Allamandas in the Morning

Nonfiction by | March 30, 2008

The terse ringing of the phone, followed by the apologetic voice of the nurse at the other end, nudged me to a befuddled wakefulness. I found myself grousing under my breath to some muted annoyance, knowing that the plans of the day have been brusquely thwarted by an all-too familiar event.

What I had mapped out as an easy, sunshiny, warm-as-a-pillow day turned into a mad rush to the hospital to join a grieving family at a matriarch’s deathbed. In a few minutes I was navigating through the swelling crowd of the hospital lobby. At the female ward, I stood witness to the tableau of a grief-stricken spouse feigning a valiant façade in the presence of the similarly devastated family members.

Mrs. Santiago was one of my favorite patients, a kindly and cheerful grandmother with inoperable hepatocellular carcinoma: liver cancer. She seemed stable during the last two months. Her clinic visits were punctuated by her infectious laughter and gentle demeanor. But she had become jaundiced, given to occasional bouts of disorientation and constantly complaining of severe right upper quadrant pain. I had believed it was time for her to return home. There I was, stuck in the hapless vacuum, barely moving, embarrassed at my own helplessness. A thousand and one thoughts raced through my mind. Still I could not find words to break the ennui of the flooded the room like the tears that stung each face around me.

Such is an oncologist’s life, always hanging on the flimsy thread that separates life and death, redemption and loss, joy and grief. Most colleagues often ask, Don’t I ever get tired of presiding over such sad scenes? Of course, I do. When I first dreamed of being a doctor, I pictured myself as Superman, saving the world from aliens and predators and resentful Lex Luthors, and still finding time to rescue the hapless kitten stuck in a tree. The road I’ve taken seems remotely detached from that, especially when one thinks about the cold facts: that more than half of patients are seen in the terminal stage; that 43% of Filipinos die of cancer without medical attention; and that most Filipinos can hardly afford basic treatment.

The late great Dr. Alex Panuncialman instilled in every medical student the value of fortitude, of looking beyond mere anatomy and physiology. Through my clinical practice in General Santos, I realized the power of telling stories: to overcome a bruised heart, to calm down a raging anger and confusion at the mere thought of cancer, to lighten a husband’s load while seeing his wife slowly waste away, or to simply take away a patient’s mind off the distressing cycle of pain and medication and pain over and over. It pays to spend time to simply listen. Sometimes words are not even necessary, the doctor’s presence and touch can mean a million things. Holding a hand and simply not letting go are, in my experience, more than enough to reassure the patient that he is cared for.

I left the hospital long after the ink had dried on the requisite papers, thinking about the happy times I had with Nanay Santiago. I remembered how her face would light up when she spoke of her grandchildren. Oh, she was lovingly proud of them. It was as if the room radiated with so much warmth and joy every time she remembered them. With heavy feet that seemed to weigh tons and an even heavier heart I muttered a silent prayer for her, thanking her for her trust and goodwill.

Then I remembered her other passion: gardening. She would often gush about her euphorbias and san franciscos before our consults ended. “Takes the mind off my cancer, Doc,” she would say. A salve pressed on my heavy heart, even in death there are lessons that patients teach me. On my way to the hospital, I caught a glimpse of allamanda blooming outside the fence, stretching and tilting their bright golden yellow campanulate flowers towards the balmy summer sun. It was as if the Psalmist whispered these words into my ears: “Weeping may endure for the night, but joy comes in the morning.” At that moment, a smile overcame my sullen face. Nanay Mrs. Santiago is happy where she is now, I told myself, beyond the pain and desolation and cares.

I went home and found that the yellow bells were still there. I heard their message that morning, loud and clear, never more eloquent, like trumpets of God shouting for joy.

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