Electric Reminiscing

Last week during July 4th celebration, we had an experience that reminded me of my days in the Philippines. You may say, how can be a holiday that is so American (US Independence Day) remind me of my home country, the Philippines? Please stay with me and keep on reading.

Our last 4th of July was kind of unusual as we were invited for dinner by our friend to celebrate it with their friend, whom I never met before. We celebrated the holiday in a farm about an hour drive away from our home, in the outskirt of a small town of rural Iowa. We had dinner – burgers, hotdogs, potato salad, and vegetable salad (very American meal) – in a log cabin near a small pond. Then when darkness came we sat in our camping chairs and watched the fireworks that was fired from the nearby town.

Even though the setting of the log cabin was similar to a small barrio back home, but that’s not what reminded me of the Philippines.

Earlier that day, since it’s a holiday and I wanted my wife to take a break too from the kitchen, so we went out for lunch. We chose a restaurant that is located in a large shopping complex close to our home. After we were seated and only a few minutes after our order was taken by the waitress, the power went out. A blackout!

Why do we call it blackout or brownout? Technically the lights are out so it’s black or dark. Should it be “black in?” And is there a difference between blackout and brownout? Many people, including me, think they are synonymous. But according to energy company’s definition, a blackout is a total power outage while a brownout is a partial reduction in system voltage or system capacity. Now I learned something too.

So while we were sitting in the restaurant without power, that brought me back memories of the power outages in Manila.

I was reminded of those candlelight dinners we had, not because we were creating a romantic ambience, but because there’s no electricity and yet we need some light so not to swallow the fish bones. Those sweltering heat that all you can do was to fan yourself with the abaniko made of fronds from buri palm. For your information, we don’t have air-conditioning in our Manila home, but we have a few Standard or Hitachi electric fans.

Most of the people, at least from our neighborhood, would go outside in the street and hangout in front of their houses when the power is out. No TV to watch any teleserye, and it’s too hot to relax or nap indoors. So no other recourse but to gossip with your neighbors outside while enjoying Manila’s evening breeze. Lahat istambay sa kalye. 

Those blackouts most of the time, would last one to two hours.  And during the 1980’s to early 90’s, we had rolling blackouts or scheduled power outages, to conserve energy as there’s not enough power supply to cope with Metro Manila’s increasing electric need. Or perhaps the government just thought it was a good fad.

Sometimes it was not just once a day that we had blackouts, as it could be twice a day or more. With the lights going on and off so often, all business becomes “patay-sindi.” Of course the real “patay-sindi” establishments or the red-light districts just gets darker. And when the power is out, Metro Manila becomes one big sauna place, with its residents sweating profusely that no amount of tawas or Rexona matters.

Even hospitals and other vital facilities were not spared from this power outages. Some of the facilities have their own power generator, but even then, their generators cannot supply all their facility’s electric need. So maybe the generators can support the power for the lights, but not the air conditioning or some other functions.

When we were 4th year medical students, one of the roles we have was to become human ventilators. One of our sign-outs was the list of all patients in the hospital on mechanical ventilator. So when the power goes out, we all would run to our assigned patients and manually ambu-bagged the patient for the next hour or so, or until the power returns. Squeezing the ambubag for an hour was a good exercise for the forearm though and it strengthens the grip. I just did not realize until then that, that was one of my duties when I signed up for medical school.

When the long-awaited electric power finally returns, you could hear a loud hurray and even applause from the whole neighborhood. As if we need to cheer the energy company for restoring the power. It’s like it was our “utang na loob” to have our electricity back. Utang na loob na buhay ‘yan!

Back to our 4th of July lunch in the restaurant, as we waited for our food, the waitress told us that our food would be ready soon. They might have gas-powered grills as they can still cook even without electricity. Though it was already starting to get hot inside as there’s no a/c. They did not have to bring out candles though as it was still bright with all the windows open. We were not given the reason for the power outage which in the first place, was a very rare occasion here.

Not too long after, our food came. The restaurants closed its doors for new customers but let those people inside finish their meals. After we were done eating, the waitress told us with a smile that we can go and don’t have to pay, as our meal was on the house. I think with their computers off, we can’t pay with credit cards anyway.

I left a generous tip on the table, both for the free lunch and for the evoked reminiscing – a sultry trip down memory lane.

A Weekend To Remember

Few days ago I drove to my outreach clinic which is an hour and a half away. As I mentioned in the past, the drive there is mostly serene and relaxing, going through picturesque rural Iowa landscapes. Unlike the frustrating drive through EDSA being stuck in traffic for an hour and half. It was a beautiful spring day too, with colorful blossoms on the trees lining the highway.

This journey provides me an opportunity to ruminate, I mean to think deeply, not chew the cud like cows here in Iowa. And a chance for some “sound tripping” too. The music album I picked that day for the drive was an album I have not listened to for quite a while. I just added it recently to my iPhone’s music library. It was Jim Chappell’s “Saturday’s Rhapsody.”

While I was cruising down the road and listening to the music, it took me back 25 years ago. To be exact, it was a Saturday night in January of 1993.

I was a fresh graduate from medical school, and I just passed the Philippine Medical Boards. Some of my friends had been harassing (kantiyaw) me for days to take them out to eat as a celebration for my recent board passing. So I told them, perhaps the coming weekend after a church function, we can go out if we wish. A wishy-washy plan.

There was this girl, a friend of a friend, who recently became part of my circle of friends, that I knew it was her birthday that weekend so I brought a gift just in case she’ll show up and join the party.

The gift was a music cassette tape. Remember them? Compact discs were not in vogue yet or they were more expensive than the cassette tape that time. It was Jim Chappell’s album “Saturday Rhapsody.”

Jim Chappell is an American jazz pianist. I’m not really a jazz type-of-guy. I am more of Pinoy folk, rock and country type-of-guy, with favorites like Freddie Aguilar, Asin and Eraserheads. But when I’m studying, I avoid those songs, as I would break out in a song which will be disruptive. So I gravitate to instrumental music or music without words. That’s how I end up listening to jazz music, especially when I was reviewing for my boards.

As I was listening to a smooth jazz radio station in Manila, I heard the music of Jim Chappell, and I got hooked. I bought my first album of his, “Living the Northern Summer.” I love his music so much that I shared this to my friends, as I gave them Chappell’s album as a gift. And that brought me to that particular night in January 1993.

I bought the album “Saturday Rhapsody” as a possible gift. That is if this particular girl would show up that night. If not, I can keep it for myself, for I still don’t have that album anyway.

But the girl showed up.

Darn, I would like to keep that cassette tape for me! Yet it was also a good thing, since it was her birthday, thus it was her blowout too. So she shared on the bill for the restaurant meal for our group, saving me some money.

After seeing the album, this girl thought that the music was kind of “bastos” (lewd), as the picture on the cover of the album was some sort of a naked woman (see photo below). She also thought I was “presko” (fresh or impudent)! But afterwards, when she listened to the album, she found that it was decent music and she liked it. It changed her impression of me too.

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We became good friends since then. We even went together to the concert of Jim Chappell when he came to Manila and performed at the Philippines International Convention Center in the summer of 1993.

In the end, the album that I gave away, became mine eventually and I didn’t have to get one for my own, as she and I shared it together. We have been sharing more than just music together for the past 25 years.

*******

Here’s a sample of one of the songs in that album “Saturday Rhapsody.” This song is “A Weekend to Remember.” It really was.

(*photo from the web, video from YouTube)

 

 

Return to Florida

We were in Florida for a few days about a week ago. We accompanied our son who had a team competition held there. That was our official purpose to go to Florida, though there were other reasons.

One reason is to escape the cold, as there was still snow on the ground in Iowa when we flew to Florida. Another excuse perhaps was to see the ocean. Iowa is a land lot, and the nearest ocean is about 1000 miles away, so it’s not everyday that we can view the ocean. But the biggest reason to return to Florida, was to see our many friends there, for we once called that place home. That was before we moved to Iowa.

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beach in Sarasota

We have lots of good memories in Florida. Spending weekends in the theme parks or time in the beach were not even the highlight of our three years of residence there, even though we’ve become good acquaintances of Mickey. First of all, it was in Florida where I started a “real” job, after three years of Medical Residency (New Jersey) and another three years of Subspecialty Fellowship (New York) training.

After finishing my training in 2000, I had to change my visa from a “training” to a “working” visa. That transition took several months to get approved, and I was in limbo with no permit to work and no place to go. I was jobless, broke, and homeless. I cannot provide for myself let alone for my wife and my daughter who was a toddler at that time.

During that dark period of our life, we were fully dependent on the kindness of friends and family. We spent a month living in our friend’s home in New Jersey, then two months in another friend’s apartment in New York, then several months with our relatives in California. We did not starve nor sleep in the streets because there were good people who adopted us and cared for us. They provided everything, from the food we eat to the diapers for my daughter. It was a humbling experience, yet at the same time awe-inspiring on how good people can be.

When my visa got finally approved in 2001, we moved to Florida for my first employment. It was a wonderful feeling to move to an apartment of our own, sleep in our own beds, buy our own groceries, and cook our own food. It was not that the food we ate during the times we were “homeless” taste bad, but it was just good to taste food from the fruits of our own labor. Florida is known as the “Sunshine State,” and for us we really experienced a sunny existence there after going through some cold and dark circumstances in life.

So during our return to Florida last week, besides seeing our friends, we also visited the homes we rented (we moved twice) when we were still residents there. We felt so nostalgic driving through the streets and neighborhoods we used to know. Although it took us some time driving around to find the homes we rented, as there were considerable changes in that area. It was sad to see that the orange groves around our previous residences are now gone and turned into commercial complexes.

We drove by the clinic and the hospital where I used to worked. We also visited the hospital where my son was born only to find that the whole building was demolished and the site was turned into a park. The hospital was relocated to a new site and is a much larger facility now.

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the new relocated hospital

I even teased my son that we’ll return him to the hospital where he was born. The back story to that was after my son was born, our daughter who was 5 years old at that time was jealous at the attention our new baby was getting. So she pleaded, “Let’s return the baby back to the hospital.”

Since technically the hospital where my son was born is gone, he can argue that we cannot return him anymore. I guess we are stuck with him. Hah!

I would be lying if I say that it was all good things that we experienced in Florida. For there were alligators there. They were not just in the lakes and swamps. They wear clothes like you and me. To be fair, they can be anywhere not just in Florida. Yet I still believe that overall, people are good.

While we were living in Florida, we had a friend and his wife who underwent a transition phase where they were in-between jobs, just like what we went through before. They have no place to go, so we adopted them and they stayed with us for a few months. We cannot repay those who adopted us before, but we can do to others what was done to us. We paid it forward.

As expected, this couple made it through their dark times and was able to get back on their own. We were happy for them.

So guess where we stayed when we visited Florida recently? At the Disney Resort? No, done that. At the beachfront hotel? No, done that too. In a tent at a campground?  Not this time. We stayed somewhere much better.

We stayed at the home of our friend whom we adopted before. A home where love abounds trumps even the most posh hotel. Not just we stayed there for free, it also gave us more time to catch up and enjoy each other’s company again. Besides, their place was cozy with a resort-like feel. Consider waking up to this view (photos below).

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We also had a meet-up with other friends who took special efforts to delight us. From a treat to a restaurant, to a home-cooked Pinoy breakfast, from home-baked bread to freshly picked malunggay for our “pabaon.” I’m not sure we deserve all these kindness but we’re thankful to all of them.

We surely had fun visiting Florida again. And we did not even see Mickey.

(*photos taken during our last trip to Florida)

Chasing Phantom Fishball

Yesterday our temperature here in Iowa finally wandered above 50º F. Considering that we had snow last weekend, and even had some flurries the day before with subfreezing temperature, we’re just excited that finally spring has sprung.

I was able to come home early with the sun still way up in the horizon, so I decided to go for a run outside.

I wore my brand new cool running shoes that I bought as a birthday gift for myself. I also planned to wear my new colorful running shorts and nifty running shirt that my wife got me for my birthday, but I found out they were still in the laundry. You see, like a child I need all the enticements to keep me motivated in running.

I’m proud to say that I finished my first outdoor 5-kilometer run for this year. Though I would not deny that I was a little out of condition and I struggled to complete the run.

While I was doing my run and I was on my 4th kilometer navigating through our neighborhood, I suddenly caught a whiff of a very familiar scent. I took a deep breath and inhaled it in to confirm. It was the unmistakably glorious smell of fishballs being fried in a lake of oil on a deep frying pan.

Instantly, I was transported back to my days in Manila, as if I entered a Twilight Zone. I felt I was in Forbes Avenue (now Arsenio Lacson Avenue) in front of the UST Hospital. I could almost hear the jeepneys and buses plying that route. Most afternoons, there was a fishball vendor there with his push-stall near the entrance of the hospital.

It does not matter if health experts say that it may not be “safe” to eat street foods, like fishballs, as you can get hepatitis A and some other illness, especially if you dip the fishballs in those jars of sauces. The reason is that some people do “double dip,” that is after taking a mouthful bite of their fishballs on the stick, they would dip it again in the sauce, and that’s how a disease is spread. Could it be the tincture of slobber that makes it more tasteful?

But my courageous friends and I don’t care what the experts say.

After an exhausting day in the hospital working as medical clerks (4th year medical students), we would trek down outside the hospital in our white uniform and all, and buy those delightful fishballs. While they were still hot and floating in oil, we would make “tusok-tusok” the fishballs with the stick, then dunk them in the different dipping sauces. My favorite one was the black spicy concoction with floating onions and siling labuyo. Sometimes I would also dip in the tangy sweetish brown sauce. Sometimes I would dip in all the three jars of sauce. But I swear, I don’t do double dip.

Interesting enough, during our 25th graduation anniversary meeting and reunion held in our medical school two years ago, they served fishballs on a stick during one of the breaks. They have the authentic taste like the ones peddled on the street. It was definitely a hit!

As I reached the end of the cul-de-sac, I came back to the realization that I was on a street in Iowa, and not in Manila. I looked around to search if there’s a fishball vendor around. But there was none. Just the leafless trees, brown grass, and the empty street that I was in.

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Was I hallucinating? Was it because I was huffing and puffing that my brain was oxygen deprived? Or was it because I was hungry and my blood sugar level was running low? Has my brand new running shoes have anything to do with it? Or maybe I was plainly home-sick again?

Fishball, o fishball, why are you haunting me?

(*photo taken during my run)

Ang Lola Kong Adik

(Addict: a person who is addicted to an activity, habit or substance.)

Sang-ayon sa mga balita, marami raw adik sa atin sa Pilipinas. Pero nababawasan na raw ito dahil sa takot kay Duterte. Noong ako’y bata pa, kapag kami ay lumuluwas sa probinsiya, ay mayroon akong natutunghayan na kakaibang adiksiyon.

Sa bahay ng aking lola sa Norzagaray Bulacan, ay nakatira rin ang isang tiyahin ng aking tatay. Maaaring sabihin na kasama siya sa mga kumukunsumo ng adiksiyong ito. Hindi ko na sasabihin ang tunay niyang pangalan, at tawagin na lang natin siyang Nana Pula.

Aking pinapanood si Nana Pula na uupo na lang sa sahig sa isang sulok ng bahay. Tapos ilalabas na niya ang mga nakasupot niyang paraphernalia. Dito mag-uumpisa na siyang mag-gayat. Magdidikdik. At magbabalot.

Pero bago ninyo isipin na shabu o crystal meth ang kanyang dinidikdik, o kaya’y marijuana ang kanyang binibilot, ay hindi ito gayon. Ang kanyang ginagayat, dinidikdik at binibilot ay nga-nga.

Siguro alam ninyo kung ano ang nga-nga (betel quid). Sa mga nakababatang Pilipino na maaring hindi na pamilyar sa sinaunang bisyo na ito, ang nga-nga ay nginunguya. Hindi ito sinisinghot o hinihithit.

Ang nga-nga ay ang combinasyon ng: ikmo (betel leaf), bunga (areca palm nut), at apog (slaked lime). Gagayatin ang bunga, tapos papahiran ng apog, at ibabalot sa ikmo. Minsan dinadagdagan pa ng dahon ng tabako, para mas matindi ang tama.

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nga-nga (image from the web)

Matapos bilutin ni Nana Pula ang kanyang nga-nga, ito ay kanya nang isusubo at nguguyain. Habang nakasalampak, ngumangata at sumisipsip ng katas ng nga-nga, ay paminsan-minsan siyang dudura ng mala-dugong laway sa siwang ng sahig na kawayan. Para siyang kambing na ngunguya-nguya, pero kontento sa kanyang buhay. At pag-ngumiti si Nana Pula? Pula ang kanyang bibig at mga ngipin! Kaya nga Nana Pula.

Meron din kaming ninuno sa Bulakan na ang tawag sa kanya ay Tatang Puti. Pero hindi dahil sa puting ngipin, kun’di dahil siya ay tunay na maputi. Siya ay meztiso at dugong Kastila. Tunay naman na may lahing meztisuhin ang aking angkan. Pero hindi ako kasama sa mga mapuputi, dahil nakuha ko ang kulay ko sa aking nanay na dugong Ilokano. Teka, naligaw na yata ang usapan.

Balik tayo sa nga-nga. Ang tradisyon na ito ay matagal nang umiiral sa Pilipinas, bago pa man tayo sakupin ng Kastila. Nabanggit ito ni Jose Rizal sa kanyang nobelang Noli Me Tangere, kung saan sa unang kapitulo ay sinaad niyang inalok ito ni Kapitan Tiago sa kanyang mga bisita. Sa kapanahunan noon, hindi Skyflakes at softdrinks ang inihahain sa bisita, kun’di nga-nga!

Ang kustombre ng pagnguya ng nga-nga o betel quid ay hindi lang sa Pilipinas. Maraming bansa sa South at Southeast Asia, at sa kalawig na mga isla sa Pacifica ay kilala ang sinaunang tradisyong ito. Sabi ng World Health Organization, maaaring may 600 milyong tao ngayon ang haling sa bisyong ito.

Ang pag-nguya ng betel nut ay ipinamana sa atin ng ating mga ninuno. Sa katunayan, sang-ayon sa mga archaeologist, may nahukay silang bungo ng tao na may apat na libong taon ang tanda, at ang ngipin nito ay may bakas ng elemento ng betel nut. Ganoong katagal na ang nga-nga!

Gaya ng sigarilyo at iba pang bisyo, bakit kaya nakaka-adik ang nga-nga?

Ang bunga o “betel” nut, ay mula sa areca palm (scientific name: Areca catechu). Ito ay may natural alkaloid, na ang tawag ay arecoline. Ang arecoline ay mild stimulant. Kaya ito’y nakapagbibigay ng energy boost at feeling of euphoria. Sa madaling salita, nakaka-high! Kaya kapag ngumunguya na sila tatang at nanang, ay sumasaya sila at para na silang lumulutang. Tripping na si lola!

Ngunit parang nicotine mula sa dahon ng halaman ng tabako (scientific name: Nicotiana tabacum), ang arecoline mula sa areca palm nut ay nakaka-adik din. Kaya bago pa naging palahithit ng tabako, o bago pa magsipagbilot ng marijuana, ay ngumangata na ng nga-nga ang Pilipino. Lahi nga kaya tayo ng mga adik?

Maliban sa nakaka-adik ang nga-nga, may iba pa bang masamang epekto ito?

Sang-ayon sa mga pag-aaral, ang nga-nga ay maaring maging sanhi ng kanser sa bibig. Iyong ibang matatanda sa atin, nag-nganganga na, nagtatabako pa, tapos nasa loob pa ng bibig ang sindi ng tabako, kaya’t mataas ang insidente nila ng kanser sa bibig.

Dahil laging ngumunguya ang kumukunsumo ng nga-nga, ito ay maari ring magdulot ng oral submucous fibrosis. Ang kondisyong ito ay sanhi ng “stiffness in the mouth and eventually the loss of jaw movement.”*

Isa sa pinakamalinaw na sanhi ng nga-nga ay ang pamumula ng bibig at ngipin. Para silang nagpahid ng sangkatutak na lipstick, pero kasama pati ipin! Maari rin itong sanhi ng tooth decay, gum disease at bad breath.

Kaya noon pa man, kapag nag-nganga-nga na si Nana Pula, umiiiwas na akong pahalik sa kanya, dahil baka mag-amoy nga-nga at apog ako. Pero nagmamano pa rin naman ako kay Nana Pula.

Subalit kahit may kakaibang adiksiyon si Nana Pula, ay mapayapang mamamayan naman siya. Mapagmahal din siya sa kanyang mga kamag-anak at kaibigan. Maaring sabihin na adik siya sa pagmamahal sa kanyang mga pamangkin at apo, kasama na ako, kahit gaano pa ako kakulit noon.

Isang araw, matahimik na pumikit si Nana Pula, lumutang at pumailanglang sa walang hanggang kawalan. Wala sa aming nakababatang pamilya ang pumulot ng kanyang bisyo, kaya’t ito’y naglaho na rin sa pagpanaw ni Nana Pula.

(*from Journal of the American Dental Association)

Fevered Musing

I called in sick. I have not done that a lot. In fact, this is the first time I did it. Many times, I just grit my teeth and willed myself to work, even if I felt like I was ran over by a truck.

I have this notion that doctors should not get sick. For who will take care of the patients? But am I really be of help or be more of harm if I go to work, while I myself is sick? After much deliberation, and after foregoing the feeling of guilt, I made the call.

Don’t get me wrong, I am no superhuman. In fact, I get sick more often than my wife. She chided that I am built poorly and of cheap quality materials. During my childhood days in Manila, we call our classmates who get sick easily “Made in Taiwan.” We pride ourselves to be “Made in Japan” or “Made in USA” if we’re the only ones left standing. Nothing against products from Taiwan. Accept it or not, we Filipinos sometimes can be racist. I am sure being made in Taiwan nowadays does not have that connotation.

I am trying so hard not to get sick. I exercise regularly, and I try to eat healthy, and I even got my flu shot. But I still got sick. Being a physician, when you’re dealing with ill patients all day, and they are coughing in your face, it’s just a matter of time that you’ll get it too. Plus we are in the middle of the flu epidemic and it is particularly bad this season.

I am in bed for 2 days straight now. I know, that in itself can make my head hurt. I am popping Advil every 4 to 6 hours round the clock, just to get relief from the fever and the body aches, even though I don’t like taking medicine.

I isolated myself in our bedroom, as I asked my wife to sleep in another room, so she’ll not get what I have. This is not the time for ‘sharing.’ I also put on a mask whenever I go out of the room, and ate separately away from the table.

I was having chills and fever when my thoughts wandered into the times in the past, when I was also sick in bed.

I was in our home in Manila, with high fever. I was still so young, that I don’t go to school yet. My body was full of red spots that were very itchy, and I’m trying my best not to expose them. (Bawal daw mahanginan.) I believe I got the measles. My mom would continuously put a wet towel in my head to try to lower my temperature. But despite of that, I was to the point of hallucinating, that my mother said I was seeing things that were not there.

Then there was the time I was in Kindergarten, when I again had a fever, and one side of my face swelled up. I looked like a squirrel that has an acorn in one of its cheek. I had the mumps. My folks painted a bluish gooey something on my face. It is a concoction of clay, blue dye and vinegar, which was a popular folklore remedy for mumps in the Philippines. My classmates in Kindergarten stopped by our house to visit me, and they saw me with my painted blue puffed-up cheeks.

I know, I know, you may be asking, why did I get both the measles and mumps when I was a child. Why was I not vaccinated? Were my parents against vaccination? Not really. I was just born before the era when MMR (Measles, Mumps and Rubella) vaccine became available worldwide. It was later offered in our school when I was older, I think I was in Grade 2 or 3. My classmates and I lined up and I received those injections despite my silent protestation as I was scared of needles.

There were several other times that I was sick as a child with colds, and my mother would put Vicks Vaporub in my chest and back. Even in my nose, when my nose was clogged up and could not breathe. She would also put Vicks Vaporub in my feet and then put socks on me, telling me that will help my fever. For many Filipinos, Vicks Vaporub and White Flower ointment were a cure-all treatment for any ailment. To this day, I hate the smell of them.

Now that I have the MD degree after my name, I know that the blue paint on my cheek and the Vicks Vaporub on my feet perhaps caused nothing to help my sickness. But perhaps just the fact that I am loved and my parents were showing they care, the best that they know how, was enough to make me feel better. And that eventually healed me of my illness.

Many times, showing people that we care for them, is enough to relieve them of their malady. I know I have plenty of that in my home as a child, and in my home now. Even when I feel terrible with this illness, I know that I am being attended to, not necessarily by a medical team, but more importantly by people who really cared for me. In fact, I still have the cup of salabat on my night lamp stand that my wife brought me this morning, and I could already smell the sinigang that she is cooking.

I was having chills when I glanced outside the window.  Snow is now falling softly. I am not going anywhere. More reason to snuggle under the covers the whole day.

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(*These thoughts were concocted 3 weeks ago. I think I got influenza, and I was house-bound for 5 days. Photo taken with an iPhone.)

 

 

Lalamunang Butas

Bahagi ng pagiging isang masinop na duktor, ay ang pagkuha ng istorya, o aming tinatawag na history, mula sa pasyente. Dahil kalimitan, maaring ma-diagnose o malaman kung ano ang sakit sa pamamagitan lang ng history. Siyempre kailangan pa rin ng physical exam at mga ancillary testing, para makumpleto ang diagnosis. Pero napaka-importante ng history.

Kaya naman kasama sa aming training o pag-aaral bilang duktor, ay ang kung paano kumuha ng tamang history. Katulad nang kung masakit ang tiyan ng pasyente: aming itatanong kung kailan pa nagsimula, o anong oras ng araw lumilitaw ang sakit, anong klase ng sakit, anong maaring nagpapalubha o nagpapaginhawa sa sakit, kung saan mismo ang sakit, o kung ito ay gumagapang sa ibang bahagi ng katawan, kung kumain ba ng panis na pansit, at kung anu-ano pa.

Huwag ninyo sanang isipin na makulit lang ang inyong duktor dahil napakaraming tanong, na pati pagkain ninyo ng pansit ay inuusisa. Ang mga tanong na ito ay kailangan para malaman ang tamang diagnosis.

Oo nga’t mayroong mga pagkakataon na hindi kami makakuha ng tamang kuwento o history mula sa pasyente. Tulad ng mga pasyenteng tuliro o walang malay na dinala sa hospital. Marami kaming ganyang pasyente sa ICU. O kaya naman ay ibang wika o dialect ang kanilang salita, o kaya’y pipi ang pasyente, kaya’t kailangan pa namin ng interpreter.

Mayroon din namang mga pasyente na hindi makapagbigay ng tama o accurate na history, dahil lito sila, o talagang magulo lang silang kausap. Para silang laging lasing. Kaya naguguluhan tuloy pati ang duktor kung ano talaga ang nangyayari.

Saludo ako sa mga Pediatrician, na kayang malaman kung ano ang iniinda ng mga bata o sanggol nilang pasyente, kahit hindi pa ito nagsasalita. Siyempre nakakatulong din ang history na ibinibigay ng magulang ng mga bata.

Mas saludo ako sa mga Veterinarian, kung paano sila kumuha ng history. Siguro ay naiintindihan nila ang bawat kahol, meow, o huni ng kanilang pasyente. Buti na lang at hindi ako pinag-beterenaryo ng nanay ko, at baka kumakahol na rin ako ngayon.

Isang kuwento mula sa matagal na panahon nang nakalipas ang aking isasaysay sa inyo. Ito’y nangyari nang ako’y intern pa sa Pilipinas.  Isang araw ay sabik na sabik na nagkuwento sa amin ang isa naming co-intern, ng kanyang karanasan mula sa hospital ward.

Sabi niya, may pasyente raw siyang may butas sa lalamunan o tracheostomy. Siguro dahil sa cancer sa larynx, pero hindi niya ito sigurado.  Kaya’t kailangan pa rin niyang kunin ang history ng pasyente.

Kung hindi ninyo alam kung paano ang may tracheostomy, sila ay hindi makapagsalita ng maayos,  dahil lumalabas ang hangin sa kanilang tracheostomy at hindi dumadaan sa vocal cord. Minsan, yung mga may tracheostomy, ay wala na ring vocal cord, at tuluyan na silang hindi makapagsalita.

Gayun pa man, desidido pa rin ang aking co-intern na kunin ang history ng kanyang pasyente.

Intern: Kuya, ano po bang dahilan bakit ka pumunta sa ospital?

Pasyente: Heh, hasi hirahp ahoh humingah.

Intern: Ganoon ba? Eh bakit ka nagka-tracheostomy?

Pasyente: Heh hasi, hanito hiyan. Halahas haho hahihahiho. Hayah haghahooh haho hang hanser sa lahlahmunah.

Intern: Teka, teka kuya. Hindi po kita maintindihan.

Luminga-linga ang aking co-intern at nagbakasakali na may kasama o bantay ang kanyang pasyente. Inisip niya, baka makakatulong ito na magbigay ng kuwento.

Sapak naman at naroon sa may pintuan ang isang kabataang lalaki. Tinanong ng intern kung kilala ba niya o siya ba ang bantay ng pasyente.

Tumango naman ang lalaki. Natuwa ang intern.

Tinanong uli ng intern kung alam ng bantay ang kwento ng pasyente. Tumango ulit ang bantay. Lalong natuwa ang intern.

Intern: Ano ba ang nangyari sa kanya?

Bantay: Ngabi ngiya, malangas naw ngiya mangingangiyo, ngaya ngagngaroon ngiya ngang nganser nga lalamungan.

Toink!

Sa kabila nito, nakuha pa rin ng intern ang wastong history. Kinailangan lang ng konting tiyaga at pangunawa.

*********

(*Ang kuwentong ito ay tunay na pangyayari, at hindi ko po intensiyon na laitin ang may mga tracheostomy o cleft palate.)

 

Pahabol na tula:

Mga lalamunang butas,

At ngala-ngalang bukas,

Mga boses na gasgas,

Hirap silang bumigkas.

H’wag batuhin ng pintas,

Bagkus tratuhin ng patas,

‘Pagkat ‘di man sila matatas,

Isip nila’y matalas.

Ang Tandang at si Uncle Tom

Ako ay may tiyuhin na Amerikano. Siya si Uncle Tom.

Tatlong dekada na ang nakalipas nang isa sa aking mga tiyahin ay nagka-penpal ng isang Amerikano. Uso pa noon ang ballpen, magsulat sa papel, at maghulog ng sulat. Matagal-tagal din silang nagkasulatan, at dumating sa yugto na gusto nilang magkita. Wala pang Facebook at FaceTime noon, kaya’t nag-planong lumipad papuntang Pilipinas ang Amerikanong penpal ng aking tiyahin.

Dahil kami ay may bahay naman sa Maynila, at para na rin tuluyang makaliskisan, este makilatis pala ang ibig kong sabihin, ang kanyang penpal, kaya pinakiusap ng aking tita na sa bahay na namin tumuloy ang Amerikano.

Itanggi man natin o hindi, marami pa rin sa atin ang nagnanais na makakilala ng isang banyaga, at mapangasawa ito. Dahil sa isip natin ito ang ating magiging pasaporte para lumisan ng bansa. At kung tayo ay medyo tag-hirap, ito ang ating pagkakataong umunlad at makaahon sa buhay. Darating kaya ang panahon na ang mga Pilipino ay hindi na mangangarap na umalis ng bansa?

Kaya nang dadalaw na ang Amerikano, hindi kami magkandaugaga sa aming paghahanda sa kanyang pagdating. Para kaming naghanda sa isang official state visit, gaya nang dumalaw si President Trump sa Pilipinas. Kulang na lang ay umarkila kami ng banda ng mga musikero at magpa-piyesta sa aming kalye sa pagsalubong sa kanya.

Lumuwas pa ng Maynila ang aming lola mula sa probinsiya at nagdala ito ng mga buhay na manok, para raw ipanghanda sa Amerikano naming bisita. Siyempre, mas masarap pa rin daw ang lasa ng native at free-range na manok. Organic pa at siguradong hindi sinaksakan ng growth hormone at antibiotic.

Isa naman sa aking tiyuhin ang sumundo mula sa airport. Hindi na ako sumama dahil puno na ang sasakyan at baka wala pang maupuan ang aming bisita. Pagkasundo sa airport, ay sa bahay na namin sa Sampaloc Manila tumuloy ang Amerikano.

Sa aking silid pinatulog ang bisita. Malaking tao pala itong Amerikano. Hindi ko alam kung paano siya nagkasya o kung naging kumportable siya sa aking munting katre. Aaminin ko medyo masikip ang aking silid, pang-Petite (Palito?) size lang ito at hindi pang-Jumbo size. Hindi ko rin alam kung naglagkit sa init ang aming bisita, dahil wala naman kaming air conditioner. Pero may bintana naman at bentilador ang aking kuwarto.

Kahit payak ang aming bahay at masikip ang aking kuwarto, ay siguro naman ay lumutang pa rin ang aming pagiging hospitable sa aming panauhin. Kung tutuusin hindi lang ang Amerikanong penpal ng tiyahin ko ang banyagang natulog sa aking munting silid. Minsan ay nagkabisita kami ng galing Papua New Guinea na tumuloy din sa aking kuwarto. Marami ring kaming mga bisitang lokal ang nanuluyan dito. Kaya puti, itim, o kayumanggi – walang kinikilingan ang aking silid.

Balikan natin ang mga manok na dala ng aking lola. Isa dito ay puting tandang, pero hindi ito pang-sabong. Dahil hindi lahat ng manok ay ihahain kaagad, kaya’t ang iba ay hinayaan munang buhay. Kasama dito ang tandang na itinali sa veranda ng aming bahay.

Unang gabi ng aming bisita, maaring pagod na pagod sa biyahe ang Amerikano, at may jet-lag pa, kaya hahayaan lang sana namin siyang matulog kahit tanghaliin pa siya ng gising. Subalit may ibang balak ang puting tandang.

Bago pa magbukang liwayway o maaninag ang liwanag ng umaga, at bago pa magsipag-byahe ang mga traysikel ay simula nang tumilaok ang puting tandang. Walang patid at masigabo sa pagtilaok ang pesteng manok. Pumwesto pa ito malapit sa bintana ng aking kuwarto.

Hindi nagtagal ay nagising ang aming bisitang Amerikano. Galit at mainit ang ulo nito. Masama ang pagkakagising. Sino nga bang hindi mauunsiyame kung mabulabog ka sa iyong mahimbing na pagkakatulog.

Paglabas niya sa kuwarto, ay ako ang kanyang nasalubong. Sabi niya sa akin: “Where is that #&*@^! rooster, I’ll wring it’s neck!”

Sa halip na sa ilang araw pa sana kakatayin ang pobreng tandang, noong araw rin na iyon, naging tangahalian na namin ito. Nahimasmasan naman ang init ng ulo at natuwa pa ang aming panauhing pandangal, nang matikman niya ang masarap na luto na inihain namin sa kanya. Tinolang manok!

Nang malaon na ay nagkaigihan naman ang aking tita at ang kanyang penpal. Sila ay nagkataluyang magpakasal, at siya ay naging aking Uncle Tom. Hindi na nagtagal pa ay nakalipad na rin ang aking tita papuntang Amerika.

Maaring sabihin na dahil kay Uncle Tom, ay naging masuwerte ang aking tiyahin dahil siya’y nakarating ng Estados Unidos. Kahit man ako ay nabiyayaan din, dahil ang tiyahin kong ito ang isa sa tumulong sa akin sa pinansiyal nang ako’y nag-a-apply na papuntang Amerika para sa aking Medical Residency Training. Dahil sa ako’y natanggap sa isang academic hospital para mag-training, ito naman ang naging daan para ako’y makapangibang-bayan.

Noong nakaraang Pasko, maliban sa aking pagtawag sa mga kamag-anak sa Pilipinas, ay tinawagan ko rin ang aking tiyahing ito na naninirahan na sa California. Siya ang pinakamalapit kong kamag-anak dito sa Amerika. Ang California ay mahigit na tatlong oras na biyahe sa eroplano o dalawang araw na drive mula sa amin dito sa Iowa.

Sa pag-uusap namin ng aking tita ay nabanggit niya na medyo lumulubha na raw ang kalagayan ni Uncle Tom at nagiging makakalimutin na rin ito. Sa katunayan, may mga ilang taon nang may sakit si Uncle Tom. Salamat na lang kay tita na tunay na nagmamahal sa kanya, at hindi niya ito pinababayaan. Isa pa, dahil nurse ang aking tiyahin, naaalagaang lubos si Uncle Tom.

Sa aking tingin at palagay, kung naging masuwerte ang aking tiyahin, mas naging masuwerte si Uncle Tom dahil nakilala niya ang aking tita at ang aming pamilya. At hindi lang ito dahil sa nakakain siya ng tinolang manok.

DSC_0048

(*photo taken during our last visit to the Philippines)

Old Friend

Hello friend.

First of all, I know it is your birthday tomorrow. Don’t be impressed that I remember that after all these years. It is just because you shared the same birthdate with my father, that’s why I cannot forget.

I know we have not seen each other in person for several years. But it is not a reason that we have not stayed in touch as friends. After all, we’ve known each other since our “uhugin” days of childhood. We even had that matching yellow shirt that we would often wear at the same time when we were kids, as if we were twins.

We played together. We ate together. We even got lost once together in a farm. We were so small then and cannot see beyond the tall plantation. But you told me that we should kneel down and pray right there in the rice field. After that, we eventually found our way back.

Remember how we played those tau-tauhan or toy soldiers? We would stand them up in the dirt while we were on our hands and knees on the ground, and we’ll hit them with marbles as if it was a war. I think I could hit more than you. And I’ll rub it in, mas asintado ako sa iyo.

Our lives were intertwined, as our families were good friends. We would go to parks and other places together. Remember how we would fit our two families in our “Ford Cortina” – all 4 adults and 6 young kids in one car? Who cares about seatbelts? Those were the good ole days.

Then your family decided to migrate to Papua New Guinea. I was sad that you were leaving us, but happy for you and your family that you would be going to a new country and pursuing a “better” life.

Yet you still came back a couple of times to the Philippines for a visit. You told me about your experience riding that big airplane and crossing the ocean. I was so envious! You told me how excited you were in going down the stairs of the plane that you slipped and almost fell down the tarmac.

Then after a few more years I heard that your family would be migrating to the US from Papua New Guinea. Again I was happy for you and your family for another new adventure. Though I honestly was saddened, as the chances that you would come back to live in the Philippines and we’ll be together again was nil.

But tadhana smiled again and our path crossed once more. Several years later I was given the chance to go to the US too. I remember how you and your family welcomed me with open arms. I even stayed in your place for a short time. You showed me around California in your new Toyota Camry. Your family toured me to Disneyland. And you even took me shopping for some muffler and gloves, as you learned I was going to New York City in the dead of winter to have an interview.

Then I too was able to chase my American dream.

One day you called and told me that you are quitting your job. Your stable, high-paying job. And that you were going to South America with your family as missionaries. I was surprised. But more so, I was so impressed with your admirable faith. I know it’s not easy to give up the comforts and luxuries of life, and leave everything behind, in the name of God’s higher calling. I don’t know if I can do the same.

I understand it took you some time getting used to the change. You told me how remote your location was in South America. That you live almost like in a jungle, and your home was like living in a big tree house. And how it would take you a couple of days to travel to the nearest city. Yet you never forget to call me once in a while when you have the chance. I know you can only make that overseas call whenever you’re in the city.

I heard you say that even though how meager your resources were and how simple your life was, you told me, that you love working in God’s mission. What a remarkable dedication. I have nothing but respect for you.

Then more than a couple of years ago, I learned that you and your family came back to the US. Though I understand, you were still live-in volunteers in a small Christian academy. At least you don’t have to fight anymore, those pesky mosquitoes and poisonous snakes that sneak inside your home.

Once in a while we’ll talk about our families over the phone. And how we would open up about our “little” problems raising our family, just like any parents have. I called you few weeks ago, and I told you that I would be praying for you and your family. I also got your “thank you” card about two weeks ago.

Then I got a phone call from your sister yesterday. What an awful news! A heartbreaking news. That you had a tragic car accident. And in an instant, you were gone.

I don’t know what to think. My finite mind cannot rationalize it. I don’t know why God called you home too soon. But I just have to trust Him. As you always did.

I cannot imagine how your family and children are taking this. I am praying for them. I would continue to support them in whatever way I can, just like I promised you the last time we talked.

I guess I will never hear your voice again. We will never have that heart to heart talk again. At least not here on earth. But hoping someday, somewhere, beyond this earth…….

Goodbye my old friend.

IMG_5013

(*in loving memory of Boying)

(**photo taken with an iPhone)

 

 

Chedeng at Chinelas

Noong makalawang araw ay bumisita sa aming bahay ang isang kaibigan, kasama ang kanyang asawa at panganay na anak. Siya ay isa ring Pilipinong duktor dito sa Iowa. Meron lang silang dinaanan dito sa amin.

Aking napansin na bago ang sasakyan niyang dala. Sabi niya, ipinamana na raw niya ang lumang Honda sa kanyang anak. Akin siyang kinantsawan na sobrang asenso na niya. Ika ko nga, “hindi ka na ma-reach!”

Kasi, naka-Chedeng na siya.

Malugod din niyang ipinakita ang mga features ng kanyang bagong kotse. Pinindot lang niya ang kanyang cellphone at umandar na ang kanyang kotse, kahit wala siya sa loob nito. Napabilib ako. Siguro pwede pa niyang i-program na utusan lang ang kanyang smartphone: “Siri, start my car.”

Mayroon din daw itong standard safety features, gaya ng automatic braking kung sakaling aanga-anga siya at hindi nakapag-preno kaagad, at nagbibigay din ng warning kung may sasakyan sa kanyang blind spot at kung siya ay antok-antok at lumilihis sa lane. Hindi lang din daw camera sa likod ang makikita niya kung siya ay umuurong, kung hindi 360º view. Higit sa lahat, kaya nitong magself-park, kahit pa parallel parking. Sabi ko nga, kulang na lang mag-drive ‘yung kanyang Mercedes na mag-isa.

Pero sang-ayon sa mga eksperto, by year 2020 or 2021, mayroon ng mass production ng self-driving cars, at available na ito sa lahat. Kahit sino ay pwede nang maging Knight Rider!

Habang ipinagyayabang ng aking kaibigan ang kanyang Mercedes, ay para kaming mga musmos na natutuwa sa bagong jolen, o trumpo, o kaya’y matchbox. Iyon nga lang, totoo ‘yung matchbox.

Noong ako’y batang paslit pa, ang kilala ko lang na luxury car ay Chedeng o Mercedes Benz. Kilala ko rin si Aling Mercedes, pero hindi siya kotse. Hindi ko pa alam noon ang BMW, Audi, Porsche, Jaguar, Ferrari, Cadillac o Lexus. Kilalang-kilala ko naman ang Sarao. Tingin ko sa mga naka-Chedeng noon ay sobrang yaman at sobrang matagumpay sa buhay.

Sa katunayan, wala nga akong kilalang naka-Mercedes noong ako’y nasa elementarya at high school pa, maliban sa isa. Siya ay crush ng bayan sa aming eskwelahan, dahil maganda na siya tapos naka-Chedeng pa. Ang tatay niya ay duktor, at sila ay nakatira sa Dasma (Dasmariñas Village).

Noong nasa kolehiyo na, ako ay namulat sa katotohanan na kahit sa mahirap na bansa’t lipunan pala, ay marami pa rin burgis. Marami akong naging kamag-aral na naka-Chedeng. May mga kaklase pa nga ako na may sarili silang kotse at naka-tsuper pa. Buong mag-hapon naghihintay lang ang kanilang tsuper sa may parking lot ng unibersidad. Hindi lang nga Mercedes Benz, may nakita pa akong estudyante na ang dina-drive ay Porsche. Okay lang, ako naman ay “Cadillac” – kadilakad.

Balik tayo sa kaibigan kong Pilipinong duktor dito sa Iowa. Habang kami ay nagku-kwentuhan ay aming napag-usapan na parang kailan lang ay mga musmos pa ang aming mga anak. Ngunit ngayon, pareho na kaming may anak na nasa kolehiyo. Ang bilis ng panahon.

Nagawi ang aming usapan noong kami ay nasa-kolehiyo pa. Siya ay nag-aral din sa Maynila. Nabangit ko na napakarami nang nagtataasang condominum sa Maynila pati sa university belt. Sabi naman niya ay marami na rin daw masasarap na kainan sa paligid-ligid ng university belt. Sa susunod niyang uwi sa Pilipinas, gusto raw niyang pumasyal at kumain sa mga turo-turo sa tabi ng unibersidad. Simple pa rin talaga ang trip ng kaibigan kong ito, down-to-earth pa rin.

Napag-usapan din namin kung paano kaming nakikipag-habulan sa mga jeepney, at kung paano kami halos makipagbalyahan at siksikan, makasakay lamang. Pinaririnig lang din naman namin sa aming mga anak kung gaano sila kaswerte ngayon, at hindi nila naranasan ang  hirap na aming dinaanan.

Jeepney_Benz

Chedeng na Jeepney

Hanggang sa napag-usapan noong kami ay nasa elementarya pa. Kwento ng aking kaibigan, dahil siya ay lumaki sa probinsiya, ay naglalakad lang daw siya araw-araw patungong paaralan nila. Ang pampublikong paaralan ay nasa kabilang barrio, kaya’t medyo malayo ang kanyang linalakad. Para mag-short cut, siya ay tumutulay sa pilapil ng mga palayan habang bitbit-bitbit niya ang kanyang chinelas para hindi maputikan. Minsan pa raw, binibitbit din niya ang kanyang chinelas para hindi ito maupod agad, upang makatipid.

Ako ay napangiti at napaisip. Ang batang nagbibitbit lang ng chinelas noon para hindi ito maupod, ngayon ay naka-Chedeng na.

Tignan mo nga naman talaga ang tadhana. Marunong pa rin itong ngumiti sa mga nagsisikap na umasenso sa buhay. Kahit na hindi Mercedes, ang kanilang pangalan.

(*photo from the web)