Estrada comeback not impossible

Neal H. Cruz, Philippine Daily Inquirer, Asia News Network, Manila

Joseph Estrada for vice president in 2004? Why not? He is not barred by the Constitution from running. That is, if he is acquitted or not yet convicted for plunder by that time. And from the way the trial is proceeding and the dilatory tactics of Estrada's lawyers, that is in the realm of possibility. If Romeo Jalosjos can successfully wage a congressional campaign from the Bilibid Prisons, why not Estrada from his suite at the Veterans Memorial Medical Center?

Some people have been floating the Estrada-for-vice-president idea recently and Estrada himself, in an interview at his suite in the hospital, is not averse to it. After all, he still commands a big following.

A recent survey showed that Estrada still has the support of 38 percent of the voters. That's a big base. Fidel Ramos captured the presidency with only 22 percent of the votes. Any presidential candidate would be happy to have as running mate a candidate with 38 percent of the votes in his pocket.

While the Constitution forbids a president from running for another presidential term (even if, like Estrada, he did not finish his first term), it does not prohibit a former president from running for vice president or for any other position. Thus, unless Estrada is convicted with finality of a crime that includes disqualification from public office as penalty, he will be eligible to run for the No. 2 position in 2004.

The question is: Is he serious? Or is the idea being floated only to scare President Gloria Macapagal-Arroyo into allowing Estrada to go abroad, ostensibly for a knee operation but actually only to get him out of the way of her ambitions for 2004?

But put yourself in Estrada's shoes. He is facing the death penalty or life imprisonment. He is being defended by a team whose only defense strategy is to delay the trial. Wouldn't you be willing to try any method to save yourself? Like going abroad for a knee operation and not coming back, for instance.

Which brings us to Estrada's knees. Does he really need an operation? And can it be done here?

The answers to both questions are "Yes." He needs an operation and it can be done here.

There are 386 orthopedic surgeons in the Philippines, registered fellows of the Philippine Orthopedic Association (POA). Every one of them can do a joint replacement, the surgery that Estrada needs.

Total knee replacement is one of the most successful operations done worldwide. It has been done in the Philippines since the 1980s. (In the United State, almost 140,000 joint replacements are done every year.) Dr. Jose S. Pujalte Jr., an orthopedic surgeon at the Philippine Orthopedic Center, who briefed newsmen at the Sulo Hotel on what ails Estrada, offered to do it for free for the former president.

According to Estrada himself, an operation had been recommended for his knees since he was vice president but he kept putting it off because he was afraid. His father also had arthritic knees and was confined to a wheelchair. The tendency to have arthritis is inherited, but of the 10 siblings only Estrada got it.

"Maybe it's because you used your knees too much," came a joke.

Estrada now has the end stage of osteoarthritis, or degenerative joint disease. The smooth cartilage surrounding the bone ends, so that the joint glides smoothly, wears out, resulting in bone-to-bone contact. It is common in the elderly. It is a progressive disease and becomes increasingly painful as the cartilage erodes. Estrada gets steroid injections to minimize the pain and inflammation but steroids are bad for the body.

To relieve the pain, restore the joint's function and achieve stability, total knee replacement is recommended. "As the arthritic knee becomes more painful," said Dr. Pujalte's briefing paper, "the patient will use it less. Function, therefore, is lost. As the arthritic knee continues to deform, the patient will feel that the joint is wobbly or unstable."

The operation replaces the diseased joint with implants which consist "of a metal block covering the end of a diseased thigh bone (femur), a plastic or plastic-on-metal combination for the leg bone (tibia) and a plastic button for the knee cap (patella)."

There are alternatives to surgery, there are many drugs for arthritis but only when the disease is discovered early, before joint damage is severe. But as I said earlier, Estrada's osteoarthitis is already at the end stage and surgery is the only way.

However, while Dr. Pujalte said that while we have 386 orthopedic surgeons who can perform the surgery here and that we should respect our doctors who are very competent and let them do surgeries that can be done here, he also pointed out that a patient must have confidence in his doctor. Trust and confidence in a doctor help a lot in the quick recovery of the patient, he said.

So, should Estrada be allowed to go abroad for knee surgery?

"If he has confidence only on his American doctor," Dr. Pujalte replied.

But will he come back when he is already abroad?

Yes, he will after four months, Estrada's family insists. To guarantee his return, his wife Senator Loi Ejercito and his son San Juan mayor JV Ejercito will sign written promises to resign their positions if Estrada doesn't return.