July 24, 2003

     I'd rather write about drunken, tone-deaf singers and stinky boarders than about news headlines that are shocking, embarrassing, and downright depressing.

     Just take a look at recent headlines. A known terrorist convicted of several bombings in Manila and Mindanao "escapes". Quadruplets born just six months into pregnancy die. Basketball star with an altar-boy image Kobe Bryant charged with felony sexual assault (spelled r-a-p-e).

     And there's that 20-something kid dating Demi Moore who is 40. How depressing that is. Especially for a good friend who maintains a clinic at St. Paul's and who's more cool and definitely much, much smarter than that dork, and has all the details of his wedding prepared. There's just one problem - there's no bride. The wedding song is ready, the dresses, the guest list, the cake design, and that's all confirmed by a mutual friend who visited him recently. Now, all he needs is a wedding date and a bride. Can somebody hook him up with a gorgeous 40-something too, like, say, Dina Bonnevie?

"The death of the quadruplets is a tragedy, and I am not discounting that. I sympathize with the parents, and one can hardly imagine their grief and suffering. But you and I know the drill. When something goes wrong, hospitals and doctors make for a convenient scapegoat."

     Meanwhile, this other headline is actually more embarrassing than shocking. A terrorist, Al-Ghozi, a confirmed member of a group affiliated with Al-Qaeda known, I think, as Jamal Islamoymoy, escaped from his jail cell along with two fellow idiots. These people were convicted of several deadly bombings in Manila and Mindanao and to let them walk just like that is, well, okay, expected. Of course, somebody got paid, are you nuts? If you still think they escaped without any help, please get an ice-cream scooper right now and scoop your eyeballs out. It's funny how quickly Malacañang forms a fact-finding body "to get into the bottom of this". Who are they kidding? Fact-finding, my butt. It's a cover-up, period!

     It's embarrassing to the rest of the world. And don't you dare tell me I am contributing to the embarrassment. First of all, I am not in the business of trying to make our country look good, that is the business of the Department of Tourism. Or that of presidential spokesman Ignacio Buni (that's "dandruff" in English, isn't it?). I don't consider myself a part of the mainstream media, but, I believe that the business of the media is to tell the truth as best they can. (In my case, if I can be as sarcastic as I can, I have done my job.) According to an older column by Inquirer's Conrado de Quiros, a group of overseas Filipino workers in Hong Kong protested the "Probe Team" television program because it was hurting the image of the Philippines abroad. The program was being aired in Hong Kong through cable TV and its stories about the mountain of garbage in the Payatas area of Quezon City, pedophilia in Pagsanjan town, cases of incest in various parts of the country, and child prostitutes, among other things, were making the country look like a God-forsaken place. In response, de Quiros wrote, "A country sells itself abroad not by inventing a good image of itself, but by doing good things. Reality, and not advertisement, is still the best advertiser of a country. You do not have a mountain of garbage burying people in a landslide, rampant pedophilia and incest, and a growing tribe of child prostitutes, you will not look God-forsaken. You keep silent about them, you will still look God-forsaken." I won't go as far as telling you to scoop your eyeballs out if you disagree but that's simply the truth.

     As a Filipino living abroad, I am embarrassed too. I watch TV Patrol everyday. And all the other programs on ABS-CBN that depict, more often than not, bad images of my home country. Programs like "The Correspondents", "Mission X", "Gus Abelgas, Nag-uulat", and two programs guilty of the worst depiction of all, "Showbiz Sabado" and "The Buzz". (Basically, anything with Kris Aquino on it is "bad image" and an embarrassment). But rather than giving a bad image of the country, ABS-CBN, in fact, is giving a good image by showing that we still have a free press. You can't have a better demonstration of a democracy than that. And please don't get me wrong. There are programs that depict "good images" too, like "Pipol" and "Good News Naman". (Speaking of "good image", and I mean good-lookin' image, there's ABS-CBN news-reporter Marieton Pacheco. She should get more air-time, or screen-time, for that matter.)

     If there's one person you should be embarrassed about, that's presidential spokesman Ignacio Buni (don't you think he looks more like he should be teaching Spanish courses in a College somewhere?). Upon hearing of the "escape", U.S. National Security Adviser Condoleeza Rice commented that her boss, George W. Bush, may re-consider his scheduled state visit to the Philippines late this year (it was learned later that the comment wasn't meant to go public). Who can blame her? If the police, who's supposed to take charge of security, is in connivance with the terrorists by letting three of them escape, would you feel safe if you're Georgie Boy? But what did Señor Buni do? After the comment reached his office, he walked up to his all-too familiar presidential podium and demanded that Ms. Rice apologize. What a moron. And that's the problem, boys and girls. We can't fix a problem because we have too much pride in ourselves to acknowledge that there is one.

     And as if that's not enough, TIME magazine headlines the news as "Terrorism Released". Release, baby, not escape. Part of the article as quoted by Philippine Star's Max Soliven reads, "...Metro Manila’s Camp Crame prison may well be the least secure high-security facility in the world. According to police director Eduardo Matillano, al-Ghozi’s cell was so badly constructed that the door could be bent open by hand. A former Abu Sayyaf member working as janitor gave al-Ghozi details of the best escape route. Before dawn, when al-Ghozi slipped out of the cell and walked out of the prison, one contingent of guards assigned to the nominally high-security block had fallen asleep while another detail has been dispatched outside the prison on a shopping mission. Even then, guards could have reacted quickly to a tip-off from another inmate, but they ignored the information about the break."

     TIME also declares "the police forces of the Philippines are a joke."

     Indeed, they are. If you disagree, please get an ice-cream scooper and...

     Last week, Manila Central University (MCU) Hospital in Caloocan City was under fire for allegedly refusing to admit quadruplets who were born prematurely at a lying-in clinic, resulting in the deaths of three babies and a fourth one after being transferred to Dr. Jose Fabella Memorial Hospital in Manila. That's according to reports from INQ7.net.

     The quadruplet's father, Vladimir Calisaan, accused MCU of neglecting his babies because he and his wife could not give the 20,000-peso deposit required by the hospital for each child. "Hindi sila kulang sa gamit, kulang kami sa pera kaya hindi kami inasikaso (The hospital didn't lack equipment. We didn't have money that's why they didn't accommodate us)," Calisaan told radio station dzBB. The babies who were born premature were not placed immediately in incubators at the MCU, Calisaan said, as quoted by the Inquirer. Calisaan added that the MCU staff had advised him to transfer the quadruplets to another hospital. "Inapura nila kaming umalis dahil walang pambayad (They hurried us to leave since we don't have money to pay them)," Calisaan said.

     In a statement faxed to INQ7.net, Dr. Raquel M. So-Sayo, MCU medical director, denied Calisaan's claims, saying, "All resuscitative measures and newborn care were given (to the babies). There was never any moment that treatment was withheld because of financial concerns."

     I believe MCU and its medical director but that's beside my point. I'm bothered about all the media coverage of the event, including editorials from the Inquirer and the Philippine Star (forget radio stations like dzBB, they employ illiterates), which tend to focus more on the culpability of the doctors and the hospitals. Most newspaper stories and TV news shows made a big deal "only" of what the father claimed that they had been passed from one hospital to another. The reports quoted both parents saying that their daughters could have survived had MCU given them immediate attention.

     Really? Has anybody noticed that the babies were born six months premature? That there was no pre-natal care? That they were delivered via normal vaginal delivery in a lying-in clinic?

     Of course, if you are not too bright, you'll believe everything the radio or a newspaper says. The death of the quadruplets is a tragedy, and I am not discounting that. I sympathize with the parents, and one can hardly imagine their grief and suffering.

     But you and I know the drill. When something goes wrong, hospitals and doctors make for a convenient scapegoat.

     The bitterness of the Calisaans is expected and understandable. They lost four children all at once. But wouldn't you agree that patients, in general, tend to exaggerate if their expectations are not met? Even if part or all of it is their fault? Wouldn't you agree that this is one of the dangers of the bill presented and trashed last year criminalizing medical practice? Wouldn't you believe that people who think they got a raw deal from doctors, even against a ton of evidence, would file lawsuits left and right?

     The Department of Health has conducted its own investigation, so I am not at a liberty to say right now that the lying-in clinic and the hospital are not at all responsible for the four girls' death and they were merely caught in the middle of something inevitable. Ironic, isn't it? You tried to help, and it is you who gets investigated.

     If you passed through internship at the University Hospital, you may have already understood why your OB-Gyne residents used to bitch (I think that's a proper description, for lack of a better word) to patients who miss their regular pre-natal check-ups. And bitch some more if somebody shows up at the E.R., 8 cm dilated, without previous pre-natal care. You just can't over-emphasize pre-natal care. It's that important. We know that even under normal circumstances, there are many factors that can compromise the survival of a newborn infant. More so with quadruplets born prematurely, in a lying-in clinic. (To those who had the opportunity to moonlight at these clinics, can somebody please explain why they are called "lying-in"?)

     It may also be heartless to put all the blame on the parents. But since we started this blame-game anyway, why not blame the sorry state of the country's health care?

     In the July 19 editorial of the Philippine Star, editors write, "...And yet some people can't help wondering if the quadruplets would have had a better chance if they and their mother had received proper health care. The four were born in a lying-in clinic, which lacked facilities for quadruplets so they were referred to the Manila Central University Hospital. Government investigators are still trying to determine why the hospital turned away the quadruplets. Mother and babies finally ended up at the Fabella Hospital - once the country's top goverment-run maternity hospital, but now barely surviving on an annual budget of P243,000."

     P243,000 a year? Are you kidding me? I heard of a stretcher purchased sometime ago by one government hospital that's more expensive than that.

     "Millions of Filipinos cannot afford the services of private hospitals so the government is supposed to take up the slack," continues the editorial. "But what can P243,000 buy in the world of health care? That's not even enough for the cheapest, simplest, coronary bypass. Private hospitals can't be blamed entirely for limiting their free services. Drugs and medical equipment do not come cheap. Qualified doctors and health workers are leaving in droves for better-paying jobs abroad, so private hospitals must make their salaries competitive. To remain viable and offer world-class services, a private hospital must turn a profit. But only a small fraction of the population can afford such services. The tragedy of the Calisaan quadruplets is just the latest reminder of the sorry state of health care in this country."

     Rina Jimenez-David, writing for the Inquirer, has this to say, "Was it poverty that killed the Calisaan quads, as their parents tearfully told reporters? Maybe so, but the bigger tragedy is that they could have survived if only the adults in charge of them had been better prepared."

     And you thought your OB-Gyne residents were just bitchin' for nothin'.

     This week's Top Ten:

     Top Ten Signs You Are Not Graduating From Medical School:

1. When you raise your hand during a case conference, the consultant says, "Save it for next year."
2. You are on trial for stabbing an OR nurse.
3. Your combined comprehensive exam scores in all subjects - 12.
4. Your extensions in all departments add up to 2 years.
5. A bed at the intern's quarters has been reserved for you for next year.
6. Your case study is titled "101 Ways To Date A Nurse".
7. While reading this list, you've already nodded your head at least three times.
8. Your name: John. This year's graduation theme: "Sorry John, you won't be graduating."
9. A hospital cafeteria worker asks, "Anything particular you'd like to eat next year?"
10. You've been in medical school since 1985.

     This week's FINAL WORD comes from Nina (a recent response to an old column, A matter of ethics):

     "I love your column, I just wish you'll attack Kris Aquino on print more. I hate that chick. That obnoxious, self-serving tramp."

     Okay. She's an obnoxious, self-serving tramp.

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     The author's e-mail address is at drgarcia@wvsumedaa.com

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