‘May go home’

In the hospital, a place where the worst can happen, there are fewer words in the clinical vocabulary that can evoke joy, comfort, or at the very least relief, than the phrase “may go home.”

For some, it represents the end of an illness that brought them to the hospital, like a high school kid who had acute appendicitis or a child who had dengue hemorrhagic fever, and after rounds of platelet transfusion, is healthy again.

For others, it represents a beginning, like welcoming a newborn baby into the family, or starting to live with a new condition, a new organ, a new routine.

Then there are those for whom it is neither an end nor a beginning, but a continuation of long-term struggle with a condition, or multiple ones, that brings them in and out of the hospital.

Regardless, “home” represents a kind of comfort and care that a hospital cannot provide, no matter how modern or technologically advanced.

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In the past, it has been the preoccupation of clinicians and public health practitioners to make everything “hospital-based,” informed by the idea (supported by evidence in many instances like childbirth) that anything outside is dangerous, and conversely, being in the hospital is the safest and surest way for patients to recover.

Recently, however, there has been a growing return to an even older idea of “home-based” care, from home visits to equipment like hospital beds and oxygen tanks that allow people to just stay at home. There are many reasons for this trend, which has been enabled by technological breakthroughs like telemedicine and portable devices: it saves money, makes the patient (and caregivers) feel much more comfortable, prevents the dreaded nosocomial (i.e, hospital-derived) infections (such as those depicted by Korina Ada Tanyu in a similarly titled piece in “From the Eyes of a Healer,” edited by Joey Tabula). Perhaps most importantly, being at home preserves the patients’ sense of dignity and familiarity amid the unfamiliar, often undignified, experience of illness.

I was reminded of this when I was interviewing traditional healers around the country, and a “hilot sa panganak” I met in Bontoc, Mountain Province explained that the herbs and massages she prepares after delivery gives so much “ginhawa,” unlike in hospitals were patients are just left in maternity wards by themselves; one of the most important events in their lives surrounded by strangers. Can we not combine the strengths of both the hospital and the home, in trying to make people feel at home in hospitals, but also in trying to enable quality care in people’s homes—and not just for the rich who have always been able to afford it?

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Health-care workers love using clinical language for themselves, too, and we also used “may go home,” MGH, in charting our lives. “May go home na ako sa wakas,” as a Philippine General Hospital intern might say as he walked along Pedro Gil, eager to have breakfast and a shower.

When I was a medical student, there were times when coming home to Laguna meant braving the kilometric queue of bus passengers in Buendia, especially around Christmas. I would just volunteer to stand in the aisle for the 2.5-hour ride just so I could come home sooner, and my effort will be recompensed by the joy in my grandparents’ faces: a mirror of my own. It was the same joy I saw in my Lola Belen back at the height of the enhanced community quarantine in 2020, when I showed up in her house after several weeks of her not being able to see any family member.

I am reminded of all of the above as I make my way home for this holiday season. In Filipino, home is a noun, “tahanan,” a zone of safety and comfort; a place where one can wipe one’s tears. But home is also embedded within a verb, “uwi,” and “pag-uwi” is not just an act of going to a certain place; it involves making that place home; it implies longing and belonging, which is why when we say “uuwian,” it can refer to people as much as places.

Such insights can refer to care, too, and how much of it depends on our efforts. Indeed, like the “bantay” who provides not just logistical but also emotional support, we are in a position to support our loved ones, in sickness and health, in more ways that we realize, and our health-care system should think of how to recognize this as a form of care in itself and facilitate it as a therapeutic ally instead of restricting it, as when hospitals severely limit visiting hours.

Which is also why we need to reflect on how we can make our homes better sites of care, not just in terms of technologies that make home-based health care possible but also in terms of normalizing the very possibility of the home as a site of care—including palliative care, physical therapy, and other needs that often escape clinical attention. And also in terms of skills that let people be effective means of support, from providing first aid to giving psychosocial support.

Of course, coming (and making) home requires having a house or a place to stay in the first place; adequate housing has long been recognized as a “social determinant of health.” But beyond calling for such structural reforms, we can also play our individual parts—including making a commitment to go home for the people for whom it matters.

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