A Somber Celebration

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

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

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

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

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

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

Why two days?

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

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

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

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

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

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

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

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

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

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

He later slept on into the eternal night.

********

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

 

Living Gift

Ten years ago, I received a “living” gift on my birthday. It was my son. Yes, he was born on my birthday. It is a gift that keeps on giving.

The only downside to this gift, if there is one, is that my birthday celebration became an afterthought since my son’s birth. It’s “his” birthday now. But that’s alright, I always like kids-themed party, with hats, balloons, and Super Mario cake for my birthday anyway.

IMG_2196

my son and I doing Math lesson in the kitchen

Recently, on my last birthday, I received another living gift. But before you think we had another baby, well it is not that. No diaper-changing needed on this one. No waking-up in the middle of the night for feeding needed too. But it requires tender-loving care as well.

My birthday gift is a plant. It is actually a Bonsai Japanese Juniper tree. My wife gave it to me, and it now sits on top of my office desk.

IMG_2154

my Bonsai tree

I really need to take good care of this living gift, like a real child. Besides that it is a beautiful tree, and that it is a loving gift from my wife, there’s more to it than that. Somehow my reputation (and career?) depended on this.

I am very aware of the common advice that says, “Never go to a doctor whose office plants are dead.”

Fake plants are not an option.

Life’s Gifts and Surprises

Another year. Another birthday. Another year older.

As I ponder on my yet another birthday, I cannot deny the fact that I am not getting any younger. In a few more years, I’ll hit the big 5-0. Then not far along, I will be in the retirement age. And I wish to retire early too. Then after that, what? The “golden” years? Somehow this “gold rush” is nothing I want to rush into. Is it really all downhill from here?

But there’s a lot to be thankful for. I have chased my dream and is living it. Nothing more can I ask for. (Or maybe that one dream of being a rock star got away.) I have a wonderful wife. I have two wonderful kids. The kids are grown up and in a few years they will be off to college and off on their own. I am healthy, or I think I am, and I have never felt better. Except for some ache here, and there, and here, and here, and …….Sorry I digress.

Over the years I have received some awesome birthday gifts. A full army fatigue uniform with matching toy machine gun when I was three. Did I tell you I dreamed of being a soldier when I was a small boy? A battery operated toy fighter jet plane that run in circles and spread open its wings, given by my Ninong, when I was six. I love it, even though I wish it could also fly. A red bicycle when I was eleven. I rode that bike until I was in college, and I even spray painted it purple once with the help of my friends. Purple? Don’t ask.

My favorite birthday gifts though are not cool toys, or some preppy clothes, or expensive gadgets. It is far more priceless than that.

About 2 weeks before my 31st birthday, my eldest child, my daughter, was born. It was an early birthday gift really, and it was a marvelous gift. A gift that just gets more precious as the years goes by. What could be a better gift?

Then nine years ago, exactly on my 36th birthday, my youngest child, my son, was born. It is a gift that keeps on giving. Because my son shares the same birthday with me, since then my birthday celebration turned into a children’s party or pushed into a secondary event. But I don’t mind. I don’t mind it at all.

Life begets life. Wonderful gifts of life. Nothing else can top those birthday gifts, right? Well I was proven wrong!

On this most recent birthday of mine, or just about that time, my wife and I had a surprise. It knocked my socks off and sent me into a tailspin! Quite unexpected, but it is a pleasant surprise.

I know I am getting old, but nothing makes you younger than this kind of life changing event. My wife and I may have shock and apprehensions initially, but now it is turning into delightful anticipation.

My two kids are getting excited too, for they know that love is never divided. It only gets multiplied.

The flowers are blooming. The grass is growing. The birds are singing. It is spring time. Life begins again. In diapers.

spring time in our home

Birthday Prayer

“God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and wisdom to know the difference.” — Reinhold Niebuhr

In my room of our home in Manila, was a poster with a picture of the sun shining through tree branches, and with the above quotation written on it. Even though I don’t have that poster anymore, the message seems to have forever imprinted in my mind.

With another birthday looming on the horizon, it’s that time again for me for an inventory.

No, I’m not doing an inventory of all the birthday gifts I received over the years, nor all of the properties I have. Inventory of my properties will be much easier, since I really don’t have much I can call my own – the banks, credit and lending companies owns most of them. I’m doing an inventory of who, what and where I am, at this point in my life.

As the above quotation said, there are things we cannot change and can change. So I have to accept my receding and thinning hairline. Wearing a hairpiece, is never an option for me (though the wig that Washington used and was common during those days, the one with side curls, looks interesting). And I should do something for my bulging and flabby belly. That means I need to keep running and do more crunches.

I read not too long ago that the average life span in the US is now pegged at 78 years old. This is higher than what it was several years ago, and people are living longer. I know I am already a few years past the halfway point of this average life span. There is no denying that I am in my middle age.

The problem is that, between my father and my two grandfathers (father’s and mother’s side), nobody among them lived past middle age. I have to contend with that genes. I cannot choose or change my family and its genetic pool. However, I definitely can change my lifestyle into a healthy one to improve my longevity.

But there is more to life than health and durability, even though those are important. Our relationships, the way we deal with our neighbors, friends and family, I believe are more precious. Things that really matter — what we want to be remembered, when we are gone.

Yes, I know I cannot change the world. I cannot change other people. Definitely I cannot change my enemies, but I can change my attitude towards them, and make them friends. I cannot even change my wife, but I can accept her as she is. Nor can I change my kids, but at least I can guide them. The only person I can change is me.

Boat in a Storm (by John Lund)

(image from here)

I am thankful for this blessed journey. I am thankful for where I have been, where I am now, and where this voyage will take me. As I continue to navigate in this sea of life, I know I cannot change the storms, the winds, and the waves. But I can change and adjust my sail.

There is one more thing I can do: trust the One who controls the winds and the waves, that He will guide me through.

I Want My Own Cake

In a few days, I will be celebrating another birthday. For the people who know me, this is not to remind you to give me a gift (but I hope it affords you enough time to shop for one, hah!). Yes, I m getting older (older than the number of kilometers in a Marathon ), but I hope I’m also getting wiser (or not?).

There are so many things I’m thankful for, and over the years I have received several gifts on my birthday that I’m indebted for. But there are two birthday gifts in particular that cannot be topped  (even if you give me $20 M gift- but I’ll accept it just in case).

The first one is  life itself. From my first breath (or my first cry, after the doctor spanked me) up to my last breath, I will be forever grateful. To be able to  live, love, laugh, cry, walk, run, eat, drink, play, work, sleep and dream…….is something that I cannot ask for more.

The second one, may be even more precious. What?! What can be more precious than life? Well, you see, life begets life. Seven years ago, I have received a gift on my birthday, that just kept on giving. It is my son, whom I share the same birthdate.

However, since the arrival of my son, my birthday celebration became secondary to his celebration. Nuts! I also would like to have balloons and Super Mario cake of my own.