Sunday, November 6, 2022

Dear Modicum

 Dear Modicum,

I can't believe I stumbled upon you again today. Reading you again made me cry because it allows me to see how far I've come.

Modicum, I have so many things to tell you. I have now my own lovely family! Apologies it took me a while to get in touch, but I am still here!

I met Ishi in Auckland, and now we have two cuties named Lucas and Isla. Lucas was born in Aotearoa and three of us moved here in the Sunshine Coast in Queensland in 2018. Isla was born in 2021.

Career-wise, Ishi and I work at the Sunshine Coast University Hospital. I am currently completing my PhD at The University of Queensland while working part-time in ICU.

I feel very emotional right now reading at my emotive writings from years back. Thank you for being my avenue to reflect on my thoughts as it definitely helped me as I navigate this journey of life.

I am just here Modicum, and I will update you very soon with many photos of us and our little ones.





Tuesday, September 22, 2015

Symphonology in Nursing Care

Have you ever refused a distraught whānau or family member from entering the emergency resuscitation room because you think it is not a right thing to do?

In our daily nursing practice, we are confronted with varying human experiences that shaped our career. From asking our patients to tick their daily meal menu to administering medications, there is an ethical involvement. Complex as it may seem, ethical decision making on the part of the nurse is paramount in every aspect of nursing care. For an action to be deemed ethical, an underlying agreement should exist.1  For two people to beautifully dance a tango, an agreement keeps the synchrony, just as the agreement between the nurse and the patient, or the patient’s whānau when it is their call to decide.

As nurses, regardless of our ethnicities and geographical locations, we employ various models of nursing care. Most often, we perform our professional roles and responsibilities in a manner that suits our style. Our own techniques in delivering our nursing care make us unique as individuals. Knowing one’s style as a novice practitioner might be a challenge at the beginning, but as time passes by, we get to know our techniques of what we think is beneficial to us and to our patients. However, a question from hindsight needs a bit of a thought, “Do we do it right?”

In New Zealand, the Te Whare Tapa Whā and the Te Wheke Māori health models serve as guiding tools amongst health care workers in the delivery of care.10 These two models emphasise and recognise the importance of the roles of whānau members on patient recovery and general well-being. Although these health models are based on Māori culture, its applicability across different cultures is evident where the integral role of family on general health is crucial. These models have been adapted by hospital policy makers on the vision to provide a culturally safe health care. While some hospital departments foster a patient-centred care framework, some adapt a patient and whānau/family-centred care framework as an approach to quality health care among New Zealanders.3,4

Aim
This article explores the Bioethical Theory of Symphonology by James Husted and Gladys Husted, its applicability to our practice in New Zealand context and its interrelatedness to the health models familiar in New Zealand. Symphonology comes from the Greek word symphonia, which means agreement. This article will attempt to expound the Bioethical Theory of Symphonology using patient and whānau-based case studies approach.

Symphonology
The Bioethical Theory of Symphonology is a context-driven, ethical decision-making model that guides holistic interaction and explores the nature of agreements between patients and health care providers in diverse clinical settings. It is a bioethical theory developed by James Husted and Gladys Husted that centralizes on bioethics in patient care. It particularly presents the need to address individualistic approaches and to prevent the pitfalls of some bioethical principles. Symphonology emphasizes patient preferences, psychological and theological knowledge, and context of awareness and of the situation.1 Implicit in this theory is the preface that for participation to exist, agreement must exist between all rational beings.1

In the context of whānau-centred nursing care, the provision of care does not just focus on our patients but also the needs of the whānau in crisis, especially if the patient becomes incompetent to decide or there are no predetermined wishes of the patient to exclude whānau members in the plan of care. If our patients could not rationally act for themselves, we should remain to act as their rational advocates.

Bioethical Standards
Its goal is to ethically provide patient care using six bioethical standards. These standards are autonomy, freedom, objectivity, self-assertion, beneficence and fidelity. These bioethical standards serve as preconditions of each agreement. They reflect characteristics intrinsic to both health care staff and patient—to anyone who has the potential to make an agreement. For health care providers, these standards provide a means to learn more about the patient and identify aspects of care that need support.1

Autonomy
Autonomy is considered as the "umbrella of the agreement" – everything stems from one's core identity.1 The patient or the whānau use his/their individual rights and power to control and to fulfil their desires. It does not connote to the usual meaning of autonomy but to the uniqueness of a person as an individual. A whānau member may be very motivated to witness a cardiopulmonary resuscitation and to support the patient in this most critical situation. This may stimulate the patient's will to live or to provide comfort as the patient dies.5,6 The reason for his motivation to witness the resuscitation makes him a unique individual. The experience would help him confirm the reality of the patient's condition and may help him cope in the process.7

Freedom
The patient's whānau needs to have the ability and the freedom to act and to make decisions about his actions. Freedom must be a precondition to any agreement.1 A patient's wife utilizes her freedom by choosing to help the staff nurse performing a bed wash to her husband and by choosing to stay beside the patient during his futile times. The patient's whānau member chooses the actions that will help her cope in the process with what she thinks are convenient to her.

Objectivity
One’s intellectual capacity is known as objectivity.1 The need to be aware of all pertinent information affects the bioethical decision-making process. Hence, the healthcare professional provides information about the patient that aids the patient's whānau member to develop an objective view of the situation, which is a major factor in executing end-of-life decisions when emergency interventions fail. The patient's whānau then, has information to make the decision about the medical treatment and subsequent ways to whether or not withdraw patient's life support, when it becomes their call to decide on a patient’s behalf.

Self-Assertion
Before entering into an agreement, the whānau members determine that they have freely chosen to get well and stay well. The patient's whānau has the power and right to control their own time and effort known as self-assertion. This implies a person's self-governance.1 In desiring to control their time at this stressful event, they optimize the brief time that they have to be comforted by their loved one. Nevertheless, when there is an unexpected death, there will be no time for those last intimate moments.8 The nurse, along with the other health care team members, can control time and effort and be able to optimize it by arranging appropriate time for families to visit, whānau conference or making the whānau room available for them. In a clinical setting where a nurse caters multiple patients, it is deemed unethical for a nurse to stay longer with Patient A who has the same acuity with Patient B, simply because the former is more talkative.  A nurse can control time and effort via fair prioritisation of needs, boundary setting and by always putting in mind other patients who are yet to be attended.

Beneficence
If the clients cannot act on their own behalf, it is the health care provider's role to do what is for the patient's or the whānau’s best interest in a benevolent manner. This is called beneficence. Whānau members will be assessed by a health care provider for appropriate levels of coping, age limit, the absence of combative behaviours, extreme emotional instability and behaviours of concerns during emergency situations. The whānau will be presented with the option to be present and members who prefer not to be present will be supported in their decision. The desire to avoid an ethical dilemma or compromise in safety from occurring is the presumed benefit.

Fidelity
Fidelity is also considered as a base structure of an agreement.1 No agreement is established if there is no intent to be faithful. The patient or the whānau member needs to be true to his uniqueness; to stay true to the decisions that have made him who he is. This is fidelity. For the health care providers, fidelity is commitment to the obligation of our corresponding professional roles.1 The whānau members who want to witness resuscitation are expected to resume to normal lifestyle and to cope well the grieving process if in case emergency interventions fail. The team provides a supportive role to the clients during bereavement as a way of being faithful to the role. However, if there is difficulty for patients or whānau members to resume to normal living like unexpressed grief, it is the responsibility of the health care team to devise approaches e.g. adequate referrals in order to address the problem and to avoid the consequences that could occur. By taking this into account, we are being faithful to our professional role.

Symphonology and Cultural Defiance
While cultural factors need to be considered in caring for a patient, there is still no justification for refusing patient’s personal wishes considered defiant to her culture in order to serve as the standard of culturally congruent care.9 If the competent patient defies her culture and prefers for her needs to be addressed differently, her autonomy and her individual wishes have to be regarded. It is the nurse’s ethical responsibility to serve as her advocate for her wishes, unless when the patient is deemed incompetent to decide and there were no prior known wishes that it’s time for the next of kin to make a call. This is due to the fact that cultural differences can also occur between different persons of the same culture.9 For example, if whānau members coordinated with the staff about doing a prayer vigil at the sedated and intubated patient’s bedside and the patient had specifically expressed prior wishes to the nurse requesting not to have this done on her, it is the nurse’s responsibility to advocate for her and explain to the whānau about her wishes in a manner that this does not disintegrate the patient from her whānau onwards.9 The bioethical standards of autonomy, freedom, objectivity, self-assertion, beneficence and fidelity should be put into consideration to address her individuality, rather than addressing the culture through the patient.9

Pitfalls of Utilitarianism and Deontology
This theory is designed to avoid the pitfalls of utilitarianism and deontology.1 The central concepts in utilitarianism focus on good versus evil. With this principle, ethical decisions are guided towards achieving what is good for a greater number of people, regardless of what is good for the individual.1 If a showering a patient in the morning yields a presumed benefit to the majority and a nurse sticks to this principle, she will do this to all her patients; however, this does not benefit few patients who only shower every other day. If a nurse provides complex details about a new condition to an anxious patient who fears to hear anything about her diagnosis on the premise that this would benefit her, it breaches the ethical standards despite the fact that a greater number of people want to know everything possible.

Deontology, on the other hand is a moral principle that determines what is right from wrong based on the adherence to the rule. When making decisions, the individual performs his role, and his role is to do what is right. Not doing one's role is wrong.1 Chinn and Kramer (2004), as cited by Cutilli (2009) stressed that what is right may not be good; it may not lead to achieving a favourable outcome.10 A nurse who employs a deontological approach on her practice does her duty regardless of the consequence of her action. If the hospital policy is not to allow whānau to be present during cardiopulmonary resuscitation in the emergency department and the health care provider sticks to the rule because he thinks that it is his duty to abide to the unit policy, it is considered ethical under the deontological principle, but this may not lead to a good outcome for the whānau member who prefer to be present, which may lead to heightened anxiety and unexpressed grief. While health care providers worry of negative psychological aftermaths on witnessed resuscitation, evidences on studies show that there is no or lesser negative psychological impact on relatives who witnessed than those who did not.11,12 Unexpressed grief leads to unresolved grief and is a known contributing factor to high cases of mental health issues.

As we further encounter bioethical issues in our practice, it is very important for us as health care providers to unlock the barriers that hamper a coordinated delivery of care. Agreement is the basis for a coordinated partnership, which enhances a smooth delivery of care in the process. By applying this bioethical theory in practice settings, we can bridge ethical gaps. As Cutilli (2009) implied, it is not a complicated job for the health care team to do especially for nurses, since most nurses are doing this already without the realisation of it. A nurse gains a feeling of efficacy for oneself by being a "consistent ethical agent" for the patient and their families.10 This is achieved by having awareness of the terms of the agreement and of the importance of the contexts within the agreement.1

Summary
Caring is the core embedded in our nursing profession. For an effective and efficient delivery of care, both patient and staff must be on the same light. It is by virtue of agreement that care becomes congruent to the individual needs of our patients and it is by then that care becomes ethical.

The writer currently works as a staff nurse in the Department of Critical Care Medicine at Auckland City Hospital in Auckland, New Zealand. 

This is the original  article of the same sort published in Kai Tiaki Nursing Journal, New Zealand, August 2015.. 

References

1. Husted, J. H., Husted, G.L. (2008) Ethical Decision Making in Nursing and Health Care: The Symphonological Approach (4th ed.). New York : Springer Publishing Company.
2. Ministry of Health. (2015) Maori Health Models. http://www.health.govt.nz/our-work/populations/maori-health/maori-health-models. Retrieved 07/04/2015.
3. Bay of Plenty District Health Board (BOPDHB). (2012) Excellence through Patient And Family-Centred Care. http://www.bopdhb.govt.nz/media/35057/1.1%20Literature%20Review.pdf.  Retrieved 07/04/2015.
4. Taranaki District Health Board (TDHB). (2014) Patient and Family/Whanau-Centred Care Framework. http://www.tdhb.org.nz/misc/documents/2014-Patient-Family-Whanau-Centred-Care.pdf.  Retrieved 07/04/2015.
5. Simpson, S. M. (2001) Near-death experience: a concept analysis as applied to nursing. Journal of Advanced Nursing; 36(4), pp520-526.
6. Laskowski-Jones, L. (2007) Should families be present during resuscitation? Nursing; 37(5), pp44-47.
7. Duran, C. R., Oman, K.S., Abel, J. J., Koziel V. M.., Szymanski, D. (2007) Attitudes toward and beliefs about family presence: a survey of healthcare providers, patients' families and patients. American Journal of Critical Care; 16(3), pp270-279.
8. Philips, B. R. (2002) Modern Medicine Network: Letters from the Heart. http://www.modernmedicine.com/modern-medicine/content/letters-heart?page=full. Retrieved 07/04/2015.
9. Zoucha, R., Husted, G. (2000) The ethical dimensions of delivering culturally congruent nursing and health care. Issues in Mental Health Nursing; 21(3), pp325-340.
10. Cutilli, C. (2009) Ethical considerations in patient and family education: using the symphonological approach. Orthopedic Nursing; 28(4), 187-191.
11. Robinson, S.M., Mackenzie-Ross, S., Hewson, G., Egleston, C., Prevost, A. (1998) Psychological effect of witnessed resuscitation on bereaved relatives. Lancet; 352(9128), pp614-617.
12. Jabre, P., Belpomme, V., Azoulay, E., Jacob, L., Bertrand, L., Lapostolle, F., ... Adnet, F. (2013) Family presence during cardiopulmonary resuscitation. The New England Journal of Medicine; 368(11), pp1008-1018.       

Sunday, June 8, 2014

My 26th Birthday

  
 Coconut  from our backyard.
I spent my 26th birthday in the Philippines. I came from a remote village. I have to go to town to get an internet connection. The mobile phone signal is so scarce. Life there is so simple. It was a break from the real world. We just stayed at home and prepared food. There were many realizations. I am excited but a little bit nervous. When I go back to New Zealand, I will be studying. I still don't know what the future holds, but I am doing the best that I can do. This photo taken  was from our backyard, this coconut was taken by my father.
                                                    

Monday, February 17, 2014

Hospice Care in the Eyes of a Young Migrant Nurse

“Isn’t it terrifying for a young nurse like you to take care of a patient waiting for death to happen?” Gary asked. The sky outside the unit was dark on that cold winter night. His lampshade created shadows as I walked into his room.  His shortness of breathing progressed and I had the morphine elixir in my hand. That question was one of the most difficult that I ever had and even up to this date, it still strikes a chord in my heart.

Trained in the Philippines, I completed a Competency Assessment Programme for Overseas Registered Nurses prior to my practice as a registered nurse here in New Zealand. Bringing along with me my acute nursing experience back home prior to my move here, palliative care in a western world was a relatively foreign context. As our education is patterned and based in the United States curriculum and with our use of western books, the concept is introduced in nursing school but we have no clinical exposure as palliative care treatment is very uncommon back home. For most of us, it is out of the cultural sphere and the thought of palliative care alone inevitably brought shivers down my spine.

When my clinical placement was announced for the bridging course, I was lucky enough to have a choice. Our course coordinator asked me to choose between a geriatric facility and a hospice care unit for my clinical placement. Despite initial hesitations, I chose the latter. On the personal level, I had that self-imposed obligation to face that fear, to know about myself better. A new experience can be a great learning curve. In my mind, this can be a golden opportunity for me to learn about palliative care and more importantly, more about my job.

Here in New Zealand, most of the palliative care patients are referred from rest homes, public and private hospitals. Generally, they are not for resuscitation. An actual experience being exposed in palliative care was new for me to grasp and personally, my mind was not that wide open enough to entertain the concept in a broader sense. There is a big cultural variation on how we view death and dying. In the Philippines, it is common for most patients and family members to expect the health care team to initiate all the possible life-saving measures to prolong life despite agony and near-death. Most of them, if not, are for resuscitation and since palliative care is uncommon, it is also oftentimes, grossly antagonized. If the very morbid patients don’t die in the hospital, patients or family members prefer for the patient to be sent home before they die, where family members can take care of them and die in their care.  In a Western context, quality life and pain-free transition to the next journey takes precedence and palliative care is a widely-accepted specialty.

That experience gave me an idea how Westerners view death and dying, in comparison to how some Asian countries view it. At first, it was a big crisis on my part as it was preloaded in my thinking that health care is all about promoting life. With my experience, with all the great support that I received from the whole team, I eventually realized that promoting life is quite different from promoting quality of life. My latest experience prior to my placement was in emergency care and the pace is whole lot different as patients in emergency stay in the department for a shorter duration. In most cases, we see people in the emergency getting well. In the hospice, you can see how patients slowly die and your role is very important to aid them to have a graceful transition, with comfort, respect and dignity.

Gary was a diplomatic middle-aged gentleman with cardiac tumour with visceral thorax metastasis. He was in the unit for 2 weeks for palliative care. A night before he died he talked with me about so many things, asked me about my home country and I asked him questions just the same. When he asked that question about my job, my mouth was suddenly controlled with the pounding beating of my heart. Myriad of thoughts flashed into my mind.  I went speechless for few seconds. I told him it wasn't hard for me take care of people dying as I have embraced the idea of caring people. It was life-changing as it has taught me to understand more about life. Deep within me, I was emotionally shattered at the thought of seeing people go. Few hours later, his shortness of breathing progressed more than what it was and he was in painful agony. I sensed that for Gary, the end is near.

My preceptor rang the family who were two hours away and I helped her in preparing cocktails of morphine and midazolam for Gary. He went to slumber and I saw him being freed from the struggle that I saw in his eyes. At that time, I was emotionally struggling and it was a little traumatic for me to testify. His phone beeped many times. With permission from the immediate kin, my preceptor asked me if I could open the messages of goodbyes and read them to Gary. I went on to the patient’s side and read them loud enough for the patient to hear while she held his hand and while being in control of the drugs. I felt like shaking and was overwhelmed with sudden gush of emotions deep inside but I forced to compose myself and be calm as much as I possibly could. All I wanted was to cry while I read those messages of goodbyes from his family members and friends. It was heart-hammering, yet life-changing. It was an experience fully loaded with cathartic emotions, introspection and interpersonal adjustments. On the brighter side, my understanding in palliative care broadened into a greater perspective.

Admittedly, it wasn't an easy process but I was wholly grateful. When I reported on duty the next day, the patient was no longer in his room. I was sure he had a peaceful transition from life. It made me realize even more that it is not all about exploring the technicalities of nursing but significantly, the interpersonal aspect as well, as both of them are equally important. As what nursing theorist Hildegard Peplau stressed in her Theory of Interpersonal Relations, the nurse-patient relationship is a “significant, therapeutic interpersonal process” and the importance of nurses’ ability to understand their own behaviour so they can help others identify perceived difficulties is paramount in nursing care.

True indeed, for me it was a great learning curve. The experience didn’t teach me about death. It taught me more about life. It also made me to think deeper on why I become a nurse.

The name used in the article is not the patient’s real name.

This is the original  article of the same sort published in Kai Tiaki Nursing Journal, New Zealand, May 2014. 

Sunday, February 9, 2014

As The Wheel Turns

I came earlier for an afternoon shift.

Today happened the most  moving moment I've ever encountered in my entire nursing life. Diana was admitted to our neurosurgery high dependency unit. She was brought in via ambulance from another facility for neurosurgical input and along the way, she developed an airway problem. CT scan showed intraventricular haemorrhage from an aneurysmal source. 

I took over the care few minutes after I arrived in the high dependency unit. As Diana and the nursing team awaited for further planning as neuroradiology team could not decide yet whether to push through for a neuroradiological intervention this time given the unsecured airway, I took over the care from a colleague who was due to go home. I was doing a jaw-thrust manoeuvre for an hour and a half while securing Diana's LMA. I reassured her to calm down as it was such a difficult time. 

Looking back on her comorbidities, the intensivist consultant said that the risks will outweigh her quality of life thereafter. Diana's cognition was intact, remained fully aware and insightful although she had unilateral ptosis and facial paralysis. The intensivist explained to the family at the bedside the prognosis. I asked a colleague a pen and paper and give it to Diana, in the hope that she may write things down while I was doing a jaw-thrust and securing her airway. 

She wrote down something.

"Talk directly to me", 
while the intensivist explained things to the family. 

She was given the options. 
Then she wrote down something again.

"Just make me comfortable."

I left work with a very heavy heart.

Name used is not the patient's real name.

Saturday, September 7, 2013

On Searching Dreams




Just a while ago while on my way to take bloods and put an cannula on a patient, my attention was called up by an elderly patient walking in the corridor, whom I looked after two nights ago while he was in the neurosurgery high dependency unit. 

He grabbed my attention. He told me, "I always think that you should train to become a doctor". I saw sincerity on his eyes. I was speechless for few seconds. I replied, "Thank you." Did he know that's what I want all my life? 

My heart melted and it made me think more about my dream again. I am living with it. I am actually waiting patiently for the right time. He is not the first one who tell and often ask me that but his sincerity so warmed my heart. Why would a person stop you randomly on a busy paced day just to tell you that?

Saying a little more, he quipped, "You know what, this is what that I want to tell you. When you will become a doctor someday, always remember that you become a doctor because God wants you to become a doctor." I gave him a wee tap and thanking him that it's so nice of him to tell me that.

It gives me flashbacks when I started my nursing practice here in NZ, in Invercargill Emergency Department. Many times, I got asked by patients why don't I want to train becoming a doctor, with a very notable one from a mother who has a son who is a medical student in Otago. One time I discussed with the Critical Care Intensivist the current management the critical patient already had and discussed with her the labs done. At one point she asked, what else have you charted? I said, "Sorry, but I am the patient's nurse." By saying this, I also encountered being dealt rudely by some other doctors and even to newbie doctors who think that we are just "nurses" literally. They are the kind of doctors who only have a little idea what modern nursing is. They are the kind of doctors who don't listen to nurses and don't consult with nurses with their management. They are the kind of doctors who treat nurses as subordinates rather than colleagues. I also meet very wonderful and intellectually and clinically shrewd doctors. If I become a doctor someday, by God's grace, I will be the kindest doctor that I can be and of course, I will do all my best to use my mind and hands for the purpose of my existence and my profession.

Back to the point, every time I meet a doctor with a very good clinical eye or listen to some innocent questions from my patients, it made me smile. Becoming a doctor takes almost the entire blueprint that I designed for myself since I was very little. Due to lack of financial resources back home, going to medical school is like daydreaming.

I strived hard to be away from home because "my" home was not the usual definition of home.  Our place was rural but it wasn't a safe place. Indeed, no place is ever safe. Not even our own home which we think is the safest place on earth. It was a home of childhood pain, mental and psychological trauma from a sexual predator. I was dipped into a deep sea of guilt, depression and isolation and worked hard to fight against the waves that drove me away from my purpose. All my life since I can remember, I have been wanting to be away from that "home" where my childhood trauma of molestation and sexual abuse took place. I have been seeking for personal refuge and freedom anywhere in the world where I think there is a chance to celebrate life, and literally to live life. 

I am so glad God sailed me to the shores of New Zealand after an arduous chase. From taking IELTS, studying for a masters degree, volunteering RN jobs just to get experience to getting a paid one, teaching part time to sustain a living in a big metropolis, the thought of being away from my family, to processing my NZ registration papers and eventually coming here in New Zealand from my humble beginnings, tears set forth through my eyes. I couldn't believe I have gone this far. 

I believe that I am now in a place where there is a big energy that I will be able to connect with in the right time. I feel so happy, filled with content at the thought of the coming of that time.

I will be the happiest boy in the world.

Wednesday, July 24, 2013

My Heart on the Crying Cop and on Activism

It's my restday today and one photo online stroke a chord in my heart about my home country, The Philippines.

I admit the fact that when I was younger, in my heart poured activism. It was important for me to survive, being one of those kids struggling to get a decent education, to fight for my rights in a place where only the rich have the bigger voice. The Philippines is a very nice place for the rich. For the poor, it is sad.

For me, being an activist blinds you to the happy side. It made me sensitive to the social issues, most often forgetting my personal ones. It was a tough decision, from being an idealistic kid, wanting to be a part for a bigger change of an ailing society for the unfortunate to become someone trying to focus more on himself for brighter tomorrows. I prefer the latter. I always believe that there is a bigger change if you start it from within.


Fighting for a social change is heroic but fighting for a personal change for me is more beyond heroism. For some of my countrymen who have near death experiences because of your activism, for a friend who was killed because of that, you are heroes. I so feel what you feel and I highly respect you for that. As the seeds of activism start to sprout within us, the feeling is so immense. I have been there. Although I recommend activism at so many points in our lives, I don't recommend you to overdo it. We can choose to be happy and exert more effort changing ourselves and we can be an agent of change for our society at large, rather than going into streets most of our lives shouting against the government, hoping for it to change.


The Philippines has generally bad governance and justice system but this does not mean we don't have good politicians. There is too much democracy and often we obliged ourselves to say something and as a consequence, bills for social change take time to become good laws, and often they don't become laws at all. We always yearn for social change, yet we are the only ones who are halting the speedy process and left us all stagnated.


I understand the anger flowing into your veins for the cases of injustice our fellowmen suffer but there is more to life. We can still be a person to others in our little ways. As a great philosopher said, we can not light other's path without brightening our own. To PO1 Sevilla, high salute for you Sir. I just couldn't understand how a government fail to feed its cops or intend them to experience hunger, especially if you are still junior police officers. I have a very high esteem on you Sir. My brother is a police officer back home and I was a witness on what he went through from being a trainee to climbing up the ladder. You go through starvation as a part of the training and honestly, it made me shed tears, a lot for these aspiring young men in uniform. My brother shared the same dream with me for a social change.


For me, we all have social responsibility but let us not forget that we also have a big personal responsibility for ourselves and by saying that, let's take time to take charge of our own personal lives first. We often listen too little but reacts too much and hitherto we fail to realize the more important things. Admittedly, despite the booming tourism in the country, there are still so many people below the marginalized poverty line. We are still in the ashes. We can then start to ponder. From the ash of the hopeless struggle, let's start from deep within ourselves and from there, let's see little by little our beloved Philippines soaring high again like an eagle.


THE STORY BEHIND THE CRYING COP

By Rem Zamora


It all started peacefully.


People were starting to converge along Commonwealth Avenue in Quezon City early Monday morning, a few hours before the State of the Nation Address.

Street vendors were selling kwek-kwek (quail eggs), bottled water and other drinks while kids were roaming around the car-free Commonwealth Avenue looking for coins dropped by passing vehicles the previous days.

What set the scene apart from an ordinary day along the busy highway: container trucks and barbed wires were in place, signs of of things to come.

On the other side of the fenced area, policemen were lying on the road resting. Some of them had been posted there since two days ago.

Chaos

At around 11:00 a.m., a big group of activists arrived near Ever Gotesco Mall. The protests began.

Activists hurriedly removed the metal fence on the island, allowing them to bypass the police barricade. Anti-riot policemen from the other side of the road ran and tried to block them, but the protesters pushed through.

There was one policeman who flashed a peace sign to the protesters, asking them to remain calm. He urged activists to hold a dialogue instead of resorting to violence.

And then chaos began.

On one side, policemen blocked and pushed protesters away. On the other, the activists told the first line of security that they wanted to go near Batasan Complex.

Rocks were thrown and people were hit with truncheons and shields. Most of the members of the media stayed on top of a dump truck to give them a good vantage view, while some remained in the middle, sandwiched by the clashing protesters and policemen.

Crying Cop

It was a long and tiring dispersal. According to reports, at least 50 were injured in the clashes.

But amid the chaos, my lens caught a scene I thought I would never see during a dispersal.

A foreign protester was berating a policeman asking him why they were hurting the people. “Why are you doing this to us? Why are you hurting us?!”

The officer simply stood his ground. “I am a policeman, I’m just doing my job.”

He said his job was to maintain peace and order. He said they were given orders and they had to follow.

Suddenly, the police officer cried.

The foreigner kept on shouting at this officer. But the policeman couldn't stop crying. He was trying to hold his tears, but he couldn't.

Another round of clashes erupted. The policemen were still trying to push and shove the protesters away. The crying cop simply stood his ground. He was still holding his shield firmly. Still weeping, sobbing.

Later, I approached the policeman and asked him his name. He said he is Joselito. A quick glance at his name tag revealed he is policeman Joselito Sevilla.

He said he is a private, and his uniform patch showed he is from the Marikina police unit.

Asked why he cried, he only said: "Sa gutom at pagod. Walang tulog. Walang pahinga. Dalawang araw na kami naka-deploy dito. Tapos ganito, nagkakagulo."

It was also PO1 Sevilla's first dispersal assignment.

Realization

I finally understood him. No sleep. No food. No rest. And he came face-to-face with protesters whose goal was to break the police line.

Sevilla was physically and emotionally exhausted.

But he was following orders. He was just doing his job not to let protesters get near the Batasan Complex.

He did not hurt the protesters, even if some were already throwing rocks and hitting cops with wooden sticks.

Finally, some protesters noticed him, too: a policeman, whom they expected to retaliate, was in front of them, holding his shield firmly, weeping.

And then they started to console PO1 Sevilla. A man held his shoulder, telling him that everything would be alright. Another woman comforted him, as she tried to give him a handkerchief to wipe his tears.

Amid the chaos, these two protesters hugged PO1 Sevilla and assured him everything would be fine.

Seconds later, other policemen noticed what was happening and they moved PO1 Sevilla away from the front lines, away from the activists.

I was caught in the middle and I couldn't find him anymore. He was gone.

Show of Strength

State forces, especially policemen, are expected to be firm and not show emotions. What PO1 Sevilla did was not what was expected of him.

Did the other anti-riot policemen remove him from the front line?

This incident only shows we are all human beings. It is not bad to show weakness by crying; that we can still do our job, stand our ground, but still be peaceful and not hurt another human being; that two opposing groups can still show compassion as shown by the man and woman who hugged PO1 Sevilla.

Hours after the violent protests, I reviewed my set of photos taken during the day. I smiled when I saw the photo of the policeman flashing the peace sign before the dispersal. It was PO1 Joselito Sevilla.
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