the dirty

have lechon, will eat

Every year, for the town fiesta, my parents would invite people to celebrate with us. At the crack of dawn, Aling Rosa and her crew of cooks will start preparing the different dishes my mom had arranged for. Year in and year out, it seems we always have the same fare but my taste buds never got tired of them. Embutido, pansit luglog and palabok, rellenong bangus, lumpiang ubod, chicken pastel, kalderetang baka, menudo, fried chicken, and my favorite of all, lengua. Yum! Favorite meal enders are leche flan, maja blanca, sapin-sapin, bibingka galapong, pichi-pichi, palitaw, halayang ube and sherbet. Burp! Of course, the fiesta is never complete without the lechon. Those who come to our place know that Kuya Roland, would have also enslaved over the roasting process since daybreak. And the fruits of his labor will definitely not go unnoticed as it would lie majestically at the center table and Aling Sonia would masterfully slice and serve the choice cuts...and for the early birds, the coveted crispy balat! An authentic Filipino feast is definitely not vegetarian.

Recently a Pinay nurse hosted a post christening party of her firstborn. It was cause for great celebration and the not so ubiquitous (here in Canada at least) lechon was the crowning glory of her buffet table. For the Pinoys like me, it enticed our gustatory senses. It wasn't a strictly Filipino gathering however. There was a number of locals who were quite awe and even grief stricken over the current state of affairs of that resplendent (it was really enticingly shiny) animal that was now the focus of our carnivorous attention. "How was it killed?" "Poor pig." "Did it experience pain?" They had gathered around it, as if in prayer for the pig's passing. Momentarily, we were halted in our attack-eat mode. As they stepped away, we stealthily made our way and started to indulge. For the karaoke contest that followed, none of the locals really wanted to win. The prize? The roasted porcine's head.

Iba talaga ang Pinoy.

white and wet

I was asleep when I got roused because of noises...l thought small pebbles were being thrown at my window. Huh? Was somebody trying to wake me? That is some throwing arm...all the way to the 8th floor. Why not just call? These were the ramblings of my somnolent mind. I think I may just have been dreaming too. Anyways, I got up, took a peek outside. It was six in the morning. Oh yeah. Even though it was still dark, I could see the streaks of white falling from the sky.

As a little girl, I fantasized about winter wonderland. As I grew up, I had an occasion or two to live out the fantasy. Hurled the snowballs. Made Mr. Snowman. Brrrrr. Boy, it was cold though and worse, the whole whiteness of it all melted. What was left was slush (reminded me of the 7-11 slushies). There was also layers upon layers upon layers of clothing that my mother wrapped me in. Agility was not possible. Early on, I realized I did not like snow and this holds true until today.

Sigh. Snow. This is early.

Last year, the first snowfall came on December 30. I remember it well because it was my first post call day after having come back from the P.I. just on December 28.

I feel the chill in my bones.

re-born

Mom's started on her treatment. Technically, she is not on chemotherapy. She is on Rituxan and thalidomide. The horrid side effects she had to endure four years ago is well buried in the past and never again. So we thought. It is deja vu.

Prior to her Rituxan infusion, she was pre-medicated with Benadryl and dexamethasone. We are told that it can elicit quite an allergic reaction. With mom though, it was more like anaphylaxis. Hyperthermia, hives, hypotension and worse of all, laryngospasm. Multiple doses of hydrocortisone later, she seems recovered but near passed out. When she came to, she insists on going home to her bed. No sense in arguing. She is back to hospital a day later. Palpitations. Her tachyarrhythmia has recurred. Thankfully, it medically converted. This all happened the day before my dad's birthday party. And so of course, mom being mom had a deadline for her cardiologist. "I have to be out tonight because it is THE birthday party tomorrow."

At the party, Mom was in her prime, resplendent in her pina gown, arm in arm with Dad as they went around the tables. She even took to the dance floor a number of times. Ate says it was as if Mom had been re-born. I must admit, I had raised my objections to the high heavens when I found out Mom insisted on going. But now, I am happy that Mom and Dad had a ball. Mom always said, "In everything you do, do it well. Do it with passion. You may very well just have one chance to do it in your lifetime." She is her own words.

unconditional

I have just come off call. Though my body yearns for my bed, my mind is still wide awake.

I had just gone through a difficult situation. A week old baby born at 24 weeks who from birth hit one rough spot to the next. As I came on call, I knew this rough spot will be erased but the baby along with it.

Scenario: gram negative sepsis in hypoxic respiratory failure, in DIC, pressor resistant hypotension (already on dopamine, dobutamine, epi drip and hydrocortisone) and in renal failure to boot. The parents were staunchly religious and believed in miracles. I again came face to face with the shadows that haunt me. I do not want to be that person who extinguishes the flame of hope but the task has befallen onto me.

I do the talk.

He is dying. If he survives, it will be no miracle. Given the fact that he is extremely preterm and the tenacity of this infection and its sequela, he is almost 100% likely to be severely neurodevelopmentally impaired. Will it be a miracle when there would be no living?

Options: continue, withdraw, DNR

Mom breaks down. Father silently wipes his tears. What do we do?

What should I say? Medically, I recommend withdrawal. All indicators are pointing towards a hopeless cause despite the best efforts.

What did I say? I believe you have to look into your heart and trust your instincts. As parents, you will only always want what is best for your child. Not for you. For your child. Whatever decision you make, I know it is because you love your child.

I feel spent.

The baby passed quietly this early morning.

They let go.

crash

This past week has been a roller coaster ride of sorts.

Bummer...my hard drive crashed. I have been without my laptop for about a week now. Basically this meant that I have not been spending quality online time with my kids and hubby. Sigh. I am back to using phone cards. I can't believe how long it is taking for my new hard drive to get delivered.

I have also learned a valuable lesson. I must regularly make back up files. As we say in our vernacular, "Nasa huli ang pagsisisi." What exactly did I lose....I lost copies of journal articles I have religiously searched for over the past year. I lost presentations which I have slaved over in preparing (literally burning the midnight oil to the wee hours of the morning). I lost my OPM. But what really hurts is that I lost all the pictures.

What I am thankful for is that whatever I lost, I can build up again.

Now, I have to start....

strong

I was happy to hand over the patients in the Unit to the next team on call at the end of my overnight shift. I was narrating events that transpired when the in-house fellow’s phone clipped to my pants suddenly rang. It was Pat. My sister had called from the Philippines and left a message for me to call back the soonest I can. I felt my heart drop and could not talk. I thought of the worse. I was visibly shaken but then regained my composure and quickly finished my hand over.

My thoughts immediately went to my mother. She was diagnosed with Non Hodgkins Lymphoma in 2003 and went into remission after a tumultuous course of chemotherapy which led to doxuribicin induced cardiomyopathy and heart failure, DVT, PTE and post steroid diabetes. Through it all she remained crusty as ever.

Four years ago, in the early morning that we woke her up and my sister and I tearfully told her about the biopsy result, her reply was,”Sabi na nga ba eh. O, hwag nyo ako luhaan at buhay pa ako. Nagawa ko na rin lahat ng gusto ko. Handa naman ako kahit kailan. Kayo ang iintindihin ko. Teka, may duktor na ba ako na pupuntahan? Tena at magpahain na kayo ng agahan.”

I finally heard my ate’s familiar voice. Mom had an MRI last week, part of her bi-annual screening. She is still quite asymptomatic but from the imaging, her abdominal nodes have enlarged and one is severely compressing on her IVC. Mom swore off chemotherapy after her experience. She has relented though to treatment with Rituxan. I spoke to her on the phone.

“Ma, ok ka lang?”
“Oo, ok ako. Hwag mo akong intindihin. Intindihin mo sarili mo dyan.” Spoken like a true mother.
“Gusto mo ako umuwi?”
“Bakit uuwi? Tapusin mo yung pinunta mo dyan. Dito pa rin ako pagbalik mo.”
“Talaga ha. Ma....”
“O, ano yun?”
“Ma, I love you.”
“Ano kamo?” My mom has never been the mushy type but her actions betray her.
“Sabi ko, Ma, I love you.”
“O sige…same to you.” Patawa talaga nanay ko but I heard her voice break.

I felt reassured though we are miles apart, I felt my mother’s strength. I can only aspire to be the same pillar of strength towards my own family.