Compassionate Considerations

On Palliative care: How do you tell a person that he is dying?

Posted on 6 February 2010 | No responses

It had been a very busy week.  Yet despite the busy-ness of preparing for the Leadership Conference, one thing was foremost in my mind the past couple of days.

Last Tuesday, I visited someone in the Intensive Care Unit of the National Kidney Institute.  Due to the many things demanding for my attention, it slipped thru my mind about the promised visit. It was already past 9Pm when I strolled through the lobby and corridors of that said hospital, triggering in me past memories of when my Dad was given a second lease on his life after surviving Klebsiella pneumonia.

I walked through the familiar corridors and up the second floor.  I did not know who the patient was. I only had a name.  One of the ICU nurses stopped me and said “Visiting hours are over” but I said I was not there for a social visit, I was there for a pastoral care visit.

She led me to one of the units where a man was attached to several machines.  He looked at me and perhaps wondered who I  was.  I approached his bed and introduced myself.  I heard the nurse use the phone and called for the relatives and said “the pastor is here…”

This man is dying.  The doctor gave him 3 – 6 months left to live.  He is only 59 years old, yet he has considerably aged because of the toll the cancer is exacting on his body.  He was recently diagnosed with colorectal cancer – but he went for a check-up because of his pneumonia.  Several tests and MRIs later – he was diagnosed with Stage 4 -colorectal cancer.

Does he know? I earlier asked his daughter during our brief encounter in the office.  “NO” we have not told him. I was reminded of an earlier writing I read about this.  When the person who is dying is not informed of his condition – they can oftentimes tell that something so major is happening to them.

While I respect the desire of the family not to inform the person of his real condition, I also wondered about the needs of their father.  About the needs of someone who is about to leave his family behind.  I would personally want to know if my time is up.  There are still many things that a dying person needs to settle in his life so that when that inevitable time comes, the person may be more ready and be more at peace.

Because death does not just occur at the cessation of breath – the process even begins days or weeks or months in advance.  A dying person would need to make amends with his past and settle emotional accounts, to grieve the things he had lost and could never have because death had already come knocking on the door.  Death does not just to happen to the person but to the family as well.  When a family made a decision not to tell a dying person the real situation, they have placed themselves in a position where they would need to create a facade of well-being, a facade that gets more and more difficult as the time draws near.

I disinfected my hands with alcohol and proceeded to place my right hand on his forehead and my left hand on his left hand. A big part of palliative care is answering the need of a person to still feel the touch of another human being.  To be connected to another human being more than being connected to machines, is an utmost need for them.  I started to pray and at times, struggled with my words because praying for a dying person who is not informed of his impending deaths would be totally different from a prayer for someone who has been told of the inevitable.

I felt steps of people around me.  We were being surrounded by the family members.  I prayed for God’s mercy expressed in His loving care for their father, for the comfort for the whole family – and for the immediate needs of finances because the bill has gone up to P300K.  I prayed for God’s loving will to be made manifest in all of their lives.

After the prayer, I looked up and saw how young the children were.  Two of the boys were still of highschool and college age and two daughters were in their early twenties.  There was a young girl who introduced herself as a granddaughter.

Lord God, they are too young to lose their father…. I silently prayed inside.

We made our way back to hospital corridors.  I was sobered by what this family is going through – and at the same time got quieted by the memories of when I was also seated in one of those benches by the corridors,  as I pondered how to get financial help when we needed it at that time back in 2001.

If you were the person dying and you have several weeks left to live- would you want to be informed of the coming of the inevitable?

Driving back home – I prayed again for the whole family.  For the person who is about to die and for the children he is about to leave behind.  God grant them your peace and comfort and may they all find their strength, individually and as a family, only in you.

Thank you A-Cross Ministries!

Posted on 30 January 2010 | No responses

Last Sunday, A-Cross ministries in partnership with Grace Communion International-Philippines conducted a medical mission for the residents of Lawang Pare, San Jose Del Monte Bulacan.

660 patients were served at this one-day medical mission.  A-Cross did a wonderful job in organizing the medical, dental and optical clinics by using the classrooms of Lawang Pare Elementary School.  GCI-Philippines took care of the food, set-up, crowd control and particularly, gospel presentation.

We had been partnering with A-Cross for quite some time now and had been able to conduct medical missions in difference places including Kalibo and Palawan, Manila, NHV Bulacan and San Pedro  in recent months.

Thank you A-Cross ministries for your labor of love. We look forward to partnering with you again for 3 more medical missions around Metro Manila ( June 20, Sept 12 and December 5).

Thank you GCI -Philippines volunteers from Lawang Pare led by Ptr Gerry Demition, Sis Ghie Ireneo and Gilbert Imbornal, NHV Volunteers led by Endo and Loida Carpio and the Counseling group from Ptr Med and Sis Henrietta Maninang EE group. Thank you Ptr Mario Natividad and Ptr Roman Saynes for helping out with the planning and logistics for this medical mission.

Together we can really do more to reach out to the less-fortunate countrymen.

When you wish you could do more…

Posted on 29 January 2010 | 2 responses

In recent days, I was privileged to participate in two back-to -back medical missions in the country.  The first one was in Tagbilaran, Bohol where 80 medical doctors from Medical Surgical Mission Team from Texas and Kaiser Permanente, LA conducted a 4-day mission.

They came prepared.  The medicines were sent to the Philippines ahead of time. My back and those of the other Filipino volunteers got really acquainted well with those  huge 75 boxes of medical and surgical supplies hauled from the church hall to the Cultural Center and Regional Hospital.

And the people came.  Just several hundreds on the first day – but the lines grew and grew each day.

I was part of the documentation team – so I got to see and interact with some of the patients who patiently lined-up to be seen by the doctors.

3 of them broke my heart on the second day of the medical mission.

This boy’s name is John Mark Cafe, 1 year old.  His parents came when they heard that there are surgeons from the US.  He has a tumor in his right kidney.  The operation alone would a lot of money.  I approached them and in her Cebuano dialect, she explained the whole situation.  I tried to help them as much as I could and even helped them expedite their  paper process to the pediatrician line.  Even had the call to the hospital arranged so that John Mark could be operated on by one of the surgeons from MSMT.  I felt the world crumbling down when I was told that he could not be operated on because there were no pediatric surgeon.  There was no pediatric surgeon from the team.  There was no pediatric surgeon from the whole island of Bohol.  The operation had to be done in Cebu or Manila.

But that meant, it would not longer be free.

I was desperate so I sent sms to my highschool classmate, asking if she could send a pediatric surgeon from Manila.  The team from Texas had the medicines, the equipment and everything else, but the pediatric surgeon.  Since this was going to be a complicated operation, there had to be a pediatric surgeon to help out and to take care of the post-operative process.   My classmate responded and said – the pediatricians were not available.

I actually sat in one corner and asked God why He didn’t make me a pediatric surgeon instead.

Then I got to meet another couple with a 2 year old son suffering from hydrocephalus.  Another major operation. Another cry for help that we could not easily attend to. This boy still has not learned how to walk, does not talk and basically acts like a baby.  His father removed the head covering and showed me what the disease has done on him.

I did not get to see the 3rd child needing another major surgery. But I was told about this young boy with a massive abdominal mass.

More than 8,000 patients were served by the 4-day medical mission in Bohol.  I was really grateful for these doctors from MSMT who took the time off from their hospital duties, paid for their own airfare and hotel accommodations here in the Philippines and did what they did for the residents of Bohol.

I would see them at the end of a long day – and one surgeon from LA wryly smiled and said “really tired..” when I asked him how he was doing.

I did not get to mention earlier that while I was sitting in one corner just silently praying for these parents and helpless children, I got an sms from the orphan I shared with you about.  He was telling me that there was no more food to eat in the house and he only had P60 left in his wallet. That is equivalent to a little more than  USD$1.

Drove me to my knees and pray.

Thank you Lord for the medical teams from the US. Bless their hearts.  Bless the work of their hands.  One of the medical doctors celebrated his birthday the day before the medical mission.  He has been celebrating his birthdays in the Philippines and he said, it has been particularly difficult for his wife.  I asked why he didnt bring his wife to the mission and he said “we have a 5-month old baby…”  Bless this young surgeon God and take care of his hands.  Use those hands that had been trained to cut through the body and make repairs where necessary.

Another doctor celebrated her birthday the day they left for Manila.  One of the team members surprised her with a huge birthday song by asking the blind singers at the airport to sing Happy Birthday to her. When she came out of the restroom, we all erupted into singing Happy Birthday to her.  Even strangers joined in the singing. I looked back from where I was seated and she was drying her eyes now covered with tears.

Bless them Lord. Take care of each of them and bring them back to the Philippines next year.  Despite the challenges and the bureaucracy they face here, please encourage them to keep on remembering the Philippines.

Thank you Lord for these doctors.

UPDATE ON JOHN MARK

He has been seen by the GIFT OF LIFE Foundation and now being assessed to be scheduled for operation either in Cebu or Manila.  Please keep him in your prayers.

“Ma, please don’t let me die…”

Posted on 17 January 2010 | No responses

This was the plea of that 11-year old Haitian girl who died today.  Trapped in the rubble and her legs pinned down.  She was discovered two days after the quake that changed the landscape of Haiti.

She was eventually freed by the rescuers who labored hard to get her out.  But it was too late. She died today because there were no medical people to attend to her – and no medical facilities and supplies that can take care of the damage done to her body.

I am watching CNN right now as pictures upon pictures of the devastation are being shown.  I feel so uncomfortable because tomorrow here in the island of Bohol, 80 doctors from USA are coming to conduct a medical and surgical mission for free.

This has been arranged for many months now.  Last year we supported them in Sorsogon and this time, it will be in Bohol.  But in the light of the devastation and continuing deaths in Haiti – how I wished that these 8o doctors from the US are simply heading to Haiti tomorrow.

This island has been a recipient of so many medical missions annually – and sometimes, they sound nonchalant about it.  This island is visited by medical team because I suspect, after the medical missions, the surrounding areas here are perfect for their rest and recreation.  Bohol has become a tourist magnet for this country – but thankfully, not as loud and dirty and wild as Boracay Island.

CNN reported that the rescue doctors hurriedly left Haiti because of security threats…  and I wish these 80 doctors majority are surgeons, oncologist and experts in their field, would be on their way to Haiti instead of Bohol.

There are more than 70 big boxes of medicines already stocked in the church hall… other medical and surgical equipment are on their way tomorrow.

We will remain grateful for these blessings. But I wish I could  move heaven and earth and send these Fil-Am doctors to Haiti where they are needed the most.

It was reported that about 50,000 people have died.  And they have been buried in massive graveyards.  What is really sad about the whole thing is that the bodies are no longer tagged to be identified.  Anderson Cooper of CNN struggled to maintain a semblance of composure when he answered Larry King and said ” all of these people just disappeared.  No one would know who they were.”

Unlike the tsunami in 2004, recovered bodies were tagged and DNA testings were done so that people could come get their loved ones.  Haiti could not do anything like that. 

All these lives just simply disappeared.

This little girl did not just disappear… but what she said will definitely haunt us for a long, long time.

God please rescue Haiti…

Posted on 13 January 2010 | 2 responses

Haiti is 13 hours behind our time here in Manila.  We are about to call it a night but in Haiti – life has been made much more difficult for the 9 million residents of Haiti.

Considered to be one of the poorest countries in the world, it will be really difficult for this small country to recover from the most recent earthquake that toppled numerous buildings and stopped the delivery of basic services to its citizens.

They are still piling the bodies as I write and the international help is still on its way.

God please rescue the Haitians.  We are praying for the rescue, medical treatment and provisions for the millions whose lives have been severely altered by this earthquake.  Please help the rescue teams find the children ad those trapped underneath the collapsed buildings.

Let the Haitians be at the very center and at the softest spot of your sweet grace.

The disappointment that was Cebu Pacific…

Posted on 13 January 2010 | 3 responses

I was driving to Tagaytay when I heard on the radio about the incidents last December 23rd in Hongkong.  Two Filipino mothers on their way home to the Philippines were being asked by the crew of CEBU PACIFIC to transfer planes because of their special children.

Apparently, the said airline has a policy where no two “mentally ill” persons could be on the same flight.

The mothers stood their ground.  There was no mention of their husbands – so picture a mother with her special child being asked to de-plane from Hongkong.  A mother and a child… no, do not forget, a special child.  Could there be any clearer picture of vulnerability??!

Cebu Pacific later on issued a public apology because apparently there was a misunderstanding of the policy. C’mon… they could have delayed the flight and called their management in MANILA to check if they understood the policy right at that exact time.

The two mothers booked their tickets – went through the gates and once onboard, were being asked to de-plane simply because of that “mentally-ill” explanation.

Now it is very clear that CEBU PACIFIC was in violation of the law.  Discrimination against women and children.. and yes, SPECIAL CHILDREN.

Did Cebu Pacific crew forget that whenever Filipinos see the Philippine carriers overseas, it is almost as if they are already home?  I would be angry if that happens in another airline bound for the Philippines – but I got angrier because it was our own airline that did this to two mothers and their special children.

Shame on you Cebu Pacific!  Yes the apology you issued was just appropriate – but you broke the law and an apology will not remove the penalty for that.

This incident just sheds light how much inconsiderate we have become.  If a big company such as CEBU PACIFIC could not even properly explain to their staff and crew what their manual states… THEN “HOUSTON… WE HAVE A PROBLEM!”

Cebu Pacific could spend millions in advertising and promotions of flights and tour packages, and YET, could not spend additional time and money to make sure that their policies are clearly understood? 

I have been flying this airline since they started using that Terminal 3.  More spacious and more accessible.  But in the light of this event, I am thankful that I am flying PAL this weekend.  And maybe I should just get PAL everytime from now on.

They should feel the ramifications of their inconsiderate attitude and behavior, and yes, their ignorance of the law.  Their franchise to operate outside the country should be suspended, because after all, they have proven that they are not capable of extending compassion and understanding even to the most vulnerable among us.

Oh, yes I forgot… my last flight with Cebu Pacific was Dec 11th bound for Kalibo. I must say that it was the most terrible touchdown I had ever experienced.  Most of the caucasians with us got really scared.  It felt like we were dropped by about 10ft on the runway – a big belly flop landing.

Cebu Pacific was recently rated as teh 5th Best budget airline in the region.  But with this incident in Hongkong, Cebu Pacific should be scratched -off the list. 

To the two mothers, we are so sorry that you had to go through with that ugly experience in Hongkong. I hope that your children were not very much traumatized despite the “menacing” way by which the crew, reportedly, handled the situation.  Accept their apology – but yes, exercise your rights to make them realize the ramifications of what they did.

Back on the grind…

Posted on 8 January 2010 | 2 responses

The Christmas songs have all been stopped from playing on the radio and in our malls.  All the holiday decorations are being put down and kept back to the different storage areas.  I also took down our lantern from the window, and while I was tempted like in the previous years (when I just let it stay until March!) – but just simply followed suit and brought it down.

Life is going back to its normal everyday grind.  Even the Manila traffic had eased up a bit – and then the following day, it was back to a bumper to bumper situation.  That is the regular traffic scene here.  One day it flows like unhindered river waters, then the next, it is clogged like any arteries of a person who does not care about his health.

The other morning at about 3AM as I was getting ready to sleep. My phone sounded off as it received an sms.  I looked at it and the first sentence alone gave me the idea that it was not supposed to be sent to me.  Initially, the message was not addressed to me – but because I care for this person, I think the message was serendipitously sent to me so that I may be able to pray for his situation.

“I could not send any New Year greetings because it wasn’t a happy one for us…” and there were some more details given elaborating the sentiment.

I waited a couple of days before I responded and gave him my empathy for what they went through during the Christmas season.  It was like walking through the railroad tracks. On the either side of the railways were awesome celebratory events and the people I know and care about. And the other side were people who were lonely and hurting and felt really isolated during the season. 

Well, we are back on the grind.  Activities are being lined up in dizzying manner.  New decade! New hopes and new beginnings.  But I must also realize that there are people who are not ready for new beginnings.  They would rather keep the old, routinary things – and even die to these things.  Let the younger people have a go at these new and exciting things!

Classes are back.  Work and services are back (but the government employees still have to receive their christmas bonus!!!) all of the nitty-gritty details of life returning to its normalcy state are upon us.

But I pray that something else is also present in our lives as we head back to the grind.

I pray that we have been imbued by the freshness of hope.

We all need it.  We all could benefit from a strong injection of hope in our lives.  Young, old, rich and poor, influential and marginalized… we all need hope.  And the freshness of this hope is not guaranteed simply because we have a new year upon us.

It is predicated upon the faithfulness of the ONE who is faithful to all of us.  Not because of who we are nor what we have done.  His faithfulness is simply because of WHO HE IS.

Yes, we are back on the grind….

But I pray that we are all geared up and saddled with hope.

Happy New Year and welcome to the new decade!

Posted on 1 January 2010 | 1 response

It was a full-moon last night as the gentle breeze was blowing to usher in the coming of the new year.  And the coming of the new decade.

Amidst the fireworks and the clanging noise that we usually go through at the passing of the old year into the new one, I could not help but be quiet and reflect on how 2009 went.  The ushering of the new year could naturally lead us to be more hopeful about the things that may have caused us difficulties the past several months.

At the end of 2009, families and friends naturally come together.  What a blessing to be with church friends on December 25th. 

Then two days after, had a reunion with my long time friends in the church.  It was amazing as we recalled most of our teenage memories and the different changes we had gone through.  There is something really special about friends that know you from years before.  We thank God for allowing us to have this friendship for more than 25 years.

It was also awesome to have been able to do the ordination of Tita Luz as an elder. 

What a sobering experience as we laid our hands on her and prayed for her surrounded by her children and grandchildren and even great-grandchildren.  At 77 years old and being the 3rd woman in our denomination to be ordained, it was very humbling to be given the privilege to do this for her.

I pray that I will be as zealous as she is in serving the Lord when I reach 77 (God willing…)

Thank you Lord for all these heartwarming events.

Thank you that in the midst of these celebrations and gatherings, you allow us to experience the simple things that truly make this journey significant and memorable – our families and friends.

For 2010, we pray for more of your loving touches in our lives. We pray for the wisdom and discernment as we go through the different challenges in our lives.  We pray for the provision we would need as we pursue the dreams and burdens you have placed in our hearts. 

I pray for the fervor to serve you in 2010 and for the encouragement when it gets to be very discouraging.

I pray for more of you and less of what I simply just want to be.

Cause us to discover our inner selves – made free to experience the depth of your love through the life of the SON.

We place our hope in you.  A lot of things were taken from us in 2009 – and may all these things be restored and more in the light of the freshness of your grace for us.

Usher us into the new year and into the new decade.

In your precious Son’s name.

AMEN.

A prayer for an orphaned young Christian brother…

Posted on 14 December 2009 | 6 responses

I was in Aklan for a Strat Plan meeting for the pastoral teams in Panay Island.  During the 2-day planning meeting, my mind was also consciously in NHV, Bulacan.  A week ago, the mother of a 16year old teen passed away. Now JR Rubio is an orphan.

I was expecting that the funeral would be around Tuesday or Wednesday.  But the relatives who arrived, decided for a sunday funeral.  The disappointment in his voice was very noticeable when I told him that I would still be in Aklan and would not be back until Sunday night.

JR Rubio was one of the camp scholars we had.  Last year for the summer camp, I asked him to help out in the Kitchen, a task that he gave with all of his heart.

A few hours after the death of his mother, I was able to call him and express my condolences.  In a soft tone of a voice – he narrated the surrounding events of his mother’s death and how they had been going through involuntary hunger in the midst of her mother’s sickness.

I cried after that call. I asked God why it has been so difficult for so many.  They had been eating only once a day – and he said, it was so rare for them to even have a kilo or rice in their house. They were starving when her mother died of the complications from her kidney disease.

During the strat meeting, I received more than 20 messages from JR.  And the messages were the same “Please pray for me!”…  since I was facilitating the strat plan meeting, I could not answer right away.  at 12:48am, he sent me another sms “Please pray for me…!”  I called his number right away and talked with him for awhile.  He was dreading the funeral the following day at 9am.

I was surrounded by very serene, pristine environment in Aklan, but my mind was alternating from the heartrending reality of an orphan’s life and the complicated pastoral assessments needed before the strategy plans were drafted.

I was thinking of him a couple of minutes ago when I got another sms with the same message “please pray for me!” -

I am writing this so that perhaps, one of you, would also join me in praying for JR.  He is a senior in highschool now.  After the traditional 9th day, his sister would go back to her job and the other brother would go on his own way..(another brother is in jail for possession of illegal drugs back in 2004)…and so in the coming days, JR who is already an orphan, would be totally alone.

Dear God,

I am too silenced by the pain that this young man is going through.  Bathe our hearts with your holy compassion – so that this teen orphan will find the strength through us.

Lord God, gently surround him with your peace.  Thoughts are racing through his mind and painful memories are running back and forth.  Perhaps a thousand questions and what-ifs are flooding his mind right now.  You, the GOD of all COMFORT, descend upon this young man now and embrace him.

Do not let him be afraid of the future.  Assure him Lord as you had assured so many orphans of your special and tender mercies for them.  Shower him with your encouragement and open the floodgates of your heavenly provision for him.

In the coming days when the support system is gone, please let him know that You have been there all along.

Give him your peace dear God.  Give him your strength.

Protect him from harm. Protect him from any undue influences that surround him in that very difficult place. Send people to guide him and to show your love for him.

It is going to be difficult for him.  This will be the first Christmas as an orphan so I pray that he would be surrounded by people that really care for him.

Instill in his heart the truth of the resurrection.  He will see his mother again. He will see his father again – and all these painful memories surrounding their deaths will also be redeemed by your wonderful grace.

I surrender JR to you.  I ask for all of these and many more for a young christian brother during this terrible time of grief.

May You be HIS ALL in all.

Thank you Father for your steadfast love and your endless compassion that surrounds us the moment we were conceived and even to our dying breath.

Through the tender name of Jesus, I pray.

AMEN

A Call For Temperance and Sobriety in our Christmas Celebrations

Posted on 10 December 2009 | No responses

The Christmas season is here.  Christmas parties are already set and people have started attending these social events.  For many companies, these parties become such annual highlights that they have become more and more lavish in preparations and expenses.  Even celebrities are commissioned as guests and presenters to make the parties more alive.

In the light of the parties that are to happen left and right, I appeal to all of us here in the Philippines to be temperate and sober in our parties and spending.  I could only imagine the amount that will be spent in homecomings, annual reunions, Christmas get-togethers and the like.  There have been times when people go through a lot of debts when the Season is over.  Too many times, when the celebrations have lost the meaning or the reason for the season, the gatherings tend to become a place for inebriated to make fools of themselves.  I cringe at some of the party games done in these occasions for entertainment.  Sexual jokes or presentations brimming with sexual innuendoes have also become the norm.

I prayerfully request that we be temperate and sober and remember.

While we have been invited to these parties in posh hotels or other venues, a growing percentage (24%!!)  of our countrymen go through involuntary hunger.

A big percentage of our country is still going through the massive loss incurred by ONDOY, PEPING, massive fire in Mandalayong and other places.

Families of the 57 massacred individuals are still trying to find the shattered pieces of their lives.

During the Advent Season, we celebrate Christ.  We celebrate our Savior whom the world in general has decided to ignore.

We celebrate the One who gave everything so that we might have all.

Let us strive to honor him in these celebrations by focusing on what He came here for.  If Jesus attended your Christmas parties, would be come home exalted or would he come home terribly ignored?

Have fun.  Enjoy these events with friends and make meaningful connections or reconnections with friends and families and even workmates.  The Lord would be really pleased with that.

But in the midst of our celebrations, let us remember that the heart of the Lord also goes out for the downtrodden, the widows, the orphans and those who go through so much without in their daily lives.  Maybe we can cut down our wine expenses and entertainment budgets. Maybe we don’t need to spend thousands upon thousands of money for a party that will last for 5 hours…. and even sponsor a party for those who only manage to eat once a day.  There are many places where people would appreciate eating three meals a day. You will be surprised to hear and see their proximity to yours.

You may ignore this and even label this post as an event-killer.  I cannot make you do these things though, that is why I am writing this as a request.

This is in behalf of those who still cry, who feel the very familiar hunger pangs, the orphans sniffing substances under the flyovers in the city and in so many more places where so many people go through daily with so much less, than we could even begin to imagine.

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