Visiting Hours Kythe is a Scottish word that means to manifest, or to make visible.

Author Madeleine LEngle used kything to describe a fictional type of communication, in a sense like telepathy, found in several of the books of her critically acclaimed Time Quartet. Kything in the Time books is a kind of wordless, mind-to-mind communication in which one person, in essence, almost becomes another, seeing through their eyes and feeling through their senses. In such a frame of mind, the two people intuitively know the meaning of what the other is telling them, disregarding such things as words or pictures. Kything is also portrayed as a way to be present with others without regard for space, time, or relative size. Through kything, humans can be together inside a subcellular mitochondrion, or in communication despite being centuries apart. In poetry, Geoffrey Chaucer once wrote, For gentle hearts kythe gentleness, and Sir Walter Scott, It kythes bright because all is dark around it. ---I enter an organization called Kythe-Ateneo, a sector-based group whose primary work is psychosocial support and play therapy for terminally ill children, as a freshman. This is at the suggestion of my best friend Pipay, whos two years older than me and from the same high school, and since I was fourteen has taken it upon herself to treat me as a kind of wayward younger sister figure. I joke that Im not cut out for it, that Im too much of a misanthrope to be able to be good at that sort of thing, that it might depress me so much Ill eventually jump out a windowbut in the interest of friendship and of some other deeper, unarticulated need to extend myself, to do something, anything for someone else, I apply. Im eventually accepted, but as a rule freshmen are disallowed from regular hospital visits for the duration of their first year in order to make way for their burgeoning emotional maturity and adjustment to college life. Hence, I rely on Pipay to ply me

with stories, to answer all the questions I was too shy to ask at the first initial training seminar what the hospitals look like, which kids stand out the most in her memory, how to approach them, what to do, what sort of people visit with her on Wednesday mornings. I begin to think I know them, and I make pictures in my mind of what they look like. There is Chinchin, five years old and a spitfire, for all her small frame. There is long-limbed and taciturn Arnel, kind of a lone wolf at fifteen, but also something of a kuya figure. There is ten-year-old Kim with bowl-cut hair and chubby cheeks, and the inseparable matched pair Marilou and Nicoleone chubby, the other willowy. It generally takes a while to get them to open up to you, Pipay tells me over a standard college students meal of rice and fried siomai in the cafeteria, but when they do, you find a plethora of little quirks and likes and interests that differentiate them from each other. Kim loves chocolate and wants to be a soldier when he grows up, like his father. Arnel plays the guitar, and is a fierce competitor at chess. Chinchins favorite activity is playing with the cooking setor rather, fiercely yelling instructions at the days ate or kuya, or throwing together a strange concoction of puzzle pieces in a plastic spot, and demanding that they eat their tinola with gusto. Marilou is sharp-tongued and contrarian, the sort of girl who throws a death glare when asked to pose for a photo, whereas her best friend Nicole is a sweet, agreeable girl, and has a smile that shines out of her face with or without a camera. ---Kythe is a non-stock, non-profit organization that was first established as a volunteer group in 1992 by two psychology graduate students from the Ateneo de Manila University. Its original purpose was to gather data for their masteral thesis on the positive effects of psychosocial support and play therapy on the emotional health and well-being of pediatric cancer patients. The experience

in turn sparked a personal and professional dedication to improve the quality of life among chronically ill children and their families. In 1992, its founders enlisted 20 student volunteers and one partner-hospital to take part in their cause. Twenty-two years later, Kythe has over 500 individual and corporate volunteers and 11 partner-hospitals. It is estimated that Kythe has worked with over 8,000 children with cancer or other chronic illnesses and their families since it inception. Kythes core competency is the Child Life Program, which aims to alleviate the anxiety of hospitalization for children who suffer from illnesses such as cancer, heart conditions, kidney disease, and blood disorders. Regular interaction and play therapy with trained volunteers are meant to allow the children and their families a measure of relief from painful medical treatments and other stressful aspects of hospital life. Also, since long-term hospitalization tends to arrest a childs growth by depriving him or her of key formative experiences like going to school, playing, studying, interacting normally with other children, and the like, the Child Life program aims to promote a childs normal development in the healthcare setting. At present, Kythe is the only organization in the Philippines to offer the Child Life Program. They have an operational student arm in Kythe-Ateneo, a co-curricular organization composed of and run by students of the Ateneo de Manila University. ---On a visit sometime in October, Pipay tells me, they find Arnels bed empty, the sheets turned down with an eerie finalitywhen I start visiting, she says, Ill soon learn that theres a difference between a bed thats only been temporarily vacated and one whose regular occupant isnt

coming back. The chess set is packed away in one of the playrooms cabinets. They wonder if his family has gone home yet. They wonder who is going to play his guitar now. Kim will follow a few months later, the result of chicken pox and a severely weakened immune system. Pipay calls me tearfully at 2AM to tell me this, tells me how she donated blood for him in a desperate attempt to be of more help, how her last visit to his bedside in the Intensive Care Unit was to drop off bars of Cloud Nine for him and his mother that theyd probably never eat, how she hates that she wont be able to attend his wake. I bite my lip and mumble into the phone, Im sorry, Im sorry, Im sorry. The words come out small, insubstantial as chocolate bars. This scene will repeat itself again over the summer with Chinchin, but its dengue that takes her this time, and we do get to go to her wake in the lonely memorial chapel at AFP Medical Center compound in V. Luna. The chapel is a small room with only a few pews laid out in front of the casket, a small side table with a coffee machine and a paper bag of pandesal for guests. The box is less than three feet long, Chinchin herself doll-like in her stillness, clothed in a pastel-colored, ruffly creation that she probably would have hated had she been alive. I will meet Marilou and Nicole three years later in the same hospital, in considerably happier circumstances. I have just been appointed the Vice President for Hospital Affairs, and am taking my team of sub-officers to AFP Medical Center for an ocular in preparation for when the visit cycle begins anew in July. They are introduced to us as graduates, cancer survivors, who only have to drop in occasionally for maintenance checkups. I recognize them instantly, though Pipay is not with me and theyre no longer the little girls from her stories. They are both high school students now, healthy and beautiful, and it delights me to see that their hair has grown longMarilous curling wildly, Nicoles a straight, shining fall.

We are here primarily as volunteers, and the agenda of the day is folding paper cranes. I sit with Marilou. She asks me what year I am and what Im studying, and is amused when I tell her Im majoring in English. Bakit, ate, anong magagawa mo diyan? In turn I answer that I love stories, and that I want to be a writer somedayand almost naturally, since the conversation has turned to stories, we get to talking about her old friends. She says shes lost count of how many people shes had to say goodbye to. Pagkamatay ni Arnel, nagsunduan na sila halos, she tells me, matter-of-factly, as though it were the most natural thing in the world. Now that I look at her there is something hard in her jawline that the softness of her full cheeks cant mask, in her otherwise bright eyes. How fitting that were in an army hospital; she looks like a veteran at fourteen years of age. I remember my friends back in the safe confines of Ateneo, where nobody seems to die. They are Literature students like me, kids from good schools, kids from closed worlds, kids for whom the real world is just starting to open up into a much bigger place. They have soft faces and bright eyes, too. I remember the looks they give mepart-pity, part-fear, part-confusion, maybe a strain of admirationwhenever we meet for lunch, when they ask why Im so busy with org-work these days and I tell them what we do in Kythe. Ang bigat naman. Is it scary? How can you stand it? Like Im the one putting myself on the front lines of a battlefield. When I ask Marilou if she comes back to visit the hospital often, she nods, equally matterof-factshe needs to, to meet the other kids, to remind them that the story of sickness sometimes has a different ending. ---We generally visit the different affiliate hospitals in groupseach group is headed by a Volunteer Leader, and assigned to a particular schedule (usually a three-hour timeslot on one day of the week) and a particular hospital for one whole semester. It goes without saying that there are no

hard and fast rules to interacting with the children in the assigned pediatric wards. Its good to be be prepared to adjust your approach to your assigned Kythe kid depending on such factors as the childs disposition, his or her physical limitations, his or her age and so on. Similarly, its not advisable to just arbitrarily decide what to do with the child; rather, activities to be done over the course of the hospital visit should be tailored according to these aforementioned needs. In general, Child Life Volunteers make use of a mnemonic called the CHILD Model in order to quickly determine how to approach and begin interacting with pediatric patients, where Ch stands for Chronological Age, I for Issues, L for Limitations, and D for Developmentally Appropriate Intervention. It helps here to think of children as being divided into roughly four developmental stagesthe Infancy Stage (birth until the age of 11 months), the Toddler Stage (1-4 years), School Age (5-12 years), and Adolescence (13-18 years). Besides the physical-biological changes that a child undergoes as he or she matures, each age group can be broadly said to have an attendant set of issues, and mental and emotional needs. At this point it benefits the volunteer to think of his or her own childhood experiences, or those of people he or she knowswhat experiences are common at that age? What concerns? One must also take into account the patients physical limitations. What is the nature of his or her illness? What procedures might he or she be going through? Here your powers of observation will be most important, but it would also help to verify these limitations in a sensitive manner with the patients parents or caregiver, who should have more than adequate knowledge about the nature of their childs condition. This is to make sure that the activities performed will be feasible for your partner kid to perform, and not inadvertently aggravate his or her illness or injury. Taking into account the childs chronological age, issues, and physical limitations, one may then devise a developmentally appropriate intervention, or a general plan of action to be applied

during ones interaction with the child during the hospital encounter. Developmentally appropriate intervention broadly refers to any activity you opt to do with your Kythe kid over the course of the visitwhether this is artwork, playing with a particular kind of toy, or simply sitting down and talkingwhich has ideally been developed with his or her unique situation in mind. ---I cross over into sophomore year and begin visiting regularly. Pipay is my volunteer group leader, and Im not sure if this has happened by chance or if she requested it in order to be able to keep an eye on me. I remember that Kythe is driven by the principle of healing through simple sharing and togetherness, that in each others presence, we and the kids somehow make each other well. The truth of the matter isnt nearly that simple, I feel, but it is at least always realconcrete enough to see and touch with my hands. On the first visit, AFP Medical Center seems to be all concrete, and stainless steel and guards who only ever speak in stern, clipped tones. The sunlight that filters in through the narrow windows is dusty and pale; theres an empty gurney parked tiredly against the glass, a rusty wheelchair and an IV stand. We are led through a maze of dimly lit corridors, and since the elevator is out, we climb a narrow set of slippery stairs in single file, all the way up to the pediatric ward on the sixth floor. We are introduced us to Ate Aida, the Child Life coordinator, a rotund woman in floral scrubs, with close-cropped hair and a loud voice that seems always poised between laughing and shouting. As per her recommendation, well be doing bedside activities today, and she leads us into a large, mint-green communal room with Disney characters painted on the walls. Inside are three children of varying ages, one to a bed, and their mothers. Introductions are brief and cursory, filled in by the details on the small handwritten signs above the headboards of each bed. Jarrell is three,

Colleen eight, both with leukemia. The one who catches my attention is Gab, a one-year-old, with a severe birth defect. The name of Gabs sickness alone is multisyllabic and frightening, but not more so than seeing for ourselves what its doneshe is a little wisp of a baby, always needing to be carried, eyes a little vacant and staring. Ate Aida tells us in a hushed voice that she has no joints. Its hard for her face to form expressions, so itll be equally hard to figure out what shes thinking. Children like this never live long; all told, its a miracle that shes still alive. On the receiving end of this information, I can almost imagine a figurative mental computer kicking into gear, drawing up the CHILD model. One year old. Female. Baby, so cannot be separated from mother. Severe birth defect. No joints, largely immobile face. Developmentally appropriate intervention? For a moment the room stands still; none of us know how to approach her. We cant figure out how to be Kythers with her. In a sense, we dont know how to love her. What a relief it is that, when I draw closer to her on impulse and put my hands over my face for peek-a-boo, the one thing that makes babies laugh almost without fail, those flat eyes light up, and she gurgles a little in what is unmistakably a laugh. I stop. Laughing cant possibly hurt her, can it? Is this how were supposed to love you, Gab? Is this okay? During bedside visits, we spread ourselves around the room; it is small enough that theres no clear divide between volunteer-kid sets, and everyones pretty much playing with everyone else. Over my shoulder I hear Gabs pretty young mother talking animatedly to my groupmate Fran about how she used to be a call center agent, but quit her job in order to take care of her daughter fulltime, how her husband is a soldier posted in Bicol and his leaves are few and far-between, how she likes to read the Bible and still believes that the dreams she has at night mean something. Meanwhile

Jarrell attempts to climb Pipay, skinny legs and arms flailing in the air, and I color in a page full of butterflies with Colleen. May crush ka ba dito? I ask, playfullybecause what else do girls talk about? She looks me in the eye and answers with an amusing gravity that is utterly unbefitting her age, Wala. E baka meron namang may crush sa yo. Equally gravely, but now with the tiniest hint of a sparkle in the eye: Meron. Marami. Later that year, Pipay graduates, and I apply to be an officer. Unexpectedly enough, I inherit her position and her habitsthe need to tell stories to and about these children, the need to write down all their names and to search for their faces each new week I return to the ward. I am obligated, now, never to miss a visit. Im in the hospital every week, sometimes twice a week. I am constantly learning things about the kids, filing them away in a little cabinet in my mind. Jarrell loves to be carried; Gab enjoys peek-a-boo and cookies and chocolate milk. Colleen loves to dance, so I make a playlist for her on my phone of all the songs she says she likesBaby, Hawak-Kamay, Nothings Gonna Stop Us Now. I learn to repeat promises to myself like a litany. Ill see you again soon. Ill see you when I dowhenever, wherever that is. Please be here then. ---Do not give money or dole-outs to patients. If asked, make it clear early on that the purpose of our visits is to provide the patients and their families with company and support. If you are told of a particular familys dire financial situation, or if you find that a patient is especially in need of help in this regard, you may refer their needs to the Child Life staff. Likewise, do not give out your cellphone numbers, home numbers, address, or any other contact information, in order to protect your privacy.

Ask permission from the Child Life staff if you intend to give food and/or gifts to the patients, as some children may be under dietary restrictions. Additionally, patients are confined in wards. Hence, if you wish to give something to one patient, you should be prepared to give the same to all the other children in the ward in order to prevent fostering envy and starting fights. The golden rule in the hospital is When in doubt, dont. Even if you have medical experience (e.g. you are a medical student or a taking up a pre-medical course, have parents or close relatives who are doctors, or are generally familiar with the hospital environment and various medical procedures) do not touch the equipment attached to the patient or in the room. Call the caregiver or nurse if the patient needs to use the restroom, and especially if the patient expresses any pain or discomfort, as they are most likely to be familiar with the childs condition and will best know how to address these difficulties. Ask the Child Life staff, patient, and familys permission before taking pictures or videos. Some hospitals also have strict rules and regulations with regard to camera use. Be sure to dress comfortably and practically for hospital visits. Long pants and close-toed shoes are required. T-shirts are encouraged for ease of movement. No plain white, pleasethe children tend to associate the color with the presence of doctors or nurses, which they equate in turn with painful medical procedures. Avoid wearing flashy jewelry and strong colognes or perfumes. Eat a full meal and take vitamins before coming to the hospital. If you are feeling sick, postpone volunteer work. If you are feeling emotionally down, postpone volunteer work. The children are very sensitive to your emotional state, and will be taking cues from your disposition and energy level during the visit. ----

Most of the hospitals we go to have been Kythe hospitals for years, and employ Child Life staff and volunteer coordinators sourced directly from Kythe, Inc., so doctors and nurses tend not to be fazed by the sight of random college students going in and out in droves, armed with coloring books and crayons and sets of building blocks. Even the children we visit and their families are often long-term patients, and remain in the hospital for months at a timeand over the course of that period, they, too, become familiar with Kythe. They build up a relationship with it. They know us when they see us. Rarely do we have to justify our presence to anyone. People assume, more often than not, that we know what were doing. From time to time, though, inevitably, there will be someone. Often its the parent of a new patient, sometimes its a new doctor or nurse, who fixes me or a groupmate with a critical eye and asks all sorts of questions we dont exactly know how to answer. Sino kayo? Anong ginagawa niyo rito? Sometimes they are not questions but statements, sharpened and thrown. Istorbo lang kayo dito. Pinapagod niyo lang yung bata. Magdonate na lang kaya kayo sa ospitalmga Atenista naman kayo e. What they really want to know, of course, is how our presence is supposed to make these sick children well. In the face of that question, the textbook answers seem flimsy. Were just here to play. Were not here for ourselves. Were here to be with themand with you, too. We cant make them well, but we want to try and make them happy. The hospital is not a terrible place. I see one girl being subjected to this relentless questioning by the father of the little boy shes doing a connect-the-dots puzzle with. He has seen her fair skin and her curly hair and pegged her instantly for a spoiled rich kid whos playing at being a good person. The set of his shoulders tells her he wouldnt have her anywhere near his son if he had a choice in the matter. I cant bring myself to blame him. I know too well what he seems to be thinking. Who are we, anyway? We dont look like we know the first thing about pain.

I place my hand on my groupmates shoulder and motion her aside with my eyes; she forces a smile as he tells the little boy, O, sige, Jimboy, kailangan ko nang umalis. Sa yo na lang yan. He looks up at her, visibly dismayed. Saan kayo pupunta? Gusto ko pang mag-color. I face the father. I have become adept in the art of deference. Mga student volunteers lang po kami. Pasensya na po. Lipat na lang po kami sa kabila. Pasensya na po sa istorbo. Pasensya na po sa abala. ---Establish a warm and caring relationship with the children by being sensitive to their emotional state. If you find a high-energy, responsive, receptive Kythe kid to play with on a particular day, consider yourself lucky. Note that not all children will open up immediately in your presence or accept invitations to play. Some may be shy, tired, or anxious due to the stress caused by frightening or painful medical procedures, as well as prolonged hospital stays. Respect the wishes of children who dont want to be disturbed. With children who seem potentially receptive but slow to warm up, be patient. Stay near them, talk gently with them, or give them a glimpse of your potential activities for the day. Allow them to come out of their shells and get to know you at their own pace. Respect the pace, space, and preferences of the child. Do not hurry the child if the child wants to linger over a particular activity, or if the child performs the activity more slowly than his or her peers. Do not force the child to do an activity that he or she will not enjoy; instead, suggest several things to do, and allow the child to choose. Likewise, do not insist that an activity be done properlytheres nothing wrong, for instance, with the kids wanting to color the sky green, or the ocean pink, as long as they enjoy themselves. Set clear and firm limits. You and your assigned patient may do anything, so long as it does not hurt either of you, or anyone else in the ward. If the child suggests something unacceptable (e.g.

wrestling, sapakan, uncontrolled running around etc.), tell them gently but firmly that this is not acceptable, and offer an alternative list of things to do. Encourage them with the idea that they will probably enjoy these things more. Establish a supportive relationship with the parents or caregiver. Make them your allies. This is especially important in the cases of children who are slow to warm up, as the parents may be able to help you break the ice, as well as advise you with regard to the childs particular interests and likes. It is likely that the child will be more inclined to trust you if he or she sees you interacting easily with his or her parents. However, most importantly, remember that we go to the hospitals to provide emotional support not only to the patients, but to their families as well. Do engage family members and caregivers in conversation if they are open to it. Empower the child rather than help. Many of the children have been subject to long-term confinement lasting anywhere from a few weeks to several years, and are therefore probably used to having even the most menial of daily tasks done for them by a caregiver, or a member of the medical staff. In light of this, it generally makes them feel good to be able to do something for themselves, no matter how small. Allow the child, for example, to open a bottle of paint on his ownor unscrew a stuck lid partway, and let him or her finish the job. Let the child draw or color his or her own artwork. If the child cannot hold art materials due to an IV drip or other obstructions, allow the child to direct your activity by giving you instructions with regard to what to draw, what colors to use, and so on. Respect the patient and his or her familys confidentiality, as well as the familys practices, culture, and traditions, which may differ significantly from your own. If the child or any members of his or her family feel comfortable enough with you over the course of the visit, they choose to tell you at length about various personal matters. Support them by listening without judgment, and keep

anything the child or the family may tell you fully confidential. Try to steer away from potentially heavy or contentious topics of conversation with the family, such as religion and politics. Do not preach to or pray over the child. Respect the Child Life Staffs directions and decisions. Do consult your Child Life coordinator at the beginning of each visit, and take any advice they might offer about which children you might choose to interact with for the day, or what activities might be good to do. They are professionally trained to implement the Child Life program, and can be trusted to be quite familiar with the particular environment of the hospital to which they have been assigned. They also have day-to-day contact with the patients in the ward, and often end up getting to know both them and their families very well. Be in the moment. Relax and have fun. Our aim, after all, is to ensure that the Kythe kids experience, to as full an extent as possible, a semblance of a normal childhoodthe surest way to do this is to leave behind all distractions, and give them all our attention, energy, and joy. ---As Vice President for Hospital Affairs, one of my first tasks for the academic year is to organize a series of training and orientation seminars for the prospective member base, to be held during the recruitment week for student orgs in mid-July. These seminars are meant to give applicants a comprehensive picture of Kythes advocacy and the nature of its worka view of what theyre getting into, so to speak, before the screening process moves into the interview stage. Of the initial pool of about five hundred applicants, the goal of the officer base is to handpick about a hundred and fifty, two hundred at most of the seemingly most competent, most understanding, most assiduous individuals of the lot.

I ask why theyre interested in Kythe. Some raise their hands timidly and say they love children, some want experience for medical school, some say the advocacy seems so meaningful and fulfilling. Some are more cavalier, though perhaps also more honestthey only joined because their friends are joining, because theres a cute girl here they want to get to know. I tell them this is serious business. I talk about retinoblastoma, lymphoma, leukemia, about how theyre big words, too big for little kids to grapple with. I show them photos, and the faces of Chinchin, Arnel, Kim, ten, twenty children in Heaven beam down on us from my Powerpoint slides. I take note of who frowns, whose eyes widen in pity or fear, who shrugs and goes back to tweeting or checking Facebook on their phone. I want to say people like you shouldnt be able to look on these faces and live. I want to say everything I have to tell you will not prepare you, one bit, for whats out there. You can know the rules like the back of your hand, the dos and donts, the CHILD model, the name of every Kythe hospital in the Philippines. At the moment that you face the child and the child faces you and you see what sickness is, youll forgetand you will have to be the one to take them by the hand and pretend you know what youre doing. You will have to relearn all the things youve been taught, on your own, if you really want to stay. After the training seminar its protocol that I have my sub-officers pass around evaluation sheets. The feedback that comes back is predictable: The people facilitating were so friendly, I liked the ice-breaker, I learned so much, I value the cause so much more now, the food was good. As Vice President for Hospital Affairs, it will be my responsibility to know all these individuals names, to sort them into volunteer groups according to their schedules, and to monitor their attendance at regular hospital visits to see if they meet the required minimum of four visits a semester. Only those with four visits and above will be considered retained members of KytheAteneo for the second semester. In my experience as an officer of the Hospitals department, only

half of the initial two hundred will meet this requirement. The rest will retain their membership by writing letters of appeal that all say more or less the same thingI could not complete my visits because of my busy schedule, please retain me as a member for the second semester, I promise to do better next time, I love the kids, Im committed to this org, I want to be a source of hope and joy and renewed zest for life for other people, et cetera, et cetera. Everyone wants to be a source of hope, where convenient. Everyone wants to give joy, where convenient, and only if they receive joy in return. As Vice President for Hospital Affairs, its my job to deal with all the parts that dont feel good, to keep everyone else safe. These people will be names on lists and letters to me; Ill know how to quantify love and commitment for each one. Ill measure it out in hours. ---Seven-year-old James is one of my last kids as an undergraduate, and upon meeting me immediately demands to know if my cellphone has a front camera. I reply yes and pull it out of my pocket. He proceeds, to my amusement, to take pictures of himselfhe is a handsome boy and he knows it, slender and tisoy, cocking an eyebrow and smirking at his onscreen. His best-friend, chubby buck-toothed Meynard one bed over, crows that he should stop that, that that sort of stuff is obviously for girls, and informs me in the same breath that James is obviously bading. Their friendship is infused, naturally, with this sort of vitriol, but I know the jibes are loving, as are the punches that James begins to throw at Meynards head and shoulders when he returns my phone and leaps into his bed seconds later. I pry them apart with my arms and the promise of toys, but naturally that starts another fightMeynard wants the fishing game, James wants the cooking set, which Meynard promptly decries as bading (obviously). After some minutes of arguing we arrive at a compromise. Meynard will

fish, and give his catch to James, who will promptly cook them and serve them to us on the condition that the word bading does not come out of Meynards mouth for at least the next hour, else he will poison our meal and we will die. Jamess mother, a smiling, benevolent presence across the room, near the television, tells me to excuse the boys; theyve both been in and out of the hospital for the past few years, and have been friends pretty much ever since. I open my mouth to answer, but am distracted because I suddenly need to pull Jamess feet away from Meynards jaw. Two weeks later, Meynard is on a plane with his mother, winging his way back to Cebu, where the rest of his family is. I walk into the ward and James runs to meet me, tries to jump into my arms and wrestle his way onto my back for a piggyback ride. He says Meynard has gone home because he is well, hes finally graduated from chemo and wont be coming back to the hospital for a while. I frown a littleJames in turn is thinner than I remember, his cheeks a little more sunken in, and his skin is warm, feverish to the touch. To distract myself, I ask him if hell miss his friend. Dont they both want to be soldiers? Arent they brothers in arms? James response is to make a face. Bahala siya. Kailan ka uuwi, James? He doesnt know, just that his mother says they still need to do some tests. He says he doesnt like tests. The doctors are meddlesome and annoying, and he hates needles. Most of all, hes worried theyll have to shave off all his hair, or that hell lose it to yet another round of chemo. Hes proud of the way its grown out. Ate, paano kung hindi na ako pogi? He asks for my cellphone and takes a few pictures of himself without waiting for me to answer, thumb and forefinger splayed under his chin. He looks up to tell me hell let me be in one of them, as long as he still gets to take up most of the frame. This is the first and the last photo we ever take, because almost as if on cue a male nurse enters and tells him to put his shoes onits time to go down to the Radiology Department for another test. In an instant, he changes, becoming scowly

and sullen and difficult. He crosses his arms over his chest. He stamps his feet. Alam mo namang ayoko dun, Kuya. Under his breath, Putang ina naman. I put on a brave smile for him as hes led away, but I dont like the look he shoots back at me over his shoulder. Its like somewhere inside him, a light has gone out. ---Over the years, Kythe-Ateneo has developed its own protocols for dealing with the death of a child. Often the Child Life Coordinator assigned in the concerned hospital will alert key members of the officer base, usually the president, the overall head of the Hospital Affairs department and/or the concerned area officers, and update them with basic information, such as the childs name and age, his or her date of death, sometimes the manner of death if asked. In-turn, the officers take over relaying the information to the rest of the member base. First it is important to determine which members assigned to that particular hospital for weekly visits may have had the chance to interact with, or developed an attachment to, the particular child, and alert them personally via call or text message. Assuring them that they may turn to their org-mates, especially those in the officer base, for support and comfort is key. After this, a general announcement is released via e-mail, underscored always by an assurance that in these instances of loss no one is aloneIf you need to talk to someone, please approach any of the officers and ask to set up a consultation. Usually also included in the email blast are the date, time and venue of the traditional commemoration ceremony, an open event held in honor of each Kythe kid who passes away. By the time I am a senior, and the appointed head of Hospital Affairs, my teammates and I have sent those text messages more times than I can count. We punch them into the buttons of our cellphones from muscle memory, our hands like machinery, the messages coming down the figurative assembly line in perfect, tactful little packages.

Hello, [name of Hospital Coordinator]. Good morning po. Pwede ko po bang hingin yung date of birth ni [name of Patient]? Date of death? Opo, para sa bulletin po. Ano po ulit yung ikinamatay niya? Thank you. Hello, team. Im sorry to be bringing bad news, but [name of Patient] from [name of Hospital] passed away last night. If you know anyone in your visit groups who might have been close to him/her, please let them know. Make sure to be sensitive in disseminating this information. If anyone needs anything, make sure you tell them that were here to support themas I am here to support you, always, if you need anyone to talk to. Please stand by for announcements regarding when and where the official memorial services, as well as the in-school commemoration ceremony, will be held. Please pray for [name of Patient], for the repose of her soul, and for comfort and strength for all her loved ones who remain behind. Hello, [name of Member]. Are you free to talk right now? Im sorry to be bringing bad news; I just thought it would be good for you to let you know personally. [Name of Patient] from [name of Hospital] passed away last night, [consider including Cause of Death if known/appropriate]. Im really, really sorry. If you need to talk to anyone, please remember that were here for you. Feel free to approach any member of the officer base you might feel comfortable with anytime. Well keep you posted with regard to details for the wake, as well as the commemoration ceremony. Please pray. Team, sino nga ba yung bibili dapat ng balloons para sa commemoration mamaya? Whos doing the prayer? Please reply. Thanks. We can do this, guys. At such time we wonder all manner of things. Why, for instance, do we feel the need to apologize when were talking to the loved ones of the recently deceased? Its not as though we killed them. Maybe its because we couldnt do anything to make them stay? Whos buying the balloons? How are we still here? ----

A Philosophy professor Im particularly close to tells me that I seem to be blooming. Ive lost weight since the start of the year, she says, and my hair has grown out. Im doing exceedingly well in her class, she saysif my final oral exam goes well, I can look forward to an A. If Im doing as well in the rest of my classes, she says, I can probably look forward to graduating with Latin honors. Am I particularly inspired? Maybe its because Im dating someone right now? I laugh and assure her theres no one, and that if I look good at all its because Im overcompensating for all the stress that is frothing just below the surface. My friends are preparing themselves in their own ways for life post-graduation. A handful are applying to medical school or law school; others are looking for jobs in the corporate world, in the government, in the development sector, anywhere theres an opening. They say they envy me my comparatively modest aspirations. I want to come back to the Ateneo English department to teach, while simultaneously taking classes toward an MA in Creative Writing at UP Diliman. Ill start off with general English and Literature subjects for freshmen, hopefully work my way up to Literature and Creative Writing electives once I have my graduate degree. That will be my life for maybe the next five years; Ive known it pretty much since I entered college. I seem to have it all figured out. I can only smile and say I hope so. The truth is that I find the rhetoric of hope tiring, these days. In his writings, Gabriel Marcel says that hope is when the soul is in darkness and turns toward a light which it cannot yet perceive. Here we understand the soul as the self, the subject, the I, and darkness as a state of trial, for instance captivity, powerlessness, loss, or solitude. Marcel uses the act of turning toward to describe an orientation of openness, a yearning to be delivered from the trial that is the obverse side of total despair. Despair obscures any possibilities of a different future, as the present conditions appear to the despairing person as permanently frozen. This can lead to a sense of desperation and eventually a giving up, and the despairing person often

withdraws from life into isolation and alienation from others. But Marcel argues that only when the temptation to despair is present can hope emergein this sense, hope is a returning home, a means of finding ones own way, of coming back to the meaning and value of ones life. If Im not mistaken it was also Gabriel Marcel that it was love that had the power to rescue someone from death. To tell someone I love you is the same as saying you shall not die. This is supposedly the greatest hope there is. The truth is that Im having a hard time tying all these things together, and my last Philosophy oral exam is tomorrow. I know its not enough to know these things in my head, to treat the connections like math, where everything adds up and there is always only one answer. My professor will size me up with her eyes across her desk and ask, So, how does all of this the relate back to your life? Do you see the world differently now? I dont know. When Colleen died at the beginning of last year I tried to write a poem, for a creative writing class this time. I thought about Colleen, about how she almost never spoke but her face came alive when she danced, about how when you finally managed to make her laugh you forgot her bald head and her patchy, scabbed-over skin. Maraming may crush sa akin. Those were big words too. They were too big to be defanged into a manicured collection of stanzas. I called on my Poetry professor then for a consultation, ostensibly to ask her How can I make this better? though I suppose the real question was How can you even write something like this? Try, she said. Some things are more important than art. Try to write, for those things. ---The commemoration ceremony runs this way. All of those who wish to celebrate the life of the child who has passed on gather at an appointed time or place, usually a classroom on campus in the late afternoon or evening. Sometimes we are as few as two or three, sometimes as many as eight,

never more than ten. We spend the first few minutes writing on little slips of paper. Maybe these are messages to the child, or song lyrics, or just a small explosion of emotion in clumsily chosen words, really whatever comes to mind. We never ask about, let alone look at, each others papers. Often the designated facilitator will flash a photo of the kid in question from the overhead projector and play some soft music to fill the silence and set the mood. The talking comes after. There are no guide questions, no real prescribed flow. Some of us talk about how were feeling, or try to. Some of us talk about ourselves. This is my first time losing a kid, my third time, my fifth time. This is my first brush with death ever, and I dont know what to do. You get asked about this at the interview all the time, whether you know what youre getting into, what youll do when a kid youve been close to passes away, but its different when it actually happens, of course. I didnt think Id cry. But most often this time to talk flowers into storytelling, and in these moments what always stands out to me most starkly is what is common. Others remember Jamess endearing fixation with his own face, his insistence on taking at least five selfies whenever someone whipped out their phone, and then demanding to see them immediately after, because of course there would be little nuances of difference. Someone else had once been ordered by Chinchin to believe that a little plastic bowl full of jigsaw puzzle pieces was vegetable soup. I am not the only one who has danced with Colleen to a novelty song, talked about dreams with Gabs mother, carried Jarrell piggyback style up and down the halls of AFP Medical Center Pediatric Ward 6C. The balloons come in at the very end. They must be helium balloons on strings; its absolutely imperative that theyre brightly colored. We take our little pieces of paper and secure them to the strings, or tape them to the balloons themselves, and then we go outside together and let them go, and this gesture is at once a handful of big, shapeless words, at once mourning and gratitude and friendship and farewell. Ive always thought that the trick to understanding words is

tacking them onto something you can see and touch with your handsthe photo on the screen back in the classroom, the wobbly loop and curl of my friends handwriting, the veritable cloud of balloons that disperses as I divide it among my group, making sure everyone has a piece of something to release into the sky. We make a lopsided circle of people, hands silently extended, our small voices going up into the pale Quezon City skyto some sweeter, farther away place, maybe. Regular hospital visits will resume the following day.