In Loving Memory

If only you can save your family  members from dying.

Uncle Aldo is one good man. I might be saying it too bluntly, but I only have a few good uncles, as far as I can remember. I love them all nonetheless. I learned to see through their flaws and choose to accept them for who they are, instead of loathing them, which seems unreasonable despite the occasional psychological trauma they cause me and some other cousins. In the end I know I will only choose to love them more than anything. I do.

I wouldn’t say Uncle Aldo is perfect or that the life he lived was saintly. He lived a simple life, built a house in a village at the foot of a mountain where everyone you know is an aunt, an uncle or a third degree cousin. He planted and harvested crops in the vast farm land they own about a kilometer away from home, towards the mountain just before you ascend to the woods. He fed the pigs and the chickens, took care of his grandchildren, visited his dentist daughter in the town proper whose clinic adjoins the store his other daughter manages. At times he comes late in the afternoon, when it’s closing time, so they would all go home together riding the tricycle owned by one of his sons.

Uncle Aldo did not insist on what type of future he thought would be the brightest. He did not preach; he considers. He listened to what I had to say–what I hold deep in my heart to say that I kept from the others–and valued my responses to his questions. One conversation gives you a moral boost, one humbling experience after the other.

He never judged.

I remember taking his blood pressure, in 2011, when I held myself captive and ran to the province for refuge. 150/90, i noted. The symptoms of hypertension continued and he was sent to the town for a consultation. The next thing I know we were hiking the mountains, tiptoeing with a long stick at hand to gather the ripened fruits of a plum tree.

Aneurysm. A weakened blood vessel in his brain ruptured, even when surgery hoped a better outcome. The timing’s impeccable. It seemed he only waited for his youngest child to return home from sailing international seas, after several months of being away because of his job. Had my cousin been delayed of his trip back home, I know can never forgive himself.

Why is it that the ones we love should be taken away from us, and why so soon?

Perhaps it’s not that it’s too soon. No. It’s just that we always wish we had more time, no matter the length, no matter the circumstances, no matter the sacrifices it entails.

Our family is the one thing in life we never thought we’d ever lose.

Of false hopes and promises

One. Two. Three. Pump.

One. Two. Three. Pump.

One. Two. Three. Pump.

I stopped doing the chest compressions momentarily. Grabbing the stethoscope in front of me, I tried to auscultate the heartbeat of the baby as I was instructed to.

Twenty.  Too small a count for a newborn’s cardiac rate, given the normal range is 120-160 beats per minute.  I heard 20 slow, hardly audible and weak beats when the pulses should be strong, rapid and clear. This baby has only been outside the womb for a day, hasn’t seen much, hasn’t felt much. His own mother has laid eyes on him for only once, a few moments right after delivery, when the pediatric team showed him to her for a couple of seconds. “It’s a baby boy,” the pediatrician announced as the baby lies on the pre-warmed bassinet, umbilical cord clamped and freshly cut, blood and vernix caseosa all over his delicate little body.

Since then, after secretions from his mouth and nose have been suctioned and drained, and the nursing staff has rendered all the newborn care that has to be done,  the fragile tiny being was inside the incubator all his life.

We went another round.

One. Two. Three. Pump.

One. Two. Three. Pump.

One. Two. Three. Pump.

For every three chest compressions I do, Sir Carl, my senior, will pump half of the ambu-bag supplying the neonate with pure Oxygen inhalation for as long as it takes until he begins again to breathe on his own, if he ever learns to breathe again, at all.

“Do you want to switch positions?” Sir Carl finally asked. He is drizzled with sweat from face to neck. He’s sweating a lot, I observed, and it’s not simply because it’s summer season or that the air conditioner is turned off or that his  sweat glands are just physiologically hyperactive.

I feel the gentle slide of my own sweat now. My hands are numbing, even when I thought otherwise.  Whether it’s from pain or exhaustion I could not exactly tell. I realize my hands aren’t the only ones feeling numb.

“Stop.”

The attending physician was clad in a smack gown as he enters the Neonatal Intensive Care Unit. He came all the way from Tanay, Rizal and travelled an hour or two just to get to the hospital that evening, of all evenings.  He searched for the baby’s heart rate and sat down, and seemed to think deeply to himself.

I can’t even manage to establish eye contact with him. This was my first time. My first baby. My first infant mortality. Minutes before his arrival, Sir Carl, I and the rest of the nursing staff knew within ourselves, amidst denial and continuous resuscitation where this is all heading to. You would not need any expert on pediatrics to tell you that the pulse oximeters are not reading accurately anymore,  or that the lack of rise and fall of the chest and abdomen in the absence of ambu-bagging indicates impending death–or rather death itself.

The baby’s hands and feet were the first ones to turn white resembling a blank canvass made out of human flesh where life used to flow. We have handled premature babies and some of them even more prematurely born than this one, yet it is him that we lost. How could a 34-week old neonate die when a baby born only at 27 weeks survives? Must it be due to his mother’s history of taking a drug people believe to aid in abortion when he was only four months old inside the womb? I realize that’s my own voice asking, struggling to be heard. Neonatal pneumonia, prematurity and the consideration of Hyaline Membrane Disease were the causes of death, the doctor eventually declares.

I tried to get a glimpse of the limp, lifeless little boy as much as I can even after what happened. I just kept on coming back to look at him, when I still can. These are the kinds of things that will haunt your soul, and it will haunt you for a long time. These are the ones that will sting for months, even years, whether or not you continue on your career or decided to take another path. I touched his hand, and examined his face for a while. His abdomen now more bloated than it was several minutes ago, and the color of his skin… I can’t even find words to describe how grim it was.

Finding a baby dying in your arms is depressing. Finding death lying in a box, however, black, cold and stiff is  a different story.

In full battle gear

I lit a candle the shade of blue outside St. Peter Parish Church on Commonwealth Avenue. The blaring of horns and the sound of the engines of passing jeepneys and buses might as well have ruptured my eardrums, but I became oblivious to stimulus of any kind the minute I started praying. My prayer was simple, yet I could not bear the way it consumed me. I wanted to subdue the sobbing, even for only a moment, but I couldn’t. I could have attempted with a box of tissues until the tears ran dry, yet even if I succeeded, I knew the weeping would just get louder inside, almost insanely, each and every time.

There has not been a day in which I do not wish that I am just having another nightmare, another night in which I’d wake up with a stream of tears on my face. I have awakened from a couple of gruesome dreams and I expect to snap out of this one, too, at the soonest possible time. But as I lie beside her every night, and as her hair drops from her scalp, brows and nostrils after each treatment, I try to wake myself up from a different dream instead. That one dream I know I will never have to sleep to endure—the dream where she is healthy and well, and not afflicted with cancer.

“Invasive ductal carcinoma,” the doctor says. Thereupon, the thing people say about feeling your whole world crashing down becomes an understatement. No other pain hurts the way it does; no other pain becomes existent. Learning that a loved one has cancer traps you in a lunatic state of incredulity. Denial, Elizabeth Kubler-Ross would call it. Superseded by a seemingly irrevocable form of anger: Why her?

I lost my father at about the same age I kissed childhood goodbye, and Mama raised us by herself from then on. I was very fortunate at the time; my two younger brothers had to continue weaving memories of their own childhood for a few more significant years. When I cook, what an arduous task it is for me to emulate the way she does it, even with her supervision. I complain about not inheriting her gift. My first love is teaching, having been exposed to the field while tagging along with her to class when I was little. She is a mother, a father, a teacher, a cook, a laundress, a doctor, a nurse, a friend, an unwavering love machine—rolled into one. She is my heroine, and the warmth of her embrace marks my fortress.

I zap myself back to reality. Life will never be the same. Something has been remarkably altered just like that, in one day, in two fine needle aspiration biopsies on one of her breasts.

I never thought my mother would get sick, let alone of cancer, of all the sicknesses in the world. In the eyes of a child, parents are indestructible, invincible. I knew this day would come, though—the natural order of the universe demanding its due place in time—but never this soon. I was hoping for an illness related to old age, one that is probably degenerative in nature, for both of them, even if it means changing adult diapers every now and then.

My father never got to wear adult diapers or use a cane or a walker. Mama, on the other hand, still has a chance.

Family members and friends merged at once into one staunch, consoling squadron after we disseminated the unfortunate news. We were gravely shaken, yet my brothers and I fought hard and long not to cry in front of one another. I felt helpless and pathetic, being unemployed and having no savings whatsoever, yet truly grateful that I belong to the medical field. Relatives are supportive and we owe it to them big-time; however, these people have lives of their own, problems of their own. We wouldn’t want to burden anybody, but that is almost akin to denying my mother treatment. I could use a job—just anything there is to earn and raise funds, but I know this ordeal entails more than just amassing a gargantuan amount of cash for chemotherapy. My mother needs us. She needs me. I would not want anyone else to take care of her than myself, and I want to do it full-time.

God provides, as always. He does so in a lot of ways and He provides well. You may not recognize Him the first time, but when you do, you’d be awestruck the second it hits you.

I run to catch the next train bound for southern Manila. I have only been to Pasig a couple of times, including one in pursuit of a job application. Armed with elaborate instructions and a considerably reliable sense of direction, I found myself being handed the medicines needed for the next cycle. “I was told by Dr. Montales to give these to you,” the lady in her late 20s—I reckon an ICanServe Foundation volunteer—says with a genial smile.

Hundreds of people pile up at one of the gates of the Lung Center of the Philippines. It has only been a few minutes since the clock struck four, and there I was, already the 200th person to fall in line on this provoking Tuesday morning. People asking for financial assistance from the Philippine Charity Sweepstakes Office—from dialysis to prosthesis, from hospitalization fees to chemotherapy drugs, among other things—gather under one roof.

Mama dons her wig for the first time. Strands of hair still cling to her scalp, but this time, counting them becomes an easy task. Holding the bag of supplies and medicines in one hand, I twist the doorknob of the chemotherapy room with the other. Her oncologist beams at the sight of us.

I could not imagine it happening: I am in a room full of fighters. All these IV fluids, all these reclining chairs, coddle only the bravest of souls.

There has not been a day in which I do not tremble in fear, not a day in which I could triumphantly suppress the incessant gush of tears from within me. One cannot hold fire in this kind of warfare, however; it is the kind that assaults to get even with the world. You have an assailant to vanquish and your faith is your greatest weapon. Faith that God always listens. Faith that this is only a test of faith. Faith that this is just another story of hope and survival you can share with an army of cancer warriors and their families one day.

You know it is.

Cancer can be fought and the battle can be won.

Cancer is ruthless, but so are we.

*Above article first published August 2012 on the Youngblood column of the Philippine Daily Inquirer.

PDI August 25, 2012 issue