BROTHER, DOCTOR, COUNSELOR, SLEUTH


Recently, my brother died in the Philippines after suffering a large stroke with complications.

I received the information on Messenger by luck, because normally I look at it perhaps weekly.  The message was concise:  “Please answer. Your brother is in the hospital.”  To underscore the urgency, two videos showed indeed my brother, using a rebreather mask, lying on a gurney, two in PPE attending him. I hadn’t seen him since an afternoon in Oakridge, Oregon, nearly 5 years ago.

For decades, he had gone to the Philippines for half the year, spending the other half in Oakland. He remained there during the pandemic and had been there 15 months. He was found on the floor in his apartment when his girl friend, Lisa, went to see him. She noted the fruit she had hung on his door 3 days earlier was still there, worried, and got a key.  As I later put things together, my brother had a stroke, ending up supine on the floor long enough to get a decubitus ulcer, a bed sore, on his buttocks, and to aspirate, causing pneumonia.  Covid testing was negative. 

He obviously needed to be admitted. The EKG and Chest X-Ray were sent to me using Viber and Telegram. In addition to pneumonia, he had atrial fibrillation with a heart rate of 190 and a left hemiplegia. Such didn’t surprise me given he had a small stroke a few years earlier, a long history of intermittent—and now apparently chronic—atrial fibrillation, heart failure, and taking anticoagulants sporadically, all of which were significant risk factors. He didn’t take his brother’s—my— advice when he was conscious; now he didn’t have a choice, but it was too late.

I learned I needed a 50,000 peso deposit, about $1100, for his hospitalization. Lisa found his wallet and a credit card, so I told her to use it. I knew nothing about his assets, US address, social security number, telephone or passport number, immigration status, end of life wishes, a trust, will, nothing. That was the way my brother liked it. I knew that I couldn’t change his mind: I never had. My father came closest, but he never fully succeeded, either. 

If you don’t have a will or advance directives, read on and note the consequences to those left behind without one to guide decisions.

After admission, Lisa periodically left to buy medications for his treatment at local pharmacies. That was how it is done there.  The CT scan showed a large right hemispheric infarct with swelling, a bad sign.  The next day, I spoke to the neurologist doctor to doctor, impressed by the detail and clarity with which the he presented information.  He wanted my brother to be put on a ventilator to support his lungs, suggesting a 3-day trial, which I thought reasonable.  At that point, we were both concerned of my brother’s ending up in a vegetative state: no comprehension, but appearing awake.

Meanwhile, I tried to sort out costs, deal with the 16 hour time difference, and help Lisa understand the seriousness of my brother’s condition.  Concurrently, I realized I would neither see nor talk to him ever again. Lisa got his computer and her daughter opened it, so we were able to find a few contacts, a bank, an investment account, a retirement account, and a smattering of passwords. I called his investment broker, and when I heard myself say, “My brother is seriously ill in the Philippines, and we need his money for the hospitalization,” I felt like a scammer. I knew nobody could do anything; I just didn’t need their saying “Wait until he wakes up,”when I already had told them he wouldn’t.

That weekend, I used his passwords to log in to a pension fund and his bank account, not that I could do anything with either.  He had 3 phone numbers to try, one with a 63 number that he used in the Philippines. I found his address in Oakland and learned from the pension fund he had no will.  I discovered his credit card was good for $2000, which was useful but already almost maxed out; his savings account had $200. 

I called my lawyer, who told me she found one name on a Listserv in the Bay Area, so I called and left both a voice mail and a summary on the Web site.  That night, I heard from the neurologist, who said the scan looked like more brain emboli had occurred along with incipient gangrene of the left leg. He was dying, so we made him DNR-do not resuscitate—although Lisa wasn’t quite ready to sign it. I had no problems with that.

That Tuesday, my brother rapidly deteriorated and died mid-morning there, early evening Monday here.  While Lisa was grieving and blaming herself, I told her my brother had been more ill than she knew, and she had done everything possible. I was all too familiar with my brother’s approach to life, but she wasn’t,  Still, she obtained his death certificate, somewhat surprising, because I thought the hospital would hold the body until they got paid.  She then sent me a video of the truck’s carrying my brother’s body to the crematorium.  I then called the US Embassy in Manila to see what they would need after he died. It was a strange call, for when they offered condolences, I was now more doctor-sleuth-executor, counseling Lisa at times, and compartmentalizing my brother into the “past” box.  I would be and am now the last surviving member of my birth family.

Once I had the death certificate, his passport copy, my passport copy, his immigration papers, Form 2060, and a copy of his Medicare card for good measure, I sent them to the Embassy, not knowing if it would be sufficient, but if it were, the 4-6 week waiting period for a Consular Report of Death, which I could use to access my brother’s accounts, would start. I would have to notify those contacts I knew, from Facebook and his phone (both very limited), a cousin, and my sister-in-law.

I was fortunate, when I dragged myself away from the ugly reality, that I didn’t have to repatriate his body and decide where to bury it; I didn’t have to deal with his personal effects, either, other than keys and ID.  In the Philippines, he had been loved. He had credit cards with enough money available that Lisa could buy his medicines and have his body cremated. She took enough grief from past girl friends he had and others who thought she had hurt him that I finally had to break social media silence when she asked me to reply to a Facebook post saying, “God only knows what happened.” I wrote, “I don’t claim to speak for God, but I can speak to what happened to him,” writing a concise hard hitting paragraph. The embassy had told me I needed to send a notarized permission letter for Lisa to use.  She operated fine with an un-notarized one.

As sole survivor, I felt strangely unmoored.  For the first time in years, I wanted to talk to my parents, for they would have understood my difficulties with my brother-their son-better than anybody else. I voiced those conversations aloud when I walked.

I asked my bank to help me with the wire transfer to pay the hospital, because it would involve nearly $12,000.  Even as next-of-kin, I had no legal obligation to act.  I was not executor, and I didn’t yet have a lawyer.  But my brother had received good care, was treated well, and I had a moral obligation to pay for it.

That was the first out of pocket money I had spent.  It was fair and just, if expensive. After wiring it, I felt an immense relief that a chapter was closed. My brother would ride off on his bicycle into the great beyond, again leaving behind unfinished business.  Lisa and her daughter would hold constant vigil over his ashes in a small shrine with two candles, a picture of him, for nine days, praying for his soul, a Filipino custom. When I heard that, I chuckled to myself, “Is 9 days long enough?” My parents would have laughed. 

Peace, bro. You were loved but man, you made things more difficult at the end than they had to be, and you still ended up with a shrine.  What a world. Don’t worry about your stuff; little brother can deal with it. 

Author, left, with brother, Oakridge, Oregon, June 2015.

2 Responses to “BROTHER, DOCTOR, COUNSELOR, SLEUTH”

  1. Marjan Says:

    Mike! You are a great brother 🌻

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