Snippets of his medical mission services with PMSNC – 2017-2018
Part I of II Series
The only way death is not meaningless is to see yourself as part of something greater: a family, a community, a society. If you don’t, mortality is only a horror. But if you do, it is not. Loyalty, said Royce, “solves the paradox of our ordinary existence by showing us outside of ourselves the cause which is to be served, and inside of ourselves the will which delights to do this service, and which is not thwarted but enriched and expressed in such service.” Psychologists have used the term “transcendence” for a version of this idea. Above the level of self-actualization in Maslow’s hierarchy of needs, they suggest the existence in people of a transcendent desire to see and help other beings achieve their potential.” – Atul Gawande, M.D. Being Mortal: Medicine and What Matters in the End
SANTA Barbara, Iloilo — Are our lives like the flowing waters of the clean Iloilo river, reflecting light images of our transcendent desire to help others achieve their potentials or is it like a swamp of dead tree stumps, with murky green algae that trap insects?
Dr. Peter Bretan regularly jogs. Some volunteers have run into him at the Riverside Boardwalk, at 2 to 3 a.m., perhaps appreciating the well-lighted boardwalk, bordered by plants and plumerias in bloom and a clean Iloilo River that is now maintained through community’s discipline with regular waste removal. A smelly swamp is on the right side, perhaps a constant reminder of what it once was: accumulated solid wastes, dead tree stumps and lifeless. A posted sign on the lamp post reads, “Ang Kadagatan Indi Basurahan.” (The seas/oceans are not trash dumps).”
Intentions make a huge difference. Think of saving lives and if need be, “making miracles,” as Bretan believes, and the Universe invariably presents opportunities to actualize your intentions to save lives that maybe cut short by a goiter as big as a grapefruit and a cleft palate or hair-lip in an infant, both of which interfere in the uptake of nutrition or in the surgeries I watched: hernia in a one-year-old infant and undescended testicles in an 11-year-old boy, which if not operated on, the baby could die.
Bretan, former PMSNC president, describes the organization: “that has been doing medical missions for 40 years and credibility-wise, it has not had any problems. When a sovereign allows you to operate and do surgeries [unlike Doctors without Borders and other medical missions] that is a lot of trust in you and a lot of people [that] you [can] save.”
In fact, PMSNC has, out of its 40 years of existence, been saving thousands of lives, “it has taken a life of its own, humbling all of us. It is a culture of medicine, giving their ultimate. It is the core of Filipino giving – reciprocation of utang na loob, and not feeling so privileged. It is universal altruism – they drink the cool-aid of “medical mission” and it is pure. It has 0% overhead. When you are exposed to what they have done, [that] it is purely run by love, you keep coming back,“ he said.
I sat behind Bretan at Misto Restaurant on Monday, January 22, 2018, and introduced myself: “Dr. Bretan, I heard about your heroic act of saving a life in 2017’s in Dumaguete medical mission. You gave blood which saved Manang Belen, and without much fanfare nor taking credit for saving her life. I also attended the 2016 orientation meeting, which you chaired, wherein a member passed out, 911 was called, yet you remained calm. After the emergency was handled, you chaired the Philippine Medical Society of Northern California (PMSNC)’s meeting, quite productive and well structured. It is really a pleasure meeting you.”
The next day, he joined me for breakfast and sensing a flow of wisdom and an interview, I asked to tape his responses.
“Why do you want to do surgeries?”
“Egotistically, it feels good to save a life. But, how about this? If you want to write an article and change something about medicine, you can save millions, according to my academic mentor. So I became an academician and became one of the youngest professors at UCSF. I also became the youngest transplant director at 34 years old at the Cleveland Clinic.” Bretan identified one of his many firsts.
A doctor of many firsts
Bretan is a urologist and a renal transplant surgeon, a Filipino-American, born and raised in California.
“I remember only memories of my parents and grandparents,” he said.
He is a doctor of many firsts. At 34 years old, he became the chief of transplant at UCLA. He also became the youngest professors at UCSF. He is a captain of the U.S. Public Health Reserves, part of the U.S. Navy, that took care of Cuban refugees and who also spent two months in New Orleans as part of its reconstituted medical team during Typhoon Katrina.
His wife is a nurse, as his daughter, his sons — a physicist and a Ph.D. AI engineer while the youngest is an artist.
“But are you not an artist as well?” I asked. He paused, then said: “I suppose I am a remodeler of bodies.”
He took undergraduate architecture courses and loves designing houses.
He took his undergraduate degree at UC Berkeley and finished his medical degree and residency at UCSF. He completed a Fellowship at Cleveland Clinic and took three years of academic courses towards a Ph.D. He enlisted as part of the military reserves and served for two months in New Orleans during Operation Katrina.
“Trained and mentored by some Nobel Laureates at various training at Cleveland, UCSF and UCLA, you become your parent, you become your professor, you never stop being a student,” he said.
He is incredibly generous in describing his mission colleagues, the likes of Dr. Araceli De Guzman, Dr. Marlene Cordero, Cynthia Bonta and her family of Rob, Lisa, Malaya (grandchild) and concludes: “They are in the cutting edge of “Going Forth” in leadership in the United States.”
Could he be describing “his heart as a prism that reflects back the goodness of others, as much as his?”
What motivates this high-achieving, highly professional, yet, deeply compassionate and caring doctor?
Renewing oneself in medical missions
I asked Bretan if he kept track of lives that he has saved. He became misty-eyed and instead, talked about his dad’s life being saved: “The only reason I am alive is I was born in Port Hueneme, as all dependents of the military are born in a military hospital. My father was five years old when his mother died. He raised his younger brother and became a houseboy for a Baptist minister. He memorized the bible and the minister gave him $500 to go to the U.S. at 21 yo, “Here make something of your self. You are smart.”
More than that, his father became a patriot. His father got drafted into the U.S. army: “6 battalions of Filipino-Americans served in WW II at Camps Roberts and Hunter Liggett in San Luis Obispo County, and ten times that, as navy stewards and chefs. I consider it a privilege that I am still alive because my dad had tuberculosis and he could have died, but did not. It is why I am a big supporter of the military,” he added.
“I am a remodeler of the [human] body.” There are three elements, “art, interpersonal skills for the family, and the high-tech surgery. Besides, have you had a job and in 45 years, [still] have growth?”
I sensed his passion for his medical career, but also a strategic view of the changes: “The career is ADD (attention deficit disorder) in itself. For example, from closed surgery to laparoscopic surgery in four years. The career changes as fast as you are changing. It is similar to the [changes] in camera [from analog to digital to mirrorless] and one of the hardest in human nature to deal with is change.”
His motto is “Saving Lives. If you want to see a miracle, you have to make a miracle,” partly taken by a line by God in Bruce Almighty that was noted by Dr. Araceli De Guzman, a fellow mission volunteer, who witnessed Dr. Bretan’s heroism.
Manang Belen was PMSNC’s first thyroid patient.
“Her thyroid gland had grown huge over the last few years, but without the resources to afford an operation, her gland grew exponentially, according to Dr. De Guzman, who was monitoring the surgery. During the operation, her blood pressure was dropping.
Though infused with volume expanders by Dr. Sheila Vaz to maintain her blood pressure, her hemoglobin was really low, at 3. (Normal is 12 to 15 grams per deciliter).
“STAT,” De Guzman called out, for blood donors to come forward.
“Take mine now,” Bretan said. Without hesitation, others followed his lead, as Rey Mallari, Kevin Miller, Sean Lio, Jessy Madayag and Dan Dublin; all were tested for compatibility. The Red Cross did not release blood supplies until the replacement was received.
De Guzman had to use her own personal cash to test for three more guys and for them to donate. “There was no bloodletting, but Dr. Bretan’s blood was used, as well as two units from other donors,” she added.
“To give blood, one must weigh at least 120 pounds. In the Philippines, women weigh less than that. So the rule became that women cannot give blood,” Bretan explained.
Another miracle save
A young mother did not know what to do with her baby born with a hair-lip and could not feed. So she left the baby to die in the Dumaguete cemetery.
But a 10 to 12-year-old boy heard the baby’s inconsolable cries and took the baby home.
Ants had penetrated the baby’s ears, according to Bernadette, a Chicago nurse, who shared her post-surgery recovery experience with this baby.
The boy’s mother heard of the Dumaguete medical mission and brought the baby to the mission and later, decided to adopt the baby.
“After the baby was fixed, healed, ready to go home – all the attending doctors became the baby’s godparents at the christening,” Bretan proudly shares his godchild’s photo from his smartphone.
Does he track lives that he has saved? “Yes, in terms of major surgeries. Thousands of lives now in major life-saving operations. But not the smaller, minor surgeries,” he said.
Curious, I persisted in my query: “Hundreds of thousands of minor surgeries,” he softly shared in tone.
“This is my marathon. This is my boot camp. This is my reality check [medical mission]. Only when you leave your comfort zone that you learn – once you see this, you snag students to volunteer when they are young. Be the highest potential you can be and be a volunteer, and be the best you can be!” Bretan emphasized with conviction, borne out by four decades of his exceptionally superior medical practice and equally distinguished decades of medical mission volunteerism.
Do you get a sense that this surgeon has a reservoir of living waters within him? I cried after writing this piece, realizing the depths of his humanity.
Part II of this series will be about Dr. Peter Bretan mentoring a resident and in turn, students while performing surgeries in a medical mission in Sta. Barbara, Iloilop
* * *
Prosy Abarquez-Delacruz, J.D. writes a weekly column for Asian Journal, called “Rhizomes.” She has been writing for AJ Press for 10 years. She also contributes to Balikbayan Magazine. Her training and experiences are in science, food technology, law and community volunteerism for 4 decades. She holds a B.S. degree from the University of the Philippines, a law degree from Whittier College School of Law in California and a certificate on 21st Century Leadership from Harvard’s Kennedy School of Government. She has been a participant in NVM Writing Workshops taught by Prof. Peter Bacho for 4 years and Prof. Russell Leong. She has travelled to France, Holland, Belgium, Japan, Costa Rica, Mexico and over 22 national parks in the US, in her pursuit of love for nature and the arts.