The Vision & Voice in my Head

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 60th 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 7th 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 7th 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.

Comments

comments

torrent
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filmkovasi
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Eugene Ramos
Such a long comment, unfortunately I do not know how to read your language.
Williamcep
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Eugenio Ramos
The crisis is still with us and will likely persist longer than hoped for. Months have passed, the impact now includes an increasing manifestation of mental exhaustion, alleviated perhaps by a more deliberate effort to practice mindfulness amid the mindlessness of situations around us. We are likely going to be stronger if we are able to survive.
Eugenio Jose Ramos
Ella, I think things can really get better once we all find the time to grant ourselves the gift of solitude - to situate ourselves in the overall scheme of things, to decide where we can contribute more and make a difference, to become part of the solution rather than add to the problem. Getting deep into ourselves is just as fulfilling as exploring the vast possibilities in this crazy world filled with all sorts of creatures.
Ella
Purpose and pride by serendipity... To reflect and not miss out why humanity is so inspiring... Reveals a profound understanding of ourselves... The power of the collective emerged... Opporunities for genuine leadership... Period of profound cleansing and renewal... Health for the Filipino people... Too many beautiful lines to mention. Despite our efforts to control the outcome of our future, life finds a way to surprise us. This pandemic taught us to embrace uncertainty and find a sense of peace, clariity and purpose amid the chaos.
Eugene Ramos
Avery, education can entrap us; in fact, a lot of what's wrong with our society is because of the education we receive from the academe. Then from medical school where the student gets basic education, he starts residency with all the idealism to help humanity. Something happens in residency; he loses that idealism as he experiences frustrations, finds ways to go around them, develops a liking for role models that perpetuate the fabulous lifestyles of doctors with successful medical practice. From taking up medicine to help his community back in Surigao, he trains to become a specialist that can only succeed by staying in Manila.To begin with, there are no hospitals in Surigao to train in, and there are no hospitals there that offer what Manila offers. This is the reality. More than 50% of medical specialists are practising in NCR. So where does the crisis start and how can we end it?
Avery
thought the article was something only you could write. I am not a doctor and neither do I have the slightest idea of how the leadership system in the PCP works, let alone the ideology and values that the leaders possess. When I examined the problems that you have pointed out it made me realize that clearly it will take a ton of effort to reconcile everything, from the opposing ideologies, political inclinations, values, interests etc... not to mention emotions and temperaments. the part were you mentioned "acquiring breadth tempers restlessness." Really struck me because it is one hard truth. I know because it's in my nature to be restless when presented with challenges or when my idea is put out on the open. My insight is that, isn't it the point of education to have you ready to negotiate your ideas and to allow your beliefs to be broken down wih the hope of having it rebuilt stronger? I guess you are right doc, the reason why a system is so stricken with conflict is that not one individual or one group for that matter is willing to negotiate for the common good, pudpud na pero totoo. No one is willing to take a deep breath, we are just at it like a dog chasing a freesbee, no thinking just all bark and aimless running.
Eugene Ramos
Edgar, There is actually so much pleasure - a rare kind of fulfillment - in sharing not what is easy to give away but what is part of ourselves. It is great that at 47 you already have that in your mind.Believe me when I say that the things that we are so attached to are the ones that give us most fulfillment, when we are finally able to detach from them. Such is happiness; the more you give it away, the more it stays with you. Gene
Corazon Devera
Life is too short. So you have to give time to your self and people around you. Material things are not the answer to one's happiness. Making others happy is what counts most.
Elvira Lastimosa
Belated happy birthday doc!
Eugene Ramos
Thank you, Professor Rudy, there is actually a big difference between complicated and complex, just as simple is not the same as plain. Language makes us homo sapiens different from the apes; the ability to organize our thoughts in a way that is clear, elegant, and with impact is far too important to be expressed just by yes and no.
Eugene Ramos
Coffee with you will be a great honor! We all will have our own time to experience what you are experiencing, there is never any doubt that everything is transient. Temporary. Impermanent. What we can do is to use all opportunities that come our way to do good in the remaining time that we have, to be thankful for everything that makes this journey such a joy!
Rhiza F. Valdes
Gene, your gifts are immensely abundant and now you should realize you have shared a lot to your family, friends, colleagues,and to those who care for you and those you care for( patients included) At age 53, I was faced with a health crisis that made me reflect and think , asking myself, what next? Plans were shelved, opportunities missed, heart aches occurred, made me realize the temporary state of life. Nothing permanent except for Change. Disappointments V's happy conclusions. Real friends, kindred spirits V's those who are just passing by, through my life. All are important and left impressions and have life changing marks in my life.. My world and that of my family's were affected by a life changing, strong event a year and a half ago. I was thrown into panic and confusion at first but I realized there is a plan for me. Struggling through all the changes in our lives, my family held on to our faith.. For hope and happy acceptance for what will come. My last treatment will hopefully be this July. I was staring at the sculpture in the garden last Saturday and I realized the answer has always been in my heart--- a heart that longs to give out love, to care for family, friends, colleagues, and patients, in a way that goes beyond what my mind tells me. If I don't make sense, Coffee ?
Rodolfo deG Ibanez
Hi Doc Gene, Ma'am Jopie is right. People with your intellectual acumen tend to complicate simple thoughts. You see complexity with answers limited to yes or no or one liners that seem to give no meanings because in their simplicity, the suppleness of the limited words hide the sincerity in its meaning. But this how the likes of Aristotle, Descartes, or even the language of Shakespeare able to reach out to people of higher intellect. Reading your thoughts written in well crafted prose expressed the sentiments of a man who has complete command of the English language. Your reflection led me to the thoughts of Jostein Gaarder, author of Sophie's World, "If we were never ill we would not know how it is to be well; if we never knew hunger, we would take no pleasure in being full; If there were never any war, we would not appreciate peace; and if there is no winter, we will never see spring." And it is in the opposite that we live life
Edgar Lerma
https://twitter.com/edgarvlermamd/status/751949087490973696
Eduardo Vicente S. Caguioa, M.D.
The crisis being referred to in the first part seems to be totally different from that referred to in the second part. In brief, the first part may be attributed substantially but not totally to poverty driven needs and uneducated population still stuck in old beliefs and lifestyle that filter into the political landscape during elections so that elections become mere extensions of a political dynasty rather than a mechanism of change for the better thru meritocracy!! Needless to say, the incumbent and past incumbents have made measures to ensure that this mechanism will not change. So why blame the clueless "mass population " who have not been educated better purposely - history is replete with this type of strategy on how to control a population and maintain power from the time of the Romans up to the present - the recent news about lack of classrooms and schools not being and the budget not being spent in certain areas speaks for itself! Reminds us of certain countries now and states that are in turmoil because of this long acting mechanism! The second crisis, referring to Doctors, is more complex and cannot be put in the proper light in just a few comments! It must be viewed on how medicine advanced with technology and how training had to keep up with the advances. It must also be viewed thru the eyes of generation x and now thru the eyes of Generation Y - the millennium generation who have starkingly very different characteristics amongst which is the "me interest" and lack of regard for "hierarchy or authority " and that they succumb to stress quickly. The role of PCP has evolved as it used the products and minds of many different training mechanisms. As internal medicine became more demanding because the knowledge base from sub specialties grew, PCP naturally had to get more sub specialty members - the growth in internal medicine is fueled by the explosion of knowledge in all of its sub specialties - it is the training institutions all over the world that have changed the landscape, not PCP. The trainee now has more choices and opportunities to choose where to put his skills to the best use! The question you are asking is why are the trainees that have long trained and spent much not willing to go to a place where they cannot use what they chose to train for ... That needs a long discussion