No More Free Concerts

Last week, I took a day off from work, drove a couple of hours, travel more than a hundred miles, just to see a concert.

It was not a concert of one of those pop superstars, like Adele or Lady Gaga. Nor was it a concert of some well-known classical artist like Andrea Bocelli or Yoyo Ma.

It was my daughter’s concert. It was their university’s orchestra performance. And it was their first concert for this school year.


I have seen my daughter play cello in the orchestra multiple times in the past. From her grade school days, to high school days, and to community orchestra. From the screechy-sound of beginners, to more polished tones of intermediate, to quite advanced.

Though this maybe the best group that she’s been a member so far. After all they were all music majors, both undergraduate and graduate students. As far as I am concern, they can be considered “professional” musicians now.

We knew back then, that when we introduced our little girl to music, that she has a special attachment to it, and we cannot deny the fact that she has a gift for it. So it was no surprise that that was the career path she chose to pursue. Even though honestly, I tried to sway her to a different path.

I know as a parent, we wanted a secure future for our kids. So we prefer professions like engineer, or doctor, or lawyer. But what’s wrong with literature, or arts, or music, if that’s where our child’s passion is? Success should not be gauge only on how much money we can earn, but also on the satisfaction and joy on doing what we love to do.

It was heartening to witness that my daughter is getting very skillful on the cello, as well as playing with the orchestra. But playing cello is not even her major. She’s majoring in another instrument. A much larger instrument, the piano. So there will be more concerts and recitals to attend to.

All those years of music lessons are finally paying off. We’re proud as well that our homeschooling “experiment,” (we homeschooled her from kindergarten to high school) was a success. All of our worries that her education was not adequate, were all appeased.

Now, my daughter is not merely surviving, but thriving in college. She even was granted a good scholarship that covers her college tuition, so we only have to pay for her food and dorm. With the cost of college education ever on the rise, ranging from $10,000 per year in state universities (for in-state residents) to $50,000 or more per year in private and more expensive institutions, getting a college degree these days can definitely break the bank.

Back to the concert. Though some of the selection they played were kind of hypnotic to me, I was able to stay awake through the concert. Over all it was fantastic. After the final bow, the audience were up on their feet. The only gripe I have on the concert is that it was not free. Sorry, I’m cheap.

But I get it. It helps support their university’s music program. Besides, the quality of their performance was superb that the concert was even recorded, and maybe aired one of these days on a public radio station. Definitely worth paying for.

So for the first time, I bought a ticket just to see my daughter perform. But I’m OK with that.

I wonder, would I have to pay a more expensive ticket when it’s time for her solo piano performance?

A Somber Celebration

Last week, we had a patient in the ICU who was unwell. Unwell, is perhaps an understatement.

He was of an advanced age though, as he was in his 80’s, and maybe has already lived a full life. Yet he was still active, lives independently with his wife, and was in relatively good health, until he got sick and got admitted to the hospital.

He came down with a bad bout of pneumonia. So bad that he went into respiratory failure and had to be placed on mechanical ventilator. This was complicated as well, as he suffered a mild heart attack too. Furthermore, he also developed brisk bleeding in his stomach, but fortunately we were able to stop that bleeding, when we did the gastroscopy.

After several days of intensive support, surprisingly he got better. He got better enough that we were able to take him off the ventilator. He was going to pull through this. So we thought.

But less than 24 hours later, he was placed back on mechanical ventilator. His blood pressure dropped as results of overwhelming infection. He went into congestive heart failure. His kidneys also started to fail. His condition got worse than ever.

We sat down with the patient’s family and discussed with them the dire situation. They decided that they would like to continue the aggressive support and hang on for two more days. I thought it was kind of odd to have so specific timeline in their request.

Why two days?

Two days later, as we’re going through our morning rounds, I was told by my staff that we will be having a party later that day. A birthday celebration right there, in the ICU.

I learned that the family of our elderly patient have called all the family members that can come, to be there and visit the patient. They brought balloons and a large birthday cake. They even brought in the patient’s dog to the ICU! But of course they have to get a permit and confirm all the vaccination records of the dog.

I also learned that the family was planning to take him off life support that same day. They would like to transition to full comfort care, and let nature take its course.

The ICU staff got a birthday card that they passed around and asked us all to sign it. Honestly, I was stumped on what to write on the card.

Do I write “Happy Birthday,” knowing that it may not be really a happy event? Or do I write “May you have more birthdays to come,” which I know would not be true at all? Or should I write “Have a good last birthday?” But that sounds morbid! Or do I write “May you have peace on your birthday,” which I think is very appropriate, but it is as if I’m foretelling death before it actually happen?

Never did I have so much difficulty in writing a simple greeting on a birthday card before.

When the family were ready, we lightened the sedation and have the patient wake up, so he will at least have the chance to witness his own birthday celebration.

The ICU staff came and crowded inside his room and sang “Happy Birthday.” Though I guess, many of us we’re feeling rather sad than happy while singing that song.

We then extubated the patient and took him off the ventilator. He was able to speak after that, though very weakly. The family gave him a piece of his birthday cake which he tasted, even if it was just the frosting.

After a while, he started to show signs of discomfort. He was obviously struggling even just to take a breath. So after the final embraces from the family and a pat to his dog, we gave him medications to relax him and made him more comfortable. He slept the rest of his birthday celebration.

He later slept on into the eternal night.


P.S. I wrote on his birthday card, “May you have a meaningful birthday.”


Pilipino Idioms of Nineteen Kopong-kopong

Recently a friend of ours has been posting article links in his Facebook about expressions that we grew up with. I find it quite interesting.

Our vernacular is rich with idiomatic expressions that would confuse the uninitiated to our native language. Or maybe even us who grew up speaking Pilipino, have no idea where these expressions came from.

Here are some of them.

1. Pahanon pa ni Limahong. Or pahanon pa ni Mahoma. Or since Nineteen Kopong-kopong.

All those expressions mean that they are from such a long time ago. Example: Iyong mga damit mo, old-style na, panahon pa ‘yan ni Mahoma. 

But who is Limahong? Or Mahoma? Or who or what is Kopong-kopong?

Limahong or Lim Ah Hong is a Chinese pirate who invaded the northern part of the Philippines and tried to seize the city of Manila from the Spaniard in 1574. So he was a real person from such a long time ago. Definitely before our time.

While Mahoma is actually Masaharu Homma, a Japanese Imperial Army general.  He was well-remembered for his role in the invasion and occupation of the Philippines during World War II. What may endeared General Homma to our people is that he ordered his troops to treat the Filipinos not as enemies but as friends, and respect their customs and religion. Thus we still say his name in our idioms.

What about Kopong-kopong? Is that a person?

Kopong is actually an old Tagalog word and also an Indonesian word that means empty, or nothing, or zero. So kopong-kopong is coined from the year 1900 which has two zero (00), thus Nineteen kopong-kopong.

2. Pagputi ng uwak

Literal translation means “when the crow turns white.” This just expresses something that will never happen. The idiom is similar to English expressions like “when pigs fly,” or “when hell freezes over.”

To use this expression in a sentence: Babayaran ko ang utang ko sa iyo pagputi ng uwak.

By the way, there’s a film that was entitled, “Pagputi ng uwak, pag-itim ng tagak” release in 1978, starring now governor of Batangas, Vilma Santos, and Bembol Roco. I did not see that film nor do I know the story plot of the movie. But during that time who knew that Vilma Santos will someday be a governor? So can we say “pumuti ang uwak?”

3. Aabutin ng siyam-siyam

Siyam-siyam or (literally nine-nine) is a term used for the annual prolonged rains brought about by the southwest monsoon or “habagat” weather system in the Philippines during the months of May to September.

The old folks believe that this rain system takes nine days and nine nights and is what they are waiting for. Especially farmers, as it makes the fields soft, and therefore easier to plow and to plant rice.

It also used to mean a long wait.

To use this idiom in a sentence: Inabot ako ng siyam-siyam sa kakahintay para makasakay ng jeep.

4. Mabilis pa sa alas quatro

This means to leave in a mad rush.

In the old Manila, in Lawton at the foot of Quezon bridge, there was a huge factory, the Insular Ice Plant. It had an imposing 10-storey chimney. It also had a loud siren. The siren goes off at 7 AM to indicate start of work, at 12 noon to indicate lunch break, and at 4 PM to indicate end of work.


Insular Ice Plant

So at the sound of the siren at 4 PM, you can just imagine the dash of the workers too eager to leave work.

To use in a sentence: Nang dumating ‘yung naniningil ng utang, umalis siyang mabilis pa sa alas quatro.

5. Wala kahit sinkong duling

This has something to do with the 5-centavo coin, which is the lowest value coin besides the 1-centavo. The 5-centavo coin back in the days was much larger (20 mm in diameter in the 1960’s) and can buy you something, unlike today, it is much smaller (15.5 mm) and practically has no value.

Singkong duling literally means a “cross-eyed 5-centavo.” A person who is cross-eyed sees a double image of the 5-centavo coin. One image is real, but the other image is not. Thus sinkong duling is a non-existent 5-centavo coin. It’s a mirage.

So if a 5-centavo has very little value, how much less is an imaginary image of it.

Use in a sentence: Hindi man lang ako binigyan ng balato, kahit sinkong duling.

6. Magsunog ng kilay

This means to study hard or staying late up night studying.

This idiom came from the fact that during the olden times, when there’s no electricity yet, people use only gas lamp (gasera), oil lamps, or candles to read when it is dark. It is then understandable that when a person is reading for a long time near an open flame, there’s a possibility that his/her eyebrows will be singed or get burned. Thus “nagsusunog ng kilay.”

I can just envision that the most studious students during those times have no eyebrows left. Whoever invented the eyebrow pencil must be a very good student!

7. Kalapating mababa ang lipad

The term is a euphemism for a prostitute.

During the American occupation, there is a place in Tondo Manila, which is a red-light district called Palomar. So before Malate, Ermita, P. Burgos, and EDSA of today came about, there was Palomar in Tondo.

The word paloma means dove or pigeon in Spanish, while Palomar means a pigeon-house. So the women offering their leisure service were called palomas de bajo vuelo or low-class birds. Thus the expression “kalapating mababa ang lipad.”


So there you have it folks. I hope you have learned something, as I did, looking up these interesting history and facts of our colorful language.

(*photo from


A Gray Day to Run a Marathon

It was time for my annual participation for the half marathon. As always, I can’t run without taking photos. I could have played Pokemon Go and capture Pokemon creatures too, but I settled in just capturing pictures.

It was a foggy and an overcast morning. Though for runners, there’s no “bad” day to run. As you can see, hundreds of runners showed up on race day. Here we are waiting for the run to start.


And here we go! Crossing the official Starting Line.

img_3577Weaving our way through downtown Des Moines.


Passing the Pappajohn’s Sculpture Park.


We’re away from the downtown buildings now. The visibility remained a few hundred yards due to the fog, as shown below.


Circling around a lake. Where’s the lake you may ask? I know you can’t see it, but just believe me, that’s a lake.


Crossing a foot bridge in Gray’s Lake. It was really gray indeed!


Even if it’s foggy and cool, we need to keep hydrated. Below are the paper cups thrown aside by the runners just past the water station.


Running around the Capitol building. The golden dome is barely visible due to the fog. It was about this time that I felt my legs starting to cramps. So I started to intermittently walk and run.


I almost crawled the last (13th) mile. But to look good for the spectators at the finish line, I ran fast for the final 0.2 to 0.3 miles to the Finish Line. As they always say, finish strong! Even if it just for a show.

Finally, me approaching the Finish Line! Look, a medical personnel is waiting.


(*all photos were taken by me, except for the last photo which was taken by my wife)

Smoking Ban

I read in the news that President Duterte is planning to sign a law that will ban smoking in all public places nationwide. My response to this is that: it’s about time!

I don’t think in this day and age, that anybody in this world have not heard or read the damning facts that smoking is harmful to our health. As a lung specialist, and an advocate of no-smoking, I laud this plan to ban smoking in public places.


I am a witness to all the grim and devastating effects of smoking. I see them everyday.

Though quite honestly, I partly owe it to the smokers, of why I have work today. But in the same token, I don’t want people to continue to smoke.

According to World Health Organization, lung cancer is the most common cancer worldwide. It is also the leading cause of all cancer deaths in the world, accounting to 1.37 million deaths annually. The number of deaths every year from lung cancer alone is more than the number of deaths from breast, colorectal and prostate cancer (other leading cancers) all combined.

In the Philippines, lung cancer is also the most common type of cancer, and is the leading cause of cancer deaths. And we have 17.3 million tobacco consumers, which makes the Philippines the number one in most number of smokers in Southeast Asia. I am not sure if we should be proud of being number one in that category.

More than 90% of lung cancers are linked to smoking. Other causes are occupational carcinogen exposure, radon and pollution. Though lung cancer can arise from people who never smoke, like the late Senator Miriam Santiago, but this is relatively rare.

Besides lung cancer, smoking also causes other diseases. COPD, heart disease, mouth and throat cancer, esophageal cancer, and vascular diseases to name a few.

I know there will be some that will complain and protest that this plan is unlawful. And surely some would say that this is unfair for the smokers. For definitely people should have the right of choice. Even the right to do stupid thing, like smoking.

But the ordinance is to ban smoking in public places only. This is not taking away your right to kill yourself by smoking. You are just not allowed to kill others too that can inhale your toxic fumes.

I remember my jeepney-riding days, where someone would be blowing cigarrette smoke in my face. So between the secondhand cigarrete smoke and the diesel fumes from the buses and jeepneys, no wonder I cannot breathe after sitting for some time in traffic.

Studies have shown that second hand smoke (exposure to others who are smoking) is almost as harmful as firsthand smoke. I pity the children who have parents who smoke in their presence. Where is their right for non-toxic air?

Several places in the world have already this smoking ban in public places being enforced for quite some time now. And I’m glad that the Philippines is catching up with the current times.

I am not denying the fact that it is very hard to quit smoking. There’s even reports that tobacco companies are making cigarrettes nowadays that have higher nicotine content, making it more addictive and making it more difficult to quit.

When I was doing my subspecialty training in Memorial Sloan Kettering Cancer Center in New York City, we have patients who were already dying of lung cancer but still cannot quit smoking. They would go outside the hospital building and smoke. This was almost two decades ago when smokers can still smoke in designated areas in the hospital grounds. I even saw a patient with tracheostomy (a hole in his throat) due to throat cancer, and he was smoking through his tracheostomy! How sad is that?

Nowadays, most hospitals have a total ban of smoking in their entire premises. In the hospital where I work now, smokers would go across the street from the hospital entrance and smoke there. Even when it’s in the middle of winter or even when snowing, where they are exposed to the elements, they would still go outside in the subfreezing temperature and smoke. Why? Because they cannot help it. How really sad is that?

So I get it, it’s hard to quit smoking. But I still support the smoking ban.

Even the cockroaches will be in favor of this.


(*images from the internet)



Don’t Send In The Clowns

What’s with this epidemic of clown sightings all over the United States?

Most of the sightings are deemed non-threatening, like a clown holding some balloons in a poorly lit street corner. Though there was a report of a knife-wielding clown that attacked a boy in Michigan, and clowns with baseball bats spotted also near that same area. There have been other reports of violently threatening clowns.

I think this is more than just clowning around.


It started in late August, when an unsubstantiated report of clowns sighted near the woods in South Carolina. Apparently these clowns were luring children to come into the woods. Since then several incidents of clown sighting were reported in other states, including North Carolina, Georgia, Alabama, Florida, Tennessee, Pennsylvania, New Jersey, Maryland, Connecticut, Texas, Phoenix and Idaho.

Nobody is sure if this mass frenzy are just pranks or hoaxes, or are unusual marketing tricks or something (related to a movie that will be soon released?), or a mad social fad. Whatever it is, it is startling and at the same time creepy. But it’s definitely not funny.

In fairness, the studio who recently wrapped up the production of the film, “It”, which is a remake of the film based on Stephen King’s 1986 novel, denies any involvement in this rash of clown sightings. The novel/movie is about a nightmarish clown who hunts children.

The White House have already weighed in on these clown threats, though deferring the matter to the FBI and Homeland Security. Even the master of horror, Stephen King himself, called for calm and to cool down on this clown hysteria.

There is a specific phobia of clowns. It is called Coulrophobia. It is not hard to understand why a person can be afraid of someone with an aberrant-looking face. It is disturbing, to say the least. I don’t understand it as well, why we have this creepy looking character graze our children’s birthday parties.

I myself, am spooked by clowns. Though I like the song “Send in the Clowns,” a ballad written by Stephen Sondheim for the 1973 musical A Little Night Music. The song became popular after Frank Sinatra recorded it, and Judy Collins’ version made the charts.

Anyway, back with this hysteria of creepy clown sightings, it is said that it is hurting the real clown business. And there was a news report that concerned professional clowns were forming a movement named Clown Lives Matter. They will hold a peaceful march in Tucson Arizona next week.

I am not sure if Ronald McDonald will join the march.

Then this week, there have been sightings of clowns in several universities here in Iowa, where I live. There were also sightings in some high schools here in Des Moines. Police have even accosted a high school student in Des Moines who was dressed as a clown. Apparently the student did it for a prank.

I am afraid that somebody will get seriously hurt with this craziness. It could be that more violent clowns would attack, or who knows, people will get so spooked that they will start shooting all these clowns.

In other news, there were sightings of clowns in the Philippines too. It may be startling, but definitely not funny.

They reportedly appeared in the senate.

Harvest Time

This morning I went for a long run, in preparation for the half-marathon that I would be participating in. The event would be in 2 weeks.

My long runs have been getting longer, and sometimes it can be tedious and boring. Maybe I should play Pokemon Go while I run to make it more exciting, and capture those fleeting critters.

I did not capture a Pokemon, but I captured these photos while I was running:


Yes, it is harvest time in this part of the world I’m living in. The fields are golden brown, the days are getting shorter, and the wind is getting colder.

In this particular field, they were harvesting corn.

Why are they harvesting corn? Because they sow corn! Shouldn’t it be that way, we harvest what we sow?


Maybe some cynics out there may disagree with me, for I know we are living in a world where so much injustice abound. People seems to reap what they did not sow, or have been harvesting in fields that are not theirs.

In my home country, we even have a proverb for that: Ako ang nagtanim, ako ang nagbayo, ako ang nagsaing, pero iba ang kumain.

Loosely translated, it says, I was the one who planted, I pounded, and I cooked, but somebody else ate it.

Yet I still believe in justice.

Lady Justice may seems to be blindfolded (I don’t know why it is portrayed that way) to the unjustness and repression happening all around us. And I’m not blind to that. But I know it as a fact that in the end, justice will be served.

That day of reckoning will come to all of us, when we will harvest what we sow.


(*photos taken with an iPhone)

Question and Answer: Sakit sa Balakang

Recently I got a message from a reader posted in the comment section of my article Mamang Hilot, regarding a specific medical problem, asking for advice.

I have received several medical questions in this blog in the past, and most of the time, I just gave a short answer and recommended that they see their local doctor. I was also asked on how to make gayuma or how to counter a kulam, but of course I have no idea how to answer those.

Anyway, I decided to answer this reader in a post, regarding her medical question. Hopefully this would be helpful to her, and to some other readers with similar issues.

A reader, named Ellaine wrote:

Good day po.

Nagpahilot po ako dahil parang kumikirot ‘yung right side ng balakang ko. Pinadapa n’ya ako, dinaganan ‘yung balakang ko, saka hinila ang hita ko pataas at may tumunog. After ilang days, parang makirot s’ya at hindi nawala ang sakit.

May 3 linggo rin ang lumipas at saka ako nag-pacheck up sa doctor. Wala naman makita sa ihi ko na infection. Kaya niresetahan lang ako ng gamot for 1 month, baka daw kasi may na-damage na nerve o nabigla ‘yung muscle ko dahil sa hilot.

Natapos ko na po ‘yung medication ko, pero still masakit pa rin s’ya. And the worst, parang gumagapang ‘yung kirot papunta sa hita, binti, paa at likod ko, kaya natatakot po ako. Kahapon po bumalik uli ako sa doctor at binigyan naman ako ng x-ray request. Agad naman po ako nagpa-xray para malaman, ngunit wala rin po nakita sa x-ray.

Sabi ng doctor baka dapat na daw ako magpa-MRI, baka daw may naipit na ugat sa balakang ko. Sabi ko po wala naman akong kakayahang mgpatingin ng ganun kamahal, dahil nasa mahigit 10 thousand daw po ata iyun.

Pag-babalewalain ko daw po ‘yung nararamdaman ko, posible daw akong malumpo. Totoo po ba na talagang maari akong malumpo? Natatakot po kasi ako. Ano po kaya ‘yung nararamdaman ko at ano ang dapat kong gawin. Baka po may maitutulong kayo.

Maraming salamat po..

Dear Ellaine,

Sa aking pagkakaintindi sa iyong tanong, ang problema mo ay low back pain, na hindi natatangal kahit may isang buwan na ang nakalipas. Parang lumala pa ito kamo nang ikaw ay magpahilot. Paumanhin na lang po kay Mama o Aleng Hilot.

From the symptoms you’re describing here (pasensiya na po at nag-English na ‘ko), I believe you are suffering from lumbosacral radiculopathy. Don’t mean to sound high falutin, but this just means low back pain with possible nerve impingement (ipit na ugat) or nerve involvement, as you describe the pain as “gumagapang sa hita, binti, paa, at likod.” One specific condition is sciatica, which is impingement of the sciatic nerve.


The nerve roots from the spinal cord as it comes out of the vertebra (gulugod), can be impinged by a muscle, or when there’s vertebral disc herniation, vertebral stenosis (narrowing), abscess or infection, or in rare cases, tumors. The nerves can also damaged by being stretched when certain physical injury or manipulation is done.

For all people with acute back pain though, the overall prognosis is quite good, as 70 to 90% of the time the pain will improve in 8 weeks or so. Very few will require invasive or surgical intervention.

Even though traditional thinking would say to stay in bed, the medical literature does not agree with this. Studies have showed that people who continue to be active, do better in dealing with their back pain and also have more shortened recovery time than those who did “bed rest.” Sorry, not an excuse to skip work. Though use common judgement when your work involves heavy lifting, like carrying sacks of rice or moving pianos.

Physical therapy when properly employed and specific exercises to strengthen the back and abdominal muscles can certainly help.

Medications like non-steroidal anti-inflammatory (NSAID), which I believe is what was prescribed to you is one of the mainstay of treatment. Sometimes it is combined with muscle relaxants. In severe cases of pain, narcotic analgesics can be used, but these are controlled drugs as they can be habit-forming or addicting. (Galit si Duterte sa mga adik!)

Non-medical intervention like cold or heat therapy to the area can be applied but mostly used during the acute phase of the back pain or injury. Massage, acupressure, and acupuncture (using long needles) have been employed but data on their effectivity is variable. Please don’t just stab multiple needles in your back.

Other procedures available are steroids injection to the spine and of course surgical intervention.

If you’re condition does not improve with conservative management (exercises, physical therapy and medication), then further work-up may be needed. Unfortunately, the imaging study to best visualize the structures in the back are MRI and CT scan of the vertebrae, which I agree are expensive tests. A plain x-ray will not be very helpful.

About the concern “na maari kang malumpo?” The pain na “gumagapang” does not necessarily means it is really bad. As I said most people with back pain recovers in time. However if you’re already experiencing focal weakness in your legs, like having difficulty climbing stairs or tiptoeing, then it can be serious. Kung hindi lang ‘yung sakit, at ikaw na ang gumagapang, eh seryoso na iyon.

So in the end, I would still recommend that you see your local doctor. An Orthopedic Surgeon or Physical Medicine and Rehabilitation specialist (also known as physiatrist) may be the best doctor to see regarding this problem. I’m hoping that you’ll just need physical therapy and a sprinkle of time to fully recover.

Hope this help Ellaine, and God bless.

Sige, padala mo na lang iyong bayad mo sa akin: tatlong Choc-Nut, ok na.



(*sa mga susunod na kokonsulta, mas mahal na po ang bayad:  5 Choc-Nut na.)



Tortured Soul

She was a tortured soul.

In spite of all the medical interventions and having a supportive family, she still was always extremely depressed. It seems that she cannot get rid of her demons and the tormenting voices in her head. The desire to kill or hurt herself consumed her every day.

She has been on different anti-depressive medications and was regularly being followed by her psychiatrist. She even had several admissions to the inpatient psych unit. Yet nothing really alleviated her condition. For a person who is barely in her 30’s, she already had a fair share of misery.


She has attempted suicide a number of times in the past. Though all of those times it was not serious, resulting no grave medical consequences. It was mostly cries for help.

But this time, it’s different.

Her family found her unresponsive in her room after presumably overdosing on a bunch of different pills. Emergency responders were called and upon their arrival, CPR was performed. They were able to establish a stable heart rhythm and patient was brought to the hospital where she was subsequently admitted to the ICU.

She laid there in our ICU, hooked to several monitors and life support. Her chest would rise and fall as the ventilator bellows air into her lungs.

Three days have passed since her admission, yet she remained unresponsive. In addition she had this intermittent jerking-like activity, which I believe was an ominous sign of severe anoxic brain injury. I called the neurologist to assist in her care.

Then few hours ago, something happened.

Her vital signs became more labile. The continuous EEG monitoring which the neurologist requested showed a significant change. The jerking-like activity have quit. Her pupils were now fixed and dilated.

My suspicion was that she now is brain-dead.

Brain death is a complete and irreversible loss of brain function. Unlike in a vegetative state which could have some autonomic or brain stem functions left, brain dead means cessation of all brain activity.

I updated her family of this recent development. Then I proceeded to do my confirmatory exam for brain death per protocol.

After my evaluation, I determined that all her neurologic functions were gone. I even performed an apnea test, which involves taking the patient off the ventilator for 8 full minutes, while providing oxygen through the endotracheal tube. If there was no respiratory motion for the entire time, and this is associated with an appropriate rise in the blood carbon dioxide level, then this is one verification that someone is indeed brain-dead.

The neurologist independently performed her evaluation as well, and also arrived at the same conclusion.

When one is declared brain-dead, it is an indicator of legal death. Different from a person who is in a continued vegetative state, who can be sustained on life support indefinitely (which is controversial in so many levels), a person who is declared brain-dead is officially dead. All life support should be discontinued. Even if the heart is still beating. No argument. No controversy.

I gathered the family and told them of my findings. They were obviously distraught, but accepted the news without any questions.

I also told them, that based on the patient’s driver’s license, she indicated that she was an organ donor. I asked the family if they would like to honor the patient’s wishes.

The family said, that they totally agree to donate the patient’s organs per her wishes. That despite of the patient’s several mistakes in her life, this may be the best decision she have ever made, according to them. And despite of her cloudy and troubled mind, she have decided on this selfless act.

I called the donor network.

I know that somewhere out there, another person will be set free from the shackles of dialysis as he or she would receive a long-awaited kidney. Another person will be given a new breath of life as he or she would receive a new set of lungs. And another person out there will be given a new lease of life, as he or she would receive a new heart.

All because of the gift of a tortured soul.

That’s Entertainment

I would say in advance that this post has nothing to do with the defunct youth-oriented variety TV show with that title, that was hosted by the late German Moreno, aired in the 80’s – 90’s.

But that’s entertainment!

No, not that show. I was pertaining to the current best entertainment in the Philippines.

Who could guess that this will be more fun that any TV show, tele-serye, or even kalye-serye? I can say that we Filipinos can only provide this level of showmanship.

There’s drama, action, and fiction – all rolled into one. Maybe next time they will add some musical as well. Oh I forgot, there’s already that. Remember, may “kumakanta,” di ba?

But before you surf crazy the entire TV channels searching for it, or go into expedition to the movie theaters or broadways, I was just alluding to the Philippine senate proceedings.

Best entertainment ever. And this is “real” life.

Witness: Pinagbabaril na po naming yung lalaki, pero buhay pa.

Senator: Ilan kayong  bumaril?

Witness: Marami po kami, nasa 30.

Senator: 30 kayong bumaril, pero buhay pa? Ano nga ulit pangalan ng pinagbabaril ninyo?

Witness: Si Neo po, your honor. (*Matrix movie soundtrack plays in the background*)

Ghost of FPJ interrupts: Pinuno mo na ang salop. Isang bala ka lang!


I’m looking forward for more of this entertainment. Though I think it will become more fascinating, when the House will soon have their own “show.”

As our slogan says, “It’s more fun in the Philippines.”

I would like to end with a Filipino proverb:

Batobato sa langit, tamaan huwag magalit.

Or the new version:

Matobato sa langit, hindi matamaan kaya nagalit.