Primum non Nocere

“First, do no harm.” These four words perfectly sum up ahimsa, the first all-important yama and my focus for this month. Non-violence, a simple concept at first glance (just don’t get into fist fights or kill anyone, right?) is actually quite complicated when we truly embody it. Up for many interpretations, ahimsa can mean speaking kindly, living selflessly, not harming any living thing (even freakishly big palmetto bugs that fall out of your cabinet and on your head), refraining from eating animals or animal products (more on this later), etcetera. More so, when we really step up our ahimsa game, a yearning not only to “do no harm,” but to DO GOOD emerges. Non-violence becomes more than a restraint; it is a call to action. Certain people who, without hesitation, give the very best of themselves to many, MANY others on a daily basis at significant sacrifice and hardship are, in my mind, modern day bodhisattvas. Dedicating one’s existence to bettering (or saving) the lives of their family members, close friends, acquaintances, and complete strangers is a tall order not suited for the faint of heart. But for some special souls, acting, living, and working with genuine selflessness, kindness, and altruism is a no brainer.

That phrase is, of course, the defining premise of the Hippocratic Oath — the vows that medical students take on their way to becoming real live doctors. I am certain that my father recited this or something similar as he navigated through medical school in the Philippines and then in the U.S. after he immigrated. I’m also certain that most physicians enter that (literally) cutthroat field with the highest and most genuine intentions — to do no harm, act as a healer, and serve the sick, injured, dying, marginalized, and privileged populations alike. Believing whole heartedly (and with other organs) in dedicating one’s life to helping others is the only way anyone could stomach the harsh realities, long hours, and enormous debts required to become a doctor.

My father epitomized that humanitarian philosophy throughout his career and still does in his recent retirement. For over three decades he was one of the most successful, and without a doubt the most beloved, general surgeons in Union County, NC. Growing up I didn’t have the capacity to appreciate just how many lives my father touched, impacted, or saved. Most of my early memories consist of his beeper going off at all hours of the day and night, overhearing interesting but sterile phone calls with fellow doctors and nurses, and him bringing home videos of laparoscopic surgery (yes, shot from the inside…COOL!). When lucky, we enjoyed family dinners together, and long-planned vacations were a precious and well deserved occurrence. My dad worked harder than anyone I know to relentlessly help people he hardly knew at all. This became quite apparent at his 66th surprise birthday party, when not only his family, colleagues, and friends roasted him with stories of his unique love, humor, and devotion, but total strangers stood up to share how they or their loved ones would not be alive without him and the immense debt of gratitude they felt. The reach of my father’s magnanimity extends far beyond just the people has healed.

My dad worked harder than anyone I know to relentlessly help people he hardly knew at all.

Of course all of his efforts were directed towards the endgame of caring and providing for those closest to him, his family. The amount of love that my dad, Virgilio Soriano Ipapo, M.D., has for my sister and me, my mother, and for the last 20 years my stepmother is, I still find, incomprehensible. He goes out of his way to spend time with his family — treating everyone to big dinners, playing host for the holidays, and attending EVERY school and professional event that he can, not just of his four children / stepchildren, but his six (soon seven) grandkids as well. Family vacations are notoriously epic, and all of my friends can attest to his ridiculous generosity and welcoming demeanor. In whatever hat he wears — father, husband, brother, friend, doctor — my dad is driven not only by those simple words, “Do no harm,” but an incessant need to love, share, and give his best self to literally every life he touches.

So when, this past New Years Eve, my father was diagnosed with advanced esophageal cancer, we were all, to say the least, devastated beyond belief. Some pesky back pain led him to his own physician who recommended further testing, revealing lesions not only in his esophagus but also in his liver, right lung, and multiple lymph nodes. With virtually no symptoms and after regular routine checkups, he (and the whole family) received this crushing news point blank. The cancer is aggressive and inoperable, and his oncologist has him on a plan of three weeks of daily radiation therapy followed by chemotherapy. He has almost completed the fifteen radiation treatments and is feeling the predicted side effects (nausea, lethargy, and loss of appetite) with full force, in stark contrast to the man we all know — vibrant, funny, and hungry for life and ramen.

Of course he has THE BEST team of doctors working with him and my stepmom, Kathy, has been the epitome of sthira and sukha (strength and softness) over the past month; I can’t imagine how hard this is for her and have the highest respect for the rock that she is forcefully learning to be. It goes without saying that the entire family (including his brothers and sisters in the Philippines as well as my mom’s extended side of the family) and his wide network of friends (biker buddies, church friends, and old colleagues) are sharing and sending massive amounts of good thoughts, positive vibes, and prayers his way. As much as I’m not a fan of the “thoughts and prayers” campaign as a go-to solution, in this case, healthy juju in any shape, form, religion, or practice is welcome, appreciated, and hopefully effective.

The laws of karma expand way beyond this lifetime.

Yet no matter how positive we all stay, I can’t help but feel overcome by oscillating bouts of deep sorrow, angry frustration, and borderline acceptance. I mean… this just doesn’t make sense. Sure, my dad has not been a shining beacon of health in his own lifestyle (as they say, “doctors make the worst patients”). But particularly since his retirement, he has been eating super well (by Western standards), incredibly active (golfing and daily gym visits), and losing some extra weight (that pesky Filipino buddha belly is now gone). All the kids have commented how great he looks, how energetic he seems, and that he actually appears to be getting younger. This is the man who, not that long ago, rode his Harley Davidson across the country and back; he went skydiving last fall (incidentally, in tribute to a friend who lost her battle with cancer); he and his equally fun-loving wife go shag dancing on a regular basis. Not quite the picture of someone who suddenly gets a formidable illness dropped on them, right?

But also… this just DOESN’T MAKE SENSE. In what kind of world does a person who devotes their entire adult existence to helping others, saving lives, and sharing compassion deserve to hear, “I’m sorry, you have advanced adenocarcinoma. Oh, and it’s spread to some of the most notoriously difficult to treat places in the body. But thank you for your service!” I know that the laws of karma expand way beyond this lifetime, and trying to find any rhyme or reason to the patterns of tragedy — cancer, natural disasters, plane accidents, etc. — will drive you crazy REAL FAST. But I have a hard time reconciling the actions and intentions my father has taken throughout his life with this news. If there is anyone who should live into their 90s and die in their bed, in their sleep, with a belly full of rice and soy sauce, it’s my dad.

NO ONE deserves cancer — not even serial killers, child pornography pushers, or illiterate, pompous, racist, petty, and cheating political leaders. Due punishment and impeachment? Yes. A tragic and painful fight for their life? No. That’s how it works right? We do good (ahimsa!) and we get good back. Fuck up and get fucked. Apparently not so much. I try my best to employ the calm, even headed, and undramatic spirit I usually am and find myself jumping ahead to the second niyama, santosha (contentment) with grasping desperation. Am I CONTENT with this major life overhaul? No, at least not yet. Am I bitter and bewildered? Most of the time. But I am trying my second best to backtrack and remember my true focus for January and, as it should be, all year — non-violence, kindness, and compassion — for my father, our family, as well as for myself.

Kindness comes in many forms…

Which brings me back to the start — the whole VEGANUARY! thing. How’d it go? Pretty good, considering. I’d give myself a 87% success rate, if I was into that kind of thing. I started out strong, slipped a few times, picked myself back up, and tried again (perhaps you can empathize). Yes, I feel more aware of my food choices and sources as well as the violence that sneakily embeds itself in my grumpy words or bitchy thoughts. But more importantly, I came across a larger interpretation of ahimsa: kindness comes in many forms… such as friendship, self care, and savoring the moment. Like when one of your best friends is in town and orders pimento cheese, which just happens to be YOUR THING, you take a bite. When you’re three weeks into veganism and you just want some goddamn REAL cream in your coffee, you do it. And when you’re having dinner with your dad at Lang Van and he wants to share some summer rolls stuffed with shrimp… you better believe you enjoy EVERY LAST BITE of those suckers.

12 thoughts on “Primum non Nocere

  1. Wow Audrey this was beautifully written. I have been thinking about your dad daily. I have so many wonderful funny memories of your dad from our childhood. I also have been so impressed with his love and joy for life in retirement. You are right that this diagnosis makes no sense and completely not fair. Let me know if I can do anything.

  2. Christine Secrest February 1, 2019 — 2:21 am

    Extremely good!! I worked and had the pleasure of knowing your Dad for 18 years. He is a very kind man. Thank you for posting this. It was wonderful to read.

  3. Your dad saved my life 8.5 years ago. I am so so sad to hear of his passing. I would not be here without him and that thought is not lost on me at all, which is why I stayed in touch with Kathy. I wish I had better words, but there will always be a place in my heart for Dr. Ipapo.

    1. Thank you for your kind words, Courtney. However, he has not passed (thankfully).

  4. Beautiful words!
    I worked with your father when I lived in the Charlotte area. He was very kind, funny, and a great doctor.

  5. Very warm tribute to your Dad. I pray for miracles to happen to your Dad. I am a classmate of your Dad. Prayers for your family .

  6. What a well written story about an incredible man. My heart breaks for and your family. Continued prayers for your beautiful family.

  7. The God that I know and worship is all knowing. I believe He is the creator of the universe and everything in it. I also study God by His teachings in the bible. If I believe any part of the Holy Bible, then I must believe it all. And I do. God’s words tell us that He can heal if He chooses to heal, and He can bring us to himself in heaven if He chooses to. God’s son, Jesus suffered much more here on earth than any of us will. The reason? to save us from the evil that was spread among us soon after creation. Giving our life to Jesus and wanting to serve Him is the way we are saved from the hell that awaits us. Dr Ipapo and I have lived in the same community for many years. I have watched him up close and from a distance in many scenarios. There is no doubt by me or others that have known him, he has lived a life full of good works and love for others. The bible says pray for others, that they may search, seek and find out about Jesus Christ…..praying each person will look inward and have the desire to serve our God and following the teachings of Jesus. That is my sincere prayer for your family. My prayer will now be to ask God to heal your wonderful father. The comfort you will have from knowing Jesus Christ will replace all the hurt and anger this kind of diagnosis will foster. I, like you just want to cry when I find out bad things are happening to good people, but we can have hope for a better life together with our family. My husband, my grown children, and I myself will be praying for Dr. Ipapo’s healing. Thank you sharing your feelings with us readers, and thank you for reading mine too. Jane Carpenter

  8. Sandra Abda King MD February 2, 2019 — 7:13 pm

    As a colleague of your dad, he was our go-to -guy when we needed a general surgeon. His kindness shone through in his bedside manner, making him well loved. His surgical skills helped so many, including my own husband, and many of my patients. My heart breaks for your family, as I do understand , that the thought of losing the Anchor of your family is devestating. As a dad he endlessly bragged on his girls. When he wasn’t holding your hand, he always had your back. Virgil , fight the good fight we are praying for you and all your beautiful family

  9. Emily Simpson Dillingham February 3, 2019 — 4:37 am

    I have been knowing your dad 30 years, I was a respiratory therapist at cmc union for 36 years, I had first hand knowledge of how great a doctor he is. He saved my mom’s life in 1987. She was in a horrible auto accident, he stayed with her all, night in ICU. Until she was stabilized. Not only is he a great doctor, but he was always so kind to all the hospital workers. I love and have, alot of respect for your dad. You all are in my thoughts, and prayers.

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