Inevitable

The hospital trips began when I was nine. They found a tumor in my mother’s arm and had to remove the mass, leaving a neat, raised scar on her tender skin. Later, they discovered that it wasn’t enough: They had to amputate most of the limb. Still later, they discovered that even that wasn’t enough: Some of the disease had found its way into her lungs, cancerous and dire.

By the time I was 11, my mother had undergone several chemotherapy sessions and I had memorized what “MRI” stood for, memorized the odors of the different hospital floors, memorized the seesawing between sick and hopeful.

This was when my 11-year-old mind started wondering: Does cancer exist in the slums?

Surgeries, chemo cycles, and the endless tests in between: How could a family afford it? My father and relatives barely pulled off a miracle to outlast the bills—a miracle made up of loans, PhilHealth benefits, and all sorts of prayers. But what about those who don’t even have a decent home, or three square meals a day?

I desperately hoped that if cancer—or hypertension, or diabetes, or any other costly disease—mercilessly arrived at their doorsteps, they would be able to survive not just the disease but the costs as well.

Of course, I would later realize that this was often not the case. Many just die. Many just deny the existence of disease in their bodies and go on as usual with the daily grind without so much as seeing a doctor. Inevitably—and likely prematurely—they pass on.

We often feel anxious when faced with an illness, and are paralyzed with hopelessness when faced with the potential expenses. In this country, it’s easy to see why.

Estimates for a single chemotherapy session in the Philippines range from P5,000 to as much as P100,000, depending largely on the type of chemo. A biopsy might cost around P2,000. A single mammography session—just to get an initial assessment of a lump in your chest, just for a chance to sleep better at night—costs about P2,000 as well.

The minimum wage of Filipinos ranges from P444 to P481 a day. Many earn less.

It’s no wonder people still dismiss cancer as pangmayaman (for the wealthy), when it is in fact among the leading causes of death in the Philippines. You hear people say they’re skipping a due checkup or foregoing a biopsy because it’s costly. Diagnosis, a first step in treating an ailment, is waived. After all, many would say, if you haven’t been diagnosed of an illness, you can’t say you have it.

Life is precarious and death is inevitable, but even more so in a country where healthcare and medicine are almost a luxury. It is inconceivably tragic that many of us have to give up trying to survive simply because they cannot afford it.

It is even more intolerable to think that much of this is because of the various injustices that tend to appear on medical bills—overcharging, overpricing, redundant fees, and so on. Further, we still keep hearing of cases where hospital patients have to show that they can pay the amount demanded, no time for questions; otherwise, they’d be left unattended in a ward or stuck in the lobby, their medical care so easily taken hostage.

No doubt there are doctors and hospitals that remain true to their duty to heal instead of merely making profit. No doubt there are ways to make healthcare more accessible and medical costs less daunting. These need to become a universal setup instead of the rarity that they are today.

A conscientious audit of Philippine healthcare—from the costs of procedures, the rates and services of medical professionals, down to the prices of the most ubiquitous generic drugs—is crucial. Certainly, there are existing regulations to help keep prices and services in check, but bearing in mind how much a common Filipino family earns, such regulations have a long way to go in doing their job.

We can hope for the day when we no longer have to be afraid of unjust medical costs, but what of the here and now? How are we supposed to react to an illness when God knows the cost of treatment only adds to it?

It’s the easiest thing to give up, shut our eyes to the difficulty that looms, and just roll over when the body collapses. But somehow, we have to keep trying, to keep wanting to live, to find a reason to get that treatment done despite it being another financial dilemma to hustle for.

Our reason to live cannot stop the inevitable, but it can make everything worth it until the inevitable comes. It is holding a long-awaited grandchild in our arms for the first time, seeing the ribbon on a son’s graduation toga, feeling the warmth of a husband’s hand. It is strength in the face of hardship, joy blooming in a field of sighs, love in the time of cancer.

I saw it. After years of hospital visits and noting my mother’s hair growing thin, I woke up one morning to be told that she had gone. All those procedures, all those loans—they were a sand castle we built to be lapped up by an unstoppable sea. That’s the inevitable.

But it took years to take her because she put up a fight. And in those years, she taught me to bake, sang songs with my sister, and laughed loudly with my father. On Feb. 14, the morning before she left, we baked a cake together—me serving as her supplementary arm, and she pouring love with the batter. She strived to live, and she did it well. Inevitably, that’s how I’ll remember her.

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 hyacinthjt@gmail.com