Josie’s Story

By Marelda C. Tria Tirona

In the book “Rediscovering Catholicism” by Matthew Kelly, the author recommends that Catholics can help in evangelization through the simple way of telling your story. “Tell your story. Despite how ordinary you may think it is, you will be amazed how easily people will relate to your journey, and be inspired by it. Despite all your faults and failings, there is real power in your story.”

This is Josie’s story.

Josephine, the youngest of my siblings, was born a premature baby. She was so tiny and sickly, I remember my parents rushing her to the hospital in emergency situations to save her life. By the grace of God, Josie outgrew her childhood sicknesses, finished college and found work as a nurse in the United States.

Sometime in the 1990s Josie was diagnosed with lupus and subsequently with breast cancer. In spite of these life-threatening illnesses, she maintains a positive attitude in life, finding joy in giving personal attention and compassionate care beyond what is required from her duties as a nurse of post-operative heart and cancer patients.

With constant medical care, she is able to enjoy life even if she has to lug around her “small drugstore” when given the chance to travel. Having accepted with resignation her illnesses as her trials in life, Josie continues to hold on to her faith in God and steadfast devotion to Mama Mary whom she constantly invokes through novenas to Our Lady of Perpetual Help and Guadalupe. Her daily rosaries are recited with lighted candles of Our Lady of Candelaria coming all the way from Jaro, Iloilo City. Her devotion to our Lady of Perpetual Help and St. Joseph were passed on to her by our late mother. Here in the Philippines, my family, sister and friends would also pray for her healing.

The biggest threat to Josie’s health came in 2007 when she was diagnosed to have a brain tumor. To understand the many miracles of transformation and renewals that happened, it is important to share at this stage some background information on Josie’s extended family.

Josie’s Family

Josie, married to an American Catholic, is childless. She and her husband adopted two children – Eileen and Luisito, at present 16 and 11 years old respectively – from Mexican parents. Their presence in Josie’s life has brought much joy and happiness. The children’s biological parents are a blessing too for they remain on hand to assist Josie in her many (medical) needs plus some household chores.

Josie’s Extended Family

In 2001, at the Cornell University Hospital, Josie had a cancer patient named Hilda with whom she had developed a close mother-daughter relationship. Hilda, married to an Ecuadorian businessman-farmer, stayed at the hospital for eight months during the course of her illness. Her death from cancer devastated her family: husband Señor Coco, son Carlos, and daughter Monica. Josie helped the family in their passage of grief, for which the family is deeply grateful. As Hilda’s family said, “It is God’s will that Hilda was Josie’s patient. Hilda got some dignity as a person and not as a patient only, to be tossed and turned... It is a case of love and respect being shared between two families.”

Josie’s extended family initially consisted of the five grandchildren of Senor Coco. Like Philippine familial relationships, the family circle eventually grew to include in-laws and their corresponding 22 grandchildren (the Conquistadores), Josie’s two children (Eileen and Luisito) and five of Señor Coco’s grandchildren (the Munchkins). The children, with ages ranging from 3 to 16 years old, are collectively referred to by the adults as “The Tribe of the Little Kingdom”.

Battle of the Brain Tumor

Medical treatment of Josie’s brain tumor (glioma) began in 2007 when she underwent robotic surgery to remove a cranial bone that was pressing on her brain (the result of a fall from the crib before she turned two years old).

On June 2008, Josie was admitted at Memorial Sloan Kettering for congested heart failure, the result of too many radiation treatments from her breast cancer and brain tumor.

On 5 February 2009 Josie underwent another operation. The doctors were able to remove all the growth in Josie’s head, but she had to be made to sleep for a couple of days until the swelling in her head subsided. She was attached to a ventilator and had a small tube in her head that served as a “blood drain”.

Señor Coco had the children pray the rosary both in Spanish and in English. The Tribe asked permission to put up a small altar in Josie’s room but at first they weren’t allowed. Eventually they were able to convince the nurses that having an altar would not do anyone harm. In fact, they said, it would hasten Josie’s recovery because her beloved Santo Niño, Guadalupe, Our Lady of Quito, and St. Jude were around her. (In my parish - the Presentation of the Child Jesus - I joined in the procession during the fiesta of Our Lady of Candelaria to pray for my sister Josie’s healing.)

On 13 February, Josie was brought back to the operating room for the removal of a blood clot that was impeding her recovery. By noon the operation was over and the neurosurgeon reported positive signs. (Was it by Divine Coincidence that, here in our parish, a relic of St. Faustina, whose intercession I asked for Josie’s healing, was being venerated?)

On 18 February, Josie was extubated and slowly woke up. The Munchkins let out a big hooray and the family and medical team cried with joy and relief.

On 7 March, Josie was brought again for surgery due to an accumulation of fluid near the area of the previous operation. A drainage tube was placed in her head. Josie woke up a day after the operation; the family had thanksgiving mass at St. Patrick and at St. Charles Borromeo.

On 4 April Josie underwent yet another cranial surgery to straighten the tube that drains the cerebrospinal fluid.

On 16 April, another operation. Josie was given the Sacrament of the Sick and Holy Communion. During the 6-hour procedure, surgeons noted that sepsis had set in. For them, this was the last straw. They left a part of Josie’s skull open to allow for antibiotic irrigation, and so that they would not have to “crack open” her skull again in the event of another surgery. Josie was also put in a medically-induced coma, was isolated in the Neuro-ICU, and was made to undergo dialysis because her antibiotics were very strong. Josie’s vital signs had become unstable and she was placed on life support.

The Tribe all prayed very hard and we in the Philippines joined them in prayer. The family’s priest-friend, Fr. Kris, told the children to leave everything in God’s hands. The children insisted on setting up a small altar again so that when Josie wakes up, she would see Papa Díos and all her saints taking care of her.

Josie came out of that induced coma on the 9th of May, a day after the fiesta of St. Michael the Archangel, patron of our hometown in Iloilo.

The Worst was Yet to Come

September 10, Johns Hopkins Hospital in Maryland, USA. Josie’s neurosurgeons conducted extensive and exhaustive exams on her. The tests revealed that Josie needed to have a biopsy done because there was a shadowing near the site of her previous tumor. Whether it was from the catheter or a new tumor, the doctors couldn’t say so they had to open Josie’s head again.

With this update, a family friend gathered together a group of elderly people at the Basilica of Our Lady of Perpetual Help to pray the Divine Mercy Chaplet. The children asked to be brought to “the nuns that you no see” (contemplative sisters) so they could ask for prayers.

In Ecuador, Josie’s adoptive family had a special mass said for her, celebrated by the Cardinal of Ecuador.

In Johns Hopkins, Josie came under the superb quality care of Dr. Henry Brem, Chief Neurosurgeon. Her surgery was done on 15 September. She was given the Sacrament of the Sick before being wheeled to the operating room at 5:30 in the morning.

The surgery lasted ten hours. Three new tumors were found near the original tumor site, in a critical, difficult-to-access area of the brain and in the way of several major blood vessels. The robotic machine that will inject the chemo drugs directly on these tumors had to be painstakingly repositioned. Doctors further said that as soon as Josie wakes up, she will be placed on chemotherapy and radiation.

At one point during the surgery, Josie flat-lined because her blood pressure had plummeted. The surgeons were able to revive her and she remained “stable but guarded” for the rest of the operation.

On 17 September Josie went through a battery of tests. The results were more than what they had expected. Josie was able to follow simple commands. The wound area had no sign of infection or leftover tumors.

Two days later, Josie was able to talk again, and The Tribe was overjoyed that the Lord had not abandoned them and their Mama Josie.

By October, Josie was up and about looking for work, for she had been forced to resign from Cornell due to her illness.

A Grim New Year

On 29 December Josie called to inform me that she would have to enter Johns Hopkins once again for another brain operation. My New Year started with hopes and prayers for Josie’s good health. As always, I had resigned myself to accept whatever God’s Will is for my beloved sister. I prayed to God and said several novenas for Josie’s successful operation and eventual healing. Surely with complete trust in God and with all the people praying for her, Josie would be granted another chance to live.

The New Year started with an ominous medical bulletin. Josie went into the operating room at 11:30 in the morning of 30 December (2009). She came out at around 7 in the evening, much earlier than expected. Dr. Brem said that some blood vessels were ready to burst (one had done so already). The blood vessels were repaired, new growths were taken out, and Josie’s “chemo wafers” were double-dosed. Due to Josie’s radiation for her breast cancer, she had developed congested heart failure and during surgery flat-lined twice. She was placed on a bypass machine so her heart and lungs could rest. She was then moved to the Cardiothoracic Unit where she stayed for a couple of days.

4th of January, Josie’s intracranial pressure had shot up and she was brought to the operating room once again.

In that second trip to the OR, surgeons found a big clot in the frontal and temporal areas. The blood leakage was small but if not controlled, it could permanently damage Josie’s brain functions. In a conference with neurosurgeons and a neuro-oncologist, the medical team decided to leave Josie’s skull open so that powerful antibiotics could be administered easily. She was to be kept attached to a heart-assist device.

On 6 January, we all received a bit of good news from Carlos, Señor Coco’s son. Josie’s doctors agreed that her cranium could now be closed and that all operated sites had been fixed. The doctors also felt that Josie was not completely comatose for her EEG showed some brain activity and her APNEA test was positive. Doctors took this as an indication that Josie was fighting for her life but that the surgeons needed to help her some more so she could survive this latest episode.

Considering this seemingly helpless condition of my sister, my concerns turned to her eventual reliance on life-support machines and to the expenses shouldered by the family of Señor Coco. I knew Josie would not like to become a vegetable the rest of her life with only machines supporting her. But the family of Señor Coco assured us that Josie was determined to not let the tumor get the better of her and that we should not worry about the financial aspects.

On 9 January, the doctors decided to close Josie’s head, the ventricular assist device still attached to her. By 11 January, while Josie’s condition remained critical and she was still unresponsive, she was noted to have improved considerably.

The Long Wait

From the start of Josie’s confinement in December 2009 to mid-March 2010, the entire family from Ecuador camped at Johns Hopkins or in its vicinity, vowing to be with Josie until she recovered or whatever the Lord desired.

Johns Hopkins allowed the children to use the conference room as their camp and classroom where they continued their schooling via satellite hook-up. Here they slept and monitored Josie’s medical condition and temperature using a colourful graph duly signed by a senior fellow. The children’s daily routine would consist of praying the rosary morning and night in Josie’s room. Every night Mass was said at the visitors’ lounge and the family prayed for friends and relatives far and wide.

The Tribe was holding up despite their sadness, fears and insecurities over losing Josie, to whom they had become so emotionally attached. During this confinement, a child psychologist was recommended to have sessions with the children, and a pediatric team was on the alert should a crisis happen.

On 14 January, Josie’s cardiologist checked if she could already do without the heart-assist device. She flat-lined. It took them awhile to bring her back and since you cannot defribrilate a patient on assist device, it became a battle of medical technology and a whole lot of “Please God!” from everyone. The decision was to leave Josie on full assist.

Desperate to save Josie by all means, Señor Coco, the patriarch, summoned to Johns Hopkins an ancestor of the family from deep within the Amazon. With the permission of Dr. Brem, the native doctor performed some ancient Amazon ritual as his way of helping Josie.

On the 30th of January Josie’s lungs had collapsed and she needed two chest tubes to re-inflate her lungs. Through all this, Josie was still in isolation and on dialysis. Her assist device was still on and she was not responding to any stimuli. This weighed heavily on Dr. Brem who, so far, had not given any indication that Josie’s condition was beyond hope.

1 February, Josie had developed sepsis and had a seizure. The family asked Dr. Brem about Josie’s chances of survival and he, a man of science, replied with “Say boatloads of prayers.” The coming week was “do-or-die”.

2nd of February, Feast of Our Lady of Candelaria. While on a visit at Dr. Brem’s home, the children suddenly started crying and wanted to return to the hospital immediately. Meanwhile, in the hospital, Carmen, Señor Coco’s mayordoma who was changing Josie’s linens, felt a hand push her away. She then saw a shadow sitting in the room’s extra chair. The children, upon reaching Josie’s bedside, yelled with joy and began to dance. Josie’s fever had gone down, the urine in her bag was a normal yellow color, her blood pressure started going up, and her pupils were reacting to light for the first time since her December 2009 surgery.

Carlos reported more happy news: Josie’s CAT scan was clear, her chemo wafers were okay, her dialysis could already be halted, cardiac status looked good (though the heart-assist device still had to be used), and lung power was improving. Josie had no fever for the last 24-hours, her urine remained normal, blood pressure became regular, and she was taken off her intravenous medicines.

5 February, cardiothoracic surgeon Dr. Mehmet Oz and his team took Josie off from the assist device with the assurance that Josie was doing okay and that they could stop worrying so much. The Tribe sent up cries of gratitude – “so we’s praying and saying MUCHAS GRACIAS PAPA DÍOS!” – but in the adorably demanding way of children added, “Pero we told Papa Díos He’s gots to stay more ‘cause Tía is no awake yet.”

While in coma, Josie’s movements were monitored by Dr. Brem. Soon after, she could move her hand when instructed, though her eyes still would not open.

Josie was eventually taken off the ventilator after her CAT scan, MRI, and chest X-ray proved good. Carlos told us you could hear a pin drop from all the tension of waiting to see if Josie could already breathe unassisted.

Dr. Brem wanted Josie to be monitored very closely so that she would not slip into a vegetative state because then her chances of waking up would be zero.

After 6 March, we received no more medical bulletins.

On March 15, our phone rang. It was Josie herself, speaking very faintly. I could hardly believe it – she had come out of her 3-month long coma! God had once again answered our prayers.

Scent of Flowers

All throughout Josie’s medical trials, strange happenings were recorded which were all part of Josie’s miraculous return to life.

While recovering from her first brain operation in 2007, the medical team smelled flowers and asked Josie if this were a new perfume brand. In 2009, recovering after another surgery, nurses came by Josie’s room to ask about the strong smell of flowers. In September 2009, in their apartment before flying to Johns Hopkins Hospital, Eileen reported a strong floral scent. Even the plane’s pilot asked for the name of Eileen’s “perfume” because it smelled so fresh and sweet. (Incidentally, flowers are prohibited in Josie’s room. Señor Coco, being of ancient Amazonian heritage, can be slightly superstitious and had all floral gifts delivered to the nurses’ station.)

A sister of the Daughters of Charity said that the scent of flowers could only mean the presence of the Blessed Virgin accompanying Josie throughout her illness. I do not discount this possibility knowing that Josie had entrusted her illness to the powerful intercession of Mama Mary. Whenever possible, she would spend hours at Our Lady’s Chapel in St. Patrick’s Cathedral and recite the rosary with her children.

The “Pretty Lady”

On the 6th of February 2010, The Tribe was sent to the chapel to pray while Dr. Mehmet Oz and his team removed Josie’s heart-assist device. There, they met a “pretty lady – she smelled nice” who told them to keep on praying because Papa Díos was listening everyday. The children asked the pretty lady for her name. She said she was Salome, Josie’s elder sister. Josie has never mentioned our sister’s name to the children. Salome was our fourth sibling who died when she was just a month old.

“Salome” would always tell the children to pray hard for Josie’s recovery, pray the rosary daily, and attend Mass. She told the children she watches over them even when they are not at Hopkins.

In thanksgiving to God, the family donated a Catholic chapel to Johns Hopkins Hospital. From May to July 2010, when the family temporarily resided in Dubai where Josie had found work, a grotto to the Blessed Virgin – requested by the pretty lady – was constructed in the garden of their house at Palm Jumeirah.

The children began immersing themselves in charity work in Dubai. They shunned fancy clothes and new shoes, preferring to use only their “miserable-looking sandals”. Having no resources of their own, the children took to selling snacks cooked by their Tía Lucy. As their grandmother, Señora Suzy said, “They look and work like starving children, to the dismay of their parents. We oldies were initially shocked to see them selling in the middle of the commercial roads but their intentions are pure.”

Some of these charity works included gathering relief goods for the tsunami victims in Japan, organizing Josie’s doctors and nurses into a medical mission in Ecuador, and raising money to support an orphanage also in Ecuador. A small chapel was also built near the house of Señor Coco upon the request of the pretty lady.

On the eve of Mama Mary’s birthday this year, the children suddenly got sick but preferred to stay in the chapel where they were observed to be kneeling on the hard cement floor and praying the rosary. Josie called us to say they had been in this position for almost four hours, without any food, their eyes trained on a spot in the chapel that had a certain glow.

Whether the pretty lady is indeed Salome or another Pretty Lady, only time will tell. All we know is that she continuously tells the children to pray for people to return to the spiritual things in life.

Encounters with our Dear Departed

On 2 February, when Josie’s condition dramatically changed for the better, the “presence” of some our beloved dead was felt. (Carmen had seen a “shadow” sitting in the room’s extra chair.)

On that same day, the children were observed waving at “somebody” in the direction of the chair. They said they saw the family’s deceased relatives, reciting their names one by one. The elders were shocked as many of those mentioned were not known to the children.

A child psychologist was called to talk with the children. But the encounter was very clear to one child, the intelligent and headstrong Charlotte, who wrote, “I no liking anybody saying we saw ‘mumu’ like in trick or treat. We saw all Abuelas, Abuelos, tía, tío, prima and primo. Is Tío Totik” (our only brother who died suddenly in 2008) “we saw sitting in chair.” According to Charlotte, our departed mother said Josie needs to stay a bit longer as she still had “lots to do”.

The adults have learned to tell when these encounters would happen. The Tribe would suddenly stop whatever it is that they are doing and, one by one, congregate in one place. They don’t talk but they could be seen listening to “somebody”.

All these encounters with our beloved dead continued until Josie opened her eyes on 15 March 2010.

Living Day by Day with God

With her brain tumor in check, Josie has returned to work. From May to July 2010, she took a job at the American Hospital in Dubai but gave it up because of too much racial discrimination. She is back working at a hospital in New York, USA.

Her ordeal is not completely over; sometime in August of this year Dr. Brem had to do a tube implant to drain the fluid from her brain. Nevertheless, the children are assured by “the pretty lady” that Josie is going to be fine.

What has inspired people of different faiths from different walks of life, people not related by blood, to form one family and support Josie in her darkest hours? Holly, one of the children’s mothers, provides a good answer:

Josie, despite her debilitating diseases, is able to enjoy life, her work, her friends, the children, and honor her commitment to the Church, especially to Our Lady of Perpetual Help and the soup kitchen. She has given us a chance to check our hectic pace of life and view our children as great gifts. From her friends and classmates to her past patients and their families; from surgeons that she had worked with before to the cab drivers who used to bring her to and from work, Josie is one person that God probably placed here on Earth to remind us that there are things in life more important than racing around acquiring material and financial success. Staying here and helping the children and supporting Josie is nothing compared to what she has done for our children and for all of us. We are forever in your debt for sharing your sister with all of us. Thank you so much.

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