Seedlings

What makes a child grow up to be cruel and manipulative?

This was the question posted to me by the mother of a patient. The parents were concerned about their nephew (let's call him R) whom they thought had a psychiatric problem. During the consultation of their child (let's call him B), I was wondering were the 7 year old B got the ugly bruise on his chest. His 15 year old cousin R was the culprit. The parents of R had begun to worry about B playing with his cousin whom they felt were bullying him. They noticed this happening about a year ago when B came home with a lump on his head. He said that R had hit him with the baseball bat. When R was confronted, he showed no remorse and gave an excuse that B deserved it because he had touched his "stuff". From then on, they asked B to stay clear of R. But as children would have it, kids will always forgive early...only to suffer again later.

I am not a psychiatrist and did not delve into the dynamics of R. It was this recent consultation that I found strange because this time the parents of R came along. They were concerned that their son had a "mean streak" and that he seemed to be oblivious of other people's pain. They have received several complaints from the school officials that the boy had been causing some raucus, such as decapitating a cat, throwing wet toilet paper on the ceilings and writing graffiti on campus walls. He would be caught stealing things belonging to other people.

During the short interview, they seemed to be good parents. R has 4 other siblings and is the second to the eldest in the family. All the other children do not seem to have behavioral problems. R seems to be alienated from the other siblings and would prefer to be on his own. Even family gatherings seemed to be more stressful with R around.

This was not a simple case of behavioral or conduct disorder.

From the discussion I had with the parents of R, he exhibited key characteristics of a sociopath:
1. no conscience
2. felt no remorse for what he did and does not care about other people's feelings
3. behaved as his the world revolved around him and thought other people existed for their own benefit and did not have the right to exist
4. treated other people as objects and is a "control freak"
5. hurts those nearest and dearest to him
6. monumentally self-important and thinks that he has great control over the world
7. habitually dishonest
8. is abusive in emotions and is highly manipulative
9. gets "off" committing acts bordering or are considered criminal in nature and has hypersexual preoccupation unusual for age
10. no empathy for other people or living beings

A sociopath is one of the antisocial personality disorders (APDs). When Pinoys label you as "anti-social" they don't actually mean that you're a sociopath. It's probably because you refuse to mingle with the crowd. The DSM-IV of the American Psychiatric Association defines APDs as "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood."

The key words here are: pervasive pattern, violation of rights of others, and begins in childhood.

Many of the parents think that their kids are probably "simply misbehaving".

The root problems of APDs stem from both environmental and genetic factors. Although the individual must be 18 y/o before one can make a diagnosis of APD, adults diagnosed to have APD are more often than not diagnosed to have conduct disorder as children.

I am glad that parents are taking a more pro-active stand on recognizing mental disorders among their children and seeking help. Physicians (pediatricians in particular) should be able to recognize behavioral, conduct and personality problems in their practice early on. After all, our practice is not simply checking whether the kid needs an antibiotic or it's time to give the next vaccine for their well child visits. In the routine out-patient clinics we have, it would be good to recognize tell-tale signs of problems among the kids during their clinic visits. You can strike up a little conversation with parents on how little Juan or Juanita is doing in school and observe his or her relationship with the parents and other children in the waiting room. Body language reveals a lot of information and our eyes are one of the best diagnostic tools for a quick physical examination of what's going on with the child.

The World Health Organization (WHO) uses the term Dissocial Personality Disorder in place of APD. It is characterized by 3 of any of the following:
1. Callous unconcern for other's feeling and/or lack of empathy
2. Gross and persistent attitude of disregard for authority and laws/rules/regulations
3. Incapable of maintaining enduring relationships
4. Very low tolerance to frustration and low threshold for aggression discharge (including violence)
5. Incapable of guilt feelings and does not profit from punishment of any form
6. Usually blames others or offers plausible explanations and rationalization for the behavior bringing the subject into conflict
7. Persistent irritability

While there may be subtypes of antisocial behavior, it is important to remember that anxiety disorders, personality disorders, depression, narcissism, somatization and substance abuse are closely related with APD and that patients will benefit from an over-all assessment rather than simply diagnosing the individual as one particular disorder.

While the American Psychiatric Association has removed the clear demarkation between psychopathy and sociopathy, evidence in the literature demonstrates that criminals fulfill most if not all the criteria of an antisocial personality disorder.

David Lykken believes that sociopaths have normal temperaments, unlike the psychopath. The psychopath has a negative temperament which makes him engage in risk-seeking behavior and is unable to internalize social norms. The sociopath on the other hand have a personality disorder due usually to parental neglect, abusive environmental set-up, peer delinquency, and either extremely high or low intelligence. Either category, however, is probably an interplay between environmental factors and genetics.

The problem here is that most patients with APD respond poorly to interventional therapy. Medications can address some of the co-morbid social and/or mood disorders associated with the APD. No clinically controlled studies are well established to improve outcome of patients with APD. It's one of the theories why criminals diagnosed with APD have poor outcome in spite of rehabilitation. Which means that either incarceration or any other punishment for the criminal offense has no remedy. When these people are released from prison, they simply commit the crime all over again. Usually, the next criminal acts escalate to the point of being fatal.

I've always believed that children are like seedlings. We plant them on either good or bad soil and watch them grow. How we take care of them during their growth matters a lot on their outcome in life later on.

It is good to remember:

"Bad families don't ruin good children. Bad children ruin otherwise good families."

[For more information on criminality, gangs and street crimes and the roots of sociopathy among criminals, you can reference http://people.missouristate.edu/MichaelCarlie/what_I_learned_about/GANGS/WHYFORM/pathological.htm]

12

That's the age of puberty for most males.

That's the average age of menarche for females.

That's also the age of the mother of one of my patients.

She could not recall the events that led to her pregnancy. After a drinking spree in a party, she woke up to 6 high school boys sprawled on the bed. She casually picked up her clothes, got dressed and went home. She is a smoker, gets bad grades in school, has had 5 boyfriends and has her life centered on the internet 10 hours a day.

These details, I got from her obstetrician. Other obstetrical and gynecological history were vague as both the mother of my patient and her parents had clammed up.

I know that many of my colleagues in Pediatrics and Obstetrics will let you know that there has been quite a shift in the maternal age of pregnancy lately. When I started my pediatric practice in the early 90s, the average maternal age for first pregnancy was between 25-28 years old. At the turn of the 21st century, the average maternal age for first pregnancies in my practice dropped precipitously to 18 years old. It was also the same time that I noticed that I had a wave of patients from unwed women whose ages ranged between 12-16 years old.

One of TIME magazine's cover read "Children having children". Teenage pregnancies are intertwined in a social and psychological complex.

First and foremost is the fact that teenagers are not prepared to rear children. Both parents, especially if both are in their teens, are emotionally, psychologically, and financially unprepared for this kind of responsibility. Children are not dogs that cavort on the streets to deliver puppies later on. Teenagers who get pregnant are still in school at the time of pregnancy. Surely, the libido of both parties whose hormones are at its peak are probably at work here. But libido does not provide food on the table.

I can only blame media for the increased rate of teenage pregnancies. While media will always hide under the "first amendment" or "freedom the press", it cannot be underscored that they have played a major role in the formation of both good, bad and kinky ways of the public. Obviously, the greatest impact is on the most gullible - the young and the ignorant.

The advent of social networking and the world wide web has made predators of the young and foolish, curious and stupid, easily accessible. So you have both informational and pornographic sites accessible to the young and the restless.

Second is a personal observation. All (and that is not an exaggeration) of all my patients from teenage pregnancies have the worst pediatric visits in the clinic. The immunization status of their kids are incomplete. When the grandparents have time, they bring the grandchild to the clinic. And they pour their hearts out at how their lives have turned topsy-turvy since then. One grandparent had asked me to talk to her daughter and her partner (16 and 17 years old respectively) on taking on more responsibility as parents. I told her, "I can only provide some advice on child rearing, but the total responsibility rests on your lap, not mine." I mean, if her daughter got impregnated at 15 years old, who am I to be convince her to change the kind of lifestyle she leads? Shouldn't she have done that when she was rearing her daughter?

I have a patient born to parents who were 15 and 16 (mother and father), 4 years ago. After a year seeing them regularly, the visits became irregular. During the visits at the clinic, I was always exasperated at how they were not able to comprehend any explanation I provided during both the well and sick baby visits. Their major concern always was not at the explanation of the immunization benefits or the disease process and care for the sick child during the visits. It was more on the expense! I lost them to follow-up after 1 1/2 years. One day, I received a text message from the mother asking me what antibiotic they needed to give her kid because her kid's been sick for over week already. I told them (like I tell all my patients) that I would want to see them at the clinic (I am not a seer as most people think). After window shopping from one physician to another, I finally saw the patient a week after the last text I received. The mother had texted me the blood results of her daughter. I told them to get admitted. She was adamant at first, but she eventually gave in.

At the hospital, I told them that I was referring them to an oncologist because the peripheral smear had shown blast cells indicative of Leukemia. It dawned on me that while I was trying to pick my choice of words on how to gently break the news to the teenage couple (with the whole family listening to my dissertation), I could see in the eyes of the mother a lack of empathy and a feeling of emptiness. No tears were shed by the couple. The first question the mother asked me after I gave a 30 minute speech was - "so what are the medicines we will give her?" I was aghast because she did not realize the gravity of the situation. The conversation became stressful because the parents did not seem to grasp the devastating news. Even the oncologist had discussed the problem regarding the parents understanding the illness of the patient. After all, it would be a great responsibility in adhering to the chemotherapy schedule and the outcome of the treatment would highly depend on this.

After they were discharged, I never saw the parents nor the patient again. I hope that instead of forum shopping, they embraced the reality that their little girl will need treatment and that they learn to take responsibilities in life.

Finally, is the stern belief that unprepared pregnancies derails one's future plans and dreams. A pregnant teenager spends a portion of her life having to raise her kid(s) while trying to focus on her studies as well. I a firm believer that it's the girls that get the short end of the stick in this dilemma. Every teenage pregnancy has the girl on the losing end. Not only because the pregnancy cuts short their career paths but affects the chances of getting married later on or engaging in a relationship that will result in a successful marriage.

While a boy can claim that the sexual tryst may have been consensual from the get go, engaging in sex with an underage minor can constitute statutory rape if the parents of the female party will claim so. Girls will need to understand early on that their bodies are vulnerable and that an inadvertent sexual liaison can result in unwanted consequences of life changing proportions.

Girls (and boys) will need to understand that parenthood is a full time job that requires not only sexual acrobatics in the bedroom, but a commitment to raising children properly. No child deserves getting less than this because of irresponsibility or ignorance on the part of the parents.

Parents and educators need to instill sex education early on so that children understand the repercussions that can result from inappropriate sexual behavior. This is the part where I don't understand why the Church is so much against sex education early on in schools. Responsibility for caring for the youth and the young is one that is shared by all and should not be taken off context and with malice by Church officials.

12.

This is a good age to just be carefree and enjoy the wonders of life.

This is a good time to celebrate that last year of being a child as one crosses over to his/her "-teen" years.

We need to guide and nurture our kids today.

Mark Twain said "It is a good idea to obey all the rules when you're young just so you'll have the strength to break them when you're old."

Exodus and Calvary

In the Christian world, this week marks the beginning of the Holy Week.

Maundy Thursday reflects on the Washing of the Feet and Christ's Last Supper. Good Friday, the death of Christ. Black Saturday, his burial and the preparation for the resurrection which we celebrate on Easter Sunday.

The Philippines, being the largest Catholic nation in Asia, once upon a time celebrated the Holy Week in prayer, fasting, abstinence, and reflection of life and death of our Lord.

Unlike many other countries where Maundy Thursday and Good Friday are business as usual, the Philippines has one of the longest weekends in the calendar year during the Lenten season leading up to Easter Sunday. The other longest weekend is the Christmas holidays.

Unlike the Christmas holidays where the expenditure is traditionally a gift giving (and receiving of course) event, the Holy Week is anticipated by most Filipinos as an opportunity for family bonding in the form of a vacation or outing. Hence, all the news channels focus mainly on the traffic of the Filipinos moving OUT of the overcrowded metropolis.

The annual exodus to the beaches or provinces has risen exponentially in the past years. The trek has literally pushed the people to pack their bags to head south to Boracay or Bohol or Palawan or Cebu. And while I have nothing against the escape to the white sands and crystal clear beaches of the country, I think that many of us have distorted the meaning of the Holy Week. Instead of reliving the passion and agony of Jesus Christ, we have preferred to pamper ourselves to the point of forgetting the reason for the season.

Which leads to the story of the lives of other people like my patient who is at the throng of death in the hospital. Diagnosed to have Acute Myelogenous Leukemia a few weeks ago and intubated in the Intensive Care Unit, the family of N.G. sleep in a make-shift room for relatives of ICU patients huddled together, praying that their daughter make it during these difficult times - in spite of the financial strain that the illness and its complications have taken its toll on them.

The other day, N.G. was extubated and hopefully, is on her way to recovery from the complications of infection in a leukemic patient. This is their Calvary and I can only join them in prayers and watch over them during the Holy Week.

While we may have our own reasons for "enjoying" the Holy Week or "suffering" with our dearly beloved, we need to redefine our purpose for the Lenten Season and not miss out on the objective of why Jesus Christ, suffered and died for our sins.

If but for once a year we need to reflect on the generosity of God's love for us, not only during the best of times but also in the worst parts of our lives, then as Catholics in faith, we need to renew this commitment.

After all, we will always need to remember that no greater love was given by God to man, than to make his only Son, suffer and die on the cross in order to save us.

We need to die a little, and reflect on our Good Fridays so that we can find meaning to celebrate our Easter Sundays.

[Photo from Lost Seed]

Inconsiderate

Let me thank a member of the country club I go to for being the subject of my blog today.

The title alone says it all. But I will let my readers be the judge of this.

Here's what happened:

Last Tuesday when I was working out, there's this guy (a member's dependent), let's call him A, who started working out quietly as well. Then his friend, let's call him B, popped in and started working out with him. After almost 30 minutes, A and B were still in the same work out space and hogging the equipments. Of course, it was taking them forever to finish. Not because they were concentrating on what they were doing. They were talking and chit chatting and checking their mobile phones for messages and replying to it in between. They were having very long conversations. And as my sweat was drying up, I casually walked up to one of them and asked, "are you finished?" That's when he picked up his towel and he and his friend moved to another spot, to another gym equipment and started their conversation again.

How sweet...

I let it pass. But it destroyed my work out routine. You know how it is when you've warmed up and are ready to lift a few weights. And then some inconsiderate person comes along to make the gym look like lover's lane.

Three days later, A is working out at the country club gym when I get there. He works out quietly and finishes some routine. Good. Then comes along another guy (I guess another friend?), let's call him C. This time, C just sits down on one of the equipments and yakkity yaks while A's working out. Every once in awhile, C would look at the large mirrors, smiles at himself and fixes his hair!!!!! Sanamagan, I wanted to slap C. He'd talk to A then face the mirror and pat his hair and arrange it and then smile at himself then talk again to A.

I called the attention of one the people at the gym to ask C to leave if he wasn't going to work out. He is, after all, occupying space. Unlike B, this guy was not dressed for the gym and was just keeping A company. The attendant had asked C if he was working out and if he was a member or a dependent of a member. C said he was not and was just a guest. And the attendant asked him to wait for A outside the gym area.

In a huff, A had stormed out of the gym and called his MOTHER!!!!!!

Mom comes in after 10 minutes and faces the gym attendant. He berates the gym attendant and demands to see the supervisor about the incident. I told the gym attendant I would go and talk to the mother, but the attendant said that he'd handle it because he didn't want the members to end up fighting.

The mother wouldn't let it go and started huffing and puffing and arguing for around 30-40 minutes in the gym. The other members were wondering what the commotion was all about. When she left after 40 minutes, the FATHER of A had called by phone and demanded to talk to the attendant as well. He berated the attendant for the "shame" brought on his son because the attendant had asked his son's guest to step out and wait for him outside.

After the mother had left, I asked the supervisor and attendant what happened.

The staff had told me that the mother was argumentative and that she demanded to see rules and regulations of the club on usage of the gym, that she felt her son was being singled out and that there are other members that make "istambay" in the gym anyway and that she'd be monitoring everyone from here on (good!!!), and that members, their dependents and their guests shouldn't be treated like that because they pay!

My first instinct was to run after the mother and talk to her. Slap some sense into her. But the the father called and sided with the story of his son and wifey. I guess there's something very wrong with this family and let it go.

But the staff and supervisor informed me that they stood pat at my complaint. I was right and the rules and regulations were clearly posted at the wall of the gym. Some people just don't bother to read. I guess some parents send their kids to school but their kids end up being illiterate.

So if the parents happen to read this blog, let me inform you that club membership is a PRIVILEGE and not a RIGHT!

In short, while we are all stock holders of the club, we all pay our dues equally. Rules and regulations of the club are for all members, their dependents, and guests. Members are responsible for their dependents and their guests. Dependents enjoy a few perks until they reach the age of 25 (which is weird for this club. They should make the maximum dependency age 21). Guests who don't pay for the use of facilities must stay outside of the facility areas and wait for the members in common areas or public areas. And guests are the lowest form of animals on the planet of the club. Not only should they obey the rules and regulations but have no privilege at all.

One word describes this family - INCONSIDERATE!

This is a huge problem among many Pinoys. They think that when they are members, they own the country club. They think the world revolves around them. When your children are wrong, they are wrong. As parents we need to explain that. Instead of barging into the gym and looking for the culprit, the mother should have asked what happened first. Then asked for the club rules (didn't they read the membership brochure?). Then talked to her son or made her son face the attendant.

But no!!! She took it to a different level. She and everyone in her family showed true meaning to the word INCONSIDERATE!

Who did they think they were?!?!?!!? Maybe next time when the boy works out, the mother should make his son wear a tiara so that we know that the Queen of Sheeba has arrived and her royalty is acknowledged. WDTF!!!!!

I can't totally blame the son for being what he is (even if the think the guy is a toad). Apparently with the way the mother reacted, the boy comes from a family that teaches him to be inconsiderate, bad manners and wrong conduct, and that even wrong reasoning has a place in the sun as long as you have money. There is something wrong with this family and the parents need to get reoriented to the proper perspective on the do's and don'ts on club membership.

I don't care if their son needs another boy to hold his hand or flirt with him or even cavort with him while he's working out. But rules are rules. They were made so that we provide some order into chaos.

Even if having another boy around their son will provide inspiration to their son's workout, some people just need to be a little more considerate with others not only at the club but in our daily lives as well.

If you can't teach this to your kids, your family can just roll over and die for all I care.

Etiquette 101

A friend of mine once told me that "good manners and right conduct is not learned in school. It's learned at home."

I blog about an old but important topic - basic etiquette - so that the concerned parties can share Etiquette 101 with their kids (and probably themselves as well). Basic etiquette seems to be a distant knowledge among the average Pinoy in the Philippines. Put them in LaLa Land and they impressively obey rules, regulations, and yes, even basic etiquette!

The following are simple basic guidelines. I hope you share it with the ignoramus around the corner.

AT THE GYM

School's out! And the gym is now occupied by these teeny bopper gym rats who don't seem to know how to use the gym properly.

Basic rules:
1. Put back the weights after you use them. There are other members in the gym. They are not your maids and you must be considerate that after you've used them, you put them back in their proper place. Cleaning up your mess is also not within the job description of the gym attendant or gym instructor. There's a basic saying "if you can't put them back later, don't lift them."

2. Don't hover over the gym equipment. A lot of young people like to work out in groups. I have nothing against these groupies, except that they end up chit chatting in the work out area, especially around a gym equipment. If you need to chit chat, do it somewhere else. Which goes to the point of putting your mobile phones off as well. I really don't mind occasional text and short calls, but really, some people feel that the gym is like the extension of their offices! It's really infuriating when they take the calls, and sit on the bench press seat for like the next 30 minutes and you're left waiting for your turn. Which also means that you're not suppose to hover around the water station as if to it the whole 5 gallons of water was yours. And please get rid of your used cups after! If you need a maid to do all these, please bring your mom or dad along so they can be your slaves.

3. Don't stare! It's not nice to stare. Whether you stare in the gym at someone who oddly looks like a bowling ball or stare at body beautiful, it's malicious to stare.

4. When you're sick, don't work out. If you're not feeling well don't work out. If you think you're going to get sick, don't work out. In short, I'm not recommending that you don't work out so that you get better. I'm recommending not working out when you're under the weather so that others don't get sick.


IN THE ELEVATOR AND THROUGH THE DOOR


As a cardinal rule, you always make the person who is inside a building, a lift, an office, a unit or wherever go OUT first before you go IN!

When I take the elevator going to my clinic, I get so stressed with so many stupid people who don't know how to take a lift.

1. Read the signs. There are some lifts that only to to certain floors. Don't fight with the control button on the right panel when you're pressing the floor and the lift replies to you "Sorry the floor you selected is a restricted floor", which means that it's not going to go to the floor you're going to because it doesn't service that floor. Read before you leap into a lift!

2. Always let people out of the lift before you jump into one. The lift isn't going to go away or disappear in front of your very eyes. I'm embarrassed at how some people push their way into the elevator once the door opens, without allowing the the people to get out of the elevator first. Some people are born stupid.

3. If you're bringing a baby stroller with your baby whom you happen to be carrying, please have the courtesy of folding the carriage. It's also important to remember that there's limited space inside the elevator. Which means - please be considerate. At the hospital, seriously ill and disabled patients have first priority. I hate it when the elevator door opens and there's someone on a wheelchair about to go in and you see some people charging into the elevator, pushing the guy in the wheelchair.

The other day I saw someone who was carrying her baby in one arm, and two (yes two) maids who shoved an old man aside so that they can take the lift all together! The maids should take the stairs next time. Since we ban med reps from taking the elevators at the hospital, I think we should do the same to the yayas, maids, drivers, janitors, body guards, aide-de-camps, as well. After all, the latter have no primary function and are, so to speak, space occupying lesions only.


DINING OUT

1. Smoke only in the non-smoking areas. Then again, public areas with enclosed spaces should not have smoking areas. As a courtesy to those who don't want to get lung cancer, please smoke outside of the eating premises.

2. Don't be rowdy. It's alright to talk and have fun. There are places and restaurants built for that kind of mood. But a restaurant should be a place where one can appreciate the food and the ambience. If you plan to have a shouting match, then go and eat at the fastfood areas. Better yet, there are karoake bars that serve food. Try to tone done your voices.

3. Don't bring the strollers of the kids inside the restaurant. Please leave it outside! Be considerate with the other people who want to get a seat in a cramped place already. Everyone wants to enjoy a meal, so please leave the space ship outside.

4. It's not nice to bring food bought outside inside a restaurant you're dining at. Which is so true especially if you have bratty kids that refuse to eat salad or sushi and you go out and buy them their staple Jollibee or lug around your Starbucks frappe in a restaurant that offers frappes as well. If you don't like their frappe, you don't need to go on a picnic by lugging in your "favorite things". This is not the Sound of Music.

5. Don't put your feet up on the chair especially if you're wearing slippers. This is not your house!

AT THE MOVIES


1. Turn off those cellphones! The lights are bothersome to other people as well. If you intend to chat, do it outside.

2. Don't put your feet up on other people's chairs. They are not your foot stools.

3. Don't eat louder than the noise the movie makes.

4. Don't talk and tell the whole story of the movie (if you've seen it already) or provide a review (you can just blog about it) and puhleez don't have a lover's quarrel in the movie house. It's distracting. Of course, that goes without saying, you don't have to have public display of affection in the movie house. If you intend to do the latter - get a room!

I'm sure my readers will find more etiquette manners which the Pinoys should learn. Share them with me and I'll blog about it!

In the meantime, this serves as my prologue to the next blog where I bash a member of the country club I go to.

Some people just don't have breeding, even if they've got the cash. As I've said, you can always take the boy out of the country, but you can't take the country out of the boy.

Lonely in love

It is said that falling in love is the greatest feeling in the world.

What happens when that feeling is gone?

A friend of mine posted this question to me the other day. Everyone thought that they were such a happy and enviable couple. Both had good professional careers and were financially stable.

Over machiatto and some cookies, I simply listened.

No there was no third party. Like all couples, they started off with so much deep affection for one another. While there was a disparity in their careers, likes and dislikes, and their sets of friends, they were at home with each other. They enjoyed good food and good times together.

It was sad to find out that over the years, their relationship took a roller coaster ride. There was no physical abuse but the emotional abuse seemed to be taking a toll on what looked like a one-sided relationship. My friend described that over the past months the weekends they spent together as "quiet and empty". It was like having dinner with a stranger. There were no stories, no discussions, nothing was talked about. There was no more anticipation on the part of his partner and the meetings became rote and routine. After so many years of being together, there seemed to be unhappiness written all over.

All relationships are lopsided. No one can truly love another with equality. One person will definitely love his partner more. But it doesn't mean that they don't love each other. Just not equally I guess.

Here was my friend, in love, and yet lonely in the relationship.

I told him that he was probably in an abusive relationship. He needed to take control of his life and that they are most likely together because they just needed an emotional anchor for one another. Something that isn't healthy. What's the point in being together if one cannot enjoy each others company? While it's altogether not about the sex alone, a relationship must have a deeper meaning than just being in the company of someone out of need.

He said that while he wanted to raise the issue with his lover, his lover hated discussing miserable topics. So they would just resume dinners in silence.

What drives one to drift away from love?

I have no answer to this. Perhaps it's because one is tired of being taken for granted. Or maybe one is tired of being the one to run to only in times of need. We can always use the pathetic excuse of "living for today" or "living only once" that's why we need to enjoy the good times and the company of other people, but a couple will need to reconcile with their commitments to one another and respect the other person's feelings as well. When that respect is trampled upon one day at a time, one deed at a time, the relationship begins to erode on its own.

When two people decide on having a relationship, they need to be sympathetic with each others wants and needs. They need to sit down and agree on it and once the relationship has been established, they need to make the vow to commitment - better or worse, richer or poorer, in sickness and in health.

There is no room for "I" in a relationship because "WE" have committed to it.

I suggested that perhaps it would be good to have a "cooling off" period. Maybe time to reassess if they belonged together and would want to spend the rest of their lives with each other.

This was not the first time I sat down with my friend on the matter. This time, however, he was not teary-eyed when he was telling me his story.

This was a good sign. I know that closure is not far.

Soon, he will walk away from being lonely in love.

American Idol Season 10 - why this season sucks big time!

So there you have it.

I really didn't mind Thia Megia and Naimi Adedapo getting eliminated. But Pia Toscano?

She's not only star material because of beauty, she leaves the show because some teeny bopper horny kids whose got unlimited texts putting the boys (some of who should have gone home early on) left in the running.

Of the 8 remaining, only 2 are women. The rest are boys.

At the rate that it's running, it should be curtain time for AI.

It's sad that talents are not recognized in this show and it seems to be that people are just voting based on popularity.

And AI has a history of voting for an Idol but not eventually even being a big hit, hits rock bottom tonight. Was this intentional on the part of the producers? From the grapevine is the fact that AI has been losing ground among its audience. I'm not surprised that they pulled one to shock the audience and keep the votes coming.

They need to change the format soon. Otherwise, the next one going home is....Ryan Seacrest.

Summer job or summer vacation?

The other day at the gym the topic among some of the parents was whether it would be best to make their grown-up kids get a summer job or have a summer vacation.

Good question.

The other day in the news was the government offering summer jobs for students who wanted to make extra money and get immersed in something worthwhile to do during the 2 months break from school. A couple of youngsters who were interviewed were elated by the fact that they would be earning on the side during the summer break.

I remember that when I was fresh off high school, I found the summer really boring. It was either to the beaches during the weekend or on weekdays I'd get on my racer bike and just spend the day pedaling away around the city or a nearby province.

My uncle's family usually had their summer vacation in Baguio. They would hie off during the warm months to a cooler place up north. And because my dad had to work 6 days a week, we did not have the luxury of going on extended vacations. Which meant that we were limited to Sunday at some beach in Cavite or Batangas and the rest of the week to watching television or just having to while the summer away.

Those were the days when there was no internet, PSP, mobile phones, DS Lite; movie houses were scarce and not in 3D, shopping malls were simply supermarkets and limited to SM and Virra Mall; theme parks (Splash Island, Manila Oceanarium, Enchanted Kingdom) were not even on the drawing board; there was no Cebu Pacific and vacationing in Palawan or Boracay or Bohol or Cagayan de Oro was not a tourist destination; there was no cable TV or iPod and that the most one had of music collections was a cassette player with a headset that looked like we were Martians!

Let's face it, today's generation has the luxury and advantage of not getting too bored each summer.

The summer right after high school, I wanted to do something different - than just ride my racer bike the whole week. My dad had asked my uncle if I could do some work for him in his hardware store (YES THERE WAS STILL NO HOME DEPOT THOSE DAYS, TOO. SO I'M ANCIENT - SHOOT ME!). My uncle acceded. At least someone he can trust can watch his store when they are on their annual "summer holiday" (much to my envy of course). When my dad talked to me about it, I instantly said yes.

The summer right after high school, I had my taste of a "job". I was the cashier for the hardware store my uncle owned. The first week was confusing. I was wondering what all those codes meant on the items that were being sold. But I was a quick learner. Aside from handling the cash register, the second week became a breeze. I was mingling with the sales clerks and I knew that the codes meant the actual price of the goods being sold. Which meant that when the customer haggled with the cost, I could give it to him at a lower price as long as I did not go beyond 20% of the actual acquisition cost. How would I know the acquisition cost? It's in the code. For example, BLACKWHITE stood for the digits 1234567890. If the SRP (suggested retail price) for item XXX was 178.00/pc and the code was BAK, the actual cost of the goods was P135. All I needed were my fingers for remembering the code! Fantastic!

By the third week I was adept at the haggling that went on at the busy shop and I looked forward to getting up early to go to "work". At the end of the month I would get my pay envelope and my eyes widened at the extra money I had earned for a month's work! I was rich in my own world. My parents made me keep the money and believe me when I say that I refused to spend a single centavo even for something that I was dreaming to buy the earnings with. To me, everything that I wanted to buy seemed suddenly expensive.

After that summer, I looked forward to all the summer vacations to come. The first job experience was exhilarating not to mention that I couldn't imagine what material benefit lied ahead if I finished college.

I started college on the track of going to medical school. It got aborted when I decided to shift to get a mathematics degree during my second year in college. I think it was the fact that medical school would still take gazillion years before I would earn my first legal pay that I decided to get a career in mathematics and then shift to actuarial science later on. When my dad found out that I shifted course, he insisted that I still take the entrance exams to med school. Which thwarted my initial employment career back to the boring corpses and biochemical jargon that looked like the world of schizophrenic brigades!

At least I made a bargain with dad. I would pursue my graduate school courses during the summer vacations because I was stressed with med school. Truth told, I hated the method of teaching in med school. The teachers were obsolete and it was pure memory work. I was bored and the challenge was just not there.

I saw another opportunity at earning when I was in the second year of my med school. I took the exam for the school newspaper - The Varsitarian. I had no writing skills at all. But it provided so much perks in terms of a stipend every 10 days and a partial scholarship if you became a staff member of the V. Aside from that was the opportunity to see your name in print, in the official student publication of the University of Santo Tomas! To this day, I don't know how I passed the exams, but I guess my writing skills weren't that bad. I rose from the ranks of a beat reporter to features writer to features editor to news editor and then to the board of editors at the end of my last year in med school.

And then I graduated from med school. Which started off my career in what I now call my profession - the doctor (BOW!).

And fast forward to the future.

Back at the gym, the ladies (and some guys) were chatting about the upcoming summer. School's out and the kids are restless. One of the mom's wanted her 15 year old son and 17 year old daughter to enroll in summer camp. The other mom wanted her 13 year old girl to join a cooking class for the summer (READ: JUNIOR CHEF). The other dad wanted his 16 year old son to join basketball camp. And there's this mom who wanted her 17 year old boy to learn fencing (REALLY!! GOSH YOU SHOULD SEE THE 235 POUND KID. HE'S LIKE THE BEST TARGET FOR FENCING! Jab anywhere with that fencing sabre and you'd nail him even a mile away!) The rest of the parents were huddled - tossing between sending their kids to the US or El Nido or Boracay or to Timbuktu (so awash in cash I guess).

I thought to myself - so this is the summer break for the rich (whatever!). Their kids work hard during the regular school days (sure sure...like they're really hard working) that the summer break should be fun fun fun!!! I guess that's the concept we imbibe on our youth. The sense of having to "work" and assume some "responsibility" does not seem to be in vocabulary or equation in the large majority.

I suggested to some of them to ask the maids to go home to the provinces for the summer break and make the kids do some household chores (and pay them for doing the chores). I got this violent reaction and you could see it seething through their eyes that they weren't too happy with making their kids muchachos and muchachas for the summer period. I could imagine some of the parents who agreed to the idea that once they broke the news to their kids the reaction of the kids would be one of abhorence, anger, defiance and "it's summer vacation mom!!! Our friends are in the beach getting a tan and we're going to work?!?!! What are we - poor??!?!?! and the drama continues. Bow!!! Clap clap clap for the dramatic household event of the year!). At the thought of the suggestion of having to make their kids (who are of age) to get a summer job or get paid doing some chores for the house during the summer was like suggesting Gaddaffi from stepping down from power in Libya.

The summer holiday, while time out from school, does not necessarily mean that it should be a time for "exploitation" for our kids (of age). But neither does it mean that the only exercise they get from sun up to sun down is bashing the keyboard of the computer and staring at FB or MySpace the whole day and being a couch potato while both parents are working their butts off so that they have money for matriculation the upcoming school year. While there is nothing wrong with being on a break and getting some rest under the coconut tree in some isolated (or even crowded) beach somewhere in never never land, getting exposed to "responsible work" has some benefits as well. Children begin to realize the learning experience on the value of money. It is not true that because they start "earning" a meager amount they lose interest in school. There is more learning experience in true life than in the classroom. It is also not true that children who are exposed to a working environment fall prey to bad company. I've always said it time and again that the weakest children who fall prey to scoundrels are those raised from dysfunctional families and that the families are to blame for their children going astray.

Now that summer's here - and that the cost of living seems to have escalated disproportionately the past few months (oil price hike, toll hike, tax hike) - what's your plan for your kids this summer - a job or vacation?




[Pictures from cartoonstock.com]

Single

This is a first for this blog. And I'm blogging on this topic because it's an assignment for a religion class of my nephew who wanted to do an interview with me on being single.

Skeptically I agreed. After all, he was my nephew. And I love being interviewed.

When I opened my email, my skepticism was verified.

I talked to my nephew on the "constraints" I had with this interview, and him being my "confessional box". He replied saying it was alright and he would just tell his teacher that I was just crazy. I think he was desperate. It was not his desperation that drove me to accede to his request. It was the fact that he understood his uncle.

The first question was:

WHY DID YOU CHOOSE TO REMAIN SINGLE?

As soon as I read this, I fell off the floor. I would have died laughing so I phoned a friend - my sister. "Did my nephew want me to go on answering this interview questionnaire?" She replied, "just answer it as honestly as you would."

Alright. So I'm single because "I don't like being a lesbian?" [nothing against lesbians as some of the nicest lesbians are my best friends]. I mean, really now. "Because I don't like women as sex partners?" or let's just put it straightforward "because of my sexual orientation and that probably I don't really like vaginas and I can't imagine anyone coming out of it?" or in modern day parlance, the simplest answer I would have given would be, "eeewww!"

Singleness was a choice I made. Unlike some who choose to be single because of professional career (which is a lot of BS) or are unattractive and instead of finding a match (read Andrew E's song - HUMANAP KA NG PANGIT) they want to get hitched with Dingdong Dantes or some Greek god or have a calling to serve their religion, I am still single because gay marriage is an anathema in the Philippines.



ON MY CATHOLIC FAITH

Don't get me wrong. While I have a sexual orientation that is common worldwide (read GAY), my faith and Catholic religion is deeply rooted on solid ground. Although there was so much confusion in my adolescent years, I needed to be syntonic with my orientation. The confusion stemmed from trying to make sense of why God was providing the confusion or was it me? Then there's the family. I mean, let's get real. I am after all Chinese and the first born male, you don't just come out of the closet and tell your dad that, "hey dad, guess what, your son is gay!" I played it by ear. I guess, like all parents, they somehow knew. I outed myself to my mom first (they are more understanding I guess), but we kept the secret to ourselves. At first they didn't like the fact that I was friends with woosies and I could feel their embarrassment. So we kept it a family secret - like the army - Don't ask, Don't tell! - became the rule.

It was during these trying times of finding myself and finding solace in accepting my sexual orientation that I prayed the most. I needed a bit of sanity in my life. I didn't like the fact that I had to sneak in and out of the house in disguise. There needed to be closure to this for me to move on. Having to deal with a family deeply rooted in tradition was driving me bananas.

One morning I looked in the mirror and asked God if this was a test of my faith. On bended knees I talked to Him to lead me out of my confusion. He provided no answer but I took to heart that I probably should try dating the opposite sex. Maybe that was where the answer lied. Seriously, I am not unattractive. I had my share of girls having a crush on me (up to now) and boys finding me attractive (up to now as well). So I tried dating a few girls. One of them ended up proposing to me. I turned her down. She cried a bucket but I wasn't ready to give up my virginity. In fairness though, I ended up being best friends with many of these girls. We became BFFs instead of lovers.

As I drew close to 21, I was firm on my sexuality. I was out and discussed this with my parents. My mom cried a bucket. My dad was infuriated. But unlike some parents, my parents seemed to understand. They accepted me for who I was. They let it be. In the back of their minds though, they would be waiting for a miracle.

As for me, I knew that I had a calling - being singly blessed.



ON CAREER AND BEING SINGLE

To say that I breezed through all the challenges in life would be an understatement. Of course we have mountains that block our paths. I had mine.

There were days when my family was cash strapped. Then there was the time when my dad had a stroke. I mean, let's face it. Life after all is not a bed of roses. And no matter how we prepare for it, we can never prepare ourselves for the worse in our lives.

I needed to focus focus focus. There was no use crying over spilled milk and the hurdles of the events in life was simply a setback. During my fellowship training in Boston, I was at the lowest of my life. The training period kept me gazillion miles away from home. From the people I loved the most. From my family and friends. It was like a new beginning of being alone. There was always the temptation to make my loins get the better of me, but I needed to focus. I was there to learn. It was an opportunity to make life better. And only I can do that. Here I was with no one to lean on (remember, this was the early 90s where the mobile phone and chatting on the internet and Skype or FaceTime or other techie gadgets were still on the drawing board). Loneliness can be the biggest factor in driving someone to do something terribly wrong.

After the summer came fall, winter, spring and the seasons had gone by. When I finished my fellowship program, I was offered to stay on to practice and do research at the University Hospital in Boston University. With my dad ill, and my mom trying to make ends meet and my sister being widowed and having to raise two kids, it was a tough decision to come home. After all, I already had a life in Boston.

After two weeks mulling over my faith and destiny, I declined the offer. The month before I left Boston, I was in tears while I was packing all my things. I was coming home to something I had no idea where I would be 5 years from then. Was I making the right decision?

I was single. Perhaps this was what fate and destiny was all about. It was time to come home.


NEW BEGINNINGS

Do I regret being single? No.

Do I regret coming home? No.

Am I happy being single? Yes.

Chaim Potok said, "all beginnings are hard." And coming home was like starting from scratch. There would be days when you'd just be counting the spiderwebs in your clinic or count the number of times the lizard made noise on the ceiling.

Yet you know you're never alone in the road less traveled. There were friends that helped you along the way and I shall never forget them. To them, I owed my jumpstart from my practice. After all, I was the only certified clinical pharmacologist that trained in the US in the university. Truth be told, I needed the money. But I didn't want to beg. There was too much expenditure that I would need to work day and night to make ends meet. I accepted lectures left and right and was on a plane from the north end of the Philippines all the way to Sultan Kudarat!

A year and a half after my return, my father passed away in his sleep. And with the little that I had, my sister and I could only afford the simplest coffin. The wake was provided free by the Benedictine order. My father's family offered to pay for a more "presentable" coffin. I turned it down. My dad would have agreed. Whatever we had on our backs was what we'd take to our graves.

I was single. And I was now in charge.

And in charge of my life as well.

There was a road that took me home to care for my mom, my sister and my niece and nephew. This was all the family I had on my back. This was all I needed in my journey in life. After I buried my father, I promised myself that I would take care of who was left behind.

And so, I remained single. Devoting my time to my profession, other peoples lives, career and yes, taking care of my family. They would experience the luxury that I didn't have while I was growing up. There would be plenty food on the table. There would be no opportunity to beg or borrow.

The kids are all grown up now. They have finished college. Eight years ago, I found my partner whom I share my dreams of growing old together with (well, don't we all want a happy ending to the story?).

Do you have plans of getting married? To a woman, of course not. The miracle of my converting to heterosexual never happened and nobody every bothered to ask me the question ever again. To my partner, well that depends on whether same sex marriage will be allowed in this country or not. As of now, we're contented with the arrangement.


"ON BEING SINGLE FOR LIFE"

There is nothing wrong with being single. You get to spend most of what you make on yourself and have a lot more to spare.

But contentment is not in material things alone. There are times I wish I had a kid (or kids) of my own but I have no regrets in my choice of being single. It is never a calling. It is a choice one makes.

Perhaps in a few years more, I will be alone. I have even imagined the most morbid scenario of dying alone. So I have asked my family to make sure that I am cremated within 24 hours of my death.

Even in death, I will choose to remain single.

[P.S. I hope you get a great grade for this piece, nephew. It wasn't easy to write this.]