by Will Liangco
“Next month, or maybe next year!” Gwyneth announces as she flashes a very wide grin—as if I shouldn’t jump at her and strangle her this very moment. I have been pestering her daily (with more self-entitlement than warranted) for my monthly stipend, and she has totally gotten inured to this grousing. As second year fellows-in-training in a government hospital, we have been at the mercy of “well-meaning” pharmaceutical companies for our monthly allowance. The national university hospital, apparently, cannot afford to give us plantilya, as if being given the opportunity to manage five cases of the rare penile squamous carcinoma in a year—which a private practitioner would be “lucky” to see in a lifetime—would make me impervious to hunger. As if the live chickens, live turtles, live goldfish I receive from my charity patients could be passed on as rent to my landlady who is absolutely livid and one promissory note away from kicking me out of this hovel.
“But Gwyneth, you have to understand, I’ve been feasting on sardines for over a week now! I now steal office supplies from the clinic. I ask someone with a car to slowly run over my tube of toothpaste to ensure I’m not wasting anything! I am just so extremely POOR!” I whine in the whiniest voice that can penetrate the spacetime continuum. Gwyneth just sort of smiles/smirks/winces again. I can no longer tell if her smile is from annoyance, pity, or botox gone wrong. Come to think of it, her lips kind of look thicker now. Her forehead is extraordinarily taut. And the fillers make her look like the hamster I had overfed as a zealous elementary school kid. I want to calmly advise her that as the senior medical representative in their company she can probably afford a real plastic surgeon so she wouldn’t look like a surprised garoupa but I guess I am just too mature for that. Gwyneth brings out a bucket of KFC, a venti Starbucks Frapuccino with whipped cream, and a box of chocolate Krispy Kreme. “I will follow up the release date of the check, Dr. Francis, but in the meantime here’s your lunch!”
I have the urge to flip the lunch table over and do a histrionic hunger strike, but in two minutes I had skeletonized two pieces of hot and crispy fried chicken. I am about to stuff my mouth with a third piece when my mother texts me and she is completely freaking out. My younger brother, Bobby, who is a utility worker in a private dialysis center, was apparently being accused of theft. I patiently read through the paragraphs upon paragraphs of her text message, which is preferable to actually talking to her, which would take hours. My mother, Luisita, is a public school English teacher in Sorsogon, and even in retirement she carried with her the skill of suspenseful exposition. She would lay out some facts first—yung kapatid mo inakusahan ng pagnanakaw!—then follow it up with how she feels about it—parang gusto ko na lang magpakamatay!—instead of, you know, telling me what he stole or where he is now aka cutting to the chase. So cutting to the chase, he apparently stole a dialysis machine, which is odd, because a dialysis machine is not something you can stash in the trunk of your car. This makes me take an anxious, aggressive slurp at my frapuccino which was swimming with coffee jelly chunks that rushed directly to my throat. I worry that some might have reached my lungs, and that I will develop lung abscess the very next day.
“I think I might have gotten rectal gonorrhea,” Jimmy, my batchmate, whispers as he suddenly springs out of nowhere.
“Whatever do you mean?” I ask with an invisible eyeroll as I atomize a chicken leg. In the past year Jimmy had diagnosed himself with lung cancer, nasopharyngeal cancer, germ cell tumor, glioblastoma multiforme, liver cancer, kidney cancer, and cutaneous T-cell lymphoma. We would randomly catch him palpating his own neck in search of nefarious tumors, or listening to himself with a stethoscope just in case his lungs were filling up with malignant fluid. I guess he has already made the rounds of all the cancers, he was now graduating into infectious diseases.
“You know Cristito, the hot surgery resident…” Jimmy mumbles.
Oh Cristito, the guy famous for having fellated the entire Ward 7?– is what I should have said. Instead I say in my rehearsed robotic/empathic voice: “Oh yes, Cristito. So are you saying you had unprotected sex with him and now you think his semen inside your asshole gave you an STD?”
“Well, it’s a LOOOONG STORY!” Jimmy’s eyes beam excitedly, unconcerned that outside, hordes of hungry patients with pitchforks and tiki torches are about to rip apart the doors of the clinic. “So Cristito is this chronic alcoholic, right, and we were both so drunk and it just so happened that it was kind of warm because the aircon was broken so he respectfully suggested that I take off my shirt… and then…”
The line of patients for chemotherapy is getting so long that I am, in fact, uninterested in what will otherwise be a juicy hospital gay rom com gone horrifically wrong. “I’ll accompany you to the infectious disease doctor on duty later for her opinion,” I chant as I ran to the chemotherapy room.
Waiting for me is Venus, a 35-year old single mother who worked as an OFW in Dubai. She was diagnosed to have stage 3 cancer of the left breast and underwent breast removal two years ago. As a former beauty queen kontesera she found it completely unacceptable that she would receive scalp-ablating chemotherapy. She opted not to follow up with her doctor after the surgery and instead flew immediately to Dubai to live with her Arabian boyfriend, Raji. It was not long, before she started to feel some low back pains and she decided to come back to the Philippines.
She greets me with a huge smile, her apprehension betrayed only by the fine finger tremors as she handed me her PET-CT scan results. Raji would be coming to Manila in two days, she exclaims, as I flip through the long imaging report. She has finally saved enough money for breast reconstruction, and Raji would like to accompany her as she shops around for the most affordable plastic surgeon. She mentioned that she has already sold some of her jewelries, and would be content with her airport Duty Free Pandora and Swarovski for now.
Venus’ stories have always fascinated me, more for the enthusiasm with which they are told. I couldn’t multi-task on emotion, however, as I read through her results. The cancer has now spread extensively to her bones, her entire vertebrae now seemingly gnawed at by hundreds of termites. Without a brace, she could one afternoon drop her phone, bend down to reach it, and hear a crack that will render her permanently paralyzed. Tumors pepper the lining of her lungs, and in a few days the fluid in the area would fail to circulate and we would need to insert tubes on both sides of her chest. Her liver is now a resident to millions of errant breast tissue, her cancer making sure that chemotherapy will be difficult if not impossible to safely deploy.
I was ready to discuss with her the results and the plans. Advice based on data, delivered with as much care as I could without seeming patronizing. Use the techniques I’ve read from the textbooks on giving bad news, with the scripted hand gestures, facial expressions, and voice inflections I have been using in the past year as a newbie with varying degrees of success. But how much information would she be willing to receive?
“I know it probably doesn’t look good dr. Francis,” Venus said before I could even speak my first rehearsed line. “But I just want to know… Raji would be coming in two days. Can I still have sex with him? And if yes, what positions are allowable? If I bend down like this would…”
By the time I finish the clinic dusk is already setting in. Provincial ambulances that had brought the patients from the most remote areas have now started to depart. The nurses are quickly filing away the charts, cognizant of the unpaid extra government hours. I scrub my hands and my face, hypochondriating that invisible droplets of chemotherapy drugs must have wafted to my skin and cause mutations ten years later. At the heart of carcinogenesis is mutation, and I’ve always wanted to rib my patients that “yes, you are now a mutant like the X-Men”, but I’m afraid I will come across as a heartless idiot with poor comedic timing.
I walk to a coffee shop to study my cases, write my papers, and look for friends to whom I can whine about this infernal hell-owship. It dawns on me that I haven’t responded to my mother’s frantic text messages. Bobby could be in prison right now as the police heroically searched for the missing dialysis machine. I also tokenistically promised my buddy Jimmy I would accompany him to the infectious disease doctor—he is probably in his dormitory right now injecting anti-gonorrhea antibiotics on himself. And how dare I even consider getting an expensive designer coffee using my own money, when I murder the lowly messenger of poverty Miss Gwyneth daily in my head.
“Hi, would you like some coffee? Would it be hot or cold?”
I just stare at the barista as I try to wrestle with the thought of separating with one hundred fifty pesos for a cup of coffee. I finally mutter, “ok give me a caramel macchiato.”
“What size?” Gillian asked. “Do you want to avail of the reusable tumbler? Do you have a Swirl card? Do you need the internet password? Have you donated to the Marawi fund? Do you want a cornbeef pandesal to go with it? Or a slice of peanut butter mousse?”
“Large,” I said with confidence. “I want a LARGE caramel macchiato. With extra fucking whip cream.”