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Death, Medicine, and What it Means to Be Filipino-American

September 17, 2021

My name is John Marco Cipriaso. I like to go by Marc. I am Filipino-American. My parents met in medical school in the Philippines, then moved and completed PM&R (physical medicine and rehabilitation) residencies in Philadelphia, where I was born. My mom is a physiatrist. My dad was a physiatrist. He passed away when I was 15 years old. He had a stroke in 2009, lived in a wheelchair for four years, then died in 2013. He is mainly what inspired me to pursue medicine. Death, medicine, and Filipino-Americanness make up the foundation of who I am. Challenges in my first year of medical school have made this clearer to me than ever, forcing me to dig deep and find an inner strength.

In the Philippines, there is nothing more important than your pamilya. I’m not just talking about your mom, dad, brother, and sister. Everyone plays a big role: your titos, your titas, your lolos, your lolas, your pinsans and your pamangkins. My mom is the second youngest in a family of nine siblings. This makes every family gathering a massive undertaking – dozens of people stuffed into one house, ranging from the babies whose names you struggle to remember to the grandmas and grandpas that you love to catch up with. But being Filipino-American, I’d only be able to see my family every so often. Growing up, I would go to the Philippines and visit  once every five years or so. Of course, I kept up with them and generally knew what they were up to, but real connections and time spent together were  reserved for those two weeks in summer or Christmas vacations. Most of what I knew about all my titos and titas came in the form of stories that my mom would tell us: tales of what they were like growing up and how they helped her succeed and become a physician.

Of course, with such a large family, dealing with death is an inevitability. Before I started medical school, I kind of thought that death couldn’t faze me anymore. I’ve seen countless family members pass away, so I figured that I had mastered the art of getting through it. Even when my dad died eight years ago, I showed up to the wake and funeral and masses and prayer services with the appearance of strength. I had to be tough for my mom, and especially for my two younger brothers, who knew less about what was going on than I did. But this past year seems to have turned that around. Maybe it was the constant worry over COVID-19, the countless dooming new headlines about politics and society, or the lonely struggle completing the first year of medical school mostly on the computer. But something in me broke. In the middle of the neurology block, I found myself in a small room in the library, completely distraught and swiping through old pictures of my dad. I thought that I had gotten over his death by now but hearing a lecture about strokes pushed me over the edge. I could barely see the screen through my tears. Thoughts about him floated in and out of my head for days: the exact mechanisms of his stroke, how it led to his state that eventually killed him, and how the heck I’m supposed to be caring for people going through the same thing when I haven’t even processed  his illness and death yet.

To add to all that, 2021 forced my mom’s family to come to terms with two massive losses. In March, my Tita Ledy, my mom’s older sister, passed away. Just last week, my Tito Jimmy, my mom’s older brother, also died. When I heard the news about my aunt, I was paralyzed and could barely think straight. I had mentioned to her that I was planning on practicing speaking more Tagalog, the national language of the Philippines, after my first year of medical school. I was getting excited to be able to better connect with her. And then, tuning in to prayer services for my late uncle, I’m a sobbing mess during a video of memories with him. He would spend weeks with us when we visited, driving us around and making sure that we were taken care of. I figured that starting medical school meant that I was ready to care for people from birth to death. It’s just not the same when it’s happening to your family and the only way that you can mourn them is through a Zoom meeting.

Even in such a massive family, my mom is the only doctor. This means that she is the point person when it comes to all things health related. Whether it’s scolding my relatives for drinking Coke and eating fried food or helping to navigate them through a complicated health system, she has always been there for them, even while living halfway across the world. My family’s health is the entire reason why I wanted to be a doctor as well. Seeing my dad after he had a stroke inspired me to be there for people going through similar ordeals. I knew how medical tragedies impacted families, so I knew that I could tackle it. At this point in my medical school journey, I feel more and more ready to enter this profession and take care of patients. After speaking to a therapist and passing my OSCE, I even feel ready for stroke patients. But I am wholly unsure of the role of the family’s go-to expert. What my mom does for the family is noble, inspiring, and important. But it also sounds impossible. Knowing exactly what mechanisms are causing your role models and loved ones to deteriorate. Trying everything you can to get your family to listen to your expertise, because you know of the possible consequences. Feeling the weight of the world when you know the inevitable before everyone else does. I cannot even begin to imagine the levels of stress when it comes to making medical decisions for people that have shaped who you are and have been there for you. Being the one to inform the rest of the family when things look bleak. Having to answer to rude questions about what caused it all. Mourning your loved ones but keeping a stoic countenance. Being a doctor, while being a kapamilya – a family member. Coming to terms with the pathophysiology of my dad’s death and watching my mom navigate these two recent deaths in her family have opened my eyes to the inevitable struggles that come with gaining medical knowledge.

My parents sought out the opportunity of their lives in coming to the United States, and I cannot express enough how much this has benefited me. I am eternally grateful for having had the experience of growing up in America, and I look forward to taking those blessings and paying them forward and serving others. But at the same time, I cannot help but notice what being the child of an immigrant truly means in this country. I had felt it while growing up, through the sneers I got in the lunchroom when I brought Filipino food in, to the laughs I heard from white kids about me “looking funny,” to the man at the DMV who thought it strange that an Asian kid was named John, and to the roommate who had to constantly remind me that “all Asians are good at music.” The recent surge in anti-Asian hate and violence made my “otherness”more apparent than ever. For weeks, I feared that a random person on the street would attack me, just because of what I looked like. For the first time, I felt glad that my dad’s parents had moved to the Philippines, away from the United States. Even though I was born right here, in Philadelphia, I will always be “Filipino-American,” never just “American.” But there is a sense of empowerment in that.

For the longest time, I figured that being Filipino-American was all about going to mass, eating adobo, and trying to remember the few words in Tagalog that you hear your parents say. It was about going to the Philippines to visit family every few years, staying connected with other Filipino-Americans in your area, and getting annoyed when your parents don’t understand how American school works. It was about sitting at the cafeteria with all the other Asian kids, learning how to speak English really well, and hiding the fact that you cut your meat with a spoon. But after this tumultuous year, I’ve figured out that being Filipino-American is about all these things and more. It’s about using religion, food, and language to still feel connected to the people that you love, even when they are a full day of plane travel away. It’s about balancing the connection with your family and trying to assimilate into a new culture. It’s about the defense mechanisms you need to learn to feel like you’re really part of the American experience.
It’s hard. It’s hard to truly be there for your family when people die since they are so far away and separated by a twelve-hour time difference. It’s hard to really understand everything that’s going on when Tagalog, which was your first language, is now something that you can barely speak two sentences of. It’s hard to truly feel ready to tackle the world of medicine in a country where you don’t fully feel welcome. But I continue to push. I push for my dad, my Tita Ledy, my Tito Jimmy, all the people who have helped lead me to where I am today. I push so that Filipino-Americans will have a physician who understands the struggle they go through. I push so that people know that I truly belong, and I am ready to positively contribute to this country. So now, I hope you understand when I get outrageously excited when Reading Terminal Market opens a Filipino restaurant. Why I celebrate Jordan Clarkson’s Sixth Man of the Year Award and Jalen Green being the second pick. Why I root for Bruno Mars and Olivia Rodrigo to have the number one song in the country. It means that my fellow Filipino-Americans are being resilient. It means that I can be resilient, too.