A House is Not a Home

It was difficult packing our stuff into boxes when my 3-year old daughter would occupy the box even before I have loaded my stuff. So the first things that needed to go from our townhouse were my two daughters. I deported them to my in-laws so my husband and I can concentrate on packing up. The speed with which I was able to put all their clothes in luggage bags and plastic bins was world record. They were out of sight and out of mind in a flash. And that day marked the beginning of the serious cleaning up of the townhouse.

However, two days after not seeing them, my 3-year old started to call the house and asked, "when can I sleep in my house?" and "when can I see you?". It was heart-breaking. So I visited them and started explaining to her that the townhouse was no longer her house and that we were moving. It took quite a couple of such explanation before it dawned on her that indeed she will not be returning to that house to sleep again. The other day, she asked, "Mom, when can I go back to my.... to your house?" I noted the effort with which she changed the "my" to "your" and that made me and my husband decide that it's about time we also sleep with them in my in-laws' place to bring back some semblance of normalcy. This afternoon she no longer asked but made a request which we could not turn down... "Mommy, can I see my house again?" So my husband and I decided to bring the two kids to the townhouse to say goodbye. I think this is an important part of the transition... to look back and say goodbye so one can move on.

As soon as my daughters entered the townhouse, they noted that it no longer was the same house they occupied. I have brought down the picture frames decorating the sala. All the boxes were scattered in the living and dining rooms making it impossible to sit and relax. My 3-year old daughter quickly went up to her room and I followed her. She ran to her bed and flung herself on it and said, "My bed... I miss you." My heart tightened with emotion. But she did not shed a tear. I told her to say goodbye to her bed and to her room. She took her Spongebob pillow and a few other familiar stuff like a hat, a handkerchief, her Cinderella slippers and the Gingerbread man stuff toy. She went to the car embracing all these familiar items. I knew that these will help her feel secure amidst all the uncertainties and changes happening around her. My older daughter commented, "Mommy, she even said goodbye to the windows." I smiled with poignancy. As we left, my 3-year old no longer looked at the house but was busy hugging her stuff toys. I could sense that she now discovered a house is simply a house... it's what and who occupies it that makes it a home. And having these with her brought her back home.

Soul Searching

Back in 2007, when I wrote the essay "The Sentiments of a Young Filipino MD", I thought a beautiful and heroic way to put a twist on this essay is for me to abandon the desire to migrate, make the sacrifice and make it good in the Philippines. That would have created a heroine and saint out of me. But it was not meant to be. Because as much as I want to do what looks right, honorable and commendable, the Spirit within clamors for something more. As much as I find the vocation of medicine truly noble, I also find another vocation within trying to get out. I long to write, to travel, to inspire people. A restless soul will remain restless until it finds rest in God. And the same restlessness is mirrored in my soulmate... the man whose musical and photographic abilities got entrapped inside his white coat. Medicine can sometimes kill doctors... figuratively. Entrapment. Perhaps if I flee the society who expects me to be a doctor and take on the role of a nurse, then my jailed spirit can be set free. A temporary respite from the insanity and stress of medicine is all my soulmate and I need. To free the soul, we needed to free the body and the mind. Perhaps, we may come back one day, whole, alive and serving.

What made us realize that it was not mere money and financial opportunity that we seek was when we sought the answer to this question: " What if we suddenly won in the lottery? Would we still migrate?" Without hesitation, the two of us answered in the affirmative. That would actually give us more freedom to do what we really love to do and the opportunity to send our little girls to an all-girls' Catholic school.

"The opposite of happiness is not sadness. It is boredom." That is a striking statement from Tim Ferris' book "4-Hour Work week". Five years in our practice and we are already experiencing midlife crisis. Looking ahead and extending that five years to ten years still reveals the same scenario. Is that it? --- Medicine being reduced to a mere occupation. We know that being doctors will remain integral in our own persona, that someday we'll miss it again... but for now, there is a part of us that is slowly dying if we don't give it the attention that it needs. It is making us less of the doctors that we wanted to be. To become whole again, we need to let go first. "Whoever tries to gain his own life will lose it; but whoever loses his life for my sake will gain it."

A lot of people say, "Take control of your life." But for us in this crossroads. I hear the voice within say, "Throw away reason and abandon your life to Him." It's time to do some soul searching... to abandon what's familiar and predictable.... to dive into the unknown... to allow the spirit to lead us to the desert... then perhaps like the Great Physician, we shall come back with a clearer vision of our mission in this world.

The Sentiments of a Young Filipino MD

I have wondered so many times why a lot of successful doctors are leaving the country. Although I am still young in this profession and have not had that great desire to leave this country -- not just yet -- I feel worried that foregoing the opportunity to migrate abroad might turn out to be a decision that I will later regret. I'd often think, What did these older doctors experience later in their practices which made them decide to abandon it altogether?

Just tonight, I caught a glimpse of the answer to my question. I thought it was just a search for a greener pasture, a desire to give a better future for their children, or disgust for the present political climate in our country, but I think it is more than that. It is something more basic, something closer to the core of our being.

Just tonight, as I was busy making plans for the coming Conferment Ceremony and surfed the web for packages for video and photo coverages, I remembered the stupendous amount that the movie stars charge for their services. I heard that for one young actor, half day of picture shoots would amount to P80,000. Then I remembered those times when we did operations for patients for the same duration and I don't get half as much for professional fees. And I am dealing with LIVES here! Precious lives! Then I remembered how my husband would try to package professional fees so that it becomes very affordable for patients. And sometimes, he even feels cheated when he sees that the cellphones of the relatives of the patient cost three times the professional fee that he is charging! Now, looking at the packages of these videos and photos which costs three to four times our professional fees, I begin to wonder. Are we shortchanging ourselves as doctors?

I remembered that conversation I had with a businessman who said, "You, doctors are in a very noble profession, that is why it is sometimes disheartening when other doctors charge so much for their professional fees."

For some reason, something inside me rebelled about that idea. Something inside me was angered. Here I am in front of a man who charges quite a hefty sum for recreational activities and feels that it is justified since these people have the money to spend for such hobbies and yet points an accusing finger to us, doctors, when we charge the same amount for taking care of their health, of their lives. Did it not ever occur to him that just like him, we have our families to feed? Just like him, we have children to send to school? Just like him, we have rents and amortizations to pay? Just like him, we need financial security which we can hope to depend on when we can no longer work? But unlike him, we have to spend more than 20 years in school, being dependent on our parents, not being able to earn a decent income until we are in our late 30s or even 40s, spend gruelling hours trying to figure out the human body and even have to push marriage and building a family at a much later point in our lives. We have sacrificed so much for this noble profession because deep in us, there is that desire to serve others. Yet, should this sacrifice be bled out of us?

When we sent our application to our respective medical schools some years ago, it was not unusual to be asked, “Why are you taking up medicine?” It may sound like a cliché, one that will make our classmates snicker when we answered, "I wanted to become a doctor to serve others." Yet, we know deep in us, at the core of our being that it is a reason which we can never deny. Of course there are other much baser needs that crop up with this fundamental reason. Along the way, the much baser reasons become predominant and then we become practical beings. We realize that unlike those who join the religious congregation in order to serve others, we do not have a community who will support us. We have to support ourselves and our families. It is then, that the pressure of the material world sets in, because we are but mere mortals who also have to satisfy our basic needs for food, clothing and shelter, and on top of that, education, financial security and retirement funds. We, then realize that we have allowed ourselves to be burdened with so much pressure in our lives, with stress which is inherent in our profession because we deal with lives, that even as we go home, we still think of our patients or what's wrong with them. How come our interventions are not working. Have we made the wrong diagnosis? And, of course, if we could not figure out the problem then the patients and their relatives will again burden us with their expectations, which sometimes prove too much since, as I said, we are just mere mortals and not God. If something goes wrong, the hungry media and some unscrupulous lawyers are just too eager to point a finger to the "erring" doctor. But when we do get to succeed in our mission of providing healing to their ailing bodies, and we charge them with our professional fees, we could not charge too much because it would be unethical. Since we did something noble, we should not be paid too much lest the nobleness fades. But for those who feel that they are justified in asking for the amount that they charge, thinking that what can be more precious in a person's life but life itself, they receive the brunt of their patient's disgust. The patient gets shocked and feels resentment towards his doctor. All of a sudden, glares of accusation are thrown at him, obviously bearing the message, “How dare you, doctor, enrich yourself out of other people's sufferings!” Then he is confronted with market-price bargaining resembling that found in Divisoria, which makes him feel degraded and unappreciated.

That leads me back to my nostalgic thoughts of the professional fees of some movie stars who just needed to host an affair for one hour and gets paid P150,000. Not so for the cardiologist who took care of the patient for a week, the surgeon who operated for more than one hour, or for the anesthesiologist who paralyzed and ventilated the patient so that the surgery can be performed on the patient -- which of course, is just "putting the patient to sleep". How difficult and complicated can that be? No, we cannot charge as much as those movie stars. If only we could, a lot of us would be millionaires by now. Don’t get me wrong, though. I have nothing against movie stars. I am just saying that they are lucky that society is more tolerant of them charging huge professional fees.

Now, I no longer wonder why doctors leave the country. There is just too much pressure placed on their shoulders, that at one point in their busy, successful career, they just wanted to be out. To breathe some fresh air. To slow down. To be out of the rat race.To have that lifestyle with the promise of more quality in their lives.

Besides, there is no pension plan for doctors here. You can still find doctors way beyond their retirement years walking along the corridors of the hospitals, with silver hairs, or worst, faltering gaits. For some, it is a matter of survival. You stop working, you stop earning. You stop earning, you stop living the lifestyle that you got used to. For others, retirement is simply not an option. They have been in the profession for too long. To be uprooted from this environment is like uprooting a plant and letting it die. I have seen how some deteriorated and wilted like a plant just after retirement. They had their entire lives revolving around their noble profession that they find themselves useless without it. Others are forced into retirement by some disabling disease like stroke, myocardial infarction, or Alzheimer's. Then depression sets in. Perhaps this is the scenario that some doctors wanted to avoid in their future lives, that is why they are taking control of it while they still can.

For me, there is no judgment here, because I think I now caught a glimpse of what's going on in these doctor's heads. And perhaps even in my own head? My apologies to those whose heads do not contain these thoughts.

Nagsesenti lang po, kasi nagsisisi akong di ako nag-artista!

(Translation: I am merely venting because I regret not pursuing a career in the movie industry!)