Mech Vent

July 17, 2006

1:40am
sa loob ng CCU ng uerm

tahimik lahat.  tulog na ang mga pasyente.  wow benign sa ccu.  wala akong magawa.  sa mga ganitong pagkakataon madalas lumipad ang aking isipan.  napapaisip ako ng kung anu-ano.  "is the world round?"  joke lang.  seryoso na.  napaisip ako kung ano itong ginagawa ko.

syet alarm ng mech vent.
(tayo sandali, suction ng endotracheal tube)

minsan na ring sumagi sa isipan ko ang tanong na "bakit ba ako nag-med?"
noong bata pa ako, engineer talaga ang gusto kong kunin.  ika nga nila, like father like son.  eh pucha, marami palang math sa engineering.  sa lahat nga ayaw ko, eh yung math.  bakit di na lang architecture o fine arts?  mahilig naman ako mag-drawing.  pwede.  pero bakit med?

nagustuhan ko kasi yung idea na astig ang itsura ng doktor.  may nakasabit na stethoscope na mamahalin, na tipong gamitin lang sa pasyente eh alam mo na yung diperensya sa kanya.  tapos nakasuot ng puting coat.  maangas.  and of course, i want to help others.  idealistic.  eto lang masasabi ko sa sarili ko ngayon: tanga.

ang hirap pala ng pinasok ko.  from 1st year to 3rd year pukpok sa aral.  foundation daw ito para sa oras na tumapak na ako sa ospital.  tapos nung 4th year (medical clerkship o junior intern kung tawagin sa ue) wasakan.  duty every other day.  kami lang ata ang med school na ganito.  di birong trabaho.  doctor-in-the-making ka na, minsan sideline pa ng trabaho ng nurse at nurse aide (no offense sa nurses at nurse aides).  taga-gawa ka na ng sandamukmok na paperworks ng pasyente, ikaw pa din ang taga-monitor, pati ba naman pagtakal ng ihi at pagtimbang ng diapers eh trabaho mo pa din.  tapos sobrang bangag ka na sa dami ng trabaho na di mo na magawang mag-aral pa.  biglang may rounds, tapos di ka makasagot dahil nga di ka na nakapag-aral.  napagalitan ka na, may sp ka pa.  wow.  one hell year.

ngayon senior intern (post-grad intern sa labas) na ako.  more responsibilities.  dahil ngayon ang turing na sa akin doktor na talaga.  may degree na nga naman ako, wala nga lang lisensya.  pero kahit na, tingin ng lahat sayo - mapa-nurses, residents, pati consultants, and especially the patients - doktor ka na.  bigat.  eto na yung pinangarap ko simula't sapul.  may MD na sa ID ko.  nakasuot na rin ako ng white coat.  bakit lost pa din ako?  bakit ba ako nag-med.

alarm ng mech vent, syet.

after 10 minutes, eto na uli ako.  galing ako sa cubicle ni mommy catherine.  naoperahan siya nung isang araw.  dumating siya na parang wala ng pag-asa ang lagay niya.  ngayon gising na at nagpipilit na tanggalin ang kanyang et.  sa tapat ko kita ko si daddy pedro.  wala si mommy, yung asawa niya.  umuwi, nagpahinga.  nangako nga pala akong sa cubicle niya ako tatambay, ako ang bantay niya ngayong gabi.
bakit ako nag-med?

kasi ito ang nakita kong paraan na sa tingin ko makakatulong ako.  no stir.

(anak ng tinapa.  yung title ko pang maalaala mo kaya haha!)

Another 365 days

I didn't announce it to the press, but I just celebrated my birthday some time ago this month.  No, I will not say when, nor will I divulge which year I was born.  I stopped counting my age at 28.

It is mandatory that I celebrate my birthday.  Everyone else does right?  It's always the usual - eat out and invite almost everyone in the clan.  It did cause a significant drop in my bank account, but it was worth it.

Vikings buffet was packed that day, despite the ugly weather.  I refused to have the staff sing to me at our table.  I hate that.

So another year has passed.  A lot of things have happened in the span of 1 year.  I graduated from residency.  I passed the diplomate boards and am now a certified radiologist.  I started my fellowship training in CT-MRI a few months back.  Life went by like a blur.

I'd like to say that I've learned something in the past year.  Yes, maybe I did.  But nothing really life altering.  I guess most of the valuable lessons in life I have already learned.

It's the start of another year.  May this one be a good one as well.

Missing Sunday

I'm tired.

Sundays are days when one can relax, spend quality time with family and friends. But for someone in my profession, even Sundays are not spared.

When I was a kid I looked forward to Sundays. We usually spend Sunday mornings at the PICC complex. Dad would go jogging, us kids would go biking or join dad in his jogging, and mom stays at a shaded place with the younger kids while preparing a sort of picnic for when we finish our jog. I remember waiting for the vendor who sells Magnolia chocolait, the ones in the glass bottles. It tasted better back then.

We'd go home after and mom cooks us a sumptuous lunch. It would always be one of our favorites, and we'd end up eating a lot.

Sunday afternoons are spent going out to the mall where we play in the arcades. I remember using up all my tokens worth Php200 (back then that would mean a lot of tokens) on this one first-person shooting game, trying to defeat the last boss character. If we didn't go out we'd stay at home and just chill. Dad would order Shakey's thin crust itallian sausage pizza, a family favorite, for merienda. Mom would make halo-halo. Us kids would be out in the garden playing. Me and kuya would be playing with our G.I. Joes playing make-believe war, while the younger brothers watch and play with the fallen heroes of our little war games.

Sunday evenings are always reserved for Mass. After Mass, we'd either eat out or mom would prepare a feast for dinner.

I always liked Sundays.

Those Sundays are now a distant memory.

When dad moved to the US so that he can augment the family income, we cut down on the time we spend going to PICC complex for our morning jogs. Lunch and dinner feasts were still there. And of course Sunday mass.

When I entered medschool I try to go home every Sunday if I can. But when I started to have hospital duties, even Sundays were not spared. I'd spend Sundays at the hospital looking after patients, sometimes forgetting to eat due to the amount of work needed to be accomplished. Sundays were no longer happy days.

On the rare occasion that I was not on duty on a Sunday, I'd spend it sleeping. Weekends off were the only days when I can catch up on sleep. If not sleeping I'd be studying. Gone were the happy Sundays.

Today is a Sunday. I'm here at the hospital waiting for the next patient. I'd probably end up working through lunch again. My brother and his family are going to visit home, and as usual I am the absentee.

In a few years, after I'm done with training I might get the chance to spend Sundays at home again. I'm hoping to try and get back those missed Sundays. To spend it with my family like I used to. Then probably Sundays would be fun days again.

More fun in the Philippines

 

 

 

 

 

from point then to point now

it's 3:05 AM.  i can't sleep.  i've been trying to read this thick textbook on my desk, preparing and studying for my next in-service exam.  who knew that in residency we still had to take exams?  as a sort of diversion, i started opening folders here in my files.  i have files from med school, about time i deleted them right?  i started looking at pictures too.  scrolling through, i saw pictures from all the way back (scanned) as well as the most recent ones.  what particularly drew my attention were the pictures from med school.  yes, med school.  that time of my life really is one of the most significant chapter in my life.  it got me thinking of how i managed to survive it all, of how i managed to be where i am now.

it all started in 1996.  i was still in second year highschool then.  before that all i ever wanted was to be an engineer.  dad was an engineer, so i wanted to emulate him.  but i was never really good at math.  up until that point i never really appreciated how good i was at my science subjects.  it was because of my biology teacher that i started thinking about a career in medicine.  she had started med school but had to stop because of financial reasons.  she took up a teaching post in out school in order to earn and save for her med school tuition.  she told us stories of her med school days, of how fun it was and how fulfilling.  that got me thinking, hey maybe i can do that instead.  after that i was gearing up for a career in medicine.  i told my parents and they were very supportive.  (oh, and my teacher was able to go back to med school after that.)

i took up bs public health in college.  in my application form for UP, i chose bs fine arts and bs biology for up diliman and bs public health and bs biology for up manila.  3 pre-med courses and one course that totally has nothing to do with medicine.  also checked the box for intarmed (7-year straight medicine program of UP), who knows right?  i decided taking up a 4 year course for my pre-med even if another great opportunity was presented to me.  had one of the best 4 years of my life.  and it very well prepared me for med school.  we took up subjects that would also be taken up in med school (anatomy, histology, physiology, biochemistry, pathology, etc) as well as having a strong background in microbiology and parasitology.  got decent NMAT grades, good enough i guess to flaunt to the medical schools i applied to.  at that point in my life, i was excitedly shouting, "med school here i come!"

i was at a fork in the road to becoming a doctor.  which med school to go to?  it was a choice of going to UST, where majority of my friends were going, or to UERM where i got accepted first, had an innovative teaching style (problem-based learning), and not to mention where all my doctors are.  i decided to apply to UERM since i was assured of a spot, only having confirmation of my acceptance to UST after about a few days after enrolling.  even after then i was presented with another option: UP med has just recalled me.  an opening came up about a week after classes started.  after weighing my options, i decided to stay.  looking back, i think i made the right decision.  i benefited from the teaching style of problem-based learning.  making good friends and having a great time while i was there were bonuses.  i was able to pass med school, clawed my way through the hell year that was medical clerkship and survived the grueling internship year.  all that was left was to pass the board exam.

it was a rough three months.  studying, or rather cramming for the boards was all i did from morning until early morning, only sleeping a couple of hours before repeating the cycle.  i did get to have a vacation of some sort, having spent a week in boracay a month prior to the board exams.  i said to myself that had i failed the exam, this trip was to blame.  a lame excuse, i know.  but lucky for me, i passed the boards on my first take.  finally, all the hard work paid off.

looking through the pictures again, i began to scroll through my pictures during residency.  time has really flown.  from pictures during pre-residency, to first year and now to my fourth and final year, a lot has happened.  a lot has changed.  back then i was so unsure of the future.  back then all i was hoping for was for this hospital to accept me into their training program.  and after that, all i ever thought of was to survive first year residency.  i have had my fair share of mistakes since then.  from forgetting to check the patient's bleeding parameters resulting to a postponed procedure, to missing out findings in imaging studies, i've experienced them all.  those experiences have taught me well.  better to make mistakes now during training than to make mistakes in my private practice.

a little less than 6 months from now, i will have finished my residency training.  this toxic year would be over.  i will be relinquishing my duties as chief resident.  next step: diplomate board exams.  but that's looking at the future.

emergency

i was driving along fort bonfacio (the camp, not bonifacio global city), it was already around 2:30 AM.  i had just come from the interns' acquaintance party, and i must admit i've had enough of my fair share of liquor.  although a bit buzzed, i still had complete control of my faculties.  

the road i was driving on had some sections blocked off for repairs, so cars had to swerve to avoid the problem spots.  as i was near the end of the road and almost at nichol's bridge, i saw a spot where cars were trying to avoid something in the middle of the road.  thinking that it was just another repair spot, i slowed down so that i'd have enough time to maneuver my car away from the repairs.  as i was passing by the spot i found out what the others were trying to avoid.  right there in the middle of the street were two motorcycles that crashed head-on.  and right there were the drivers of the said motorcycles, lying bloodied in the middle of the road.

i quickly parked my car on the side of the road and immediately went to assess both drivers.  i came up to the one closest to me.  he had several lacerations on his face and arms, but was conscious and seemed stable enough.  after doing a quick initial survey, i told him to just stay still and assured him that additional help was on the way.

i immediately went to the next driver, and oh boy was i in trouble.  first look at the guy and i knew we had to transport him out of here and bring him to the nearest hospital asap.  he had a big contusion hematoma on his right maxilla and zygoma, he had deep lacerations all over his face, he was spluttering blood.  initial survey also showed a fractured right leg.  he was unstable and he kept on moving.  i asked a bystander to hold his head in neutral as i assessed him further.  i was asking for some first aide materials as the crash happened just a few meters from a police station.  the disappointing thing is, the police station did not have any.  i asked if they could get me some planks of wood that i can use as a splint for the fractured leg.  while all this was happening, i kept on shouting to all to call an ambulance.  my frustrations were mounting as i saw that the people were all just standing there while i tried to help out these two accident victims.  i had to hold the patient down as he kept on moving his fractured right leg.  after making a makeshift splint i personally called for an ambulance.  in less than 10 minutes one came.  imagine my disappointment when the paramedics told me that they did not have any cervical collars because apparently they already used up their supplies on the last call.

after performing some first aide, i asked the paramedics to transport both patients to the nearest hospital.  at first they told me they were going to bring them to this one hospital.  to my assessment it was too far.  i told them to bring both patients to the hospital where i do my residency as it was just a few minutes away.  i told them i'd drive behind them.  to my surprise they brought the patients to another hospital.

at the said hospital, the paramedics didn't even endorse the patients properly.  i was the one who did.  after making sure that both patients were taken cared of, i left them in the capable hands of the physicians at the ER.

blood-soaked and tired, i drove my way home.  it was around 4:30 AM when i got home.  needless to say, the adrenaline rush washed away all the effects of all the alcohol i drank hours prior.

it just pissed me off that the witnesses to the accident did not show any initiative to help.  all i heard them say was,"buti na lang may dumaan na doktor" or "buti na lang nandyan si doc!"  had the people there showed some initiative and some sympathy, we would have transported both patients to the hospital a lot faster.

(events happened June 12, 2011 at around 2:30AM at fort bonifacio)

silk 2.0

(written on January 2007, lifted from my other blog.)

summer ng May 2003 nung nangyari ito.  summer ng 2nd year college.  nasa bahay ako.  wala si manang, yung aming kasambahay, day off niya.  so ako na lang ang nagluto para sa aming magkapatid.  di naman pang-professional ang level ko sa pagluluto pero nakakain naman yung mga niluluto ko, so pwede na din.  medyo may mantika na sa kamay ko nung tinangka kong kunin ang bote ng asin.  nadulas mula sa kamay ko yung bote, nabasag sa kitchen counter at nagkalat ang mga bubog.  teka, ba't may kasamang pula?  dugo pala yun, nahiwa pala ang hypothenar aspect ng kanang kamay ko.  medyo mahaba yung sugat.  dali-dali akong tumawag sa mommy ko para sabihin ang nangyari.  pumunta daw ako sa clinic.  ilang sandali pa ay may bumusina sa labas.  nandyan na ang driver ng tita, dadalhin daw ako sa clinic.

sa clinic tiningnan ng naka-duty na doktor ang sugat ko.  nilinis ang sugat, nilagyan ng betadine para ma-disinfect.  tapos bigla niyang sinabi na kelangan daw tahiin ang sugat ko.  syet.  so eto na, tinurukan ng anesthesia tapos tinahi.  masakit din pala.  all-in-all mga 7 stitches din ang inabot.  maganda naman yung pagkakatahi.  kahit parang zigzag ang korte ng sugat ko eh nagawa naman niyang mahabol ng tahi.  after 10 days, tinanggal na yung sutures ko.

bakit ko ba ito nakuwento?  ngayong nasa med school na ako eh madami na akong natahing sugat sa kamay.  at sa paa.  at sa ulo.  at sa mukha.  pero nung unang beses ko ito gagawin, syet sobrang takot ako.  junior intern (medical clerk kung sa ibang hospital) ako nun.  paano kung pangit ang pagkakagawa?  pano kung tabingi yung tahi?  naaalala ko yung unang beses na yun.  takot na takot on the inside pero calm and collected on the outside.  form before function daw.  pero halata mo pa din na may takot.  eh ang lakas ba naman manginig ng kamay ko habang nagtuturok ng anesthesia at habang nagtatahi.  pero naging maayos naman ang pagkakatahi, down to the very last suture.  naging confident na ako mgtahi pagkatapos nun, madami na akong natahi pagkatapos.  suture sa OR, suture sa clinic, pati nga pagtahi ng bagong panganak eh nagawa ko na.

ang galing din ng nakaimbento ng surgery, pati na din ang mga gamit sa pagtahi ng sugat.  kahit nasugatan ka, gaano man kalalim ang sugat eh natatahi pa din.  gumagaling ang sugat.  pero yung nga lang, nag-iiwan ng marka, ng peklat (malas kung keloid former).  alam mong may nangyari, may pinagdaanan.  parang heartache.  pag nasaktan ka, masusugatan ka, minsan madudurog pa ang puso.  pero in time, naghihilom din ang sugat.  parang tinahi ang nagpira-pirasong puso.  pero may maiiwang marka, may maiiwang peklat.  tanda na may pinagdaanan.

nasa ER ako ngayon (may internet dito hehe!).  may dumating na pasyente, nahiwa yung kamay.

"(tawag sa nurse aid) suture set nga po.  pahingi ng silk 2.0!"