The Quest for Balloon Spray Paint

 

This afternoon, Marga told me she needed balloon spray paint and three meters of white velvet ribbon for tomorrow.

Tomorrow?!?

“When did your teacher tell you this?”

“Today,” she said.

I checked her assignment notebook, and sure enough, there was a new note from her teacher.

I was furious! Not so much because of the short notice, but because I DIDN’T EVEN KNOW WHAT THOSE THINGS WERE!

It was already 3 PM. I hurriedly Googled the items and figured my best chance of finding them would be at a party supplies or balloon shop. So, after Hannah was dismissed from class, we drove around General Santos City, guided only by Google Maps.

Shop #1 was along a busy street near the public market. When we got there, there was no parking available. I couldn’t possibly leave both girls in the car while I went inside to check if they had effin’ balloon spray paint!

Shop #2 was in an abandoned, partially demolished building. Damaged by the recent earthquake? I don’t know. The shop was no longer there.

So I drove the girls home, grumbled a little about how teachers should give parents enough time to find these things, and decided to continue the search by myself.

The thing is, I already had my entire afternoon planned. I was supposed to finish my backlog of echo reports and catch up on my Zone 2 runs.

Ngunit, subalit, datapwat…

There I was, slowly driving through parts of GenSan I very rarely visit, looking for balloon spray paint and three meters of white velvet ribbon.

BALLOON SPRAY PAINT!

Until this afternoon, I didn’t even know such a thing existed.

Finally, I found a store selling balloons, party supplies, Christmas decorations, foil papers, girls’ ribbons and scrunchies, cheap toys, trinkets, and all sorts of what-nots, all obviously made in China.

The kuya guard was already pulling down one of the metal doors when I arrived. I hurried inside and, to my delight, found everything Marga needed! I even bought some cute hair ribbons for Hannah.

At the counter, I excitedly told the lady how happy I was that they had balloon spray paint.

“Ma'am, dili man na pang balloon.”

“Ha?!? Unsa man diay nang lingin-lingin? Balloon man na!”

“Dili man na balloons, Ma'am. Circles man na,” she replied, sounding almost as exhausted as I was.

I looked at the can again. It was gold spray paint, all right. And there were colorful, shiny circles on the label that I had automatically assumed were balloons.

Apparently, they were just circles.

Forty-seven years old. A cardiologist. A mother of two. And apparently, someone who can no longer distinguish balloons from circles. In my defense, I was tired, stressed, and my eyesight wasn't what it used to be!

I decided to buy it anyway. At least my daughter would have something to bring to school!

When I got home, Hannah was ecstatic about her new ribbons.

Marga looked at her things and, with all the innocent sincerity of a little girl, said, “Mommy, thank you. I’m so excited to show these to teacher tomorrow.”

Hay, anak. You have absolutely no idea what your mother went through today.

Anyway, I’ll be going shopping again tomorrow. 

And oh the "velvet white ribbon" that I got? That's not velvet, that's satin. 

But I bought an entire roll, all thirty meters of it. 

Perhaps your teacher will be happy with that already.

Respect Goes Both Ways

 

        A few days ago, I began seeing the same headline on social media, in slightly different forms: “Masungit / Ma-attitude na nurses, bawal na sa public hospitals”. I understood immediately why it caught people’s attention. We have all had unpleasant encounters in hospitals, both private and public. Sometimes we get a curt answer, an impatient tone, or we encounter someone who seems too busy to explain. When you are sick, frightened, in pain, or worried about someone you love, even a small act of impatience can feel much bigger than it normally would.

        The headlines came from the Department of Health’s recently circulated 8-Point Patient Experience Standard, described as a “Commander’s Guidance” for government hospitals. Its first point is simple: agaran at magiliw na atensyon, which simply means prompt and courteous attention. There is nothing objectionable about that. Patients and their bantays deserve courtesy, kindness, and respect. They deserve to be spoken to as people, not as bed numbers, diagnoses, or annoyances in an already crowded day.

        What made me uncomfortable was how quickly the public conversation seemed to stop at the word magiliw, and more specifically, at nurses who were supposedly not magiliw enough. There are, after all, seven other points. The same standard also speaks of a pleasant environment, clean toilets, functioning lights, reliable social support, adequate equipment, organized queues, and updated information. Read together, the eight points tell a much broader story. They are not merely telling nurses to smile. They are telling hospitals to work.

        I practice in both public and private institutions, and the contrast between the two is not always as simple as people imagine. Public hospitals carry enormous patient loads with limited resources. Private hospitals may have better amenities, but they have their own frustrations as well, such as delays, unavailable tests, malfunctioning equipment, complicated processes, fragmented communication, financial concerns, and patients who are sometimes left unsure of what is happening or why.

        These are systemic problems. They are not things that a nurse, physician, or any individual healthcare worker can solve alone. Yet they shape the patient experience profoundly. They also shape the working environment of healthcare workers themselves, adding to workload, frustration, and the strain of caring for people within an imperfect system.

        Perhaps this is why I find the eight-point standard useful even outside government hospitals. It reminds us that patients experience healthcare not only through the treatment we prescribe, but through everything surrounding it. Was someone there when they needed help? Could they find the correct room? Did anyone explain the delay? Was the toilet clean? Was the hallway safe and well lit? Did the equipment work? Was there somebody to help when the family could no longer afford what was being asked of them? Did they know what was happening next? These things sound small until you are the patient.

        At the same time, there is another part of the conversation that deserves to be said plainly: respect and courtesy should go both ways. Healthcare workers must be respectful. A stressful day does not give us permission to humiliate patients, and being overworked does not make cruelty acceptable. Professionalism still matters when we are tired. But patients and their families also have a responsibility to treat healthcare workers as human beings.

        In my conversations with nurses, I have heard stories from the other side of the bedside as well. One nurse told me that a child’s bantay punched him after he was unable to insert an intravenous line on the first attempt. I have personally seen family members shout at nurses over matters that had little to do with nursing care, such as a leaking faucet, a television remote that would not work, an air-conditioning unit that was not cold enough. The nurses happen to be the people within reach, and so the frustrations usually land on them. Because the nurses are often the most visible people in a hospital, particularly when something goes wrong, they become the human face of problems they did not create and often have no power to solve.

        This does not mean that healthcare workers should respond to frustration with equal hostility. We are professionals, and illness makes people frightened, impatient, and sometimes unreasonable. Part of our work is to understand that. But compassion cannot mean accepting verbal or physical abuse as an ordinary occupational hazard. A patient's fear deserves understanding; it does not give anyone permission to punch a nurse. A family's frustration deserves to be heard; it does not make the nearest healthcare worker responsible for everything that is wrong with the hospital.

        We sometimes forget this because medicine is a caring profession. There is an assumption that because we chose to care for people, we should be endlessly patient, endlessly understanding, endlessly available. We should absorb anger because the patient is afraid, tolerate insults because the family is worried, and accept shouting because people are under stress. To a point, we do. Anyone who has spent enough time in a hospital learns to recognize that anger is often another expression of fear. But understanding why someone is angry is not the same as saying that every behavior is acceptable.

        Sometimes the complaint is justified. Yes, some nurses may be rude. There are doctors who are rude, too. There are clerks, guards, technicians, administrators, patients, and relatives who can be rude. No profession has a monopoly on kindness, and none has a monopoly on bad behavior. But I worry when a systems problem is reduced to an attitude problem. A nurse cannot make up for an understaffed ward by simply being nicer. They cannot speak gently enough to make ten additional patients disappear. They cannot personally fix the broken light, buy the missing equipment, create another bed, shorten the patient queue, speed up a laboratory machine, or invent a social worker when none is available.

        At some point, telling exhausted healthcare workers to “be nicer” just becomes one more burden to carry. One of my professors at the University of the Philippines, Dr. Nemuel Fajutagana, once expressed this idea in a way that has stayed with me: “If we truly value life, we cannot keep patching a broken system with the sacrifices of those who hold it together.” In the same statement came another line that may be even more important to this discussion: “The dignity of patients matters and so does the dignity of those who care for them.”

        Those two ideas are not in conflict. We do not protect healthcare workers by caring less about patients, and we do not become more patient-centered by treating healthcare workers as if their own humanity is irrelevant. A good hospital should be able to hold both truths at the same time: patients should be treated with courtesy, and healthcare workers should be treated with courtesy. Patients deserve to be heard, and healthcare workers deserve to be heard. Patients should not be humiliated, and neither should the people caring for them.

        That is why I hope we do not remember the DOH’s eight-point standard simply as the rule that said nurses should no longer be masungit. The real challenge is not merely to make healthcare workers kinder. It is to build hospitals, both public and private, where kindness has room to exist, where the toilets are clean and the lights work, where queues make sense, where information is available, where equipment functions, where social support is accessible, and where patients are treated with dignity.

        And where the people who care for them are treated with dignity, too.

The Stubborn Old Tree

A few days ago, I met an old friend I hadn’t seen in more than three years.

I was attending a conference in Manila and remembered his birthday was coming up, so I jokingly asked him for a birthday lunch treat before flying back home. Surprisingly, he was free. (I had forgotten Wednesday was a holiday. People in medicine don’t really have holidays.)

So we decided to meet in a posh restaurant near the airport. His treat, of course.

But while he was on his way, a motorcycle bumped his maroon vintage Mercedes and he had to go through all the tedious fuss of Philippine police bureaucracy. So naturally, our supposedly sophisticated reunion downgraded into uncertainty and logistical chaos.

I decided to head straight to the airport instead.

While waiting for the check-in counters to open, I completely lost track of time immersed in my worn-out secondhand copy of Truman Capote’s Breakfast at Tiffany’s. Then he called and said he was driving straight to the airport.

So after all these years, we ended up having our reunion at airport Chowking over glasses of water. No food ever arrived. Which somehow made the whole thing even more funny and appropriate.

We talked loudly about everything and nothing at all: faith, or its eventual demise; DDS and the dismal state of the country; death; loneliness; resignation letters; why I insist on drowning my existential angst with all sorts of busyness.

At one point he laughed so hard at me and said I was the only person he knew crazy enough to simultaneously collect so many jobs and responsibilities, as if I were voluntarily hitting myself on the head with rocks. Then after a pause he looked at me and said, “You enjoy it. You just pretend you don’t anymore.”

Only old friends can say things like that.

We are very unlikely friends. We met twenty-two years ago because of Friendster, brought together by our mutual love for the Beatles and books.

Since then we’ve weathered through the many seasons of our lives.

I went back home down south, got married, and now spend my days raising two beautiful daughters while balancing medicine, teaching, writing, and all the chaos in between.

He climbed the corporate ladder in the same airline company where he was already working when I first met him online. He remains single despite his good looks, extraordinary intelligence, and brooding charm -- qualities my PGH friends insist are visible only to me. Haha.

He still thrives in solitude and adventure. I, meanwhile, continue overcommitting myself to institutions and responsibilities in ways only he seems capable of seeing through.

Eventually I had to look at my watch and panic because my flight was boarding soon.

At the airport gates, we hugged each other. That long, tight, affectionate hug you give only to people you know will remain part of yourself no matter how many versions of you have already existed.

And somewhere in that absurd airport reunion, over fluorescent lighting and untouched Chowking trays, I realized how lucky I am to have friendships like this.

The older I get, the more I realize that love exists in many forms, and often escapes neat definitions and categories altogether. Some people arrive loudly and briefly. Others simply remain. Quietly, persistently, through years and seasons and silence.

Years ago, I wrote in this same blog that conversations with him always leave me feeling “Ondoyesque” -- a post-typhoon Ondoy analogy I coined around 2010. He had this way of unsettling me, making me contemplate my life, my choices, the dangerous what-ifs and could-have-beens. Back then, our conversations often left me with a strange ache I could never quite explain.

But this time felt different.

After more than two decades of steady friendship, I no longer came home with pain or longing or the urge to abandon the life the universe has so generously given me.

Instead, I came home overcome with immense gratitude -- for both answered and unanswered prayers. For the life I have now. For the husband and family I fiercely love. For old friendships that endured. For all the roads taken and all the roads mercifully left untaken.

And perhaps maturity is finally realizing that not every meaningful love story in our lives was meant to culminate in possession or permanence. Some were simply meant to accompany us through our becoming.

A day after our airport reunion, I greeted him for his birthday and sent him a caricature I made of him using ChatGPT (haha!) -- him with his books, mountains, guitar, backpack, beer, all the things that somehow became symbols of his existence through the years.

His reply was simple and deadpan as always: “Patience, you’ll get to be just as OLD soon, and yup, you can count on it, this much older friend will still be around.”

And perhaps that is one of the most beautiful things life can offer us: people who quietly persist through the different seasons of our lives like some stubborn old tree refusing to die.

And when you know what you have while it is still there, aahh, perhaps that is life’s greatest gift.

 

From FOMO to JOMO

 Today I woke up at dawn shivering.

I dreamt there was a very strong earthquake. As I ran outside tightly hugging my daughters, parts of the ground beside us suddenly rose, and our car rolled away, crashing into a broken wall. The earth shook violently beneath our feet. We cowered down, praying, my children screaming.

Then I woke up.

Two days ago, I submitted my resignation from the academe.

That initial wave of relief I felt has now slowly turned into dread. I have always been a teacher. I invested my time, my heart, and my soul into teaching. And while I felt so alive and at home with my students, I also felt myself slowly drowning inside an institution where I no longer felt aligned, understood, or at peace.

I had to make a choice.

Today, I felt FOMO. And it crept into me through a dream of earthquakes. I am being shaken and stirred.

But I know this much:

Institutions will forget. I will always be replaceable. My light will burn out someday.

But the students I taught will remember.

My children will remember.

My body and mind will remember that I chose to protect them.

And I know that what is meant for me will find me again.

Today, I have FOMO.

I will not resist it. I will sit with it for now.

Tomorrow, JOMO will come.

And I will still be there. Not a different person. Not a burnt ember of the woman I once was. Still me.

Because today, I chose to protect me.

Never a Prophet in One's Own Town

 Two years ago, I enrolled in graduate studies in Health Professions Education because I wanted to be better: for my students, for my institution, and for the kind of doctors we are trying to form. I paid for these courses, attended workshops and conferences (some of them international), read widely, reflected deeply, and returned home carrying ideas I believed were thoughtful, contextual, and doable.

I didn’t do this to collect certificates. I did it because I believed that if we understood learning better, we could teach better. And if we taught better, we could serve our communities better.

However, I learned another lesson somewhere along the way. We can never be a prophet in our own town.

When I began proposing changes: small ones, careful ones, grounded in evidence and lived experience, I realized that being prepared does not always mean being heard. Sometimes, the more invested you are, the easier it is for your ideas to be dismissed as “too ambitious” or “too idealistic.” Sometimes, institutions would rather listen to voices from outside than to those who have stayed, labored, and cared within.

This isn’t a story of resentment, although it seems like it is. I still believe institutions are made of people doing their best within constraints they may not fully control. And I understand that change is threatening, not because it is wrong, but because it asks something of everyone.

Still, it is quietly painful to realize that effort does not guarantee trust, and training does not guarantee influence. I’m learning to sit with that. But I will not deny that this fire within me, because it burns oh so brightly, is burning me out. This voice within me, which nobody hears, is tiring me, exhausting me. I've always thought that the brighter we burn, the faster we burn out. And here I am dragging my feet exhaustedly, trying to get through every long day, hoping that better days will come soon.

Perhaps this, too, is part of education: understanding that growth doesn’t always translate into immediate transformation of the spaces we love. Sometimes it simply prepares us for future conversations, for different seasons, or for places where our voice will land differently.

For now, I’ll keep learning, not to convince or to change things, but to remain whole. And I’ll trust that the work we do to become better educators is never wasted, even when it feels unseen. 

We have to keep going even when we are unseen. Perhaps someday, a new town will embrace us, and allow us to grow and make the changes we are destined to make.