it right, since grade school. I learned it from watching super robot anime, Voltes V. One of its weapons was the “Ultra-electromagnetic Top.”

Back to Navigational Bronchoscopy, the procedure involves placing an electromagnetic locator board underneath the patient. With a special software it transforms the patient’s CT scan images into a virtual map that can lead you to any specific point you want. With this modality, it improves the yield and accuracy of biopsy results.

Let’s say there’s an 8 mm nodule in the patient’s lungs seen on CT scan. I can program this as my “target,” on the software. Then using the specialized scope, I will follow the virtual image on the screen, that will help me navigate turn by turn into the different bronchial passageways until I reach the target for biopsy. It is like doing bronchoscopy with a GPS.

This technology evolved less than 10 years ago and is becoming mainstream in the past few years. Even though I have performed more than a thousand conventional bronchoscopies since I finished my Pulmonary Fellowship training in 1999, I want to stay current with the changing times. So I went to train for this new technique.


our training facility

Meet Jackson, my trainer. He is not an expert bronchoscopist. He is a pig. No, I’m not calling people names. He is really a pig! Sacrificed for the sake of science. Here is Jackson’s lungs where I practiced and tried to sharpen my skills in Navigational Bronchoscopy.



Who said you cannot teach an old dog a new trick?

This morning, with the assistance of one of my junior partners, I performed a Navigational Bronchoscopy on a real patient. Even though the location of the target was quite difficult to reach, the ability that required hand-eye coordination came out naturally for me – honed from years of playing video games.  And guess what? It was fun too. Just like a video game.

Who said nothing good will come from playing a video game?


PS. The girl whom I sat with who played Tetris for hours, years ago? She’s now my wife.



Sa Dating Tagpuan

Nasaan ka na aking mahal,

Ako ba’y iyo nang nalimutan?

Ako sa iyo’y naghihintay,

Dito sa dati nating tagpuan.


Kamusta ka na aking sinta,

Ikaw ba ay mayroon nang iba?

Hindi sa ako ay nagdadamot,

Ayaw kitang maging malungkot.


Sumasagi pa ba sa ‘yong isipan,

Ating makukulay na nakaraan?

Hanap-hanap tunog ng ‘yong mga yapak,

Matamis mong tinig, pati na halakhak.


Nasasabik sa iyong halimuyak,

At sa dala-dala mong bulaklak,

Matagal-tagal na silang nalanta,

Ang samyo nila ay nawala na.


Dito sa taas ng tahimik na burol,

Sa lilim ng malalaking punong kahoy,

Dito sana’y muli mo akong dalawin,

Huling hantungan ko’y muling dungawin.

IMG_3674(*photo taken at a nearby small cemetery)

Fishy Stories

The other day, one of my friends at work came back from a fishing trip. He was bragging about how big a fish he caught. Well, we all have heard of those “fishy” stories, where a 1-foot fish that was captured was exaggerated into a whale-of-a-story.

But my friend has a photo to prove his claim. It was not a whale, but I have to agree, it was big.

And what did he do with his prized catch? He released it back. What? All the trouble of catching it, then just setting it free?

That’s what many people do, especially here in the US, who fish for pastime or sports. They sit (on docks or in boats) or stand (as in fly fishing) for long hours, waiting for a fish to bite. And when they reeled in a fish, they release it back.

I don’t get it.

Why go through all the hassles of catching fish, only to let them go? But maybe that’s the Filipino in me speaking. In our culture, we don’t fish for pure leisure. We catch the fish, to eat the fish!

I have been invited to go to recreational fishing trips before, but many times I declined. I am not a fan of fishing. Though it’s not that I have not gone fishing before.

When we were still In New York, we joined some Filipino friends, where we went fishing in Long Island, but not the conventional way of using reel and rod. We waded in the shallow ocean waters and used a long net. With several of us holding on the net we tried to enclosed and catch schools of anchovies (dilis). Of course we ate those dilis.

Then when we moved to Florida, a family visited us from Canada who like to go fishing. So we took them to St. Petersburg pier. It was during that time that my wife said “I hate fishing.” Her sentiment was not hating fishing as much as the waking up so early. We had to get up at 3 in the morning, so we can be at the pier at 5, because they say it was better to go fishing when it was still dark.

Now whenever we have to wake up early for a trip, she would blurt out: I hate fishing!

Here in Iowa, a couple of years ago, another family and ours went camping. It was near a lake. So we rented canoes and tried fishing on the lake. After a couple of hours canoeing, and fishing, we did not catch anything. Not even a small dinky fish. But it was a fun experience though.


my son during our last fishing trip

Back in the Philippines, do you know that I can claim that we were fishermen? We catch fish for a living, at least for a couple of years.

My father besides being an accountant, dabbed into entrepreneurship, like poultry, mushroom farming, and cassava cake bakery. All of them were not successful, but he tried. His biggest business endeavor was owning a fish pen.

I was in high school at that time when my father rented an area in the middle of Laguna de Bay. There we erected a fish pen with bamboo poles and enclosed it with net. This is where we farmed bangus (milkfish). We put thousands of fingerlings, smaller than my pinky, into the pen, and then raised them for several months, until they were as long as my forearm. Milkfish by the way is the national fish of the Philippines.

We even built a small nipa hut on stilts next to the fish pen, in the middle of Laguna de Bay, which is about 15-minutes boat ride from the shores of Alabang. So every Sunday, my family would visit the fish pen, and spent hours swimming and canoeing around the pen. But most of the time we just watched the bangus grow.

We don’t even have to feed the bangus, for they eat the “lumot” and plankton in the lake. Though at times we bought sacks of stale pan de sal from Mang Godoy, who owns a local bakery shop in Sampaloc. We would throw these pan de sals inside the pen, just to watch the bangus devour them like hungry piranhas.

In fact the easiest way to fish that I learned was to throw a pan de sal inside the fish pen and when they gather around the bread, just scoop them out of the water with a net. Voila! We had bangus for lunch.

When it was time to harvest the bangus, it was so neat to watch as workers closed them all in a large net. It may take hours. But after all the labor we would have boatloads of flapping fish ready to sell in the market.


fish pen in Laguna de Bay with Mt. Makiling in the backdrop (photo from the web)

Unfortunately, our fish business did not last that long. With typhoons, personnel problems and other setbacks, we did not profit from it, but barely broke even. So after two harvest seasons, my father sold the fish pen.

I think we were not meant to be fishermen.

Nowadays, the only fishing that I do is inside the market or a store. And I don’t need a pole, or a line, or a bait.




Panaghoy ng Sikada

Ako’y isang pobreng alindahaw sikada,

Labing pitong taon, sa dilim ako’y nangapa,

Nakapiit, at parang nakalibing sa lupa,

Sa wakas, sa liwanag ako ngayo’y lumaya.


Matapos umalpas sa mundong ibabaw,

Iisa ang hangarin, pakay ng aking buhay,

Ang makita at makaulayaw ka, o aking mahal,

Hanap-hanap kita sa madlang karamihan.

mga sikadang nagliligawan

mga sikadang nagliligawan

Alam kong maraming karibal na manunuyo,

Boses ko’y nasasapawan ng maingay na koro,

Alam ko rin namang maraming pwedeng pagpilian,

Ngunit tanging ikaw lang ang sa aki’y hinirang.


Iilang araw lamang ang sa akin ay linaan,

Konting sandali lang ang sa aki’y pinahiram,

Kaya sinta ko, dinggin ang aking awit,

Bago ako pumikit sa gabing pusikit.


Bakit hindi tayo pinagtagpo ng tadhana,

Yaring buhay ba’y mauuwi sa wala?

Tinig at lakas ko’y unti-unti nang nanghihina,

Awit ko’y handog na lang sa mundong mapayapa.


bukang liwayway at mga sikadang namatay

(photo taken with iPhone)


Handiwork of Love

Do you like crochet? (Pronounced crow-shay.) No, it’s not a country in Southeastern Europe, that is Croatia. And no, it’s not something that you eat, that’s croissant. Crochet is a handicraft in which yarn is weaved into a patterned fabric using a hooked needle.

Now we’re clear.

Years ago when we were still in Florida, I received a dainty crochet blanket as a gift. It was made by one of my patients. She learned that my wife and I were expecting a baby boy, and thus she lovingly made a baby blanket for us.


my son’s crochet blanket

Crocheting and knitting are endeavors that need basic skills, some appropriated time, and a great deal of patience. It also takes vision on how the finished piece would look like while you’re still working on it. Sometimes it is hard to foresee the beautiful final art when what you only have is a small knitted mess, an entangled needle, and lots of balls of yarn.

When my patient gave the baby blanket to us, she told me that it took her a longer time to finish it as she was not as fast as she used to. You may be amazed if I tell you that my patient was ninety-one years old at that time! And frail too. With her advanced age, failing eyesight and with her arthritic hands, it was really a labor of love.

The more amazing part was, according to the patient’s daughter, halfway through the project, she made an error on the pattern but realized it much later. So she uncrocheted (is that a word?) or undo the piece up to the area of the mistake, and weaved it back over again.

What have I done to deserve this gift? I am not sure.

My son is now eleven years old. The crochet blanket sits in our closet. But I cannot give it away, as I know how painstakingly it was created. It is like an heirloom now. Maybe someday my son will use it for his own baby.

More recently, I received another knitted piece. It was a lovely table cover. It was done by a lady that was recovering from cancer. I know that she just finished chemotherapy then, as her hair have not grown back fully, when she gave the gift to me.

However, the lady was not my patient. Her husband is. I diagnosed him with Idiopathic Pulmonary Fibrosis (IPF) - a deadly debilitating lung disease that has no known treatment at this age of modern medicine. Oxygen and comfort measures are the only things we can offer. Most patients die within 3-5 years after the diagnosis. And the sad part is as the lungs progressively fail, they suffocate to death.

Needless to say, my patient, like all other IPF patients, died within a couple of years. Yet his wife, who herself was sick, gave me this beautiful knitted item, which is definitely a handiwork of love. It now sits atop one of our coffee table.

Again, what have I done to deserve this? It should be me offering inspiration and comfort to them. Instead it was I who was inspired by them.


my knitted table cover gift

Life can be difficult and downright harsh at times. Yet this knitted creations are testaments of human love. They are constant reminder to me, that people, no matter what the circumstances they are in, can be thankful and giving. And this makes this world wonderful, despite of all the ills we find in it.

We may not all learn how to knit or crochet. But maybe we can all learn to live kindly with one another and inspire one another in a loving knit of humanity. What a beautiful handiwork that would be.


Noong isang umaga, habang ako’y tumatakbo sa aming lugar, ay napadpad ang aking isipan sa lugar na aking kinalakihan. Ang aming kalye ay masikip at ang mga bahay ay dikit-dikit.

Ito ang kalye kung saan ako nanggaling, at ito ang dati naming mga kapitbahay sa Sampaloc, Manila. IMG_1598_3 Hindi lang mga batang paslit ang laman ng kalye kundi may mga lalaboy-laboy na hayop din sa dating naming lugar.

Ito ay mga askal (asong kalye). Kapag sinamang-palad, nagiging pulutan sila ng mga nag-iinuman doon sa kanto. IMG_1595_2 Ngunit iba na ang mundong ginagalawan ko ngayon. Layu-layo ang mga bahay at malalawak ang mga bakuran at bakanteng lupa.

Ito ang isa sa aming kapit-bahay, isang barnhouse, na nasa gawing likod ng aming tahanan dito sa Iowa. IMG_3606 Ito naman ngayon ang mga lalaboy-laboy na usa (deer) sa aming lugar ngayon. Maaring sabihin na mas masarap na pulutan ito kaysa “asosena.” IMG_3642 Kahit paano ay nami-miss ko pa rin ang dati naming lugar at mga kapit-bahay. Maliban sa mga maiingay na lasing doon sa kanto.

(*photos taken with an iPhone)

Pestengyawang Pag-ibig

May mga bagay na masarap alalahanin at sariwain. May iba naman na ayaw nang balikan, at halos sumpain. Ngunit meron din naman, kahit hindi gusto, kayhirap talagang limutin.

Naaalala mo pa ba, noong tayo’y nasa unibersidad pa? Isang mapagpalang araw, ako’y iyong kinausap at nilapitan. Ang sabi mo’y ika’y sinugo at nautusan lamang. Gusto mong maging tulay sa akin at sa matalik mong kaibigan. Ngunit mula noon, mundo kong matahimik, iyong binulabog, inistorbo, at pinatiwarik.

Ang pakay mo ay hindi ko naintindihan, ako’y nalito at parang naalimpungatan. Ikaw ang napusuan, at hindi ang ‘yong kaibigan. Ako’y nabighani sa mala-mestiza mong kagandahan. Kumabog ang dibdib at ang aking katinuan ay panandaliang lumisan. Walang patumanggang dinakip mo, puso kong walang kalaban-laban.

Ipagpatawad mo, ang aking kapangahasan, at minahal kita kaagad (parang kanta ni Vic Sotto lang). Nagalit at nagtampo tuloy sa ‘yo, ang iyong kaibigan. Alam ko rin naman, na may syota ka nang matagal. Pero ganoon daw talaga, kapag ang pesteng pag-ibig - pagnasok sa puso ninuman, lahat ay hahamakin, masunod ka lamang.

Naalala mo pa ba, nang kita’y simulang ligawan? Ako raw ay baliw, ika ng karamihan. Malabo raw at walang pag-asa, lalo na’t may boypren ka na. Parang sumusungkit, ng buwan sa langit. Ngunit ako’y hindi mo pinagtabuyan, kundi hinimok pang lumaban. Pintuan ay hindi ipininid, bagkus iniwang may puwang.

Natatandaan mo ba ang bigay kong mahahabang rosas? Sila’y nakakahon, animo’y hindi kukupas. Dinayo ko pa ang Cubao, binili sa mamahaling tindahan. Hindi sa Quiapo o sa Dangwa, kumuha ng bargain lang. Tuloy baon ko’y naubos, sa loob ng isang buwan. Pero OK pa rin naman, ma-impress ka lamang.

Naaalala mo pa ba, sa klase lagi kang tinatabihan? Parang buntot na nakasunod, sa lecture hall, sa library, pati na sa tambayan. Kulang na lang sundan ka hanggang sa loob ng CR. Kahit mahirap mang mag-concentrate, ganado naman mag-aral. Pati halimuyak mo, ay sinaulado ko, amoy ng iyong pabango, at sabong panlaba ninyo.

Naalala mo pa ba, ng tayo’y mag-date? Sa SM Megamall, doon tayo’y nagtagpuan. Nagkayayaang kumain sa isang Japanese restaurant. Pinakilala mo ako, kay Sushi at kay Sashimi. Wala akong masabi ng mantakin ko si Wasabi. Anak ng tokwa, maanghang pala! Hindi mo man lang ako pinabalaanan, kundi iyo pang pinagtawanan.

Natatandaan mo rin ba, nang ako’y sumama? Pumasyal sa Subic ng iyong barkada. Nang panahon nang mag-swimming, umikot ang aking sikmura. Ako’y nanghina kaya’t sa kubo, nagpaiwan na lamang. Walang kaabog-abog, ako’y hinalikan, para raw guminhawa, aking katawan. Ngunit sa halik mo, tuhod ko’y nangatog, at parang dikya na lalong nanlambot.


naghahanap ng dikya

Naalala mo ba, ng sa inyong bahay kita’y binisita? Isang exclusive at gated subdivision ng mga Ayala. Tumagtak ang pawis ko, nang makita ko sa gate ang tatay mo. Ako’y tunay na naalangan, parang langaw na tutumpik-tumpik sa pintuan. Ngunit salamat pa rin, ‘di man binigyan ng masyadong pansin, at least hindi binugaw, kundi pinapasok pa rin.

Mahigit dalawang taon din kitang sinuyo’t linigawan. Parang asong nakaabang, sa biyayang malaglag sa hapag-kainan. Hindi ko nga maintindihan kung ano ang aking kalagayan. Tingin ko ika’y aking nobya, pero ang nobyo mo’y iba. Hindi mo naman ako itulak, at hindi mo rin kabigin. Iniwan mo lang akong laging nakabitin.

Subalit sa isang masalimuot na ikot ng kapalaran, ako’y nauntog at tunay na natauhan. Ako ba’y pinagmamalasakitan o baka pinaglalaruan lamang? Naghihintay pala ng wala, nakatungangang mahulog ang mga tala. Mga bulag na mata ko’y sa wakas ay dumilat, sa masakit na katotohanang, hindi mo ako mahal at ginogoyo lamang.

Dalampu’t limang taon na pala ang mabilis na kumaripas. Ngunit mga alaala ay hindi pa rin kupas. Hindi ako nagdaramdam, kahit nagmukha akong tanga. Dahil minsan isang panahon, ikaw ay naging inspirasyon. At dahil minsan isang kahapon, minahal kita nang tunay na walang pagtatanong.

Wala akong panghihinayang at wala ring pagsisisi. Matapos humilagpos sa iyo, ako’y nakabangong muli. Tadhana sa aki’y naging mabait, at muling ngumiti yaring pag-ibig. At kung iyong tatanungin, ligaya ko’y abot hanggang langit. Sa piling ng aking asawa at ng aming mga supling, hanap kong paraiso, akin ring nakamit.

Nasaan ka na kaya ngayon? Sana naman, ika’y naging masaya rin.



Under a Glass Ceiling


somewhere in Manila

Even though it was only less than 3 months since we have visited the Philippines, I am already missing my native land. I miss walking beneath the swaying palm trees and wandering around a tropical garden.

But the other day, we visited something similar.IMG_3638

We walked in the midst of lush vegetation, typical of a rain forest.IMG_3613

Took shelter from the sun under the broad banana leaves.


And was greeted by familiar tropical fruits, though we did not pick them. First of all, they were not ripe yet. Second, we are not allowed to.


We also found cool water falls in the midst of the thick flora.


It was indeed a beautiful tropical garden.


No, I am not back in the Philippines. In fact, I am not even in a tropical place. All of these were inside a huge glass dome, right here in Des Moines, Iowa, where winter is cold and harsh.

But inside this big greenhouse, the temperature is controlled, where it is warm and balmy all year round, just like the tropics.


There was even a patch of desert plants in one corner.


And of course, there were lots of beautiful tropical flowers for us to admire. Here are a few of them.






Spending some time in the garden was a cool (or should I say hot!) experience.

It does not matter what the weather outside. Whether it is spring, summer, fall or even if it is the dead of winter. I don’t care even if there is a blizzard outside. For under this glass ceiling, I felt right at home.

I wonder if they would let me set up a bahay kubo (nipa hut) in here.


(*photos taken inside the Des Moines Botanical Center)

Long Awaited Concert

When I came home today, I was greeted by a high-pitched humming music. The sound was loud enough that I felt the whole neighborhood was buzzing.

No, it was not an out-of-control orchestra. Nor a marching band that went bonkers.

It was a mass choir of cicadas.

As I went out in our yard, I really felt the vibrating noise, especially when I walked under the trees. I saw cicadas everywhere.

On the tree.


On the grass.


And even on my hand.


There are many species of cicadas. What is appearing this time here in Iowa is the 17-year variety of these noisy insects. That means this certain species had disappeared for a long time. For seventeen years they have vanished out of sight and lived under the ground in hushed darkness.

But now they are out. They have emerged. And in swarm.

swarm of cicadas on our tree

swarm of cicadas on our tree

After long years of silence they are singing their song. Happily and loudly. At least it is better than the song I heard recently from the Philippine senate that was part of a privilege speech.

Humans sing when we stretch and vibrate our vocal cords. Crickets produce their sound by rubbing their wings. Cicadas on the other hand sing by vibrating two ribbed membrane in their belly, and their hollow abdominal cavity amplifies the sound greatly. Some species can register more than 100 decibel when singing. Come to think of it, my belly also rumbles loudly when I am hungry.

And what are these chirpy cicadas singing about? It is actually a love song. They are calling for their mate. Some love songs can make you cry. Some love songs can pierce your ears.

With all the throng of merry cicadas singing, I admit the sound can be deafening. But I will enjoy this special concert while it last. For I have to wait another seventeen years to listen to this remarkable event.

Here’s a sample of their lively music.