Thursday, May 29, 2008

Bite Me!

Some pleasant surprises.

Today, I had my last shot of anti-rabies vaccine. I had to leave a conference call at a little past three in the afternoon to catch my 4:30PM appointment at the RITM in Alabang. There was traffic near Magallanes, as usual, and it was almost four when I got into the SLEX. Surprise, surprise... there was no traffic all the way to Alabang and I made it to my appointment with the last needle.

So off to Window Number 2 again, to see Ms. Grouchy Nurse. She was all smiles today, and even managed a jolly "Good afternoon!". I smiled back, returned the greeting and handed her my Orange Card. She wrote down the usual stuff on the prescription paper.

"You will pay only the consultation fee of fifty pesos. The vaccine is free.", and with the sweetest smile she asked me to proceed to the cashier, and then to the pharmacy.

After paying and submitting the prescription, I returned to the now transformed Ms. Sweet Nurse of Window Number 2. She handed me my number card. I was Patient Number 75. And so the final wait officially commenced.

In less than a few minutes, the voice on the loudspeaker blurted out, "Number 75!" I, Dennis E. Concepcion, nearing 43 years old, had become but a number in this facility. I surrendered my number card and entered the injection room for the last time. Another surprise await me. There were quite a few more doctors around, with nameplates saying "Participant" dangling from their necks.

"Wow, am I now Specimen Number 75?" I must have looked at them with curious stares, so Ms. Alpha Nurse offered an explanation.

"You are so lucky. There is a seminar today and your vaccines are free. Doc here is going to set up a bite center in their place." That explains the discounted fees. And I thought Ms. Grouchy Nurse turned Ms. Sweet Nurse was just glad to send me off after my last shot, never to be seen again in that facility.

I glanced at the middle-aged man with old-fashioned eyeglasses, checkered shirt and perma-pressed pants. I wanted to ask Ms. Alpha Nurse if she was sure Dr. Checkered Shirt was a real doctor and not a veterinarian. I crossed my fingers and prayed he learned enough in the seminar not to prick me in the wrong places.

First needle on the left arm, the second on the right. It was all over in a couple of minutes. Ms. Alpha Nurse told me not to lose my Orange Card, as if it was a badge of honor - or a Purple Heart for being wounded in combat.

"Your vaccination is good for three years. You can have yourself bitten by dogs as much as you want!". With that, she sent me off, reminding me to hang around for a while to make sure there will be no allergic reaction.

Three years of immunity. I felt like a Survivor castaway earning the immunity talisman for winning the challenges. Over a month of regular shots, no alcohol, and driving all the way to Alabang to catch my late afternoon appointments - all because of a tinnie-winnie dog bite gone awful. But all that is behind me now, and I can look forward to three years of worry-free dealings with dogs. I wonder if they have similar vaccines for annoying people?

So bite me. I'm 100% rabies-free.

Wednesday, May 7, 2008

Of Dog Bites And A Boy Named Kelly - Chapter 2

Our little story continues.

Kelly is a six-year old boy I met at the Research Institute for Tropical Medicine (RITM) in Alabang, where I went to for my anti-rabies and anti-tetanus injections. I came in a little past ten on a Monday morning, and the place was simply chaotic. The amiable guard at the front entrance explained that people may not be aware that the facility is open 24 hours a day, 7 days a week for new patients, thus people who got bitten by animals during the weekend tend to wait until Monday to go there.

It was already past the 11AM cut-off time when I got through the initial registration process. There were three of us - me, Kelly with his grandmother and a little girl with her mommy, daddy, auntie and grandmother. We were told to take our lunch and get back before 2PM. Since RITM sits on an isolated hill, we have no other choice but to wait it out in the facility's spacious compound. Not a bad option after all, as it overlooks the Ayala-Alabang Golf Course and the sprawling Filinvest City.

That was when I met Kelly and his Lola. We filled out and submitted our patient's registration at just about the same time. When we were told that it was already cut-off time, I and his Lola tried to convince the nurse to accommodate us before they close for lunch, but to no avail. This common predicament started off our conversation.

Kelly, I found out, was bitten by his own pet dog. He was staying up late at night playing computer games when he went out of the room to take a pee. Unfortunately, he stepped on his sleeping dog, a huge Labrador, and the startled dog bit him on reflex, with it's fangs lodging on his back side. According to their story, the dog quickly withdrew when it realized that it was Kelly he had attacked. Moral of the story: even pets can be dangerous.

We decided to take our lunch together at the canteen in the adjacent building. It was a huge hall overlooking rolling hills and the golf course - not bad for a government hospital canteen. The food was not bad either, and considering the cost, it's a good bargain. It was during lunch, with the magnificent view of the rolling hills and the gentle breeze on our hair, that I got to know more of Kelly's story through his Lola.

Kelly's mother was her eldest child, the pride and joy of her parents - a school achiever who graduated with a degree of Foreign Service. She got married early though, with her childhood sweetheart. When Kelly was barely a year old, she progressively lost her eyesight. After hopping from one hospital to another, their world came crumbling down when it was confirmed that both her kidneys were deteriorating abnormally fast.

The failing eyesight, it turned out, was because her high blood pressure had burst the blood vessels of her retina. Both her kidneys soon stopped functioning. From then on, she had been in and out of the hospital, with blood transfusion and hemo dialysis becoming a daily routine. Their story was all too familiar for someone whose own mother had to contend with kidney problems.

She spoke about how she had to learn how to administer peritoneal dialysis, how her daughter slips in and out coma, of the endless wait for a kidney donor. She spoke of the emotional distress, of not knowing how it will all end, of just wanting to do anything - try anything to save her daughter's young life. Tears fell from her eyes when she spoke of their final surrender, when her child, her frail body on the verge of giving up, asked that she be allowed to go and rest.

She was tired and guilty that she had caused so much distress and suffering - emotionally and financially, to her family. Kelly was there anyway, he will take her place. She just wanted to give up the fight. It was a valiant fight - but one they could never hope to win. Even if as a daughter and a young mother, she was not ready, she surrendered everything to God's will, and asked that her parents do the same.

Suddenly, there was a connection between me and the woman across the table. As she was telling me her story, her daughter's story, I recalled my own mother's struggle with diabetes and all its complications. She was telling my own story from another perspective! If I were devastated with losing my mother, there is nothing more heartbreaking than a mother burying the child she bore in her womb and nurtured through the years.

I remembered our own struggles as a family when our dear Nanay was admitted to the hospital for the last time. Sometimes, in our desire to hold on to our love ones for as long as we can, we tend to overlook the pain and suffering that they have to go through. When Kelly's mother died, it took years for those she left behind to recover and accept the fact that she is gone. I remember my own struggles, the many regrets for lost opportunities to express love and gratitude, the many "if only" that kept playing in my mind.

We found ourselves sharing our experiences during those difficult days after the passing of loved ones. Hers was a firsthand experience of a mother seeing her daughter slip away right before her very eyes. Mine was of a son, many miles and oceans away, trying to hold unto a fading hope of recovery for a mother who gave so much for her family. The scene was surreal, with both of us looking far into the horizon even as we spoke with tears streaming down from our eyes. I had tried to hold back the tears, but eventually had to let it go.

But it felt so good. I felt a certain lightness in my being just talking with her - a total stranger who shares a common experience of loss. It was only after five years that she was able to bring out again the pictures of her daughter, and she had come to accept her untimely departure. After all, she has two other children, and Kelly, to take care of. Kelly's father had gone abroad and started a new family, although he still keeps in touch. She had no ill-feelings about his decision. He is still young, and she does not take it against him to find happiness of his own. She said she makes it a point to explain to Kelly why his grandparents have to raise him as their own son. He seemed to understand, even at a very young age.

At a little past 1PM, we went back together to the Animal Bite Center. There were already many people waiting at the reception area, even more than there were in the morning when we first came in. Kelly's name and mine were called one after the other at around 3PM. We sat across each other while waiting for the nurses to prepare the syringes to be used for the skin test, two each for both of us.

He asked me, quite nonchalantly, "Are you afraid?"

Wanting to be honest and to somehow assuage his fear, I replied to him, "A little bit. Are you?"

"No, not all. My Lola said it will just be like the bite of a little ant." Enough of assuaging the fears of a little kid. I had clearly underestimated his guts.

We were both secretly throwing glances at each other when the nurses finally pricked the skins on our arms and injected the serum. If it was supposed to be like an ant's bite, as Kelly's Lola had claimed, it sure was an ant the size of a dog. The serum was painful! But Kelly stood his ground and his face was without any trace of fear or hurt.

What choice do a grown up man have against such a show of grit? I have to step up to the plate and pretend as if I did not feel any pain myself. The skin tests produced two small humps on our arms, and the nurses drew circles around them with labels and the time we have to come back to have it examined prior to the actual injections. We went out of the room together, and decided to wait out the time outside the building.

While his Lola busied herself with talking with another woman who accompanied a neighbor's rather unkempt kid, Kelly sat down with me on the porch by the building's driveway. We compared the needle pricks on our arms and he asked me what the labels were for. I told him it was to determine if we will have any allergic reactions to the injections that will come later.

Fear. I finally saw a glimpse of fear on his face. He thought the two test injections were just about it, and then he can go. He called for his Lola and asked if they can just go home. He said he is tired and sleepy, and besides, the wound has healed. His Lola prevailed upon him to stay put, assuring him that the injections will be less painful that the skin tests. When his Lola left to resume her conversation with the other woman, Kelly turned to me again.

"You know, my dog had vaccines. And the wound is already healing. I'm okay now. Do you think I still need to get injections? Can I go home now?" Kelly, the little brave boy, was betrayed by fear in his eyes.

"Are you afraid now? You were a brave boy a while ago. You did not cry like the others."

Looking down on his slippers, he said softly, "It actually hurt a lot, a lot more than the dog bite itself. I did not cry because I told you I will not. And you did not cry either, so I just pretended it did not hurt."

"It is okay to cry if it really hurts. You do not have to worry about me or the others. Did you see the other kids? They were all crying and shouting like pigs being slaughtered." He then lifted up his face, looked at me, then let out a faint smile.

"Are you rich? You have a car, you must be rich." I told him I am not, that I need the car for my work and to get around.

"My Lola said I should study hard so I can get rich and buy my own car. I am an honor student! Maybe I can be like you when I grow up?" Then he rattled off his grades - very impressive. I would have been proud if I were his father.

"Do you have a family? Why did you come here alone? Do you also have a son?" The questions are shooting out from his mouth one after the other.

"Yes, I have a family - my father and my brothers and sisters. But I do not have a wife and children. " I was struggling with the right words to say. I was not ready for a father-and-son type of conversation. They do not teach this in management school!

"Oh! Like me! I don't have a mama and papa, but Lola and Lolo love me very much. And I have my aunties and uncles. My mama died when I was a baby." His voice was happy. but I can see the sadness in his eyes.

"You are one lucky boy! Your Lola is great. I'm sure she loves you very much."

"Yes, but I wish I have a mama too, like my classmates. Why is your mama not with you now?"

"My mother also died almost 10 years ago." Suddenly, it seems like I was talking to myself as a little boy. "Like your mama, she had problems with her kidney."

Nanay would have been there with me had she been around, as she had always been.

When I was in fifth or sixth grade (don't ask me why I can't remember correctly now - blame it on three-letter word that starts with "a"), our school organized a 3-day Boy Scout's Camp-out. The camping ground was not very far from where we live, but it required us to stay for two nights and 3 days. As such, we were required to undergo a medical examination by the school doctor to make sure we are fit enough for the activities.

After the doctor had examined me, he had a worried look on his face when he spoke with my teacher. He had detected a murmur in my heartbeat and suspected symptoms of rheumatic heart disease. I cannot be allowed to join my fellow scouts, classmates and friends all, for my first ever camp-out. Me and my friends were frustrated as we were all looking forward to this event. Everyone passed the medical examination, except me.

I was crestfallen. I cried all the way back home. I told my Nanay about what the doctor said. I pleaded for her to ask the doctor and my teachers to allow me to join my classmates. She went back with me to the school. The doctor told her that he was worried I may not be fit enough for the physical activities. My mother spoke with my teachers as well. I do not know how she did it, but she managed to convince them to let me join my troop. I was overjoyed.

I had a wonderful time camping out with my friends and other boy scouts from different schools. I can't recall now if she stayed at the camp the entire time, but I do remember that Nanay would always be around during those 3 days, staying with teachers at the faculty tent. She stayed out of sight most of the time though, but I knew she was just there, always making sure that she was around in case anything went wrong with me. She was my angel then as she is now that she is in heaven.

My Nanay loved me enough to protect me and make sure no harm will come my way, but she loved me even more by allowing me space to grow and discover the world on my own.

"Do you remember her? I only saw my mama in pictures. But I love her very much. Lola said my mama loves me very much too." I looked at Kelly and wish he would always remember his own words when he grows up.

"Have you been a good boy?"

"Yes!", he quickly said, then let out an impish smile. "Well, sometimes I am not. Is that why I got bitten by our dog and had to be injected?"

"No, of course not. Sometimes things happen even if we do not want to. But you have to learn from them, so they will not happen again." He nodded, then fidgeted with his fingers.

Just then, the street kid accompanied by the woman speaking with Kelly's Lola came out of the facility and played around the driveway. He was dirty, barefoot and malnourished. He was oblivious of the warnings from the guard and other people. Apparently, he was attacked by the woman's dog when he taunted it. The kid was eleven years old, but was only as big as six-year old Kelly.

"Will I be like him because of the dog bite?" He had a worried look on his face, throwing glances at the other kid. He thought the kid had gone sick and crazy because of rabies.

"No, you will not end up like him because many people love you. Your Lola will always take care of you."

He let out a wide grin on his face. "And my mama too! Lola said mama is always watching over me. I do not see her, but she is my angel in heaven." I smiled back at him, and remembered my own angel in heaven.

When it was time to have the injections, he went in first. I was expecting a loud cry from him, like all the other kids who had theirs. There was none. After a few minutes, my name was called and I was asked to come into the injection room. I met Kelly on his way out. He asked that I stoop down so he can whisper something to my ear.

"It really hurts. But its okay. I'm a grown up now. Don't cry when it's your turn, ok?" With that, he waved goodbye to me.

As I sat through the seven injections for that initial session, I had Kelly on my mind. The little boy who loved his mother even if he could not even remember how she looked like, the little boy who was not afraid of anything because he put all his trust in the unconditional love and protection of his mother.

As the nurse buried each needle deep into my muscles, I took the pain as little Kelly did - bravely and without fear. He did his mother proud. I was not about to fail my own.

Postscript: This blog entry is dedicated to the mothers in my family, most especially to our dear Nanay. It's been almost 10 years since she passed on and left us bereaved, but her memory lives on. On this Mother's Day, I pay tribute to her and all the women who made all of us possible.