Steak and Rye

It was late afternoon of New Year’s Eve, and I was rounding on our patients in the ICU. I came to one room and the patient was sitting upright in his bed. On his bedside table was a tray with a large piece of steak on a plate, a drinking glass, and a bottle of rye whisky. What? Is this a restaurant or hotel? Is this the new hospital food?

Most of our patients in the ICU are not awake enough to eat food, let alone have a solid meal like that. We provide nutrition through a tube in their nose that goes to their stomach and they feast on liquid feedings. Or if their gut is not working, we give them “gourmet” nutrition through their veins. In fact once patients can eat solid food, most of the time they graduate out of the ICU.

But what about this patient? A slab of steak? And is alcohol sanctioned by the hospital now? Here’s the story.

He presented to the hospital with worsening shortness of breath. After some imaging work-up, he was found to have a large tumor in his chest. I saw him several days ago when he was admitted in a regular room, not in the ICU. We were consulted for the lung mass and I scheduled him to have a bronchoscopy (a procedure putting a flexible scope to the lungs) and biopsy.

However before the scheduled procedure could be done, he suffered a cardiorespiratory arrest, got intubated, was hooked to a ventilator and was moved into the ICU.

Good thing was despite the circumstances, he improved enough that we got him off the ventilator. Yet we don’t have a tissue diagnosis to confirm that what he has is cancer, even though the signs indicated that it was malignant. But we needed to be sure.

So I proceeded with a bronchoscopy and got a biopsy, and finally established a diagnosis. It was lung cancer alright.

Unfortunately his condition got worse again. He again required ventilator support, though a non-invasive type, which is like a CPAP machine. I told him that the final pathology proved that it was cancer. And based on its extent, plus with his grave condition, he was an unlikely candidate for any surgery, or chemotherapy, or radiation to treat his cancer.

That’s when he decided that he wanted to go on his own terms. His own way. Like Frank Sinatra’s song, “I did it my way.”

He requested that we discontinue the non-invasive ventilator, even though he was struggling without it. He asked to have a New York steak and a bottle of rye whiskey for his last meal. So in between labored breath and heavy heaving, he chomped on his steak and sipped on his rye.

When I came to his room that afternoon, despite his terrible situation, he was even smiling while having his last supper.

After he had his meal, we transitioned him to full comfort care per his request. No more ventilators, nor machines, nor any more interventions. Only comfort medications. And while he was watching TV in his ICU bed, waiting for the ball to drop in New York’s Time Square, he quietly slipped into a blissful sleep.

Just before the old year ended, our patient went out peacefully into the eternal night. He exactly did it his way.

For us who made it through another year, may we find new aspirations, new hope, and renewed zeal for life, as we face this new year.


New York’s Higher Learning

“If I can make it there, I’ll make it anywhere. It’s up to you, New York, New York.” …….Frank Sinatra

New York City. Arguably the center of the world. Many people from every part of the globe would like to make it their destination, and find their luck there. And like in Sinatra’s song, “I want to be a part of it, New York, New York.”

And it was.

I had so many experiences and lessons learned during my few years of stay there. First, was the educational and post-graduate specialty training that I received in the top medical institutions there. This became the foundation of my professional career, from which I draw my livelihood to sustain my family. Somehow, I still feel proud, unwarranted or not, to claim that I am New York-trained.

Second, it was in New York, that my first child was born. It was here that I first experienced the joy of fatherhood. With that though was the realization of the responsibility beyond just fulfilling my own dreams, but also providing for the future and dreams of my children. For this reason, I learned to strive even more harder.

It was also in here that I learned to tap on my apartment’s ceiling at 2 o’clock in the morning, to stop my neighbors’ dance party, who lives above me, so my wife and I, and my newborn baby can sleep. I guess you need to learn to fight for your right and speak up your mind, if you “want to wake up in that city that never sleeps.”

waking up in a city that never sleeps (image from

This is where I chased an intruder who was able to enter my apartment, out of my door, down the stairs of the apartment complex, and through 2 blocks of crowded streets. On hindsight, I should have never run after that thief, for I could have been killed, especially if he was carrying a weapon. But when the adrenaline was pumping through you, I guess it bypasses your brain and your better judgement. It awakened my territorial and survival instincts.

It was in New York City that whether you are at work, commuting in the subways, or walking in the streets, people have learned to: mind your own business; rely solely on yourself; trust no one; and don’t walk, run. And so did I.

But it was in the last few months of my stay in New York that I received my greatest education. After changing my decision to stay in the US for my children’s sake, instead of going back in the Philippines after my post-grad training, I had to switch my visa from an exchange visitor (needed for the training)  to a working visa (needed for a real job). A process that can take some time. And in my case, it did.

After completing 6 years of specialization, and armed to the teeth in training, I was all gung-ho to start work. But I was put on hold……Suspended animation….. As I cannot work without a change of visa, I had no choice but wait. Days of waiting turned into weeks……and weeks turned into months……and months into several more months…….

In a place that is always hustling and hurrying, a place where it only takes a fraction of a second from the time the traffic light turns green to time the car behind you honk its horn, a place where times ticks a little faster like in a New York minute – is where God taught me patience, and the virtue of waiting.

With no work, no income, and with a 5-figure amount in dollars of credit card debt, that was increasing by the day, I was forced to leave my apartment because I plainly cannot afford it. My family became one of  the hundreds of homeless people in New York City. Our only difference from the other homeless people who wanders in the streets, was that a caring family took us in and let us stay in their home, without paying rent, and even fed us for free.

homeless in New York (image from

During the several months that I was jobless, we moved from one family’s home to another, relying solely on their goodness and mercy. It was here that I experienced complete helplessness in providing for my family. I realized that in life, diligent and hard work may not be enough, for we all need grace.

Then every week, when we went to our church, church members and friends who knew our predicament, will quietly hand me $10, $20, or $50, telling me to buy something for my daughter who was 2 years old then. I knew these people were not rich. They too have barely enough and just trying to make both ends meet, but they shared the little that they have. It was a touching experience. And it was a humbling experience.

From being independent, to becoming fully dependent. From minding my own business, to others caring and looking after my own business. From trusting no one, to fully trusting and having faith. It was a complete turnaround. It was in New York City that I found renewed confidence in people and a stronger reliance in God. It was here that I received a course of “higher” learning.

After more months of waiting and still out of work, my family and I finally flew to California and stayed with my sister-in-law to escape the harsh winter. I left New York City with a heavy heart but thankful, humbled but not defeated, broke but hopeful. I admit, I was also wiser, more enlightened and insightful.

Three  months after we left New York, only then did I received what I was praying and waiting for.

New York, New York. Yes, I made it there (though barely). And I believe, I can make it anywhere.