Tuesday, August 21, 2018

Cancer Institute figures into Glenn Diaz's The Quiet Ones

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What with all technical papers I need to write and the oncology journals I need to read, I can't get my eyes off Glenn Diaz's The Quiet Ones (Ateneo Press), winner of the 2017 Palanca Grand Prize. It is a masterful work of someone who breathes the English language in Filipino atmospheric conditions. The book is about a call center agent who gets involved in a scam and who scrambles out of Manila to escape the authorities. The details that intersperse the story make the novel riveting: such as this scene at the PGH Cancer Institute. Alvin's mother had pancreatic cancer.

Sunday, August 19, 2018

Exhortation to move on

John Calvin's exhortation to live the Christian life begins with the reminder that we can't live perfectly in this world. How beautiful is the Christian faith! It is aware of man's limitations, does not burden him with back-breaking toil for an otherwise unattainable salvation, but offers him the assurance that all he needs is to put his faith not in himself but in God.

I insist not that the life of the Christian shall breathe nothing but the perfect Gospel, though this is to be desired, and ought to be attempted. I insist not so strictly on evangelical perfection, as to refuse to acknowledge as a Christian any man who has not attained it. In this way all would be excluded from the Church, since there is no man who is not far removed from this perfection, while many, who have made but little progress, would be undeservedly rejected.

But the young Calvin turns us back to God's Word, as if to tell us, "I know your frustrations." I wonder how much of The Institutes is autobiographical. I read the passage below and think that this mirrors my own experience: the struggle to worship God amidst the filth and dirt of sin, failing, but moving on, getting closer to the goal of Christlikeness inch by inch, until the time when God calls me home.

What then? Let us set this before our eye as the end at which we ought constantly to aim. Let it be regarded as the goal towards which we are to run. For you cannot divide the matter with God, undertaking part of what his word enjoins, and omitting part at pleasure. For, in the first place, God uniformly recommends integrity as the principal part of his worship, meaning by integrity real singleness of mind, devoid of gloss and fiction, and to this is opposed a double mind; as if it had been said, that the spiritual commencement of a good life is when the internal affections are sincerely devoted to God, in the cultivation of holiness and justice. But seeing that, in this earthly prison of the body, no man is supplied with strength sufficient to hasten in his course with due alacrity, while the greater number are so oppressed with weakness, that hesitating, and halting, and even crawling on the ground, they make little progress, let every one of us go as far as his humble ability enables him, and prosecute the journey once begun. No one will travel so badly as not daily to make some degree of progress. This, therefore, let us never cease to do, that we may daily advance in the way of the Lord; and let us not despair because of the slender measure of success. How little soever the success may correspond with our wish, our labour is not lost when to-day is better than yesterday, provided with true singleness of mind we keep our aim, and aspire to the goal, not speaking flattering things to ourselves, nor indulging our vices, but making it our constant endeavour to become better, until we attain to goodness itself. If during the whole course of our life we seek and follow, we shall at length attain it, when relieved from the infirmity of flesh we are admitted to full fellowship with God. (Emphasis mine.)

Saturday, August 18, 2018

On Mon Tulfo's diatribe at the PGH Emergency Room

The news of Mon Tulfo berating a tired Emergency Medicine resident made my blood boil. Nurses were talking about it when I made rounds yesterday, which was how I had learned about the incident. The journalist Tulfo brought a child who sustained minor injuries to the Philippine General Hospital's Emergency Department; the child was assessed at the Triage and was deemed a non-emergent case. The child was therefore not immediately attended to. Mon Tulfo lashed out invectives, and official accounts report that he even showed the physician the middle finger--all these, while the event was recorded illegally through a camera phone. Many issues surface here--patient privacy, physician-shaming, and so on--and if there's one good lesson to come out of this, it is that you never attack people mindlessly just because you're a media personality.

The issue of rendering service equitably comes to the fore. PGH medical personnel are called to serve the ill and dying, and we do so gladly, passionately, with all our hearts and minds and, when tough times come (and they do come often), even our pockets, even if we're discouraged, nay, forbidden to. How can we muster the strength to not spare our money to pay for mechanical ventilation just so our patients can avail of this life-saving intervention? How many times have we acted, not merely as physicians, but as social workers: looking for sources of funds so our patients get better and stronger? To deliver the best medical care to the steady influx of patients, we need to prioritize who needs help the most the soonest. This was the process that the child injured by Mon Tulfo's car went through: an evidence-based, pragmatic, and effective system called the triage. This was the process that Mon Tulfo, in a horrifying display of hysteria triggered by an inordinate supply of self-importance, wanted to bypass. 

So this is why the Mon Tulfo incident strikes a chord among my colleagues: it is a mockery of our daily struggles against sickness worsened, and even caused, by poverty. We do not have a shortage of compassion in the hospital, even if our hospital beds overflow with occupants. Mon Tulfo's outburst was a short-sighted, anger-laden, ignorant, uncouth diatribe. It is people like him who make our work harder than it already is.

But we carry on.

Friday, August 17, 2018

God's sovereignty and suffering

Cameron Cole on the sovereignty of God and the death of his child.

For me, one of the most comforting things in surviving and recovering from the death of my child was knowing that God was completely and fully in control in his death. Before he created the world, my God had marked the number of days that my son would live.

That means that his life was complete. That means that his death was not random; it was not accidental. That means that it has meaning and purpose.

And it also means that God is in control of my redemption and my healing.

Wednesday, August 15, 2018

Tuesday, August 14, 2018

Monday, August 13, 2018

Sunday, August 12, 2018

Saturday, August 11, 2018

New day, new coffee

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I love how the coffee maker mimics the sound of quiet thunder whenever I make a fresh brew at 5 am. I never have much use for alarm clocks, but this ritual of coffee making is part of my slow, graded, and gradual ascent to total wakefulness. Praise be to God for a new day.

Wednesday, August 8, 2018

Old friends

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Tears come to me in moments that surprise me: seeing a father walking his kid to school, hearing a blind man sing an old kundiman, and, this afternoon after work, reading Justice Antonin Scalia's eulogy for his friend, Martin Feinstein, then first executive director of the John F. Kennedy Center for the Performing Arts. Justice Scalia said:

"It is with the greatest curse of advancing years that our world contracts, as friends who cannot be replaced, with insights into life that are not elsewhere available to us, leave us behind."

His speeches, compiled in the book, Scalia Speaks: Reflections on Law, Faith, and Life Well-lived, reveal the brilliant mind of a kind person who loved his country, family, faith, and friends. I finished this collection today, after a grueling day at the clinics, with so many patients hoping for another day to dawn. Perhaps this is why I don't mind these packed train rides: I get lost in my thoughts and prayers and books, and in those precious minutes of wrestling with my thoughts and conversing with God and making sense of words in my Kindle, I find rest.

Something dawned on me, too, as I read of Justice Scalia's account of William Howard Taft, George Washington, and Abraham Lincoln—excellent leaders who propelled the United States into what she is now (but, as Justice Scalia pointed out, they were not just leaders but above all good men). It is that we lack leaders to whom we can look up to, leaders who inspire and not just command. I don't think we fall short of these kinds of men and women in this country; perhaps they're not just part of this government.
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