Why it's St. Luke's or bust for Napoles

MANILA, Philippines – There's a side story in the never-ending saga that is the pork barrel scam and its alleged mastermind Janet Lim Napoles: her continuing, lingering medical issues.

Late February, Napoles left her detention center in Laguna for a battery of medical examinations at the Camp Crame General Hospital to determine the cause of her "hypoglycemia, drastic weight loss, chest pains, severe abdominal pains, and profuse menstrual bleeding."

The tests showed a cyst in her uterus but Philippine National Police (PNP) ob-gyn Michelle Daguno said it was "not life threatening so far." Napoles originally wanted the medical exams to be held at the St. Luke's Medical Center in Taguig, but a Makati court ordered the exams to be held at Camp Crame after a PNP doctor assigned to Napoles said the hospital at the PNP headquarters had the right facilities.

Napoles and her team agreed to the change in venue.

In a new motion, however, Napoles is taking a harder stance.

In a motion filed before the Makati Regional Trial Court Branch 150 Thursday, March 6, Napoles said she wants "to undergo medical surgery and hospital confinement at St Luke's Global, and not at any government facility." (Emphasis theirs) 

Aside from the cyst, tests at Crame also revealed an increase in CA-125 levels, a biomarker used to detect ovarian cancer. On February 26, Napoles' CA-125 levels were at 68.80, with the "normal range" being 0.00-35.00. Napoles' special counsel Fay Isaguirre Singson said they have yet to rule out the possibility of ovarian cancer but added only surgery and a biopsy could say for sure.

Napoles also said in the motion that even after the medical exam, symptoms of her ailment and the pain persisted. Singson added Napoles still experienced "profuse menstrual bleeding" as a result of the cyst. While Napoles' condition is "not alarming," Singson said the menstrual bleeding was still a cause for concern.

"Kung patuloy yan, pwedeng anemia, leukemia," she added. (If it continues, it could lead to anemia, or leukemia.)

'Rights of the patient'

Why is Napoles insisting on St. Luke's and not "any government facility?" Her lawyers list down 3 reasons:

Modern equipment. Both Daguno and Napoles' personal ob-gyn Dr. Elsie Badillo-Pascua recommended Napoles undergo surgery to remove the cyst. Pascua, who is based in both St. Luke's Taguig and Quezon City, said Napoles could have the cyst removed via open surgery or laparoscopic surgery. Pascua also floated the possibility of undergoing a total hysterectomy.

In the motion, Napoles' team says "St. Luke's has the most advanced medical equipment in the country." Laparoscopic surgery or minimally invasive surgery is not available in Camp Crame. Her camp also questioned facilities at Camp Crame, citing a report by ABS-CBN News' Anthony Taberna which said facilities had to be rented out by the Crame hospital because it "did not have the equipment needed for such examination."

Napoles underwent a transvaginal ultrasound, CBC, CA 125, PTT, pap smear, HV-4, CA19-9 and PT tests in Crame.

Relationship with doctors. Singson said it's a matter of trust. "It's not about the capacity of the doctors, we don't want to undermine the PNP doctors," she told Rappler after the Thursday hearing. She said owing to the nature of the procedure, Napoles wants to be in the hands of doctors she knows. But according her own testimony, Dr. Pascua did not meet Napoles until her medical examination in Crame.

Pascua told the court it was Dr. Michael Villa, Napoles' diabetes doctor, who recommended her to the controversial figure. Villa, however, told the court he "assumed" Napoles was well-known to Napoles and her family since she was top-of-mind in their search for a ob-gyn.

A patient's right. Napoles' team said "it is the primordial right of every patient to choose" the kind of treatments she will receive, the doctors who will treat her, and the place where she will be treated. Citing the Societal Rights of Patients, her team also argued: "The patient has the right to regain and/or acquire the highest attainable standard of health, in a non-discriminatory, gender sensitive, and equal manner."

Singson also said it's a matter of Napoles' level of comfort, due to the "sensitivity" of the procedure. "Syempre bubukaka siya for the procedure, the exams. It has to be someone she's comfortable with," she explained. (She's going to spread open her legs for the procedures.)

Hearing reset

Napoles is detained at Fort Sto Domingo in Sta Rosa, Laguna, for allegedly detaining former aide turned pork barrel scam whistleblower Benhur Luy. Napoles' brother Reynald Lim, is also among the accused. He is currently at-large.

On Thursday, Almeda reset the hearing for Napoles' latest motion. The prosecution, composed of Assistant City Prosecutor Edmund Sena and Senior Assistant City Prosecutors Christopher Garvida and Henry Salazar were both out to take a mandatory continuing legal examination for prosecutors.

The defense, composed of Napoles' special counsels Fay Isaguirre Singson and Evita Magnolia Ansaldo, meanwhile were unable to present witnesses.

Luy's new counsel, Patrick Maglinao, was also present during the hearing. Maglinao admitted they had yet to "coordinate" with the team of public prosecutors, but said they would oppose Napoles' motion. "There are other hospitals available," he told reporters.

The next hearing is scheduled on March 11, at 10 am. Singson said the defense will present PNP General Hospital ob-gyn Michelle Daguno and PNP ob-sonologist Imelda Calo to testify on the need for surgery. – Rappler.com