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In one of the exclusive enclaves of the old and nouveau riche  lived a grand old lady who had family connections in all the three main islands of the Philippines (Luzon, Visayas, Mindanao but then again, even among us lesser mortals, isn’t that the story of our lives?) through intermarriages of her cousins, nieces, nephews and two daughters. As it was among many members of  old families, they marry their kind so that one of her daughters was also married to old money which greatly enhanced their portfolio, estate and land holdings in Luzon, Visayas and Mindanao but most all in the second biggest island in the country.

One day I got a call (and you must have noticed by now that I always got a call from the daughter but that’s how things really happened)  from the older daughter asking me if  I would be so kind as to visit her Mom in their ancestral home as she, the daughter was in the middle of corporate slug fest in another city in the north, fighting tooth and nail for a board seat and field work on yet another high rise project in the suburb and that her mother who was having fever was living  alone with just the maids (her word, although I would have preferred kasambahay but then I don’t know if the word had already been invented in the late nineties). She added that her younger sister who flew in from Manila early in the day would be there to meet me.

As I did not have a car at the time, I was picked up by a  massive black Land Rover (does it come in any other color?) and was ushered into a place which sent me time and location warped I might as well have been brought to Europe from this city in an hour.

Everything about the house, no, the manse was grand. The hard wood main doors were as huge as a cathedral’s.  They were opened by a uniformed maid and I was told to wait as the ‘Senyora ay nagbibihis pa’.  There were antique statues of various saints on intricately carved console table. If it had not been for the helipad and the swimming pool outside, I would have felt  like I was in a cathedral and fought the urge to genuflect or kneel. I looked around in awe as my small time, small town background did not prepare me to be in the midst of such grandeur and wealth in a third world country like the Philippines. The paintings might not have been Canaletto or Caravaggio ( I have seen many of his works in a cathedral in Valletta, Malta)   all right but I recognized some works of Filipino masters. There was an Amorsolo, an Edades and even works of modern masters which to date will have been conferred National Artist awards. The shiny, lacquered piano was a baby grand and just when I was about to take a seat,  the younger daughter went out to meet me. She was how I expected her to be –  gentle and mild in her ways and a cut above the rest pretty despite her middle age. She welcomed me with a hand shake and narrated her mother’s story as we walked towards her mother’s room.

The room, as the rest of the mansion was consistent with the old world theme – the same Victorian inspired picture frames that showcased the Senyora in her youth and about a dozen other portraits of her late husband, her daughters and her grandchildren. There was a huge king sized bed made of mahogany (or whatever hard wood, it was hard to tell), a boudoir made even bigger as the occupant was a gaunt old lady but still stood out with vestiges of her resplendent youth and Hispanic features . To the right of her room was a huge walk in closet that showcased her collection of many long evening gowns and signature purses and shoes.

The younger daughter left me to examine her mother. After having  examined and talked with the mother, I took  my leave and discussed my treatment plans and options with the daughter who I interrupted from her long engagement with her mobile phone.

When the daughter realized the prospect of her mother being admitted to the hospital, she suggested  if arrangements could be made for private duty nurses in three shifts and that treatment be undertaken in her home and that if  I could visit her mother every day until she was well.

As I showed my discomfiture and trepidation, she insisted and reiterated having her mother treated  at home. She held my hands with both her fragile hands and pressed them tightly against my thighs. She said ‘But Doctor, you don’t understand.’

She was right, I did not understand what she wanted.

She explained further  ‘Doctor, there is no doubt I love my mother but you see, I was just talking  to the vet and I  need to fly back home soonest  because my pony is sick.’


Mom was sick. Pony was sick.

It  did seem like a very difficult choice. It did seem like an imponderable  decision to make  especially because it was a Shetland pony.

I was appalled. I was mortified. I was left speechless in disbelief.  I managed a  faint smile,  misty eyed as I turned to leave, my heart bleeding  for the mother who in a little while would be alone with the maids in that huge cold, old world splendid stone house.

N.B.  Ladies and gentlemen, the uber rich are different from you and me.

DISCLAIMER: The identities of the subjects in the vignettes and other stories on this blog are intended to be ‘anonymous’ to protect the patient and their families and keep the doctor-patient confidentiality or fiduciary relationship. The personas cited here are not meant to be blind items or fodder for gossip. My lips are zipped in that department. Some of their identities and circumstances have been altered but the nuances of their medical condition are fact and not hidden behind veiled medical-clinical fiction. Think Oliver Sack’s ‘The Man Who Mistook His Wife For A Hat’. Okay, it’s like comparing Roederer Cristal rose wine with vin d’ table but  I know you see the drift.