PDI Opinion: Adding fuel to the COVID-19 inferno

What a fucked-up time we are living in now. Every hour, something infuriating just seems to happen in this country. The website version of this rant here.

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Adding fuel to the COVID-19 inferno

It's hard not to envy the Singaporeans. Through a televised address on March 12, Prime Minister Lee Hsien Loong laid out in a mere 11-and-a-half minutes the state of his country amid the COVID-19 pandemic, and his government's plan of action. The speech was clear, concise, and, most importantly, reassuring, the gist of it being: We are wading on uncharted waters, but your leaders are on top of things.

How nice to have a government--or even just a head of state--that actually knows how to talk to its people, instead of sending them into alternating states of panic and paranoia.

The same day as Lee's address, President Duterte also faced his nation. He was two hours late to the scheduled broadcast, and when he finally appeared, it was to announce--in increments--the provisions of the Metro Manila quarantine. "Announce now, details to follow" was the gist of the whole affair, as if the document he was reading were the most banal and unimportant thing.

Days later, his lackey, presidential spokesperson Salvador Panelo, also took to the podium. Mind you, this was before the actual announcement of the "enhanced quarantine"--now the whole island of Luzon was to be locked down. Among the many things Panelo said: The Cabinet was about to propose a Luzon-wide lockdown to the President (so why was he already blabbing about it to the media?); the country was taking South Korea's lead in locking down (Korea has done no such thing); eating bananas and gargling saltwater would prevent you from getting COVID-19 (they won't); and the operations of such services as supermarkets and food cargo deliveries would be impeded (the Department of Trade and Industry had to quickly go on record to refute that statement).

Neither instance was out of character; anyone who has lived through all three-and-a-half years of Mr. Duterte's presidency should by now be familiar with its penchant for chest-beating and noise-making set to maximum. "We can say what we want and get away with it" has always been the gist of this government.

It's only rational, then, to think that, for all the proactive actions it has indeed taken, this government remains blithely unaware of just how extraordinary and precarious a time we are living through--that now, more than ever, the unhinged minds occupying its highest echelons must take responsibility for every single word they utter.

In the two instances cited above, what transpired afterward was only expected. Perhaps for the nth time within the span of two weeks, many people in Metro Manila found themselves panic-buying, prodded by vague, doomsday-like proclamations from above to head to groceries, pharmacies, and other establishments. In other words, crowding in public places--and, quite possibly, transmitting the virus among themselves. The pictures of these crowds--the indirect result, it must be emphasized, of the government's reckless mouth--are just some of the stuff that health care workers' nightmares are made of these days.

And it isn't just its mouth this government can't control; it also doesn't care about the kind of messages it sends out to its already anxious and agitated people.

The country running short on testing kits for the virus? Let's have asymptomatic politicos get tested, anyway, violating the algorithm set by the Department of Health, and have them parade their results in public. Meanwhile, patients under investigation for COVID-19 are dying in our hospitals without even knowing if they were positive for the virus.

A pandemic laying siege to our fragile health care system? Let's have a law-and-order solution to this public health problem, with checkpoints manned by the military, ill-equipped and clueless about the necessary hygienic precautions (though hopefully not as clueless now).

Nobody expects any government to get through this pandemic perfectly. But the least it can do is provide a reassuring voice to its people, and show them it is exhausting every possible means to get them through this unprecedented time--something numerous local government units, through the leadership of their mayors and governors, seem to be achieving.

Our national government, on the other hand, is only adding fuel to the Philippine COVID-19 inferno. Not only are we facing a virus the world still knows very little about, we must also deal with leaders who don't know how--or don't care--to talk to us like they actually want us to survive this pandemic.

PDI Opinion: Normalized inhumanity

My fourth piece for Inquirer-Opinion is dedicated to my alma mater--the website link here.

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Normalized inhumanity

There aren't enough beds to go around in our public hospitals. And if you think the country is in a hurry to fix this problem, think again.

At the Philippine General Hospital (PGH), where I was once a postgraduate medical intern, it is normal to see some admitted patients in the emergency room (ER) being accommodated on Monoblocs. In the charity wards at night, the bantays--the patients' assigned companions, sleep either on chairs or on cardboard sheets spread beside or under the patients' beds.

And that's only scratching the surface of the Philippine public health situation.

The old PGH labor and delivery room, before it was torn down to give way to what has become a protracted reconstruction, could get so crowded it resembled a parking lot: women on steel stretchers placed side by side, with just slivers of space in between for careful movement. Oh yes, charity patients used--and still use--uncushioned stretchers, usually outfitted with just a thin sheet of cloth to separate the woman's body from the cold surface.

At least the patients just stay in bed. I'd been in numerous in-house emergencies where the bantays had to push the drastically deteriorating, bedbound patient alongside the physician on duty all the way from the ward to Radiology. Where was I? Running--in a place where life is oftentimes a literal race to get things done--to have the needed scan approved and scheduled instantly by the radiologist on duty. Where was the hospital aide whose job it supposedly was to push the bed? Pushing another patient's bed.

And yet, there aren't enough voices demanding the provision of more items from the government to employ more health care personnel. There isn't enough outrage at the fact that what is supposed to be our best government hospital still persists in primitive conditions.

It's reasonable to believe the people with the money and power to actually change things don't even grasp the ground-level reality of our public hospitals. Look at how our leaders justify their splurge on a multimillion-peso scam of an ornamental cauldron for the Southeast Asian Games, after having slashed next year's national budget for health by an infuriating percentage. In times of sickness, they inhabit a world of their own: plush suites that can give luxury hotels a run for their money, the bantays with their own beds, and massive TVs and high-speed internet access to pass the time. Even the apathetic middle class have a myriad of private hospitals to choose from; should they opt to go to PGH, there are still air-conditioned private quarters to check into.

The state of hospitals such as PGH is nothing new. In fact, it has been like this for so long, we hear the depressing anecdotes and instinctively think, "That's just the way it is."

As I write this, a hallway continues to substitute for the ER lobby of PGH, threatening to burst during peak hours with all the sweaty, tired bodies jostling for the attention of an overwhelmed team of medical professionals. A single converted ward--the main stand-in for what used to be a multi-part complex--is stretched ridiculously thin to accommodate almost all the patients admitted for emergency care. And these patients on their stretchers have spilled over into neighboring hallways and even a portion of the hospital's central elevator lobby.

We've heard again and again how our doctors are overworked and underpaid; how our nurses are overworked and even more underpaid. When a doctor tweets, "Ubos na ubos na ako (I'm totally spent)," it's now somehow taken as a fact of life and fodder for after-work conversation.

But at least resident doctors who go on 24-hour duties every three days get to go home to a bath, a warm meal and a soft bed at the end of it all. Ditto with nurses who drown in paperwork alone every shift. The luckiest even have well-appointed call rooms to retreat to during down times.

Our patients, on the other hand, have no choice but to endure the deplorable conditions of our government health care facilities, for lack of more humane and accessible choices. Suck it all up, to put it bluntly.

For our patients, it's already a battle just to be seen at the ER. In the wards, bantays continue to sleep on the floor, waiting for that day when the patient finally gets discharged or dies. Behold, this normalized inhumanity.

Turning 26

Victoria Peak, December 2017.

When I turned 25 a year ago, it was a different world then. I was coming home to Iloilo after two weeks in Dumaguete as a fellow to the 56th Silliman University National Writers Workshop. For lack of a less cliché sentiment, those were two of the best weeks of the year. I'd submitted my application on a whim, after thinking I wouldn't even make the deadline, already somehow resigned that I'd never be part of the workshop's history. 

I spent a good part of that birthday transiting in the marketplace that was Mactan Airport. There were no direct flights from Dumaguete to Iloilo, and I was determined to be home before evening, so I'd booked the early morning flight to Cebu and boarded the plane hungover from the previous night's farewell festivities. I didn't mind the blur of it all; the mental haze somehow made the day all the more deviant and, thus, exciting. In a week, I'd be in Bicol with two of my best friends from high school; in two more, I'd be in Japan, for the first time, with my mother and brother.

When I turned 26 yesterday, I'd had three hospitalizations within a span of five months--first, for H. pylori gastritis three days before Christmas last year; then for an appendectomy last month, and a readmission after that operation for partial gut obstruction.

I'd spent a good seven months back in Iloilo, eased into a routine so far off from the toxic, patient-filled life of residency training I'd envisioned.  

I'd seen 52 movies since New Year's, aside from a number of TV series, plus a pirated copy of the filmed version of London's National Theater's "Angels in America." I'd read more non-medical books than I could recall reading within a similar length of time (among those books, David Mitchell's "Black Swan Green," Wilfredo Pascual's "Kilometer Zero," Mookie Katigbak-Lacuesta's "Burning Houses").

I'd seen what will probably be the most atrocious production of Jonathan Larson's "Rent" I will ever see in this lifetime, and also a so-so touring production of "The Lion King," the source movie being one of the defining movies of my youth.

I'd gone on a supposedly secret, 24-hour trip to Hong Kong very few people knew about. 

And my father had been gone for just a little over seven months. It's this last bit, I suppose, that's fueling this emotional logorrhea. It's hard to believe it's been that long, but you can do nothing else but believe it, y'know.

Passing the boards and other matters

So this is what the morning after feels like. Oscars speeches are made of mornings like this. I feel new, reborn.

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I'm the least thing from an exemplary Catholic. So believe me when I say everything I'd prayed for has come true. Better: You know what they say about Simbang Gabi, the nine morning masses preceding Christmas Day, that when you attend all nine mornings, things will happen for you? Again, I'm no exemplary Catholic, but.

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The Physicians Licensure Exam is a game of chance. It's not standardized. It hardly measures anything as far as being a competent doctor is concerned. Questions are repeated, sometimes more than once. Some are lifted off review books. Some are lifted out of certain institutions' review materials. Typographical errors abound. I wish the examiners would take it more seriously. But I bet all they'd tell me is, "Who are you to complain?"

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I was in Robinsons Magnolia yesterday when the results were released. Some friends and I were watching "Care Divas" at the nearby Peta Theater, and that was where we had agreed to meet. The signal in the area was atrocious: Thirty minutes of refreshing my phone, and then when it finally came out, it was almost ten more minutes of loading that page. Those ten minutes felt like a day. The calls and texts soon followed. I was half-running inside the mall, but I didn't care. 

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My grandfather--my father's father--would have been 95 the day before yesterday. Picture this: At four years old, going up the stage with him to receive my very first gold medal in school; at five, me and my siblings standing in a corner of our roof deck back home, punished for some trivial misdeed, while he stood somewhere off-center, barking orders at the house help; me at six, just arrived home from school and greeted by his reedy frame, that distinct smell of last night's alcohol sticking to his shirt, his veiny hands brought close to my forehead; me at seven, and him in and out of hospital, until one day lung cancer got the better of him. 

I try my best to remember: me, whom they say looks very much like him. I find my memories of him grow fewer by the day, and sometimes I'm no longer certain about the details. Do I have the shape of his face right? The sound of his voice, the way he walked? I wish to remember, and to remember more.

s/p Internship: More from the year that was

This is the second of a two-part documentation of the seventh year in med school.

I'm reluctant to turn this post into some kind of lazy-ass photo dump, but when you're trapped in a city that's really no good for your writing brain, and said brain's slowly turning to mush from indolence, then you really have no choice. Here's 42 more pictures from the year that was, including some NSFW and never-before-seen ones (but that's really pushing it).

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1. This is what your doctors do when they don't have patients. Remember when this was a thing? (Internal Medicine emergency room call room, September 2015).

2. Two from the National Museum: "Mother's Revenge" by José Rizal (terra cotta, 1894); and Manansala's carabaos.

3. More from that Corregidor trip: (top to bottom) the Manila skyline; view of Malinta tunnel from the park behind the Pacific War Memorial; statue of the Buddhist fertility goddess at the Japanese Garden of Peace; making friends.

4. Trying my hand at paparazzi-ing during the premiere of the restored version of "Kakabakaba Ka Ba?" (1980, directed by Mike de Leon and starring Christopher de Leon) at Trinoma.

5. Making fools of ourselves--and damn entertaining ones at that--during the Mr. and Ms. Surgery pageant.

6. More from that La Union trip: (top to bottom) clingy toothbrushing at Flotsam and Jetsam Hostel; roadside garlic to ward off evil; customary stop at the Church of Our Lady of Manaoag in Pangasinan on the way home.

7. More from that Mt. Pamitinan climb: (top to bottom) side trip to Wawa Dam, where a kid shat in the water; Brother Terence and I diggin' those rocks.

8. Pediatrics rotation! (Top to bottom) 3AM at the emergency room triage before leaving for Dinagyang in a few hours; with my stellar service clerks in the wards; while not catching newborn babies ((c) C. Vistal).

9. This is my brother from another mother. This is what he does for leisure.

10. Playing with light at the 2016 Art Fair Philippines.

11. After the Disney-themed "One Night Stand" cabaret, where we used to be regulars, at 12 Monkeys Music Hall and Pub. ((c) C. Vistal)

12. More from the "Les Mis" gala after-party at the Diamond Hotel. There were four Filipina Fantines in that room: Lea Salonga (replacement, 2006 Broadway revival; will next be seen in Atlantis' "Fun Home" in November); Joanna Ampil (replacement, West End original, 2003-2005 & 2007-2008); Menchu Lauchengco-Yulo (1993 Repertory Philippines; will next be seen in Resorts World Manila's "Annie"); and Rachelle Ann Go, who played the role in that production.

13. Putting on our best sober faces at 1AM at The Fort. Check out our balloon-filled ride. ((c) C. Vistal)

14. More from Community: (top to bottom) J and I with our barangay health team; the river, the main attraction of Barangay Lumipa in Bailen, Cavite; J and I celebrating his birthday at the Residence Inn Zoo in Tagaytay (it is no longer worth visiting and should just shut down).

15. The day after the 2016 national elections, we took a wrong turn on our way to Community and found ourselves at the official birthplace of Philippine independence. 

16. More from that last hipster trip to Punta Fuego. ((c) C. Vistal)

THE FOLLOWING POST MAY BE NSFW.

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17. Diagnosis: Abortion, early, septic, induced. s/p spontaneous passage of products of conception. 

18. More from our fake graduation (a.k.a. the university graduation) at the Philippine International Convention Center. With some of the people who matter.

19. After the Sunog-Puri ceremonies, which we headed. Damn evil fun, it was.

20. More from the grad ball, including us hangin' out at the posh women's comfort room.

21. Finally, at the college graduation in UP Diliman. This was during the singing of our class song, which more than half of us no longer memorized. 

s/p Internship: The year in 12 images

This is the first of a two-part documentation of the seventh year in med school.

It's true, what they say: Internship really is the best year in UP Med. It's hard to believe the year went by that fast, and I'm finally done with school (though, of course, you can argue that school never ends for a doctor). Heck, being called "doctor" still feels kind of surreal, as if finally reaching that goal made it all the more distant and intangible. But how to capture the past 12 months in as brief a post as possible?  

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1. Rotating under Service 3 of Internal Medicine, a department I actually like, despite its flaws. 

2. Turning the National Museum into our own Wednesday afternoon photo studio. Did you know it used to be the old Senate Hall?

3. Returning to Corregidor after a decade. Every kid in this country ought to come here some time.

4. Block Christmas party, or getting Donna Tartt's "The Goldfinch" and David Mitchell's "The Bone Clocks" for presents! And just look how happy we all were! 

5. Surfin' with my girls in San Juan, La Union. And successfully riding a surf all the way to shore after almost an hour of falling off the board!

6. Climbing Mt. Pamitinan in Rizal, or that time we thought we'd die by getting our throats slit by razor-sharp rock edges.

7. Stalking Cameron Mackintosh at the after-party of the "Les Miserables" Asian tour-Manila gala night.

8. Community! Or learning to cook and dealing with people in a rustic healthcare setting and being more than just plain ole doctor. And escaping to Tagaytay at the end of every week!

9. Turning 24 in OB-Gyne, where we lost weight and gained pimples and occasionally turned into grumpy monsters.

(c) C. Vistal.

10. Kayaking with three people, or Punta Fuego for the final time as "kids."

(c) P. Zamora.

11. Fake graduation! Or that time we went on duty in OB-Gyne, left the hospital at 1AM, slept a bit, donned our sablays and put on our freshest faces. 

12. The grad ball, or getting wasted one last time as a class.