by Eugenio Jose F. Ramos, MD

With the horrible things that preoccupied us at the height of the COVID-19 pandemic, we probably didn’t notice that good things also happened. The sky cleared up, ambient noise disappeared, expressions of love came spontaneously and often, priorities were rearranged under forced discipline in a lockdown, and aggravations in our head cooled down. Today, after the worst is over, we are hopefully able to see the past and the present with more clarity. Bad things did happen to good people, and bad people are still around to put us on our toes. The rich are as comfortable as ever, and the poor have remained despondent. Regardless of the lessons, the good and the bad will flourish. Depending on the default mode of our orientation, we are either grateful for the blessings that we have or perpetually stuck in a recurrent state of inadequacy. When we think about it – if we give ourselves time to reflect- our needs are simple, it is our wants that confound us.

Back home, we have a 10-cu. ft.  frostless ref and a 10-cu. ft. freezer in our kitchen, and a smaller ref by the bar adjoining our living room. The freezer is north pole to me as well as my wife who is a busy physician like me. All 3 appliances are open for exploration, a source of both pleasant and unpleasant surprises when necessity beckons. One Christmas, my wife discovered a turkey at the freezer’s farthest end of the uppermost layer. Carbon-dating fixed its ice-age at 18 months. I had heard somewhere that a turkey becomes most tender when aged in the freezer, which saved the day for our cook. We had a tasty unplanned turkey – at least half of it – that Christmas; the unfinished half was probably kept in the ref beside the freezer – a half-way-house of sorts– for a few more days after Christmas, unless the people in the kitchen finished it off right after the dinner. (If nobody remembered a whole turkey, who would remember half a turkey!).

The big frostless ref is opened more frequently, of course; no ice to dig food out of. After I bought a separate hot-and-cold water dispenser, however, I have been opening it less. When I do, there again is another reason for consternation! When our children were very young, the ref chronicled their “unfinished business”, e.g., half-empty tetra-paks with straws sticking out, half-consumed cake slices and sandwiches, or unfinished glasses of milk from the breakfast table, perched randomly on containers and boxes the contents of which are eventually smelled, taste-tested and vetted for human consumption. Any ounce of doubt lands the food into the garbage bin. Since the ref is frostless, no ‘icebergs’ serve to remind us that another cleaning is in order. The memory of the last cleaning is not the basis for the next; there is no such memory. Cleaning the ref becomes imperative only when molds are discovered, and everything else inside quickly causes dread. The ref has become a parking lot for over-ordered food deliveries and uncompleted overindulgence, a snapshot of abundance that hasn’t travelled down the gastrointestinal tract. Last week, for instance, I saw 2 half-empty bottles of salsa of the same brand in 2 different locations inside. Since the salsa lover is my son and he would only open the ref to look for what meets his eyes, and since his mother seldom opens the ref herself, the likelihood that a salsa “out-of-stock situation” in the pantry would trigger a trip to the supermarket is real; it happens all the time.

The smaller ref by the bar is south pole to everyone because we rarely linger in that part of the house. It is an exclusive repository of fruitcakes, chocolates, and other sweets. Almost all are gifts and pasalubongs (by their glut, we no longer doubt why diabetes has become an epidemic). Our fruitcake collection is enviable – from the ones that look expensive by the nature of the nuts that they embed to ones that are given as a token of get-it-over-with thoughtfulness. A first-in-first-out policy in serving fruitcakes is employed, some of which have been in the ref for 2 years (not because we like to hoard, but because nobody remembers that they are there). I tell the househelp to serve the fruitcakes to people who drop by the house – especially their own relatives – along with the ground coffee from the hinterlands that has lately become another common giveaway. But they always forget because other than the fruitcakes (just half a dozen so far this season, welcomingly replaced this year by rum cake), there are still cakes in boxes on the kitchen table that must be given away first. Indeed, sugar is the common ingredient of most giveaways every Christmas, poison only to those who can resist putting a slice in their mouths. The cakes at home are in addition to the “thank-you” cakes that my wife and I regularly receive (with resignation) from well-meaning patients in the clinic and the hospital. We give them away to our secretaries, the nurses, and the residents, preferring to focus on the pleasure of giving instead of the adversity that sugar causes – something like offering present gratification over the health hazard that may or may not happen in the future. All in the spirit of Christmas!

But this is not just about food in and out of refrigerators, we can check our closets, too. We see clothes and neckties, scarves and barong materials, hats and accessories, and shoes and belts – all gifts – in random states of disarray, some still in boxes, used no more than once or never at all. Among many of us, our living rooms, bathrooms and bedrooms, too, are a repository of air purifiers, scented candles, Occitane hand lotions and soaps, kitschy decors – accoutrements of style that clutters the senses. Every Christmas, we exchange gifts with friends and family; we give, and we receive. In some instances, we give because we received. The usual giving-and-receiving cycle becomes a closed loop among friends and colleagues – an picture of urbanity that conjures exclusivity and inaccessibility to many Filipinos who have to work for daily wage. It is, in fact, an insensitive exchange among materially blessed people with big refrigerators that are seldom opened, and closets that are full of unused clothes and dusty boxes. We in the medical profession give each other gifts because we refer patients to each other. We love to give gifts to people we appreciate; we relish receiving gifts from people who appreciate us. But the gifts, themselves, we seldom need, rarely use, or eagerly consume.

But, of course, it is the thought that counts!

As we elevate humanity from the pits of materialism and captive utilitarianism, and acquire the sophistication for simple decency and civility, how we wish that in time people would learn much simpler ways of expressing profound gratitude, and to expect nothing more than the sincerity and sufficiency of such a gesture, without having to give or receive in excess that contributes to  waste and clutter. Waste aggravates global warming and environmental degradation, not to mention molds in refrigerators, poor health and obesity, decadence and misaligned values.  Why can’t we give because it is the right thing to do, and not because we must? For whom do we give, really, when we give away what we have in excess, what we don’t want, or when we no longer have space in our homes for the next batch of gifts and purchases for the holidays? What joy is there to give away what we don’t value other than it saves us space?

I still practice, on occasion, a ‘panata’ to load my car’s front seat with fresh goodies – even the ones I like to keep (good fruitcakes, included) – and drive around during the Christmas season. At traffic stops, as the street-children swarm around the car, I bask in the opportunity for redemption. In their younger years, my children would join me in the car – with the toys that they initially did not want to give away. Seeing their faces glow as they handed over their favorite toys to the street children was bliss. Giving to refresh our values and reorganize our priorities is not really a selfless act, but it’s a good start. They say it is wrong to give to these mendicants; it will spoil them. Mother Teresa had a rebuke to this: “What’s wrong with spoiling the poor? We have been spoiling the rich all these years!”   

We, physicians, have been spoiled for a long, long time more than we care to admit. We have been receiving blessings that are easily overlooked because we mix them with – or mistake them for – what we think we are entitled to receive. The pandemic seems to have evolved a new way of adapting to the virus of materialism that sets the lucky ones apart and further spurs social inequity. No doubt, the medical profession makes us more comfortable than most. The rest of our fellowmen are not as fortunate, hanging by the clutches of inequality and uncertainty amid our abundance. We now see blatant greed undisguised, as colleagues give in to the vulnerability of their needs and the vagaries of their want.

Perhaps, we should be less dependent on freezers and frostless refrigerators so we could discern what is fresh from what has molds, what we should preserve from what we should let go.  Unless we find the time to reexplore where we came from and how we began, who can tell how many succulent turkeys there are buried in the thick ice of insensitivity, just waiting to be rediscovered – to awe and transform us!

Dead at 65, 6 years short of the average life expectancy of a Filipino male.

As I looked down at Rick in his casket, I tried to mute the chatter from his classmates huddled at the benches behind, while I preoccupied myself with the chatter in my own head. The flowers and Rick’s casket in front would soon become the backdrop for what was bound to happen later: a class picture, with Rick lying in state.  I was familiar with many of Rick’s classmates present; a few hadn’t changed significantly, but some looked spent even for their age. Gravity in our age group is a curse, I said to myself, something that may benefit from intervention. One of these classmates would no longer likely be around in the next class picture, I whispered to myself. Terrible that I had such morbid thoughts while watching them smile at the smartphones handed to a non-classmate photographer, the photos to be shared in Facebook and Instagram perhaps after some generous photo editing. Welcome to the Age of Transitions! Another journey ended, another chapter closed, another beginning to be started. I sat there motionless as Rick’s friends took turns talking about memories of their common past. But my mind was somewhere else, listening to a voice telling me that there’s no past nor future to think about, only the present.

News of death dissolves in and out of my mind as losing friends and acquaintances at the fringes of advancing age happens with unsettling frequency.  As I sat there watching the various life-forms in front of Rick’s casket at the far end, the movie in my mind began to whirl. For the last few years, it would play sporadically, making my adult children worry about those blank stares and alarming moments of ‘not being present’ at the dinner table. The movie plays vividly in vignettes when news of death of someone I know reaches me –  unexpectedly without warning of a prior illness, as a welcome relief to pain and suffering, or at the end of a long and well-lived life. It pulls me out of my body and puts me in a trance.  

The movie that spins in my head is quite simple: it is a chase after something visible but inaccessible. And it has the necessary conflicts and complexities to make that chase a time-bound challenge. I produce the movie, write the script, direct and act in it. I also do the musical score, which varies depending on how the conflicts are resolved, or when the screenplay becomes more complex as more characters make their appearances. It is actually a movie in search of a happy ending, which is increasingly tough to frame as time goes by.

What is a happy ending? Is it the same as dying happy?

We are born, we go through infancy, adolescence and adulthood, we make something of ourselves, earn a living, build a family, earn respect and recognition, grow old, get sick and then die. We all want to reach old age. Or perhaps not all of us. There are humans that are perennially on the verge of being born, unable to savor life on their own, and there are those who reach old age without leaving adolescence. People die – some at a very young age, others at the peak of their careers, others when they’re shrunken and disconnected. Some die suddenly; others have to suffer through pain and despondency; some are better off dead than being in a perpetual state of dying, draining the life out of those who take care of them. At the metaphysical level, miserable people die before their deaths; the great ones linger on longer after they die. Hopefully later than sooner, our turn will come. Some of us actually learn to look forward to it.

Our friends and loved ones will mourn us, a temporary distraction that may last a few days to a few weeks, and then life moves on. It is healthy to accept that we will be forgotten. Fool ourselves not that we will be remembered, unless of course we reincarnate as a virus that latches on to and mutates in the DNA of people whose lives we’ve touch during our lifetime. Our individual identities may disappear, but our narratives will surface in their movies, digitally embedded in Netflix 5.0 of the future generation, when knowledge, information, and even entertainment are experienced through quantum physics. (I am in awe that my search for meaning creatively transcends the limits of mortality while in a trance at a dead friend’s wake!)

On closer look, my movie seeks redemption; it subscribes to truth, fairness, and justice coming together in a quest for serenity. I know I can end the movie now and I must, but the conflicts are not easy to resolve, nor the complexities, to untangle; sometimes, it is as if the movie acquires a life of its own, allowing the conflicts that remain unresolved to run their own course, no longer controlled by the scriptwriter, the director, or the producer!  So sitting there at the wake of yet another friend, I asked myself: What if death comes before I can have that happy ending?

Am I good-to-go? Now?

This obsession with time, specifically the lack of it, continues to preoccupy me long after I celebrated my 60^th birthday 7 years ago, the age that I had decided to be the time to let go, to let things be, to be free! I declared to myself and to friends that turning 60 had to mean something more profound than legitimizing the indulgences and follies of senior citizenship. The start of my 7^th decade was to be the time to reconnect with, and give back to, the bigger world outside – beyond work and the perks it provides, deep into the substance of things where meaning hides. The years of career growth, building a name for myself, learning great things from amazing people, gaining wonderful friends, acquiring and using influence, building my estate, bringing up my children well, enjoying positions of respect and leadership are all that I am now. Well, probably not all. My children’s education – their upbringing, intelligence, and maturity – already assure them of a good start in life; my wife has a respectable career and can take care of herself; my siblings have families and lives of their own. Material wealth has neither been a deprivation nor a desire; the drive to join the rat race ended years ago when I realized that there was more joy pursuing simpler things than to satisfy other people’s standards.

Now I am about to turn 67  and I am still here, lucky in so many ways that success can be defined, so how can I even fret about this! And yet in the many moments when I’m by myself, everything becomes even clearer: I ache for that simple life!  A life unencumbered by the demands of tradition, rituals, work, and exacting relationships; a life with and for the senses, of fascination and wonder, elegance of language and behavior, creativity and new ideas, music and laughter, warmth and compassion, timelessness and connectedness.  I know that I can do a lot of other things for many more people; spend money on things that matter, and perhaps make a bigger difference in another (uncharted) territory.  But I also need to stop worrying about things that I have no control over, non-deliverables that I should stop feeling guilty about, mediocrity of people who are best forgotten. It has been 7 years since I acquired senior citizenship, but the resolve that I had then to get myself out of self-created traps has not been met. Dreary moving pictures in my mind continue to haunt me, depriving me of the joy of being untangled, free, and being in the present.

How do I put my mind to rest?

Sequences of disengagement from a comfortable but complex life fade-in and fade-out, interposed with images of being disconnected and disenfranchised. I am at the center, lost in thought, floating above fear and hesitancy, determined to simplify, and at some point decidedly rewired for a whole new world outside a safe, predictable, but otherwise boring life. The movie is already running too long, with chases going in various directions. Incoherence is setting in, there now is a need to edit. I must zero in on that one chase that creates meaning, wing it, and then have enough time to experience it for real. (As it turns out, I am the movie editor as well!)

Editing one’s life in the 7^th decade provides a pleasurable rush. Depending on one’s level of tolerance to unfinished business, it can also be one big panic attack. There are movies that fade gently with the music, there are some that end abruptly with a jolt. There are no set standards in how a movie should be written, edited, directed, scored and acted in; so many elements are beyond our control even if we are the movie producer. We have responsibilities and commitments; they stay with us for as long as we care. Even when we don’t. Sometimes they enslave us. Letting go is never easy, but it is the best way – the only way, perhaps – to acquire, hold on to, and benefit from that one element that is essential to one’s search for meaning: The present time.

How my movie ends, if it ends, only time can tell. The moving pictures in my aging mind can be reformatted into a Netflix series or shelved for irrelevance.

It was getting dark; I left the wake quietly, after looking at Rick for one last time. He is gone forever, but to Stella, his siblings, and to us, his friends and colleagues, he is going to stay a while longer. He was a good man, a very decent human being who loved and laughed a lot. Whatever movie he had in his mind during his lifetime ended well long before he died, when he decided to cut down on his surgical practice, finally marry Stella at 55, move out from their condo in Pasig to a smaller house in the suburbs where he would cook special dinners for both of them, and they had all the space to walk and play with their dogs. Unresolved conflicts, if there were any, were just but embellishments that didn’t diminish an otherwise solid life.

by Gigi Bautista Rapadas

Gigi Bautista Rapadas is a close friend, a colleague at the University of Sto. Tomas during our years together as campus journalists of The Varsitarian, the university’s student newspaper with a circulation then of 32,000. She has since then moved on to a successful career with Ayala, gotten married, raised a family. When she turned 50 a decade ago, she wrote an article on Turning 50. That was a very insightful article, and I shared it in Facebook with friends. When she turned 60 a few days ago, I expected nothing less than another article. And so here it is!- Gene Ramos

It is only with age that one can see clearly; what is essential is invisible to the young. – With apologies to Antoine de Saint Exupery, “The Little Prince”

A decade since I wrote my short piece “On Turning 50”, I reflect on where and who I am at this point in my life. Have I remained the same person, or do I see the world with a new pair of tinted glasses yet again?

This year I am set to retire from “work” as I have known it the past 40 years, and a new world beckons. I have been looking forward to retirement for so long, a retirement that will allow me to do what I want to do, and not do what I do not want to do. Will retirement be as wonderful as I think it will be?

And here is my realization.

My retirement will be as wonderful as I make it. I will create my own happiness, with the certain support of my husband Raffy and my whole family. At 60, I am a different person. When buying shoes, I no longer look for my old favorite Ferragamo shop; I look for Clarks. I do not need bags in all colors, or a black bag in five different brands with five different shapes and sizes. I have earned my stripes but do not need to show them off. I (more accurately, we) have earned material self-sufficiency but do not need to flaunt it with a logo on my bag or my wrist or my ears or my feet.

I have exchanged my Rolex for a Fitbit, recording my steps and how much water I drink in a day. The Rolex sits at home in our safe, waiting for a special occasion when a wearable gadget is not appropriate. Or maybe just waiting to be inherited by someone who will be more appreciative.

Last December, our family went to a big outlet store complex in Japan and for the first time I did not buy a single item for myself. I did not really need anything, and more to the point, I did not crave anything. To be honest, I will still wear my jewelry and use my signature bags but do not look to accumulate more. The accumulation phase of my life is past and I do not miss it.

I see what you’re thinking. And it’s true too. Maybe it’s because I know that the semi-monthly deposits to my bank account will soon stop, the bonuses that come periodically will soon end. Or maybe it’s because I am becoming more like my mother, whose detachment from all things material is admirable, almost legendary. (A very very long way to go though!) Or maybe it’s just because I have turned 60.

One evening a few weeks ago when our eldest son Oogie and I were talking, I mentioned that for Raffy and me, the future is definitely shorter than the past. And he scolded me and said he does not like hearing me talk that way. But it is true. If we are lucky, our future will be half as long as our past. And we need to make the most of every minute that is given to us – savor life, cherish our loves, dance and sing when we feel like it, squeeze every joy that we can out of the opportunities afforded us.

I have for a long while now understood that I am not invincible. The aches and pains, the body parts that no longer work as well as they used to, the frequent feeling of tiredness, the sagging, the wrinkles, the unstoppable bulging of the belly, and everything that comes with the passing of the years – all these are constant and ever-increasing reminders of aging. But I have come to terms with all these. With the “age appropriate” changes have come some precious lessons that I now live by.

I do not worry unless there is a definite reason to worry. Premature worrying helps nothing and no one. If I or my loved ones take a medical test and the results need further tests for confirmation, I do not worry about it until the subsequent tests turn out positive for something serious. It never has, thank God. I do not squander a perfectly good day by getting angry, or at least I try really hard. It is not worth the energy, especially if the other party is oblivious to the fact that he/she caused me to lose my cool. I do my best to rectify the situation and move on.

I still do not suffer fools gladly, but I am more tolerant of them. I have come to accept that we are all different, with some more different than others.

I make time for myself. This has become easier now that the kids are grown and have their own lives. I honestly don’t have a bucket list, but I know I really enjoy traveling with my husband and with the whole growing family, I know I love spending time in the kitchen and becoming better at baking and cooking, I know I relish every milestone our grandchildren go through. And I will do all and more of those when I retire.

I accept my limitations. I know I will never be a good pianist; I took lessons for a couple of years when I was 50 because it was a childhood dream, and quickly realized that the piano did not like me. Well, I certainly do not like it either. So there!

I still juggle many balls every day, but I absolutely know which balls are made of glass and which ones are not as fragile. The glass balls I make sure I catch, like family, and faith, and friends, and health. Everything else is on a “best effort” basis, assuming I even want to expend the effort. If some of the other balls fall, then hopefully they bounce. If not, que sera sera.

As Fr. Mon Merino said in his homily yesterday at a mass to start off my 60th birthday celebration, a study showed that true happiness is a result of the relationships we nurture: our relationship with God, our relationship with others, and our relationship with ourselves. Those are my glass balls.

I will be grateful. I will wake up every day thankful that I have been given a new day to live, and I will close my eyes every night thankful for the day that was. I will be grateful for the loves of my life who love me back, for friends who care, for God who has blessed me and my family immensely.

I will give back. I will pay it forward. I will make a difference somehow, and this will not be measured by revenues raised, or costs reduced, or projects completed, or careers jumpstarted, or staff mentored. Mommy in her talk yesterday said that I am a woman of grace and substance. I think that I need to work on the “substance” bit more. Maybe when I write another piece ten years from now, I will be able to tell you if I have found a way to inject a greater purpose and more meaning in my life.

In the meantime, I will apply for my Senior Citizen’s card, brandish it proudly, enjoy its privileges, and focus on making my last year in the office, and the coming retirement years, count.

Here’s to 60!

 On the occasion of my birthday, I celebrate today as a day of gratitude for many reasons – for the presence of friends and colleagues just to honor me, for the convergence of circumstances and events that have brought us here today, for the 60 years that Jopie and I are celebrating this year  – Jopie’s last February , and mine last June 19.

In behalf of my wife, my children and myself, thank you!

Turning 60 means many things to many people. Starting last February, every time I take my family out to dinner, Jopie has been quick to open her purse; I still need to get used to the fact that she’s not paying for dinner, just fishing out her senior citizen card. She has become so enamored with her senior citizen card, she brought it out again one time at Mercury Drug when I was about to pay for Avodart, my prostate medicine. This morning, she already had my senior citizen card application form ready.

Indeed, being a senior citizen has its entitlements. Dr. Bengzon wrote about it in his 4-page handwritten letter to me which was delivered to my home on the eve of my birthday. Thank you, Dr. Bengzon, for having the elegance to write me a letter by long- hand. If you must know, I have kept all the hand-written letters from you and Dr. Sarmiento through all these years. When the story of The Medical City is retold and people celebrate your lives, I can auction those letters for the insights they provide!

At 60, there’s nothing that I appreciate more than letters of that kind, books that speak to the mind and the heart, gestures that seek to connect, opportunities that point to bigger things other than the ones that preoccupy us, and people who remind us that we can be a lot better than what we say we are.

Since this occasion is my initiative, I claim the privilege of indulging myself with a few words. Jopie always warns me that when I write as when I speak, I should keep it simple because people do not understand me. Well, people nowadays express themselves through emoticons and stickers; and more and more are losing the love for reading. Indeed, how can they understand what they do not read!  If we don’t watch out, our world would get smaller and dull and lonely because we have lost the magic of thought and imagination.

The story behind this sculpture requires some capacity for abstraction, the ability to connect beyond what our eyes can see. But it is not only what we see that matters, it is what we listen to, if we listen at all!

Yesterday, before the veil was installed to cover the sculpture, I was having lunch at Café France overlooking the garden. There were 2 medical students having lunch as well; we could see the sculpture from there. I asked them what entered their minds as they looked at the sculpture. (The sculpture is of a stethoscope shaped like a question mark, with a big key planted into the stethoscope’s diaphragm). One of them answered, “ The key to my success as a doctor is to use the stethoscope properly”. Simple and shallow, but true! Indeed, success in the use of the stethoscope also depends on how well we clean our ears. How success is defined nowadays rarely transcends the physical.

What are the things that bog us down, scare us, or motivate us as we go through the ages?  Before we can get answers, we first have to ask questions. We must admit that asking the important questions when there is so much noise is as difficult as getting the answers under the same circumstances. Just like many of you, turning a decade has been a big deal to me. At 30, I was hesitant at first and then relentless later, single-minded, focused and occasionally reckless; I was very physical. “Can I do it?  Should I? Do I have what it takes to make something of myself? Of course I do!     But am I sure?”

At 40, I was at my peak – a high-paying job in the corporate world, lots of world travel – business class, a country club membership, my 3 children growing up healthy and doing well in excellent schools, a loving wife who was doing well in her own career, a comfortable home, lots of friends, a respectable name for myself. Midway through that decade, I started to have doubts, as ambition, arrogance and the demand for authenticity created conflict. I became restless, I began to question many things – the need to aim higher, my capacity to pursue bigger things, the value of my work, the relevance of religion.

At 50, I had to set my priorities straight – an attempt to organize the questions in my head, to distinguish facts from fallacy, to appreciate harmony from noise.  It was exactly 10 years ago when I finally decided to leave the pharmaceutical industry that I had grown so much in and learned and earned a lot from. Seventeen years of growth and affirmation, of confidence gained and comfort secured. What more was there to prove, what more did I need? Was I happy?

Ito na lang ba?

Ten years ago, I told myself it was time to go back to basics, to focus on being a doctor because I knew I would always be one, that I was a good one but could be better. After 17 years as a pharmaceutical executive, I had acquired a perspective that many of my colleagues in the medical professional never had the opportunity to acquire. I knew that my experience could make a difference in my practice. And so, 10 years ago, I left the business world to be 100% with Medical City. As a cardiologist. I was finally home and I thought that my restlessness would abate. In no time, however, I became part of Senior Management. Management AGAIN! And then slowly, being a doctor acquired a dimension that was different from what I originally planned for. Another stage to perform on, with far greater demands for leadership and bigger opportunities to make a difference.

At 60, things that were important before no longer spark excitement. We are more tolerant, more accepting, less inclined to violent thoughts – even when those thoughts do mischievously entertain. These past 10 years in senior management have been nothing but great opportunities for leadership not just for me personally but for the entire institution.

I thank Dr. Sarmiento, our chairman,and Dr. Bengzon, our president and CEO, for trusting me and giving me the space to spread my wings just as The Medical City also  started flying over wider territories. Dr. Bengzon loves to talk about those 3 elements that our institution aspires for and aims to be defined by: audacity, accountability and community. We have taken big risks, we have challenged traditions in medicine and medical practice, we have grown both in volume and in reach. Our accountability for those risks and the outcomes of our initiatives, we have never shied away from. But scientific expertise and advancements in technology have little impact – other than prolonging life perhaps – if the lives we save enhance only our stature as an institution of excellence but not the experience of being truly human.

Can I do a lot more in my present position here, or can I find more fulfillment making a difference in my individual capacity as a doctor?  Is there still time to do other things?  Those nagging questions have kept ringing in my ears, and I know that Jopie has been watching me grapple with the compromises and rationalizations that really do not answer those questions. The questions in my head: Am I doing what I love to do the most?

 Am I truly happy?

When I see a friend quit a comfortable job to take a different path, or make bold decisions that have nary any guarantee of success, I take notice; I am awed. The road less traveled taken by people who are not afraid!  Every time a colleague dies without warning, I get a jolt. Life interrupted at the threshold of significance! Life is short, what am I doing here? Where am I headed? How come the God that everyone else is worshipping does not seem to be the same God that I am looking for?  Why am I afraid?  What am I afraid of? Should I be afraid?

Our institution has grown in stature and in reach, our ambulatory clinics have replicated all over, our hospitals in our expanding network are imposing as they are impressive, our facilities are top-of-the-line, we have the best doctors that we can be proud of!

Is this all there is to it?

Indeed, we have been audacious, and we have been responsible and accountable, but there has to be something more than all those parameters that define health advancement and financial success, more than the revenues and EBITDA, more than the strategies for competitive superiority – that we should not disconnect from, that we, in fact, should jealously establish strong links to.

Which brings us to Dr. Bengzon’s 3^rd element: COMMUNITY – Community is about people both within and outside our institution aspiring for things bigger than themselves, whose lives we may not be able to extend all the time, but whose quality of life we can always enhance just as theirs enhances ours! People connecting to people; people listening, doing and responding to acts of kindness, giving more of themselves for the love of it, finding beauty and humor in the many ways that people cope with the rigors of daily living, people embracing a new way of thinking, enjoying a sense of well-being and transforming wherever they are into a place of joy; people transcending their sadness, seeing beyond the physical and learning to appreciate that there is more to life than staying alive.

How will my 7^th decade be?

I was in that state of mind last December when I got a call from a senior cardiologist from another institution. He requested me to see his friend, an artist, who was in our ICU. It was an honor, not only because the senior cardiologist is a Who’s-Who in Philippine cardiology whom I admire and respect very much, but also because he wanted me to take care of a highly-respected man in Philippine Art. Because the patient preferred to stay in our hospital than go home, he has been with us since December 2015. The regular doctor-patient interaction in the months that followed has led me to experience on a regular basis the joy of just being myself in the presence of this old man whose frame of consciousness did not include any reference to his illness.

That senior cardiologist is Dr. William Chua, the Father of Philippine Electrophysiology. After my fellowship at the UP-PGH 30 years ago, he waited for me at the Philippine Heart Center as one of only 2 cardiologists who would train under him, but I changed my mind. The patient he referred to me last December and who is still here in the hospital is no other than Mr. Arturo Luz, our national artist, a man of poise and dignity.

Dr. Chua – Bill – is the best president that the Philippine Heart Association never had. He was already vice-president and was about to be elected president when he stepped down – to give way to his friend who wanted the presidency more than he did. And then Bill withdrew from our midst to pursue painting, mount exhibits here and abroad, and awed us in the medical profession with the example of his life in its simplicity. We don’t remember how that friend of his was as a PHA president, but Bill has since then grown much bigger in our hearts and imagination. His life truly inspires! He still practices cardiology and is still the last word in cardiac rhythm disorders and the modern health technology that supports the discipline. He is a man of science, of the arts, of everything that is elegant about the civilized world. He truly is a Renaissance man.

And then he surprised all of us some more:  from painting, he went into sculpture. In one of those Saturdays in the second quarter of this year, after visiting our friend, Mr. Arturo Luz in his room on the 15^th floor, he called me to join him in the garden. “Eugene,” he exclaimed, “this garden is a perfect place for art that your patients can experience. How come you are not using it?” That question stunned me!  And then he gave me a model of the sculpture he had in mind. In an instant, as I looked at the model, I knew that this was the answer to my question – exactly what to give to TMC on my 60^th birthday. You see, by then I had already decided that my life from hereon would no longer be about receiving but about giving back. And what a better way to give back, for a start, than this sculpture that represents the answer to many of our questions.

Bill entitles his sculpture “THE ANSWER IS IN THE QUESTION”. Before I showed the model to Dr. Bengzon several weeks ago, I had spent time looking at it and reflecting on how directly it tells me – and all of us doctors and non-doctors alike – how we must confront the issues that impact our lives. The first step is to ask the important questions.

Bill asked me to write something to be inscribed in the plaque beside the sculpture. This is what I wrote, and I am sure that many of you who have have gone this far in life can empathize:

  “  I sought for so long,
to tame the riddles in my head,
                        and calm the quivers of my heart,
                            ‘til I found myself alone and discovered quietly
                                that all I needed was to listen.”

After many years of work and challenges, after failures that let us down, and successes that give us pleasure and a sense of power, we ask ourselves the question:  What is our purpose in life?

Our purpose in life is to be happy. How do we find happiness? The answer is in the question. To find happiness we have to be happy. Cheri Huber, the author of “The Key” says, “That which we are seeking is causing us to seek”. Another author, Jon Kabat-Zinn, says, “Wherever you go there you are!”

(Jopie is right, I really might be difficult to understand!)

Here is the sculpture, Dr. Sarmiento and Dr. Bengzon and the rest of the staff of The Medical City, in behalf of my wife, Jopie, and our 3 children – Eric, Nicole and Julienne, and with the generosity of Dr. William Chua, the inspiring help of Mr. Sari Ortiga, the owner of the Crucible Art Gallery who made everything seem so light and easy, and in gratitude to Mr. Arturo Luz who, in illness and advanced age, has inspired us to see beyond our present circumstances, we give you Bill’s sculpture that creatively reminds us that  Medicine is both a science and an art, and neither is more important than the other.

A very inspiring friend invited me to dinner last week, and we talked about birthdays and transitions. I think I was being too reflective; he smiled and quipped” “At 50, you should have fun. At 60, you should make everything and everyone a source of amusement!

Indeed, life should be a source of amusement …and in the final analysis, of happiness. I look forward to the years ahead with a lot more fun and irreverence, a readiness to laugh at myself when I make simple things so complicated. I look forward to having this garden filled up with more gifts of art that many of you will gladly bequeath. We are a community, we know the answer, we will make things happen!

June 20, 2016

What becomes of us as the years pass? Do we become what we like to be or do we end up with no choice but to like what we have become?

A life that exceeds 80 years is likely a celebration of fulfilled aspirations; a life cut short at 50, a tragedy of wasted possibilities. Taking a good look at our individual lives, we see a single snapshot when we look back; we see a series of milestones when we look ahead. Like train-stops that serve to remind us where we are in a journey, these milestones keep us aware of both time and distance, specifically what is left of them. Stephen Covey has an excellent way of summing up all these milestones in a phrase: To learn, to love, to leave a legacy. With so many things to aim for and too little time to accomplish them, how we balance the various elements in our lives within the limitation of time ultimately determines where we find ourselves – and how people find us – at the end of the journey.

Milestones are embedded at the back of our minds when we enter college and most especially when we choose our profession. Things that have to happen have to happen at certain time frames. We are one thing when we are 16, but we are something else –or supposed to be something else- by the time we turn 21. When we finish college by 21 or 22, a whole new set of milestones take shape as we decide on one career path over another. We make a big deal of turning 30 as we imagine reaping the perks of a promising career in the years that follow.

By the time we turn 40, life begins to take on a new meaning. We begin to peak and acquire a certain standing in the community where we circulate. Many assume bigger roles in the associations where they belong; some look forward to becoming their leaders. We go through the so-called midlife crisis at around this time when we perceive a mismatch between our dreams and our achievements so far. The pursuit of success becomes complicated because success assumes diverse definitions, some of them perverse.

As we turn 50 – as I did in 2006 – we seek to simplify things by realigning our definition of success with what really makes us happy. Happiness becomes more personal, closer to the self than to the dictates of friends and family. Retirement crosses our minds more often, just as health concerns become more real. Eventually we turn 60, and senior citizenship confers on us the privileges of the 20% discount and a sharper focus on the generic drugs with the best price for our blood pressure and cholesterol. With luck and a more disciplined attention to the warnings of decline, we may make it to 70, then 80, and, why not, 90. A hundred years is, perhaps, too much to aim for but as the years add up we learn to appreciate the numbers in a much grander way.

Numbers influence the decisions that we make – both the major and minor ones. We celebrate milestones depending on the numbers we associate them with. Our 1st birthday – and the 1st birthdays of our children- are painted in our minds with balloons and clowns and a birthday cake with a single lighted candle at the center, recorded for posterity by a videocam that is permanently stuck on the father’s face, and orchestrated by the mother who throws herself at the frenzy of the moment. The 100th birthday is absolutely an even bigger day – this time for the offspring of the clueless celebrant who may not even know where she is or who her children are. Indeed, the first birthday and the 100th are occasions celebrated not by us but by the people whom we take care of or who now take care of us. In-between these milestones, we either grow and gain mastery doing great things, or occupy space and flaunt a lifetime of insignificance.

The first year of marriage is bliss, with adjustments and difficulties overpowered by love if not by passion. The first wedding anniversary is an exclusive romantic occasion that every wife looks forward to and every husband who values peace should never forget. The first anniversary of an achievement – and even the first death anniversary of a loved one or a respected individual – never passes unplanned, unacknowledged, or unprepared for. People always remember the first; the second seldom comes close. The first of anything is almost always imbued with passion, commitment and great promise for the years to come; the second that follows is usually soon forgotten.

Ten years of marriage, happy or otherwise, is a milestone for couples who learn to put up with each other’s idiosyncrasies. A decade at work calls for an award or recognition, if not for excellence, at least for loyalty and resilience. A lot of things go into 10 years of any endeavor. We come out of it whole or broken, but we come out different either way. Time changes us; we learn to adapt. When we can’t, we learn just the same.

We expect certain changes – progress, if you may – as we move through the numbers, because we like to believe that time confers on us wisdom or even just recurrent opportunities to redeem ourselves. At 18, we become legal; at 21, we go mainstream; at 25, we think of work and survival; by 30, we start a family; at 40, we look forward to comfort and achievements; at 50, we consider things greater than ourselves; by 60, we expect peace, quiet and security; at 75, we count our blessings. We bracket the numbers in our lives with the sparkle of our hopes and aspirations. Twenty-five years is silver; 50 is gold; 75, diamond.

In time, 100 will become the norm as medical science and technology assume a major role in the ‘evergreening’ of the human species. As we struggle through the wrinkles and the sagging breasts and unreliable tumescences; as we attempt to renew ourselves – with tablets and injections and vegetable-cum-fruit juices and all sorts of anti-oxidants– we may have to establish a new order in the way we count the numbers. When 60 becomes the new 40, and adolescence extends up to 30, joie d’ vivre could put our world at risk of being crowded with people who love life but only for themselves!

As the number of our years moves onward, we have a choice of not allowing ourselves to do more of the same things that keep us safe and comfortable. We can open our eyes to the reality that a lot in our lives, no matter how important they may seem, are spent on things of little consequence – transient things with no significant impact on the community where we live. We can bravely opt for substance rather than form, and enhance instead what we can no longer extend. If all that science can provide is a longer life for moneyed people with overstretched faces and overblown egos, 100 would be to plastic what 75 is to diamond, and people who refuse to see it would never know the difference.

What becomes of us as the years pass? To be sure, we become older and richer in years. Everything else depends on whether we can count on ourselves to go for what counts the most -in an era where what counts is masked by distractions ironically created by an obsession to accomplish more with so little effort and in the shortest time possible.

I turn 57 today, not at all affected by the cursory “ Happy Birthday!” greetings that I receive or do not receive. It has been 7 years since I got all excited and uptight about turning 50, presently disappointed with myself for having let the years pass without the fervor that defined the previous decades of my life. How time flies, and how it unnerves my state of unreadiness.

Unreadiness for what?

For the time when time stops, I guess, and the numbers lose their meaning. When we can no longer look forward and add more numbers, and can only look back and see, with clarity and surrender, that there is only the here-and-now to experience and savor; that there is nothing we can do about the past and there is no future to look forward to, and all we have is ourselves, hopefully with the people we love and the things that matter to us, in the present as it presents itself.

June 19,2013