Chicago - It’s not the place to be in October. Rainy, chilly, and grey, the windy city is not La Jolla or Maui. But the American College of Surgeons traditionally holds its annual clinical congress here every three years, so here I am with colleagues, learning the latest developments of our profession.
Unlike at previous meetings, the general mood is somber. Health care reform is in every surgeon’s mind. One survey indicates that up to a third of surgeons are set to lay down their scalpels and seek other avenues of work or retire prematurely if socialized medicine were implemented in the United States. The jubilant greetings I encountered, the happy faces I saw were those of physician surgeons visiting from outside the states -- Italians, Chinese, Filipinos, Argentineans, Japanese, Vietnamese, Africans were excited to be in Chicago. They could hardly wait to test the latest DaVinci robotic instrument and try out other American-made surgical innovations.
Every morning, I take the taxi from Union Square to McCormick West, where the congress is held. I take the taxi again every evening back to the train station. Having left New York for Southern California twenty-four years ago, I am reminded that the thirty degree weather now cuts through my woolen clothing and bites my bones. From the relative warmth of the crowded Metra Station, I rush to the comfort of the back seat of a taxicab. At times, I just peer out at the crisp skyscrapers and wonder how people can live in the bitter cold. Most of the times, I chat with the drivers.
I met two drivers from Poland, one from Czechoslovakia, an immigrant from Algeria, a transplant from South Korea, a Caribbean, a native Irish woman from Chicago. Their driving mode, temper, attitudes, political, cultural, and religious views vary, as expected. Others are politely quite, some are chatty. Some are happy and love their job. Others are sour and work in silent desperation. I find them all interesting.
The happiest was Piotr or Peter. He had immigrated with his family from Poland fifteen years ago. His children are in their twenties and early thirties, some of them are now married. “To other Poles?”, I asked. “No, no, no -- to Americans. One American from here (Chicago), the other American from South America (Colombia). Ah, these kids”, he laments, “ they have become Americans!”. “Do you still get together for reunions, family holidays?”, I asked. “Yes, but not like in Poland.” I told him that Filipinos like big family reunions and that even here in the states, we try to get together often, specially during Christmas. “Yes,” he agreed, “In Poland, we also have big Christmas celebration with the family. But now, here in America, it’s not easy to get everyone together. This Christmas, we will be spending the holidays in a friend’s house, outside of Chicago.”
The unhappiest fellow was the Czechoslovakian, specially since I initially thought I heard him say he was from Slovenia or Ceausescu’s Romania. He was one sour dude. He had been waiting “for one hour” in the taxi pool and had gotten no passengers. I offered to give him an extra tip, but he said he was so unhappy, he was going to give me a ride for free! I felt our conversation was not going anywhere, so I asked about his family. I find that subject invariably melts the heart, unless I am in conversation with a hardened soul. He lightened up a bit. Czechoslovakia was better when it was a communist country, he declared outright. I reminded him about the oppressed masses under the Communist regime, food lines, etc. “Nah..” he dismissed my comments. “During communist time, everyone had a slice of bread or no bread -- but everyone was equal. Now, only the rich have bread, the poor have nothing.” For a minute, I thought he was talking about the Philippines!
So why did he leave Czechoslovakia? He had won the immigration lottery. Every year, he told me, a lottery is held and four families win passage to the United States. He was one of the four winners, out of 3,500 applicants. He should consider himself lucky, I said. Yes, but then his son got sick, was diagnosed with desmoid tumor or sarcoma and died at age 14. He knew everything there was to know about the cancer because he went to the public library to research the subject. I asked if his child got treated. Yes, a team at the University Hospital had done everything but could not save his boy. No wonder, he carried so much sadness on his shoulders.
The Korean was all business. He did not talk much, but he drove well and was efficient. He had the latest credit card machine installed in between the car seats. All I had to do, as soon as we reached our destination, was swipe my VISA and the trip was paid. He reminded me to add the tip on the machine. As always, I left a bigger tip -- as we all tend to do with credit cards.
The Muslim driver from Algiers was most fascinating. He was pleasantly surprised I knew about the Seven Pillars of Islam. I told him we, Christians, say our morning and evening prayers and occasionally pray the office of the hours, but not as frequently or as regularly as Muslims do. “It is most important we pray”, he tells me,” otherwise how can we live our lives well?” In his distinctly Arabic accent, he laments that children and young adults preoccupy themselves with material things, like video games and computers, but pay little attention to the spiritual dimension of life. So I asked if he were teaching his children Islamic spiritual values. Of course, he says, but it is a constant struggle to inculcate in our children our cultural and religious heritage. Tell me about it, I said silently.
Last but not least, was the Irish woman taxi driver, born and raised in Chicago. She looked to me like a fiftyish grandmother or a teacher. I didn’t asked why she chose to be a driver, just that I didn’t recall ever hailing a taxi driven by a lady. She gave me a nice Irish smile, to indicate somehow that my comment was universal. Was she happy that a fellow Chicagoan was in the White House? Boy, did that question elicit a flurry of political commentary. As it turned out, she was a big Sarah Palin fan! I like Sarah too, I said. Unfortunately, the odds were stacked against her; Katie Couric and her liberal media cohorts did a nifty job of ambushing Palin before national TV. “What is this country coming to?”, she threw up her hands, while still driving carefully. “President Obama wants us to work, work, work so that thousands of lazy bums can sit, sit, sit. What happened to honest-to-goodness American labor ethic?” When the subject turned to federally-funded abortion, she asked if I was a Christian. Roman Catholic, I replied. She happily gave me a Christian pamphlet and a list of spiritual authors she had written on a small pad with a pencil. I had read some of those authors, I told her. Kathy beamed and gave me an Irish blessing as I got out of her taxi and joined the teeming mass of humanity into Union Station, in downtown Chicago.
I learned the latest updates in surgery at the 95th Annual Clinical Congress and precious human vignettes from the taxi drivers of Chicago.
___________________
Dr. Gamboa is the author of the book "Virtuous Healers: Models of Faith in Medicine."
more . E-mails from the Desert - by Dr. Edgar A. Gamboa
25.SEP.09 The doctor is out
28.AUG.09 Health Care Reform: Getting the Facts Right
08.MAY.09 Yosemite's Half Dome
24.APR.09 Obama, Notre Dame and the Culture of Life
27.MAR.09 A friend goes on vacation
06.MAR.09 The Garden of Eden
06.FEB.09 Double Speak
30.JAN.09 A Cup of Tea, Before Sunrise
16.JAN.09 A different kind of Santa
19.DEC.08 A lonely Christmas...
28.NOV.08 The Perils of Capitalism
21.NOV.08 Sold-out Audience Cheers for Asian Silk Road Concert
31.OCT.08 The Sarah Palin Factor
10.OCT.08 Restore Traditional Marriage - Vote YES on Proposition 8
19.SEP.08 Olympics, Philippine Style
08.AUG.08 Wisdom - where to find it?
25.JUL.08 Moonlit Beach
11.JUL.08 Breast Cancer Treatments
27.JUN.08 Breast Cancer 101
13.JUN.08 PATHWAYS
06.JUN.08 Coming Out Soon! "Virtuous Healers"
30.MAY.08 Filipino Nuncio
23.MAY.08 Pan de Sal Cruise
search archives
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Friday, October 23, 2009
Friday, September 25, 2009
The Doctor Is Out
EMAILS FROM THE DESERT by Edgar Gamboa, MD, FACS | SAN DIEGO, 9/25/09 -- In the increasingly complicated discussion about health care reform, every legislator and economist seem to suddenly possess a comprehensive knowledge of what is ailing the health care system in the United States.
Everyone – from the corridors of the White House and halls of Congress to newsrooms and TV stations across the nation – knows how to treat this malady. Why is health care in the US getting financially out of control and draining up to 16% of the GNP? Why are 40 million citizens uninsured? Why is the most affluent nation in the world ranked 29th worldwide in infant mortality?
Many solutions have been proposed: a public health option, insurance portability, mandatory coverage of pre-existing disease, tort reform and caps on malpractice award, affordability of formulary drugs, $1.2 trillion stimulus, emphasis on physical fitness and preventive health programs, etc. Criticisms abound as well: health benefits rationing, facilitation of euthanasia or death panels, unrestricted federal funding of abortion, socialized medicine, governmental dominance of the health care industry, stifling of medical research and innovation, elimination of conscience clause for pro-life physicians, etc.
In this raging debate, one important voice has not been listened to. The art and science of medicine rests, in essence, on the relationship between the patient and the doctor, between the one who is sick and the one who, by knowledge and experience gained through years of clinical training and practice, cures that sickness. Everything else revolves around this unique interaction between two human beings.
Yet, in the attempt to improve health care today, albeit well intentioned, the physician has been brushed aside, if not maligned. The politician is in. The doctor is out.
One surgeon addresses this matter in a September 17th letter to President Obama. I quote Dr. Richard Armstrong's letter in its entirety below:
September 17, 2009
President Barack Obama
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
Mr. President,
I have followed the health reform debate closely from its beginning. In many ways, I have followed this since the beginning of my career in medicine 33 years ago. In your speech to Congress last week you said that the time for bickering should be over and we should get down to the real work of fixing the problems. I agree with you. I have read HR3200 and the proposed bill from the Senate finance committee. I must tell you, Mr. President, that these proposed pieces of legislation will not fix the problems. Each of these or a compromise of the two will do nothing but add to the cost, the bureaucracy and the waste that you have said repeatedly that you want to reduce. Although you have stated that we should keep what works and fix what doesn’t, the reality is that it is our systems of health care delivery, organization of government programs and the insurance industry that represent the true issues. These aren’t working for Americans and are at the heart of the issue. Massive new government intervention, billions of dollars of new government spending and regulation will not solve these problems. The problems will only be multiplied and it will be more difficult for physicians and patients to navigate an already overly cumbersome system. America has the most advanced health care in the world. Although many of the advances in medicine and medical science have benefited from the financial support of the government, it is not the government bureaucracy that is responsible for how far we have come. The success lies with the individual physicians and scientists whose passion for the truth, for solving complex problems and for persisting until they are solved, has given us what we can be proud of as a nation, excellence. The majority of physicians in this country are driven each day by the desire to provide excellent care to each patient they see. Doctors do not begin their days thinking about the joy they will receive from navigating the morass of insurance and government regulations that have become so entrenched in our daily lives. The joy comes from our work, one patient at a time, one problem at a time. The joy comes from a job well done and America’s patients benefit. We have not, as a group, been engaged in a meaningful conversation with the administration or congress about solving the difficult issues of providing health care for all Americans while maintaining quality and integrity. We are a deep well of experience, wisdom and talent. We are willing to come to the table. Yes, American medicine is fragmented. We are not represented by one uniform society. Less than 15% of us belong to the AMA and yet the media and your administration continue to speak as if the AMA speaks for all of us. It does not. Although its member physicians have made tremendous contributions to medical advances and patient care, the corporate organization of the AMA is a part of the problem, not a part of the solution. This physician’s organization, Sermo, has outlined some basic ideas and ways to begin the discussion in our Open Letter and the Physician’s Appeal. You have the podium, Mr. President. You have the ability to slow this legislative freight train down before it pulls us off a cliff that will damage our ability to provide excellent care to America’s citizens, not improve it. Personally, I have no political agenda. I am deeply concerned about the course you are taking. I implore you to take the time to meet with working physicians of America. I implore you to listen carefully for it is the healthcare professionals that have made medicine in America the best in the world, not the government. We can help you move this forward constructively. Please give us that opportunity.
Sincerely,
Richard A. Armstrong MD FACS
more . . . E-mails from the Desert - Dr. Ed Gamboa
28.AUG.09 Health Care Reform: Getting the Facts Right
08.MAY.09 Yosemite's Half Dome
24.APR.09 Obama, Notre Dame and the Culture of Life
27.MAR.09 A friend goes on vacation
06.MAR.09 The Garden of Eden
06.FEB.09 Double Speak
30.JAN.09 A Cup of Tea, Before Sunrise
16.JAN.09 A different kind of Santa
19.DEC.08 A lonely Christmas...
28.NOV.08 The Perils of Capitalism
21.NOV.08 Sold-out Audience Cheers for Asian Silk Road Concert
31.OCT.08 The Sarah Palin Factor
10.OCT.08 Restore Traditional Marriage - Vote YES on Proposition 8
19.SEP.08 Olympics, Philippine Style
08.AUG.08 Wisdom - where to find it?
25.JUL.08 Moonlit Beach
11.JUL.08 Breast Cancer Treatments
27.JUN.08 Breast Cancer 101
13.JUN.08 PATHWAYS
06.JUN.08 Coming Out Soon! "Virtuous Healers"
30.MAY.08 Filipino Nuncio
23.MAY.08 Pan de Sal Cruise
Everyone – from the corridors of the White House and halls of Congress to newsrooms and TV stations across the nation – knows how to treat this malady. Why is health care in the US getting financially out of control and draining up to 16% of the GNP? Why are 40 million citizens uninsured? Why is the most affluent nation in the world ranked 29th worldwide in infant mortality?
Many solutions have been proposed: a public health option, insurance portability, mandatory coverage of pre-existing disease, tort reform and caps on malpractice award, affordability of formulary drugs, $1.2 trillion stimulus, emphasis on physical fitness and preventive health programs, etc. Criticisms abound as well: health benefits rationing, facilitation of euthanasia or death panels, unrestricted federal funding of abortion, socialized medicine, governmental dominance of the health care industry, stifling of medical research and innovation, elimination of conscience clause for pro-life physicians, etc.
In this raging debate, one important voice has not been listened to. The art and science of medicine rests, in essence, on the relationship between the patient and the doctor, between the one who is sick and the one who, by knowledge and experience gained through years of clinical training and practice, cures that sickness. Everything else revolves around this unique interaction between two human beings.
Yet, in the attempt to improve health care today, albeit well intentioned, the physician has been brushed aside, if not maligned. The politician is in. The doctor is out.
One surgeon addresses this matter in a September 17th letter to President Obama. I quote Dr. Richard Armstrong's letter in its entirety below:
September 17, 2009
President Barack Obama
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
Mr. President,
I have followed the health reform debate closely from its beginning. In many ways, I have followed this since the beginning of my career in medicine 33 years ago. In your speech to Congress last week you said that the time for bickering should be over and we should get down to the real work of fixing the problems. I agree with you. I have read HR3200 and the proposed bill from the Senate finance committee. I must tell you, Mr. President, that these proposed pieces of legislation will not fix the problems. Each of these or a compromise of the two will do nothing but add to the cost, the bureaucracy and the waste that you have said repeatedly that you want to reduce. Although you have stated that we should keep what works and fix what doesn’t, the reality is that it is our systems of health care delivery, organization of government programs and the insurance industry that represent the true issues. These aren’t working for Americans and are at the heart of the issue. Massive new government intervention, billions of dollars of new government spending and regulation will not solve these problems. The problems will only be multiplied and it will be more difficult for physicians and patients to navigate an already overly cumbersome system. America has the most advanced health care in the world. Although many of the advances in medicine and medical science have benefited from the financial support of the government, it is not the government bureaucracy that is responsible for how far we have come. The success lies with the individual physicians and scientists whose passion for the truth, for solving complex problems and for persisting until they are solved, has given us what we can be proud of as a nation, excellence. The majority of physicians in this country are driven each day by the desire to provide excellent care to each patient they see. Doctors do not begin their days thinking about the joy they will receive from navigating the morass of insurance and government regulations that have become so entrenched in our daily lives. The joy comes from our work, one patient at a time, one problem at a time. The joy comes from a job well done and America’s patients benefit. We have not, as a group, been engaged in a meaningful conversation with the administration or congress about solving the difficult issues of providing health care for all Americans while maintaining quality and integrity. We are a deep well of experience, wisdom and talent. We are willing to come to the table. Yes, American medicine is fragmented. We are not represented by one uniform society. Less than 15% of us belong to the AMA and yet the media and your administration continue to speak as if the AMA speaks for all of us. It does not. Although its member physicians have made tremendous contributions to medical advances and patient care, the corporate organization of the AMA is a part of the problem, not a part of the solution. This physician’s organization, Sermo, has outlined some basic ideas and ways to begin the discussion in our Open Letter and the Physician’s Appeal. You have the podium, Mr. President. You have the ability to slow this legislative freight train down before it pulls us off a cliff that will damage our ability to provide excellent care to America’s citizens, not improve it. Personally, I have no political agenda. I am deeply concerned about the course you are taking. I implore you to take the time to meet with working physicians of America. I implore you to listen carefully for it is the healthcare professionals that have made medicine in America the best in the world, not the government. We can help you move this forward constructively. Please give us that opportunity.
Sincerely,
Richard A. Armstrong MD FACS
more . . . E-mails from the Desert - Dr. Ed Gamboa
28.AUG.09 Health Care Reform: Getting the Facts Right
08.MAY.09 Yosemite's Half Dome
24.APR.09 Obama, Notre Dame and the Culture of Life
27.MAR.09 A friend goes on vacation
06.MAR.09 The Garden of Eden
06.FEB.09 Double Speak
30.JAN.09 A Cup of Tea, Before Sunrise
16.JAN.09 A different kind of Santa
19.DEC.08 A lonely Christmas...
28.NOV.08 The Perils of Capitalism
21.NOV.08 Sold-out Audience Cheers for Asian Silk Road Concert
31.OCT.08 The Sarah Palin Factor
10.OCT.08 Restore Traditional Marriage - Vote YES on Proposition 8
19.SEP.08 Olympics, Philippine Style
08.AUG.08 Wisdom - where to find it?
25.JUL.08 Moonlit Beach
11.JUL.08 Breast Cancer Treatments
27.JUN.08 Breast Cancer 101
13.JUN.08 PATHWAYS
06.JUN.08 Coming Out Soon! "Virtuous Healers"
30.MAY.08 Filipino Nuncio
23.MAY.08 Pan de Sal Cruise
Friday, August 28, 2009
Health Car Reform: Getting the Facts Right
As I write about the current national debate on health care, I get a sense of what Pope Benedict XVI might have felt at Regensburg. Compelled to speak about Islam and violence, the Holy Father was keenly aware he was walking on thin ice. The Vatican’s track record during the Crusades was not a shining example of Christ’s teaching on peace and justice . Yet, despite the historical baggage, Pope Benedict forged ahead to address the errors of Islamic fundamentalism.
In good company, therefore, I will speak about health care reform. A short essay like this simply cannot cover the health care debate in a fair and comprehensive manner. So, I will address the issue in a series of articles.
At a recent Knights of Columbus convention in Phoenix, a well-educated Filipino, upon learning that I was a surgeon, brought out the topic of health care reform. From his perspective, the solution to providing health care to 40 million people without medical insurance was simply to reduce payments to physicians, hospitals, and drug companies. He must have read the USA Today interview of House Speaker Nancy Pelosi, who assured the nation that securing $1.4 trillion to fund a new government program was easy – the government would simply tax doctors, hospitals, and pharmaceutical companies.
So I asked my brother knight what he thought I would get compensated for if I got out of bed at 2 in the morning, rushed to the ER to examine a patien t, reviewed the blood tests and CT scans, diagnosed appendicitis, then brought the patient to the Operating Suite for emergency surgery. And what if I kept the child or adult in the hospital for several days of intravenous antibiotic treatment, saw him or her every day on rounds, conferred with the nurses and updated the family regarding the patient’s clinical progress, then checked the patient again in the office for the next couple of weeks until he or she could go back to school or work?
My fellow knight promptly mentioned a dollar amount that was easily ten times what I would actually get paid for. Assuming, I did not get an IOU check from Sacramento, as is happening these days under the state budgetary crisis.
And what did he think I would get paid for services rendered after surgery? He guessed wrong again. How about zero dollars, I said. Everything that surgeons do after surgery falls into what is called a postoperative “global period” of 60-90 days when all services provided for the patient are free.
He thought I was joking. “Doc,” he said, “don’t you get paid $500 every time you opened a chart?” This led me to conclude that he (and millions of Americans) must have been listening to the President of the United States who claimed that surgeons got $50,000 for amputating a leg. I wonder on which planet these surgical fees are being disbursed. Overworked physicians can certainly use such generous reimbursements here on earth for the ever increasing malpractice premiums we pay to protect ourselves from lawsuits that have become casino lotteries for patients and malpractice lawyers.
Knowledgeable experts estimate that if tort or much-needed malpractice reforms were instituted, and defensive medicine eliminated, health care expenditure in the United States will immediately be reduced by $200 Billion a year.
Last year, an article entitled “Patient Perception of Medicare Fee Schedule of Laparoscopic Procedures was published in a surgical journal (Surgical Innovation, September 19, 2008). It was a study conducted by a team from the University of Miami School Of Medicine and presented to the Society of American Gastrointestinal Endoscopic Surgeons annual meeting.
Concerned that the public (and congressional representatives) are under the erroneous notion that physicians receive substantial remuneration for surgical procedures, the team surveyed 96 patients. 83% of the patients had been operated on.
The survey revealed the following: Almost all of the patients (98%) thought Medicare should pay more for technically difficult surgical procedures. 32% felt Medicare paid physicians well but 91% thought Medicare should increase fees for doctors.
Interestingly, patients thought that surgeons were paid $14,963 for a gastric bypass operation and that Medicare should increase payment for the laparos copic procedure to $16,877, when, in fact, Medicare pays only $1,504 for such an operation.
For gallbladder surgery, patients thought that surgeons were paid $8,746 and that they deserve to be paid $10,555 for the operation. In actual fact, Medicare pays $620.
Medical students surveyed in a 2007study thought that surgeons got paid $3,000 for gallbladder surgery while most surgeons thought they were getting paid $700. Again, the actual payment was $620 for removal of the gallbladder by laparoscopic surgery. Such compensation also included medical care before and after surgery.
For initial patient visit to the doctor’s office, the survey showed that patients think Medicare pays $144 and that doctors deserve to be paid $181. In fact, Medicare pays surgeons $90.58 for a patient’s visit. Additional visits are paid lower.
The study concluded that “lawmaker perception of Medicare physician reimbursement probably resembles public perception, which may explain the fact of the ever-threatening cuts in Medicare reimbursement to physicians.”
Next year, Medicare plans to cut reimbursements further by another 20%.
Jolted by facts, my friend in Phoenix said that Medicare had trouble containing costs and that Medicare constitutes only a fraction of most medical practices anyway. He was right. Depending on type and location of practice, Medicare makes up 20-40%. However, what he did not know is this: most, if not all insurance companies, now set fee schedules as close to Medicare rates as possible. And Medi-Cal rates are even lower than Medicare.
That is why most physicians, while recognizing the value of universal heal th care, are concerned that the proposed government option plan will be nothing more than a Medicare clone.
I will examine another aspect of health care reform in the next article.
more . . . E-mails from the Desert - Dr. Ed Gamboa
28.AUG.09 Health Care Reform: Getting the Facts Right
08.MAY.09 Yosemite's Half Dome
24.APR.09 Obama, Notre Dame and the Culture of Life
27.MAR.09 A friend goes on vacation
06.MAR.09 The Garden of Eden
06.FEB.09 Double Speak
30.JAN.09 A Cup of Tea, Before Sunrise
16.JAN.09 A different kind of Santa
19.DEC.08 A lonely Christmas...
28.NOV.08 The Perils of Capitalism
21.NOV.08 Sold-out Audience Cheers for Asian Silk Road Concert
31.OCT.08 The Sarah Palin Factor
10.OCT.08 Restore Traditional Marriage - Vote YES on Proposition 8
19.SEP.08 Olympics, Philippine Style
08.AUG.08 Wisdom - where to find it?
25.JUL.08 Moonlit Beach
11.JUL.08 Breast Cancer Treatments
27.JUN.08 Breast Cancer 101
13.JUN.08 PATHWAYS
06.JUN.08 Coming Out Soon! "Virtuous Healers"
30.MAY.08 Filipino Nuncio
23.MAY.08 Pan de Sal Cruise
search archives
Keywords:
Issue date:
· Type either Keywords, Date or both.
· Date examples: 5/30/02, >5/30/02
In good company, therefore, I will speak about health care reform. A short essay like this simply cannot cover the health care debate in a fair and comprehensive manner. So, I will address the issue in a series of articles.
At a recent Knights of Columbus convention in Phoenix, a well-educated Filipino, upon learning that I was a surgeon, brought out the topic of health care reform. From his perspective, the solution to providing health care to 40 million people without medical insurance was simply to reduce payments to physicians, hospitals, and drug companies. He must have read the USA Today interview of House Speaker Nancy Pelosi, who assured the nation that securing $1.4 trillion to fund a new government program was easy – the government would simply tax doctors, hospitals, and pharmaceutical companies.
So I asked my brother knight what he thought I would get compensated for if I got out of bed at 2 in the morning, rushed to the ER to examine a patien t, reviewed the blood tests and CT scans, diagnosed appendicitis, then brought the patient to the Operating Suite for emergency surgery. And what if I kept the child or adult in the hospital for several days of intravenous antibiotic treatment, saw him or her every day on rounds, conferred with the nurses and updated the family regarding the patient’s clinical progress, then checked the patient again in the office for the next couple of weeks until he or she could go back to school or work?
My fellow knight promptly mentioned a dollar amount that was easily ten times what I would actually get paid for. Assuming, I did not get an IOU check from Sacramento, as is happening these days under the state budgetary crisis.
And what did he think I would get paid for services rendered after surgery? He guessed wrong again. How about zero dollars, I said. Everything that surgeons do after surgery falls into what is called a postoperative “global period” of 60-90 days when all services provided for the patient are free.
He thought I was joking. “Doc,” he said, “don’t you get paid $500 every time you opened a chart?” This led me to conclude that he (and millions of Americans) must have been listening to the President of the United States who claimed that surgeons got $50,000 for amputating a leg. I wonder on which planet these surgical fees are being disbursed. Overworked physicians can certainly use such generous reimbursements here on earth for the ever increasing malpractice premiums we pay to protect ourselves from lawsuits that have become casino lotteries for patients and malpractice lawyers.
Knowledgeable experts estimate that if tort or much-needed malpractice reforms were instituted, and defensive medicine eliminated, health care expenditure in the United States will immediately be reduced by $200 Billion a year.
Last year, an article entitled “Patient Perception of Medicare Fee Schedule of Laparoscopic Procedures was published in a surgical journal (Surgical Innovation, September 19, 2008). It was a study conducted by a team from the University of Miami School Of Medicine and presented to the Society of American Gastrointestinal Endoscopic Surgeons annual meeting.
Concerned that the public (and congressional representatives) are under the erroneous notion that physicians receive substantial remuneration for surgical procedures, the team surveyed 96 patients. 83% of the patients had been operated on.
The survey revealed the following: Almost all of the patients (98%) thought Medicare should pay more for technically difficult surgical procedures. 32% felt Medicare paid physicians well but 91% thought Medicare should increase fees for doctors.
Interestingly, patients thought that surgeons were paid $14,963 for a gastric bypass operation and that Medicare should increase payment for the laparos copic procedure to $16,877, when, in fact, Medicare pays only $1,504 for such an operation.
For gallbladder surgery, patients thought that surgeons were paid $8,746 and that they deserve to be paid $10,555 for the operation. In actual fact, Medicare pays $620.
Medical students surveyed in a 2007study thought that surgeons got paid $3,000 for gallbladder surgery while most surgeons thought they were getting paid $700. Again, the actual payment was $620 for removal of the gallbladder by laparoscopic surgery. Such compensation also included medical care before and after surgery.
For initial patient visit to the doctor’s office, the survey showed that patients think Medicare pays $144 and that doctors deserve to be paid $181. In fact, Medicare pays surgeons $90.58 for a patient’s visit. Additional visits are paid lower.
The study concluded that “lawmaker perception of Medicare physician reimbursement probably resembles public perception, which may explain the fact of the ever-threatening cuts in Medicare reimbursement to physicians.”
Next year, Medicare plans to cut reimbursements further by another 20%.
Jolted by facts, my friend in Phoenix said that Medicare had trouble containing costs and that Medicare constitutes only a fraction of most medical practices anyway. He was right. Depending on type and location of practice, Medicare makes up 20-40%. However, what he did not know is this: most, if not all insurance companies, now set fee schedules as close to Medicare rates as possible. And Medi-Cal rates are even lower than Medicare.
That is why most physicians, while recognizing the value of universal heal th care, are concerned that the proposed government option plan will be nothing more than a Medicare clone.
I will examine another aspect of health care reform in the next article.
more . . . E-mails from the Desert - Dr. Ed Gamboa
28.AUG.09 Health Care Reform: Getting the Facts Right
08.MAY.09 Yosemite's Half Dome
24.APR.09 Obama, Notre Dame and the Culture of Life
27.MAR.09 A friend goes on vacation
06.MAR.09 The Garden of Eden
06.FEB.09 Double Speak
30.JAN.09 A Cup of Tea, Before Sunrise
16.JAN.09 A different kind of Santa
19.DEC.08 A lonely Christmas...
28.NOV.08 The Perils of Capitalism
21.NOV.08 Sold-out Audience Cheers for Asian Silk Road Concert
31.OCT.08 The Sarah Palin Factor
10.OCT.08 Restore Traditional Marriage - Vote YES on Proposition 8
19.SEP.08 Olympics, Philippine Style
08.AUG.08 Wisdom - where to find it?
25.JUL.08 Moonlit Beach
11.JUL.08 Breast Cancer Treatments
27.JUN.08 Breast Cancer 101
13.JUN.08 PATHWAYS
06.JUN.08 Coming Out Soon! "Virtuous Healers"
30.MAY.08 Filipino Nuncio
23.MAY.08 Pan de Sal Cruise
search archives
Keywords:
Issue date:
· Type either Keywords, Date or both.
· Date examples: 5/30/02, >5/30/02
Friday, May 8, 2009
Yosemite's Half Dome
Yosemite National Park is one of California’s treasured natural preserves. One of the nation’s first wilderness parks , Yosemite encompasses 761,266 acres or 1189 square miles. The “park” actually spans over three million acres of the Sierra Nevada if adjoining wilderness preserves, as designated by Congress, are included.
Yosemite makes natural wilderness -- rivers and waterfalls, cliffs and meadows – readily accessible every year to three and a half million tourists, campers, and hikers from all corners of the world. For San Diegans, accustomed to long commutes, it is merely 450 miles away or a pleasant 8-hour drive up I-5.
We owe a debt of gratitude to pioneers like Galen Clark, Yosemite’s first official guardian, and naturalist John Muir. Their efforts led to the preservation of this vast wilderness for generations to enjoy. Presidents Roosevelt and Lincoln as well issued presidential directives to protect this environmentally “green” project.
Have you given in to your adventurous side and climbed Yosemite’s El Capitan, or its second great cliff, the 87 million-year-old Half Dome? I have climbed Half Dome twice, and as quickly regretted it. It is a grueling ascent to a height of 8,836 feet above sea level. Hikers gifted with prime cardiovascular reserves and well-oiled limbs can make the extremely strenuous hike in 12 hours or less. For weaker mortals, like myself, the hours can painfully stretch much longer.
We have been trekking to Yosemite for years. The crisp mountain air and starry nights are unfailingly a pleasant way to spend summer days and nights with family and friends. We’ve pitched tents by its streams, gone fishing, built campfires, and slept in campers . We’ve also rented cots at Camp Curry or availed of more comfort at the Lodge, hiked through the meadows, and climbed up to the waterfalls.
In recent years, led by my naturalist brother Robert, we’ve set our sights to climbing the daunting Half Dome cliff. Five years ago, I almost died after a punishing day long hike when my knee gave out four miles into the descent back to the valley. But memory is short, and challenged (taunted, really) by my physically fit progenies a year ago, I climbed it a second time. Which endeavor resulted in blisters, aching limbs, and the loss of at least four toenails.
My consolation was that, as darkness descended on the way back to camp, bears and mountain lions had either had their supper or simply failed to spot me. Hikers of Yosemite have been known to simply disappear during nightfall -- into the bellies of beasts, presumably.
I’m not sure if the privilege of wearing “I climbed Half Dome and made it” is good enough to justify this insanity. But I have to say it is worth doing, at least once in your life -- like skydiving or sailing around the world.
Summer is just around the corner. Put Yosemite in the top of your list. You will not regret it, unless you fall into the temptation of climbing Half Dome, or El Capitan. Just kidding...
more . . . E-mails from the Desert - Dr. Ed Gamboa
24.APR.09 Obama, Notre Dame and the Culture of Life
27.MAR.09 A friend goes on vacation
06.MAR.09 The Garden of Eden
06.FEB.09 Double Speak
30.JAN.09 A Cup of Tea, Before Sunrise
16.JAN.09 A different kind of Santa
19.DEC.08 A lonely Christmas...
28.NOV.08 The Perils of Capitalism
21.NOV.08 Sold-out Audience Cheers for Asian Silk Road Concert
31.OCT.08 The Sarah Palin Factor
10.OCT.08 Restore Traditional Marriage - Vote YES on Proposition 8
19.SEP.08 Olympics, Philippine Style
08.AUG.08 Wisdom - where to find it?
25.JUL.08 Moonlit Beach
11.JUL.08 Breast Cancer Treatments
27.JUN.08 Breast Cancer 101
13.JUN.08 PATHWAYS
06.JUN.08 Coming Out Soon! "Virtuous Healers"
30.MAY.08 Filipino Nuncio
23.MAY.08 Pan de Sal Cruise
Yosemite makes natural wilderness -- rivers and waterfalls, cliffs and meadows – readily accessible every year to three and a half million tourists, campers, and hikers from all corners of the world. For San Diegans, accustomed to long commutes, it is merely 450 miles away or a pleasant 8-hour drive up I-5.
We owe a debt of gratitude to pioneers like Galen Clark, Yosemite’s first official guardian, and naturalist John Muir. Their efforts led to the preservation of this vast wilderness for generations to enjoy. Presidents Roosevelt and Lincoln as well issued presidential directives to protect this environmentally “green” project.
Have you given in to your adventurous side and climbed Yosemite’s El Capitan, or its second great cliff, the 87 million-year-old Half Dome? I have climbed Half Dome twice, and as quickly regretted it. It is a grueling ascent to a height of 8,836 feet above sea level. Hikers gifted with prime cardiovascular reserves and well-oiled limbs can make the extremely strenuous hike in 12 hours or less. For weaker mortals, like myself, the hours can painfully stretch much longer.
We have been trekking to Yosemite for years. The crisp mountain air and starry nights are unfailingly a pleasant way to spend summer days and nights with family and friends. We’ve pitched tents by its streams, gone fishing, built campfires, and slept in campers . We’ve also rented cots at Camp Curry or availed of more comfort at the Lodge, hiked through the meadows, and climbed up to the waterfalls.
In recent years, led by my naturalist brother Robert, we’ve set our sights to climbing the daunting Half Dome cliff. Five years ago, I almost died after a punishing day long hike when my knee gave out four miles into the descent back to the valley. But memory is short, and challenged (taunted, really) by my physically fit progenies a year ago, I climbed it a second time. Which endeavor resulted in blisters, aching limbs, and the loss of at least four toenails.
My consolation was that, as darkness descended on the way back to camp, bears and mountain lions had either had their supper or simply failed to spot me. Hikers of Yosemite have been known to simply disappear during nightfall -- into the bellies of beasts, presumably.
I’m not sure if the privilege of wearing “I climbed Half Dome and made it” is good enough to justify this insanity. But I have to say it is worth doing, at least once in your life -- like skydiving or sailing around the world.
Summer is just around the corner. Put Yosemite in the top of your list. You will not regret it, unless you fall into the temptation of climbing Half Dome, or El Capitan. Just kidding...
more . . . E-mails from the Desert - Dr. Ed Gamboa
24.APR.09 Obama, Notre Dame and the Culture of Life
27.MAR.09 A friend goes on vacation
06.MAR.09 The Garden of Eden
06.FEB.09 Double Speak
30.JAN.09 A Cup of Tea, Before Sunrise
16.JAN.09 A different kind of Santa
19.DEC.08 A lonely Christmas...
28.NOV.08 The Perils of Capitalism
21.NOV.08 Sold-out Audience Cheers for Asian Silk Road Concert
31.OCT.08 The Sarah Palin Factor
10.OCT.08 Restore Traditional Marriage - Vote YES on Proposition 8
19.SEP.08 Olympics, Philippine Style
08.AUG.08 Wisdom - where to find it?
25.JUL.08 Moonlit Beach
11.JUL.08 Breast Cancer Treatments
27.JUN.08 Breast Cancer 101
13.JUN.08 PATHWAYS
06.JUN.08 Coming Out Soon! "Virtuous Healers"
30.MAY.08 Filipino Nuncio
23.MAY.08 Pan de Sal Cruise
Monday, April 20, 2009
Obama, Notre Dame, and the Culture of Life
On May 17, 2009, in the campus of the University of Notre Dame, my wife and I will be seated at the Joyce Center among thousands of students, faculty, parents and alumni, listening to the President of the United States address the graduating class of 2009.
Our daughter, Lauren Marie, would have received her diploma by then. However, two decades earlier, if President Obama’s “culture of death” philosophy had won over Notre Dame’s Catholic “culture of life” theology, our daughter would never have graduated. Simply because she would never have been born!
In 1987, we found out that my wife Lucie was pregnant. Previously, she had suffered a few miscarriages. I was a surgical fellow at the University of California San Diego at the time and we sought the help of pediatricians at the university medical center. Well-respected professors in pediatrics and genetics recommended an amniocentesis. They felt that it was important to know if Lucie was carrying a defective embryo, and therefore at risk for yet another miscarriage.
We both were troubled. What if the amniocentesis confirmed the worse – that the fetus was defective? The answer from the experts was straightforward: a therapeutic abortion. Why carry a risky pregnancy to term, which would likely end in spontaneous abortion anyway? And if the fetus survived, did we really want to raise a retarded baby, who would be a burden to carry for the duration of his or her unproductive life?
Our medical colleagues could not even understand why we were reluctant to have Lucie undergo an amniocentesis. What was there to think about?
Lucie as a pediatrician and I as a surgeon were familiar with the medical science on which the experts based their recommendations. We were also practicing Catholics and aware of the traditional teaching of the Catholic Church on abortion and the protection of human life.
If we proceeded with an amniocentesis, there would be the minor risk of an induced abortion. If the study confirmed that the fetus was normal and healthy, that would be great news. However, if the fetus were shown to be defective, would we then have it aborted?
We thought long and hard. We prayed about it. The medical arguments for amniocentesis and potential abortion were compelling. The Catholic and ethical considerations were convincing. Even if the baby turned out to be physically disabled or mentally retarded, we ultimately decided that we would accept God’s gift of life in gratitude, even if the future did not look too bright.
To this day, we are glad we made the decision to “keep the baby”. The pregnancy went smoothly and Lucie delivered a bouncing, robust, and healthy baby girl. We have four children and that baby is our only girl. What a bundle of joy she is!
Lauren Marie graduated in the top of her class in grade school and high school. She has been in the Dean’s List at the University of Notre Dame. Far from being the burden that medical experts had feared, she has been the jewel in our eyes and a delightful gift to our lives.
Yet, had we followed the promptings of the “culture of death” rather than the “culture of life”, we wonder what our lives would have been without her.
It is estimated that over three thousand abortions occur in the United States every day. The majority are not the rape or incest cases that pro-choice or pro-abortion advocates, the liberal media and Planned Parenthood are so concerned about. Most abortions are the result of lack of information regarding viable alternatives to abortion, such as adoption. Many are based on unfounded fears – will the baby be defective? How can I financially support the baby? How much of a burden will the baby be? What will my parents think? What will the future be like?
The controversy surrounding President Obama’s commencement address at Notre Dame, from my viewpoint, is not so much about the university’s traditional invitation to a sitting president, which dates back to President Dwight Eisenhower. Rather, it is about Notre Dame’s awarding the President an honorary doctor of law degree. How in the world can the foremost Catholic University in the world justify conferring such an honor on a politician whose major policies to date have trampled on Catholic ethics and principles?
As an Illinois state legislator, Barack Obama personally worked to block legislation banning the killing of disabled newborns that survived botched abortions. In the US Senate, the senator from Chicago was involved in fundraising to continue the practice of partial-birth abortion (an obstetrical technique to deliver a live infant except for the head which, in utero, is incised and suctioned resulting in death). As a presidential candidate, Obama promised the passage of the Freedom of Choice Act that would eliminate all existing regulations from the practice of abortion.
In the President’s first 100 days, he has issued executive orders facilitating the funding of international abortion agencies and for stem cell research utilizing human embryos. President Barack Obama disregards scientific data that confirm the embryo’s human characteristics or the developing consensus that adult stem cells offer a viable therapeutic and ethical alternative to embryonic stem cells.
At present, President Obama is preparing the federal government to eliminate conscience protections from physicians and from clinics and hospitals morally opposed to carrying out abortions. Furthermore, he has appointed to the White House and key federal agencies bureaucrats and lawyers recommended by extremist abortion advocacy groups.
Freedom of speech is guaranteed by the constitution of the United States and the President should be allowed to speak his piece at Notre Dame. However, his record speaks for itself and should be more than sufficient to persuade the University of Notre Dame not to confer an honorary degree which exemplifies its recipient as the embodiment of the Catholic values of the University of Notre Dame and the ethical and moral aspirations of its students, graduates, and alumni.
###
Our daughter, Lauren Marie, would have received her diploma by then. However, two decades earlier, if President Obama’s “culture of death” philosophy had won over Notre Dame’s Catholic “culture of life” theology, our daughter would never have graduated. Simply because she would never have been born!
In 1987, we found out that my wife Lucie was pregnant. Previously, she had suffered a few miscarriages. I was a surgical fellow at the University of California San Diego at the time and we sought the help of pediatricians at the university medical center. Well-respected professors in pediatrics and genetics recommended an amniocentesis. They felt that it was important to know if Lucie was carrying a defective embryo, and therefore at risk for yet another miscarriage.
We both were troubled. What if the amniocentesis confirmed the worse – that the fetus was defective? The answer from the experts was straightforward: a therapeutic abortion. Why carry a risky pregnancy to term, which would likely end in spontaneous abortion anyway? And if the fetus survived, did we really want to raise a retarded baby, who would be a burden to carry for the duration of his or her unproductive life?
Our medical colleagues could not even understand why we were reluctant to have Lucie undergo an amniocentesis. What was there to think about?
Lucie as a pediatrician and I as a surgeon were familiar with the medical science on which the experts based their recommendations. We were also practicing Catholics and aware of the traditional teaching of the Catholic Church on abortion and the protection of human life.
If we proceeded with an amniocentesis, there would be the minor risk of an induced abortion. If the study confirmed that the fetus was normal and healthy, that would be great news. However, if the fetus were shown to be defective, would we then have it aborted?
We thought long and hard. We prayed about it. The medical arguments for amniocentesis and potential abortion were compelling. The Catholic and ethical considerations were convincing. Even if the baby turned out to be physically disabled or mentally retarded, we ultimately decided that we would accept God’s gift of life in gratitude, even if the future did not look too bright.
To this day, we are glad we made the decision to “keep the baby”. The pregnancy went smoothly and Lucie delivered a bouncing, robust, and healthy baby girl. We have four children and that baby is our only girl. What a bundle of joy she is!
Lauren Marie graduated in the top of her class in grade school and high school. She has been in the Dean’s List at the University of Notre Dame. Far from being the burden that medical experts had feared, she has been the jewel in our eyes and a delightful gift to our lives.
Yet, had we followed the promptings of the “culture of death” rather than the “culture of life”, we wonder what our lives would have been without her.
It is estimated that over three thousand abortions occur in the United States every day. The majority are not the rape or incest cases that pro-choice or pro-abortion advocates, the liberal media and Planned Parenthood are so concerned about. Most abortions are the result of lack of information regarding viable alternatives to abortion, such as adoption. Many are based on unfounded fears – will the baby be defective? How can I financially support the baby? How much of a burden will the baby be? What will my parents think? What will the future be like?
The controversy surrounding President Obama’s commencement address at Notre Dame, from my viewpoint, is not so much about the university’s traditional invitation to a sitting president, which dates back to President Dwight Eisenhower. Rather, it is about Notre Dame’s awarding the President an honorary doctor of law degree. How in the world can the foremost Catholic University in the world justify conferring such an honor on a politician whose major policies to date have trampled on Catholic ethics and principles?
As an Illinois state legislator, Barack Obama personally worked to block legislation banning the killing of disabled newborns that survived botched abortions. In the US Senate, the senator from Chicago was involved in fundraising to continue the practice of partial-birth abortion (an obstetrical technique to deliver a live infant except for the head which, in utero, is incised and suctioned resulting in death). As a presidential candidate, Obama promised the passage of the Freedom of Choice Act that would eliminate all existing regulations from the practice of abortion.
In the President’s first 100 days, he has issued executive orders facilitating the funding of international abortion agencies and for stem cell research utilizing human embryos. President Barack Obama disregards scientific data that confirm the embryo’s human characteristics or the developing consensus that adult stem cells offer a viable therapeutic and ethical alternative to embryonic stem cells.
At present, President Obama is preparing the federal government to eliminate conscience protections from physicians and from clinics and hospitals morally opposed to carrying out abortions. Furthermore, he has appointed to the White House and key federal agencies bureaucrats and lawyers recommended by extremist abortion advocacy groups.
Freedom of speech is guaranteed by the constitution of the United States and the President should be allowed to speak his piece at Notre Dame. However, his record speaks for itself and should be more than sufficient to persuade the University of Notre Dame not to confer an honorary degree which exemplifies its recipient as the embodiment of the Catholic values of the University of Notre Dame and the ethical and moral aspirations of its students, graduates, and alumni.
###
Friday, March 27, 2009
A Friend Goes On Vacation
Emails from the Desert...A Friend Goes On Vacation
Reprinted from the Asian Journal
Around 1990, Lucie and I visited the Blessed Sacrament at St. James Church in Solana Beach. The parish kept a selection of books for those interested in reading while keeping vigil in the chapel. She picked a small volume from the stack, entitled “Opening to God” by Thomas H. Green, S. J., and handed it to me.
We were both fascinated by the author’s bio on the back cover, which in part read: “Father Thomas Green is a native of Rochester, New York...has advanced degrees in education and physics from Fordham University...and a Ph. D from the University of Notre Dame...is presently the Spiritual Director of San Jose Seminary, Manila, Philippines and Professor of Philosophy and Theology at Ateneo de Manila University.”
It was an engrossing book on prayer. Fr. Green had a unique way of lucidly explaining the “Our Father”, as I had never heard or read before. Consequently, I began to pray the “Lord’s Prayer” with a better understanding since I first recited it in kindergarten. I tracked down the books that Fr. Green had used as references for his work. That research opened up a wealth of classic works on prayer and spirituality.
Faithful to his Jesuit upbringing, Fr. Green blended the spirituality of St. Ignatius of Loyola which I was familiar with and Carmelite spirituality which I was interested in but found difficult to decipher. The collected works of the famous Carmelite poet, St. John of the Cross, are fascinating but tough to grasp. Fr. Green, however, made it easier to understand St. John’s mystical theological concepts.
Fr. Green, I found out, was a very popular retreat and spiritual director in Manila (his conferences were standing room only). He had written many popular books. I understood why he was so well-loved by his audience as I read all his books: When the Well Runs Dry, Darkness in the Marketplace, Weeds Among the Wheat, A Vacation with the Lord, Drinking from a Dry Well, Prayer and Common Sense, Come Down Zacchaeus, The Friend of the Bridegroom.
I learned that Fr. Green’s manuscripts were published by Ave Maria Press of the University of Notre Dame and that his books were so well received that they were published in several languages (French, German, Italian, Spanish, Korean, and Indonesian). Later, I had the opportunity to meet with Frank Cunningham, editor and publisher of Ave Maria Press. It was delightful to learn how Fr. Tom and Mr. Cunningham worked together to develop so many popular books.
Soon after I read his first book, “Opening to God”, I wrote Fr. Green a short letter to let him know how much I enjoyed reading the book. To my surprise, he promptly sent me a postcard, acknowledging my letter and informing me that he was on a trip to several Asian countries to conduct retreats and conferences, as was his practice during his summer vacation.
Thus started a series of letters (emails when the internet later became available), which culminated in my visits to San Jose Seminary to chat with him. He returned the favor by spending time with our family in San Diego, celebrating Mass at home and giving a lecture at USD.
I always knew when Christmas was around the corner. Fr. Tom’s newsletter was always the first to arrive, usually around the first or second week of December. My family newsletter, on the other hand, usually got to the post office after Christmas or the New Year, and in some extreme years, at Valentine’s!
It was an honor and a privilege to have known Fr. Tom. He made my day when he sent me a personal copy of his book as soon as it got published. He reviewed the manuscript of my first book and suggested the title: “From Mt. Krizevac to Mt. Carmel” because, as he pointed out, it was two books in one. Last year, even as his health was failing, he reviewed and wrote a blurb for my second book, “Virtuous Healers: Models of Faith in Medicine”.
It was a very sad day, when I received an email from Fr. Khing Vano that Fr. Tom Green had passed away. His last Christmas letter had indicated that his health was deteriorating and that he was waiting to see what the Lord had in store for him.
It is a gift to get to know a dedicated missionary, a famous author and a living saint fairly well. I am grateful for the communications and conversations we had over the years. Fr. Tom taught his students at San Jose Seminary and his retreatants many valuable things. Faithfulness and trust in Divine Providence was one of them. As a young missionary, he had been directed to start his missionary work in Japan. Due to a drastic change in circumstances, however, he ended up in Manila instead. He did not understand why that happened, but he never questioned the Lord’s plans for him. And thus he flourished where he was planted.
The lesson I like the most was his insistence that spending time in prayer (even in “dry prayer”, as when “the well runs dry”) was not a waste of time because spending time with the Lord never is. He said not to worry if we did not feel like we were progressing spiritually. He offered the example of an operation, for instance an appendectomy.
Prior to the operation, the patient would experience abdominal pain, nausea, and vomiting. During the operation, when the patient was under general anesthesia, he or she would obviously be unaware of the extent of the surgeon’s technical efforts to correct the problem. After surgery, in the recovery room, the patient would wake up, still experiencing abdominal pain from the incision and nausea or vomiting from the anesthetic drugs. For the patient, nothing has changed. His condition remains as dire as ever.
As in the spiritual life, only God knows how much work has been done inside us. We remain clueless.
Fr. Green encouraged everyone to set aside time for a retreat, or what he called “A Vacation with the Lord”. I truly believe that Fr. Tom Green is now spending a grand vacation with his Friend.
###
more E-mails from the Desert
Dr. Gamboa is also the author of the book "Virtuous Healers", a collection of essays that offers a timely, insightful, and often personal look into healing and spirituality, life and death, in everyday encounters.- AJ
06.MAR.09 The Garden of Eden
06.FEB.09 Double Speak
30.JAN.09 A Cup of Tea, Before Sunrise
16.JAN.09 A different kind of Santa
19.DEC.08 A lonely Christmas...
28.NOV.08 The Perils of Capitalism
21.NOV.08 Sold-out Audience Cheers for Asian Silk Road Concert
31.OCT.08 The Sarah Palin Factor
10.OCT.08 Restore Traditional Marriage - Vote YES on Proposition 8
19.SEP.08 Olympics, Philippine Style
08.AUG.08 Wisdom - where to find it?
25.JUL.08 Moonlit Beach
11.JUL.08 Breast Cancer Treatments
27.JUN.08 Breast Cancer 101
13.JUN.08 PATHWAYS
06.JUN.08 Coming Out Soon! "Virtuous Healers"
30.MAY.08 Filipino Nuncio
23.MAY.08 Pan de Sal Cruise
09.MAY.08 TAKE COURAGE !
02.MAY.08 Rethinking Iraq
25.APR.08 Heralds of Hope
18.APR.08 Pope Benedict XVI Visits America
11.APR.08 The Sage
Reprinted from the Asian Journal
Around 1990, Lucie and I visited the Blessed Sacrament at St. James Church in Solana Beach. The parish kept a selection of books for those interested in reading while keeping vigil in the chapel. She picked a small volume from the stack, entitled “Opening to God” by Thomas H. Green, S. J., and handed it to me.
We were both fascinated by the author’s bio on the back cover, which in part read: “Father Thomas Green is a native of Rochester, New York...has advanced degrees in education and physics from Fordham University...and a Ph. D from the University of Notre Dame...is presently the Spiritual Director of San Jose Seminary, Manila, Philippines and Professor of Philosophy and Theology at Ateneo de Manila University.”
It was an engrossing book on prayer. Fr. Green had a unique way of lucidly explaining the “Our Father”, as I had never heard or read before. Consequently, I began to pray the “Lord’s Prayer” with a better understanding since I first recited it in kindergarten. I tracked down the books that Fr. Green had used as references for his work. That research opened up a wealth of classic works on prayer and spirituality.
Faithful to his Jesuit upbringing, Fr. Green blended the spirituality of St. Ignatius of Loyola which I was familiar with and Carmelite spirituality which I was interested in but found difficult to decipher. The collected works of the famous Carmelite poet, St. John of the Cross, are fascinating but tough to grasp. Fr. Green, however, made it easier to understand St. John’s mystical theological concepts.
Fr. Green, I found out, was a very popular retreat and spiritual director in Manila (his conferences were standing room only). He had written many popular books. I understood why he was so well-loved by his audience as I read all his books: When the Well Runs Dry, Darkness in the Marketplace, Weeds Among the Wheat, A Vacation with the Lord, Drinking from a Dry Well, Prayer and Common Sense, Come Down Zacchaeus, The Friend of the Bridegroom.
I learned that Fr. Green’s manuscripts were published by Ave Maria Press of the University of Notre Dame and that his books were so well received that they were published in several languages (French, German, Italian, Spanish, Korean, and Indonesian). Later, I had the opportunity to meet with Frank Cunningham, editor and publisher of Ave Maria Press. It was delightful to learn how Fr. Tom and Mr. Cunningham worked together to develop so many popular books.
Soon after I read his first book, “Opening to God”, I wrote Fr. Green a short letter to let him know how much I enjoyed reading the book. To my surprise, he promptly sent me a postcard, acknowledging my letter and informing me that he was on a trip to several Asian countries to conduct retreats and conferences, as was his practice during his summer vacation.
Thus started a series of letters (emails when the internet later became available), which culminated in my visits to San Jose Seminary to chat with him. He returned the favor by spending time with our family in San Diego, celebrating Mass at home and giving a lecture at USD.
I always knew when Christmas was around the corner. Fr. Tom’s newsletter was always the first to arrive, usually around the first or second week of December. My family newsletter, on the other hand, usually got to the post office after Christmas or the New Year, and in some extreme years, at Valentine’s!
It was an honor and a privilege to have known Fr. Tom. He made my day when he sent me a personal copy of his book as soon as it got published. He reviewed the manuscript of my first book and suggested the title: “From Mt. Krizevac to Mt. Carmel” because, as he pointed out, it was two books in one. Last year, even as his health was failing, he reviewed and wrote a blurb for my second book, “Virtuous Healers: Models of Faith in Medicine”.
It was a very sad day, when I received an email from Fr. Khing Vano that Fr. Tom Green had passed away. His last Christmas letter had indicated that his health was deteriorating and that he was waiting to see what the Lord had in store for him.
It is a gift to get to know a dedicated missionary, a famous author and a living saint fairly well. I am grateful for the communications and conversations we had over the years. Fr. Tom taught his students at San Jose Seminary and his retreatants many valuable things. Faithfulness and trust in Divine Providence was one of them. As a young missionary, he had been directed to start his missionary work in Japan. Due to a drastic change in circumstances, however, he ended up in Manila instead. He did not understand why that happened, but he never questioned the Lord’s plans for him. And thus he flourished where he was planted.
The lesson I like the most was his insistence that spending time in prayer (even in “dry prayer”, as when “the well runs dry”) was not a waste of time because spending time with the Lord never is. He said not to worry if we did not feel like we were progressing spiritually. He offered the example of an operation, for instance an appendectomy.
Prior to the operation, the patient would experience abdominal pain, nausea, and vomiting. During the operation, when the patient was under general anesthesia, he or she would obviously be unaware of the extent of the surgeon’s technical efforts to correct the problem. After surgery, in the recovery room, the patient would wake up, still experiencing abdominal pain from the incision and nausea or vomiting from the anesthetic drugs. For the patient, nothing has changed. His condition remains as dire as ever.
As in the spiritual life, only God knows how much work has been done inside us. We remain clueless.
Fr. Green encouraged everyone to set aside time for a retreat, or what he called “A Vacation with the Lord”. I truly believe that Fr. Tom Green is now spending a grand vacation with his Friend.
###
more E-mails from the Desert
Dr. Gamboa is also the author of the book "Virtuous Healers", a collection of essays that offers a timely, insightful, and often personal look into healing and spirituality, life and death, in everyday encounters.- AJ
06.MAR.09 The Garden of Eden
06.FEB.09 Double Speak
30.JAN.09 A Cup of Tea, Before Sunrise
16.JAN.09 A different kind of Santa
19.DEC.08 A lonely Christmas...
28.NOV.08 The Perils of Capitalism
21.NOV.08 Sold-out Audience Cheers for Asian Silk Road Concert
31.OCT.08 The Sarah Palin Factor
10.OCT.08 Restore Traditional Marriage - Vote YES on Proposition 8
19.SEP.08 Olympics, Philippine Style
08.AUG.08 Wisdom - where to find it?
25.JUL.08 Moonlit Beach
11.JUL.08 Breast Cancer Treatments
27.JUN.08 Breast Cancer 101
13.JUN.08 PATHWAYS
06.JUN.08 Coming Out Soon! "Virtuous Healers"
30.MAY.08 Filipino Nuncio
23.MAY.08 Pan de Sal Cruise
09.MAY.08 TAKE COURAGE !
02.MAY.08 Rethinking Iraq
25.APR.08 Heralds of Hope
18.APR.08 Pope Benedict XVI Visits America
11.APR.08 The Sage
Monday, March 2, 2009
The Garden of Eden
(Reprinted from The Asian Journal)
Sometimes I wonder how far we, human beings, should go. How deeply should we venture into the mysteries of the universe? Does the One Infinite Intelligence want us to discover and unravel all of the intricacies of the created world? Or does God – whatever our finite minds can conceive the Eternal Being to be – want us to just go along for the ride?
Does God want us to go into stem cell research, into genetic engineering, into cloning? Or does He/She want us to simply enjoy the fruits of creation, without dismantling its delicate clockwork or messing things up?
The church, a fount of wisdom enshrined through centuries of experience in human affairs, cautions us against pushing the envelope. Yet, we now realize the error of suppressing Galileo Galilei’s heliocentric explorations into the universe. No less than the great Pope John Paul II apologized for that shortsightedness. Three and a half centuries later, Pierre Teilhard de Chardin, the brilliant Jesuit paleontologist, probed20this issue. The Vatican has yet to put de Chardin on the pedestal he deserves.
Is stem cell research in our day and age a parallel dilemma? Or does caution in tinkering with the seeds of creation – and being aware of the logical principle that the end does not justify the means – endow us with the wisdom to uncover an ethical solution to the problem of regenerating beneficial cells?
The author of Genesis struggled with this issue, around 900 BC. The Israeli writer(s) came up with a simple story of the Garden of Eden (literally, “The Garden of Delights”). Stay here, Adam and Eve. Live well and enjoy the fruits that have been provided for you gratis. But, stay away and do not touch “the tree of the knowledge of good and evil.”
Curious and undisciplined as human beings were in the beginning of time -- and still are to this present age -- Eve ate the apple and gave the residual to Adham (Hebrew word for “man or humankind” or “a creature made from dust”). And Adam did not even have the courage to admit that he had succumbed to the temptation; he blamed Eve (Hebrew word for “mother of all living”)!
Thus, God banished man and woman from the Garden of Eden and let them out into the world, to bear the pain of childbearing, to raise food from thorns and thistles, to labor for their daily bread “east of Eden”. Yet, as history unfolded, mankind multipl ied and prospered. Human beings discovered fire and harnessed the energies of the earth. Man learned to utilize water, oil, and the planet’s essential resources. Our ancestors conquered the mountains and the seas. They planted and they built. The frenzy of uncontrolled building led to the Tower of Babel. At that point, God said enough is enough. I let you free to roam and discover the earth, but you now think you are the masters of the universe. You will speak in different tongues and realize the errors of your ways.
The genius in this tale of the Garden of Eden is that it is a human being’s effort (or the Jewish community’s effort) to make sense of the complex mystery of God’s creation. It is an attempt to make sense of man and woman’s relationship with the Being from whose creative hands they originated.
The Garden of Eden is more than a prescientific explanation of cosmology. It is an effort to make sense of how far we, human beings, can venture to develop the earth and the skies and the resources God has bequeathed us, and how careful we need to be so that we are not blinded by our brilliance and think we know it all.
I am amazed at the haughtiness of people who regard the Garden of Eden as a simpleton’s story, or Scripture a bunch of fables. Naïve comments on this subject, such as those from prominent media personalities, only reveal them to be intellectually nimble perhaps, but essentially cerebral lightweights. & nbsp;
In 399 BC, Socrates was forced to drink a poisonous concoction of hemlock for railing against pseudo-intellectualism. The great Greek philosopher had insisted that people who think they know it all are dangerous. People who think they know, when in fact they do not, are pathetic. Unfortunately, these pseudo-intellectuals can be outright disastrous for they often are the ones who, by sheer chutzpah and a deluded sense of greatness, run our governments, our churches, and our many institutions. In other words, they run our lives!
One can examine the stimulus package and spending bill that the United States Congress just passed and note how on target Socrates was.
It takes wisdom to acknowledge that we know that we know nothing – or, at least, that there are many things we do not know. Yet, while Socrates and Plato and Aristotle made us aware of this simple fact, many have yet to learn this truth.
###
Sometimes I wonder how far we, human beings, should go. How deeply should we venture into the mysteries of the universe? Does the One Infinite Intelligence want us to discover and unravel all of the intricacies of the created world? Or does God – whatever our finite minds can conceive the Eternal Being to be – want us to just go along for the ride?
Does God want us to go into stem cell research, into genetic engineering, into cloning? Or does He/She want us to simply enjoy the fruits of creation, without dismantling its delicate clockwork or messing things up?
The church, a fount of wisdom enshrined through centuries of experience in human affairs, cautions us against pushing the envelope. Yet, we now realize the error of suppressing Galileo Galilei’s heliocentric explorations into the universe. No less than the great Pope John Paul II apologized for that shortsightedness. Three and a half centuries later, Pierre Teilhard de Chardin, the brilliant Jesuit paleontologist, probed20this issue. The Vatican has yet to put de Chardin on the pedestal he deserves.
Is stem cell research in our day and age a parallel dilemma? Or does caution in tinkering with the seeds of creation – and being aware of the logical principle that the end does not justify the means – endow us with the wisdom to uncover an ethical solution to the problem of regenerating beneficial cells?
The author of Genesis struggled with this issue, around 900 BC. The Israeli writer(s) came up with a simple story of the Garden of Eden (literally, “The Garden of Delights”). Stay here, Adam and Eve. Live well and enjoy the fruits that have been provided for you gratis. But, stay away and do not touch “the tree of the knowledge of good and evil.”
Curious and undisciplined as human beings were in the beginning of time -- and still are to this present age -- Eve ate the apple and gave the residual to Adham (Hebrew word for “man or humankind” or “a creature made from dust”). And Adam did not even have the courage to admit that he had succumbed to the temptation; he blamed Eve (Hebrew word for “mother of all living”)!
Thus, God banished man and woman from the Garden of Eden and let them out into the world, to bear the pain of childbearing, to raise food from thorns and thistles, to labor for their daily bread “east of Eden”. Yet, as history unfolded, mankind multipl ied and prospered. Human beings discovered fire and harnessed the energies of the earth. Man learned to utilize water, oil, and the planet’s essential resources. Our ancestors conquered the mountains and the seas. They planted and they built. The frenzy of uncontrolled building led to the Tower of Babel. At that point, God said enough is enough. I let you free to roam and discover the earth, but you now think you are the masters of the universe. You will speak in different tongues and realize the errors of your ways.
The genius in this tale of the Garden of Eden is that it is a human being’s effort (or the Jewish community’s effort) to make sense of the complex mystery of God’s creation. It is an attempt to make sense of man and woman’s relationship with the Being from whose creative hands they originated.
The Garden of Eden is more than a prescientific explanation of cosmology. It is an effort to make sense of how far we, human beings, can venture to develop the earth and the skies and the resources God has bequeathed us, and how careful we need to be so that we are not blinded by our brilliance and think we know it all.
I am amazed at the haughtiness of people who regard the Garden of Eden as a simpleton’s story, or Scripture a bunch of fables. Naïve comments on this subject, such as those from prominent media personalities, only reveal them to be intellectually nimble perhaps, but essentially cerebral lightweights. & nbsp;
In 399 BC, Socrates was forced to drink a poisonous concoction of hemlock for railing against pseudo-intellectualism. The great Greek philosopher had insisted that people who think they know it all are dangerous. People who think they know, when in fact they do not, are pathetic. Unfortunately, these pseudo-intellectuals can be outright disastrous for they often are the ones who, by sheer chutzpah and a deluded sense of greatness, run our governments, our churches, and our many institutions. In other words, they run our lives!
One can examine the stimulus package and spending bill that the United States Congress just passed and note how on target Socrates was.
It takes wisdom to acknowledge that we know that we know nothing – or, at least, that there are many things we do not know. Yet, while Socrates and Plato and Aristotle made us aware of this simple fact, many have yet to learn this truth.
###
Thursday, February 5, 2009
Double Speak
The Asian Journal
Emails from the Desert...
Dr. Edgar A. Gamboa
Double Speak
It is not exactly the French "double entendre"; but, one finds in the Visayan lingo double words or curiously repeated words. If I wrote this piece sweating ink to achieve content and style, it would be tinu-uray nga sulat (authentic or honest-to-goodness writing). However, if I were sitting bored during a lecture and started doodling, without much thought (huna-huna) or deliberation (duha-duha), that would be sulat-sulat or suwat-suwat. Genuine poetry is balak, while a drunkard's wild verses would be balak-balak.
If you mastered ballroom dancing and participated in "Dancing with the Stars", you would definitely be dancing (sayaw). But if you were just gyrating in front of the mirror in your room, without much regard for footsteps or rhythm, you would just be dancing-dancing or nag sayaw-sayaw lang. Unless, you were doing the itik-itik, the traditional "duck dance. " But then again, the repetitive word makes sense because the Bayanihan folk dancer in you is not the real Donald Duck (itik).
Similarly, if you whistled at a pretty girl -- like in the good old days when you would not be sued for sexual harassment -- that would be taghoy.. If you were in the shower, whistling a tune that was neither here nor there, your effort, no matter how virtuoso the repertoire, would merely be taghoy-taghoy (“whistle squared”).
Repeating an action word weakens or diminishes the verb, as if the particular action is not performed in a serious or deliberate manner. Thus sulat-sulat is writing something without diligence or concentration and sayaw-sayaw is dancing without much regard for technique or gracefulness.
The classic double entendre is a figure of speech which carries two meanings, one of which may not be readily apparent. But in Visayan, the second word renders the original noun, pronoun or verb smaller in size (balay or ba'ay is a house, while balay-balay or ba'ay-ba'ay is a playhouse or a small nipa hut ), quicker or short-lived (bisita-bisita is a short, quick visit), or incomplete (tulug-tulug or tug-tug means half asleep and higda-higda literally means not quite lying supine in bed).
Hilak is to cry; hilak-hilak is to also to cry but not as much tears ("crocodile tears") should be flowing down one's cheeks. Patay means dead, but patay-patay as in patay-patay ug trabaho is working oneself to death. Saka is to climb or go upstairs; saka-saka is constant or repetitious climbing. Itoy is a puppy; itoy-itoy is to follow meekly, which is a docile puppy's desirable trait.
Repetitions are not confined to action words. This linguistic technique is commonly applied to pet or nicknames, as in TonTon, Ging-ging, Tingting, JunJun, Lingling, etc. Note also the Visayan penchant for names ending in "-ing" – Carling, Darling, Coring, Naning, Paking, Pacing, Taling, etc.
Doubling is also a technique for describing a structure that is temporary or unreliable, as in "atup-atup" (a makeshift roof). Or something that is false as in kwarta-kwarta (counterfeit or play money). Interestingly enough, gamay-gamay should denote a small person or animal but it commonly refers to the "small but terrible" individual who possesses extraordinary traits (strength, intelligence, courage, etc.). Thus, gamay-gamay lang pero maayong laki or bright kaayo (he/she is small but very smart).
Interestingly, why is someone gifted with a high IQ maayong laki, not maayong babae? Was it because goodness in the male species in the old Visayas was perceived to be akin to intelligence and goodness in women to virtue? But, we digress. That difference can be the subject of another linguistic exploration.
In an archipelago of 7,100 islands (depending on whether it's high or low tide, of course), going for a swim in pristine, ever-inviting waters is a favorite pastime among Filipinos. But rarely do weekend swimmers undertake a strenuous long distance swim. It is delightful enough to just languy-languy (swim-swim) because the water might be, who knows, slightly deep (laum-laum). On the weekend, at the beach, while the children are playing (dula-dula or duwa-duwa), the adults can rest a bit (pahulay-pahulay) after designating someone to watch the kids (bantay-bantay) every so often, from the corner of one's eye, because real close surveillance would be bantay.
One must run away from a mad dog (DAGAN!) but one can take a leisurely jog to exercise (dagan-dagan). Or play hide and seek (tago-tago). Or a game of catch with water-marked ground boundaries (tubig-tubig).
If you think about it, so many Visayan words are verbalized twice: kaon-kaon (snacks, not a real big dinner), ila-ila (to introduce), tan-aw-tan-aw (to view in bits and pieces or not to stare), tambal-tambal (home remedy, not administered by a nurse or doctor), sakit-sakit (not a full blown illness or something not too painful which can easily be treated with hilot-hilot, a bit of the native treatment), kanta-kanta (to sing as an amateur in Tawag Nang Tanghalan (the erstwhile Philippine version of American Idol) and not to worry if one's vocal struggles are off pitch or the wrong tone). By the way, if one sings yabag-yabag, that is arang-arang (a bit better) because the gutsy Elvis impersonator is only slightly off key and not as hopelessly off scale as really yabag !
Even Visayan food is not immune. Bud-bud or bod-bod (suman in Tagalog, the popular delicacy made of steamed sweet rice wrapped in banana leaves), sapin-sapin, another colorful delicacy, and halo-halo are good examples. When in the kitchen, chop the meat and veggies well (tad-tad or tagud-tagud) and take time to cook properly, not just luto-luto, which is playful or careless cooking.
At times, words are repeated to convey courtesy. One might ask guests to lingkud-lingkud lang una (just sit down), or hulat-hulat lang or hulat-hulata lang (please wait a while Sir (or Ma'am) and please be patient, as when one is confined in the reception room of a busy physician's office). A gracious host and hostess would always politely ask their guests to kindly return soon (balik-balik unya).
Words are so oft repeated that one wonders if the Visayan brain is wired twice or if a significant cultural event in the past (pre-dating the Visayan Lapu-Lapu, the fierce chieftain of Mactan who resisted the Spanish Invasion and killed the renowned explorer Ferdinand Magellan, because this First Filipino hero's name is also doubled!), or a royal edict or something had mandated verbal repetitions.
Or is it simply because the Asian attitude is to be delicate and sensitive, rather than forceful and forthcoming, and the mere repetition of words conveys such courtesy?
If a husband goes out drinking with friends (barkada), it is not advisable to tell his wife that he is going out to drink (inum) tuba (coconut wine) or San Miguel beer. It is more diplomatic to say he will just inum-inum (have a few small drinks) with his friends. He might also say, as my uncle used to say, that he was just going out for a walk or suroy-suroy ( to wander around aimlessly) . Or, lakaw-lakaw lang which means to take a walk with no particular destination. And perhaps to smell the flowers along the way – simhot-simhot lang.
Hinay is to go slow. Is hinay-hinay slower than slow or slower than fast? Or is it the courteous and proper way to tell someone to slow down. If the front seat passenger (or wife) tells the driver (or husband) to drive slowly (hinay), Mr. Andretti might feel insulted. But not if his wife requested, in her melismatic voice, to "hinay-hinay lang, Darl." That way, there will be no lalis-lalis (a small argument).
Curiously, driving fast is pas-pas. You can tell a cab driver to go super pas-pas so you will not be late for your appointment, but you cannot tell the driver to pas. He will give you a puzzled look. Dali-dali is to hurry; the single dali is understood as hurry, but not the single pas.
The same goes for duc-duc or duk-duk, i.e., striking a nail with a hammer. You can't say the one word duk, as in i-duk ang lansang because that would not make sense. It will have to be duk-duka ang lansang (pound the nail). Same thing with calling the waiter or waitress with the time-honored sit-sit. No, you cannot just sit (pun intended).
You may recall encouraging your childhood playmates to climb a tree (kat-kat), but they would not have understood if you simply said kat. Just as you could not ask your lavandera to lad – she had to lad-lad so your wet clothes could dry in the sun. Nor can you say do not dak, if you asked the lavandera not to drop (dak-dak) the laundry basket. Similarly, you could not simply say kut, if you wanted your household help to scrape (kut-kut) the coconut or cantaloupe for desert.
Along the same linguistic rule, you cannot say that your teeth are pud or pod from eating. But if you said pud-pud, people will understand that you chipped or cracked your teeth from biting (kit-kit) on a sugar cane stalk or on an aged coconut. Same thing with sug-sug if your hand catches a wood splinter. You just can't say sug.
If you are a sculptor, you cannot til (or chisel) something into art. Like Michelangelo, you will have to patiently til-til the marble into something remarkable.
Are Visayans naturally being diplomatic, courteous, sensitive to other people's feelings? Or are we plainly inefficient, having to speak twice as much, laden with human frailties? Langay-langay (slow like a turtle), tapul-tapul (a bit lazy), sulti-sulti (to gossip or spread rumors), pala-pala (to flatter) – do these repetitious words define us?
Or are we rather faithful to a hallowed tradition? Sige-sige bisag unsaon (to go on despite the odds), simba-simba perme (to attend church often), tabang-tabang (to keep on helping) – are these our inherent ethnic virtues?
Whatever it is, double speak is the way Visayans talk. I am not a Tagalog expert, having spent only a year in Manila for postgraduate internship at the Veterans Memorial Hospital. Much less am I an expert in the other Filipino tongues. But do barong-barong, dahan-dahan, tagal-tagal, etc. suggest a similar linguistic trait?
How about Hawaiians? Don't they like to dance the hula-hula, eat huli-huli chicken, and get a lomi-lomi massage? Is double speak solely a Visayan thing or a wider linguistic trait that originates from Asian /Pacific Islander roots?
I hope some expert linguist out there can sort out this sari-sari mystery for me. Then I can get out of this hilit-hilit (small corner) of our home and join my wife for kapi-kapi (a small cup of coffee). Maybe...but what do we make of hong-hong (to whisper) and the quadruple honghong-honghong?
And what in the world is the rationale for tang-tang (to remove), bis-bis (to water the plants or flowers), bit-bit (to carry a purse or basket) and their rat-tat-tat quadruples: tang/tang-tang/tang – bis/bis-bis/bis – bit/bit-bit/bit????
###
Emails from the Desert...
Dr. Edgar A. Gamboa
Double Speak
It is not exactly the French "double entendre"; but, one finds in the Visayan lingo double words or curiously repeated words. If I wrote this piece sweating ink to achieve content and style, it would be tinu-uray nga sulat (authentic or honest-to-goodness writing). However, if I were sitting bored during a lecture and started doodling, without much thought (huna-huna) or deliberation (duha-duha), that would be sulat-sulat or suwat-suwat. Genuine poetry is balak, while a drunkard's wild verses would be balak-balak.
If you mastered ballroom dancing and participated in "Dancing with the Stars", you would definitely be dancing (sayaw). But if you were just gyrating in front of the mirror in your room, without much regard for footsteps or rhythm, you would just be dancing-dancing or nag sayaw-sayaw lang. Unless, you were doing the itik-itik, the traditional "duck dance. " But then again, the repetitive word makes sense because the Bayanihan folk dancer in you is not the real Donald Duck (itik).
Similarly, if you whistled at a pretty girl -- like in the good old days when you would not be sued for sexual harassment -- that would be taghoy.. If you were in the shower, whistling a tune that was neither here nor there, your effort, no matter how virtuoso the repertoire, would merely be taghoy-taghoy (“whistle squared”).
Repeating an action word weakens or diminishes the verb, as if the particular action is not performed in a serious or deliberate manner. Thus sulat-sulat is writing something without diligence or concentration and sayaw-sayaw is dancing without much regard for technique or gracefulness.
The classic double entendre is a figure of speech which carries two meanings, one of which may not be readily apparent. But in Visayan, the second word renders the original noun, pronoun or verb smaller in size (balay or ba'ay is a house, while balay-balay or ba'ay-ba'ay is a playhouse or a small nipa hut ), quicker or short-lived (bisita-bisita is a short, quick visit), or incomplete (tulug-tulug or tug-tug means half asleep and higda-higda literally means not quite lying supine in bed).
Hilak is to cry; hilak-hilak is to also to cry but not as much tears ("crocodile tears") should be flowing down one's cheeks. Patay means dead, but patay-patay as in patay-patay ug trabaho is working oneself to death. Saka is to climb or go upstairs; saka-saka is constant or repetitious climbing. Itoy is a puppy; itoy-itoy is to follow meekly, which is a docile puppy's desirable trait.
Repetitions are not confined to action words. This linguistic technique is commonly applied to pet or nicknames, as in TonTon, Ging-ging, Tingting, JunJun, Lingling, etc. Note also the Visayan penchant for names ending in "-ing" – Carling, Darling, Coring, Naning, Paking, Pacing, Taling, etc.
Doubling is also a technique for describing a structure that is temporary or unreliable, as in "atup-atup" (a makeshift roof). Or something that is false as in kwarta-kwarta (counterfeit or play money). Interestingly enough, gamay-gamay should denote a small person or animal but it commonly refers to the "small but terrible" individual who possesses extraordinary traits (strength, intelligence, courage, etc.). Thus, gamay-gamay lang pero maayong laki or bright kaayo (he/she is small but very smart).
Interestingly, why is someone gifted with a high IQ maayong laki, not maayong babae? Was it because goodness in the male species in the old Visayas was perceived to be akin to intelligence and goodness in women to virtue? But, we digress. That difference can be the subject of another linguistic exploration.
In an archipelago of 7,100 islands (depending on whether it's high or low tide, of course), going for a swim in pristine, ever-inviting waters is a favorite pastime among Filipinos. But rarely do weekend swimmers undertake a strenuous long distance swim. It is delightful enough to just languy-languy (swim-swim) because the water might be, who knows, slightly deep (laum-laum). On the weekend, at the beach, while the children are playing (dula-dula or duwa-duwa), the adults can rest a bit (pahulay-pahulay) after designating someone to watch the kids (bantay-bantay) every so often, from the corner of one's eye, because real close surveillance would be bantay.
One must run away from a mad dog (DAGAN!) but one can take a leisurely jog to exercise (dagan-dagan). Or play hide and seek (tago-tago). Or a game of catch with water-marked ground boundaries (tubig-tubig).
If you think about it, so many Visayan words are verbalized twice: kaon-kaon (snacks, not a real big dinner), ila-ila (to introduce), tan-aw-tan-aw (to view in bits and pieces or not to stare), tambal-tambal (home remedy, not administered by a nurse or doctor), sakit-sakit (not a full blown illness or something not too painful which can easily be treated with hilot-hilot, a bit of the native treatment), kanta-kanta (to sing as an amateur in Tawag Nang Tanghalan (the erstwhile Philippine version of American Idol) and not to worry if one's vocal struggles are off pitch or the wrong tone). By the way, if one sings yabag-yabag, that is arang-arang (a bit better) because the gutsy Elvis impersonator is only slightly off key and not as hopelessly off scale as really yabag !
Even Visayan food is not immune. Bud-bud or bod-bod (suman in Tagalog, the popular delicacy made of steamed sweet rice wrapped in banana leaves), sapin-sapin, another colorful delicacy, and halo-halo are good examples. When in the kitchen, chop the meat and veggies well (tad-tad or tagud-tagud) and take time to cook properly, not just luto-luto, which is playful or careless cooking.
At times, words are repeated to convey courtesy. One might ask guests to lingkud-lingkud lang una (just sit down), or hulat-hulat lang or hulat-hulata lang (please wait a while Sir (or Ma'am) and please be patient, as when one is confined in the reception room of a busy physician's office). A gracious host and hostess would always politely ask their guests to kindly return soon (balik-balik unya).
Words are so oft repeated that one wonders if the Visayan brain is wired twice or if a significant cultural event in the past (pre-dating the Visayan Lapu-Lapu, the fierce chieftain of Mactan who resisted the Spanish Invasion and killed the renowned explorer Ferdinand Magellan, because this First Filipino hero's name is also doubled!), or a royal edict or something had mandated verbal repetitions.
Or is it simply because the Asian attitude is to be delicate and sensitive, rather than forceful and forthcoming, and the mere repetition of words conveys such courtesy?
If a husband goes out drinking with friends (barkada), it is not advisable to tell his wife that he is going out to drink (inum) tuba (coconut wine) or San Miguel beer. It is more diplomatic to say he will just inum-inum (have a few small drinks) with his friends. He might also say, as my uncle used to say, that he was just going out for a walk or suroy-suroy ( to wander around aimlessly) . Or, lakaw-lakaw lang which means to take a walk with no particular destination. And perhaps to smell the flowers along the way – simhot-simhot lang.
Hinay is to go slow. Is hinay-hinay slower than slow or slower than fast? Or is it the courteous and proper way to tell someone to slow down. If the front seat passenger (or wife) tells the driver (or husband) to drive slowly (hinay), Mr. Andretti might feel insulted. But not if his wife requested, in her melismatic voice, to "hinay-hinay lang, Darl." That way, there will be no lalis-lalis (a small argument).
Curiously, driving fast is pas-pas. You can tell a cab driver to go super pas-pas so you will not be late for your appointment, but you cannot tell the driver to pas. He will give you a puzzled look. Dali-dali is to hurry; the single dali is understood as hurry, but not the single pas.
The same goes for duc-duc or duk-duk, i.e., striking a nail with a hammer. You can't say the one word duk, as in i-duk ang lansang because that would not make sense. It will have to be duk-duka ang lansang (pound the nail). Same thing with calling the waiter or waitress with the time-honored sit-sit. No, you cannot just sit (pun intended).
You may recall encouraging your childhood playmates to climb a tree (kat-kat), but they would not have understood if you simply said kat. Just as you could not ask your lavandera to lad – she had to lad-lad so your wet clothes could dry in the sun. Nor can you say do not dak, if you asked the lavandera not to drop (dak-dak) the laundry basket. Similarly, you could not simply say kut, if you wanted your household help to scrape (kut-kut) the coconut or cantaloupe for desert.
Along the same linguistic rule, you cannot say that your teeth are pud or pod from eating. But if you said pud-pud, people will understand that you chipped or cracked your teeth from biting (kit-kit) on a sugar cane stalk or on an aged coconut. Same thing with sug-sug if your hand catches a wood splinter. You just can't say sug.
If you are a sculptor, you cannot til (or chisel) something into art. Like Michelangelo, you will have to patiently til-til the marble into something remarkable.
Are Visayans naturally being diplomatic, courteous, sensitive to other people's feelings? Or are we plainly inefficient, having to speak twice as much, laden with human frailties? Langay-langay (slow like a turtle), tapul-tapul (a bit lazy), sulti-sulti (to gossip or spread rumors), pala-pala (to flatter) – do these repetitious words define us?
Or are we rather faithful to a hallowed tradition? Sige-sige bisag unsaon (to go on despite the odds), simba-simba perme (to attend church often), tabang-tabang (to keep on helping) – are these our inherent ethnic virtues?
Whatever it is, double speak is the way Visayans talk. I am not a Tagalog expert, having spent only a year in Manila for postgraduate internship at the Veterans Memorial Hospital. Much less am I an expert in the other Filipino tongues. But do barong-barong, dahan-dahan, tagal-tagal, etc. suggest a similar linguistic trait?
How about Hawaiians? Don't they like to dance the hula-hula, eat huli-huli chicken, and get a lomi-lomi massage? Is double speak solely a Visayan thing or a wider linguistic trait that originates from Asian /Pacific Islander roots?
I hope some expert linguist out there can sort out this sari-sari mystery for me. Then I can get out of this hilit-hilit (small corner) of our home and join my wife for kapi-kapi (a small cup of coffee). Maybe...but what do we make of hong-hong (to whisper) and the quadruple honghong-honghong?
And what in the world is the rationale for tang-tang (to remove), bis-bis (to water the plants or flowers), bit-bit (to carry a purse or basket) and their rat-tat-tat quadruples: tang/tang-tang/tang – bis/bis-bis/bis – bit/bit-bit/bit????
###
Friday, January 23, 2009
A Cup of Tea, Before Sunrise
Emails from the Desert
Edgar A. Gamboa, M.D., FACS
There is something to be said about getting up early in the morning – before the sun rises – saying your prayers (Vigils, as the monks and hermits do), then sipping a warm cup of herbal tea, or hot coffee, as the case may be.
The sun hesitates to rise above the horizon, your clock slows gently down, and life takes a calm and tranquil turn. Somehow, it isn’t night or day, nothingness or being…just you, immersed in the wonder of God’s immeasurable creation.
The children are not off to school yet, or, if they are in college, they are in never-never land; your spouse may still be dreaming dreams; the world, in any event, has not yet decided to stir from its slumber.
Merchants have not opened their shops nor have businesses started counting their monies. In your side of the globe, the politicians have yet to grab their microphones and no one has fired a gun; peace, for the moment, reigns supreme.
The hustle and bustle of city traffic have not mercilessly encroached into your day. You have not stepped on the unending treadmill of life’s familiar rat race.
Your troubles are nowhere in sight. Your obligations are somewhere in the distance. Your list of things to do is not within reach. There is a stream of happiness in your soul and a sparkle of gladness in your spirit.
You’ve had a good night’s rest and the physical world has chosen not to bombard your senses, yet. In the back of your mind, you know this nirvana will not last forever. You pick up the morning papers, or worse, turn on your TV, and you know that magical moment will vanish into thin air!
There is in our inner core an attraction to this treasured moment. Harried office staffers may not realize it, but I assume that is why they pass by Starbucks for a cup of latte or cappuccino on their way to work. Others forego the coffee and pass by church for traditional early morning Mass. While still others simply kiss their slumbering wife and children goodbye before heading out of the house before dawn.
The mystics recognize this as the deepest tranquil point and central stillness of our being, where we are linked in communion with the One who created us.
When you were a child, you would not sit quietly, sip a cup of tea and contemplate like this. You would rub your eyes, bolt out of bed and, without caring to wash your face or brush your teeth, confront the world headlong like an energizer bunny.
I do recall, on lazy Saturday mornings, when school was closed (thanks God), my little brothers and sisters would sit in the patio or the outside staircase or on the steps leading to the dirty kitchen adjacent to the house, and spend a half hour or so just staring at the yard. We would watch a frog leap from the wet grass and busy flies buzzing from the fence to the clothesline. Or we would simply observe ants lining up in procession up the post.
Every so often, our father would ask if we wanted to go with him to pick up something. All excited, we would file, in our pajamas, into the old Studebaker, and fight for the window seats. Papa would drive to a tiny spot, just outside the city, where an old, old lady would be cooking puto maya. She would wrap the steamed sticky sweet rice in banana leaves and, with a toothless smile, proudly hand her home made delicacies to us in a brown paper bag. For a few pesos or centavos more, Papa would buy a potful of sikwate (native hot chocolate) with it.
Sometimes, we would stop by the bakery for a bagful of hot pan de sal. When we arrived home with our prized goodies, Mama would be waiting for us at the breakfast table, where she had set a plateful of sliced ripe mangoes from Guadalupe. Wow, that was heaven on earth!
Edgar A. Gamboa, M.D., FACS
There is something to be said about getting up early in the morning – before the sun rises – saying your prayers (Vigils, as the monks and hermits do), then sipping a warm cup of herbal tea, or hot coffee, as the case may be.
The sun hesitates to rise above the horizon, your clock slows gently down, and life takes a calm and tranquil turn. Somehow, it isn’t night or day, nothingness or being…just you, immersed in the wonder of God’s immeasurable creation.
The children are not off to school yet, or, if they are in college, they are in never-never land; your spouse may still be dreaming dreams; the world, in any event, has not yet decided to stir from its slumber.
Merchants have not opened their shops nor have businesses started counting their monies. In your side of the globe, the politicians have yet to grab their microphones and no one has fired a gun; peace, for the moment, reigns supreme.
The hustle and bustle of city traffic have not mercilessly encroached into your day. You have not stepped on the unending treadmill of life’s familiar rat race.
Your troubles are nowhere in sight. Your obligations are somewhere in the distance. Your list of things to do is not within reach. There is a stream of happiness in your soul and a sparkle of gladness in your spirit.
You’ve had a good night’s rest and the physical world has chosen not to bombard your senses, yet. In the back of your mind, you know this nirvana will not last forever. You pick up the morning papers, or worse, turn on your TV, and you know that magical moment will vanish into thin air!
There is in our inner core an attraction to this treasured moment. Harried office staffers may not realize it, but I assume that is why they pass by Starbucks for a cup of latte or cappuccino on their way to work. Others forego the coffee and pass by church for traditional early morning Mass. While still others simply kiss their slumbering wife and children goodbye before heading out of the house before dawn.
The mystics recognize this as the deepest tranquil point and central stillness of our being, where we are linked in communion with the One who created us.
When you were a child, you would not sit quietly, sip a cup of tea and contemplate like this. You would rub your eyes, bolt out of bed and, without caring to wash your face or brush your teeth, confront the world headlong like an energizer bunny.
I do recall, on lazy Saturday mornings, when school was closed (thanks God), my little brothers and sisters would sit in the patio or the outside staircase or on the steps leading to the dirty kitchen adjacent to the house, and spend a half hour or so just staring at the yard. We would watch a frog leap from the wet grass and busy flies buzzing from the fence to the clothesline. Or we would simply observe ants lining up in procession up the post.
Every so often, our father would ask if we wanted to go with him to pick up something. All excited, we would file, in our pajamas, into the old Studebaker, and fight for the window seats. Papa would drive to a tiny spot, just outside the city, where an old, old lady would be cooking puto maya. She would wrap the steamed sticky sweet rice in banana leaves and, with a toothless smile, proudly hand her home made delicacies to us in a brown paper bag. For a few pesos or centavos more, Papa would buy a potful of sikwate (native hot chocolate) with it.
Sometimes, we would stop by the bakery for a bagful of hot pan de sal. When we arrived home with our prized goodies, Mama would be waiting for us at the breakfast table, where she had set a plateful of sliced ripe mangoes from Guadalupe. Wow, that was heaven on earth!
Saturday, January 10, 2009
A Different Kind of Santa
Emails from the Desert…
Dr. Edgar A. Gamboa
Christmas 2008 came and went. The New Year has begun. Are you one of those who take stock of all the gifts you received from Santa Claus, thank those who kept you in mind during the season, then wonder what to do with all your stuff?
Despite the global economic downturn, we in these United States are still blessed with many material things. CostCo, Wal-Mart, Toys-R-Us, and the ubiquitous shopping malls that proliferate from Oahu to Manhattan, ensure that even a part-time worker can fill those stockings with enough goodies and line the Christmas tree with toys and gifts.
Which, indeed, is a blessing. Everyone loves Santa, no one likes Scrooge. But don’t you get the feeling that perhaps we, in this side of a lopsided globe, just have too many things we don’t really need?
I read about a family who arrived at this juncture – and did something about it.
Instead of sweaters or electronic gadgets or another set of something, these wise parents requested their grown up children to give them, for next Christmas, some charitable deed – an act of kindness – performed to benefit someone else. It could be something as simple as volunteering in a homeless shelter or soup kitchen, buying a stranger a sandwich and a cup of coffee, or teaching a child to read.
One act of kindness that made someone’s day brighter. That was all they asked for Christmas. And the idea caught on.
Their children (and their spouses) came up with all kinds of cool stuff for Christmas gifts -- helping out with Little League sports, collecting blankets for the homeless, donating books to the local library, teaching English to refugees, etc. Soon, their grandchildren came up with their own gifts of kindness – wrapping toys for orphans, collecting school supplies for needy children, distributing gifts to poor families.
The family tradition took root. It became more involved as, year after year, everyone in the family looked for a variety of ways to become a different kind of Santa. Someone delivered a Christmas tree to an “adopted” family and decorated it with gift certificates. The electric and water bill of a senior citizen was fully paid. Colorful backpacks with schools supplies were distributed to students in poor neighborhoods. Orphans across the world were fed and sheltered through monetary donations. Houses and schools in slum areas were gradually built.
The gift-giving rules are simple. The charitable deed has to be done within the year. It can be performed by spending money or giving of one’s time and energy. It can be simple or elaborate, done solo or in teamwork with others. It starts at New Year so that everyone in the family has twelve months to come up with something they could present as their special gift on Christmas Eve.
To keep track, they started taking photos, wrote about their “gifts”, and compiled them in the family scrapbook.. Every Christmas, the family celebrates the birth of the Savior knowing that they had all done something, big or small, to make someone else’s Christmas better.
This humble but remarkable family has captured the true spirit of Christmas. For did not Christ, the reason we celebrate Christmas, say: “Whatever you did for one of these, you did it for me.”?
Filipino-Americans would not find this kind of Christmas giving too unusual, having migrated from a third world where abundance is the exception, rather than the rule. But it is easy to get caught up in the individualistic and materialistic culture of Western society and, in effect, depart from the traditional value of the bayanihan spirit.
Thus, it would be worthwhile for us, Filipino-Americans, to get ourselves and our children more involved in projects that will benefit our kababayans, here in our adopted country and back home in the mother country.
Humanitarian projects, such as medical missions, the construction of schools and clinics, educational funds, and the building of homes (such as those successfully promoted by Gawad Kalinga) can be endeavors worth our time, commitment and effort.
###
Dr. Edgar A. Gamboa
Christmas 2008 came and went. The New Year has begun. Are you one of those who take stock of all the gifts you received from Santa Claus, thank those who kept you in mind during the season, then wonder what to do with all your stuff?
Despite the global economic downturn, we in these United States are still blessed with many material things. CostCo, Wal-Mart, Toys-R-Us, and the ubiquitous shopping malls that proliferate from Oahu to Manhattan, ensure that even a part-time worker can fill those stockings with enough goodies and line the Christmas tree with toys and gifts.
Which, indeed, is a blessing. Everyone loves Santa, no one likes Scrooge. But don’t you get the feeling that perhaps we, in this side of a lopsided globe, just have too many things we don’t really need?
I read about a family who arrived at this juncture – and did something about it.
Instead of sweaters or electronic gadgets or another set of something, these wise parents requested their grown up children to give them, for next Christmas, some charitable deed – an act of kindness – performed to benefit someone else. It could be something as simple as volunteering in a homeless shelter or soup kitchen, buying a stranger a sandwich and a cup of coffee, or teaching a child to read.
One act of kindness that made someone’s day brighter. That was all they asked for Christmas. And the idea caught on.
Their children (and their spouses) came up with all kinds of cool stuff for Christmas gifts -- helping out with Little League sports, collecting blankets for the homeless, donating books to the local library, teaching English to refugees, etc. Soon, their grandchildren came up with their own gifts of kindness – wrapping toys for orphans, collecting school supplies for needy children, distributing gifts to poor families.
The family tradition took root. It became more involved as, year after year, everyone in the family looked for a variety of ways to become a different kind of Santa. Someone delivered a Christmas tree to an “adopted” family and decorated it with gift certificates. The electric and water bill of a senior citizen was fully paid. Colorful backpacks with schools supplies were distributed to students in poor neighborhoods. Orphans across the world were fed and sheltered through monetary donations. Houses and schools in slum areas were gradually built.
The gift-giving rules are simple. The charitable deed has to be done within the year. It can be performed by spending money or giving of one’s time and energy. It can be simple or elaborate, done solo or in teamwork with others. It starts at New Year so that everyone in the family has twelve months to come up with something they could present as their special gift on Christmas Eve.
To keep track, they started taking photos, wrote about their “gifts”, and compiled them in the family scrapbook.. Every Christmas, the family celebrates the birth of the Savior knowing that they had all done something, big or small, to make someone else’s Christmas better.
This humble but remarkable family has captured the true spirit of Christmas. For did not Christ, the reason we celebrate Christmas, say: “Whatever you did for one of these, you did it for me.”?
Filipino-Americans would not find this kind of Christmas giving too unusual, having migrated from a third world where abundance is the exception, rather than the rule. But it is easy to get caught up in the individualistic and materialistic culture of Western society and, in effect, depart from the traditional value of the bayanihan spirit.
Thus, it would be worthwhile for us, Filipino-Americans, to get ourselves and our children more involved in projects that will benefit our kababayans, here in our adopted country and back home in the mother country.
Humanitarian projects, such as medical missions, the construction of schools and clinics, educational funds, and the building of homes (such as those successfully promoted by Gawad Kalinga) can be endeavors worth our time, commitment and effort.
###
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