Wild Goose Run

January and February are usually the coldest months here in Iowa. It is too cold to run outside, at least for most people. The last time I went out to run was back in December, and it was actually Christmas Day as we had a spring time weather that time.

But today is different. By the way, it is 02 02 2020, how neat is that? Even though it is February, our temperature is above freezing (40º F), which is unusual for this time of year for us.

So I decided to go out for a run.

It is a sunny day and our big pile of snow is starting to melt. It may take several days of “warm” days like this to melt them all down though.

Then I met some flocks of wild geese. They usually fly south for the winter, but I am seeing more and more of them staying here in our place even for the winter months.

These geese are equipt for the cold anyway, as they have down feathers which we even use to insulate our jackets. In fact goose down jackets are one of the warmest jackets you can get and has the advantage of being lightweight. But I know they can be expensive.

Here’s more geese coming for a landing.

There is more cold weather forecasted for this coming week, and we will be back to subfreezing temperature, and more snow as well. But for a day, I enjoyed going outside with the wild geese.

A wild goose chase? Maybe.

my shadow selfie with the geese

(*photos taken with an iPhone)

Hospital, Cafeteria, and Sanctuary

I was in charge of the ICU that day and it was quite busy. Though it was not that up-to-my-eyeballs hectic for I still had time to go down to the hospital’s cafeteria for lunch. Many times I would grab meal to-go and head back to the ICU work station and inhale my food while doing some computer charting. That day I had the luxury of eating my lunch more leisurely in the cafeteria itself.

Our hospital’s cafeteria is by no means a fancy place to dine in. It is after all a cafeteria serving hospital food. Nothing against hospital food, but if I have time to spare, I will eat somewhere else. Our cafeteria though has a section that has glass wall and ceiling that gives you an atmosphere of being outside. Yes it is still winter and there’s snow on the ground, but the sun was shining that day, so I went there so I could soak up the sun for a change.

However if the hospital cafeteria is as inviting as the photo below, once I settled there they have to pry me like a barnacle from my seat for me to go back to work.

(photo taken in the Philippines at Manila Bay, a few years ago)

Besides the obvious of getting food to eat, there is another reason I stay a while in the cafeteria. That is, it gives me a chance to be away, even for a short time, from ICU work and from the constant hounding from the patients, residents, nurses, and other doctors. Though almost always, when I’m on a lunch break that is when I am called to the Emergency Department for a new admission.

But that day was different. I was enjoying my lunch alone and my phone was unusually silent. I guess the cafeteria gods were smiling at me. I consider these lunch escape my sanctuary – away from the chaos and the harsh reality of the ICU.

The hospital has a chapel too. But that is not the kind of sanctuary I am talking about here. I just needed a place to take a breather.

Then while I was savoring my food, but more so my silent interlude, a man approached me at my table. How dare him interrupt my break time? Who was he to disturb my lunch? Of course I did not react that way and instead I looked up and gave him a smile. It may be forced, but a smile nonetheless.

The man introduced himself and said that he recognized me from a previous ICU encounter. I learned that I took care of his mother in the ICU several months ago. After he gave me some details, I remembered her mother – she had cancer and became septic after receiving chemotherapy. She got very ill very fast and stayed in our ICU for several days. But she recovered.

The man then pointed to his mother, my previous ICU patient, who was sitting in a table a few paces away. They have an appointment with their oncologist at the Cancer Center and that’s why they were in the hospital.

How many patients have we taken cared of in the ICU who was as sick as she was, and have a chance to meet them later after their discharge and were doing relatively well? Sadly to say, that is a rarity. For many of them even if they get out of the ICU, they were never the same. And some don’t even get out at all, I mean not to the world of the living.

This man just stopped by to thank me. It was an interruption that I would appreciate after all.

Then when I was about to leave, a man that I met in the ICU earlier that day sat in a table near me. He was absorbed in his thoughts while eating by his lonesome. Like me he was also taking a break. Perhaps the cafeteria was his sanctuary too, an escape to the sobering truth in the ICU.

Though this man’s predicament was much different than mine. His daughter was our patient in the ICU, and she was not doing well. She had a tumor in her brain that was surgically removed, but even after more than a week post surgery, she remained on life support. Her life was hanging in the balance with uncertain future. Worse part is, she was only 20 years old.

It is very understandable for her family to be heartbroken. No wonder her father rarely leaves her bedside, except for a brief cafeteria break. As a father who has a daughter with similar age, I can only imagine the agony he’s going through.

I needed to go back to the ICU. We needed to help this young lady and her distraught father.

Tracing Vicki Belo’s Wedding Trail

We Filipinos are fond of fairy tales. The wedding of celebrity doctors Vicki Belo and Hayden Kho in 2017 was nothing short of a fairy tale. At least in the place and setting where it happened.

(above photo taken from the web)

I was waiting for my invitation to that great event but I think the mailman misplaced it. On second thought, maybe I was not really invited.

So I did the next best thing, I visited the place where the wedding reception was held. It was in the Opera House in Paris, or also known as Palais Garnier.

This 19th century architectual masterpiece was built by Charles Garnier and opened in 1875. Today, it is home to Paris Ballet, and besides being a venue for great art performances, it is also open for visitors to tour. Well, I guess it can be rented for a wedding reception too.

It was almost closing time when we got to the Opera House, and so we did not have much time to roam, but just enough to get a feel of this grandiose place.

Here’s the majestic staircase where Belo and Hayden did their magical wedding dance.

Of course I had to climb up those steps as if I’m in a fairy tale story too. My wife and I did not dance though on those stairs for we might stumble and fall, and end up in a tragic tale instead.

Here’s the grand foyer (photo below) where the wedding banquet and tables were set up. The newly wed couple and their guests dined under these intricate painted ceilings and opulent lights.

As I said, this is an Opera House, so here’s the auditorium that can sit 2000 people and where the real magical performances are happening.

Below is an interesting Christmas tree made up of ballet shoes which was displayed during our visit. I have no idea what the golden tractor tires are for.

There is also a mystery surrounding the construction of this palatial edifice that facts and fictions are blurred. The famous tale of the “Phantom of the Opera,” a classic novel by a Frenchman, Gaston Leroux, a story that was retold in so many ways was inspired from the history of Palais Garnier.

We roamed around the halls perhaps looking for traces of Belo or perhaps searching for the phantom, until a lady with a bell called everyone still inside the opera house announcing that it was time to close. We were among the last ones who exited the place that night.

The Phantom?

I know this place was already enchanting even before Belo rented this place. Maybe someday I’ll have my birthday bash or a wedding anniversary here. Alright, I’ll dream on.

From Belo’s wedding reception place, albeit two years too late,

Pinoytransplant.

(*photos taken with an iPhone at Palais Garnier, Paris)

10 Years of Blogging: Making A Landmark

Over the history of mankind, people have built structures that have become landmarks. They are a testament of the people who constructed them. Here’s a few that I have visited.

There are landmarks that are enduring and have lasted the passing of time.

Petra, Jordan

There are landmarks that are flawed, but that only make them more endearing.

Pisa, Italy

There are landmarks that symbolizes what a nation and its people stands for.

Washington DC

And then there are landmarks that are very popular and have become cultural icons.

Paris, France

I am not saying that I have created a monument of such significance as of the structures above, for that will be delusional. However I am proud to say that this blog is now 10 years old which I consider an achievement, for that is way more than the average life span of a blog site. My writing has flaws and is far from perfect, but I am still a work in progress.

This blog represents my personal ideas and nobody else. Moreover, I stayed true to my original purpose to keep this blog for the mere joy of writing – no ads, no commercials. If you should know, I still haven’t made a single cent from blogging.

I have posted more than 900 posts and this site has garnered more than half a million views. I know that is really not considered a very popular or a viral site that can have million of views a day. Yet I hope that like a landmark, I am leaving an impression in this blogging world in my own little way. I owe this though to you my dear readers.

And as long as I am enjoying this journey, I will keep on blogging. Thank you for your continued visit.

Sakit sa Balakang, Sambong, at Badjao

Isa sa pinaka-mabentang artikulong inilathala ko sa blog na ito ay ang “Question and Answer: Sakit sa Balakang” (posted Sept 2016). Hanggang ngayon ay mahigit sa 100 tao kada araw pa rin ang sumisilip sa artikulong ito. Marami talaga yatang may masakit na balakang sa ating mga Pilipino. Bakit kaya?

Dahil marami pa rin ang nagtatanong tungkol sa sakit sa balakang, at dahil halos magkakatulad naman ang mga katanungan ay tumigil na po akong sagutin ito ng isa-isa. Pero naglathala naman ako ng aking pang-finale na sagot, “Sakit sa Balakang: Final Answer” (posted Aug 2018).

May natatanggap pa rin akong mga tanong sa sakit sa balakang hanggang sa ngayon, pero dedma na lang po ako. Pero noong nakaraang ilang linggo ay may nagtanong na hindi ko yata kayang palampasin lang, dahil maraming anggulo ito. Kaya’t heto na naman ako, sasagot muli sa isang katanungan.

Ito ang tanong ni Rowena (last name witheld).

Good day po.

Dati po bewang ang medyo masakit na parang ngalay sa akin ng mga nakakaraang araw. After ilang days sumakit po balakang ko sa bandang kaliwa lalo na pag nahakbang ang kaliwa kong paa. Nag pa-check up po ako at may UTI daw po ako. Niresetahan ako ng antibiotic at sambong. Pero kinagabihan lalo tumindi ang sakit.

At bago po nangyari ang lahat, meron po kasing nanghihingi ng limos na babaeng Badjao na may dalang bata. Hindi ko po s’ya nabigyan dahil wala akong barya. Para po siyang nagalit. Bago umalis tinapik po niya ako sa kaliwang bahagi ng balakang.

Nalilito na po ako at nahihirapan. Kaya po nag-search ako at baka may makatulong sa akin. Maraming salamat po.

Dear Rowena,

Sa iyong pagpapahayag ng iyong sintomas, sa aking tingin ay may kinalaman sa galugod (spine) ang dahilan ng iyong sakit sa balakang. Lalo na kapag gumagapang ang sakit sa hita at paa, at kung tumitindi ito kapag naglalakad. Maaring naiiipit ang ugat (nerve root) sa galugod kaya’t sumasakit at parang nangangalay.

Paki-basa na lang ng buo iyong artikulo kong Question and Answer: Sakit sa Balakang para sa mas kumpletong paliwanag at iba pang sanhi ng sakit sa balakang.

Kung ito ay UTI o kaya’y bato sa pantog o daanan ng ihi, maaring makaranas din ng matinding sakit, ngunit ang sakit ay hindi dapat gumagapang hanggang paa. Kung may iba pang gumagapang o nang-gagapang sa iyong hita, eh baka pulis na ang iyong kailangan.

Hindi ako pamilyar sa sambong, kaya’t ni-research ko pa kung ano ito. Ito ang aking napag-alaman tungkol sa sambong:

Ang sambong ay isang mabangong halaman. Ang scientific name nito ay “Blumea balsamifera” o “Blumea camphor.” Ito ay may medicinal properties. Isa rito ay ang diuretic effect – ito iyong nagdudulot ng pagpapaihi. Maari itong makatulong sa UTI o kaya para mailabas ang bato sa daanan ng ihi.

Dahil ang sambong ay mayroong methanolic compounds, ito ay nakakatulong din sa ubo at sipon. Ito rin ay may antibiotic properties dahil ito ay naglalaman ng cyptomeridiol at ichthyotherol acetate. Hindi naman siguro dahil sa sambong kaya’t lalong tumindi ang sakit ng iyong balakang, maliban na lang kung tumungga ka ng balde baldeng tsaa ng sambong ay maari itong makasikmura.

Tungkol naman sa mga Badjao, sila ay isa sa mga diskriminadong katutubong lahi ng tao. Sila ay kilala na “Gypsies of the Sea,” dahil sila ay nakatira sa mga kubo sa dalampasigan o kaya’y sa mga bangka na matatagpuan sa Sulu Sea. Ang kanilang kabuhayan ay ang pangingisda o pagsisid sa mga perlas.

Dahil sa digmaan, politikal na mga isyu, diskriminasyon, at komersyalisasyon ng pangingisda, sila ay natataboy sa kanilang tahanan sa karagatan. Marami sa kanila ay umaalis sa kanilang tradisyonal na lugar at nakikipagsapalaran sa mga barrio at lungsod.

Photo of a Badjao girl that went viral (image from Rappler)

Alam kong may mga Badjao na gumagala-gala sa mga siyudad at humihingi ng limos. Hindi ko alam kung ginagamit pa sila ng mga sindikato. Ngunit huwag naman po sana natin silang paratangan na mayroon silang dalang sumpa o kulam sa mga taong hindi sila napagbigyan, o mga taong hindi nila nagugustuhan.

Una sa lahat, hindi po ako naniniwala sa sumpa ng Badjao. Pangalawa, hindi na nga natin sila matulungan, napag-iisipan pa natin sila ng masama at inaakusahan na nais nila tayong saktan.

Rowena, alam kong naghahanap ka lang ng kasagutan sa iyong nararamdamang sakit, ngunit ako’y nakatitiyak na walang kinalaman ang pagtapik sa iyo ng Badjao. Pero kung sinabi mong hinambalos ka o tinadyakan ka ng Badjao, ay ibang usapan na iyon, at maaaring mo siyang paratangan na sanhi ng iyong sakit sa balakang.

Hanggang dito na lamang po muli, at salamat sa patuloy ninyong pagtangkilik.

Rendezvous With A Famed Lady

I’ve got to see her.

She probably has the most recognizable face. I am not her secret lover nor am I looking for an affair. I’m not even a devoted fan, but I just got to meet her to discover for myself what is this madness about her.

It was a cold and cloudy morning with intermittent drizzle, but that did not deter me from meeting her on our appointed date. The subway transit, known as the Metro was not running due to the labor force strike, but that did not stop me either. I could walk, or I could use Uber.

So I went to the palace where she resides. They even have these aesthetic glass pyramids in the inner court (photo above).

When I entered her royal residence, I passed through some naked guard statues. I thought to myself, if our medical mission is here, some of these guards could avail of our “operation tuli.” But I get it, circumcision was not in vogue in that era.

Some of the sculptures were really huge.

And so were the paintings.

The palace was enormous with more than 60,600 square meters to roam around. You could get lost here. I climbed up some majestic stairways and passed through several long hallways in search of my lady.

Finally, I entered the room where she was (photo above). For some reason, there was not much crowd around her that day. I think I was fortunate, I don’t have to navigate through a long line. Or perhaps I was favored, and she set aside a time for me to meet her.

In the end, I was face to face with her, my lady, Mona Lisa.

I was a little disappointed though. Maybe I was expecting more. Maybe I was thinking that it was something more grand, and not a tiny 30 x 21 inches affair. Or maybe I was just hoping that she would break into a full smile when I meet her. Maybe.

Now I cannot forget her enigmatic smile. And just like the sentiments in the song “Mona Lisa” by Nat King Cole, I felt the same:

Do you smile to tempt a lover, Mona Lisa?
Or is this your way to hide a broken heart?
Many dreams have been brought to your doorstep.
They just lie there and they die there.

Are you warm, are you real, Mona Lisa?
Or just a cold and lonely lovely work of art?

(*My wife took these pictures, and this rendezvous had no intention of being disloyal to my real lady. Photos taken at Louvre Museum)

Auld Lang Syne: A Look Back

I am reposting an experience I had several years back. Original piece published December 2013.

**********

I was on-call that New Year’s Eve. As I remember it, even though it was the holiday season and no patient wants to be in the hospital, it was still very busy for us.

It was a time of a bad flu season and our ICU was full. In fact there was even a pandemic that year of a bad strain of influenza A, the H1N1, or otherwise known as “swine flu,” and we had confirmed cases in our hospital. The hog farmers here in Iowa detest the name “swine flu,” as it was detrimental to their trade.

Despite of my toxic duty, I was able to finish my rounds and saw all our hospital patients for the day (took me 12 hours or so), and made it just in time to a gathering of some Filipino friends for the New Year’s party.

I was only warming up with our friends when I was called for a “stat” consult that I have to see right away. Before I left, my friends told me that if I finish the consult and it was still before midnight, then I should come back to the party. It was around 10 o’clock when I drove back to the hospital.

The patient that I came back for was a woman in her 40’s. She had breast cancer and sad to say, despite all the surgery, radiation, and chemotherapy that she underwent, the cancer had spread to the lungs and pleura (covering of the lungs).

The patient was obviously struggling to breathe when I examined her. The chest x-ray that was done that night, which was requested by the oncologist showed hydropneumothorax. That means there was collection of fluid and air in the space surrounding the lungs. And that was the reason I was consulted, to surgically place an additional chest tube (as she already had one in place) to drain the fluid and air.

After reviewing the chest film and comparing it to the previous chest x-rays, I determined that the finding of hydropneumothorax was old. In fact the chest x-ray was unchanged compared to films from few weeks ago.

That meant that the worsening of the patient’s respiratory status was not from the collection of air and fluid primarily. Placing another chest tube would not matter as the lung was trapped and would not expand further. I surmised that her further deterioration was from the advancing cancer itself.

Maybe the patient and her family was hoping against hope that there was still something that can be done. Maybe they were grasping for straws for a possibility that she could see another New Year.

I explained my findings and I then solemnly, but respectfully told them that in my viewpoint, placing another chest tube would not matter, and that would not relieve her breathing difficulty.

Right after hearing my opinion, that was when the patient and her husband made the somber decision that it was time. Time to end it all. Time to let go. Time to transition to comfort measures only. It was time for her to rest.

The patient’s husband went out briefly, maybe to talk with other family members who were outside the room. When he came back, I bid them goodbye and left.

As I went out of the room I saw two girls, both were probably not older than 12 years of age. They were crying, while an older woman was comforting them. I assumed those young girls were the patient’s daughters. I think it would be safe to say that they were not having a “happy” new year’s eve.

I looked at my watch. It was less than an hour to midnight.

By that time the rest of the world was partying while waiting for some fancy ball to drop. At that time most people were celebrating while waiting to welcome the New Year, while another family was also waiting – waiting for suffering to end. Waiting not to welcome, but to say their final goodbyes.

I did not go back to the party. I went straight home to reflect, while the song Auld Lang Syne (translated as Times Gone By) echoed in my head.

Should old acquaintance be forgot,
And never thought upon;
The flames of love extinguished,
And fully past and gone:
Is thy sweet heart now grown so cold,
That loving breast of thine;
That thou canst never once reflect
On auld lang syne.

**********

Post Note:

For us who will be welcoming another new year, may we face it with hope and optimism, and embrace with reverence this precious life we are given.

(*Auld Lang Syne is traditionally sang to celebrate New Year at the stroke of midnight, but it is also sang in graduations and funerals; photo taken at Musée d’ Orsay.)

Milestones

(Below is what’s I wrote in our holiday greetings/newsletter that we gave out for this year.)

When we go on road trips, we often take notice of those numbered markers at the side of the road. These are mile markers or milestones telling us how far we’ve come. In our life’s journey there are also milestone events.

Some milestones are simple, yet joyous. Like when your kids graduated from diapers and are fully toilet trained. We are way, way past that milestone, yet we cherish those moments for children are small only for a short time.

Some milestones are bittersweet. Like when your firstborn leave home for college. We are past that too, as our daughter has been in college for a few years now. In fact she will be graduating next year, which will be another milestone.

Some milestones are just sad. Like when you become empty nesters. We’re not there yet, as our son still lives with us, but not for long. He will be a senior in high school this coming school year, and will be off to college in another blink.

There are some milestones you don’t want to broadcast. Like when you hit 50, and realize that you’re old. Both my wife and I are past that too but we did not have much fanfare about it.

But there are some milestones you’re simply proud of. And that’s the kind of milestone we are having this year. My wife and I are celebrating our 25th wedding anniversary. I know further adventure awaits us and we are looking to more milestones on this journey.

There are events though that are more than just milestones. They are earth shattering and have altered the course of history. Like when Jesus came to this earth to save us from our sins. It changed the destiny of us all. We celebrate His birth on this Holiday season.

May we all experience a Blessed Christmas and a Prosperous New Year.

(*pictures from our photo file)