MANILA, Philippines - It was never easy to be a doctor at the Philippine General Hospital. Most doctors who have interned in poor hospitals around the country know this to be an understatement. They know only too well how painful it is to stay awake for 48 hours on straight duty plus class work. Even more important was how to be numb to the unrelenting burden of poverty evident among the patients and the hospital's severely limited resources.

Dr. Jose "Ting" Tiongco gathers the thousands of stories he has personally witnessed at the PGH starting the early 70s, in a book that documents "the agonies and triumphs of both doctors and patients who have peopled this venerable institution through the ages."

The book, "Surgeons Do Not Cry" is also a prequel to his already published "Child of the Sun" in the 1980s which details the dream of a cooperative movement among medical professionals.

In its launching, Tiongco autographs his book with a quote from Filosofo Tasyo of "Noli Me Tangere:" "No todos dormian en la noche de nuestros abuelos," which translates to "Not everyone slept on the night of our forefathers." Indeed, there were those who closed their eyes and enjoyed cushy lifestyles abroad while the rest toiled under very restricted circumstances.

Tiongco is an engaging storyteller, bringing us to the actual scene of the many incredible stories on how difficult it is to live, to be sick and to die poor.

He tells of this three-year-old boy, "like a little black monkey (with) long thin arms and legs and bloated belly, his heart beating fast like a little sparrow" who had a severe case of hookworm infestation and badly needed a blood transfusion or he would die. The thousands of hookworms in his body consumed any nourishment given him. The usual practice of having relatives donate their blood in place of whatever the patient would use up could not apply in this case; the relatives were severely anemic themselves. In the end, the good doctor gets to donate the blood himself, and his colleagues are inveigled into the process. From this experience, he organizes a walking blood bank drive among the universities and exclusive schools urging youth , the First Quarter Storm rebels, with the cry "Ibigay ang dugo sa masa, huwag ikalat sa kalsada (Give blood to the poor, don't spill it out on the streets)."

In stranger than fiction accounts, the book goes through the gamut of intense human experience-forgiveness from a badly battered, burned and beaten 6-year-old girl named Cherry whose mother, demented from drugs, regularly applied a hot iron on her back and used her as a human ash tray. Louella the mother tops this by gouging her daughter's eyes with a barbecue stick. The little girl loses her sight but remains sweet and good-natured. But as she daily suffers ministrations for her burns, she still cries out for her mother: "Inay, inay, bakit mo ako iniwan? (Mother, why did you leave me?)"

Humility is a hard earned lesson as Tiongco experiences the death of a patient who would have been well had the doctor not inadvertently touched a major blood vessel. Arnulfo was the sole breadwinner for 10 children and Tiongco offers to donate his monthly salary of P480 to them when he is told to take off and get drunk by older, more experienced colleagues.

We cannot help but chuckle at his account of how an entire bottle of soda popped into a man's anus is finally extricated amidst howls of pain and the rousing cheer, "It's a boy!"

Or the poignant leave-taking of a colleague whom he bumps into. Jimmy E is rushing off to the mountains as martial law is declared while Tiongco, in his ER garb, runs to the emergency room (Jimmy E. is later found mutilated, tortured, defiled and murdered by shadowy figures toting guns).

The shifts through the kaleidoscope of human experience as the author captures poignant moments can be gripping as death veers in, as pain mounts. But Tiongco is never maudlin. In fact, many more humorous anecdotes lighten the book, naughty, mischievous schoolboy stuff that pokes fun mostly at himself.

The undercurrents are unmistakable though -seething anger, flashes of futility but never surrender, Tiongco is not one to shrug his shoulders in resignation, though many times tears well up in frustration. There is a lot of Filosofo Tasyo in him, but the Ibarra within wins out: the rebel fighter, the "bandido" who upsets the system and who, by harangue and harassment, gets the necessary medical tools and other support.

More than fond reminiscences and flashes of the iridescence of youth long gone, Tiongco also tells us how those who stayed "awake" dealt with their anger, the Romulos and Jimmys who take to the hills, as well as those who choose to make their pile in America.

Tiongco's anger does not diminish, but we need to read, not only between the lines but between books. The seething anger documented in "Surgeons" alchemized over decades into the anti-system, but pro-active entity: the Medical Mission Group Hospital and Health Services Coops, Tiongco's contribution towards making health services readily available to a mass base in Luzon, Visayas and Mindanao. "Child of the Sun," the earlier book, highlights this. "I shifted operating rooms, still using an even bigger knife. It has been bloodier, but the cancer is being excised though there is still a long way to go."

The thread of continuity then, is Tiongco's transition from a hotshot German-trained neurosurgeon to a practical visionary whose passion for a world where quality medical services are available to all, is concretized in MMG hospitals all over the country. His crusade has brought in about 10,000 health workers-doctors, nurses, midwives, attendants, janitors-who bring to life the mission in 24 MMGH chapters in 24 coop hospitals and five diagnostic clinics all over the country.

Many have taken notice of such initiative, among them former US First Lady Hillary Clinton when she was still handling the health portfolio in her husband's administration. More importantly, the effort has positively affected farmers and other folk in areas where the initiative has taken roots, particularly in Mindanao where Tiongco hails from. MMGS hospitals have become a byword in the hinterlands.

In the process, Tiongco had to lay down his surgeon's knife; in place of the scalpel, he now uses his tongue to incise, pluck out, cut off and continue his advocacy.

This surgeon does not cry; but neither has he slept in quite a while. -

"Surgeons Do Not Cry" is available at the UP Press Bookstore located at Balay Kalinaw, corner Guerrero and Dagohoy Streets, UP Diliman, Quezon City, and at selected bookstores.