Is Senator Miriam physically fit to be president?

This week, several patients have asked me if Sen. Miriam Defensor Santiago is still physically fit for the rigors of a presidential run and the possible six years of public office if she wins.

She disclosed over a year ago that she has stage 4 lung cancer, and she recently said that she was declared by her physicians to have licked the cancer.

I do not know the details of her ailment and clinical course since she was diagnosed, so it’s not proper for me to venture on her medical outlook in the next several years.

This is the reason that we proposed in this column several months ago (“Medical clearance for candidates?” 5/30/15) that the Commission on Elections require all candidates for elective positions to submit a comprehensive medical clearance proving they’re really physically and psychologically fit to handle all the stresses of the campaign and the public office should they win.

It’s not enough that one quotes his/her physicians about one’s state of physical and psychological health. It should be an official certification from a credible hospital or institution, signed by a respected medical specialist, stating whatever medical issues the candidate may have—currently or in the past—and the specialist’s opinion if the candidate’s medical history can have a bearing on his or her performance should he/she get elected.

I find it difficult to understand that employers require medical clearances even for employees seeking rank-and-file positions, and yet, we don’t require it for people seeking important positions in public office, whose physical, mental and moral state the nation’s future hinges on.

Holistic health disclosure

If we, the citizenry, are truly the bosses or employers of our public servants, then we should require, not request, a full disclosure of a candidate’s health—holistic health, that is.

Incidentally, speaking of holistic health, this is also the reason why I support the Ombudsman’s disclosure of any information based on hard evidence they have concerning certain candidates who they deem are not morally fit to be in public office. One’s morality and integrity are part of one’s holistic health. But that’s digressing from the topic.

Going back to Senator Miriam’s state of health and physical fitness, I suggest that she requests for a certification or full disclosure from her medical team. I know personally her main attending physician, former health secretary Espie Cabral, and if she certifies officially that the good senator—based on the collective inputs of her colleagues in the medical team handling her—can handle the rigors of a presidential campaign, and the subsequent six years of public office should she win, then I would take it as a strong reassurance of the senator’s physical fitness.

The attending physician knows one’s medical condition(s) from the past to the present, and one’s long-term prognosis or outlook based on one’s complete medical history.

My personal advice though for someone (not necessarily Senator Miriam) with a stage 4 cancer is to take it easy and avoid anything that can give one undue stress. Although it’s true that the stage 4 cancer may be temporarily in remission (under control), all cancers—much more so lung cancer—can be tricky, and just when one thought one is cured already, it can come back with a vengeance. And stress is usually a major triggering factor.

If we go by statistics, stage 4 lung cancer has a survival rate of less than 10 percent in five years, even with the best of medical care with all currently available effective modalities of treatment. That means that only around six to eight, at best nine, patients would still be around in five years.

Fighting spirit

I believe that Senator Miriam’s fighting spirit and positive attitude makes her a strong candidate to be one of the lucky few who will survive stage 4 lung cancer even after five years. But the least she needs at the moment is anything that can rev up her adrenaline and fray her nerves.

I have my highest respect for Senator Miriam, and even if she retires from public service this day, she will always be remembered as one of those who had left an indelible mark on our country’s politics and government service.

I think she has done her part well, and she has inspired many who can take the cudgels to continue her brand of public service. At 70, she deserves a well-earned retirement from public service, and just serve as a member of the unofficial “Council of Elders” from whom the nation’s president and other leaders can draw wisdom from.

But, in fairness to the nation, we need a full-time, energetic and holistically healthy leader, who will most likely remain so even at the end of his or her term of office. If Senator Miriam could no longer assume the rigors of her work at the Senate—requiring her to take an indefinite leave when she was diagnosed to have a refractory chronic fatigue syndrome and subsequently, stage 4 lung cancer—then how much more the rigors of the presidency which would require her to be on call 24/7, especially during times of natural or man-made disasters and other crises?

I sincerely believe that for her sake, and the nation’s sake, Senator Miriam should not proceed with her presidential bid.