Illusive Hope

During my last weekend call, one of the many admissions I had to the ICU was a man in his 70’s, who was found unresponsive in his home. Since he lives alone, he probably have been lying on the floor for a couple of days before he was found.

After work-up in the emergency room, it was determined that he had a large stroke. As he was very sick and unstable, we were consulted to admit him in our ICU.

The next day, after providing supportive measures, his vital signs stabilized and he became more responsive, and even following simple commands. Yet he still has significant neurologic deficits due to the devastating stroke.

The patient’s son who was the power-of-attorney, talked to me and showed me his father’s living will, which specifically detailed that in case he had an “irreversible condition,” he does not want to be on any form of life support including artificial nutrition, like tube feedings or even intravenous fluids.

I assessed that with the severity of the stroke, the likelihood of “good” recovery was doubtful. My projection was that he would never live independently again, would most likely be nursing home-bound, and definitely would not be the same person that they know. In addition, he could even get worse as the swelling of the brain increase. No question, I painted a grim scenario.

After hearing my assessment, the patient’s son and family, were ready to call hospice and just make the patient comfort cares. The son told me that his father, for sure would not like to live a life with such a poor quality as I have projected. Though I told them, that the neurologist whom I consulted have not seen the patient yet, and perhaps they should wait on what he has to say.

Not long after, the neurologist came. He extensively reviewed the CT scan of the head, and he made a careful and detailed neurological examination of the patient, as he tried to evoke even obscure reflexes that I can only read in the medical textbook. After his evaluation, the neurologist, the patient’s son, and me, went in a room for a conference.

The neurologist explained that with his estimation, even though the stroke was large, since it involved the non-dominant side of the brain and mostly the frontal lobe, he believes that the patient can still have a “meaningful” recovery. In addition, since the acute stroke was a few days ago, he thinks that the swelling was on its way down, and perhaps we were already past the worst phase. He backed this with his expert knowledge of brain anatomy and function.

Thus the neurologist believed that at best, though it may take months of rehabilitation, the patient can talk – though with a funny accent, walk – but with a limp that he even demonstrated, and maybe could even live independently later on. He definitely painted a more rosy picture than the gray picture that I have painted.

Hearing the neurologist’s opinion, it was obvious we have a “slight” difference of opinion. Perhaps slight was an understatement.

After considering the neurologist’s evaluation, the son and the family changed their mind and decided to defer calling hospice and instead support the patient as much as possible, including tube feedings and all.

To be honest, I was a bit perturbed that I gave such a bleak prognosis than what the other doctor gave. Have I given up on that patient too soon? Have I killed the embers of hope prematurely? Perhaps I have become so pessimistic in my view of things. Perhaps I have seen so many prolonged sufferings and bad outcomes despite our best intentions and efforts in my ICU experience. Perhaps I was just saving the family from the heartaches of clinging to unrealistic optimism. Or perhaps I become more cynical and have lost my faith in hope.

In my defense, maybe I just see the front end and the acute catastrophic courses of patients in the ICU, and have limited exposure to the success stories of patients’ wonderful recovery after prolonged and extensive rehabilitation.

But even though I felt betrayed by my negativism, I felt relieved that I have heard a differing opinion, and perhaps gave a chance to a life that we almost gave up on too soon. Even though I felt embarrassed and almost apologetic for my opinion, I was thankful that we gave hope a chance. Everybody deserves that chance.

The following day, when I rounded on our stroke patient, he was more obtunded and unresponsive. He now have labored breathing and had to be placed on a ventilator. I then requested a repeat CT scan of the head.

The CT scan showed what I was afraid would happen: a further extension of the stroke and more swelling, displacing the structures of the brain beyond the midline and even herniating down the brainstem. This was unquestionably a grave condition, and most likely fatal. No more differing opinions.

The family decided to transition to comfort cares, and the patient expired a day later.

I did not kill hope. It died.

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Sheep Crossing

When we we’re traveling in Jordan, our tour bus came to a sudden stop not because of traffic, nor stop sign, nor because of a bus stop.

It stopped because of this.

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I am not sure why the sheep cross to the other side, when the grass is greener where it came from. Maybe the grass always looks greener when we look at it from the other side.

Discontent, can put our lives in peril.

(*photo taken in rural Jordan)

Hanging Gardens

When we visited the Holy Land last month, we went to the city of Haifa, the third largest city in Israel. Haifa is where Mount Carmel is located.

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monument of Elijah in Mount Carmel

Mount Carmel, as you probably know, is the site where prophet Elijah, as recorded in the Bible, challenged the prophets of Baal in where his sacrificial offering was set ablaze by a fire from heaven. But that’s for another post.

What I want to feature now is another popular tourist site also found in Mount Carmel, the Baha’i Gardens.

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The Baha’i faith is a religion, which started under 200 years ago by a Persian, of the name Siyyid Ali Muhammad Shirazi, who proclaimed himself as the prophet Bab (Bab means “gate” in Arabic). Today, some 7 million people practices this religion.

The Baha’i Gardens or also known as the Hanging Gardens of Haifa, are garden terraces around the shrine of the Bab.

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These gardens are relatively new, as its construction was started in 1987, and was completed and opened to the public in 2001. It has 19 terraces and has about 600 steps.

From the garden terraces you can view the Mediterranean ocean, the port of Haifa, and part of the city.

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We entered the garden from the top entrance and work our way down through steep stairways. Definitely it was much easier going down than up, as long as you don’t get dizzy and fall down the steps.

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Starting from the bottom and going up the stairs will be a real chore, unless you feel like Rocky-in-training.DSC_0595

The gardens are linked by a set of stairs that are flanked by streams of running water cascading down the mountainside through the steps and terrace bridges. These waters are fed by fountains on each terrace level.

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The Shrine of the Bab is the second most holy place for the Baha’is. The Bab was executed in 1850 in Iran and his remains were later brought to Haifa and laid to rest in this site in 1909. The original mausoleum was turned into this beautiful shrine built in the 1950’s, complete with a golden dome.

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Located also in the gardens is the Baha’i Archive Library which holds many of the sacred items of the Baha’i faith (photo below).

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Today, this garden and shrine attracts more than a million visitors a year. It is also a pilgrimage site for the Baha’is. And since this place is considered sacred, they would like visitors to be reverent and be quiet while visiting this garden. For sure it is a beautiful place just to be silent and reflect.

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I may not be a Baha’i pilgrim, but as a life’s pilgrim, I feel grateful and blessed to visit this magnificent place.

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(*Most photos taken with an iPhone, except for the B&W photos, which I took with Nikon DSLR, but forgot to check that its mode is on “effects,” so the B&W shots were unintentional.)

Paalam Kaibigan

 

Alam kong hahantong sa ganito,

Hindi sa dahil hindi ko napagtanto,

Ngunit kahit pilitin ko mang itanggi,

Tuloy pa rin itong mangyayari.

 

Yakapin man kita nang mahigpit,

Hihilagpus ka pa rin sa aking bisig,

At ayaw man kitang bitiwan,

Takda ka pa ring lilisan.

 

Tinangay na nga ba ng kahapon,

O tinalikuran na ng panahon,

At wari bang ako’y iyo nang iniwan,

Sigabo ng aking kalakasan.

 

Habang sa salamin aking pinagmamasdan,

Ang anino na nasa aking harapan,

Anyo at kasagsagan ng kasiglahan,

Ay bakas na lamang ng nakaraan.

 

Ngunit hindi ko dapat ipagluksa,

Kun’di dapat pa ngang ipagsaya,

Kaibigan, minsan nating pinagsamahan,

Kaya’t paalam na, o aking kabataan.

(*thoughts as I hit half century of life; an ode, or maybe a eulogy, to my lost youth)

 

Walking Where Jesus Walked

Life is a journey they say. As I commemorate my fifth decade here on earth, I decided not just to go for a trip, but for a pilgrimage. I wanted to walk where Jesus walked.

In tracing the steps of our Saviour, we ventured to Bethlehem, the birthplace of Jesus. But unlike the familiar Christmas hymn, “O Little Town of Bethlehem,” Bethlehem today is not a little town but a thriving busy city.


We were led to an old church, the Church of Nativity, where it was believed, based on tradition, to be the site of Jesus’ birth.

At the basement of this church was the marked site where He was born. But there was no shepherds. No angels singing. Just a crowd of eager people trying to make a bee line to see this site.

Then as we traveled through Israel, I saw signs that points to Nazareth, the place that Jesus spent most of His years – from His childhood until He started His ministry. But the Bible was silent about those years He spent in Nazareth.

We followed Jesus’ footsteps into the river Jordan. This is where He was baptized, signaling the start of His ministry.

Some in our group even decided to be baptized in the Jordan River.


Jordan River is not as a large and mighty as I imagined. Though it appears “muddy” as it was described in the scriptures. No wonder Captain Naaman of the Syrian army as recorded in 2 Kings, refused to dip in this water.

Yet, muddy or not, I must at least dip my hand, and my belief.

Then we followed Jesus’ footsteps into the mountains near Jericho. This is the mountain where it was believed He was tempted.

What could it be like to spent 40 days and 40 nights in this barren place? Though interestingly today, there is a stone quarry at the foot of the mountain. Definitely lots of stones that can be turned into bread.

Then we looked for Jesus’ traces in the town of Cana. This is where He performed His first miracle, where in a wedding feast, He turned water into wine.


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Our trip then led us to a town that He spent some time during His ministry, a town called Capernaum or Capharnaum.

The only remains of this town today are ruins. Though the site is still beautiful as it is beside the lake, known as the Sea of Galilee. We even saw the remains of an old synagogue (photo below).


Even though we only see ruins of that Capernaum town, it showed us a glimpse, a window if you will, of where Jesus walked.

We climbed a mountain beside the Sea of Galilee. This they say is where He gave His teachings or His sermon on the mount, that became known as the Beatitudes.

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As I looked at the beautiful scenery, I tried to listen through the blowing wind, to His voice and His teachings, in that Beatitude mountain.

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We even had the chance to sail across the Sea of Galilee, where on this very waters, He shouted “Peace, be still,” amidst the roaring waves and howling winds. Good thing there’s no violent storm when we sailed across it.

img_4535 I could even imagine the footsteps that He left on the waters, when he walked on it. But no one among us tried to walk on the water, for that will be preposterous.

We followed Him through Jerusalem. We climbed the Mount of Olives, where He spent some time teaching and praying.

From the Mount of Olives we viewed the City of Jerusalem (photo below). This is where Jesus wept when He looked into the city and the temple, knowing of its coming destruction.

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Then we trace Jesus’ footsteps into the walled city of Jerusalem and walked in its streets and alleys.

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We followed Him into the Garden of Gethsemane where He fervently prayed, the night before He was arrested.

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Then we walked the path known as Via Dolorosa or the Way of Suffering. This is the path that he chose to walk on his way to Calvary in behalf of you and me. (Photo below is Station V of the Stations of the Cross in the Via Dolorosa)

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We then went to the place known as the Skull Hill (calvarium is Latin for skull) or also known as Golgotha. This is the place believed where Jesus was crucified and died, so we can have life.

Below is the Skull Hill today. Old photos of this hill showed it is really shaped as a skull, though recent earthquakes have changed its distinct features.


Then we went to see the tomb where they laid His body after He died. (The Garden Tomb is one site, though there’s another possible site, the Holy Sepulchre Church, which we also visited.)

We even went inside the tomb. But that tomb was empty. For He is risen! And that is the very foundation of my faith.

As we celebrate this Lent season, may we contemplate on His life and what He has done for all of us.

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at the Sea of Galilee

And as a pilgrim, I realize that walking where Jesus walked would be pointless, unless we also follow His will and walked spiritually as well, where He walked.

May we have a meaningful and glorious Easter.

Little Things

While we were on a trip in Israel, we stopover for lunch in a restaurant overlooking the Sea of Galilee. Even though it is named the Sea of Galilee, it is actually a lake and not a sea.


Besides enjoying the view, I enjoyed the food there as well. The most popular in their menu being beside the Sea of Galilee is fish of course. And that was what I ordered.

After the meal I saw this sign on a wall.


That is absolutely correct. Be thankful for even the small stuffs in this life. Like a good meal. Or a beautiful day. Or a smile from a stranger. Appreciate the little things. Nothing wrong with this reminder, right?

Except that we must be careful on what we call  as “little things” as it could be a slight jab or even a downright insult. Depends on the situation, I guess. You don’t believe me?

Well, here’s the whole story of this sign.


(*Photos taken at a restaurant in Tiberias, Israel)

Walking Through Old Jerusalem

In our trip to the Holy Land, we walked inside Old Jerusalem. It is a walled city that roughly covers one square kilometer within the modern city of Jerusalem. It’s a place that has been, and still is, the center of constant clash of powers throughout history.

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The city of Jerusalem have been surrounded by walls for its defense since ancient times. These walls have been destroyed several times but also have been rebuilt through the ages depending on whose occupying the city.

Since Biblical times, the walls of Jerusalem have been well-known. Photo below is the tower of David, old Jerusalem’s citadel, located on the western side of the walled city.

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Most of the walls that exist today is from the Ottoman Empire of the 16th century, when Sultan Suleiman decided to fully rebuild the walls.

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Entrance through the walled city is through several gates. Currently there are eight open gates to the city. The ninth gate, the Golden Gate, is blocked and closed, as according to tradition, is awaiting for the arrival of the Messiah.

Below is one of the gates leading to the old city. I believe this one is called the New Gate.

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We entered the city through the Jaffa gate and began our walk inside the old city.

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Perhaps the most known part of Jerusalem’s wall is the Western Wall, or also known as the Wailing Wall. This is considered sacred by the Jews, believed to be the only remnant of the wall that was part of the Second Jewish Temple, rebuilt and renovated by King Herod the Great, and was destroyed by the Romans. (The first temple was built by King Solomon and was destroyed by the Babylonians in 587 B.C.E.)

The Wailing Wall has been the site for pilgrimages and a place to pray for the Jews, where it is believed that one has immediately has the “ear of God.” Below is part of the Wailing Wall.

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Walking through the narrow streets and alleys inside the old city gives you a feeling that you’re walking through the pages of history.

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Most of these small streets are only passable by walking.

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Though there are very narrow alleys that cars can drive through.

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There is also a part of our walk that we went through market-like alleys. As a Filipino, I feel like I was in Divisoria or Tutuban in the Philippines.

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There is food, spices, jewelry, and other merchandises as you can imagine.

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There is even this Holy Rock Café. Only in Jerusalem.

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But perhaps the most visited locations in Old Jerusalem are the churches and religious sites.

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A famous path for pilgrims and visitors is the path known as Via Dolorosa, or Way of Suffering. It is also called the Way of the Cross. This path is believed to be the path that Jesus took from Pontius Pilate’s court, to Calvary, and finally to his tomb.

On this Way of the Cross are 14 stations where significant events were believed to have happened. However, many of these locations were based on traditions only, rather than hard facts or archeological findings.

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Above photo is station V, where Simon of Cyrene was compelled by the Roman soldiers to carry the cross of Jesus. Below are other stations we passed through.

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We also passed this church, the Holy Sepulchre Church, which by tradition is the site that encompass both Calvary where Jesus was crucified and the tomb where he was buried.

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As expected it was packed, and there was a long line of people waiting to enter this church.

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It will be unfair and I will not give the real picture of Jerusalem if I only mention the famous sites for Jews and Christians. In fact, if you view Jerusalem from afar (see the very first photo), the most conspicuous structure is the golden dome, known as the Dome of the Rock. This is a Muslim shrine believed to be the site where Muhammad ascended to heaven.

Below is the Mosque of Omar, which is adjacent to the Church of Holy Sepulchre.

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Definitely Old Jerusalem is a place that provides a passageway to the storied past. It is also a crossroad of the past, present, and perhaps even of the future.

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It was quite an experience for me walking through Old Jerusalem, adding my footprints in the thoroughfare of time.

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(*all photos taken with an iPhone)

 

Not Bound for the Promised Land

During our trip to the Holy Land, we visited  a place known as Mount Nebo, which is located near Madaba, Jordan, or the land of the Moabites in Biblical times. It’s pretty high that it provides a panoramic view of the surrounding areas around it, including the land known as the Biblical Canaan.


On Mount Nebo’s highest point, the remains of a church and a monastery was discovered in 1933. Today a Christian chapel stands on its site.


As we were enjoying the view beneath an iron cross, the tour guide was giving insights and explaining the significance of this place to our group.


While another group near us was having a devotional and they were singing the hymn “I am bound for the Promised Land.”

You probably know or heard that song:

I am bound for the promised land,
I am bound for the promised land
O who will come and go with me
I am bound for the promised land.

But the irony of this is, historically, here in Mount Nebo was where Moses stood and God showed him Canaan, the Promised Land from afar. But here also in Mount Nebo was where Moses died and was buried, without reaching the Promised Land. Moses was not bound for the Promised Land.

Moses, even though he was chosen by God to lead the Israelites out of Egypt and to go to the Promised Land, was not allowed to enter it. All his life work – including 40 years of top-notch Egyptian education, including military tactics and operation, and another 40 years as a lowly shepherd just to learn patience in preparation for his mission, and finally 40 mighty years of leading God’s people out of Egypt, and into the wilderness, on their way to the Promised Land – yet he never set foot to that land.

Was Moses a failure then? Not at all!

Sometimes we are assigned something to do, but we may not see the conclusion of that work. We may have started something that we are not able to finish, not because we are a failure, but because it is not planned for us to fully fulfill that. For God has some other plan for us, or He had appointed another one to finish the work we have started.

More importantly, when Moses stood there in Mount Nebo, while looking at the Promised Land from afar, he did not complain to God why he was not allowed to enter the land that is “flowing with milk and honey.” A land that was promised to his ancestors, Abraham, Isaac, and Jacob. A land he probably dreamed of claiming all his life. He humbly submitted to God’s plan for him.

He may have not entered the Promised Land here on earth, yet God had a better plan for him. For he was taken up to the Promised Land in heaven.

So we may not be able to achieve the dreams or goals we set for our lives here on earth. We may never live a life so rich that it is “flowing with milk and honey.” We may not be able to claim the “promised life” we hoped for here on this world. We may not be bound for the earthly promised land.

But may we set a higher goal, the one God had promised for us. To live in heavenly Canaan with Him.

(The sign under the cross reads: “Just as Moses lifted up the serpent in the desert, the Son of Man must be lifted up, so that everyone who believes in Him may have eternal life.” John 3:14-15)

 

The Adventures of Iowa Jones

Have you heard of Indiana Jones? Forget him. I introduce to you, Iowa Jones and his (mis)adventures. Here is his quest to find the Lost Temple of Doom.

It started in a deserted place forgotten by time.


A place where the terrain was so alien, it’s out of this world. Could it be in another planet?


Then Iowa Jones came to a path that seems to be blocked by a stone wall.


But as he inspected it closer there was a narrow passageway, as if it’s a secret path through the stone walls.


So he pressed on and walked through the unknown path. What danger could be lurking ahead? Would there be a big Rolling Stone? Or maybe giant Beetles? Would he meet Mick Jagger or Paul McCartney? Huh?


Anyway, some of the stones seems to have caved in. Were the stone walls moving? Would he be crushed to his death?


While some of the passageway seems to be so clear that it was even lighted by the sun rays.


Iowa Jones even took short rest under the stones to catch his breath.


But he knew that he must hurry as the dreaded army of the Last Crusaders of Doom was pursuing him.

Iowa Jones must also avoid the booby (poopy?) trap that were scattered on the path.

These booby traps are left by the Last Crusaders’ fierce beast the Donkey Kong.


Even though tired and weary, Iowa Jones continued on his quest.


Then he came near a clearing. He now has a glimpse of the temple!


Finally he now stands in awe in front of the Lost Temple of Doom.


Then he saw the Guardians of the Galaxy, I mean the Guardians of the Temple. They were assigned to protect it against the army of the Last Crusaders of Doom.


They warned Iowa Jones that the temple should not be rediscovered by the army of Doom, or else the whole kingdom of Camelot (not reigned by King Arthur, but by camels) will be doomed. Good thing he understands and speaks their ancient language.

So with all his might Iowa Jones toppled down the temple like Samson, without the long hair, of old.


Alas, it was not a Temple of Doom, but rather it was a Doomed Temple.

And all that was left were ruins. The End.


This story was brought to you by the jet-lagged brain of Pinoytransplant.


(Photos taken at The Treasury in Petra, Jordan, a site named as one of the seven wonders of the world, built more than 2000 years ago. And with Pinoytransplant as Iowa Jones.)

Walking in the Land of History

In my lifetime, there are trips that I really cherished. Journeys that have deep personal meaning, that they are more than just trips.

Like the trip we made a few years back to the place that gave me so much inspiration since my teenage years (see previous post). And to see and be there in person in that awe-inspiring place was a life-fulfilling dream.

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me in the Grand Canyon

Then there are the trips that are always dear to me. Trips that bring me back where I came from. That even though how far I wandered, this place always pulled me back, for this is where my heart is. Home.

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photo taken somewhere in the Philippines

This year we made another epic journey. To a place whose relevance is more far-reaching than the place itself. A place so rich in history, that the events that happened here changed the course of humanity. This place has a special spiritual meaning to me: to walk where my Savior walked.

Jerusalem as viewed from the mount of Olives


(*More post of our trip to Jerusalem to follow. No, not the musical chair, but the real trip to Jerusalem).