Music, faith and medicine

Two weeks ago, I began to think of how much hospitals have been part of my life and, strangely, this happened as I was watching a play.

There was my mother, who throughout most of my adolescence, was in and out of the hospital fighting cancer. In my 20s, there was an Auntie — no blood relations but, Asian-style Auntie because she was one of my mother’s best friends — battling heart disease and diabetes. Unmarried and living alone, she relied pretty much on our family for her trips to the hospital. With time, she lost her zest for life and on her last trip to the hospital, as I helped her out of the car, she cried out, “I am so tired, I am so tired. I might not see you again” and although she said that every time we’d have her admitted into the hospital, I felt that time, that she had indeed lost all her will to live.

In the last 10 years or so, hospitals have again become an important part of my life as I raise very young children, while caring for very old parents. The visits to the hospital for the kids have been more for routine check-ups, but I do have one daughter with congenital heart disease, and who has had two open- heart surgeries.

It’s a different matter with my parents, both in their 90s—the routine check-ups are actually becoming rare now. But the hospital admissions have increased in frequency, because of all kinds of emergencies, mostly infections with extended confinements as each admission brings new hospital-acquired infections and problems.

A hospital musicale

All these thoughts while watching a play, a musicale to be more precise. It was a different kind of musicale, a one-night-only performance staged as part of the 50th anniversary of The Medical City (TMC). The musicale reenacted the hospital’s history, from its founding as ABM Sison Hospital, and its evolution with a new name and new site, and its growth into a large health conglomerate with hospitals and clinics in different parts of the Philippines, as well as overseas.

In the musicale, two professional actors were engaged for the role of a physician and patient who would introduce each of several acts. All the others in the cast were from the hospital staff, who put in many off-duty hours to plan out and rehearse the song and dance routines. In one of the early musicale numbers, I recognized one of the country’s foremost infectious diseases specialist in a “chorus line” that included one of the hospital security guards.

The finale of the musicale brought the house down when two of the hospital pioneers went up the stage, in identical suits down to the bow, to sing, and to dance: Dr. Alfredo Bengzon, president and CEO, four days short of turning 82; and Dr. Augusto Sarmiento, board chairman, even younger at 93.

I first got to know Dr. Bengzon when he was health secretary in the heady days after the Edsa revolt. I was on the opposite side of the fence, or so I thought, pressing for health reforms especially around the use of medicines, which had become totally unregulated during the Marcos dictatorship, with high prices, banned drugs and outrageous marketing practices.

Slowly, Dr. Bengzon convinced me that we could work together, as he took by the horns powerful multinational drug companies and initiated the Generics Act, one of the most revolutionary (and least appreciated) reforms in our country’s health care system.

Our paths would cross again when he asked me to design and teach a course on health and culture for Ateneo Graduate School of Business, and, still later, a social medicine module for still another one of his seemingly elusive dreams, Ateneo School of Medicine and Public Health.

I can’t say no to the Jesuits, I tell people, but it’s really Dr. Bengzon. Naturally, in came TMC. Over the years, Dr. Bengzon would occasionally draw me in for advice on the social and cultural aspects of hospital care. As with our encounters in his Department of Health days, he was well aware of how critical I could get about the quality of care and patients’ rights. Two years ago, and I write this as a matter of editorial disclosure, he invited me to join their board of directors as an independent director.

Coming from NGOs and the academe, it has been a totally different experience sitting on a corporate board. Sitting on a board as an independent director means hard but insightful work looking at statistics on everything from hand-washing (monitored through staff radio frequency identification) to average length of confinement, with the goal of having shorter stays. You read right there. The hospital knows that the longer the confinement, the more risks the patients are exposed not just to infections, but to losing the will to live.

As an educator, I perk up listening to how the training of physicians and other health professionals situates hospitals as only a part of a broader continuum of care. That means hospitals need to find out what happens after discharge, in communities and in homes.

Certainly, TMC does not have a monopoly on these reforms and innovations, but, in the 50th anniversary celebrations, I saw how it all comes together, to use the anniversary theme, through reflection, identity and audacity.

Jewels and treasures

In an anniversary speech, Dr. Bengzon referred to an essay by the late Fr. Horacio de la Costa, “Jewels of the Pauper,” referring to how Filipinos, amid great hardship, have always had two treasures: music and faith.

I’ve walked through TMC’s corridors and departments many times, each time marveling at the technologies and the complex management systems needed to run, as TMC’s name implies, a mini-city. But the fanciest equipment and tests remain cold and useless unless you have people who have music in their hearts, music here in an expanded sense not just of moving bodies but of active and inquisitive minds (malikot ang isip, a term which is both cerebral and physical, and musical).

The TMC musicale got me thinking of how wonderful a musical performance can be used to generate social capital and memories in our institutions. But I thought, too, of how the staff would not have performed as they did if they did not love what they were doing in TMC — musicality in medicine when you think about it.

More dire, more infectious than the bacteria and viruses is despair, and this is where faith must come in, a faith in the competence of individuals and institutions, as well as a faith in forces more powerful than we are. I thought of Dr. Bengzon’s faith — through some pretty tough times — in the abilities of people, and of the Filipino.

Not just in hospitals but in medicine and health care, music and faith must come together as a partnership of people, patients and providers who trust each other, committed not just to fighting disease and death, but to fight for life.

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