St. Luke's Daughters of Nightingale 1978: July 2008

Patti has shared this beautiful poem and I shall quote from the lyrics. May I ask all for your indulgence dear friends, ladies and nightingales. You have all open your hands, hearts and minds to me and I cannot ask for more.

It doesn’t interest me what you do for a living.
I want to know what you ache for
and if you dare to dream of meeting your heart’s longing.

It doesn’t interest me how old you are.
I want to know if you will risk looking like a fool
for love
for your dream
for the adventure of being alive. .. “THE INVITATION” by Oriah Mountain Dreamer

Please indulge me a little farther. May I share with you an article written and published at PDI (Philippine Daily Inquirer) in Nov. 30, 1999. Matagal na pero nilalakasan ko na ang loob ko though this will eat up a space in the blog. Particularly, Oddie, with your permission, I like to share this with Yasmin or in direct lingo please let Yasmin read this. Thanks a lot.

JC Parian
PDI, Lifestyle Section, November 30 1999

It is unthinkable that one’s heart should be cut open. All other organs are vital but they are vital only to life. The heart is more. Nobody writes a poem about a bladder. There is no music sang with words about the esophagus. No love spoken with my entire pancreas. The heart is the one unthinkable cut. (Itals by PD!)

No one grows up to be 24 just to be sick. You walk through life, listen to parents, enjoy family, go to school, try your best to get an education, enter the work force, have your own family, and then plan later what else you could do. This is the linear projection of life where you move from one plateau to the next, from one state of existence to another. That’s the normal arrangement. But my so called life stayed a medical odyssey. I wish it were something you just read in medical journals or some grotesque medical mix-up where, instead of taking out the left kidney, the right was removed. Now, I have a life that is too real to even fictionalize.

First Failure
I had my first failure at the age of 24. My heart was two-fisted more than the normal size. I could right away say, at least for consolation, I go a big-heart or I am big hearted. I did not know which sounded better; all I knew was that I was too frighteningly weak to move. I couldn’t raise myself out of bed without being pulled up, couldn’t turn to sides without help. If I didn’t hold tightly on the rails of the ladder going upstairs and gave myself the hardest push to move my body upward, I wouldn’t reach my bedroom. Stairs began to frighten me. My legs were bloated. Fingers, knees and toes were painfully inflamed. I couldn’t turn my head to sides because of rheumatic stiff neck. My pulse was growing weaker and faster. And worse than the physical sensation was the feeling of losing all power as if all the energy inside was beginning to leave me. My thoughts were centered on the physical symptoms I hardly cared about neither choosing a doctor or choosing life; and this proved nearly fatal.

Ditse (second eldest sister) accompanied me to the Philippine Heart Center for Asia to look for the referred cardiologist. Alas, he wasn’t around. In my condition matched with my volcanic temperament, I told my ditse to look for a doctor who was available at that exact time. Whoever he was didn’t matter. This thinking proved to be a big, big mistake.
I was hospitalized, ordered to be on bed rest, took heart medications and the diuretic pill called Lasix which removed excess fluid and retained body fluids. I had congestive heart failure. My heart could no anymore cope with its normal workload as a consequence of undiagnosed rheumatic heart disease for years.

As the years went by, the disease left its wrought and damaged my heart valves. Unlike other body organs, the heart has not capacity to bring itself back to its natural anatomical structures. The pathophysiology is irreversible, unfortunately. Once damaged, forever damaged. My heart was doomed. Nothing could bring it back to normalcy except, perhaps, a heart transplant. I went home reed-thin, bathing in heart drugs, drowning in sorrows and taking only a silent death wish.

Death Wish
After some months of recuperation, I went back to work and school. I tried to assemble my life back to somewhat a semblance of normalcy. Work and school were ways of keeping busy and pushing away the sadness, anger and that lacerating, finger-pointing kind of questions: Why me? Why does it have to be me? Why now? What for is life if you know you wouldn’t be able to travel its road map of adult life? I was inconsolable.
Sometimes, it was easier to flee from the task of incorporating our own destructiveness and major crisis rather than accept the unacceptable. Instead, I tried driving them away by resorting to coping techniques that have worked before. The first was denial; it couldn’t happen to me. I was good. I was a Sunday school teacher from age 12 to 21. I followed the rules. A second technique was to go on: keeping busy, pretending to carry on as if nothing was happening and changing m biological system. A third method was to call for help. I deliberately avoided good medical evaluation. I guessed it was easier to die than linger in physical sufferings. I whispered carelessly to the wind, hoping she would do the job of sending the message to God, that I would will myself to live for only two years; then it could be over. This was the inner psychic drama I was living. And the thought of death was not too terrifying to confront, and so it kept on dancing with me.

After two years, I resigned from work and went alone to Baguio to climb its highest hills to talk to God, had that dialogue that’s been playing on my mind, and tried to get some answers. I believed Baguio was my rabbit hole, my spiritual inn where I poured out all my feelings. Mother understood the hurting. Much to her fears and worries, she let me go, almost saying I should go look for something that would ease my pains and come back whole again. I rented an apartment and did nothing except mope, walk and cry drumful of tears. I stole a seat for reflection in one of the convents in the city, without the nuns’ knowledge nor permission. It was soothing and comforting just to sit on a bench placed near the edge. There, I let loose all the hurts, the disembodied anger, the unknockable pains. I tried to climb the Lourdes Grotto but realized its steps, 200 and more, were daunting, and found out later that a jeepney ride could help me reach the top. My heart was pounding so hard (I was afraid) it might pound its way out of the chest wall so I took the jeepney ride to reach the top of Dominican Hill. It was fabulous on the hill. A hotel was surrounded and guarded by countless, graceful, mature pine trees. So, this was where the old pine trees were hiding. Unexpectedly, the sight and smell of them doused the anger that was slowly eating like acid into my heart. And I forgot to have conversations with God. While sitting and praying on an open chapel outside the hotel, thick fog embraced and scared me away. I ran as fast as I could forgetting about my bad heart. This slight incident made me laugh but I still held on to my goal. I took long, tepid walks around Burnham, Legarda, Wagner, Leonard Wood, Maryhurst and Session roads.

Survival Instinct
I ranted , raved, and screamed. Anger was my name then. I walked in the rain, hoping that the rain would dissolve me. I wanted the earth to open up and swallow me. During these dramatic walks, there were four or five instances when I felt like someone was nudging and tapping my shoulder to turn around and look back. I heeded the call; turned around and saw four or five perfectly beautiful rainbows which presence gave color to my grim outlook. I took this to mean that God was telling me to go home and everything would be all right. After April and May in Baguio, I went home carrying uncertainties but fully marching head on ready for anything and anyone.

I had another congestive heart failure in July. It was worse than before. The same bloated legs, dyspnea, rapid pulse, difficult movements, loss of appetite and this abnormality called cardiac arrhythmia. My heart was beating confusedly, abnormally and irregularly. Another cardiac aberration has surfaced bringing me additional discomforts, You cannot heart the lub-dub normal cardiac sounds anymore. The heartbeats were anguished and garbled. From this time on, my heart was totally out of sync.

Whenever I was in the hospital, much to chagrin of the nurses, I always demanded for the results of my blood and mechanical laboratories. This was not easy as it usually resorted to verbal tussles but I always argued with the nurses and doctors that “this is my body, I have a right to know what’s happening, you cannot keep me away from myself!” I was the kind of patient whom everyone grew to hate. I asked this quibble of a doctor how come the Doppler echocardiogram had shown my heart valves performing within normal limits yet I was having heart failures. He said, “maybe” I have thrombosis, that’s why I needed surgery. The “maybe”, that “everything was on my mind”, that I was overly depress and too fulminant to see reality filled me with gigantic rage and saw this doctor shrunk to the size of a thumb, fired brimstone on him an swatted him off my bedside. My thought balloon saw him crashing on the mirrored room of the Heart Center where I was confined. This doctor’s dubious knowledge and incompetence to relate, somehow, awakened my whatever’s left survival instinct. In my self-prescribed rituals, say hello and goodbye with a little style, I saw this doctor in finale with a mango cake in tow as a way of bidding him adieu. That’s all he deserved, a mango cake. Of course, he had no inkling about my tiny ritual. As I walked from his clinic, I knew it was high time to call for help. Not just any but honest to goodness help, if I could find it. And I did.

Good Doctor
Lesson. Do not choose doctors at random. Do not stand before the hospital’s hard-plated directory of doctors and pick one whose name sounds sweet. Do not get mango-cake doctors. Get the one that works best with you. Health cannot be arbitrary. Patients have no way of knowing doctor’s medical performances as there are no lists where we can choose based on our assessment of their competence, experience, expertise and humanity. Criteria for selecting are loosely based on referrals and affinities. It helps to listen to your instinct. Heed what it says. It is safer to see two, three, even four doctors and choose the one who can help the most.

If I were giving up on me, my family wouldn’t. By November, this embattled dysfunctional, broken heart was failing again. “Tell me about yourself”, asked Dr. Roberto A. Anastacio, the cardiologist my family looked for me. “It would take us all afternoon to tell you about myself. I doubt if you have the time.” The doctor was piqued with my answer but he didn’t give up on me, too. He retorted that he didn’t care how long it would take as long as I tell him about myself. My thought balloon came to fore, “was he for real or was he trying to be cute?”No popular expert cardiologist in his clinical kingdom would do such parochial, time-consuming task. They normally put the stethoscope on your chest, close their eyes afterward, write the prescription, of course, with some little talk on the side. Then you pay the bill. And it’s over. Rarely do you get the opportunity to talk about your ailments to your attending physician, more so allow you to make them the repository of your emotions. Not all medical doctors are equipped with relational, psychotherapeutic skills.

“Where do you want me to start? Childhood? High school? College?”
‘Wherever’, he said. The just stared and waited. He won I began talking about myself. And somewhere I broke down, finally, I cried unashamedly, unabashedly. I was such a spectacle. The doctor let me be. He knew I needed surgery but he wouldn’t tell me until all the laboratories were done and substantive data were sufficient. I agreed with the approach. Upon examination, while lying on that acerbic clinical table, he told me I had severe valve regurgitation. So that’s it, the source of my chronic heart failures. Instinctively, I knew from that moment on that there would be no turning back.

Open-heart surgery
I was good news and bad news. The good news was, something could be done about my heart condition. The bad news was, there were 13 things organically wrong with my heart. The heart has four valves, the mitral, aortic, tricuspid and pulmonary valves. Three of my heart valves were damaged and obstructed. I needed open-heart surgery where the heart valves would be repaired, two valves had to go and be replaced by mechanical, plastic valves. The surgery would be an act of faith. It would be a gamble. My life was o n a slot machine.

Dr. Avenilo Aventura, my cardiac surgeon, told me the procedure, “That means I couldn’t wear a bikini anymore,” an attempt to be witty. The good doctor softly smiled and assuaged my battered soul by saying, “What do you need a bikini for when you have an interesting personality.” Nice. But my Polyanna attitude had almost left me. What stayed was the picture of my heart being cut, chest sawed, ribs ripped apart, heart-lung bypassed by a machine, heart momentarily stopped to be able to excise, repair and replace the valves.

I was 27 years old. It was going to be Christmas. I was a pathological case. A malignant, dead-end affliction. And the process was such a bitch.

I believe no other surgery can affect people the way an open-heart surgery does. For it is unthinkable that one’s heart should be cut open. All other organs are vital but they are vital only to life. The heart is more. Nobody writes a poem about a bladder. There is no music sang with words about the esophagus. No love spoken with my entire pancreas. The heart is the one unthinkable cut.

I checked in at the Heart Center on November 10, 1984. Every day was a day of endurance and the hospital the perfect setting for tests on the human spirit. And I would not have made it without my family. It was my luck to be born and raised in a good family. Papa, Mama, Kuya, Ate, Ditse and Bimbo (youngest) helped me tide the difficult days. They nursed, fed, bathed, dressed, recorded fluid intake and output, flushed my waste, financed medical care, and tried to make me laugh. These they did without minding the cost and without complaints. I wanted to set them free from me but only death could make that. (Postcript: My father Pablo Parian passed away on December 10, 1985, one year after my surgery, you could just imagine the pains my illness caused me but my mother has a way of easing pains and taught me to look at it as my father’s way of breathing life into me. A life for a life.)

Choosing Life
I wanted the surgery to be done at once. The discomforts, physical aches and suffering were just too much. Times like these make you wish for instant death, the ultimate reliever. But nobody quit lest they be tagged a loser. The dictum was, you go on, you slug it out until the end. But where was the end? You didn’t know just what to do. Yes, you call on God, sing all the hymns, recite all the memory verses and learn to live out of your body. Projection or day dreaming has helped me transcend the pains. I have learned to fly to the mountains, to the beaches. Somehow, this eased my pains. “Sagada” on my mind made me remember how to reach the moon and the stars. The mind was a reliable ally during these completely bed-ridden and functionless days. Why could medicine not look at death as a solution, too?

The surgery finally took place nearly a month later, on December 10, a day declared internationally as Human Rights Day. That was my day. Everything seemed to be okay until 11 hours later, when I still didn’t wake up, causing the nurses and my family to panic. Later, it was explained that it was my super-enlarged liver, almost reaching my thigh, which delayed expected waking time. It was the nurse’s voice shouting, ‘Juliet, Juliet gising. Isa lang valve!” That woke me up. I could not fathom what that was all about. What happened to me? I could not see. I was motionless. But I could sense. Slowly, it dawned on me. A voice was telling me, I was given back my life. Whether I wanted it or not solely rested on me. I felt I was in the bottomless sea so I treaded up the surface. Then, I began to breathe. Yes, I wanted to live.

I could not stop crying. The nurses kept on telling me to stop but couldn’t. I just had heart surgery and emotions were risks. I could not understand what state of consciousness I was into at that time. My body grew tensed the moment I heard the whirring sounds of the suction machine. A kind male nurse whom I could hear but could not see begged to be understood why he needed to suction the secretions on my nose, mouth and throat. Every time he put that trans parent, tiny, slither of a tube into my mouth, I felt my body jerked up on air. I felt assaulted. Tears welled down on my face from the horrific pain induced by suctioning. Stop it! Please, stop it. So painful. Voiceless shouts which the nurses couldn’t hear. “Juliet, kailangan mo ito!” They answered screaming into my ears, thinking I was hard of hearing, If only they knew I could hear their caresses, even their thoughtlessness. I demanded for a pen and paper. They gave me. I tried to tell them to stop the suctioning and let my mother inside. Only doctors and nurses were allowed in side the recovery room. Family and kin were forbidden. Better that way for them not to witness the horrors of intensive coronary surgical recovery.

“Somebody hold my hand. I feel so cold. Please, somebody hold my hand,” I repeatedly uttered to anybody who watched or stood near me. When I heard the familiar voice of Dr. Anastacio, I cried. “Thank you. One valve only. Thank you.” I knew he didn’t understand. But when he said, “You’re doing fine, Juliet. You’re doing fine”, his faltering voice betrayed him. I told him I didn’t want his assurances, I wanted him to hold my hand for it felt so cold. He was my only connection to familiarity, to closeness, to family. But he couldn’t understand me.

Next Stopover
Surgical Intensive Coronary Unit was my next stopover. The room was glass walled. There were doors for the medical personnel and another that led to a waiting room cum solarium area, the door for the family. My family had camped outside. And I, the princess of wounded hearts, was a precious specimen under microscopic observation in a room complete with all the razzmatazz.

I was awake but not in synchronicity with the flow activities. Images flickered on and off. The “French Lieutenant’s Woman” was the movie on my mind. I wondered why it kept rolling on my mind. In some odd, quirky way, I was uninterested in me and in what they were doing to me. I could just not flow with the routine activities. There was this sense of standing apart from myself, watching them watching me. I could see the nurses working on me, checking me up but not feel them. What was the matter with me? Nurses and doctors continually hovered at me but there was no inch of a response. Nada

The surgery was done on a Monday but I became fully aware and awake on a Friday morning. A simple sponge bath could wake one up to consciousness. When a nurse gave me one, I felt little chills. “Nurse, what time is it?” She said it was 4:30 A.M. Something inside me snapped. “That early? But why are you giving me a bath?” She had to as her shift was about to end. Then she wrapped me like a native suman sa ibos as I was cold. I just had surgery and the last thing I need was a bath, but thanks to her, she lead me back to reality. There I was, grouchy and testy, meaning I was back.

The first thing I asked for was the coldest Coke available. Naturally, it was against the doctor’s orders and postoperative regimen, but my sisters were delighted to see me come back to life so they obliged with my tweet of a request. But as soon as I drank the Coke, I spitted it out as it burned my poor, achy, throat. Mother kept me awake by continually making me drink hot milk and cookies. She was positive it would stave off any possibilities of slipping back to limbo. Milk and cookies worked. It made me long for some better food. They were hurrying me to get out of bed and walk around the room, But all I ever wanted was to sleep. When I told this to Dr. Anastacio, he told me to sleep. Immediately after, he saw me close my eyes. It surprised my family to learn that I never felt any postoperative pains. I was half more than astonished that I never felt any twitch of pain at all. So, I lay there, grateful to be alive but still could not shake off the horror and sadness, nor escape the sense of awe. What had they done to me? I stroked the hanging wire that went into and out of my abdomen. There was this horrible sadness that flowed like blood inside me. I was filled with this sense that my body had been grotesquely mutilated. I couldn’t bring myself to open my chest and be proud. What had they done to me? I had been anatomically raped.

I slept most of the days. I just flowed with my body’s tempo to heal itself. Later, I would think of everything. But for now I would revel in this glory of being freed from those terrible body ill feelings, no more nausea, loss of appetite, throwing up, difficult breathing, inability to move. The angels of mercy weaned me from staying only in bed, from dangling legs on bed to standing, walking within the room, nurse’s station, neighbors’ room to the wash room. I never thought that simple activities like eating, moving urine and bowels, taking a bath, brushing the teeth would be these tremendously crucial. Nurses would ask me to put a pillow on my chest as a safeguard when they tapped my back to induce coughing and remove phlegm. And because of this, also from the instinctive desire to protect my chest from all corners, all violations, all possible accident of contacts, that I had become attached to the pillow as Linus to a security blanket.

New Heart
Tick. Tick. Tick. Tick. These were the sounds made by the prosthetic valve they put inside my heart which was made of silastic material, a kind of soft, inert silicone rubber. My mitral valve was excised and implanted with the Bjork-Shiley mechanical valve. The tricuspid and aortic valves were repaired. They were planning to replace tricuspid with a prosthetic valve, as well, but my critical condition prevented the surgical team to do so. I was told that I would be on coumadin the rest of my life. (as if I would never be on drugs the rest) It was disconcerting but I would deal with this later when I had already recuperated. Meantime, I would pour out all my energies on healing.

Sleep and hunger drives have always been considered telltale measures of recovery, of healing. Indications were strong that I would make it sans the complication. The doctors were happy and proud to save another human. My family rejoiced in my sterling recovery that they continually gave what I longed for. No matter how tired with pressures from work and taking care of my, my sisters and brothers always saw to it that they fulfilled all their obligations.

Embraced By The Sun
Wrapping gifts for big and little cousins was my first serious activity after surgery. I spent Christmas at the hospital. Family came, heard Mass in the hospital, celebrated in the waiting area. So, this was what Christmas really meant. Birth. Life. Salvation. Hope, A second chance.

December 26 was my coming home day. My sisters brought me to the hairdresser before I went home. My hair was the butt of my emotions. When I felt bad, I cut it. I was so skinny. I looked like a skinless longganisa but no mistaking, I was very delighted to be back home after 45 days stay in the hospital. There was that glowing feeling inside as if a fine emotion has touched me. Nothing could elude me this time. Everything, as in everything, including ants, would hold me captive. What fears could possess me now when I had met the Cyclopes and carried the fierce Poseidon in my heart?

I woke up at dawn, walked to the terrace and sat facing east, waiting for the sun. I saw Mother came home from marketing. She wore kimona to the market, a rare moment because Mother usually went to the market dressed almost like a rag, as she opined, what for were the good dresses when you just haggled for fishes, fresh goods in mud-laden stalls and walked in the gutters. Beside, dressing up separated you from the simple folks. But this time, she wore her fines, as it was her youngest daughter’s rebirthing. The sun was beginning to show its face and strength to the world. Daylight has begun. And I, the princess of wounded recycled hearts, stood up in her direction, opened my arms and wallowed in her sunbeam. I would not begin thinking about the mechanical valve, the ticking sound, and all that included in my healing. I would not wrangle with thought questions about how life operated, how death was just sitting beside it, how the twin sisters of fate and karma work, how divinity was matched with miracles, what was destiny’s master plan and how science fit in all of these. As for now, I would catch the sun.