A 2020 Vision

(I was asked to contribute a page for a high school students’ yearbook. My son was one of the co-editors. Their theme was Vision 2020. Here’s the message I wrote.)

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Vision is a precious gift from God. It is one of our senses that we use to interact with the outside world. With our vision we can see a cloudless summer sky, the intricate details of a flower, the changing colors of the autumn leaves, and so much more.

The term 20/20 vision means that one can see a specifically sized target at a distance of 20 feet. 20/100 vision means one can only see the target at 20 feet what another person with 20/20 vision can see at 100 feet. The bigger the bottom number, like 20/200, the poorer the vision.

So important is vision that if we are deprived of this faculty it is considered a disability. But there is a graver condition than having no sight. According to Helen Keller, “The only thing worse than being blind is having sight but no vision.” What an interesting insight from a blind person.

Vision is not just the state of being able to see, but it is the ability to think about and wisely plan for the future with imagination, optimism, and most of all faith to the One who holds our tomorrow. I believe that this is a far more important gift we are given. 

To the graduating class of 2020, we extend to you our sincerest congratulations.

“Where there is no vision, the people perish.” Proverbs 29:18

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Post Note:

Who could have envisioned that the year 2020 will be this unsettling? And we are only a quarter through it. I feel sad for senior students, including my daughter who is supposed to graduate from college next month. She still would graduate, but there will be no commencement ceremonies due to the Covid-19 pandemic. With or without graduation ceremony, should not lessen the momentousness of their accomplishments.

(*The photo above was from a few years back, taken at Nevada’s Highway 50, the loneliest road in America, a perfect place for social and physical distancing.)

A Beautiful Night

I did two overnight in-hospital ICU call in a span of three days lately. This has obviously derailed my circadian rhythm. Normally in our group of intensivists, a doctor only do 24-hour duty once a week or less. But this is not normal times.

So on the day I was off after my back to back calls, I woke up in the middle of the night and cannot sleep anymore. My body was fatigued yet my mind was awake. Instead of tossing and turning in bed, I got up and went to another room so not to disturb my wife who was fast asleep.

I pulled up a chair and sat by the side of the window and stared outside. The night was still and the moon was halfway through the horizon in the sky. The warm glow of the moonlight bathes the whole surrounding and it was quite enchanting. It was after all the super pink moon – the biggest and brightest full moon of this year 2020.

Ah, year 2020. Who could have predicted that this year would be this challenging? At my work we have more than 30 ICU beds, but with the predicted patients surge from COVID-19, our hospital has a contingency plan that we could convert other parts of the hospital into temporary ICUs and that we could potentially take care of 90 critically-ill patients on ventilators. The good thing is we have not seen that kind of surge like what is happening in New York City and New Orleans. At least not yet. I hope we never will.

We do have several confirmed COVID-19 patients on ventilators though, and they are pretty sick. But they are getting better, and the truth is many of them are getting off ventilators after a few days. Even our first ever confirmed COVID-19 patient that ended up on mechanical ventilator improved and got off of it after almost three weeks.

There were deaths though from this virus, even in our ICU and we cannot deny that. In fact the other night that I was on call, there was one patient that was a COVID-19 suspect and I placed him on a ventilator that night. Of course I had my full protective gear when I intubated him. Yet despite of our best efforts he died. But testing came back later that it was not the novel corona virus, but he had positive blood culture for a bacteria and he died from an overwhelming sepsis. People die from other causes as well, not just COVID-19.

As I gazed outside the window, I uttered a prayer for strength and protection not just for me, but for all the healthcare workers that continue to fight this battle. I also prayed for my family and all the families of frontliners who are at continued risk of contracting this disease from us when we come home. More importantly I prayed for the patients and their families that are going through such a woeful and difficult time.

The saddest part of this pandemic is that patients in hospitals are going through their ordeal alone, as family and friends are not allowed to visit them. And for those people who succumbed from this COVID-19, they die alone with nobody to hold their hands even in their last dying breath. It is really heartbreaking.

I looked at the radiant full moon and it was glorious. I observed that the light of the moon cast long shadows on the lawn from the trees. I was unaware on how the trees around us had gone so big and tall now. The evergreens that stayed lush and strong through the cold months and had survived many bitter winters. The deciduous trees that were currently barren but the leaf buds were beginning to appear for it is spring time after all, reminding us that life begins again. I also noticed that there were faint stars in the sky, though their light were subdued by the bright moon, yet they were twinkling whether we see them or not.

All in all, it was a beautiful night.

Photo by David Besh on Pexels.com

Then a thought came to me as if God was answering me. Even if we are going through the night, if we don’t dwell on the shadows and focus on the light, there is still beauty around us. Many times darkness heightens our senses to appreciate the light and other lovely things that we may have taken for granted. Yet the most reassuring thought is that even how dark the night is, morning is surely coming and a new day will emerge.

Yes, we may have lost many in the night and we should remember them, but for most of us, we are going to be alright. Have a blessed and meaningful Easter everyone.

Coming to the Dark Side

Because of this COVID-19 pandemic, as a defense it is now advised that everybody wears a mask when going out. However, there is a shortage of masks available and other personal protective equiptment in many hospitals. Dark times indeed.

Thus, I’m wearing my own respirator mask to work.

“You are unwise to lower your defenses.” – Darth Vader

(*Warning: not a true protective mask. Rest assured for I am donning an officially prescribed PPE when dealing with patients.)

Seriously

From out of the blue, I received a greeting recently from a classmate in pre-med and in medical school whom I have not heard from for a long time. In fact I am receiving many thoughts and prayers from friends and family lately knowing that I am a frontliner in this war against COVID-19 especially in the ICU.

I wondered what prompted my classmate, but I was both surprised and touched that she remembered me and also my birthday. After hearing from her, I was reminded of our class party during our senior year in undergrad which was held in their upscale home in the Philippines.

In that party we had a game that was patterned to the old game show “Make Me Laugh.” The idea was that the “contestants” would try not to laugh as “comedians” do their best to make them laugh.

Being one of the jokesters during my college days, I was one of them who would attempt to make people laugh. There were 3 classmates of ours as “contestants,” and there were 3 of us “comedians.” If the first comedian was unable to make the contestant laugh, then the 2nd and the 3rd would give it a try. The contestant who would not crack a smile or laugh wins.

I was the first comedian.

I was a lanky kid in college, weighing 115 lbs in a 5’8” frame body. I look like Fido Dido. My gig was I borrowed an over-sized leather jacket (yes, there were leather jackets in Manila) from one of my burly classmates, and I filled the sleeves and the chest area with socks so I looked muscular. I also borrowed a heavy duty power twister bar from a classmate to show that I am trying to flex my arms. In other words, I am like the Filipino actor “Palito” impersonating Arnold Schwarzenegger.

On the first contestant, after I came out of the room and started walking to the contestant, she already burst into laughter as well as the whole class. I did not have to do much. Needless to say the 2nd and the 3rd jokesters did not even need to come out.

On the second contestant, I saw that she was trying so hard to keep it composed when I came out. But when I walked towards her and came face to face with her, she was red and to the point of bursting. After I tried to flex my muscles by bending the power twister (in which I really struggled), she finally lost it and broke into a laugh. Again the 2nd and the 3rd comedians did not have to do a thing.

On the 3rd contestant, I could sense that I would have difficulty making her laugh. She had this calm demeanor that was unperturbed by my nonsensical act. And while the whole class was already rolling in their bellies laughing, she just looked at me with a half-a-smile like that of Mona Lisa. After a minute of trying, I failed to make her laugh. I was a failure!

By the way, the second and the third jokesters did not succeed as well.

At the conclusion of the game, some classmates got hold of me, dragged me, and dumped me in the swimming pool. I had my full street clothes and shoes on! I was just the first one that was thrown into the pool though as what followed next was a pandemonium with many of the class being shoved into the pool. And we were not even drunk as there was no alcoholic drinks involved.

It was not supposed to be a swimming party. Perhaps they blame it on me, for not able to make that particular classmate laugh, that ended up into a pool-dumping frenzy.

On the side note, I know many of my classmates live in exclusive gated communities and have their own swimming pools. However, I pride myself that we have a bigger pool at our house in Sampaloc Manila, that is the whole street turns into a large swimming pool after a heavy downpour.

I admit, I was goofy when I was young, and perhaps I am still today though I may have mellowed. Maybe I just don’t take myself seriously. However at that time I wonder, were they laughing with me or were they laughing at me? It’s just funny that the kid who they probably would not take seriously before is now seriously taking care of people who are ill and in serious condition.

Life has a weird sense of humor.

(*photo taken a few years back at Petra Jordan)

To Immunity and Beyond

(I was asked to do a 5-minute health talk for our local congregation. Of course our church is doing virtual service now, so it was on-line using Zoom platform. Here’s what I presented.)

In this time of pandemic scare, we can wear a mask to prevent the virus from entering our system. In the hospital where we have confirmed or suspected cases of COVID-19, besides mask, we also don gown, eye goggles, and gloves. But what happen if the virus breaks through these barriers and invades our body? Since we really don’t have good medicine to fight the virus, we have to rely on our immune system to fight it.

How can we then boost our immune system? Here are some basic recommendations that we all can do. Let’s talk about the NEWSTART.

N– nutrition. That means eating the right kind of foods. Scientific and medical studies have supported that eating vegetables and fruits can improve our immune system and of course our health in general.

The more colorful the fruit and vegetables – like red, purple, yellow, green -the better, which means they have more anti-oxidants. Antioxidants help repair damaged cells and tissues. Vitamins are antioxidants.

There’s some pilot studies that they are giving mega-doses of Vit. C intravenously in COVID-19 patients. For us, we don’t need Vit. C intravenously, just eat the whole orange or some strawberries. That will taste better too.

There’s also some data that N-acetylcysteine (NAC) helps boost our immune system. NAC is needed for our body to manufacture gluthathione which is a premier antioxidant. NAC is found in legumes, like lentils, beans and peas. You can get NAC supplement in stores too.

E– exercise. Now that it is not too cold outside, go for a walk. Use common sense though and follow the recommended social distancing. Still practice the 6 feet distance from the crowd or don’t walk in a crowded area. But we are in Iowa, we have lots of open fields to exercise. 30-60 minutes of moderate vigorous exercise can release extra immune cells into the system. Exercise will make you look good too.

W– water. The best and the only hydrating fluid you really need. Our body is about 60% water. The brain 70% water. So if they call you airhead, that’s bad. Waterhead? That’s fine. We constantly lose water in our sweat, urine, even through our breath. We lose more water when we have a fever. When we fight an infection, we need to be properly hydrated. Many of our systems needs adequate water to be functioning properly, including our immune system. It is recommended to drink 2 liters of water a day, roughly 8 of 8-ounce glass of water.

S– sunshine. The sun rays can boost our immune system. Besides helping us produce Vit. D, the sunshine can also kill germs. That’s why we place that stinky shoes under the sun to kill the germs and the smell. OK, you don’t have to give that look to your family member, just tell them nicely – how about let’s go out in the sun.

T– temperance. In other words self control. I don’t have to tell you that smoking and alcoholic drinks can be detrimental to our health. As you can surmise, smokers are more susceptible to lung infection.

A– air. Fresh air. Stale air has more CO2 content. We need to replenish the stale air inside our home. Go ahead open the windows. Or go outside and breathe in fresh Iowa air. I hope you’re not near a cattle or pig farm. Or not near somebody who is coughing. Oxygen which in air of course is essential not only for the immune system but for us to live. Practice taking deep breaths. Better yet exercise and so you’ll breathe deeply.

R– rest. We need to have adequate rest or sleep. It is recommended that an adult person sleeps 7-8 hours a night. I know many of us are not getting that. Teenagers who think they don’t need sleep, actually needs 8-9 hours of sleep. Younger kids even need longer hours. Sleep deprivation can weaken our immune system.

T– trust in God. Many scientific studies have shown that people who believe in a higher power, recover faster when they are sick. But we don’t need medical or scientific studies to tell us that. We know that our God is bigger than our world’s problem.

There’s a story in the news about an atheist Italian doctor, and with what’s going on in Italy, he became a believer in God. As the saying goes, there’s no atheist in a fox hole. It’s important that in times like these that we put our trust to the One who is still in control.

Stay safe and healthy everyone.

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PS: To get a glimpse of how our immune system fights a virus, you can read my previous post, “A Battle Within,” (read here).

(*image from astroyard.com)

Fearless

I am fearless. But that’s not true. It’s not that I’m scared of spiders or cockroaches. It’s more than that.

I think we all know that we are in a middle of a war. The casualties from this COVID-19 pandemic continues to rise and it is devastating. More devastating are the news that healthcare frontliners are becoming casualties themselves. The news of doctors – from China, Italy, France, Indonesia, Philippines and more – dying from getting infected with the novel corona virus from patients they are trying to save, sends shivers to my spine.

I know there are risks from my chosen profession. From being overworked and being sleep deprived to being cursed by patients and being sued, that goes with the territory of our duties. I can live with that. But to risk your own life from contracting a possible deadly disease and even worse, to endanger your own family from passing on the illness at home makes me afraid. Very afraid.

For those people who are not taking this pandemic seriously and continues to party or not follow the recommended social distancing and community quarantine, or for those who think they are strong and invincible, please think again. If it’s not you who would be severely affected, it may be someone that you love that could suffer, because of your foolish actions.

Today, I came face to face with only my mask in between, with this deadly disease in our ICU. As I place an endotracheal tube to the patient’s passageways to hook her to a ventilator, I can only pray that my personal protective gear will be enough shield from this invisible enemy. Though I pray even more that heaven’s hand will be my shield.

I know this is only the beginning of my daily battle and confrontation with this foe. And it is expected that the worse is yet to come.

Fearless or not, I swore an oath to do this job. So help me God.

(*photo taken at Jardin du Palais Royal)

A Silver Lining

They say that in every dark cloud there is a silver lining. I totally understand that what is going through our world today with this pandemic is alarming and quite nerve-racking to many, yet maybe there are some lessons we can learn from this time of crisis.

I read from one blogger from Italy, a nation that is hardly hit by this COVID-19 pandemic, on how he have learned something from this calamity. He said that he has a “bad” habit of going to a coffee shop 3 to 4 times a day. But since many establishments are closed, coffee shops included, he now brings to work coffee from home in a thermos, and he realized that he was wasting lots of money before. An eye-opening reality.

A day in Florence Italy, before COVID-19 scare

I agree with his realization. Do we really need to go to the coffee shop several times a day? Do we really need to spend lots of our time and money in clubs and bars? Do we really need to eat in a restaurant every night just because we can? Do we really need to go to the mall to buy that 100th pair of shoes?

What we might think is important before, may not be so important after all. This changing times changed our perspective.

I have a friend that posted a photo of a store where uniformed police officers standing guard to a huge pile of toilet paper. That may be extreme, but I believe they were trying to enforce a limit on how much a buyer could get. Who would have thought that we will see something like this, for all we know is they guard only valuable things like gold bars and jewelries. I guess you cannot wipe your behind with your jewelries, nor could it make you clean.

In time of crisis we determine which ones are needs, and the rest are just wants.

It is also interesting in this crucial time that we now have deemed the healthcare workers, (from doctors, nurses, to even the ones that clean and sanitize our hospitals), and the farmers who provide our food, and the grocery workers that stock our food, and the truck drivers that keep the pipeline of essential supplies going to where it is needed, and the police officers that implement the law of lockdowns and curfews – are people more important than movie actors and actresses, pop singers, professional athletes, and other famous people we used to treat as gods.

I have nothing against famous people. What I am against is how we view them compared to the people around us that give us valuable service. Let us give these “regular” people their proper due.

Since we are advised to do social distancing, I encourage all of us to do our fair share of this. I know some of the recommendations by the health authorities may not be feasible to some. Like there is a recommendation that no group of 10 or more people should gather together. But how about those people in very densely populated cities where there might be 10 people already sleeping in one room? How can you do social distancing of at least 6 feet apart, if you already live like sardines?

As we are forced to stay home, let us just be grateful to spend time with our own family – our children, our parents, our siblings – the most important people in our lives that we barely spend time with before. Even though we are not in a beautiful vacation resort or in a cruise to an exotic place, may we find this opportune time with our families, inside the four walls of our home, precious and productive.

It is quite sad to think that it took a pandemic for us to set straight our priorities in life. I know that this crisis will also pass just like every problem we have, but I hope that the lessons we learned from this, we will not forget.

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(*Photo taken during our visit last year, way before the travel ban and lockdown.)

Panic Mode

With the novel corona virus or known as COVID-19 hugging every story line and preoccupying our thoughts and conversations, here are my reactions to these current news:

COVID-19 cases in the US continues to rise, and there are confirmed community spread now here in Iowa.

Bring it on. Our group has been preparing for the worse, and we are ready to be in the frontline of this fight. Just to let you know, our group of Critical Care/Pulmonary specialists, me included, have been brainstorming now for a while on how to respond to this crisis. We have instituted disaster mode schedule to man our ICU’s, though we hope that it will not go to the extreme like what is happening in Italy, where they have to decide who lives or who dies, as there’s shortage of ventilators and ICU beds.

The stock market continues to free fall.

That’s alright. Nothing much you can do about that. Besides, I’m still working and I don’t have much invested in stocks anyway.

The school is out for a month.

Good! At least I know where my kids are. That is they’re at home, and they are safe.

Almost every business are shutting down, including bars, restaurants, shopping malls, and movie theaters.

That’s fine. That would curtail some of our family’s spending

The NBA season and the NCAA March Madness have been suspended.

No big deal. Even though that’s the only thing I watch on TV nowadays, this would give me more time for sleep or tunganga. Or perhaps I could read that book I always wanted to read.

There’s no more toilet paper in stores.

No problem. We still have the tabo (dipper). We Filipinos are not fazed with this toilet paper shortage.

There’s no more rubbing alcohol and hand sanitizer in stocks.

No worries. We still have soap and water. Plus we can improvise with solution of bleach and water for disinfection. Or for kicks, use cheap vodka or whisky as hand sanitizer as some of those strong drinks have more alcohol content than 70% isopropyl alcohol.

All canned goods in grocery stalls have been hoarded out.

I don’t care. We have stocks of gourmet tuyo that our relatives from the Philippines brought us when they came to visit us last month.

There’s no more rice in Costco, Walmart, and all Asian stores here in our area.

Oh no!!! We’re doomed! It’s the end of the world!

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Here’s a song from the days of my youth: