Tag Archives: family

Hospital, Cafeteria, and Sanctuary

26 January 2020

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I was in charge of the ICU that day and it was quite busy. Though it was not that up-to-my-eyeballs hectic for I still had time to go down to the hospital’s cafeteria for lunch. Many times I would grab meal to-go and head back to the ICU work station and inhale my food while doing some computer charting. That day I had the luxury of eating my lunch more leisurely in the cafeteria itself.

Our hospital’s cafeteria is by no means a fancy place to dine in. It is after all a cafeteria serving hospital food. Nothing against hospital food, but if I have time to spare, I will eat somewhere else. Our cafeteria though has a section that has glass wall and ceiling that gives you an atmosphere of being outside. Yes it is still winter and there’s snow on the ground, but the sun was shining that day, so I went there so I could soak up the sun for a change.

However if the hospital cafeteria is as inviting as the photo below, once I settled there they have to pry me like a barnacle from my seat for me to go back to work.

(photo taken in the Philippines at Manila Bay, a few years ago)

Besides the obvious of getting food to eat, there is another reason I stay a while in the cafeteria. That is, it gives me a chance to be away, even for a short time, from ICU work and from the constant hounding from the patients, residents, nurses, and other doctors. Though almost always, when I’m on a lunch break that is when I am called to the Emergency Department for a new admission.

But that day was different. I was enjoying my lunch alone and my phone was unusually silent. I guess the cafeteria gods were smiling at me. I consider these lunch escape my sanctuary – away from the chaos and the harsh reality of the ICU.

The hospital has a chapel too. But that is not the kind of sanctuary I am talking about here. I just needed a place to take a breather.

Then while I was savoring my food, but more so my silent interlude, a man approached me at my table. How dare him interrupt my break time? Who was he to disturb my lunch? Of course I did not react that way and instead I looked up and gave him a smile. It may be forced, but a smile nonetheless.

The man introduced himself and said that he recognized me from a previous ICU encounter. I learned that I took care of his mother in the ICU several months ago. After he gave me some details, I remembered her mother – she had cancer and became septic after receiving chemotherapy. She got very ill very fast and stayed in our ICU for several days. But she recovered.

The man then pointed to his mother, my previous ICU patient, who was sitting in a table a few paces away. They have an appointment with their oncologist at the Cancer Center and that’s why they were in the hospital.

How many patients have we taken cared of in the ICU who was as sick as she was, and have a chance to meet them later after their discharge and were doing relatively well? Sadly to say, that is a rarity. For many of them even if they get out of the ICU, they were never the same. And some don’t even get out at all, I mean not to the world of the living.

This man just stopped by to thank me. It was an interruption that I would appreciate after all.

Then when I was about to leave, a man that I met in the ICU earlier that day sat in a table near me. He was absorbed in his thoughts while eating by his lonesome. Like me he was also taking a break. Perhaps the cafeteria was his sanctuary too, an escape to the sobering truth in the ICU.

Though this man’s predicament was much different than mine. His daughter was our patient in the ICU, and she was not doing well. She had a tumor in her brain that was surgically removed, but even after more than a week post surgery, she remained on life support. Her life was hanging in the balance with uncertain future. Worse part is, she was only 20 years old.

It is very understandable for her family to be heartbroken. No wonder her father rarely leaves her bedside, except for a brief cafeteria break. As a father who has a daughter with similar age, I can only imagine the agony he’s going through.

I needed to go back to the ICU. We needed to help this young lady and her distraught father.

Bye at the Window

20 October 2019

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It’s autumn here in our part of the world and the leaves are changing colors. We see them everyday as we peek through our windows. In fact, we can watch the time go by through our windows and witness not just the changing of the leaves.

When our son was much younger, he would always tell us when we leave to wave goodbye at the window. So as our car would pull out of our driveway, he would be watching at the window and waving goodbye. He would feel bad if we would not wave back at him. It was his some sort of reassurance that everything would be alright. He would do this especially with his mom that it became their tender ritual. So when my wife would leave him even for a very short errand he would say, “Bye at the window, Mom.”

Children seems to have a hard time dealing with being left behind. Remember the first time we let them sleep alone in their bedroom? They would do all kind of delaying tactics so that we would not have to leave them in their room for the night.

Like, “Can you check for spiders on my bed?” “There’s none left, the monster under your bed ate them all.”

Or, “Can I have another drink of water?” “That’s your 5th glass of water, you will pee on the bed.”

I don’t know about you, but our kids did something similar. However we had to be firm in our actions so they would develop that sense of independence.

Maybe you remember when you dropped your kids on their first day of school in kindergarten. Perhaps some of them clung tightly at your skirt or perhaps they wrapped around your leg and would not let go. We have not really experienced dropping our kids in kindergarten since we homeschooled them, but I just wonder what kind of fiasco they could have done.

Our kids are grown up now. Our daughter has been gone for a few years and is almost done with college, while our son is a junior in high school. He still home schools, but he now attends some Advanced Placement classes in a community college nearby. He also drives now, and a couple of months ago his driver’s license was upgraded that he can drive all by himself but still has a restriction that he cannot drive alone after midnight or before five o’clock in the morning.

Few weeks ago, my son humorously told my wife (*in a deeper voice too*), “Bye at the window, Mom.” But this time it was he who was leaving, and my wife was the one waving goodbye at the window.

My wife said that it really felt weird and different this time. She felt so nostalgic as my son was pulling out of our driveway and she waved goodbye at the window for the longest time until the car made a turn at the street corner and disappeared from her sight.

There is definitely a twinge of sadness on these rites of passage. Yet, they must come to pass.

I think we had it wrong all along. It is not our kids, but it is us parents who have a hard time letting go.

(*photo taken by my wife as my son drives away)

New Year, Old Receipts, and Memories

3 January 2017

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It was New Year’s Day. I woke up early even though I stayed up late the previous night and spent it with the company of friends, and did not sleep until past midnight to welcome the arrival of 2017.

What’s up with me? Even how late I stayed up the night before, I still wake up early the next morning. I think it is how I’m wired or just how I was trained – to wake up before the sun goes up. Though that morning, it was past 6 already, yet it was still dark. It was a Sunday too. No work, and no place I needed to go.

But since I couldn’t sleep anymore, I got out of bed, and searched for something to do. Besides, it is a new year, so better start it right. Plus in the Chinese calendar, this year is the year of the rooster. So we really should be getting up early like the rooster, right? Maybe I should have started crowing cock-a-doodle-doo or tik-ti-la-ok (that’s what Filipino rooster sounds like) to wake up the whole neighborhood.

I thought of cleaning up and vacuuming the house, but my wife and kids were still asleep, so I looked for something to do that was more quiet and muted. I found myself in the office room, where the computer and the file box of bill statements were, and decided to do the bills.

What better way to start a new year, than paying debts and doing bills?

Even though I do my bills on-line, I still keep paper bills and receipts on file. As my storage box was already bursting with old bill statements and receipts, I knew I had to get rid of some of the old ones to make room for the new.

As I was looking through the files and files of old bills, I came across the receipt and paperwork of our very first family car here in America. It was a second-hand Honda with about 50,000 miles mileage. We bought that car after I finished my training and after landing a real job. That was 17 years ago and we were still living in Florida at that time.

Having only one car at that time, and with no good public transportation system where we live, my wife and my daughter, a toddler at that time, would go with me when I go to work in the morning. They would wait in the car at the parking lot while I do my hospital rounds. From the hospital we will drive to my clinic and drop me off there. Then my wife would take the car to go wherever they needed to go, and just pick me up later in the afternoon. That way they will not be housebound the whole day, plus my wife could also do some errands like grocery shopping.

When we moved to Iowa in the middle of a harsh winter, we were ill prepared to drive in the snow, sleet and ice. And one snowy morning I ended up driving, I mean slipping, into a ditch that the car needed to be extricated. That was when I decided to trade-in our old Honda, and got myself a car with an all-wheel drive that can frolic in the snow.

While sorting old receipts, I also dug out a hospital bill from Scottsdale Arizona, issued about a decade ago. I attended a medical conference in that city, and brought my whole family along.

While in Arizona, my son who was 3 at that time, started to breathe heavily. He then also started to wheeze, that I could hear even without a stethoscope. Being a trained lung specialist, I knew that there was something wrong. That was the first time we learned that he has asthma, and that he was having a bad asthma attack.

We brought him to the nearby hospital. Not long after, he was given a nebulizer treatment (asthma medicine given via mist) in the Emergency Room. While the nebulizer was being administered with a “cute” pediatric oxygen mask that was shaped like a dinosaur snout, my son was crying. I asked him if he was in pain or if the treatment was bothering him, but that was not it.

When I continued to query what was wrong, he finally said, “It’s purple!”  He was referring to the “cute” oxygen mask that he thought was for girls. That was also the first time we learned that he does not like purple, nor does he like Barney.

I also found from my file box, stacks of old receipts from the gas company, including our very first one when they initially filled the propane gas tank of our house here in Iowa. We have gas tanks (LPG cylinders) too, when I was still living in the Philippines, but the gas tank we have here in Iowa is bigger. Much, much bigger.

Since we live beyond the outskirts of town, there are no gas pipe connection from the city to our home. So we have a large (up to 1000 gallons) underground gas tank, which needed to be filled regularly. Propane gas heats our home during winter, and powers the boiler for hot water. Even our fireplace is propane powered. Where we live, people could endure summers without air-conditioning, but would not survive winters without heaters.

When I was growing up in Manila, I wondered how could Santa Claus dropped by in a house without a chimney? I could have not thought that one day, I would be living in a house with a fireplace and a chimney, even though I don’t believe in Santa anymore. I could have not thought that winters could be this bitterly cold as well.

Even though gas was important for us, I am sure though that it was not just propane gas that kept us warm. In our home, the embers of love is much more important than the furnace and the fireplace. We have spent 12 happy winters in this house, and counting.

I was so absorbed in my thoughts that I have not noticed that the sun was already way up in the horizon. Who would imagine that a file box of bills would be such a treasure trove of nostalgia and memories?

Despite the sentimentality associated with them, I still have to make room in the file box for the new ones. Just like facing a new year – out with the old and on with the new. So I took out the old and outdated receipts, and toss them through the paper shredder.

As for the memories, I am keeping them.

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Nothing To Do In Iowa

30 August 2016

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Summer here is on its last leg, and autumn is knocking on our doors. Yet we are still trying to squeeze out the fun of what’s left of this summer.

Like the summers before, we again had a few friends and relatives from out-of-state who visited and stayed with us here in Iowa. They came from New York, from Florida, and even from out of the country like Taiwan and the Philippines.

One friend who came from Florida, was told by her office mates when they learned that she was flying to Iowa, that there’s nothing to see and do in Iowa. Except if you’re a Presidential candidate and you’re campaigning.

True, Iowa is not a tourist destination, like California or Florida. There may not be much to see here. But for our friends, seeing us, maybe is reason enough for them to visit Iowa.

Yet we tried our best to show our visitors what is here to see. We toured them around the city of Des Moines, the covered bridges of Madison County, and the farm fields of Iowa. Some of them even had the chance to go to the annual Iowa State Fair.

They said that our state fair is truly part of Americana. For where else can you go around the fair grounds while chomping on a whole turkey leg or a pork chop on a stick? Or munch deep-fried Oreos or deep-fried Sneakers? Or see the biggest cow, or the biggest pumpkin? Or see the famed butter cow sculpture?

This summer, we also had the chance to visit other states, like Montana and California. We have a few relatives in California, including my mother-in-law, who sadly to say, got awfully sick and eventually passed away during our visit there. Thus our vacation had a sudden turn of sad events.

She was hospitalized in a small hospital in Hollywood. In fact, the hospital was a couple of blocks from Sunset Boulevard and all the touristy spots in Hollywood. But driving back and forth to the hospital and where we’re staying was not a pleasant trip, as we were most of the time stuck in terrible traffic in the Los Angeles area.

photo taken after we visited my mother-in-law at the hospital

 

My mother-in-law stayed in the ICU for a few days, and I had the chance to talk to her physician. I introduced myself as an ICU doctor as well, so we can have a direct talk about the nitty-gritty details involved, as well as management, and of course prognosis.

The ICU physician was nice to me. Though he was in a bit of disbelief that I am practicing in Iowa. Perhaps he, like many others, have the impression that there’s nothing but corn and cows in Iowa.

He even asked my kids what do they do for “fun” in Iowa. My kids just politely said “a lot” without giving much details. I’m sure the good doctor was expecting answers like going to Disney, or visiting a theme park (which we also have though not as famous), or going to the beach.

My kids could have answered, how about catching fireflies. Or riding ATV in the cornfields with our friends. Or riding bike in dirt trails. Or perhaps just watching the sunset, or counting the stars.

As he was leaving, my mother-in-law’s doctor told me that he felt “sorry” that I live in Iowa. I just smiled and did not answer. It was past eight in the evening, and I knew he was not even on-call that night for he told me so, and yet he was still making rounds and seeing patients.

Me in Iowa? If I’m not on-call, I’m done with work by five in the afternoon, and I’m doing something “fun” by that time. Or maybe I’m just home spending time with my family.

In reality, it was me, who felt sorry for him.

For somebody who have lived in Manila, New Jersey, New York City, California, and Florida, I know what I’m talking about. And that’s why I chose to live where I’m living now.

Yes, there’s nothing to do in Iowa.

me and the bike trail in the middle of cornfiels


 

Home Sweet Home

17 November 2014

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Several weeks ago, when my son came home from a weekend autumn camping, as soon as he entered our door, he shouted: “Hoooooome, sweet home!”

Maybe he sorely missed his comfortable bed after sleeping for 2 nights in a tent and on a hard ground. Or maybe he was yearning for a warm shower, as he had not showered for 2 days, for the campsite where they went to did not have shower facility. Or maybe he got sick enough from using the porta potty, as again they did not have restrooms with running water. Or maybe he was longing for his mother’s delicious home cooking. Or maybe he just missed home.

But this was not an isolated occurrence. In fact, every time we come home, whether it was from a rugged camping, or from a luxurious outing, from a short excursion, or from a long road trip, or even from a dream vacation, like Disney World and Hawaii, he still calls “Hoooome, sweet home!” as soon as we enter our current home here in Iowa.

That makes me ponder, do my kids really regard our home as a “sweet home?”

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Recently, my wife have transposed our old video cassette tapes into DVD’s and we watched a few of the tapes we have. I enjoyed specifically the ones when my daughter and son were much younger, when we first moved in to this house. Our first summer. Our first Thanksgiving. Our first winter. Our first Christmas. Our first Christmas tree. And other special events.

But there are also the “not-so-special” events that may have not been videotaped, but captured in my memory nonetheless. My kids running in the yard. Raking the fallen leaves and then jumping into the pile of leaves. Watching the deer in the yard, eating our flowers. My wife chasing the deer away. Plowing and shoveling snow (though that’s not my favorite). My kids making snow forts and igloos. The hurried breakfast. The more relaxed dinner. The bedtime rituals with my children. My kids playing music. And the times we just plain playing goofy.

We have lived in this house for barely 10 years, yet I am already packing so much memories in this home, that will last a lifetime. I know I have cherished memories from our home in Sampaloc Manila where I spent more than 25 years of my life. But those memories are now being rivaled in this home where we currently live.

As I looked into every corner of this house, there’s a fond and loving memory attached to every nook of it. The porch. The stairways. The kitchen. The family room. The sun room. The basketball driveway. The yard. And even the guest bedroom, where my mother who have recently passed on, spent several months with us, every time she came for a visit.

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Yet in the end, I don’t think it is the house itself.  Rather it is the people that we surround ourselves and share these beautiful moments with, that is really more precious. And those people, we call our family.

As we approach another Thanksgiving season, just like the Pilgrims of old, who celebrated and gave thanks for their new country and their new home, I join them, and as a pilgrim myself, in thanking God for our home sweet home.

Last night, as we experienced an early snowfall this season, and after driving, or should I say slipping and sliding in the snow, and after a few tense moments of treacherous travel, we finally arrived home safe and sound. After pulling up in our driveway and entering our garage, my son once again exclaimed, “Hooooome sweet home!”

Right after he got out of the car and entered the house, he also complained, “Mom, it still smell like fish in here!”

It is home alright.

(*photos taken with an iPhone)

Of Goslings and Ducklings

6 June 2013

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June has rolled in upon us. The entry of this month heralds that spring will be officially transitioning into summer here in the northern part of the hemisphere. Born and raised in a tropical country, where there is eternal summer, I can’t wait for the summer to come, after experiencing a harsh winter here in Iowa. Come to think of it, we even had a snowstorm in May this year!

Another thing that June is known for is weddings. This month is named after Juno, the Roman goddess of marriage, and that may be the reason why it is the most popular month to tie the knot. Many couples will take the plunge this June and start their own little family.

Speaking of family, it’s not just humans who raise their little family this time of year. I can see mother deer and their fawns, as well as big and little rabbits frolicking in our yard, much to the dismay of my wife, as they eat her flowers.

A few mornings ago while I was running, I saw a family of geese swimming in the pond near our place.

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A couple of weeks ago, we also came face to face with a family of ducks, while we were dining in a restaurant that is beside a man-made pond.

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Like the seasons, with spring turning into summer, then into autumn, and finally into winter – these little goslings and ducklings will grow and mature, and then not too long after, they will become parents and will have little critters of their own.

It was spring last year when we learned that my wife was pregnant with our third child. And it was also spring last year that we lost our supposed to be third child in an early termination of pregnancy.

Few nights ago, my wife commented that we could have been holding our 5-month old baby right now. Yeah, that’s an endearing thought.

But we don’t dwell on the “what ifs” and “could have been.” We have long accepted that it was not meant to be. Besides we have two “older” children that are constant source of joy and inspiration for my wife and I.

Being a parent, I believe, is the greatest privilege that our Creator have endowed us.

For all the parents out there who have little ones right now, can you please hug your babies a little tighter, for our sake. May you all have a beautiful summer.

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Life’s Gifts and Surprises

Still My Beating Heart

5 November 2011

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She laid there motionless in the ICU bed. The only movement was the regular rise and fall of her chest as the ventilator blows air into her lungs. The only activity in the room was the continued bleep and tracings of the bedside monitors attached to her, indicating that she still has a blood pressure, and a heart beat, for otherwise she really appeared lifeless.

As I entered the dimly lit room, I noticed a photo on top of the counter near her bed. It was a photo of a happy family. In it was the patient and her husband, surrounded by their eight children. Yes, eight. That was kind of large family to an American standard, or perhaps anywhere else nowadays.

I appreciate families placing photos beside their loved one’s bed. Especially in our patients in the ICU as most of the time we never knew them before they got sick and deteriorated to their current condition now. Somehow the photos gave us an insight to the life, a snapshot if you will, of whom we are taking care of. It humanizes them, at least to us. That they were someone’s mother, or wife, or friend. Or they were once a decorated soldier (as their uniform indicate), or a coach, or a teacher. That they are not mere blob of a body hooked to life-sustaining machines.

My patient was in her early fifties. I learned that all the eight children that she have, were all adopted. They ranged from sixteen to eight years of age. That tells me what kind of person I am caring for. A woman with such an enormous heart, with overflowing love to adopt eight kids, and call them her own.

Unfortunately, it was also her heart, I am talking now of her anatomic organ, that caused her illness.

Few years ago, she needed an open heart surgery to replace one of her heart’s valve, the aortic valve, which was diseased. The aortic valve is the one that opens and closes as the heart pumps out blood from the left ventricle (the main pump chamber) into the aorta (the big artery that distributes blood to the head and the rest of the body). Her aortic valve was replaced with an artificial mechanical valve.

A replacement mechanical valve can last for many years, in fact, a lifetime, unlike a tissue valve (usually a pig’s or a bovine’s valve) which only last an average of ten years. However, a mechanical valve increases the risk for forming blood clots, and thus the recipient of those valves requires to be on blood thinners (anti-coagulants) permanently.

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mechanical heart valve

A few months ago, our patient underwent a necessary outpatient simple surgical procedure that required her anticoagulation to be interrupted briefly. Sadly to say, this caused a catastrophic event. She developed blood clots that led to a very extensive stroke. Our patient really never recovered completely after that. In spite of all the efforts and rehabilitation, she never walked again, she never spoke again, nor she did much of anything anymore.

I can just imagine the heartache to her husband and their kids to see her in that state of helplessness. But their family tried to move on.

And now this happened. She developed a severe bacterial infection that spread into her blood system. She went into septic shock. This infection caused a bacterial nidus to settle in her mechanical heart valve, a condition called septic endocarditis. The problem with a prosthetic metal valve affected with an infection is, it cannot be treated with antibiotics alone, it needed to be removed or replaced surgically. A surgery that she perhaps cannot survive through, nor can she survive without.

As I met with her husband and discussed her grave situation, he softly told me, with tears rolling down his cheeks, that the most loving and humane way of caring for her, was to let her go. I cannot agree with him more. And as we end our talk, he was not the only grown up man with tears in his eyes, for I did too.

The children came one by one to her room and they said their final goodbye. It was so painful to watch. After that, the life support was taken off. All the medication drips, except for medication to keep her comfortable, were shut off.

After several quiet moments of waiting that seemed like an eternity, her beating heart……the heart that was large enough to adopt such a large family, and the heart with such infectious love to share, and the heart that beat for others…..became still. Very still.

Search for the Perfect Tree

6 December 2010

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Six years ago we had our first real freshly cut evergreen for our Christmas tree. When I was growing up in Manila, we rarely put up an artificial Christmas tree if at all, more so a real live one. I don’t think there are available real pines for Christmas trees back home? And even if there are, we surely cannot afford them anyway.

The real ones were so much better, from the way they look, the way they feel (though sometimes prickly), and the way they smell. We like them very much that every Christmas we had real ones ever since, except for last year.Well, last year was when we exchanged our white Christmas for a warm Christmas, when we went back home in Manila for the holiday season. In fact, that was my first Christmas back in the Philippines after 15 years of living abroad.

About two weeks ago we went to a tree farm to choose and tag our Christmas tree. So there we were, in a freezing cold, out in vast open farm, with endless rows after rows of evergreens, looking for the perfect one. After passing tree after tree after tree, they all looked the same to me. But my wife has strict criteria. “Oh, that’s too tall. That one is too small. Oh, that’s to shaggy. That’s too baldly. That’s too fat. That’s too thin. That’s too asymmetrical. That’s too…..”. And so on and so forth.

After several minutes of walking through several rows of trees, my wife sensed my lack of enthusiasm, so she sent me and the kids to the farm’s office to get warm. She continued her quest to look for the perfect one. She probably looked over hundreds of them, and I’m not exaggerating.

It was comfortable and toasty inside the farm’s store and office. There was even a man dressed like Santa in a corner handing out gifts. I told my son, who is seven, to go and sit at his lap so he can have the loot that he was giving away. However, he did not want to go, and told me that Santa might have a bad breath. I tell you, my boy is either anti-Santa, or too old for that, or too smart that he knew that the loot from Santa was not worth the trouble. So we just bought popcorn and watched the toy train as it rolled through a miniature town on display while we waited for their mom.

After some time, that seemed like eternity, my wife have not yet returned so I got worried. I called her then on her cellphone to make sure she was still doing OK, and that she was not lost in the forest of trees, or got kidnapped by Christmas elves. She answered and said that she was doing fine and was near a decision on picking the right tree. Sure enough she came back minutes later and told us that she tagged the perfect one.

Yesterday, we went back to the farm to have our chosen tree chopped down and wrapped so we can take it home. You see, you don’t want to harvest your pine too early, or it will dry up and lose all its needles even before Christmas arrives. So usually we choose and tag it by the last week of November, and have it cut down and bring it home by early December.

Our pine was cut down, wrapped, and was tied on top of our car. We then went home with our perfect tree.

After all the trimmings, the decorations, and the lights were placed, I admit that it was beautiful. As I stood beside it with my wife and kids, and gazed some more, I agree that it was indeed a perfect tree. Not that I can tell the difference from all the other evergreens that I saw in the farm. But what makes it perfect are the people I am with as I stood there watching. People that I hold very dear in my heart.

our perfect tree