WHAT STICKS | Madison Palmer
The first night I spent in the Philippines with my Auntie Neng, I saw her sleeping in our stilted bamboo payág and thought I saw the ghost of my Grandma. Like a kid, I wanted to crawl back under the covers with Grandma and feel her hot cheek on mine. I remember Auntie Neng was often around while I was growing up, partly in the care of my grandparents, yet we seldom spent time together. She always seemed to have somewhere else to be. While Grandma was traditional and strict, Auntie Neng seemed adventurous and wild. It didn't occur to me until that very moment, as I watched her sleep, that she and Grandma looked nearly identical. It was my first time ever in the Philippines, and it was Auntie Neng's first time back in fifty years.
I didn't know why she never returned, having left for California in her early twenties as a new nurse. Nearly everyone in my family is a nurse. Grandma used surgical cloths as napkins for her kitchen, leading me to associate the blue gauze I use to soak up blood in the operating room with dinner. Auntie Neng wears her laundered scrubs as pajamas for bed (a habit I also adopted while in training). Every family friend's house has a black and white portrait of a young nurse in her glowing white uniform next to their crucifix.
At my first invitation to join my trip, Auntie Neng seemed hesitant. But after much back-and-forth and the promise of visiting the famous Taal volcano, I convinced her to board a plane. As it turned out, her fiftieth nursing reunion in Davao City was just a month away and I figured a road trip would be the perfect way of asking Auntie Neng questions I wished I had asked Grandma. My desire for her wisdom was selfish: I was about to enter my third year of medical school, and I'd never felt more lost in my identity. Medical school is one of those things I didn't understand until I was in it, and once there, I wasn't sure if I liked how its chaos and competitiveness fit me. It seemed like nursing was closer to the models of care that inspired me, so why did I choose to become a doctor? And worse, I felt like a bad person: never moral enough, never mature enough, never reasonable enough to do the work required. I felt like I was throwing spaghetti on the wall to see what sticks. When I told my aunt how I felt, she responded "I love throwing spaghetti on the wall!" I thought Auntie Neng was using a metaphor until she added, "That's how you know it's cooked."
I had never talked to Auntie Neng about being a nurse. When I'm with her, I revert to my 10-year-old self, my only duty being to eat well and have room for seconds. Many things about her remain a mystery to me, but here are the things I do know: She learned martial arts to defend herself in her nursing job when things got out of hand; she takes me to Silo Silo to get buttery BBQ squid; I'm slightly scared of her. She once attached an intercom speaker to her truck to tell pedestrians they were walking too slowly. The truckers know her by her call sign "Moonshadow." She is the only nurse I know who would work all night, then drive to ski all day, only to drive back for her shift at the psychiatric hospital the following evening. Even though I'm 25, I'm still her little niece.
A few days into our road trip, she agreed to sit down and answer questions. This would be the first time we'd talked to each other like this, peeking into the store of her dreams and motivations. Being her interviewer felt like taking the plastic off the living room couch: forbidden.
"Why did you decide to become a nurse?" I pressed 'record' on my voice memo app. We had just finished dinner; the humors of vinegar and fish weighed in the air. "For me, it wasn't really travel…I just wanted to serve humanity…," Auntie Neng replied as she fished through her bag for some photographs. She showed me one of her posing in a blazer with blown-out hair, bangs, and Black-Swan-style eyeliner. "Don't I look like a movie star?" she asked. She did. One of her patients, a man with AIDs, was a Hollywood makeup artist and asked if he could do her makeup after he was discharged. "There were two of us nurses. I took them to my apartment, and he did our makeup."
I thought about what my school would do if I did this with a patient. Blurring patient-friend boundaries is against medical school protocol. I specifically recall having a class where I role-played as a doctor refusing a patient's invitation to hang out. But to my Auntie Neng, helping her patient fulfill his wish made sense, even if it meant bending the rules. The rest of our interview followed along those lines, with Auntie Neng recounting stories about her patients rather than talking about herself.
Filipino culture is so family-oriented that we care for patients as if they were our relatives. Caring for family members is sacred, yes, and it is also full of grief. Eight years prior, I had watched Grandma slowly lose her mind and her body. When I imagine caring for every patient like I care for family, I wonder if I have that much love to give. I have a lot of regrets about Grandma's death. We had a complicated relationship filled with love. I was "thick-headed," she liked to say—with her angry pinches and tough love also came a sentimentality: "You'll remember your grandma, won't you?" she always asked.
During our weeks-long trip, we went everywhere—and as promised, visited the Taal volcano, located in the province of Batangas about 30 miles south of Manila. But it was only when we went to Auntie Neng's reunion that my vision of Auntie Neng came into focus.
The reunion, themed “Filipiñana” and “'70s retro,” lasted two nights. Hundreds of nurses danced Zumba-style disco clad in '70s memorabilia on an elevated runway. This is awesome, I thought as I watched my Auntie Neng, in her 'Golden Girls' wardrobe, laugh alongside her classmates, Jo and Mary Ann, who both had moxie. I was shy when I first met them. It was like watching a remake of Little Women: their camaraderie was infectious as they played and clamored over each other like sisters. They all changed into matching shoes that looked like socks: Auntie Neng's pink, Jo's black, and Mary Ann's black and pink. "No matter where we are in the universe, we find each other," Auntie Neng said. While they were self-proclaimed "good girls" in school, they also admitted to sneaking out at night to smuggle durian into their dorm, a fruit banned from hotels because of its ability to fill an entire building with its garlicky, oddly human musk.
Seeing them together, I felt envious of their relationship—it's the kind of joyous, carefree connection that is found in childhood but seldom in adulthood. My friendships in medical school feel uneasy, as we're all bent on reaching our dreams to heal others without knowing how to heal ourselves. We're all in this together, right? I ask myself as I walk into my foundations of medicine class, but I'd be lying if I said we weren't divided—by our ethics, our politics, our views on what it takes to heal.
"If you interview anyone, you have to start with Jo," Mary Ann said, "She is our valedictorian." Jo smiled shyly and rolled her eyes as if this were something that happened often. Like many Filipino nurses, Jo became the one to see the world, living and working in the U.S. That dream started early. Growing up, she said, "I would see this beautiful lady in white. She would stand in front of her house every morning waiting for her pedicab to work." The fashionable uniforms, dreams of being well-traveled cosmopolitans, the focus on hospitality—the romantic imagery and aesthetic draw of nursing—were all reminiscent of old-time recruitment ads for flight attendants. I understood Jo: I love wearing my scrubs; they imbue the wearer with moral duty. But it wasn't just duty that brought me to sacrifice so much to be a doctor; it was the draw to follow something Grandma had started, some wild shot in the dark to go outside our circumscribed world. Medicine was our grasp for freedom.
Mary Ann has the gravitas of someone who knows what's going on. She always leads grace, attends church on her iPad, and continuously wears head-to-toe pink floral attire. Like Jo and Auntie Neng, Mary Ann practiced nursing in the States, although it hadn't been her intention. "The opportunity just came up when I applied. When the travel agency found us jobs, there was one in Detroit and that's how I got there." Once there, her commitment was all-in. "In America, when they didn't shampoo patients' hair, I pitied the patients with their matted hair, so I’d pull their heads to the sink and wash them there." It was a small thing, yes, but that culture of care stood out in the hypnotizing churn of the hospital. A few nights later, I watched her wrestle a giant crab into a bag before she put it in the freezer to cook dinner for me—it reflected the same dedicated determination she gave her patients.
As she spoke, I thought back to the era she was describing. I get emotional about Filipino nurses at that time, not just because the majority of nurses were doing dangerous, underpaid work, but because of something I can't quite explain. Words fail. No description will capture the montage that flashes across my mind, like Grandma's betadine-stained fingers trying to cure me of childhood splinters or stories about the hundreds of nurses joining in potluck each year in Oxnard, California. The increasing nurse vacancy rates in 1960s America were echoes of WWII nursing shortages, rioting, and lack of decent pay. U.S. efforts to recruit foreign-born Filipino nurses were strengthened by the 1965 Immigration and Nationality Act, which allowed them to apply for U.S. visas. Meanwhile, economic forces in the Philippines under the Marcos regime pushed overseas workers to stay abroad. Against all odds, my Auntie Neng and her fellow nurses made the best of the circumstances facing them
When it was my turn to leave the Philippines, Auntie Neng, Mary Ann, and Jo sent me off. I felt like I didn't get enough time to fully understand their stories. There is the history of countries, wars, and economics—and there is the history of dreams. "You never stop being a nurse," Auntie Neng said in reference to a disabling fever I suffered during our stay. It's true: I felt like I received the best medical care in the world in the hands of these retired nurses. In my bag, I had multiple gifted Ziplocs of Tylenol, anti-diuretics, and vitamin C tablets, hand-labeled with dosing instructions. There was another dictum they added in their good-byes to me as a soon-to-be doctor. "Respect nurses!" they demanded as I rolled my luggage out the door. "We've been through a lot, you know? We experience the pain of our patients. We know how they feel. Don't be up there on your pedestal."
I knew I was someone who might like my pedestal. Would I ever forget our shared history? I am reminded of them whenever I'm in the hospital: the betadine-stained skin before the first incision, the blue blood-soaked operating room towels. The hospital is a place I never thought I'd find home, and yet, in the nurse breakroom, there is dried mango from Cebu—the same as the package sitting on my desk in my apartment. Feeling flushed and faint during a skin graft operation, it was the nurses who huddled around me, sat me down, and gave me a cup of orange juice. I was adopted by the staff from that point on. When I didn't know what was going on, it was the nurses who put the correct scissors in my hands, told me if I broke sterility, and assuaged me if I made a mistake. I looked like I knew what I was doing because of them.
I still don't know what it is I'm looking for in medicine, but there is something magical that happens when I feel my ancestors gently raise my arm to hold the hand of a patient suffering from severe burns. Grandma's origin story is now a part of my own. When I get back to my medical school dorm, everything looks the same, but everything feels different. I see the mountains and think of Jo dreaming of running away; I take a shower and think of Mary Ann washing her patient's hair; I cook spaghetti and throw it on the wall to see what sticks.
Madison 'Sonni' Palmer is a queer, mixed-race Filipinx writer who holds a BS from the University of Massachusetts Amherst and is studying at Stanford Medical School. She writes to heal.