“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?”
“Ayaw mo ng Math?”
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.