THE FEAST OF SAN PEDRO CALUNGSOD

THE FEAST OF SAN PEDRO CALUNGSOD

The intake form had been misfiled — placed, probably by my clinic assistant Dolor, who was meticulous about most things and occasionally catastrophic about one or two others, in the folder for the following month rather than the correct one — and so it was that on a Tuesday afternoon in June, fourteen months after Archbishop Cornelio Tan-Reyes died in the presider's chair of the Basilica del Santo Niño with a sentence still in his mouth, I sat at my desk in the clinic on Osmena Boulevard sorting through old patient files and came across, unexpectedly, the intake form of a man I had not seen in three years. I had been at the clinic since one o'clock. My mornings were for surgery — the operating theater at Chong Hua was a twenty-minute drive north in the best traffic and forty-five in the worst, and I kept clinic hours from one to five on the days I was not scrubbed in, seeing patients who needed follow-up or consultation, reviewing files, signing referrals, doing the administrative sediment that accumulates around any medical practice the way sediment accumulates around anything that has been in one place long enough. The air conditioning ran at the temperature I preferred, which Dolor considered punishing and my patients considered bracing and which I considered simply correct. Through the window, the afternoon light had the quality it gets in June in Cebu City — diffuse, heavy, white rather than yellow, the light of a sky that has been thinking about rain for several weeks without committing, the kind of light that flattens shadows and makes the city look like a very detailed photograph of itself. The file review was the kind of work I have always treated as meditative rather than administrative, which is perhaps an unusual way to describe going through old patient records, but which reflects something true about how I was trained to read — not skimming, not sampling, but attending to what is actually there, the way you attend to a body on the table. A patient file is a narrative, if you read it correctly: the initial presentation, the assessment, the treatment, and then the silence at the end, which is either recovery or death or simply the ending of the clinical relationship, the patient having moved on to another physician or another city or another life entirely. I had been a physician for eighteen years. I had accumulated, by that June afternoon, more silences at the ends of files than I had any practical use for, and reviewing them was not entirely unlike going through old photographs — recognition, assessment, the particular weight of things that are finished. The form was unremarkable in its appearance, which is to say it was the standard two-page intake document my clinic had been using for years, the printed fields filled in with a small, compressed handwriting that I recognized before I recognized the name: Aurelio Sarmiento, date of birth, contact information, referring physician — a colleague of mine who had described him, in her referral note, with the phrase he needs someone who knows how to keep a wound closed, which I had thought, at the time, was an unusual way to refer a patient, and which I now understood, as I had come to understand a great deal over the preceding fourteen months, with a precision I would have preferred not to have. The date was three years earlier, almost exactly — a Thursday in October, the dry season just beginning, the city in the particular mood it gets when the rains stop and everything dries out and the air carries a clarity that feels like a gift you know is temporary. And there, on the line marked Reason for visit, in the same small compressed handwriting: Difficulty breathing. I held the form for a moment without reading further, which was not something I typically did — I am, by training and by inclination, a person who reads to the end of things — but there are objects that have accumulated enough meaning to require a pause before you continue with them, and this was one of those objects, though it looked like nothing. A piece of paper. Printed fields. Someone's handwriting. The form was three years old and it was also, depending on how you chose to count, fourteen months old, or thirty years old, or as old as the arrangement that preceded everything, which is to say it was as old as the original decision, made by a man who is still alive and from whom no formal accounting has been extracted, to use the architecture of a charitable institution as the infrastructure of a financial crime. I use the phrase original sin with the ambivalence of someone who was formed by theological language and has since had occasion to examine the formation carefully, but I keep using it because the other available phrases — financial impropriety, fraud, the laundering scheme — do not contain what the theological phrase contains, which is the understanding that certain wrongs do not simply occur but propagate, that they put structures in place that outlast the original act and require, eventually, their own reckoning. Difficulty breathing. What Aurelio Sarmiento had been carrying when he wrote those two words was not a respiratory complaint. This I knew by the time I found the form — knew it in the full, documented, medically attended sense in which a physician knows things about a patient, which is to say I knew it and could not tell anyone I knew it and would not tell anyone I knew it and have not told anyone I knew it and do not intend to. The seal of medical confidentiality is not a technicality I shelter behind. It is not a convenience. It is the foundational structure that makes possible the kind of speaking that only happens in one place in a person's life — the room in which everything can be said because nothing said there will leave — and the day it becomes negotiable, the day a physician decides that some secrets are too large to keep, that the weight of external consequences outweighs the weight of a promise made in the form of an entire professional ethics, is the day the room ceases to exist, and the harm of that absence would be, in the aggregate and over time, immeasurably greater than the harm of any individual secret maintained. I have never permitted myself to think of it as negotiable. I did not permit myself then. I do not permit myself now. This is not the same as saying it has been easy. I want to be exact about that. Fourteen months, at the time I found the form. Fourteen months since the feast day of Pedro Calungsod, patron of Cebu, the April 2nd on which the archbishop stood at the ambo and placed his hands on either side of it and began to speak about martyrdom, and sat down in the presider's chair, and did not get up again. Fourteen months during which I had operated on approximately four hundred patients, driven to Chong Hua and back through the city's perpetual construction approximately three hundred times, eaten breakfast alone in my apartment looking at the strait where the container ships rode at anchor in the haze, argued with Detective Sergeant Eusebio Quiñones about the nature of institutional faith on approximately twelve separate occasions, and sat, for every waking hour of every one of those days, with the specific fact of what I knew and what I chose to do with it. This is its own kind of breathing difficulty. It is not the kind you write on an intake form. I had been thinking, for those fourteen months, about the word martyr. The word arrived in English through Latin and through Greek, and in Greek it is martys, and martys means, simply, a witness. Not a person who dies for belief. Not a person who suffers for a cause. A person who has seen something and can testify to what they saw. The dying — the specific, particular dying that the word now carries in every language it inhabits, the fire and the blade and the thrown stone — came later, as a consequence, because what was seen was dangerous to those who preferred it unseen, and the most reliable way to prevent a witness from testifying is to ensure the witness is no longer available to testify. This the early Church understood from personal experience. It built its ceremonies around the deaths, elevated the deaths into the center of its meaning, made the instrument of the dying into an icon held in the hands of the saint — the palm frond, the arrow, the wheel. It is practiced at this transformation. It has had centuries in which to become practiced. The second Filipino saint is Pedro Calungsod. The first is Lorenzo Ruiz, a calligrapher from Binondo who was martyred in Japan in 1637, his feast day in September, his death by torture so protracted and precise that the Japanese officials who oversaw it understood it as an invitation to recant and he understood it as an invitation to remain exactly where he was. Calungsod is the younger saint and the younger martyr — a Visayan teenager, seventeen at most by the estimates of the historians, who died in Guam in 1672 alongside the Jesuit priest Diego Luis de San Vitores while performing a baptism. He was beatified in 1985, canonized in 2012, his feast day April 2nd. The circumstances of his death are recorded with the matter-of-factness of mission documents: a man named Matapang, who had refused baptism for his daughter and who had heard the rumor — common in that period, spread deliberately, a piece of psychological warfare against the missionaries — that the holy water brought for the sacrament was poison, came with another man named Hirao and a party of armed followers and killed them. San Vitores was killed first. Calungsod, who could have run — there are accounts, in the mission records, suggesting he was warned, that there was time — did not run. He stayed in the room where the killing was happening and was killed in it. Why he stayed is the question the Church answers one way and history answers more cautiously. The Church says faith. History says that we cannot know what passes in a person's mind in the seconds between the recognition of danger and the decision about whether to remain. Both answers are true, which is the condition of most things that actually matter. I grew up with Pedro Calungsod's face on the wall of my grandmother's house in the Poblacion district, which is to say I grew up with a painting of a teenage boy holding a palm frond and an arrow — the instruments of his death transformed into emblems, through the Church's practiced alchemy, of what the death signified — and I accepted this the way you accept the furniture of childhood, as simply the normal condition of the world into which you were born, no more requiring explanation than the shape of the rooms or the smell of the kitchen. My grandmother, Lola Coring, had a particular devotion to him that was not simply the regional loyalty of a Visayan woman for the Visayan saint, though it was also that. She had survived, as a young woman, something she never described to me directly but which my mother had told me about, in approximate terms, when I was in medical school — something that had required her to see what she had seen and then to continue living in proximity to those who had preferred she not see it, and to do this for the rest of her life in the same city, on the same streets, in the same basilica where the Santo Niño had survived every burning that the city had survived. She lit candles for Pedro Calungsod every April 2nd. She believed in the intercession of the witness — believed that a saint who had been a witness himself, who had stood in a room where a violent thing was happening and stayed, was available to those who carried their own witnessed things in their bodies and were trying to live with that carrying with some measure of grace. I am not certain I believe in intercession. I am not certain, if I am being entirely honest about the contents of my own mind, that I believe in anything sufficiently specific to be named. What I was formed by is not the same as what I believe, and the space between the two is where I have spent most of my adult life. But I have been thinking about the witness, about the original meaning of the word, about what it is available to a person to do with what they have seen when the seeing is constrained by the very thing that made it possible — when the room in which the speaking happened is also the room that cannot be described, when the knowledge and its protection are the same object and you cannot set one down without setting down the other. What I know about myself, at the point at which I am beginning: I am still a surgeon. My hands are still steady. I say this because both facts require saying, and because neither fact is as simple as it sounds. I have excellent fine motor control. I have never suffered a tremor. I have operated in conditions of considerable stress — the emergency bay at two in the morning, the patient arriving with a machete wound or a crush injury or the specific damage that a body sustains when it goes through a windshield at speed — and I have performed correctly in all of those conditions, have kept my attention clean and my hands steady and my assessment accurate, and the fourteen months preceding that June afternoon had not altered this. I know because I checked. Not consciously, not as a deliberate test, but in the way you know any capacity you rely on — by the continued absence of failure. And yet. The steadiness of a surgeon's hands is a professional asset, a piece of neuromuscular luck maintained by practice, and I had always known this and had always been grateful for it and had never until these fourteen months thought of it as a question rather than an answer. It has become a question. I do not know what to do with the fact that I can still cut accurately, can still hold a wound closed until it will hold itself, can still do the thing I was trained to do and am trusted to do, in full possession of what I kept and what I chose. Whether this is a demonstration of integrity — the seal held, the hands steady, the physician unchanged — or whether it is a demonstration of something else, something that is the shadow-side of integrity and that I have no precise word for, is a question I have been living with for fourteen months and which I am not, as of the afternoon I am speaking from, closer to answering. Aurelio Sarmiento wrote Difficulty breathing on his intake form and came to see me and told me the part of it he was ready to tell and I kept it and keep it still, and three men died who were connected to what he knew, and I kept it, and they died, and I kept it, and the man who administered the dying sat in a courtroom and gave a three-hour statement in a quiet voice and was convicted, and the man who is responsible for what required the dying arranged a quiet departure and was not convicted and is, as of the afternoon I am speaking from, living in a retirement house in Baguio and saying daily mass in a private chapel, and I kept it through all of this, and I would keep it again, and I cannot make peace with that and I am not trying to. What happened in the three weeks following the archbishop's death — the investigation, the deaths, the poison, and the structure of the cover-up that the poison was protecting, the confession made in a confessional in Mandaue City and the seal that descended over that confession and what it mirrored, the old man in Consolacion who had been waiting thirty years to be a witness, the documents in Tacloban, the journalist, the arrest at the airport, the resignation that arrived in the place where a prosecution should have been, and the letter I wrote to the Medical Ethics Board in the careful abstract terms of someone who cannot speak from their own case but will not be entirely silent in the face of it — I am going to account for as fully and as honestly as I can. I am not telling it to justify myself. Justification is not available to me in the form I would want it — the clean, complete form in which the thing you did and the thing that happened can be made to cohere — and I have stopped looking for it. What I did was correct by the ethics I hold, and the ethics I hold are the only ones I have, and I have examined them with everything I am capable of bringing to an examination, and they do not bend. But ethics are not the same as outcomes, and outcomes are not the same as peace, and I am not at peace, and I have decided, fourteen months in, that the discomfort itself is a form of witness — that to carry the shape of what happened without softening it, without finding the angle from which it looks acceptable, without telling myself the story in which the three dead men are not also the consequence of a silence I maintained — is the only testimony available to a person in my position, and that testimony is what I owe. I owe it to no one who would recognize it as payment. I owe it anyway. I will start with the feast day. I will start with the basilica on the morning of April 2nd, the light coming through the doors off the sea, the congregation assembled for the Feast of San Pedro Calungsod, and an archbishop at the ambo with his hands on either side of it, beginning a sentence about the martyrs of the present age. He did not finish the sentence. I have been finishing it ever since, in different ways, with different endings, and none of them have yet felt exactly right.