Doctors

After leaving Dr. Libarnes' Cardinal clinic with my diagnosis on June 23, 2009 I consulted with 6 other doctors regarding treatment (Dr. Libarnes himself was not a surgeon, and therefore could not be responsible for my care). Overall, with the exception of one particular doctor from that hospital where politicians seek political asylum, I found them to be a great bunch, generally brilliant, compassionate, and kind. I'd like to mention some of them here:

Dr. Charlotte Chiong - Neuro-otologist, Capitol Medical Center. She partners with Dr. Gap Legaspi as the neurosurgeon, and together they form the Batman-Green Arrow team that performs Approach #2 surgeries. I did not have the opportunity to meet Dr. Legaspi. What I remember the most about Dr. Chiong was that she spent a full hour with me during the consult. Out of the corner of my eye, I kept sensing her secretary signalling to her that she had to be somewhere else soon, but her demeanor never changed, her patience never wavered.

Dr. Ed Mercado - Neurosurgeon, Cardinal Santos Medical Center. A dynamic personality who oozes competence and confidence. Can switch comfortably between boardroom English and street slang. In short, a cool guy who's the best at what he does. I've been trying to think which local actor I would choose to play him (since this is often a good way to describe someone). Probably Eddie Garcia (a younger Eddie Garcia of course).

Dr. Willy Lopez - Neurosurgeon, Medical City. More of the quiet, studious type. Radiates intellect and compassion. Probably to be played by Rowell Santiago. Rowell Santiago today, not Rowell Santiago of the Sharon Cuneta days.

Dr. C. F. Fung - Neurosurgeon, Private Clinic, Hong Kong. - Arguably Hong Kong's best. Level-headed, mature type who was remarkably gracious answering our questions mostly posted through my cousin Jarvis who's a doctor in Hong Kong, although eventually I did have a personal consult with him in early August. Closest guy I can think of to play him would be John Woo himself in a cameo role, wearing a crazy wig. :-)

My sister Jocelyn also had a number of phone consults with some US doctors, namely:

Dr. John Adler of the Stanford Medical Center
Dr. William Slattery of House Ear Institute
and
Dr. Michael McDermott of the UCSF Medical Center

Overall, these guys also left me with the same general impression: Brilliant, thoughtful, deliberate, with a touch of humor and compassion.

Now I had to pick one, a process which is infinitely more difficult than deciding on which actors would play them. :-)

In my family there was, I guess understandably, a strong preference to see me seek treatment in the US. I really do see their point; all other things being equal, the best US doctors are probably a bit better than the best Philippine doctors, only because they have better access to technology, and have had a larger pool of patients to gain experience on (because of the much larger US population). In fact, I remember that during my first consult with Dr. Mercado, I asked him the following question: "If I were your son, what would you advise me?" Even he acknowledged that he would send me to the US but only provided it was to one of the top 5 surgeons.

BUT, the way I looked at things, all other things were not equal. I told my family that surgical skill was only one factor, we also had to consider logistics, comfort, and resources. Dr. Mercado also inadvertently touched on this when he answered my question above. He said that Filipinos not only did not end up with the top 5 surgeons, they tend to end up in the US equivalents of Dumaguete or Cagayan de Oro, simply because these places were where their logistical support and resources were.

As Sun Tzu once said:

"When an army is dispatched on a distant campaign the expenses borne by the people together with the disbursements of the treasury will amount to a thousand pieces of gold daily. There will be continuous commotion both at home and abroad, people will be exhausted by the requirements of transport, and all affairs will be disrupted."

I told my family that I had no doubt they would be willing and ultimately able to help and support me whatever the resource requirements. But I asked them if such would be practical? Are the differences in technology and surgical skill so large and so clear that we should ignore all other considerations and seek treatment from top surgeons in the US? Difficult to answer, but I believe the answer is "no". I would much rather have very good treatment here at home, see my daughter before leaving for the hospital, and recover on my own bed.

In the end, after a few difficult weeks, I decided to go with Dr. Ed Mercado, for the following main reasons:

1) He inspires my confidence. For both tangible (i.e. reputation, record, etc.) and less tangible (i.e. demeanor, "connection", etc.) reasons.

2) I am comfortable with his methodology - to "debulk" the tumor or make it smaller by removing its core, leaving behind the shell which will later on be "killed" via Gamma Knife radiosurgery. In my layman's mind, I am convinced this method provides the best odds of leaving the cranial nerves intact.

3) I have a preference for having treatment in the Philippines and recovering at home.

Accompanied by Kathy and my sister Christine, we went to see Dr. Mercado last August 6 to set a surgery date. I am at peace with the decision. I believe God was with us then, and I believe He will be with me six days from now...