Of Hawks and Turkeys

Last Saturday was gray, damp and cold. It was windy too with strong wind gusts all day. It was a dreary day. I hope Thanksgiving would be a better day as it may be hard to be in a thankful spirit when you’re freezing, fighting fierce winds and just trying to hold on to your hat.

As we were going out, I noticed a large bird hovering high above a field. It could be an eagle as we have eagles in Iowa, though rare. But I believe it was a hawk, as they are so many here in our area. Hawks and strong gusts of wind are what we have in abundance here in Iowa, so no wonder our two big State Universities’ sport teams are called Hawkeyes and Cyclones.

I know hawks or even eagles may not be the right bird to talk about during this occasion. We should be discussing turkeys, right? By the way, wild turkeys abound in our area as well. You can spot them just hanging out in the empty corn fields. Perhaps we can skip the grocery and just capture one of them and make it our dinner for the Thanksgiving.

Enough of the turkey, and back to the flying hawk that I saw. Maybe flying was not the right term, for it was barely flapping its wings. It had its wings open, and like a big kite, it was effortlessly gliding in the sky. It did not seem to mind the strong gusts of wind, and may even be thankful for it. For the stronger the wind, the higher it soared.

Sometimes the strong winds in our lives, those gusts that we think will shred our plans, and those storms that can blast our dreams away, may just be helping us soar to higher heights.

Last week, the lady in the gym’s reception desk, the one who greets me cheerily every time I come in, gave me a book. The book was entitled “Praise God for Tattered Dreams.”

I have observed this lady as always upbeat and has a sunny disposition in life, day in and day out. I am impressed on how she remembers all the names of the gym goers, as she greets everyone by name. And I mean everyone.

Few months ago this lady, after greeting me for years since I have been coming to this particular gym, learned that I am an ICU doctor. She then told me that she was a patient many years ago, in the hospital where I work, and even stayed in the ICU. But that was a couple of years before I came to Iowa.

Since then whenever she sees me, she would always try to convince me to write a journal about my experiences as an ICU physician. She said that it may be interesting to share those stories, and I may even make some money from it.

Last week, after coaxing me to write a journal every time we meet, I finally told her, that I was indeed already writing a journal. Well, sort of. I told her about ‘this’ blog. I rarely tell people I know, that I blog. Why? So I could write about them!

After learning that I write, she went to the back, retrieved a book from a drawer and handed it to me. She told me that she wrote and published this book, and it’s about her trying experience. She added that I can borrow and read it, but if I spill coffee on it, then I have to buy it.

She narrated in the book that she was a vibrant mother with two young boys, and with a promising career, when out of the blue, she suffered a near-fatal stroke. It was a large bleed in the head. She was only 33 years old at that time.

She was close to death when she was brought to the hospital. The doctors, including the neurosurgeon, gave her only 10% chance to live.

But she lived!

She was comatose for several days and spent 3 weeks in the ICU, and a total of 3 long months in the hospital. This does not include several more months of rehabilitation after being discharged from the hospital.

She described that half of her body was paralyzed and was unable to speak for a while. In that dark moment of her life, she found God and discovered a new purpose in life. When she felt that her dreams have ended, God showed her that she was only beginning to live a more meaningful life, for which she was very thankful for.

Now she is speaking and walking with almost unnoticeable residual of her stroke. She is happily working in the gym and encouraging people to be healthy and happy. She definitely has a story to tell. From tattered dreams to an inspirational life.

As we gather around our dinner table this Thanksgiving, with our roasted holiday bird, (the turkey, not the hawk), let’s thank God for everything. Including our trials and disappointments. For storms and strong winds can make us soar higher.

Happy Thanksgiving!

IMG_5638(*photo taken with an iPhone)

 

Slow Run

It’s summer here in our place. Well, not quite officially, as the summer solstice is not until June 21 which marks the official start of summer in the northern hemisphere. Yet the mercury is rising, as our high temperature for the past few days and the coming week will be in the 90’s to even reaching 100 º F.

But this morning, it was a comfortable 74 º F, so I went out for a run. It is also about this time of year that I should start preparing for the half marathon, if I should decide to join again this coming fall.

As I was approaching the small pond in my running route, I have to stop and let the family of geese get off the road before I could pass. The mother goose was already hissing at me as I was approaching them. They can be very territorial you know. But that’s fine, I can share the road with them, and I have no plans on swimming in their pond.


When I came to the wooded areas, I also saw a deer. But it bounded quickly away before I could take out my phone out of my pocket to take a photo. It might be sneering at me that I am too slow.

Same thing happened when I came to an area where a couple of wild rabbits were on the side of the road foraging for food. They also scurried away at the sound of my slow feet, before I can get near them. They may also laughing at me for being slow.

I admit, I am getting slower. Maybe my age is catching up on me. I have no match for the swiftness of the deer and the hare. They seem to dash so effortlessly and yet so gracefully. While me, I push for every step of my way to get to a pace that runners would even consider “running.”

Maybe all of us can relate in one way or another, and in different endeavors, that we feel we are no match to the “competition” we are going against. Whether it be in sports, or in school, or in our work, and in life in general.

Then as I was fighting my way uphill, I saw this guy.


Yes, that is a snapping turtle. And I was “quick” enough to take a photo of him.

They are called snapping turtles not because they snap their fingers as they go, rather they have the ability to snap, as in bite an attacker. That’s why I kept my distance.

The pond, or any body of water that I know in this area, was hundreds of meters away. I don’t know how long it would take him to get there, if that was where he was heading. But I’m sure his slow pace does not stop him from continuing, for that’s who he is.

It gave me a good insight for the day.  Life they say could be like a race. But it is not always for the swift, but to those who kept on running.

 

Not Bound for the Promised Land

During our trip to the Holy Land, we visited  a place known as Mount Nebo, which is located near Madaba, Jordan, or the land of the Moabites in Biblical times. It’s pretty high that it provides a panoramic view of the surrounding areas around it, including the land known as the Biblical Canaan.


On Mount Nebo’s highest point, the remains of a church and a monastery was discovered in 1933. Today a Christian chapel stands on its site.


As we were enjoying the view beneath an iron cross, the tour guide was giving insights and explaining the significance of this place to our group.


While another group near us was having a devotional and they were singing the hymn “I am bound for the Promised Land.”

You probably know or heard that song:

I am bound for the promised land,
I am bound for the promised land
O who will come and go with me
I am bound for the promised land.

But the irony of this is, historically, here in Mount Nebo was where Moses stood and God showed him Canaan, the Promised Land from afar. But here also in Mount Nebo was where Moses died and was buried, without reaching the Promised Land. Moses was not bound for the Promised Land.

Moses, even though he was chosen by God to lead the Israelites out of Egypt and to go to the Promised Land, was not allowed to enter it. All his life work – including 40 years of top-notch Egyptian education, including military tactics and operation, and another 40 years as a lowly shepherd just to learn patience in preparation for his mission, and finally 40 mighty years of leading God’s people out of Egypt, and into the wilderness, on their way to the Promised Land – yet he never set foot to that land.

Was Moses a failure then? Not at all!

Sometimes we are assigned something to do, but we may not see the conclusion of that work. We may have started something that we are not able to finish, not because we are a failure, but because it is not planned for us to fully fulfill that. For God has some other plan for us, or He had appointed another one to finish the work we have started.

More importantly, when Moses stood there in Mount Nebo, while looking at the Promised Land from afar, he did not complain to God why he was not allowed to enter the land that is “flowing with milk and honey.” A land that was promised to his ancestors, Abraham, Isaac, and Jacob. A land he probably dreamed of claiming all his life. He humbly submitted to God’s plan for him.

He may have not entered the Promised Land here on earth, yet God had a better plan for him. For he was taken up to the Promised Land in heaven.

So we may not be able to achieve the dreams or goals we set for our lives here on earth. We may never live a life so rich that it is “flowing with milk and honey.” We may not be able to claim the “promised life” we hoped for here on this world. We may not be bound for the earthly promised land.

But may we set a higher goal, the one God had promised for us. To live in heavenly Canaan with Him.

(The sign under the cross reads: “Just as Moses lifted up the serpent in the desert, the Son of Man must be lifted up, so that everyone who believes in Him may have eternal life.” John 3:14-15)

 

Harvest Time

This morning I went for a long run, in preparation for the half-marathon that I would be participating in. The event would be in 2 weeks.

My long runs have been getting longer, and sometimes it can be tedious and boring. Maybe I should play Pokemon Go while I run to make it more exciting, and capture those fleeting critters.

I did not capture a Pokemon, but I captured these photos while I was running:

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Yes, it is harvest time in this part of the world I’m living in. The fields are golden brown, the days are getting shorter, and the wind is getting colder.

In this particular field, they were harvesting corn.

Why are they harvesting corn? Because they sow corn! Shouldn’t it be that way, we harvest what we sow?

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Maybe some cynics out there may disagree with me, for I know we are living in a world where so much injustice abound. People seems to reap what they did not sow, or have been harvesting in fields that are not theirs.

In my home country, we even have a proverb for that: Ako ang nagtanim, ako ang nagbayo, ako ang nagsaing, pero iba ang kumain.

Loosely translated, it says, I was the one who planted, I pounded, and I cooked, but somebody else ate it.

Yet I still believe in justice.

Lady Justice may seems to be blindfolded (I don’t know why it is portrayed that way) to the unjustness and repression happening all around us. And I’m not blind to that. But I know it as a fact that in the end, justice will be served.

That day of reckoning will come to all of us, when we will harvest what we sow.

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(*photos taken with an iPhone)

Serendipity

Serendipity: the occurrence or development of events by chance in a happy or beneficial way.

Several days ago when my family and I were driving to Glacier National Park in Montana, while we were in a middle of nowhere in a lonely highway, we came to a site that was unexpected, at least for us. We had to stop and enjoy the view, for just a little longer.

Of course we were expecting great views in Glacier National Park, a wilderness in Montana’s Rocky Mountains, known to be one of the most picturesque landscapes in North America (I’ll make a separate post about Glacier National Park later, I promise).

However, while we were still hours away to our destination, we serendipitously saw this field full of bright yellow flowers with the snow-capped mountains seen from the distance. It was  just us and some bees on that field.

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a field somewhere in Montana

Later on we learned that they are canola plants, the source of canola oil, and are commonly farmed in this part of the US. We were just not familiar with them. But still, I think you’d agree that it was such a beautiful sight, right?

Sometimes in life, there are things or events that we are not expecting, but happen as a pleasant surprise. Of course the opposite is true as well, when we have such high expectations and then we become extremely disappointed by the turn of events. We even have a law for that – the Murphy’s law: “If anything can go wrong, it will.”

Well, back to the positive side of things, there are also “mistakes” that turned out to be just right. The discovery of Penicillin and the development of Post-it are prime examples.

Are there really fortunate happenstance?

When I was applying for Internal Medicine residency training program after I graduated from medical school in the Philippines, I sent out more than 50 application letters to different universities and hospitals in the United States.

A classmate of mine who was also applying, gave me a list of US hospitals and universities that would likely accept foreign medical graduates like us. I am not sure where he got this list, but that was an era before the heyday of the internet, whereas now you can “google”just about anything.

The list that he gave me was scribbled in a hospital’s pad paper with a letterhead. So I sent applications to all those on the list. And for good measure, I also sent one to the hospital on the letterhead, even though it was not on the list. How did my friend got the stationery? I have no clue.

Out of more than 50 applications I sent, I received only 8 or 9 invitations for interview. I needed all those invitation letters to apply for a visa to enter the United States.

You know that traveling from Manila to USA cost a fortune, not to mention traveling to different States where those hospitals were located, and so with limited resources, I was forced to choose only 3 hospitals to go for an interview – all were in New Jersey and New York, and all within a train or a bus ride away from each other.

After all the interviews, each applicant would rank their preferred hospital or training program, while every hospital would also rank their chosen applicants out of the hundreds they interviewed. Then the National Resident Matching Program matches all applicants to training programs by using a mathematical algorithm. There’s always a chance that an applicant won’t be accepted nor matched.

Where did I end up matching and doing my training?

I matched at a hospital in New Jersey that was an affiliate of Columbia University. Though this hospital was not on the list that I was given. It is the one on the letterhead of the stationery with the list!

Serendipity? Maybe it is destiny.

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(*Photo taken with an iPhone)

Purple Crown and Thorns

(I know Prince’s untimely death has hugged the news in the past several weeks and many people wrote articles with “purple” theme, but this post has nothing to do with Prince.)

There are things in this world that are unwanted.

When I went out for my morning run today, I came near a pond and a large mother goose was standing at the middle of the road. Nearby is her family. The protective mother goose stared and hissed at me. I was an unwanted guest.

I went slowly and timidly, as far as I can on the other side of the road, so not to agitate the goose further. After I passed them, they quietly slipped into the water and swam away.

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Not long thereafter, another bird, an aggressive red-winged blackbird hovered wildly above me. It made repeated dives on my head while chirping loudly. I think she has a nest nearby, and she’s telling me to go away. Definitely I was unwelcome there.

I probably would do that too, if an intruder whose intention I am not sure, would go near my family.

But there are other things that are unwanted and unwelcome, which we try to get rid of. Like weeds and thistles from our lawn and garden.

Back to this morning run, after my confrontation with the goose and the blackbird, I went out to the lonely gravel road to continue on my run, where I have not been for a while. There I noticed this purple thistle at the side of the road.

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I did not know that this weed, can grow this tall, as the moment we see it in our garden, we pull them out immediately. I did not know as well that it can produce beautiful purple flowers. Thorny yet exquisite.

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thorny crowns

This weed is known as the milk thistle (scientific name: Sylibum marianum). It was named such due to the milky sap that the plant produce when cut. It is native to the Mediterranean, but is now found throughout the world.

It is not just in the manicured lawns and gardens that it is unwanted. Even in prairies and pasture land where cattle roam and graze, farmers try to eradicate them, as they are considered noxious weed. The reason is it can be toxic to cattle, sheep and other livestocks, if they eat them.

So most of the time, this purple weed is left to grow only on the side of lonesome roads, or in wild, forsaken places. An outcast, if you will.

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But I will argue that despite being unwanted by most of the world, it survives. Defiantly existing to show its beauty for anyone who would stop and appreciate. It has spiny-edged leaves, prickly stems, thorny crowns, yet colorful blooms.

My little research also tells me that this thistle even though it is toxic to cattle and other ruminants, it is perfectly edible and safe to humans, provided we don’t eat the thorns. There’s even studies to suggest that it has medicinal property, like treatment for liver diseases, and also been looked at to treat cancer.

An unwanted and lowly prickly thistle. Yet there’s beauty and purpose for its existence. Just like many other things in our lives.

I know you have an annoying classmate or officemate that you wish would migrate to the moon. Or you have unwanted daily tasks that you wish you don’t have to deal with. Or you experience thorn-on-the-side everyday challenges that you hope to live without. And the list of “unwanted” things go on and on.

Yet they exist for a reason. We just have to look a little closer.

(*photos taken with an iPhone)

 

Ripples

The other day, while I was out for my morning run, I looked up to the sky and saw an interesting cloud formation. It looks like ripples.

I know ripples, or a series of small waves, can form in water, that is in liquid form. I guess ripples can form in water that is in gaseous state as well, which are the clouds. I wonder what caused this cloud ripples. Superman’s supersonic boom?

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cloud ripples

I am always fascinated with ripples. Have you ever watched it form from a small drop of a pebble to a bigger and bigger concentric circle of wavelets that reaches the other side of the pond? From a small plop, to a huge effect.

When I was a child my father taught me how to skip stones in the surface of the water. So whenever we come to a water’s edge, like a river or a lake, I tried to skip stones. Many times it will bounce once or twice before it sink, though at times, I can have the stone skip more than that. (The world record for the number of skips according to Guinness Book of Records is 88, imagine that!) When I get tired of skipping rocks, I just throw one far out and watch the ripples form.

The science behind the ripples is both simple and complicated. From the disturbance of the medium, to the preconditions of periodic motion, to the formation of traveling waves. I’m sorry if I caused you bad memories of your high school physics. In simplistic term, a wave of energy is created from a source and is send out and grows in magnitude.

Do you know that we can create a ripple effect too? No, I am not talking about plopping yourself in the water. Though I know many of us will create a tidal wave when we jump into a pool.

What I mean is no matter how small our acts may be, it can create an effect that has much bigger consequences. One simple smile, or a little helping hand, or one small gesture of kindness, can induce a wave of good vibes and positive effects on others, more than we know. The same is true with a frown or one little act of rudeness can spread ill feeling to a much larger circle around us.

So what would your ripple effect be?

(*photo taken and edited with an iPhone)

 

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.

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