Empathy and Compassion

Last Saturday my daughter Janice sent a text message to me saying she's arriving late. She's going with friends to a funeral. Her classmate's Dad just died.

May 28 was the burial. My daughter asked permission to attend. I volunteered to drive for her and a couple of her friends.

I do not personally know the bereaved family. But my daughter was insistent she must go. She felt her presence can comfort her classmate somehow. I knew it would, so I was sure my time will be well-spent.

We attended the mass at the Assumption. After that, the throng of mourners trooped to the burial grounds at Orchard. Upon arrival, the mourners were seated and after settling, some songs were sang. A brief silence ensured after the songs, then the widow went up front and thanked those who were present. She was deeply emotional. We understood. And we wept with her.

When it was time for all the family members to take a last look at ther departed for the last time, it was an extremely emotional sight. One of the three children couldn't contain himself. He was trembling and almost collapsed. Fortunately, he was propped up by relatives.

I was moved. I can feel what they felt. I can put myself into their shoes. I knew what they were going through. And I was thankful I was there to add to the salve that eased their pain. Even if I was silently there. Even if they didn't know me.

But I knew some of those in the crowd. So I slipped an envelope to one of the widow's colleague and requested that she gives it to the widow. Surprisingly, the widow knew me. She saw me a few times when my daughter was still going to school. And she knew what we just went through. She understood, she was thankful, and she instanly and easily related. I felt sorry for them, I felt relieved and I felt happy that I was there. I felt I was able to walk with her in her shoes.

I was thankful that I went to the burial with my daughter. I was glad I had the opportunity to extend a bit of help. I knew it somehow eased a burden. In attempting to ease the pain in others, I felt better with my own pain.

Empathy - that's putting yourself in others' shoes. Compassion - that's walking with others in their shoes.

It's quite awkward. But it works - for both the walker and the owner of the shoes.

Continuity

Anyone who undergoes crisis in life gets stalled somehow. Some important things need to be set aside. Schedules are reset to give focus on urgent matters. Finances are reworked. Often finances dry up in so short a time especially in cases of a major accident, illness or death.

After going through our daughter's two years of illness that ended in her death, we've been to the depths so to speak.

In spite of the fiery trial, we say we are more than fortunate. Relatives, friends and many others rallied behind us. They provided continuity to our lives. Though we had to take occasional and extended leave from work, our career somehow did not suffer. My wife's even took some positive turns as her role in her organization became more pronounced. And while I took a turn to a less stressful and more independent assignment, it is no less personally rewarding.

After four months of our daughter's illness in 2006, our life-savings were wiped out. We stared at raising a 7-figure budget for her continued medical expense. We say God provided our needs, moving the hearts of people who in turn extended their helping hands to us. I always wax emotional whenever I remember how much love and care we received from countless people, often times I feel we did not deserve. While my family sold some properties, we have not been tried to the point of blood.

People who reach out to others could be God's way of providing fluid continuity in peoples' lives. He did so greatly to us. Many times during those two years, we could have stalled. But somehow, we kept moving on because family and friends were simply there by our side. Old friendships were renewed, lost ones were regained, new ones emerged. Indeed you know who your real friends are when you're down and we realized we have many, Big, big thanks to you guys. I guess no one could be more proud at how much and how far family and friendship provide a solid support system.

We thus count it a joy to have undergone a fiery trial though we admit we sometimes felt abysmally down during those times. But God always provided a way out, often in ways we never imagined and in ways that displayed His glory. God indeed provides continuity through people.

Now, it is our turn to provide continuity to others' lives. And while we did so in minor ways during those two years, we can do it in a more active way now. We just started by placing a modest donation in the name of some friends to the Child Life Program of Kythe at the Davao Medical Center for pediatric cancer patients. We also committed to assist a leukemia survivor to college and enable her to appreciate and fulfill her life dreams.

Honestly, I feel a little discomfort writing about what we do (because I may not even be able to make a dent). But continuity to our own life and to others' lives is our individual and collective responsibility. We owe ours to many others, we owe it to others who need us. We just need to open our eyes, reach out, or be sensitive to others' needs.

Continuity - this is life. It is what life is all about.

Yam's 40th

Yesterday, May 27, was Yam's 40th day. It was so quiet at home. Our silence was gladly diverted to Yam's pictures. On her framed picture, she exudes tranquillity and joy. Her eyes glitter, her smile captivates, her countenance radiates life. She hugs on to Ashlee, her brown cuddly bear given by her Tita Helen in June 2006.

After breakfast, the three of us at home went onto our chores for the day. Quietly and purposefully.

At about 4 in the afternoon, it was breezy at the Forest Lake, Davao City where Yam was laid to rest. Where I stand gave me the best vantage look at the gently flowing Davao River and the luscious vegetation nearby. The undulating terrain exemplifies the waves of life and the serene environment suits my mood. The soil on Yam's plot was freshly cleaned up. The grass has taken root, thanks to the frequent afternoon rains.

I began to mutter words and phrases I used to tell Yam when she was still around. A long silence, then prayers were said, but not very long. Tears flowed, but weren't buckets-ful. Memories flashed, but weren't in torrents.

We have accepted. We are moving on. But the grief lingers. We terribly miss a characteristic laughter, a gentle voice, a trusting heart. But deep within us, we silently nod in trust and gratitude at God’s unfathomable and infinite wisdom.
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(Our special thanks to Manny Mascunana who offered a mass for Yam at the Carmelite in Cebu, and to our friends and relatives who offered their prayers for Yam where they were on this day. God bless us all.)
(Yam's elder brother Joseph posted in his site his thoughts on Yam's 40th day.)

CHIBISUKE (written by Yam in May 2007)

(This was posted by Yam on her Multiply site sometime late May 2007 just before her elder sister enrolled at UPDiliman. She was into those anime thing which perhaps made her familiar with words like chibisuke. She was back to school June to August but reverted to home study in September. We wish she could have written more. But she was either busy with home study or was on treatment. She was so fond of bantering with her sister who, in turn, was so Ate to her)

hindi niyo siguro alam yang word na 'chibisuke'...well, merong storya yan...nakakatuwang story...

kanina kausap ko ung 'genius' ko na ate(sa phone, syempre)nasa manila siya eh...tapos nag-usap sila ni mommy...tapos kinausap niya ako...

nag-usap kami ng mga sooooooooo out of dis world na mga bagay...tapos dumating kami dun sa topic na LAST MONTH pa namin pinag-aawayan. yung pag-spell ng word na chibisuke.eh kasi ang pag pronounce nyan na word is chi-bi-ske.syempre kung i-spell mo yan ay chibiske pero noooooooo! hindi ko alam bakit ganyan yung spelling nya.tanungin nyo ung mga hapon.hehe...anyway,since 'genius' nga siya tinanong ko ulit siya kung paano i-spell ung word...

C-H-I-B-I-S-K-E-E
yun yung sabi niya na spelling...syempre mali diba? chibiski na ang pagbasa nun

C-H-I-B-I-S-C-K-E
mali parin.syempre tawa ako ng tawa kasi ang tagal tagal na namin yan pinagaawayan...tapos try siya ng ibang letters na kasunod ng S...yun nga nung sabi niya na C-H-I-B-I-S-U-K-E (himala!!!) eh tama yun eh...syempre sabi ko tama...sabi nya nalaman daw niya yun kase naalala niya yung sakura...eh pag sasabihin ko yun na name sakra ung pag-pronounce ko...

MERON PANG ISA!!!!! hehehe...

tapos na yung chibisuke thingy...pero humirit pa yung ate koh!! (grabe talaga yun eh...) nagtanong ako sa kanya kung meron siyang tv sa kanyang kwarto...(dorm eh) sabi niya wala...pero sabi niya meron sa lobby...syempre naman! kung walang tv eh di mababa yung fun nila diba? sabi din niya malaki daw...so, nagtanong ako... plasma? alam niyo ba anong sabi ng 'genius' ko na ate? huh? huh?
??????

ito lang ang sabi niya--

ano yang plasma? syempre tawa ako ng tawa!!! isang up diliman na student? ndi alam ano ang plasma? so in-explain ko sa kanya...blah, blah, blah...tapos sabi niya, oo lagi, hindi na ako genius!...(bumigay din!!!) so syempre ni lait-lait ko muna siya...tapos sabi ko isusulat ko ito sa multee...mwahahahaha!!! yun...doon nag-start kung bakit ko isinulat itong beri so ambot na story...so, sa ate kong .HINDI na genius-hhahbhleeeehhwwwww!!!

Yam's Article Published in Big C Magazine

I received a package through the mail last Friday. Upon receipt, I knew from my heart what was inside and that I had been expecting this. Within my expectation is something that could have changed due to a recent event.

Opening the package and going through its contents brought me a pleasant surprise and a deep feeling of elation - one that made my day and many days to come. It was a copy of the April-June 2008 issue of the Big C Magazine, a three-time CMMA award-winning magazine about cancer, and in it is Yam's article on her journey with leukemia. She submitted the article mid-February, shortly before we brought her to Asian Hospital for check-up. On the cover is Toti Fuentes, a well known singer, composer and musical director.

Both Toti and Yam have things in common. They are both in the magazine because they had cancer. And they both passed away before the magazine came out, leaving behind them volumes of fond memories to loved ones and to many others

To access Yam's article, click HERE.

Grief and Relief

When a loved one dies does grief automatically overcome the bereaved family?

I guess not really. When Yam expired in the evening of April 17, we sort of expected the event coming. We just didn’t know when and how. Our second son, Joseph, saw it all – how Yam peacefully made her last two gasps, then expired. Mom and Janice were also in the room, John and I were rushing in.

When the hospital staff finally documented the fact and declared Yam lifeless, I calmly requested for family private time. The hospital staff obliged and we locked the room. We silently wept, clutched on to each other. Each of us knelt or stood beside the bed and held the lifeless body of our dear “bunso“. Breaking the silence after a long interval, we took turns in hugging her while she was warm. We thought it was important to accept that a loved one has just departed. And we were all there by her side.

We then took a brief time to send a message to our relatives and closest friends. And then back to Yam’s bedside. Shortly thereafter, our closest Davao-based friends informed us that they were coming. We alerted the hospital staff to allow us more time with Yam as it was normal to take the body to the morgue in an hour. They acceded to our request.

When our friends arrived, we hugged, sang songs and wept while sitting around our dear departed. We talked and focused on immediate concerns. We sorted out what family members needed to do, while they volunteered to do other necessary tasks. After about an hour, we called in the hospital staff to do what were necessary. It was time to rest in order to face another day.

We saw to it that each family member was involved, but not taxed. We figured that we needed to work by pairs, except for Dad who needed to get arrangements fast and smooth. By the time Yam’s body was ready for viewing, a handful of colleagues were there to extend condolences.

The wake brought us pleasant surprises and realizations. Yam's classmates and friends came as did Dad's and Mom's as well as her siblings' friends and colleagues. Close relatives arrived from Luzon. Calls, text messages and emails were received from all corners of the world.

But we didn't expect there were many more to come. Yam's teachers and school administrators were there. Wreaths and flowers arrived from some important people. Parents of Yam's classmates came. And there were some whom we absolutely have no connection with, who just mentioned they heard about Yam and were touched by her life story. And then there were the text messages and emails from many others, some who have not met Yam but read about her story.

The burial rites were simple. It was held at the cemetery chapel. We saw to it that we were on schedule. Pastor Mark Pineda of the Pujada Community conducted the rites. Dr. Caridad Fiar-od gave the first eulogy on behalf of Yam's relatives, friends and supporters all over. Teacher Rose Zosa talked of Yam as her student. Kaling Reyes, Yam's classmate, read Karla's (Yam's best friend) email. Dad then outlined some lessons learned from Yam's life and times then thanked everyone for everything. When it was time to lower the casket, light-green balloons were released to the air. The mourners bade their last goodbye, dropping their choice flowers down the casket. Then the bereaved family members gave the event its closure by spading in the first batch of soil that buried the casket.

There were 21 vehicles that ferried the mourners. Four buses, 4 vans and the rest were private vehicles. (May we thank PWC, UPMindanao, DNSC, DOSCST, SPAMAST, USeP, PWC, ATI-RTC, APO, Dole-Fil, Globe, Greg and Chic Mendoza, the Magdoboys, the Pujada Community, Abe, the Trio of Irvin, Lou and Malou, and to everyone who assisted in one and many ways. We also thank many others who stood by and supported us all the way since Yam got sick (no order of priority): our relatives, PCSO, First Hand, Outreach Asia, Pisay74, Bibaknets, Semians, Pisay75, NSDB-PNC7405 Alumni, the Macasaets, Pres Emer Roman, UPMin, DOSCST and Mati community, PASUC, Annabel Vega-Ganal, Atnet's Friends, Yam's physicians and nurses, and many, many others).

In sum, grief seem not to overtake the bereaved all at once. There were things that needed to get done, there were customs and rites to follow, and there were people to share with and who shared. And when people shared and were shared with - they relieved the grief many times over. The customs, rites, symbolisms and ceremonies are time-honored and time-proven ways to relieve the grief and salve the pain of the bereaved.

I remember what a high school classmate once wrote, which I paraphrase: "Joy when shared by many, multiplies in awesome proportion. Sorrow when shared by others, divides infinitesimally." How great are the ways of the Creator.


Next Article: "O Death, Where is Thy Sting?"

When Death Stared At Us

Yam was 10 years old in 2006 when she was diagnosed of leukemia. She had 3 courses of chemotherapy, then a bone marrow transplant – all in 2006. She bounced back to wellness quite fast, was back to school and did things she was happy doing. She was back, not exactly to her old, but to a new, normal. She was happy as she always was and we were extremely happy, too, as did her friends and her many supporters. Death stared at us, but Yam saw victory from its very threshold.

A year after transplant, she had two bouts of infection that needed hospitalization. In both, she bounced back pretty well. But this March to April episode? It was just simply too long. Will she bounce back as she always did?

Yam’s pediatric-hematologist-oncologist wasn’t exactly comfortable when she examined her on February 29. She advised us to go to Manila to check on the skin rashes. But the slight eye bleeding bothered her, more so because Yam’s platelet count was normal. Déjà vu? This was how Yam appeared when she first saw her in April 2006.

After 23 days in two hospitals in Manila and so many days at a Davao hospital, we kept facing a blank wall. So when we were informed of the relapse on the night of April 12, we were devastated but weren’t exactly caught off-guard. We felt the same feeling we had two years back when we were first informed she had leukemia, back but this time we were a little bit numb. And on the educational side, the information somehow explained the fever that refused to go away and the bone marrow that didn’t produce enough normal blood cells.

The following day, I got hold of the telephone and talked lengthily in succession to Yam’s two pediatric-hematologist-oncologists. I gathered that the prospect for remission is slim (very slim). To achieve remission requires high-dose chemotherapy. And post-remission long-term survival and quality of life are uncertain. This time, the battlefield consists of highly resistant cells. And the body may be too tired to withstand episodes of more furious battles.

Getting together as a family on that Sunday, we wondered why we called in a pain management specialist a few days before. We reflected on the occasions when we asked the doctors directly about Yam’s chances. We asked why Yam told her Mom, “Mama, ayaw na” but kept on fighting just the same. We felt some relief on why we entertained letting go at some moments of helplessness at the sight of a lovely but terribly sick child. We wondered why Dad was so restless until he took counsel with a minister. And we were thankful that all of Yam’s siblings had been with her for days by now.

Coming home from work on the weekend of April 5, Yam’s Kuya John stayed for the week. On April 10, her Kuya Joseph arrived from Manila and all three siblings took turns in cheering Yam up and getting involved in various chores at home and in the hospital. Now complete as a family, we all bowed down to God by Yam’s side and solidly and in unison asked Him for one great miracle. We then PUSHed (Pray Until Something Happens) together every day.

In the evening of April 15, after intensely going though the medical chart and looking at Yam’s clinical condition, two of Yam’s doctors jointly talked to us (Mom and Dad) in a room. While in discussion, three of our closest friends in the city, were waiting downstairs to visit. The meeting with the doctors was tearful and delved on matters of fact. We were clearly briefed on possible scenarios. We were clarified on possible options and assured that choices were clearly ours. After the doctors left, it was our turn to talk with our closest friends. By then, we weren’t holding back. We talked about and prepared ourselves on things that can happen. We felt so comforted and reassured by friends so avid and loyal.

The next day, we took care of Yam and carefully observed her behavior and responses. She was restless, had moments of incoherence and sudden surge of energy. On intervals, she asked for her favorite shake, drinks and ice cream - with complete specifications. It was a joy for the family to satisfy her whims. In the afternoon, she rattled off some names. We frantically called the person by cell phone when we recognized the name. She got to listen to her Kuya John assuring her he’d be by her side come evening time.

The morning of April 17 has given us perhaps the most profound experience the family ever had. As early as 7am, Yam’s doctors visited. Mom has to call Dad at home to rush up. Dad had to pass by a potential blood donor to make sure blood is available. After all, Yam’s blood counts were bottom low.

Upon arrival at the hospital, the doctors told us what they see. They have dealt with so many cases like Yam’s and can read the signs so well. And having understood what they were saying, we asked for family private time.

Dad assured Yam we all loved her so dearly and we would not like to let her go, if we had our way. But we are ready to let her go if she believed Jesus was her Lord and Savior. She nodded as she did when her Kuya Joseph asked the same question a few days back. Dad assured her that the family will be okay, that we will take care of each other and we will be by her side.

Mom assured her that Jesus will meet her where she goes and where she goes there will be no more sickness, pain or suffering. In her innocent voice, she blurted, “Sama kayo”. Mom then explained that each of us have our own appointment with the Lord and that we will all be together in the future. To which she asked, “Kailan?”

The siblings then took turns talking to her, whispering to her and hugging her, to which Yam responded in warm and quiet affirmation. She then requested her intravenous connections removed, to which Mom explained that it was needed for infusing her optimum comfort medicines. It was about 11am, Thursday, 17 April.

By 7:45 pm, Yam had her last two gasps of air and peacefully expired in her sleep. Death kept staring at her, and this time, it was a victor. Or is it?

(coming… “O Death, Where Is Thy Sting?")
(coming... "Grief and Relief")

Romancing A Deadly Disease

(Two things: First, I had difficulty choosing the title for this piece. As a compromise and to capture my ambivalence, I place both titles. Second, my daughter Janice and I visited the House of Hope at the Davao Medical Center yesterday. We met with Xai of Kythe Foundation which is playing an enormous role in improving the lot of pediatric cancer patients in the hospital by providing psycho-emotional help as integral part of the healing process of the patients. During our talk, Xai affirmed the therapeutic effect of blogging not only for the blogger but for the readers as well.)

When our daughter Yam spent 23 days in two hospitals in Manila and was transferred to a Davao Hospital on March 25, we never doubted she will bounce back to wellness. Her March 10 engraftment analysis showed 100% donor's graft and therefore was leukemia-free. Although her CT scan showed a spleen enlargement, a developing abscess in the liver and some nodules in her lungs, she was being treated with high-end anti-biotics. While she tested positive for the dreaded cytomegalovirus, she was immediately given treatment. Her persistent menstrual bleeding was likewise minimized and controlled.

As she did in two previous bouts with infection, we knew she will bounce back. She had the best doctors we knew of and she was receiving utmost hospital care. She had strong will and spirit, we had friends and family support, we were focused in providing everything she needed, and we had prayer warriors backing us up.

When we decided to transfer to a Davao hospital, we went through elaborate preparations to eliminate possible medical risks. The doctors ascertained her medical condition, set into motion the treatment regimen and made the necessary medical abstract and endorsements. We made special travel arrangements with the airline while a long-time friend provided the hospital to airport vehicle.

At the Davao end, hospital transfer arrangements were done and so with the airport to hospital transport. Yam's Davao doctor was ready to visit, the hospital staff was alerted, the hospital room was prepared so Yam was immediately whisked to her room without going through normal procedures. Yam seemed to have just transferred to another hospital room with a three-hour travel interval. It was also a change from her Manila-based male doctors to her Davao-based female physicians who all previously handled her since 2006.

So far, so good. Medications were administered as planned and adjustments were done when needed. On March 29, the cytomegalovirus test was negative. Yam's Ate Janice also arrived from Manila and beefed up family support. Yam's tutor Chirlen had been around to assist in many ways and her Kuya John was just 3 hours away. Mom stuck by her side on a 24/7 in spite of becoming accessible to her work and workmates. Dad was hovering around, always ready to get outside-the-room needs met. Yam's menstrual flow also stopped.

But the fever just won’t go away. The blood counts just wouldn’t rise. The energy just seems to dissipate. The body began to waste away. The petechiae became visible and began to enlarge. The “drug of last resort” wasn’t getting the job done and had to be stopped. The shift to other antibiotics didn’t get the fever off at all. And the blood transfusions were needed every other day. Signs of allo-immunity became apparent as the platelet count rises after infusion but quickly plummeted down in a day or two. Yam’s bone marrow was simply immobilized. Yam was not improving, she seemed not responding to medications.

On April 12, her laboratory tests showed she relapsed. Leukemia was back to her frail body.

(Continue to ... “When Death Stared At Us”)