when the patient is someone you know

Death brought me here tonight. 72 hours postmortem, I went back to my province to pay my last respects to him.

 

This is the case of my Uncle, a 54 year old, Filipino, Merchant Marine who had Adenocarcinoma of the Lungs and Metastasized to his Brain.

 

For a Medical student, it is a case stage 4 cancer with poor prognosis. The most aggressive surgical, chemo, and radiation treatment can only extend his stay for a few months but the quality of life will also be compromised. Then there will shoot a myriad of symptoms here and there indicating the dysfunction of other organs as well. Lesser urine output, sensory and motor deficits, weight loss, and the one I’m most dreaded to see: Pain.

 

But for a Nephew, it is a case of prayer brigades and clinging to all hopes, wishing this to be an exemption. Wishing that for this time, this case would be the statistical discrepancy of Clin Epid. For this time, God may pull out a Miracle. The same feeling was with me when another Uncle passed away due to several masses on his Liver. Here’s the thing: when you live as a man of science, you live with the cold facts. But when your emotions get involved, you deny even if the tumor is as big as your face, you get angry at the realization of it. You look out and try for alternative methods. Bargain and Haggle with God a lot. And become more than willing to roll the dice to recovery no matter how slim the chance is.

 

My Uncle had been bravely battling cancer for the past year. You won’t notice it until you know. And the falling hair and mega dose of chemo and radiation initially didn’t weaken him. Muntik pa nga siyang makipag-away sa truck driver nung namalengke kami. Actually nakipag-away na kasi binato na niya ng saging yung gago.

 

But like what one song says, ‘even the best fall down sometimes.’ December came and he was not the jolly and strong uncle we used to know. He stayed at our place for a few minutes, and he can’t even walk. When they were trying hard to make him lie on the sofa, our eyes met. And amidst the pain and difficulty of breathing he was feeling, he smiled at me. As if he was the same strong uncle whom I always pick up in the airport when he visits us, the same uncle who always jokes around me, who always tell me stories of his fights during his youth. That uncle who always pat me in the back and says, “Bilisan mo maging doctor ha?”

 

His smile to me that day was the last time we had eye contact. I nodded at him and smiled back. And we smiled at each other. There was no need for words or lovey dovey background music and dramatic speech for me to tell him that I care for him so much, and for him to tell me that he’ll be OK. All we had was that a-less-than-a-minute-eye contact. And that memory is something for me to keep for as long as I’ll live.

 

The last 10 days, my Dad infused Kabiven on him to keep meet all his nutritional requirements thru IV to keep him alive. Me and sibs were asked to check on it from time to time, then my grandmother asked me a very simple question: why are you still keeping him alive? Why can't you just let him cross over without artificial nutrition?

True that there really is no hope for that case, but as Physicians, we would still want to prolong life, right? But what if prolonging life means prolonging agony? What if the pain meds are good, thur removing the agony, but, still, not improving prognosis? The patient might be on a downward spiral, but because of the doctors, puts it on slow motion? But what will Ethics say if we don’t? Will stopping it be called Euthanasia? Will continuing it be called torture? Problem with ethics is the black or white of it. There is no blacker or whiter. For me, neither medicine nor relationships can be defined in black and white.Real life only comes in shades of grey. So we just did what we have to do, and let spend his remaining days in the least painful way possible.

 

Now as I write this, I can say he is in a better place right now. I am not fishing for Condolences or Sympathy. Maybe saying a little prayer for him right now would help. I am doing this for it is my way of immortalizing him.

 

maybe this could be A Eulogy to this Uncle of mine who looked into the eye of Cancer and spat on its face,

 

too bad, Cancer fought back.

 

He battled it, It humbled him, and now, he is in peace.

 

 

 

 

This is Dedicated to my Uncle, German Ebilane Garcia. May he Rest in Peace.

 

(No Condolences, please. Thank you)