We were finally able to pull Smoketh out of bed for our Christmas dinner with Mrs. T and Amelia Borrelia, and to be fair it didn’t require blackmailing, threats of physical violence, or the use of a magnetic crane. Six months ago Smoketh decided to quit clinical practice cold turkey. She endorsed all her patients to other nephrologists, quit all the administrative jobs she had been holding begrudgingly for years, and went totally invisible online. It seemed obvious at first, but after divesting herself of all clinical responsibilities she realized that she suddenly had time. That she could wake up at 10 am, crawl on all fours to the kitchen with hair draped over her head like Sadako, eat toast, and crawl back to bed with a mug of coffee in one hand. Then she could guiltlessly watch Korea-novelas the whole day.

“It will be difficult to come back, now that you’ve had a taste of freedom,” Dr. Libarñez, a mentor, had told her.

Smoketh initially thought that she was merely in a state of pure katamaran, or that she only needed a short break to reset her brain, or that she just needed a night at Sonya’s Garden. Nice problems to have, she told herself, problems of the privileged. However, months and months of introspecting, glued to the bed, made her realize that she needs help. Stat!

I reminded Smoketh that we had already been armchair psychoanalyzing each other for decades, and although these were frequently done inebriated I would like to believe that our group therapies at the Shrine Motherfucker and Oar House Pub have been helpful. Sometimes we would quietly listen to each other’s whines, but our predisposition was to blather, compete for airtime, and give unsolicited advice. This started in med school, when our issues were mostly about failing in Anatomy and Biochemistry, continuing through fellowship training when the core problem was poverty, up to the present with all the miseries and drama of adulthood. And through all these we realized that we have committed every possible mistake in the art of listening.

Smoketh and I tried to identify what these mistakes were. Mine is being judgmental, having the tendency to say things like “Smoketh, you are being a whiner…” and invalidating feelings like “…just because you got 19 out of 50 in Histology doesn’t mean that you should get all gloomy and stuff…” which leads to flipping the spotlight on myself, “…ako nga, 7 over 50”. For extra measure I might attempt to sound wise by contextualizing the situation in the greater scheme of things: “We whine over these exams while our patients suffer from incurable diseases! Happiness is a choice! Time heals everything! What doesn’t kill you…” And when I run out of advice I would still prefer to yak, opting to fill the air with platitudes and unusable crap like, “It is what it is.” Or if the issue was already passé by the time we were talking about it, “It was what it was.”

This time my rather obvious assessment of Smoketh’s State of Sullenness manifesting as complete bed rest can be summarized into four points: 1) Taking care of critically ill patients for over a decade has led to cumulative emotional distress. 2) Endless Viber messages from hospitals and patients amplify this emotional distress. 3) The recent death of her father, Mr. Chung, has raised this distress to astronomical levels and 4) The thought of seeing patients while still in profound grief will lead to total emotional shutdown.

Recommended treatment: alcohol, platitudes, gossip, and guilt.

“Don’t you miss your patients?” I asked Smoketh. “The grandmothers that you’ve been very fond of? Your patients awaiting kidney transplant? They need you! You said that you love them!”

“I don’t love them anymore,” Smoketh said.

We therefore concluded that we, her friends, were no longer enough. That we were making things worse as untrained headshrinkers. Smoketh needed a board-certified, not an alcohol-certified, therapist. ASAP!

Smoketh went on a psychiatry hunt, but she was still apprehensive. She asked me how it had been for me seeing multiple psychiatrists in the past. I knew that sharing my experiences required me to be vulnerable, but it was another opportunity to turn the focus on myself.

The first time I saw a mental health professional was in grade 2 because of “night terrors”. My aunt brought me to a clinical psychologist who did her clinics at home in a posh village in QC. It was the biggest house I had seen at that point, and we “oohed” and “aahed” as we walked through her garden which was fully adorned with Christmas decors.

“Remove your jewelries and try to look as poor as you can,” my aunt whispered to my parents. Someone had told her that looking poor helps lower the professional fee. The psychologist was a nice, beautiful lady with the most stunning white skin and soft, hypnotic voice. I was immediately drawn to her, and I felt that just being in her presence immediately fixed whatever was wrong with my brain. She asked me to draw a house, a person, and a tree. She asked me to write 3 adjectives about myself. When I had to go to the bathroom I walked through a corridor with walls full of beautiful paintings and past the dining room. The dining table was full of gifts, bottles of wine, ornate gift baskets wrapped in cellophane, chocolates, flowers, and fruit. These must be Christmas gifts from family and wealthy clients, I told myself. She caught me staring hungrily at all the goodies, specifically the chocolates wrapped in shiny, colorful foil, and must have felt pity. She picked up something from the table. “Here, you can have this Will,” she said kindly as she handed me a piece of Storck. As we took our owner type jeepney back to the province my mother said that she doesn’t think we can come back for a follow-up, as the fee turned out to be a staggering P500 per hour. She put her jewelries back on.

My aunt found a child psychiatrist in Ortigas who took my case. I would talk to her for thirty minutes, was given a pill, and then the night terrors were quickly vaporized. I suspect that I just outgrew them. But whenever I felt like something was not right, like when I would feel uneasy if my shoes weren’t tied properly, or if I was getting too fixated on turning the light switch on and off, I would ask my parents if I could see the psychiatrist again. It wasn’t as expensive as the psychologist, but it was still difficult to fork over P250 for the consultation fee. Plus we had to drive for 2 hours from the province to get to the clinic in Manila.  Eventually my parents suspected, correctly, that the regular follow-up check-ups were just an excuse for me to go to the SM Megamall next door so I could buy the latest issue of Uncanny X-Men, and the consultations stopped. In med school I was perpetually gripped by social anxiety. One day, after class, I decided to walk into Ward 7, the psychiatric ward, to ask the chief resident if I could take some mood stabilizers. Like the ones they had been teaching us in Pharmacology, I said. I took Zoloft for one year, and it was one of the happiest years of my life.

Over pizza and penne pasta I handed out my Christmas gifts to Smoketh, Mrs. T, and Amelia Borrelia. It was 2 weeks before Christmas, and UP Town Center was packed with happy people. I disclosed that my gifts were random objects at home that I had decided to recycle and re-box in a rush, and that I could no longer remember their contents. I ordered them to think of the gift as a deliberate attempt to go with the concept of Pop Mart’s blind boxes.

“I think I really like you as friends, because I didn’t ditch you,” Smoketh said, eyes bleary. “By the way, I decided not to buy gifts this year. But you know what, I just bought packed castañas from the grocery. This is therefore my gift.” She stood up and tossed each of us a pack of No Brand Roasted Chestnuts.

Mrs. T apologized that she would have to leave early, not because of her four kids, but because she has to practice for their Christmas party performance which, of course, is “Salamin, Salamin”. She had managed to escape performing in a hospital Christmas party for almost a decade, but this time a more senior consultant had told her point blank that it’s her turn. About time, too, as the last time she performed in a party the dance craze was still “Asereje”. The frequency of these parties, and people’s emotional instability were starting to peak.

The first one I attended this year was the Christmas party of the internal medicine department back in November. The main organizer was my friend, Dr. Steven Dones. He took care of the catering, came up with the parlor games, and personally bought all the prizes from Flying Tiger. He was also the emcee. He started the program brimming with enthusiasm, but after thirty minutes of trying to hype up the exhausted crowd he became visibly exhausted himself. After dinner and a few games he declared that the party was over. But there’s still a table full of Flying Tiger goodies for prizes, I said.

“Thank you everyone, instead of a raffle you all can just grab whatever item you want on your way out,” he said weakly on the mic. “Travel safely!” Nobody was required to dance, nobody was asked to stop staring at their phones. Everybody went home happy.      

Smoketh reported that she started seeing a psychiatrist, which all made us clap and cheer. The first one she consulted was her friend Dr. Sigmoid “Ziggy” Florida. Bad idea. They would talk over Zoom for an hour, but in the end she couldn’t tell if he was being a psychiatrist or being a patronizing friend whenever he said things like “It’s ok to rest”. She is now with a different psychiatrist, Dr. Sarah Jane Overlord, and is adequately medicated. She spends less time in bed now. She also started to use the expensive treadmill which had been sitting idly in her room for years, the handrails of which she had only been using to hang wet clothes. She could still not get herself to see patients, but she resumed teaching med students.

As we were clapping for Smoketh, Amelia Borrelia said that she had something to confess.

“I would like to announce that I, too, have started to take escitalopram,” she beamed.

“I knew it!” I said. “I knew it! There was something different about you!”

“Yes,” Amelia said. “And the difference is that I don’t hate everything anymore.”

We resumed eating pizza. It would be a good, adequately-medicated Christmas Season.

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