spaghetti sauce with sugar

I woke up decidedly early today. It is Easter. Also, it is Nikki's third birthday. I felt pangs of guilt as I, the mother, am in Toronto while her party was in full swing. Jun did not really think about getting a party together seeing that I am not around. But he pulled through at the last minute. Our two other kids had parties through their seventh birthdays. I wouldn't want Nikki hounding us about breaking traditions (sort of), years from now, just because I am unavailable. I have too much guilt already.

So, I made my way to the kitchen and knew exactly what I would make to honor this day. Spaghetti of course. A Pinoy birthday would be incomplete without it. Okay, okay. Some would argue that Pancit is the staple. But you have to admit that since Jollibee, the spaghetti seems to have ousted it. Either way, both dishes use noodles which is really the essence of the thing. Long noodles....long life. And the garnishes, the flavors to life.

Onions, garlic, green pepper, mushrooms, ground beef, tomato sauce, tomato paste, salt, pepper, mozzarella cheese. Anything else? O yeah, the pasta. My mind wafted to a different time as I begin chopping away. My memories bring a smile to my lips.

It was my Family Medicine and Community Health rotation during internship year. My group (Francis, Jom and Nette) was going to cap our stay and express our gratitude to our barangay by throwing a small party. Of course, what could be easier than spaghetti? Naturally, we also had barbecue, hotdogs on sticks with marshmallows, cake and ice cream. Come to think of it now, it sounds like we hosted a children's party. Where were the Boyoyong clowns?

I digress.

I was in charge of making the spaghetti. It was a big task. We were going to feed a multitude. I was going to cook them up the best spaghetti (classic meat sauce with meatballs) they ever tasted. I made sure I had my oregano. It was a hot day and I was already sweating it out. Our housemother would peek in from time to time but we would shoo her away. Finally, it was ready and I called her back in to give her first taste. I was proud. She made smacking noises with her lips and tongue. She proceeded with a very interesting comment, "Aba'y di mo ba sasangkapan ng ke-chap?" Huh? Francis and I looked at each other. And then it struck me they wanted sweet spaghetti sauce. Pinoy style, Jollibee style. Uh-oh. "Wala po kaming ketchup." She then miraculously produced a whole gallon full of UFC. And started to pour it in to the huge vat of my sauce. I think my jaw dropped open. She stirred and stirred. Tasted again. And then darted to her cupboards outside. This time, she brought in a bag of sugar. I was horrified. I have never seen spaghetti sauce with sugar, let alone ketchup. But I just stood there transfixed. And finally, she said,"Ayan, tamang-tama na. Sarap ng sauce mo."

Remembering now just brings me chuckles. Back to present time. My sauce is coming to a slow boil and I let it simmer. I sing "happy birthday Nikki" quietly in my mind. I call Pat. "I made spaghetti." As she was to help herself, I said, "I did not put sugar ha." A look of incredulity shadowed her face. "San ang asukal natin?" I begin to laugh. Am I just one of a few who does not get this sugar in sauce thing? Or am I totally alone?

evolution

When I first set foot here in June 2006 to pursue my training, it was summer. The climate was a temperate 24 to 28'C I think. Titing, my cousin who graciously took me in the first couple of weeks, would laugh at the sight of me. She would be in her shorts and I would be wrapped in a sweater. I would tell her, "Eh hindi naman ako balat Canadian 'no! Balat Pinoy ako."

Now, after having braved and lived through 5 or 6 snowstorms (they say this winter is record breaking with the amount of snowfall so far) and chilling in temperatures as low as -25'C, I welcome the fact that we are finally getting temperatures over the freezing point. Today was a pleasant 6'C. I am sure last winter, I wouldn't bear having the heater off. I wouldn't have been able to bear going about without at least three layers on. This time it is different. I ventured outside wearing my shirt and jeans, topped by my wool coat. No scarf, no gloves and no hat. I felt free. And oddly enough, not cold.

Am I finally molting into my Canadian skin?

Well, clearly, I am still in the process of evolution. A number of native locals have already taken to wearing shorts! I remember last year, when the temperature reached 10'C in the spring, I spied a number of bikini tops and tanks worn in the outside. Crazy Canucks!

The end is near!!

The end of winter that is. Punxsutawney Phil (of groundhog day fame) predicted six more weeks of winter, and as if to prove him right, a snowtorm just passed yesterday.

However, it is time to spring forward. Daylight savings time has been lifted. I just realized that the sun has slowly been reclaiming its lost glory during the winter. At seven in the evening time, she still reigns. In a showing of her return, her rays caused almost a blinding glare upon the whiteness of the snow. I feel her warmth upon my cheeks and I feel my spirits lifted.

Another Barney song comes to mind...

Oh Mr. Sun. Sun. Mr. golden sun. Please shine down on me.
Oh Mr. Sun. Sun. Mr. golden sun. Hiding behind a tree.
These little children are asking you. To please come out so we can play with you.
Oh Mr. Sun. Sun. Mr. golden sun. Please shine down on me.

Mr. Sun? I have always thought of it as Mother Sun. Whatever. I was humming this same song as I tried to secure my footing over the mounds of snow. Whoa!! I almost fell as I stepped on a patch of ice. Focus. Focus. Old Man Winter is not quite finished with his tricks yet.

being earnest

Thought I'd share these words of wisdom.

When you know you have done wrong or even if you weren't entirely wrong, be humble enough to say three things.

1. I am so sorry.

2. It was my fault.

3. How can I make it right?

ventilation

No. This is not a blog about how to ventilate a baby. Or maybe it is. Hmmm. Really it is more for me to fan down my slowly burning feelings of irritation rather than it explode into a fireball. I need to ventilate.

I was in the resuscitation room with a 33 week baby, who was born via complete breech extraction. Oh, and the head did deliver a minute and twenty seconds after the rest of the body. So it was no surprise that she was not so sterling. Lucky me, I was with a team comprised of RT's, RN's. Or was I? I did not want to lose time. The heart rate was good but she was apneic. I reached for the bag. A team member's voice squeaked out, "Oh, I think we should suction and stimulate her." Huh? I said no. But she proceeded her own merry way. I held my breath and gently said, "I will do bag mask ventilation now." The baby started to breath but when she did her efforts were tremendous. She was sucking her chest in literally and breathing over 100 resps per minute. Our oxygen was up to 100% and her sats were just 84. I said, "We are intubating." The same squeaky voice piped in again, "Really?" "Maybe she'll be better with just some good CPAP." Arghhh. My eyes went heavenward. "No." "Even if her oxygen requirement were to go down but with that work of breathing, she will tire out and her lungs will be collapsed by then." I intubated the child. When I was in, the same now irritating voice said,"Are you sure you're in?" Cripes. "I can barely hear a thing." Okay, I see chest rise. I see sats going to 94 and the Fi02 down to 50. I said through gritted teeth. I am sure I am in. Thank you.

I am sure there is a lesson or two I can get from that whole experience. But right now, I can't even bring myself to reflect. I just want to ventilate. Breathe. Ohm. Ohm.

de-briefing

As part of our reality checks in the fellowship, we were entreated today to a half day of "letting it out." The frustrations, the difficulties, the moral distress, fatigue, inexplicable demands and expectations...and the list goes on and on. A bull session of sorts. I did not really speak up but I soaked up what my co-fellows had to say. It is comforting to know that I am not alone in what I feel and experience. But I am not writing this now to enumerate the many cruxes of this fellowship I voluntarily allowed myself to get wallowed up in. At the end, one thing that our facilitator advised us to do is to list down three things that went well in the previous 24 hours and three things that could have been done better. A form of self reflection, a catharsis of sorts. So let me see. I am post call today.

Hmmm...three things that went well. Let me start with one first.

Just as I had clocked in for my night call, an overhead anouncement resonated. "Code OB! Code OB!" This meant that there is a stat delivery and either mother or baby are in peril. In this case, it was the baby. Limp, blue and not breathing. Palpating the cord, I counted 8 in a 6 second span. 80 beats per minute. I went straight to bag mask ventilation. No more tactile stimulation. I needed to get this baby breathing. The father was just standing over my shoulder. In less than 30 seconds, the baby was taking breaths and giving timid cries.A couple seconds more and the baby was pink and crying. Dad was teary eyed and thankful. If he only knew how thankful I was too. Thank you Lord. A disaster was averted.

I am still thinking about the other stuff. Or maybe I will turn in already. Tiredness has set in.

Mental note to me: Be mindful of my everyday occurences.