Pepito and Paulina Burlaza planned carefully for their retirement. He was a Vietnam veteran, electrician for the city of San Diego, father of four daughters and one son, and a handyman who taught all his children the difference between a Phillips and a flat-head screwdriver.
She was a schoolteacher and later a stay-at-home mom.
Their family grew together, as did their home, on a corner lot in a modest San Diego neighborhood. With the birth of each baby, Pepito found a way to make room. At first he added onto the back of the house, and then an entire floor when they had no where to go but up.
Theirs is an album of birthday cakes, Christmas trees, graduations, walks down the aisle, and grandchildren.
At 62, with Pepito newly retired, he and Paulina returned to the Philippines, the country where they met and married, to build their dream vacation home.
After nine months, with just the final coat of paint left to finish in the garage, Pepito had a stroke.
He was in a coma for weeks and eventually taken from a hospital in the Philippines to a nursing home in San Diego County. His family believed American medicine could do more for him.
“Everything was just hope,” said Elsa Burlaza, the second-eldest of Pepito’s children.
Pepito never fully regained consciousness. He lived in a vegetative state for 10 years. He was unable to speak, move, eat or breathe on his own. He had a feeding tube in his stomach and a tracheostomy tube in his throat.
Paulina spent hours nearly every day by his bedside. She never returned to their dream home in the Philippines.
The pension Pepito had nurtured was used in part to pay for his nursing care. While he qualified for MediCal, the state’s program for the poor and disabled, his income was such that Paulina was required to pay a $1,100 monthly deductible.
Pepito was one of thousands of people in California kept alive each year with machines in special wards called subacute units. They are the end of the line, the place where modern medicine can keep you alive but where there is little hope for recovery.
Pepito didn’t have an advance directive, a document stating his medical wishes. He and Paulina never had a conversation about what to do if the other could no longer make health-care decisions for themselves.
With her faith and culture to guide her, Paulina did her best to honor what she believed her husband would have wanted. To be by her side, till death.
Pepito’s heart stopped beating in the early morning of April 14. Paramedics and ER doctors tried to revive him for 15 minutes before pronouncing him dead.
Elsa got the call.
The doctor told her they did everything they could to bring her father back.
“In my head I was thinking, ‘Why would they do that? He has a DNR,’” Elsa said.
DNR is short for Do Not Resuscitate.
The paperwork for Pepito’s DNR was never signed. Without one, first responders in California must try to save a life.
To read more about the Burlaza family and to participate in the conversation about end-of-life issues, go to impossiblechoice.org. There, you can consult with medical experts, share your experiences, visit a subacute unit through videos and learn how this project came about.
