Losing Somebody Else’s Fight

“Kamusta ka?”

“Maayo naman!” said the ten-year-old boy with a flash of his cavity-laden teeth. I began to tickle Eric in the stomach and was satisfied to see him giggle and move about in his metal stretcher bed because of what I was doing. At least, he was wide awake and playful, as a child should be. With a tumor the size of a five-peso coin in his brain, he probably would not be able to celebrate his next birthday if he did not undergo surgery soon.

Of course he did not know this. He did not have to. My senior resident and I had just told his mother, and the only response we got was a meek crying, as if mourning for her still living child.

Eric is the youngest of seven children. His parents brought him to PGH from Masbate because they noticed that he had difficulty walking and would often fall to the ground whenever he attempted to run. Understandably, his parents were shocked to find out that what they thought to be a quick orthopedic problem turned out to be something more sinister. At the rate it was growing, his tumor could compress the part of his brain that controlled his heart rate and breathing in a few months’ time, weeks even.

He would die without knowing he was dying, taking with him whatever potential he had and whoever he was meant to be.

“Matalino ka ba?”

He kept sniggering (No facial asymmetry, good), and turned his head away, refusing to reply.

“Eh anong favorite subject mo?”

“Filipino po.”

“Ayaw mo ng Math?”

“Hihihi. Ayaw.”

I stopped my neurologic examination and looked at his mother, who had now begun to run her fingers through her underweight child’s brown hair in gentle, sweeping strokes. My mother used to do that when I had fever as a child; I would always remember the feeling of warmth and serenity it brought. This mother’s doting gesture was not meant to primarily comfort, however. It was her apology to her son for giving up too soon.

“Wala po kaming pera pampaopera, Dok.”

“Hindi po puwedeng ganun ‘Nay. Gawan po ninyo ng paraan. Tawagan ni’yo po lahat ng kamag-anak ninyo. Mangutang po kayo kung kailangan. Anak ni’yo po iyan; kapag namatay iyan, wala nang bawian ‘yun.”

She continued to cry, wiping her tears with her dirtied Good Morning towel.

“Dok, wala po kaming kakilala dito sa Maynila.”

“Ano bang trabaho ng asawa mo?”

“Nagtatanim lang po ng mais at kamoteng kahoy.”

“Magkano po ang dala ni’yong pera nung pumunta kayo dito?”

“Isanlibo lang po, Dok. Nabawasan na kasi bumili pa ako ng mga gamot kanina.”

I ran through the numbers in my head:

  • Operating room needs: 20,000 pesos
  • Anesthesia needs: 7,000 pesos
  • Serial cranial CT scan: 5,000 pesos
  • Antibiotics and medications: 15,000 pesos
  • Laboratory workups: 5,000 pesos
  • Mechanical ventilator: 2,000 pesos + 400 pesos/day

Our neurosurgical team could defray the cost of operating room needs by using other patients’ excess medical supplies. We could even pay for his post-operative imaging. But taking out the tumor was just the beginning. To treat his brain cancer comprehensively, in all likelihood Eric would need chemotherapy and radiation therapy immediately after surgery. Otherwise, the tumor would recur and it would mean having to start from square one again. We had not even discussed the genuine possibility of surgical complications.

“Iuuwi na lang po namin siya, Dok,” she said, not looking at me, but at her son who remained oblivious to the somberness of our conversation.

To begin with, children do not belong in a hospital. They are meant to watch Batibot, play Agawang-Base and Langit-Lupa, get into fights deciding “Sino ba talaga ang taya,” read about the adventures of the Hardy Boys and Nancy Drew, bring out their parents’ slippers when they arrive, and help set the dining table every night. They are not supposed to be bedridden, intubated, catheterized, injected with, or operated on.

They cannot fight their fight, and nothing is more disheartening than hearing their parents refuse to fight for them.

“Gusto mo nang umuwi?” I asked Eric in resignation.

“Opo, Dok! Wala na kaming peh-raaaa… kahit piiiii-so.”

I smiled with a sigh.

(Was that even possible?)

Some days, you cannot save them all.

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10 comments

  1. “They cannot fight their fight, and nothing is more disheartening than hearing their parents refusing to fight for them.” — This is true, and sad.

  2. Sad ronnie :-(… Toomany of these in pgh, and i never got used to them

  3. I admire doctors for learning how to numb themselves from pain. It’s difficult seeing people suffer from their condition and being caught up in a situation wherein these patients can’t do anything about it anymore because they lack the resources. I’ve experienced interacting with patients a couple of times and it just breaks my heart whenever I see them in this state. I wish I knew how to lessen the pain.

    • …somehow, i think we learned to focus on what is, and be objective. You can’t actually lessen the pain…it’s more like being able to separate thinking and feeling during moments that you need to.
      …it won’t do to cry in pity while explaining poor prognosis, even if deep down you feel like bawling in frustration…
      Somehow, we learn to cry silently, secretly, deep within. For lives we hope to save but couldn’t…
      The worst thing that can ever happen to a doctor is to become numb to it all.
      It is not the goal.
      It is not a talent.
      It shouldn’t even be a skill you should wish to have.
      But it does happen to some of us. Sadly.

  4. Its really a sad situation. Unfortunately, we encounter so many patients like him in PGH. I do not think that we, as doctors, can truly numb ourselves from pain. After doing everything we can for our patients, we just learn to accept reality as it is and leave everything to God’s care. As human beings ourselves, we also need to take care of our own welfare, emotions and psyche. It is our defense mechanism to accept things as they are and to resign to faith and fate. It looks as if we are turning numb, but in reality, we are just protecting ourselves. It is truly sad to see patients get more sick and eventually succumb to death, but at the end of the day, we just need to heave out a sigh, say a short prayer, turn our backs and leave every negative feeling at the hospital bedside. That’s the only way that we can remain sane and be ready to face another patient.

  5. Yes, too many of these in PGH. Admittedly, nothing really gets us mad as hearing lines like, “uuwi na lang kami kasi walang pera”…. On the other hand, nothing else shuts me up as when a parent says, “may awa ang Diyos!” like he really means it. I do believe in Science, but at the cost of coming across as self-righteous, I believe in God’s wisdom more. I try and do my best for my patients (pay for the whole course of treatment if need be), but I can only “save” those whom He wills to live. For me, it’s not that I have learned to be numb to others’ pain (because I did leave once or twice to hide my own tears while telling a parent that it’s time to let go). It has just gotten easier when I finally got it in my head to unlearn playing god. I think we criticize these parents for giving up all too easily on their kids because we “know” we’ll never do it with our own. However, we also forget that theirs is a different reality…something that I hope you and I never get to live through.

  6. i keep reading your blog hijo. i cried with this.
    and i keep praying for you.

  7. Nini P. Clemente

    Sad, sad, sad! I’m really hoping that our country’s leaders do more for the people instead of themselves! Your essays are so heartwarming and so raw with honesty!

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Names, dates, and events may have been changed to protect the identity of patients. The stories are not meant to provide medical advice for specific illnesses. The author neither accepts online consults nor gives medical advice online. Please consult your trusted physician.