As one gets older, one starts to do things in reverse.

When I see babies, I explain to parents that part of the neurodevelopmental assessment is their cephalocaudal growth. Which means that control of motor skills begin from the head first.  Then they turn from side to side, are able to sit with support, sit alone, stand with support, stand alone, walk with support, walk alone, climb and run effortlessly.  Even their brain development is too rapid that you’d miss these milestones at the blink of an eye.

It’s the opposite as one gets older.

Things happen in reverse.  You have difficulty ambulating, standing, and later prefer to lie down. Even the synaptic discharges are far and few.

As one gets older, one starts cutting out people from their lives.  Either because you’ve seen your friends (and relatives) get buried ahead of you, they’ve moved away, or you’ve simply drifted apart.  It becomes painful to attend homecomings because lately, you’re but a handful.

The Christmas season causes anxiety because for many, that Christmas list becomes practically nonexistent.

You take less pictures because those selfies aren’t great shots anymore.  Or that some memories are best kept in your heart and not the iCloud or a photos app.  And instead of looking for love, you dig for it from within your heart.  There are no tears left to shed, because there is nothing to cry over anymore.  The feeling of waking up each day becomes tedious, taxing, and routinary.

Changing diapers from childhood to our senior years and moments is the irony of ageing.

This is the mirror image called LIFE.

Yes.  This is an opinion regarding the “rumours” on the health of the President.  Even before he was elected into office, the wagging tongues claimed that “reliable sources revealed” that the president was not “physically fit” for office.

Politics, after all, has no greater friend than envy.

I get that. For someone like him who has practically lived a more laid back political life as Mayor in Davao, the presidency does NOT provide the same “stress” condition as a city official. I don’t think the president even thought that this was going to be a very, very, very difficult job.

For the record, I am not a fan of any president.  I believe that each and every government official – voted or appointed – should serve the public well.  I may be an optimistic fool, but that’s my take.  Every person sitting, breathing, working and living from the money paid by taxpayers, owe the people their unrelenting allegiance to serve the people well. Your accountability is greater.  And because you’re a public official, everyone has the right to call out the inadequacies of those in government.  Those in government should not be onion-skinned about the right of people to voice their opinion on matters that count.  Or on what is real from fake news. Those who follow the leader, should keep an open mind that the world does not revolve around them alone, their political affiliations or their personal agendas.

While we give everyone the “benefit of the doubt” or try to “see the good” in everyone, accountability is an issue that cannot be simply looked at the other way. The truth, after all, is essential to all government officials.

For months on end, there’s been speculation after speculation of the health of the president.  From the colour of his skin, to the way he walks. From the increased girth of the abdomen, to his holding up his right chin.  From those visits to the hospital at the odd hours of the morning, to the unscheduled trips abroad.  People wonder – is he really sick?

Unlike the previous presidents, where a medical bulletin is provided by the attending physicians regarding the health of the president(s), this sitting president leaves all to speculation.  Perhaps for personal reasons, he would rather keep his health issues to himself.  And while we respect that, it so happens that he is, after all, the president of the Republic of the Philippines now.  Where the consequences of his health will definitely affect a nation, the political scenario, and those surrounding him.  Any bad news would make him a lame duck and will definitely shake up the political environment, considering that the rightful constitutional successor, is (A) a woman, (B) a “yellow”, and (C) was bullied beyond recognition by the “boys” in the circle of the president.

It’s “friends” like these who destroy his name that make him feel so alone today.  I am willing to bet that if he reveals his true medical condition, prognosis and all, the political landscape will change overnight.

But this is how politics plays out.  A total circus in every sense of the word.

And there’s no turning back at this political point in his life.  He was duly elected.  Sworn.  And cannot just say, “I quit. I’ve had enough”.

At 73, you’d really wonder what we’d want out of life.  I get the fact that his intentions are pure.  And will continue to give him the benefit of the doubt that he wants to solve the country’s problems.  The dream of a better nation, after all, isn’t his alone.  It’s the dream of 106,512,074 (as of this writing) Filipinos.  And we’re all depending on one man to lead us to the Promised Land.  And that’s a lot of weight to carry.

The issue here is that we can’t all be at the Promised Land.  Like every journey, there will be people who won’t make it with the herd.  There will be squabbles along the way.  There will be those who will get lost because the road was rough and difficult to follow.  But that only happens when there is division in the ranks.  When there are people during the journey that would want take advantage because they want to be there ahead of others.  This journey is not about colour or creed or sex.  It is about a race that has been wanting to have a better life for the longest time.  It is about the people of a nation that wants to move out from the shame of being called “sick man of Asia”.

But it is the role of the President, as head of the herd, to try to make sure that no one is left behind.  That division among its people because of friends and those he owes election debts to is kept to a minimum if not nil.  Mr. President, you owe nothing to anyone.

You see, we are all following the President’s path.   We, the people, are tag-alongs.  Some of us may not be as close up front as to where the President is.  There are those that are just a “selfie” away from him. Critics will need to understand where the question of the health of the president is coming from.  It is because the current living and economic conditions have become more difficult to bear for every ordinary Juan. Those who are lugging behind, would want to have a quick peak at the leader of the pack.  Asking, where on Earth are we headed for?

And that’s the reason for asking about his health.  We get that.  Everyone gets sick. We all will die eventually.  The leader of the pack must show transparency.  There is no shame in saying whether you are sick or not.  After all, with modern medicine, every disease has better prognosis nowadays.  And when truth is revealed, people tend to be more understanding and sympathetic. It puts all speculations to rest.

At 73, he’s lived a great life.  Family.  Friends.  An industrious city built from scratch.  He has a lot to be proud of.  When health lets you know that it’s time to slow down, it’s a sign.  To reflect on who and what matters most in life.  Regrets are only for fools.  Remember, it’s not only your family that worries about you. In reality, 106 million Filipinos are banking on you to leave them with a better Philippines. That’s the political agenda every President should be committed to. No more. No less.

It is time to show that the administration takes more effort an leaving a legacy worth remembering.

Especially for the last, the least, and the lost.

In 2009, Lord David Owen, a British parliamentarian who served as foreign secretary published an article, co-authored with Dr. Jonathan Davidson in Brain, “Hubris Syndrome:  An acquired personality disorder? A study of US Presidents and UK Prime Ministers over the last 100 years.”

Hubris syndrome is a disorder of the possession of power, particularly power which has been associated with overwhelming success, held for a period of years and minimal constraint on the leader.

Yes, there is a leadership personality disorder. And it is called Hubris Syndrome.

The 14 symptoms of this disorder are:

• narcissistic propensity to see their world primarily as an arena in which to exercise power and seek glory
• predisposition to take actions which seem likely to cast the individual in a good light (i.e., in order to enhance image)
• disproportionate concern with image and presentation
• messianic manner of talking about current activities and a tendency to exaltation
• identification with the nation, or organisation to the extent that the individual regards his/her outlook and interests as identical
• tendency to speak in the third person or use the royal “we”
• excessive confidence in the individual’s own judgement and content for the advice or criticism of others
• exaggerated self-belief, bordering on a sense of omnipotence, in what they personally can achieve
• a belief rather than being accountable to the mundane court of colleagues or public opinion, the court to which they answer is History or God
• An unshakeable belief that in that court they will be vindicated
• Loss of contact with reality; often associated with progressive isolation
• restlessness, recklessness and impulsiveness
• A tendency to allow their “broad vision”, about the moral rectitude of a proposed course, to obviate the need to consider practicality, cost or outcomes
• hubristic incompétence, where things go wrong because too much self-confidence has led the leader not to worry about the nuts and bolts of policy

This was an interesting study where Hubris Syndrome was noted with President George W. Bush and observed a history of alcohol-related problems as related illness.  Bush demonstrated hubristic traits.  British prime ministers David Lloyd George, Neville Chamberlain, Margaret Thatcher and Tony Blair fitted the criteria for Hubris syndrome.

Interestingly, the “comorbidity of narcissistic personality disorder, and perhaps hubris syndrome, with other personality disorders such as histrionic, borderline and sociopathic disorders presented a real problem…If hubris syndrome, or traits of hubris run in families, this would tend to support the existence of the syndrome, or point to possible comorbidity associations. ”

The paper goes on to pointing out that

Because a political leader intoxicated by power can have devastating effects on many people, there is a particular need to create a climate of opinion that political leaders should be held more accountable for their actions.

Hubris syndrome in politicians is a greater threat than conventional illness to the quality of their leadership and the proper government of our world.

Qualities protective against disproportionate hubris, like humour and cynicism are worth mentioning.  But nothing can replace the need for self-control, the preservation of modesty while in power, the ability to be laughed at, and the ability to listen to those who are in a position to advice.

At a time when we are seeing a rise in the populist rulers, it is a good reflection to step back a bit and consider the merits of the study of Owen and Davidson.  After all, as early as 1964, RE Neustadt has argued that a “governed people’s view of a leader’s effectiveness is typically determined by what is happening to them during the leader’s term of office.”

Hubris syndrome is not something that we see in government alone.  It encompasses even the field of academics or business.  From the whiteboard to the board room.  This personality disorder can afflict everyone who has had a taste of power but has not been able to recognise and manage their hubris well.

The history of madness is the history of power.  Because it imagines power, madness is both impotence and omnipotence.  It requires power to control it.  Threatening the normal structures of authority, insanity is engaged in an endless dialogue – a monomaniacal monologue sometimes – about power.

– Roy Porter, “A Social History of Madness: Stories of the Insane”, Weidenfield & Nicholson, p. 39, 1987

Aristotle couldn’t have summed up better the outcome of hubris.

We often underestimate our abilities, simply because we’re used to being undermined.  We’re afraid of exploring of what’s in store in our lives because more often than not, we’ve settled into our comfort zone.

Dolly Parton once said, that “storms make trees take deeper roots“.

I’ve had friends that have asked me about making career changes.  Interestingly, of all the professions, the health and medical profession is the most resilient.  That’s because a lot of doctors (nurses, pharmacists, medical technologists, etc) go into this field because of their “calling”.  Unlike other professional journeys, those in health care and its allied specialties are “dedicated” servants to their careers. Of the health professionals, being a doctor is perhaps the most difficult and challenging.  And I’m not talking about the tests and costs to becoming one here.

Few career paths require such relentless resolve and commitment as the path to becoming a doctor. I am sure that the thousands of doctors out there have their own stories to share.  Some memorable and fulfilling, others tragic and disappointing.  Like everyone else, doctors have feelings.  As a matter of fact, I think that it’s one of the most (if not the most) stressful professions.  Ever.

Being a physician is like tiptoeing on eggshells.  It’s not everyday that you get run of the mill cases where it’s only a cough or cold that needs water and bed rest in order to get better.  It’s usually the cases of having to decide on life and death, on having to tell the patient or their relatives the bad news, of having to grieve with patients rather than celebrating life – that make the profession challenging to hold on to.  The younger ones are usually burned out early.  The older ones would prefer to retire.

Ironically, while there is distinction in being a physician in the Philippines, there are challenges in the daily grind. Multitasking is the norm.  There’s the select few who mix teaching with a little bit of practicing the profession.  They join the academe while dedicating a few select hours to healing.  The second class are those who mix corporate life with an even thinner (or no) practice.  These are the captains of the industry who manage to sneak in a few patients after office hours.  Some of them give up their clinical profession and eventually stay in the corporate world. The third group are those who are full time government employees but engage in private practice if and when they can (usually after office hours or on weekends).  The fourth group are the entrepreneurs who squeeze in personal business trade with their clinical practice.  They usually personally own the business and are able to balance their (other) dream job with their practice.  Finally, there’s the full time practitioner.  He/she hops from one clinic (or hospital) to another (braving the horrendous traffic of the metro) from the break of dawn to dusk is their way of life.

Each of these categories have their pros and cons. The reason for multitasking range from financial remuneration to a personal satisfaction of being able to fulfill one’s passion (academics, research, corporate, business, governance).  The bottomline is, we spread ourselves too thin.

Too busy that we’re not mindful of our daily activities and end up being caught by the burden of doing things for others. Forgetting to be kind to ourselves in the process is not the kind of existence we signed up for, just because we are doctors. We cannot heal others when we are not strong.

You see my friends, we are like trees.  Nature (or life) creates storms to test our resilience every now and then.  Sometimes the storms come one after another testing how strong our roots are.  Other times, and hopefully more often, there are good days – allowing our roots to dig deeper and become more resilient as we prepare for the storms of our professional lives.