Unang Buwan

April 23, 2006

I was deep in dreamless microsleep when Mike jolted me awake, "Huy, may pasyente ka sa CRM." And in a second I sprinted off to the OB-Gyne ward consultation room with stet, bp apparatus and logbook in tow. As I passed through the door, holy crap! All I could see was red. Red, thick blood flowing profusely down the patient's legs. Oh crap talaga. This is definitely another admission. She just gave birth last week, was discharged with a bill of clean health and was given a typewritten prescription of antibiotics. Apparently, she didn't take them because Co-Amoxiclav was not as important as, say, her new baby's formula or her family's meager food budget. So she went on to acquire endometritis which can only be managed with confinement (which was free), lab exams (P350 for a transvaginal ultrasound, P100 each for CBC and urinalysis), stronger antibiotics (which cost P3,000-5,000 per day), blood transfusion and lots of IV fluids. After our resident enumerated each expense, we all found ourselves staring at the blood droplets on the floor in deep miserable silence. The husband sat on the floor with one hand across his face. The patient smothered her face with a blood stained hospital blanket, in an attempt to hide her tears. I, on the other hand, was thinking, God, I can't help them! The feeling of helplessness and hopelessness was choking me like a vise.The resident was most likely thinking the same thing. After sorting all possibilities, they decided to try out a government hospital. With all the blood cleaned out and a fresh new adult diaper, the patient was wheeled off with a referral slip, which she'd probably won't use anyway...because in the middle of the way they'd think, this thing would just go away, like a cold or a rash. And they'd go home and forget the whole night ever happened. They'd forget about the P5000 buck expense that they were supposed to shoulder and postpone worrying about a worse scenario than this, like maybe, hypotensive or septic shock. After they left, I collected all my stuff: my stet, bp app and logbook and closed the CRM door. It's quite easy actually to just pick up from where you left off, and wake up to a future that was as bright as the morning sun. Which makes me a little guilty of course. But perhaps the thing that will forever stick to me is that no matter how much you try, you can't save everyone. But you will save some of them, and in some way make their lives a little better...and that should be enough.

April 26, 2006

Venoclysis, a.k.a. blood extraction, a.k.a. one of the top reasons why people hate doctors. Also one of the reasons why I hate being less than a doctor. It's not because it makes me feel yuck, I mean, hello, I've seen worse, like a retracted abdomen filled with warm blood and pelvic innards (as in parang isang giant kaldero ng dinuguang di pa luto). Aaaanywaaaays...I just hate it that I'm not infallibly good at it yet. And what makes things worse is that mas lalo ka pang nang-hahassle ng mga taong uber-agrabyado na in the first place. Like yesterday when I woke up this cancer patient at 6am for an order for a white blood cell differential count. She just had surgery the other day. Blow #1: For a couple of months, she thought she was pregnant but it turned out that she only had this pathologic "sago-like" stuff in her uterus called hydatidiform mole which makes your belly swell up, like you're pregnant and gives a positive result in a pregnancy test. Blow #2: A hormone called bHcg was found to be elevated in her blood so she might even have choriocarcinoma, a kind of cancer that is a sequelae of H. mole. So stress diba. And because of some stroke of bad luck, I just happened to be horribly incompetent at that certain point in time. Ginawa ko lang naman siyang pin cushion. I pricked her 3 times because her circulation defied the forces of nature. Even if you go for the biggest pulsating vein, her blood simply refused to flow. Joemal did 2 more pricks. God, buti nalang kaya pa niyang ngumiti in between shrieks of anguish. Deep inside I was wishing for this huge mallet, like the one you see in Looney Toons shows, to hit me on the head a couple of times just to make things even. Pero wala eh, so binigyan nalang namin siya ng pandesal. Na walang palaman. Hehe, stress!

April 30, 2006

OB-Gyne Ward rotation is over! Parang hanging umihip lang sa mukha mo ng ilang segundo. Parang isang lagok ng kape na dumaplis sa lalamunan mo. Parang splitsecond na tisod sa isang maliit na butas sa kalsada. Parang isang mumunting sampal sa braso pag may langaw na dumapo. Akala mo kasi minsan ang parusa ay magpakailanman kaya madalas kinakatakutan o iniiwasan. Eh sandali lang naman e. Bukas at bukas rin, mababaon ang lahat sa limot ngunit matitira ang ikaw na iba na sa taong nakagisnan kahapon.