Good Morning, Dok!

“Good morning, Dok!” he would always say in the morning when we did our rounds. Despite being 18 years old, his voice was a high-pitched squeak of a boy reaching puberty — awkward, but always happy and thankful nevertheless. It was one of the effects of his brain tumor, in addition to his short stature and delayed maturation of physical appearance. Any stranger would incorrectly guess his age to be no more than 12 or 13.

That was the same greeting he used when I first met him and his mother in the OPD. With a wide-eyed smile, he said “Good morning, Dok!” in his characteristic sharp voice that jerked me from my sleepy attempts to get a decent clinical history.

Seeing the effect of his brain tumor in his cranial MRI, I wanted to admit him to the wards on that same day, so that we could schedule his surgery at the earliest possible time. But as I was about to call the ER and provide admitting orders, he asked, “Dok, pwede po bang next week na lang ako ma-admit?”

“Bakit naman?”

“Kasi Dok, magbi-birthday muna ako sa ‘min sa Sabado,” he said, as a child would when begging to buy a toy.

Of course, I had to concede.

“Thank you, Dok!”

From his first hospital day, he never missed an opportunity to greet me and the rest of the neurosurgical team. In the wards when I spread out the charts, and once more when I collected them to check my seniors’ orders. At the bedside of other patients waiting for their surgery schedule. Along the corridors. In the cooperative store while buying food. On the stretcher that would transport him to the operating room.

Always happy. Always thankful. As a child would.

“Good morning!” I always replied, with a smile and a polite bow. End of conversation.

After his surgery, he never woke up.

In the intensive care unit, while consoling his mother who was crying on my polo shirt, I found out that of three children, he was the only son. His OFW father had yet to hear the news, and his mother didn’t know how to tell him.

Always happy. Always thankful. As a child would.

And I never found out why.

Or how.

In a field where patients live and die with uncertainty, it has become an almost conscious effort not to get too close to patients and their personal lives. It is not apathy, but a means for self-preservation when a patient’s clinical course does not go as planned. The interplay between health and illness could never be understood fully unless one probes the social environment in which they are set, but having too many other patients, histories, diagnoses, and surgeries to think about leaves very little time for emotional hang-ups.

“Good morning, Dok!” he said on the operating table while waiting for the anesthesiologist to put him to sleep.

That was his goodbye.