The End Of A Miracle

(I am reposting an article from December 26, 2010, “My Christmas Calling.” I wrote it after being on-duty on Christmas day.)

Christmas morning. Freshly fallen snow was on the ground. It was a White Christmas after all.

Bah, humbug!

I forced myself to get up from bed. My throat was sore. It felt like somebody stuck a fork in my throat and scraped it raw. My body aches like I just ran a marathon. I caught a Christmas bug, you know. No, not the “joyful feeling” of the holidays. A real bug.

I don’t want to go to work, emotionally and physically. But I have to. I am on-duty for Christmas. Our patients in the hospital, especially in the ICU, needs my care. (But who will care for me?) On days like this, I just have to suck it in, take a couple (or make it a handful!) of Tylenol and will myself to go.

I left home with the kids still sleeping and the gifts under the tree unopened. Maybe I would be able to come home early and we can open the gifts together.

In the hospital I greeted people with perfunctory “Merry Christmas,” though I was not feeling the “merry” part. In fact was in a Scrooge-mood.

It was a busy day: 32 total hospitalized patients I rounded upon, 2 hospitals I went to, 19 ICU patients, 12 ventilator-dependent, 2 carbon monoxide poisoning that needed hyperbaric oxygen treatment, 1 chest tube insertion, 1 endotracheal intubation, 1 arterial catheter placement, 2 central venous catheter placement……. and a partridge in a pear tree.

As I dealt with the very critically ill patients and talked with their families, I knew that I was not the bearer of good tidings and joy, but rather of grim news most of the times. As the families broke down into tears and came to term to the gravity of the condition of their loved ones, I thought that these people were experiencing far worse Christmas than me. At least I am going home tonight. My patients will not. Some of them will not come home, ever. And for these families, Christmas will never be the same.

Slowly my “Grinchy” attitude peeled off and was replaced with a sympathetic spirit. I then realized my purpose for this holiday: that is to give my compassionate care for these unfortunate people, in this supposed to be joyful occasion.

The last patient I admitted to the ICU on Christmas came late afternoon. He was 32 years old. When he was 7, he received a life-giving gift, when he became a recipient of a heart transplant. His “miracle” heart had kept him alive for all these 25 years. However, for the past few years, his existence was less than joyful. Complications after complications have developed, and one by one his organs started failing. Including his borrowed heart.

Today he was brought to the Emergency Department barely alive. After transferring him to our ICU – placing him on a mechanical ventilator, putting tubes and catheters in his body, and flooding his system with medicines – his condition did not really improve much.

I spoke with her mother in the ICU’s waiting room. She quietly, but boldly stated, in between sobs, that she was ready to let go of her son who have suffered enough. She indicated to me that she just wanted his “boy” to go gently into the night.

Somehow, the ‘miracle’ heart will be resting this Christmas night.

Did the miracle ended?

I don’t think so. For the miracle of love persists. Love that is shown here by letting go. Letting go in some occasion, is more selfless than holding on.

There is another 7-year old boy who is waiting for his gift. That boy is my son waiting at home. He may be anxious to open his gifts. Or maybe he’s anxious just to see me come home.

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Payapang Daigdig

Christmas is around the corner. And once again, I’m missing home.

Home where the street carolers are singing “Sa may bahay ang aming bati, merry Christmas na malualhati.” Or “Ang Pasko ay sumapit, tayo ay magsiawit.” Or if by chance you ignore them, you’ll hear “Thank you, thank you, ang babarat ninyo, thank you!”

One song that I have not heard for a long time is this song: “Payapang Daigdig.” It is perhaps our Filipino equivalent of Silent Night.

It was written by Felipe de Leon. The song has been inspired as they said, by the turmoil brought by World War II. It was first sang during the Japanese invasion of the Philippines. De Leon penned the lyrics of this hauntingly beautiful song, after seeing his hometown, Manila (my hometown too), in ruins.

If you listen to the song, it is quite amazing that its message is in stark opposite of the reality of that time.

To all the OFWs, expats, and all Filipinos who are missing home this Christmas, may you find peace, despite of all the unrest, on this holiday season.

 

(*video taken from YouTube, posted by Analyn Solano)

Lights Up

Our Christmas lights are up.

Actually, I set them up since last week. Only to take them down again.

No, it’s not that the neighbors complained that it was too early for Christmas. It’s not that we contemplated on canceling Christmas. And it’s not that Santa is not coming to town. Nothing like that.

Why I took the lights down has a more rational reason.

Last week, when we were experiencing a seasonably warm November (up to 70’s degrees Fahrenheit), I decided on a whim to put the Christmas lights up. I hang them up at the edge of our roof. I rather put them up when it was warm and not when it’s bone-chillingly cold.

So with my trusty ladder, and with the help of my son, I climbed up and dangled our Christmas lights for all the neighbors to see. By the way, I was not the earliest among our neighbors to set up Christmas lights. I saw one down the road, even two weeks earlier than me.

Risking life and limb (maybe not life, only limb, for it was only 10 feet high), and after more than an hour of work, I completed setting our outside Christmas lights up. I was so proud of my accomplishment.

Only to find out, after I plug them in to the electric outlet, that almost half of the lights were not working. What a bummer!

All my efforts and time spent were gone down the drain. I suddenly felt my back really ached. Maybe it was more imagined than real. I almost got a headache too, when I thought of banging my head to the wall!

I have no one to blame but me. Why did I not check the lights if they’re working or not, before I hang them up? Yeah, very brilliant of me.

My wife said, trying to keep a straight face, “at least you’re not making that mistake again.” Thanks dear, that makes me feel better. Not.

I left the unplugged bum lights hanging for a week , while I let my disappointment simmer down a bit.

Then this week, after getting a new set of Christmas lights, which I think was time for an upgrade anyway, I finally took the old non-working lights down, and hang up my new brighter and yet more energy efficient LED lights.

And yes, I tested them first, even if they’re new, before I hang them.

Our temperature also got significantly colder this week, with the lowest in the 20 – 30’s degrees Fahrenheit. But I just bundled up, suck it up, and do what I needed to do.

As I look at our Christmas lights tonight, somehow they look more beautiful than ever. They better be, for I spent double the time and effort putting them up. Make you appreciate the things that you work your tail off.

Of course I also gained a notable experience and a valuable lesson learned: never assume, always check it out first. And that just not apply to Christmas lights.

I am not taking them down until after next year’s Christmas.


(*photo taken with an iPhone)

Christmas 2015

We are experiencing a seasonably warm December right now. In fact we have more rain than snow this month, that we had flooding in downtown Des Moines these past couple of weeks. Yesterday it felt weird that we even had a thunderstorm, with lightnings and pouring rain this late in the year. Is this Iowa winter?

Come to think of it, if it has been cold enough, with all this moisture in our area, this could all be snow!

I know it’s not just here in the Midwest that we are experiencing the relatively warm weather, but also in other parts of the US. Some friends of ours in New York City even posted in Facebook that it was 70º F today there. I guess there will be no snow in Central Park this Christmas.

Experts said that it is El Niño, the periodic warming of the equatorial eastern Pacific Ocean, accounting for this phenomenon. Or is this global warming?

It’s not that I am complaining, for I’ll rather have a warm day than freeze, but my children have been wishing for snow for Christmas, just like the song “I’m dreaming of a white Christmas.” And they may not be the only ones who are praying for snow.

Then today, on this Christmas eve, it came. Santa Claus? No. Snow!

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We will have white Christmas after all.

From our family to yours, may you have a Merry Christmas!

(*photo taken with an iPhone)

 

When You Wish Upon A Star Wars

I entered the room and stood silently at the foot of his bed, watching him breathe. He was hooked to a small ventilator that is connected to a mask covering his face with straps around his head, that he looked like a jet fighter pilot. Beside the bed was his father and his mother who were obviously distraught, yet trying to hold off tears.

Luke* (not his real name) was one of our ICU patients. Even though he was only in his 20’s, he had his fair share of surgeries and hospitalizations than many patients in a geriatric floor combined.

He had a genetic disorder that prevents the development of various organ system. This affects the skeletal system giving them a peculiar look and stature, that some people coin the term FLK syndrome: Funny-Looking Kid. Though for me, there’s nothing funny at all. This disorder also causes heart defects, and can involve other organs like the lungs, liver, gastrointestinal tract, lymphatic and blood system. Even so some people with this genetic disorder could live to adulthood, some would succumb to this disease early in life.

Luke had a number of surgeries to fix his heart problem, and other procedures too many to recall. He had been treated in well-known hospitals like Mayo Clinic, for his disease. But despite of all the technology and medical interventions, his body continued to betray him.

For the last several months he had been in and out of the hospital, usually staying for several weeks at a time, including ICU stay. I have taken care of him a number of times in the past.

In spite of his illness, Luke tried to live his life as “normal” as possible. His family gave him the opportunities and the best care they could. His mother, who was a patient of mine too, had the genetic disorder as well, albeit with a milder manifestation, thus I knew the family well.

One thing I learned, was that Luke likes Star Wars, even though the first Star Wars movie came out more than a decade before he was born. Yeah, he was a fan of this movie genre, just like the rest of us, I guess.

In this last hospital admission, Luke came in with a lung infection causing respiratory failure, requiring intubation and mechanical ventilation. He came on Thanksgiving Day.

After several days in our ICU, we were able to extubate (take out the endotracheal tube) him, only to place him on a non-invasive positive pressure ventilator (NIPPV) with a face mask, as he cannot breathe on his own. This is like a CPAP machine. At least he can stay awake and not be sedated on the non-invasive ventilator, and he can speak as well. He can only tolerate a limited time off the NIPPV, and had to be hooked right back on it. He would not survive without it.

As I watched him with his “jet-fighter mask” with his bed as his vessel, what came to mind was that in a cruel twist of fate, this kid who likes Star Wars, now breathes like Darth Vader: whoooh….poooh, whoooh…..poooh, whoooh…..poooh. Every breath, there’s a gush of pressurized air coming out of the ventilator and through his mask.

After one holiday, another one is approaching. Christmas is just around the corner. And Luke remains in the hospital, ventilator-dependent, with no clear sight that he’ll get better. He knows it, and his family knows it. Luke’s days here on earth is numbered.

With wishful thinking, maybe he can linger a little longer to see the new Star Wars movie which he was looking forward to seeing for the longest time. But how? Him in the hospital? On a ventilator?

But wait, isn’t it Christmas season after all?

Wish granted!

After making elaborate arrangements and collaboration, Luke and his family will be going to a movie theater, to be accompanied by some medical staff, for a special private showing of the “Star Wars: The Force Awakens,” when it opens this weekend.

After that trip to the theater, Luke will be going home for Christmas with his family, on hospice care. No more hospitals. No more ventilators. No more pain.

Perhaps he could stay home until Christmas. But if not, Luke could soar into the heavens and once and for all, walk on stars. His final home.

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(*name intentionally changed for privacy)

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Update 12/22/15: after posting this story here, I learned that our patient was featured in the local news. See link here.

 

 

A Christmas Miracle

We have entered the month of December and Christmas is only 3 weeks away. For this month I would like to re-post stories that happened around Christmas, which I have witnessed first hand, and that I have written several years back.

I first published the following story, “Gift of Life,” on December 15, 2010.

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Gift of Life

Everybody said that her pregnancy was ill-conceived and ill-advised. But who are we to judge her?

Mary (not her real name) lies in our ICU. Her 21-year-old body looks frail and debilitated, her skin is pale and sallow, and her breathing is irregular and shallow. Attached to her sick body are a number of tubes, catheters and monitors. The regular bleep and tracings in the monitor screen above her bed tells me that she is still alive, although she looks otherwise.

Mary was born with cystic fibrosis. This is an inherited disease caused by a defective gene that causes thick mucus plugging of small tubes and ducts, mostly affecting the lungs and the digestive system. Patients suffer with frequent lung infections, digestive problems, and usually succumb with respiratory failure or liver failure. The disease is fatal that many patients will die in their childhood and adolescence. However, in the past few decades, with the improvement of care, patients who made it through adulthood has an average lifespan of 35 years.

Mary’s childhood was anything but normal. She was in the hospital or doctor’s office so often more than she was in school. She was on medications constantly. She had known more doctors than childhood friends. She experienced more than her share of suffering and disease. But she had beaten the odds. Now, that she made it through 21 summers tells me that she is a fierce survivor.

But now, this pregnancy. Her family doesn’t want her to have this. Her doctors told her that her body may not be able to tolerate the additional stress of pregnancy and that it will be very high risk to continue. But she made up her mind that she will keep this child whatever the cost.

Due to developing problems and complications, she was admitted to the hospital’s maternity ward on her 32nd weeks of conception, where she was expected to stay for the rest of the pregnancy. However, after a few days in the hospital her condition worsened. Her liver function deteriorated and she went into fulminant hepatic failure. Mary slipped into coma. She was then transferred to our ICU.

Because her baby may get compromised further, we had no choice but to deliver the baby, even if it was barely 33 weeks old (full term is 38-42 weeks). Mary underwent an emergency caesarean section.

Now, 3 days after her baby’s delivery, Mary still remains in our ICU. She continues to be comatose.

As I stand beside her bed to examine her, I see the pictures of her newborn baby posted on the wall of her room. Being a parent, I cannot help but feel a twinge of sadness. Will she ever know that she brought forth a beautiful baby, premature, but otherwise healthy boy? Will she ever hear the yearning cry of her dear child? Will she ever see the sweet smile of her son? Will she ever hold her baby in her arms, the life that she fought for so dearly to bring to this world, even if it meant going against medical advice?

I just hope that someday this precious boy would be grateful and proud to the mother, he may never know. And may he appreciate and realize the challenges, the difficulty, the sacrifices her mother went into, to give him the gift of life. Yes, even in exchange of her own life.

But wait. This is Christmas season. Time of miracles. Maybe there will be one here tonight.

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Post Note:

After I published this story, Mary did improved and recovered. She got out of the ICU and eventually went home to take care of her beautiful baby. I took care of Mary a few more times and I always asked her about her baby boy. Her son became her pride and joy.

Sadly, Mary eventually succumbed to her illness last year, leaving a very young son, who at least experienced a mother’s love, even for so short a time.