The Long Wait to Cure

By Lance Isidore Catedral
Essay

At 4 PM, when most government offices were about to close, when cars were trapped in Metro Manila traffic, when students and employees fought for space in the MRT, the queue of new patients outside the Medical Oncology Clinic was as long as when the day had begun. On my table was the pile of new charts still unopened—each cream-colored folder bearing the name of a human being waiting to be called in.

The waiting area smelled of clothes drenched in sweat, what with the tropical afternoon heat and humidity. These people came from all over the Philippines—a country of seven thousand islands, blessed with year-long sunshine and white sand beaches and broad smiles but plagued with poverty and corruption. They brought with them tumors of different sizes and shapes, of varying degrees of aggression, in various parts of their anatomy. Perhaps many of them wondered, during this long wait, if they would live long enough to their son’s graduation or if they could still blow next year’s birthday candle.

For the rich and powerful, who could afford air-conditioned lounges in the most exclusive of hospitals, this long waiting time would be a waste, but for many of them who could barely even afford a complete blood count, this was a step closer to cure—if it existed at all.

Somewhere in the thick crowd was a woman named Faith whose folder sat at the top of the pile. She was twenty-three years old. She came from a nearby province, an hour away from Manila. As I called her name through the microphone, my voice reverberated throughout the Cancer Institute. But there was no commotion, no indication that someone was approaching the consultation room. Just as I was about to call the next name on the pile, a man—the patient’s father—told me that she was too heavy to carry, that she was in the opposite end of the hall, and begged if I could go to her instead.

Faith lay on a narrow metallic stretcher, listening to music with her earphones, a distraction from reality. Her left forearm was amputated when a tumor appeared in her wrist two years ago. The tumor was cancer—mesenchymal chondrosarcoma, the biopsy had read. She said yes, without hesitation, to amputation. She had just graduated with a computer science degree and landed a stable IT job. No cancer was going to hold her back.

Months after surgery, she felt a lump in her lower spine. It grew larger by the day, a threatening mass that would usher another chapter of her life. This time, she needed chemotherapy. She went to a private hospital where she finished four cycles of chemotherapy. It only made her a little better; the mass had not disappeared completely but was at least as big as a basketball. Her treatment—which included expensive chemotherapy medications, admission to a private room every three weeks, and expensive laboratory and imaging tests—caused a financial strain on her family. Her father was a traffic enforcer, her mother a housewife. In the Philippines, people pay for their treatment out of their pockets. PhilHealth, the government-run health insurance provider, only paid for her treatment partially. With no other options left, her family opted to bring her to a public hospital like ours.

I met her with the assurance that I would do everything I could to help her. As a practicing medical oncologist in the country’s largest public hospital, this meant me giving the best concoction of chemotherapy medications available, but this also meant I would take on the role of a social worker. What difference would an ambitious, evidence-based treatment strategy mean to her if she wouldn’t be able to get the medications she actually needed?

Cancer takes a toll, even in middle-class families. Some sell their small pieces of land, or have their kids stop schooling to save on tuition, or work additional jobs, to pay for treatment. Even curable cancers become death sentences for those who do not have the financial means.

For the next weeks, her parents and brothers would fall in line in offices of government officials who gave checks worth a few thousand pesos—not much compared to the overall cost of her treatment but, when put together, amounted to a substantial amount, sufficient to tide her for at least three cycles of chemotherapy.

“Do you want to go through with this?” I asked Faith when she got confined. Her mass had grown in size during the waiting period, and it looked like she had a massive backpack in her sacrum.

“Yes, of course,” she said. She asked if she would ever get better—the perpetual question, the answer to which was never a simple yes or no. If only life were simpler.

“Let’s hope so,” I said. “This is your best fighting chance.”

Faith’s first cycle did not go without any complications; she suffered severe neutropenia and did not feel well for many days. I discharged her after a few more days, only to have her readmitted for the next cycle.

When I go home after tiring days in the hospital, I often dream of the time when cancer will become as easily treatable as a simple skin infection and we don’t have to worry about the cost of treatment. It is a dream that pushes me, and the strong and optimistic army of physicians in the country, to do what we can, given our limited resources.

But my patients’ hope springs eternal—not just Faith’s but of most of the names in the chart pile. At the end of the day, no charts remain on my table, only unopened gifts—warm meals, fresh fruits picked from the backyard, pieces of candies, and slices of pies, whatever these patients could muster, their gratitude overflowing despite their poverty. If only to offer them, the underprivileged, a chance at a cure, all my exhaustion will have been worth it.

Editors and Contributors

GUEST EDITOR

Eric Gerard H. Nebran is an educator and illustrator from General Santos City. He is currently a PhD Comparative Literature student at the University of the Philippines–Diliman. His research interests include orality, history, and literary productions of his hometown.

REGULAR EDITOR

Jude Ortega is a short story writer from Senator Ninoy Aquino, Sultan Kudarat Province. He has been a fellow in two regional and four national writers workshops. In 2015, he received honorable mention at the inaugural F. Sionil José Young Writers Awards. His short story collection Seekers of Spirits is forthcoming from the University of the Philippines Press.

CONTRIBUTORS

Mikhael M. Labrador is from Koronadal City, South Cotabato, and has been residing in Cebu for the past eleven years, working primarily in the business process outsourcing industry. He is an avid travel hobbyist and a former editor of Omniana, the official student publication of Notre Dame of Marbel University.

Noel Pingoy is a graduate of Notre Dame of Marbel University and of Davao Medical School Foundation. He finished residency in internal medicine and fellowships in hematology and in medical oncology at the University of the Philippines–Philippine General Hospital. He divides his time between General Santos City and Koronadal City.

Mubarak M. Tahir was born in the village of Kitango in Datu Piang, Maguindanao. He earned his Bachelor of Arts in Filipino Language (cum laude) at Mindanao State University in Marawi City. He lived in General Santos City when he taught in the campus there of his alma mater. His essay “Aden Bon Besen Uyag-uyag” won the third prize for Sanaysay at the 2017 Palanca Awards. Currently, he is teaching at the Davao campus of Philippine Science High School.

Lance Isidore Catedral is completing his residency training in Internal Medicine at the University of the Philippines–Philippine General Hospital. He also has a degree in Molecular Biology and Biotechnology from UP Diliman. He was born and raised in Koronadal City. Since 2004, he has been blogging at bottledbrain.com. His interests include Christianity, literature, and medicine.

Saquina Karla C. Guiam has been published in the Rising Phoenix ReviewScrittura MagazineSuffragette CityDulcet QuarterlyThe Fem Lit Mag, Glass: A Journal of Poetry, and others. She graduated from Mindanao State University in General Santos City with a bachelor’s degree in English and is currently studying for her master’s degree in Ateneo de Davao University. She is the Roots nonfiction editor at Rambutan Literary, an online journal showcasing literature and art from Southeast Asians all over the world, and the social media manager of Umbel & Panicle, a new literary journal inspired by plants and all things botanical.

Benj Marlowe Cordero from General Santos City is currently working in Dubai as a Sales Coordinator and has yet to graduate from Holy Trinity College of GSC. He spends his days off playing Overwatch, constructing a fictional language for his novel, and completing his poetry collection, under the rose. He likes shawarma, singing in the shower, and Rick Riordan.

Marc Jeff Lañada hails from General Santos City and currently resides in Davao for his undergraduate studies in the University of the Philippines–Mindanao. He was a fellow during the Davao Writers Workshop 2017, and some of his works were published in the Dagmay literary journal. His poems talk about landscapes, especially the overlooked or underappreciated places in General Santos and Davao.

Claire Monreal is a student at Central Mindanao Colleges in Kidapawan City, Cotabato Province. Her poem “Survived a Bullet” is a finalist in the 2017 Cotabato Province Poetry Contest.

Joan Victoria Cañete is a registered medical technologist from Kidapawan City, Cotabato Province. “Superficial Swim,” her poem for this issue, is a finalist in the 2017 Cotabato Province Poetry Contest.

Patrick Jayson L. Ralla is a graduate of Mindanao State University–General Santos City with a Bachelor of Arts degree in English. He is currently working as a private school teacher in Polomolok, South Cotabato, and is taking up a Master of Arts degree in Literature at the University of Southeastern Philippines, Davao City.

Paul Randy P. Gumanao hails from Kidapawan City, and teaches Chemistry at Philippine Science High School–SOCCSKSARGEN Region Campus. He was a fellow for poetry at the 2009 Davao Writers Workshop, and 2010 IYAS National Creative Writing Workshop. He is a former editor in chief of Atenews, the official student publication of Ateneo de Davao University, and is currently finishing his MS in Chemistry from the same university.

Mariz Leona is an AB English student at Mindanao State University in General Santos City. She is from Lambayong, Sultan Kudarat.

Boon Kristoffer Lauw, a chemical engineer–turned–entrepreneur from General Santos City, is currently based in Quezon City. During his practice of profession at a beer-manufacturing plant last 2013, he began to pass graveyard shifts with random musings that eventually took form in writing—and, inevitably, stories.

Erwin Cabucos, born and raised in Kabacan, Cotabato Province, is a teacher of English and religious education at Trinity College in Queensland, Australia. He received High Commendation literary awards from Roly Sussex Short Story Prize and Queensland Independent Education Union Literary Competition in 2016. His short stories have been published in Australia, Philippines, Singapore, and USA, including Verandah, FourW, Philippines Graphic, and Quarterly Literary Review Singapore. He completed his master in English education from the University of New England.

Mother and Son

by Lance Isidore Catedral
Nonfiction

(This piece first appeared in the anthology Through the Eyes of a Healer.)

He cried like a baby, and maybe that was what he was in his mother’s eyes.

With her eyes closed, she looked like she was sleeping. On her arms and limbs were multiple bruises; they started appearing just six months ago, like random pencil blots on a skin canvas. Then came the pallor, unexplained weakness, and a feeling that something wrong was going on. She couldn’t put a name into it until months after her descent into being bedridden, just around the time when her doctor, after seeing her lab tests, to her she had leukemia.

The boy was fourteen, but he had the eyes of an old man who has been through a lot. He cared for her mother, brought her to the hospital for intermittent sessions of blood transfusions, put up with the long queues at the Blood Bank, and even pleaded with the Social Services staff to give her free antibiotics.

On Mother’s Day, he was still a boy — soft wisps of hair just starting to grow on his armpits, his voice barely beginning to crack — but already mother-less. Her mother’s blood infection was so profound that even the strongest antibiotics were rendered powerless. Her platelet count was too low as to graciously permit spontaneous bleeding to happen anywhere in her body: her eyes, her lungs, her brain. That was what killed her: a ruptured vessel, perhaps, that decided to snap in her cerebrum. She was gone in minutes.

As he grieved and sobbed and wished that this was all but a dream, IV lines were still attached to her mother’s veins made fragile by many pressure to the bare acceptable minimum were dripping in futility.

It was just another day at the hospital. They boy had to bring his mother’s body home. He had been through a lot, surely he could handle her mother’s funeral too.

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To the Mouse I Shall Be Dissecting this Afternoon

by Lance Isidore Catedral (Nonfiction)

(This piece was first published in Bottledbrain.com, the author’s blog.)

Hey.

We’ve known each other for more than a week now, 11 days to be exact, and I know this because you’re special.

I remember visiting you on that lazy Saturday morning and you looked at me with your red, searching eyes, as if to say, I’m pregnant. You weren’t mistaken.

I don’t know if you were excited as I was—or I was excited as you were—but knowing that you were conceiving half-day old kids thrilled me to pieces. I told my friends all about it, and they were wishing you all the best.

From then on, I kept coming back to you, talking to you, handling you by the tail to see if everything was alright. Thankfully, you seemed to be in perfect health.

But right now, I, who glaringly and openly professed to be your friend, will do to you the two most despicable things one could ever do to a friend—one, I’m going to kill you, and two, I’m going to kill your babies.

I’m not even going to ask for your forgiveness, but all I ask for is that you hear me out one more time because what I will say is true.

Your death will not be humiliating as the deaths of those who ate Racumin for breakfast and drooled moments later. It will not be useless as the deaths of those who craved for cheese and stumbled upon a painful trap. It will not be cruel as the deaths of those who happened to see a cat and got teethed by it.

Instead, yours will be glorious, filled with celebration and dignity and honor because, yes, people will learn from it.

I will never forget you.