STATEMENT OF RICARDO ATIENZA, M.D
IN THE MATTER OF: Events surrounding the shooting, and breaking and entering at the residence of Dr. Armando Y. Acosta, M.D and
Kristina N. Dela Cruz, M.D (his wife)
on April 26, 2015.
HELD ON: April 27, 2015,
Police District Station 9, Quirino
2-A, Quezon City
PRESENT: Inspector First Class Felix B. Ulan;
Inspector Third Class Clarita
INSP. CAPAWA: I know this is difficult for you, Dr. Atienza, so just start wherever you think you need to give us the whole story.
DR. ATIENZA: Okay, so… uh… I don’t know. I already talked to one of you last night?
INSP. ULAN: Yes, but there are narrative blanks we need filled in.
DR. ATIENZA: Am I a suspect?
INSP. ULAN: No.
DR. ATIENZA: So this is… ?
INSP. ULAN: Just standard procedure.
INSP. CAPAWA: Take your time, Doc. Would you like some water?
DR. ATIENZA: Please. Thank you. Okay, I’m not sure where all this begins. I guess when we first met. The three of us met early in our first year in med school, and we just seemed to hit it off naturally. Mando was a hypochondriac; so was Tina, which is probably why they gravitated towards each other right from the beginning.
INSP. ULAN: A what?
DR. ATIENZA: A hypochondriac… someone abnormally anxious about one’s health. There’s a phenomenon that’s quite common among first-year med students. Every time we study a new condition, at least a fifth of the class is going to come down with symptoms. For example, when you do motor neuron disease, every twitch becomes a symptom of amyotrophic lateral sclerosis, rather than just simple fatigue, which is what it really is ninety-some percent of the time. Every headache is caused by a brain tumor, every vague chest pain signals the onset of a heart attack. But no matter what the disease happens to be, Mando would be sure he had it. It became a class-wide joke. When we studied cervical cancer, I said to him, “At least that’s one you don’t have.” He agreed, almost begrudgingly, it seemed to me. But Tina’s anxiety more than made up for it. She ran off for a Pap test that very afternoon.
I was convinced then, as I am now with years of practice and experience—I’m a psychiatrist, by the way—that this shared neurosis of theirs was why they want to become doctors. I mean, think about it: here are two people who are deathly afraid of death, both going into the one profession that takes on death on a daily basis and tries to defeat it… or at least, put it off. It might also explain why they both went into the fields they did—Mando cardiothoracic and vascular surgery and Tina OB-GYN. Maybe it’s also why we became such good friends—I had a need to analyze other people, and Mando and Tina had the need to analyze themselves, over and over again.
Don’t get me wrong, they’re both terrific people; crazy sense of humor and a lot of fun to be around, not at all scared or superstitious about the things most med students are. Mando and I were anatomy lab partners freshman year, and he developed a macabre fascination with the body parts we progressively removed from our cadaver. One day, as Tina reached into her bag for the keys to her apartment, she found herself gripping a finger. Tina repaid Mando in kind. When Mando tried to catch a little sleep during a thirty-six hour ER rotation, she used a red pen to paint petechiae all over the exposed parts of his body. When he woke up, she innocently asked what was wrong with his skin, then watched him freak out as he looked at himself in the mirror.
But the pranks they pulled on each other had nothing on the jokes our classmates played on them. They both took the ribbing with good grace, though—they may be insecure about some things, but they were totally secure in their abilities. And at the end of the four years, no one was surprised when they finished numbers one and two in the class and announced their wedding date for the day after graduation. They weren’t just desirable for each other, they were desirable for hospitals everywhere. St. Luke’s accepted them as a “package” so they could do their internships together—and St. Luke’s never does that, and never did again, as far as I know.
We stayed good friends throughout internship and residency, and on into practice. I can’t deny being somewhat jealous of Mando. Still in his residency, Mando was handling heart transplants and coronary bypasses on his own! Everyone who saw him operate praised his skills as a surgeon. It was almost as if, by being inordinately good at bringing seriously ill patients back from the brink, he crushed his fear of disease and mortality. Mando was definitely going places in medicine. I’m not exaggerating when I say that he was largely responsible for getting me my position at the hospital here. It was typical of the charming control he tried to exert over all his friends and associates. I’d told him on the phone one night I didn’t think I was getting anywhere in Cebu, and he had said, good, because he “wanted” me working near him, anyway. Two weeks later, I received an invitation from St. Luke’s, mentioning that Dr. Acosta had assured them I’d be a valuable addition to the clinical staff. There was no doubting that even at that early stage, he was a star. They were grooming him to take over the transplant program and whatever he wanted, they tried to get him. Including a shrink from the far South.
One day, Tina called me. This was about five or six months after I’d moved to Manila. I was still single in those days and was spending a fair amount of time at their place. She sounded agitated and asked me to come right over. What was it, I asked, but she wouldn’t tell me over the phone. So I raced right over.
“What is it?” I asked as soon as Mando answered the door. He and Tina looked grave.
“We’re thinking of trying for a baby,” Tina explained.
That was what they’d called me over for?
“You’re in OB, Tina,” I replied, still not quite getting it. “You must know how it’s done.”
Mando finally cracked a smile. “No, that’s not the point, Rick.”
“Then what is the point, Mando? Certainly you don’t need my permission to get off birth control.”
“We really want a child,” Tina confessed. “We have for a long time.”
“Is there…uh…any physical problem?” I asked, feeling queasy. These two aren’t about to ask me to sleep with Tina, are they?
“It’s not that, you numbskull,” Mando said, finally catching my train of thought. “ We’ve gone through all
the tests. We’re pretty sure if we try, we can conceive.”
Typical Acosta—everything completely analyzed beforehand. “Then I really don’t know what we’re talking about,” I said.
“We’ve been through a lot of emotional turmoil, and we’re sharing this with you not just because you’re the best shrink I know, but because you’re my best friend, too. I mean, here’s the thing, Rick: are we mature and stable enough to bring a baby into the world?”
I was incredulous. “What!” I stammered. “Mando, you make life-and-death decisions every day in the operating room. Tina, you bring other people’s children into the world every day. How much more mature and stable is there than that? I’ve seen the way you deal with mothers and babies. You love kids.”
She chimes in: “What Mando’s asking, Ric, is whether you think—and you have to be painfully honest, that’s why we’re asking—if you think all our anxiety and insecurity and hypochondria would rub off on the child and make him—or her—crazy? With our personalities and all that’s going on in the world today, I worry I’d be so afraid I wouldn’t let my child cross the street by herself until she’s ready for college. And if—God forbid—she gets sick…What am I talking about? Of course she’ll get sick; all kids do, and I’m afraid I’d just go to pieces and this child would grow up an even worse neurotic than Mando and I are. With all our hangups, can we be good parents?” A tear trickled down her cheek.
My heart went out to both of them. So much of a therapist’s time is spent trying to get his patients to truly see and accept themselves and then to go on from there. But here are these two friends of mine, both magnificently accomplished, the envy of those around them, zeroing in on their own problems like a heat-seeking missile and beating themselves up over them. In a way, they were like a single organism: what one thought, the other thought; what one felt, the other felt.
We talked for a long time that night. I won’t go into all the details here, but gradually, I think I got them both to believe me when I said they would make terrific parents. To these two people so afraid of disease and death, I said that the only immortality people can have is through their kids. I thought it was just about the best short-term therapy I’d ever conducted, and it felt great to be able to do it for two people I care about.
In the weeks that followed, their attitude changed. They seemed happier, more serene. They seemed to have made peace with themselves and their own fears. I’d say it was another five or six months later, give or take, that Tina took me aside, and in an excited, girlish voice, whispered, “We’re pregnant!”
“And you’re okay about it all now?”
“More than okay,” she said. “I can’t remember being this happy. It’s like feeling completely alive, and it’s not just me—Mando, too.”
In the weeks and months that followed, all their attention centered around the expected new arrival. Tina started showing, gradually getting bigger and bigger, and to use the old cliche, looking more and more radiant. She joked that she finally had credibility with her own expectant mother patients.
As soon as they learned from the ultrasound that it was a boy, they began calling him Matthew, and put together a nursery—baby blue walls and all that. Then, proving that they both hadn’t completely gotten over their hypochondria, Mando explained the special air filtration system that he’d had installed in the room. There was also a dedicated outlet wired to both the house’s electrical system and a backup generator, just in case the kid should ever need a heart monitor, a respirator, an oxygen tent, or any other emergency apparatus. That may seem like overkill to you but that was okay as far as I was concerned. They could fawn all over him but in the end, Matthew would live his own life, not theirs.
Everyone who came to the house got a tour of Matthew’s room by the proud parents-to-be. With a month to go before the due date, the nursery became so stuffed with toys you could hardly move around.
The big surprise to everyone who knew Mando and Tina was that as the big day approached, they announced they were doing a home birth. “Just as women had done for thousands of years before the invention of hospitals and the discovery of bacteria and sepsis,” Tina declared. I thought it was too radical and counterculture, but after all, Tina is an obstetrician and Mando a surgeon, and if this is their way of liberating themselves from their fears of the process, then it’s all for the good.
May I have some more water, please? Thank you.
After all that, I cannot possibly describe to you how I felt when I heard the baby was born dead. It was like a sick joke, one of the many that had been played on them in med school. Apparently, at the last moment, the cord wrapped around Matthew’s neck tightly enough to strangle him. If they’d been at the hospital rather than at home, who knows? Perhaps they could have saved him, and I’m sure that thought’s crossed Mando’s and Tina’s minds, too.
A lot of what happened then is a blur to me now, but I do remember two things: Tina and Mando carrying their dead little boy, wrapped completely in a baby blue blanket, back to the hospital for the post-mor… the autopsy. They both looked a hundred years older. Like they wrestled with God, and lost.
The other thing I remember is the first time that I went over to their house after the tragedy. The door to Matthew’s room had been locked tight with a heavy deadbolt. No one ever saw that door opened again. At least I didn’t. A sad thing but not unusual. Did you see the film The Secret Garden? A man mourns his wife by locking up the garden that she loved and burying the key. One of my own patients in Cebu did something similar. He padlocked the room he shared with his wife, and did not open the room until he remarried five years later and needed the space.
INSP. ULAN: And all this happened how long ago, Doc?
DR. ATIENZA: Let’s see. This was 21 years ago? Yes, 21 years ago.
INSP. CAPAWA: And they didn’t have any more children after that?
DR. ATIENZA: No. It was as if God had confirmed all their worst fears; that He was giving them a message. They said they wouldn’t adopt children either. They couldn’t survive the pain if anything happened to another child of theirs.
After a while—I’m talking several years—it was as if the tragedy never happened. They never spoke of it, and their friends knew never to bring up the subject. The door to the nursery remained closed and locked, but it was as if Mando and Tina had never tried to have a child. We see this kind of reaction a lot in psychiatry. The only way to cope with severe loss is to compartmentalize the pain, to cut out of one’s life whatever it is that’s causing the suffering.
But obviously, the experience did affect both of them, though not all negatively in Mando’s case, as paradoxical as that may sound. Mando had always been a brilliant surgeon, up-to-date on all the latest technology and how to use it in new and creative ways. But after Matthew’s death, he became even better, a magician, almost. By that time he had become the head of the hospital’s transplant program—widely known, and patients from as far as Agusan del Sur and Ubay, Bohol, beat a path to his door. Not being able to save his own child all those years ago must be why he is so driven to give many others a second chance at life.
INSP. ULAN: Tell us what happened last night, Doc, beginning with the call.
DR. ATIENZA: Let’s see. It was about maybe a quarter to eleven…I was home alone. My wife and her sister had taken the kids to see a movie. My phone rang. It was Tina. She sounded hysterical. She asked me to come over right away. Mando had been shot. How badly, I asked. She couldn’t tell me. I asked if she’d called for an ambulance and the police. She said… no, so I said I’d call them.
She said, “No! Don’t do that!” She was adamant, and begged me to come as fast as I could. Pale as death
INSP. CAPAWA: You didn’t find that strange?
DR. ATIENZA: I did, but—
INSP. ULAN: But you did as she asked, anyway.
DR. ATIENZA: Yes. I should have called for help—an ambulance at the very least, but Tina lived only five or so minutes away, so I just ran out the door.
When I got there, Tina was waiting at the front door. Pale as death. Also, it seemed to me her hair had turned white overnight. How, I don’t know. Some call it the Marie Antoinette syndrome, but is this medically possible? Without saying anything, she led me through the front hall and up the stairs. I could see furniture knocked over in the living room and in the kitchen.
Mando was lying at the top of the stairs, his shirt stained with blood. I bent down to examine him. He was breathing. He opened his eyes slightly when I felt for his pulse. The wound appeared to be on the lower left side of his abdomen. There was a lot of skin laceration; he’d lost some blood, but as far as I could tell, nothing major had been hit. His pulse was strong, a good sign.
“Call for help,” I said to Tina.
“Not yet,” Mando gasped.
“Mando says we should take care of things here first,” Tina said, suddenly strangely calm and coherent. I was confused.
“What happened?” I asked. She started to come unglued again.
Eventually, I got out of her that first they heard the sound of breaking glass from the patio in the back. Then, they’d heard footsteps. Someone had broken in. Mando went to see what had happened. Tina heard shouting. When she came out of the bedroom, she saw a young man, probably in his late 20s, holding a gun. He took their money, then said he knows Mando is a doctor and that he has drugs in the house. Mando told the guy he didn’t, but the guy was desperate. He raced through the living room and the kitchen, overturning furniture, forcing open cabinets and drawers, ransacking everything that looked like it could anything of value.
The intruder didn’t find what he was looking for on the first floor, so he went up the stairs. Mando blocked his way, but the burglar pushed past Mando, smashing Mando on the shoulder. He scrambled up the stairs; Mando staggered after him.
When the burglar saw the padlocked door at the end of the second floor hallway, he assumed he had found what he was looking for. He demanded that Mando unlock the door. Mando refused. Furious, he ordered Tina to get the key. Mando pleaded that there was nothing in the room that the man could possibly want. The robber pulled the trigger. Mando was thrown backward against the wall. Tina screamed and rushed over to him. The robber turned back toward the closed door, aimed directly at the dead-bolt lock and fired at it, again and again.
The edges of the door splintered. Tina screamed, “No!” and tried to stop him from going in, but he pushed her roughly out of the way. He threw the door open and rushed in, leaving Tina sobbing over her husband.
Then…after that, she called me.
INSP. CAPAWA: Just a sec, Doc. Where was the burglar at this point? Still in the house?
DR. ATIENZA: No. Tina said about half a minute after he shot the lock and went into the room, he ran out screaming.
INSP. ULAN: Now, why on earth would he do that?
DR. ATIENZA: I’m getting to that point. After I examined Mando and after determining he would live, I said I’ll call the cops and see to an ambulance. She shook her head emphatically and…pointed to the shattered door.
I was quite exasperated with Tina at that point. Nothing made sense. Why shouldn’t I call for an ambulance?
But as soon as I got inside the room, my…oh, God… my blood froze. I don’t know how to…
INSP. ULAN: Just describe what you saw.
DR. ATIENZA: I’d seen nothing like it before, in all my life. The crib, baby furniture, and stuffed toys were all gone. In their place was an assortment of gleaming metal equipment that looked like it had come from the most modern intensive-care unit. The room was eerily silent except for the intermittent and persistent sounds of technology. A…heart-lung machine burbled. A bank of monitors clicked and whirred and blinked, and small screens showed multiple continuous EEG and EKG tracings and readouts for respiration, rectal temperature, and basal metabolism.
And in the middle of all that, on a contraption that looks like an operating table, attached to all kinds of wires and leads and completely covered by a clear plastic tent is…is a body. It had several IV lines and a naso-gastric tube.
INSP. CAPAWA: A body?
DR. ATIENZA: Naked. It was the size of a small adult male, with several open but bloodless wounds. Upon closer examination, I pegged the age at about 18 or 20 from the skin texture and facial hair. The body was lean but the musculature was weak and flaccid, as it would be from a total lack of exercise or use. But the thing that struck me was the face: soft, delicate, in some ways matching the age of the body but curiously blank, without any the stress or character lines of experience or personal history, of pleasure or pain. Because clearly, this body had had none. And with a shudder that turned my insides to jelly, I knew beyond all doubt that this was Matthew.
INSP. ULAN: The dead child?
DR. ATIENZA: He hadn’t died at birth. The body Mando and Tina had brought to the hospital was a stillborn she had somehow secretly secured. The home birthing had all been part of a carefully thought-through plan. The equipment had been there in that room all that time, the backup electrical system they’d installed had been put in to service it. They’d kept their baby in that room since the moment of his birth, continually drugged— probably shot up with Tramadol or Haldol—never moving, never actually becoming a person or taking part in life in any remotely human definition of the term.
I staggered out of the room, consumed with horror. “What have you done?” I rasped at Tina. But I knew the answer to that, too. My two brilliant friends—technically adept, pathologically insecure, medically neurotic—had planned, conceived, and nurtured a young, healthy bank of genetically compatible spare parts for both of them. As a transplant specialist, Mando knew the difficulty of obtaining suitable donor organs, and even when the organs became available, there was always the problem of tissue rejection in every case. So, he and Tina set up their own private stock, ready and available for either or both of them to harvest whenever the need arose. Lungs, heart, liver, heart, kidney, pancreas, intestines, eyes, vessels, bone marrow, even the brain if they ever found a way to transplant pieces of that—it was all right there on the table, waiting. A hypochondriac’s secret garden.
Somehow I managed to speak. “How could you, Tina?”
She grabbed my arm, tried to pull me to her. “Ric, you told us the only immortality we could ever hope to have is through our kids. You’re the one person in the world who should understand.”
“Understand? I understand that this is the most evil, monstrous thing I have ever seen. You are both playing God.”
I can’t tell you exactly what happened next, but I must have pulled myself loose from her. As if in a trance, I staggered back to the nursery door. “Ric, no!” Tina called after me, but I was oblivious to her. I was dazed, numb to everything as I lurched to the master control unit and pulled the plug.
INSP. CAPAWA: And that was when you called us?
DR. ATIENZA: Yes. That was when I called you.