Whatever happened to superwoman
there she is
conquered by separation anxiety
tempered by baseless guilt

And the walls have trapped you in,
and you grumble in your defense
She is not made to bend by the walls
she stops before she is lost

You two
You were made in different worlds
Better divided
than crumbled by your worst.

Understanding you means understanding your core. Getting to it is painful. Getting out is painful, too.
But could you numb me and take away the pain?
We could afford some numbness. But you see, pain is pain. We could numb it again and again. You would need to heal to truly take away the pain.
Then why do I have to go through that horrible pain?
Because maybe, just maybe, I can heal you.

Didn’t I tell you it will hurt even before we started?

Hindi ko alam kung ano na tong pinapasok ko. Madugo pala.

You ain’t getting through the core until it’s gritty.

Ang iba ang nilalaman, punong-puno, sobra-sobra ang ibibigay. Ang iba naman ang kalooban puro peklat na, wala ka nang makuha. Ano kaya ikaw?

Wag mo na itago yan. Mas masakit pagtinatago mo.

ang bone marrow biopsy.
malaman.
bow.

Thank you Hema for the BMAs.

“Sino si Jimmy?” I was asking myself as I walked home. Somebody with a chronic disease? Somebody with terminal cancer? By the way his daughter remembered me and how she seemed happy and open enough to update me, I knew he was one of the patients I did touch the life of. It reminded me there and then that these are lives of people we touch as doctors and it is indeed a great responsibility. Every little encounter might have an impact to the patient and their family. I have always been very slow in seeing patients wherever I am. One reason is because I couldn’t resist having to always appraise and explain to the relatives and the patient. If patients need empathy, I’d give them. I think that I’ve been a good doctor in that way. I am happy that med school starting from subjects like Introduction to Patient Care has taught me that–to always go beyond just the biomedical aspects, but also see the psychosocial, economic, and cultural issues surrounding the patient’s disease.

Today, however, I just felt guilty because I have been a very bad doctor. I had bitterness. I had bad sleep. I’ve also been having nausea and troubling polyuria and polypdipsia. I was very grumpy and I scolded 3 of them unnecessarily.It was indeed a horrible day. In the middle of OPD continuity, I just sighed to myself. “F*ck. Ayoko na.” I remember, I said to one of them:
“Ano po? Hindi ninyo matandaan ang gamot na iniinom ninyo!? Ano po?! Kaninang umaga lang ang huling inom ninyo, hindi nyo ba po agad matandaan!? At iisa pa lang po yon. Isang gamot. E madali po pala kayong lasunin e, hindi nyo alam kung ano ang iniinom ninyo.” Then I realized I was too harsh. What if he had bigger problems that day? What if he was just really forgetful? I had to ask him why he didn’t remember. He said he’s just forgetful. I had to explain the importance of knowing his meds and offering an alternative by asking him to list down his meds and always keep in his pocket. He thanked me at the end of the visit. And I had to joke him because of my guilt, “Salamat po saan? Sa pagpapagalit ko sa inyo? wala pong anuman.” He laughed and promised me that he will remember all his meds from now on.

I just wonder how many Mang Jimmy’s out there would remember me for the comfort I gave them and there family? How many Mang Jimmy’s out there would loathe me for my bad days when I scold them. It is indeed a challenge to be a doctor–to put oneself behind, however one feels bad, and put the patient at the center. Or maybe, the greater challenge is for the doctor, to appreciate life more, and live a life of well being and happiness so that every patient encounter is filled with a projection of the beauty of this sacred life.

RIP Mang Jimmy.
To doctors out there, let’s celebrate life and our power to share that celebration with our patients and their families.

Do I deserve the silence
The equivalent of your space
And what of your undefined hostility
anger or just plain indifference?

I ask calm in return
of my turning my back on you
For it is as much your loss
as my hope that I burn

For it was no choice
just a thoughtful narrative
the merits you could distill
affirm beyond the noise

Do I deserve abandonment
as I lead you out
after I let you in
too close to pain me this moment

What of distance
that I cannot touch you
what of the lines of love and friendship
both gone with the other’s absence

I ask too much
because I give too much
I cry for the calm
as my turbulence wails such.

It was my hero shell
that wished I made you smile
It was my shielded love
that wanted you truly well

Your armor is your pride
My narcissism is my downfall
That in the battle, no hero, no love
could spell happiness to abide.

the way you have to run for blood because they just can’t procure donors and worse–they know they can riv it..guess why… they have known they need blood for years now.

f@ck the guarantee letters–> why do we really have to have these stop gap measures and not have more comprehensive coverage. well, I guess… one more dialysis to make up for the 4 weeks of missed hd is worth it… till next month, or should i say week guarantee letter! don’t clog the catheters please—can’t buy em with your guarantee letters.

and beds? no beds… you could just glare at the man on bed 14 just can’t find a nursing home and why hurry to go…hospital food is free. (and the mask affords some shield against HAP. )… and maybe he cursed that bed, the next man on it got intubated.

oh… no labs? MSS again?! isn’t it enough that CBC and crea na k and urinalysis are free! hmn… Dear MSS, referring our very indigent patient… we badly need the diagnostics and it will really matter in the management of our dirt poor patient. Maybe Mang Dan should do a mimeo of mss letters ready to be filled in.

No CT scan?! we overused the machines again… even the aircon!

poverty. tiring poverty.
and you just can’t help but smile when you hook a mech vent without shedding a bit of Sagip money…
and oh yeah! we don’t need to prescribe the heparin and soluset?! we have stocks?! wow! way to go!
and you just can’t help but grunt when people complain of PGH service–what the heck? at the micro level, its thousands of employees breathe, eat, talk service to the ends of pagbaluktot sa maikling kumot!

grumble. grumble. grumble.

I was that
that warrior in a woman
who will fight for it…
and I could just die
beaten up by the waves
and I could just burn
from the heat up above
just to feel the current
just to touch the high

and I did die
crying out loud
that I did…
I did love so boldly
so deeply and madly

but the flesh is weak
the soul is gone
and the love is…
just that dear wonderful memory
so sweetly by my side
so dearly a dream…
to stay a dream.

sadness.

anger…
I didn’t know.
indifference…
maybe.

I have been right.
Always right.
Damn.

Dr : ..ah, nagpunta po kayo dito dahil sumasakit ang dibdib ninyo… Gaano ho ba ang tinatagal ng sakit ng dibdib ninyo bago mawala?

Last Patient: Ah… mabilis lang ho naman.

Dr: Gaano kabilis ang mabilis sa inyo?

Last Patient: Mabilis lang po talaga mawala ang sakit. E di sasakit. Tapos hahaplusin ko ang dibdib ko. Ayun… mabilis lang.

Dr: Gaano ho ba ang mabilis sa inyo? Sa akin po kasi ang mabilis mawala na sakit sa dibdib ay 10 years (yes, dear readers, It’s hard for me to move on, pero di ko naman sinabi out loud).  Sa inyo po, ano ang ibig sabihin ng mabilis mawala?

Last Patient: Basta mabilis lang po.

Dr: isang taon po bago mawala?

Last Patient : hindi po. mabilis lang.

Dr: Yung mabilis po ba, nawawala na sa loob ng isang araw?

Last Patient: A basta po, kapag puyat lang ako. Tapos mabilis nawawala.

Dr: Ano nga po ang mabilis? Sa loob po ba ng kalahating araw nawawala na?

Last patient: Mas mabilis po.

Dr:  sa loob ng tatlong oras?

Last patient: Mas mabilis po

Dr: (Bakit kaya nya ako pinapaisa-isa? huhuhu)  sa loob po ng isang oras?

Last patient: Opo. Mabilis lang po.

Dr: Ah, mabilis lang po sa inyo ang sakit ng dibdib na tumatagal ng isang oras?

Last patient: Hindi po. Mas mabilis pa po.

Dr: (sigh) Medyo inuubos nyo na po ang pasensya ko ma’am. (sabay cutie smile) Isang oras po ba o mas mabilis pa? Kalahating oras?

Last patient: (smiles) Mabilis lang po. Ganun na nga.

Dr ???

Last patient: Kalahating oras.

Dr. : Ah…kalahating oras.

Last patient: Pero pagpuyat lang po ako. Opo.

Dr. : Ah… Gaano naman po kadalas ang ganung klaseng pagsakit ng dibdib?

Last patient: Ah… di naman po ganun kadalas. bihira lang po.

Dr: (thought bubble: Nakupo!)   Ah…bihira lang po. Gano po kadalas yung bihira? Araw araw po ba? Isang beses sa isang linggo?

Last patient: Basta po bihira. Kapag napupuyat lang po ako.

Dr: Ah. Kasi po hindi ko alam kung gaano kayo kadalas napupuyat? Araw araw po ba?

Last patient: Hindi po. Bihira lang po.

Dr: (OMG!!!)  Ah… mga isang beses sa isang linggo?

Last patient: Opo. Mga ganun. Kapag napupuyat ako.

Dr: Ah. ok po.

——– rest of history——–

Last patient: Teka po pala doktor, pwede ko po ba ipaexamine ihi ko? Masyado po ako madalas umihi.

Dr: (Araykupu. Gaano naman kaya kadalas ang madalas?)  O sige po, paminsan.

Last patient: Ano po dok? Sabi ko po gusto ko sana paexamine ihi ko.

Dr: Sige po. Paminsan. Kapag puyat lang kayo.

Last patient: (giggles and taps doctor lightly)  dok naman…

Dr: (anye nye! bakit pag joke ang bilis magets?)

Hmn. Where is Patdu?

Jonathan adopted her. Unlike his other children, Patdu is very dark, and smaller than most of the other kids.  I loved Patdu like my own. She looked like me the most. Having her there made me feel a little bit of a sense of family.  There was no special treatment she got from me, though… because I never did any parenting to begin with. I just watched by and admired the kids play about. I wouldn’t work hard to get food for them.  I forgot about them sometimes. I’d rather stash them with their goodies and allow them to be responsible for themselves.  I have always believed children should take care of themselves early. I’ve been spoiled and now I feel like I can’t stand on my own. That won’t happen to my kids. Also, I am too lazy to take care of the kids.  

The thing is, they are not my kids. I have been forbidden by the law to see them.  Jonathan adopted them after all.  They didn’t see me fit to be in that house. For which in front of the court,  I could only say, yes, I am useless and selfish. There was no argument, no case.

That should be the end of the story but in the gloomy days, I still think about Patdu.  In my saga of what-ifs, I wonder if Jonathan doesn’t like her anymore and doesn’t take care for her anymore because she reminded him of me.   Maybe he let her go out on her own, venture into her own world.  Still, I do hope Patdu remains to be one of them.  I left that home without saying goodbye. I didn’t know I wouldn’t be back. My world just pulled me away and Jonathan just shut the door in anguish at my conflicted nature. I couldn’t leave my world.  The voices kept calling me.  The images kept tugging at me. That is my world of what ifs. Jonathan would not understand the what ifs.He could not hear the voices and could not see the strangers. 

His anguish has crushed me day to day.  I felt it was unfair because I did hear voices and I did see people that were for me, real. I could still remember the distinct feeling of being at home with them.  I could distinctly distinguish that feeling from the feeling of an unfair pariah. Maybe that was why Patdu kept coming in my dreams. I was searching for someone to understand the unfairness of this and the pain of being pariah.  I never intended to hurt and I came to love.  I was still searching my links to that home.  

 Where is Patdu?