I’m publishing this blog post a bit late. I can’t stand not writing about a blogger friend and defy her preference for “slipping away” silently.
Goodbye blogger friend. We will miss your blog posts, your writing and your knack for demystifying music to us, cold souls.
Goodbye fellow bone doc. Even if we rarely had a chance of actually doing bone surgeries together, we shared the same tenacity for fishing out the medical absurdities of our work.
I hope you did take the “wave and smile” I made during your induction to the fellows fold a warm welcome and congratulations.
In all my years of practice as a physician and orthopedic surgeon, it dawned on me that I get the ultimate satisfaction from patients’ “‘smiles” at the end of their treatment program. There’s no doubt also that I get extreme satisfaction from technical masterpieces of orthopedic work that came my way during the course of my practice. But there’s none yet so far, as equally as pleasurable and satisfying as seeing your patients beaming with a smile on the last day of your rehabilitation program.
One time, when I was alighting my car on a parking space near a fast food center, I almost had a misstep after a short, muscular guy shouted, “Doc A!!!!” . The guy is sporting sunglasses, a Lakers bull cap, city shorts and tennis shoes. He was beaming with a smile and was waving his hand frantically while moving towards me. I stopped for a moment standing near the stairs, totally confused at who this stranger is coming towards me. I didn’t recognize him even if I tried so hard to remember his face. When he was an arms length away from me, he extended his right hand for a handshake and is now smiling and laughing at me. “You don’t remember me now doc?!” said this stranger. “I’m Mr. B!, the one of your patients who had this below knee amputation after that bombing incident near our marketplace, remember?” I looked down his lower extremities, I barely recognized his prosthetic leg despite the city shorts he’s wearing! “You’re Mr. B?!” I blurted surprisingly. “But you look and walk so “normal”! “Thanks to you doc. If it weren’t for your help, I’m probably be some useless person, begging my ass in the streets by now”. For a moment, I felt like a big man beaming with pride. I smiled back and offered a tight handshake and a hug.I was so damn happy he was smiling and was walking like a normal person again!
I treated Mr. B in the hospital for more than a month, trying to save a mangled lower extremity brought by an exploding improvised explosive device( IED). Undergoing several operations, I was hoping I could save a few inches more of an amputation stump, so it wont be an above knee amputation. It’s relatively easier to rehabilitate below knee amputees than patients with above knee amputations. But there’s more than to amputations and surgeries for this patient. I was trying to help a person recover from a traumatic experience and help him become functional person again, contributing to his community. I was giving him hope that even with prosthetics, even if without money for prosthetics, he’ll live a normal, life again. That was the challenge.
Together with his family, we inched our way, through rehabilitation and difficult obstacles along the way. Finances were dwindling and prosthetics are almost always costly and difficult to obtain in this part of the world. Rehabilitating patients with prosthetics is even harder. Most patients complain that it is far more eassier for them to just throw of their prosthetic leg and use crutches instead for the rest of their life. But me and Mr. B is pinning our hopes on, hope. We annoyed many agencies with our persistence – foundations, prosthetic centers, rehabilitation centers. When Mr. B finally got into an in house rehabilitation for the differently abled person, I lost contact with him for more than 6 months. He was in another place the last time we talked on the phone.
Then this unexpected meeting happened.
“You mean, you are really Mr. B?” I was asking him again and again out of disbelief. “Opo, doc!” his huge smile is most viral. I can see the very happy, lively and “normal” guy in him now. It was as if nothing happened in the past. This guy, who was at the brink of depression months ago, is one very happy, one very normal person again.
I tell Mr. B’s story to all my patients who are at the brink surrendering to their afflictions. He even serve as a model for my patients that has had amputations. Even such traumatic experience couldn’t erase one of man’s hallmark of ” humanity”- hope.
As for me, I smile with pride and confidence telling this story to all my other patients. I always take pride in my patient’s stories of hope and how’d they’d live through years despite their predicaments. That was always my mantra in this profession. Hope for my patients, smiles in their heart. I’d be one very happy doctor if I can at the very least achieve that…
Lift your head, baby, don’t be scared
Of the things that could go wrong along the way
You’ll get by with a smile
You can’t win at everything but you can try. “With A smile, Eraserheads”
Once in a while, in our busy and chaotic medical life, a few patients would come by and jerk you off your comfort zone for empathy and go bonkers on the absurdities of life. They come into your clinic like the usual patients complaining of this or that disease. The moment you ask these patients about their history however, you pause at one point in awe and be moved for a while. Something hit you and had hit you hard. You are, in medical numbspeak, “infected” with their moving story.
One of my few personal favorites is the story of Mang Pedring. Mang Pedring, is a fifty something bread winner of his family. The father of four and a laborer, he frequents and works part time inside these gambling site to earn his living. He barks (as kristo) in a cockfight, a tayador in a tumbo (I wont bother expounding on this because I really have a vague idea what this coin gambling is) and a meron in a card game called Pusoy or tsikitsa. He broke his left arm after falling off a motorcycle. He was on his way to the cockpit- the gallery for cockfighting.
A cockfighting match barker or kristo doing his stunt in the game to earn his living (Photo credits to the original owner)
It was almost a month after his injury when he sought consult at my clinic. Prior to this, Mang Pedring went to a number of bonesetters, a doctor, and was actually admitted in one hospital for 5 days. His last closed reduction and casting didn’t went well for some unknown reason (I learned later, that he took off his mold because it felt so tight for him, without consulting his previous doc). What’s worse is, he drained his funds going through all these unsuccessful attempts at “fixing” his broken arm.
Funds, which he revealed, was a pool of money earned from gambling- from the throw in of his fellow gamblers when they learned of his predicament, and (the most disheartening was) what he earned as a cockpit kristo or barker while his right arm is strapped in a sling and a cast. That helpless ironic sight, as I imagined from his story, made me twitch in empathy. I cannot imagine raising my broke arm in an attempt to earn my living, much more do it in a gambling site. He came begging me to fix his arm so he can go back to his ‘work” and earn for his family.
What I was trained of course, is not to give weight on his conflicting circumstances but focus more on his ailment, which is his broken arm. Orthopods were trained well to aim at a holistic treatment of a “broken” patient- to return the patient to his functioning, pre injury status. In Mang Pedring case, to his gambling “work”.
I owe it to Hippocrates and to mankind to do just that and leave the morality of his gambling work to the society’s judgment. In fact, I never pass on judgment unto Mang Pedring. I simply wanted to bring him back to his pre injury level. Whether his work qualifies (or not) as a job for many of us, that is not my concern and is not what struck me in his story. It is his struggle to earn a living while still on the mercy of a cast over his left arm. The ghastly scene is further brutalized by having to work as a barker in a cockfight. What suddenly flashed in my mind? A wounded gladiator.
Funds depleted, and totally frustrated at his broken arm, I reapplied his cast ( as a temporary “fixation”) while we where looking for funds for his operative treatment. I said I could help finding a sponsor for his metal implant and negotiate for a “free surgeon”. He only has to look for his medicines needed during the operation. Right there, I saw Mang Pedring’s eyes beaming with happiness. He cried in front of me. Cries, which really whacked me out of my objective senses for a minute. I saw his desperation. I saw his hope. Now his desperation is mine too. His hope, lies in what I could do to ease out his predicament. I have to fix his broken arm. Soon. Fast.
Then what he said (in hiligaynon) before leaving struck me the most:
“I gotta get back to the cockpit and the tumbuan doc and ask again for a “throw- in” for my surgery. I know people there would help me”
I scratched my head in disbelief. Mang Pedring was and even in dire needs, look up to his gambling and fellow gamblers for help. Whatever our society has passed judgment as morally wrong wouldn’t matter to this guy for as long as it saves his limb and and put food in the table for his family. For once, I thought Jesus, the kristo, was disguised as a gambler. Mang Pedring is and will probably be a gambler. But his aspirations and dreams were similar (or parallel) to the non gambling patients I’ve treated. He wanted to return to his job and feed his family. Whether his method or job is morally wrong to some of us that is not my hemisphere of expertise. I simply wanted to return him to his pre injury functioning level. Period.
After 2 more casting sessions, Mang Pedring didn’t come back to my clinic anymore. While in the process of “pooling” funds for his surgery, he felt his armed healed already and removed his cast. Of course I wanted to confirm that with an x-ray. I also wanted to see if the money he pooled is really safe in his piggy bank and not to the gambling aficionados. I didn’t get that chance. One gambling insider later told me Mang Pedring is back in the cockpit again, without his cast and seem to have a functioning arm. I just smiled. Perhaps my work has ended successfully there.
Perhaps, I made a gamble on Mang Pedring.
(Photo credits goes to Islander in the City, here)
Barely two weeks ago I got the news that a good friend’s dad died of complications from an untreatable disease. In the few times we interacted, I instantly liked the bare realism of tatay. Tatay, as I fondly call him, reminds me of my dad’s astute stubbornness and brute witticism. The down to earth jolly individual who grew out of the market’s daily grinds, never fails to surprise me with his “i am in control attitude”. He is after all a dad to his children. When the news of his death reached me, I found myself groping with sadness..
Me, a doctor, a surgeon. Born into the hard life, molded into steel (so my story goes) still…and still, I am groping with sadness.
When we lost our dad to liver cirrhosis three decades ago, i barely had any idea what grief means. I was only eight years old. I never knew a thing in this world but “play”. When I grew enough to miss my dad, I began to use that missing as a source of inspiration for pursuing my dad’s dreams for us. Together with my mom’s unwavering love, I drew inspiration from that ‘missing” and strength from my dad’s memories. In a way, I never really faced off with sadness before.
Until again this time, when another semblance of my dad came along…and left. He reminded me what once my dad’s fondest “cliche” for us.
Live today as though it will be your last.
Seek the best in all that you do.
Never put a thing off for tomorrow what you can do today.
Dream small, dream big, above all, never fail to dream…
Yes, they are cliche today. But in my job where I rub elbows with a “dead man walking” almost daily, the only cliches are those “cliches, you need to settle”…
RIP, tatay. Thank you for reminding me of my dad. Please pass this to him when you guys meet up there: “I love his cliches“
I’m publishing this blog post a bit late. I can’t stand not writing about a blogger friend and defy her preference for “slipping away” silently.
