Why I Do It (and Why I Continue Doing It)

You never forget your first love. Even if you’ve already come into terms with the fact that you’re definitely not going to end up together, your first love still occupies a special part of your heart. I initially had qualms about facing my first love again and to make things even more difficult, we were to spend two whole months together. Dear Lord, how am I going to survive this? 

But here we are. It’s over. My OB-GYN internship rotation is officially over, and I’m exhausted. I feel so drained both physically and mentally, but every day of that seemingly endless pre-duty-post cycle was worth it. I learned a lot. I had fun. And most of all, I got to be a witness (as well as directly assisting) in the everyday miracle of bringing new life into this world.

Pre-Duty days were spent charting countless of new and follow-up patients at the OB-GYN General Service out-patient department. Normally, I liked seeing patients in this kinds of environment, since it’s relatively more benign and there was no pressure of urgency, but there were days when the OPD still went a bit out of hand. Intense. One particular day had us charting way past 5pm in the afternoon. I didn’t get the chance to eat a proper lunch! Still, our days at the OPD gave me the chance to learn from the rich pool of patient cases in UP-PGH. I know the basics of pre-natal check-up like the back of my hand, and can confidently do internal examination and the Pap smear test. What a far cry from my old self, who basically panicked at the thought of having to do IE. (Read about my memorable LU IV OB-GYN experience here: Crepes, Cramps, and Contractions)

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Service B-est! :) Endless charting at the OPD is nothing when you’re with awesome co-interns and residents! || Photo from Biel Faundo

Duty days were, of course, where the action was. It was real roller coaster ride going through 4-5 straight OBAS (OB Admitting Section a.k.a. OB emergency room) and LRDR (Labor Room – Delivery Room) duties. All those unbelievably toxic duties! In the OBAS, we practically defined fast charting. And every time our resident would yell out “Admission!” caused a rapid call to action to ‘admit’, which entailed inserting an IV line, drawing blood, making the patient’s identity “flag”, and of course, the insistent reminder to fill up that patient info slip (the perpetual Kaalaman form). I was unfortunate to have two Labs Master duties, both on High Risk Fridays. This meant that I had no other task during the duty day, except to run up and down to and from the Department of Laboratories to submit specimens and retrieve and take note of results. And when there is a suspected pre-eclampsia patient, stat Alb meant stat Alb, and make sure the labs know it!

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The benign color spectrum at the LRDR :) Thank you, thank you to our stellar clerks and our awesome residents for everything! And of course, thank you to all the mommies who allowed us to be a part of an important milestone in their lives. || Photo from Gienah Evangelista

 

On the other hand, LRDR duties were spent on labor watch. Whew. All that toco-monitoring! All that TIC (Temporary-In-Charge) work, what with all the LR backlogs I had the weird tendency to get decked Young Primigravids (ie. 18-year-olds and below who were pregnant for the very first time), so you can only imagine how my patience was repeatedly tested by these obviously-too-young-for-this types. They generally had a low pain threshold, so they didn’t take labor too well. I had to repeatedly counsel them about the responsibility they were to face as new mothers, and that they had to stop thinking only about themselves from that point on. Another life was going to be at the mercy of their hands, come the birth of their child.

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I love Pay duties. I love witnessing the “ideal” side of things. But most of all, I love Complete Bed Rest duties. Yaaay~ || Photo from Gienah Evangelista

 

I definitely wouldn’t miss the 24-hour monitoring duties at the OB ward, not to mention the grabe-naman-tama-na-po list of To-Do’s that required me to line, line, extract, and line some more. The end of OB-GYN also marks the potential end of my OR career, should I choose not to go into a cutting specialty in the future, so there’s that to think about. And yay, no more 7AM Summary Rounds! No more I-don’t-know-anything Gyne Onco and Tropho Rounds!

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“Nasaan na ang pasiyente? Higa na sa kama! Tanggal ng pambaba!” 

All-in-all, I’d say that I had a pretty fruitful OB-GYN Internship rotation. I had a blast helping all the new mommies. There were definitely days when I would repeatedly question why I continue to do this doctor thing. God knows how extremely difficult duties can get. And though you are granted a day of rest what with the true post-duty status, it can never be enough, ’cause before you know it, you have to go on duty yet again. It never ends! It was definitely a bloody business, but I learned that as long as you push hard enough and don’t give up, good outcomes can definitely be expected. It was all definitely worth it, considering everything you’ve gained at the end. #BabyOut

Hinga ng malalim, pigil, and push! Only 70-something more days left of Internship! Let’s do this!

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Community Medicine Week 5: Familiar Paths

“Home isn’t a place. It’s a person.”
– Stephanie Perkins

Tita Nini, the midwife of Barangay Luksuhin Ibaba, and I were walking towards the tricycle terminal, together with one of our Barangay Health Workers, Nanay Aida, after another long Wednesday clinic day. Wednesday was our busiest clinic day, the day when most of the patients came to consult, especially the pregnant women who were to be seen by the midwife for their prenatal check-up. That said, it was quite understandable why the three of us were eager to go home and rest a bit.

We were halfway towards the Luksuhin Public Market when Tita Nini remembered she had to check something out at one of the local parlors. Parlor-parlor din ‘pag may time! Nanay Aida offered to come with her. I smiled and said that I’ll go ahead of them.
“Sigurado ka ba, dok?” asked Tita Nini, looking a bit reluctant to let me go off alone. “Kaya mo ba mag-isa?”
“Ay, oo naman po, Tita Nini! Kayang-kaya!” I laughed, reassuringly. My two companions heartily laughed along while waving good-bye and walking towards the direction of the local parlor.

As I proceeded towards the tricycle terminal on my own, I thought about the ease at which I reiterated that I was fine on my own. I also realized that it was true, that I could easily head back to Barangay Sulsugin by myself, that I no longer feared getting lost, that I knew my way back to my foster home, that a lot about Luksuhin Ibaba has become familiar.

Five weeks can never be enough to fully understand a place and a way of living, but in this very short time, I’ve grown to be fond of these paths. It is a far out cry from my first week, during which I felt like a lost wanderer most of the time. I remember being so wary of having to commute everyday just to reach my assigned barangay. I remember being so afraid of getting lost, of ending up who knows where with no idea how to get back home. But now, the paths have become familiar. The place has really grown on me.

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The barangay health workers of Luksuhin Ibaba, Dr. PJ Francisco (Family and Community Medicine resident), and I after our vital signs OSCE || It’s been a great five weeks. Thank you for making me feel right at home! :)

But more than the place, what I’ve really grown fond of are the people. Also among my fears upon starting out was feeling a bit lonely amidst all the new people. Though I’ve never been much of a shy person, there is still always that worry that there’ll be difficulty getting along with people. But everyone here has been more than welcoming. The new-found friends in my health team as well as within the other people of the community will surely never be forgotten. I’ve learned a lot from them about the simplicity of life, the dedication to work, and the importance of family. Because of them, despite being a mere visitor, I felt that I found something of a home here in Luksuhin Ibaba and in Sulsugin.

As my community medicine rotation is slowly coming to an end, I hope I was able to contribute something, no matter how little, for the betterment of the people of Luksuhin Ibaba.

Community Medicine Week 4: Recognized

” There is undoubtedly a lot of pressure that comes with recognition, which can be a good thing and a bad thing all at the same time.”

– Prabal Gurung

I had just finished another clinic duty and was walking towards the tricycle terminal found just behind the public market. I was in the middle of one of my usual daydreams when I was suddenly pulled back into reality by an eager “Hello po, doktora!”. Looking up, I saw that it was one of the tricycle drivers. He was already pulling away from the terminal, a passenger on board his vehicle, but when he saw me, he took time to greet me and even call out at his fellow drivers, informing them that I needed a ride. The man I assumed to be a foreman of sorts directed me to an empty tricycle and immediately informed the driver where I was going home to. I didn’t have to say anything. They already knew.

It felt strange to be recognized. I honestly couldn’t remember how I got acquainted with the tricycle driver, if he consulted at the barangay health station (BHS), at the rural health unit (RHU), or maybe even visited our foster home in Sulsugin as an acquaintance or relative of our foster mom. There was nothing about my appearance that may have tipped him of my identity. I wasn’t in scrubs, wasn’t wearing an ID, nor carrying any of my medical tools. The tricycle driver simply knew that I was their doctor.

Going into this rotation, I knew that it was going to be a challenge being the sole doctor at the barangay health station. With Luksuhin Ibaba being the largest and most populated barangay in Alfonso, I had the additional challenge of having slightly more patients than my co-interns. That said, maybe it was inevitable that people would start actively seeking out this sole doctor. For some of them, you’re the only doctor they’ll ever get to see.

It really is such a different world here in the community, compared to what I know in UP-PGH. Back in the hospital, my patience would repeatedly get tested after being called “Nurse! Nurse!”, “Ate! Ate”, or worse “Ineng! Ineng!” by patients and their watchers. All these, even after all these years and after finally earning the right to wear my Intern’s coat. I’d all but grown tired of correcting them about my confusing position as ‘almost a doctor’. But here in the community, even without the coat, people recognize me as their doctor. And though this initially brought me delight, thinking that, at last, I’ve sort of arrived! I actually talk knowledgeably and act skillfully enough to be seen as a physician!, the recognition now brings a little bit of panic in me. For I once again realize that to be called and recognized as a doctor is more than just a title, it is really such a big responsibility. Being a doctor makes people put their utmost trust in you. There will be moments when you’ll literally have lives on your hands.

“…to be called and recognized as a doctor is more than just a title, it is really such a big responsibility.”

Two more weeks remain of my stay as the intern-in-charge of Barangay Luksuhin Ibaba, and I’m planning to make the most of every moment. I’ll do my best to prove worthy of my patients’ trust and their everyday greetings of “Hello, doktora!”.

Community Medicine Week 2: Breathless

“Life is measured not by the number of breaths we take, but by the moments that take our breath away.”  

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When a patient comes to you, complaining of difficulty of breathing, a long list of differentials come to mind, ranging from the apparent pulmonary etiology to the more complicated renal pathology. But in the case of A.D., 23/F, it is highly probable that her shortness of breath is caused by an exacerbation of her bronchial asthma, most likely exercise-induced. It is probably her own fault, knowing that her lungs can’t handle prolonged walks, much less keep up with her healthy, non-asthmatic friends when it comes to physical activity, yet still attempting to assert herself. Ayan tuloy, hingal na hingal…  To think I’d have an uncontrolled asthma week here in the community. Sigh…

It is ironic that an aspiring doctor such as myself would have several co-morbidities, yet it is proof that physicians, no matter how much they are sometimes revered as mortals attempting to combat death, one disease entity as a time, are still quite human when it comes right down to it. A beloved Family Medicine consultant once told me that I should look at my illnesses as a sort of blessing in that they help me empathize more with my patients. I know first hand what pain is, and not just physical pain, and I know first hand how difficult and extremely debilitating it can all get. I know what it’s like to feel so hopeless, when you feel so, so weak that it’s hard to even feed yourself. I know what it’s like to gasp for air, to literally be breathless. 

when the doctor becomes the patient…. || 23-year-old female presents with shortness of breath and slight chest tightness; Tx: Salbutamol 2mg/tab q6 for now || Never take breathing for granted. Some of us find it so difficult to do.

So, even more so now that I’m in a way running my own clinic at the Luksuhin Ibaba Barangay Health Station (BHS), I make it a point to listen to my patients’ stories, to believe in pain scores, to take note of all complaints. If it is something they deemed important enough to warrant a consult, then by all means, let me do my best to address all concerns. I’ve heard all sorts of complaints during my clinic duties at the BHS. There was a young mother who brought her 2-month-old baby for ‘loss of appetite’ when in fact, the baby was well and healthy, just a little bloated and  needed a little burping. I simply taught the mother about feeding cues and to not force feed her baby. I also had a variety of ‘headache’ complaints, the history-taking of which was almost enough to induce a headache of my own. Di ko po alam, doc. Basta po masakit! goes on, while another insists, Ay, 10 out of 10 po talaga, doc! Ganun kasakit! Still, pain is subjective. 

My determination to hold clinic today despite my breathlessness seems to bear little as I only saw three patients today. But maybe, for the three of them, my efforts were a big deal. They were able to see a doctor (well, almost a doctor) today. They were able to get free medicines today. They were able to be advised today. And as always, I am comforted by their grateful smiles. 

I remain constantly appreciative of the little moments, those quiet patient times when you can just converse freely with patients. A welcome change from hospital life (UP-PGH life, in particular) where everything seems to be in fast forward and just the mere thought of taking your time is seemingly punishable by demerit. It is these quiet moments that frequently go unnoticed, frequently taken for granted. We are sometimes so overcome with excitement, with adventure, with twists and turns, that we fail to appreciate the quiet times. 

But they are, in fact, what we live for. They are the very moments that make every breath we make worth making.

Community Medicine Week 1: Wandering and Wondering

“Not all those who wander are lost.” – J.R.R. Tolkien

Beginnings and endings are equally difficult to experience, but for different reasons. In the case of this week, beginning our community integration proved challenging because everything was new and different. Adjusting needed to be done as we prepared for living with our foster families, and working at our respective barangay health stations. We were to meet and converse with a lot of people, and truthfully, there was really no way of preparing oneself. That we will feel lost is an understatement. No amount of orientations or endorsements would be able to give you the exact picture of what you were to face. You only ever learn by experience, by opening yourself to discovery.

The Alfonso Municipal Hall, which doubles as the Rural Health Unit

This past week, I began my duties as the medical intern of Barangay Luksuhin Ibaba. One notable difference I had with my fellow interns was that I was the only one who didn’t reside within my assigned barangay. This made me consider two things – First, what the residents of Barangay Luksuhin Ibaba may think : could the fact that I wasn’t living in their barangay create some sort of gap?; will this make them more distant, less willing to deal with me? Or am I just overthinking things? I don’t know if it has ever been done that the Luksuhin intern be assigned a foster home in Luksuhin per se, but I wonder if it will make some sort of difference.

Second, how can I, a partially directionally-challenged person, survive daily commutes without getting myself lost? I dislike communting by myself as I tend to get off at all the wrong places. I really fear not knowing how to get home, so imagine the internal panicking that happened when I found out I was to commute daily to my assigned barangay. Still, I let myself be open to this challenge and learned the routes and fares from Sulsugin to Luksuhin (and vice versa), as well as from Alfonso Proper to Luksuhin (and vice versa). Not a lost wanderer anymore!

Ready for clinic duty at the Barangay Luksuhin Health Station!

Still, as one of my favorite authors, J.R.R. Tolkien, wrote in his famous poem, not all wanderers are lost. I certainly felt like a wanderer this first week at Alfonso, going about day-by-day without a clear direction in mind, simply aiming to get to know the ropes of things. And, so as not to get lost, I gladly opened myself up to the challenge of integration, of slowly getting to know and engaging within the community.

I had my first interaction with the Barangay Health Workers (BHW) of Luksuhin Ibaba last Wednesday. The previous interns said that Wednesday Barnagay Health Station (BHS) clinics were busy, and boy, was it really busy! I barely had the time to converse with the BHWs, aside from our short chitchat over lunch, what with the number of patients that came for consultation. I saw more than 20 patients on my first day! Wednesday’s rush got me browsing through my clinical notes, much that I was a bit more prepared for Thursday’s clinic. Truthfully, I was a bit hesitant about holding clinic duties on my own, without the familiar guidance of a resident or consultant to guide me, especially in my diagnosis and management. To make things a bit worse for my nerves, the people here have such great respect for doctors. How they smile as they greet you, Good morning doktora! How they hang on to your words as you attempt to explain their illness and treatment plan. Oh the pressure. But, I think I did alright. I certainly found talking with the patients enjoyable. One notable patient, an elderly man with hypertension, even made an effort to come back a few hours after I saw him for a consult, just to give me a small token of his appreciation – a pen. His simple effort made in complete gratitude did not fail to made me smile.

I had another interesting patient encounter during my duty at the Rural Health Unit (RHU) earlier today. It was a morning filled with consults of coughs, colds, and fevers, when come the afternoon, an 8-year-old boy came with a laceration on his forehead, brought about by a rough round of play time at school. Thank God it spared his eyelids! But the wounds was deep enough to require suturing. So suture, I did! To think that I’d still need my surgery skills during my community medicine rotation! At first, I was wondering how I was to go about it, what with the need for instruments and all, but it was good to know that the RHU was equipped with the basic suturing supplies!

After this first week of wandering and wondering, I plan to continue getting to know Barangay Luksuhin Ibaba and its people. I look forward to hearing their stories. As the new place slowly turns into a different form of home, and the stranger slowly becomes a familiar face, this wanderer will soon find direction amidst all the challenges she will face.

Live While We’re Young

I’m a little behind on my writing, aren’t I? Okaay. Maybe not just a little. Ugh. As much as I’d like to blame the whole ‘I-can’t-access-Wordpress-what-on-earth-is-wrong-with-my-Internet?!’ situation, that’s not really the real problem here. Once again, I found myself caught in between my two worlds. I spent any free time I had, resting while I could, spending time with my loved ones, and indulging in good books, movies, and dramas. I am such a lazy writer, gah. 

Thus, here is my effort to get back on the road of the written word. I have at least two blog entries I have to write to catch-up (will work on those soon!), but before I backtrack, I’d better get these thoughts written down before I get too lazy again… #internshipissoooooootiringyetfun #howtomaketimeforwritingpo

As we were ending our Ophthalmology rotation (much to my absolute regret, see more in a future blog post), I was suddenly struck with an unexplicable sense of impending doom. It was weird. At the back of my head, I wondered if something bad was going to happen, or if it was a symptom of some sorts (Med Tidbit: feeling a sense of impending doom could actually point to a variety of diseases, including  anxiety attacks, depression, myocardial infarction, and even aortic dissection). Thinking back, it was probably just because we were starting our Pedia rotation the next day after. Something about dealing with such a toxic rotation, and the fact that I’ve never been really good with kids, must have had me in jitters. And the only bad thing that happened that day was that I forgot my umbrella and got wet from the starting drizzles. 

And now, all of a sudden, I find myself halfway through Pedia. It wasn’t bad at all. In fact, there are several moments when it was actually fun.

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Weeks 1-2 of Pedia Internship consisted on unlimited charting at the OPD Sick Child Clinic and the numerous Subspecialty Clinics, and at night, ER back-up duties. Our three-woman duty team did great! Jobs tend to get a lot easier when you’re working with awesome people. But, since it’s the PGH PER we’re talking about, it is inevitable that things get a little rough every once in a while…
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And we end up pretty tired from it all. But of course, being the benign team that we are, we do get short nap times. :)) PER Triage hits! #kinderjoypamore #presentingKatyFairy || Photo credit (c) JB Besa — stolen shot! 
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Always a treat to go on post duty binge eating with these two! :)) Much to the regret of my stomach and wallet though… Haha! The post duty sleep that soon follows this is quite something as well, and the eventual realization that things have once again come full circle and you have to repeat the whole Pre-Duty-Post cycle once again. Haaaay Buhay Medisina! || Photo credit (c) Myza Espallardo

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Weeks 3-4 sent me back to the Pedia Wards and this time around, I got to spend time with the Hema Onco patients. One of the challenges of being a Hema Onco (HO) Intern was that you went on duty alone and you were semi-in-charge of all 15 HO patients admitted for the tour of your duty. Mini-JWAPOD-ship every duty!

Still, the greatest challenge for the HO intern was probably training your heart to deal with the hardships of caring for children with cancer. It honestly broke my heart, seeing all these children, some as young as 11 months old to adolescents at the bringe of adulthood, dealing with such a complicated thing such as cancer.

One time, when I was in the middle of monitoring duties, 18-year-old L.O. (not her real name) caught me off-guard with such a difficult question. As she held her arm out so I could take her blood pressure and pulse rate, wearing such a sad expression on her face, she asked me, “Dok, kailan po ba gagaling ‘tong leukemia?“. I honestly struggled with an appropriate answer, completely unsure of how I should go about it. I went with a general reply, saying that patients, being different from one another, also responded to treatment regimens differently. She only had to do what she ought, be compliant with her medications and to take care of her self, so we could hope for her best shot at recovery.

It was a sad reality, what these children have to deal with. Instead of spending time playing, having fun, learning, making friends, discovering the world and what it had to offer, they were stuck in a hospital, getting their blood examined daily, dealing with medications and diagnostics here and there. They were forced to struggle with the war of life versus death, when they haven’t really gotten their fair shot at life yet. Meanwhile, their families, especially the parents, were facing their own battles. It is unimaginable how a father or a mother could bear seeing their child suffer. Dealing with mortalities at the Pedia ward was difficult, to say the least, both for the loved ones left behind and for healthcare workers like us.

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A beacon of light within such a sad reality… It was a common sight at our HO Ward, having do-gooders come to share food, gifts, and time with our patients. :) These characters from Star Wars came not only once to cheer up patients and to wish them a speedy recovery! || Photo credit (c) Teedee Estrada

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And just like that, we’re in Week 5-6 of Pedia internship! Time to spend time with the newborns at the catchers’ area/NICU. First duty down, and it went pretty well! Here’s looking forward to more fun and learning! Can’t believe I actually worried about this rotation in the first place… Hehe!

Twinning! :) My first catch of  Pedia Internship is this live baby boy! Cutie! Photo taken and posted with mommy's permission
Twinning! :) My first catch of Pedia Internship is this live baby boy! Cutie! Photo taken and posted with mommy’s permission || Photo credit (c) Myza Espallardo

Tales from the SOD

Late post! This blog entry chronicles some of my favorite experiences from our Surgeon-on-Duty (SOD) rotation last August 12 – 25 2016 . It was a challenging yet fun two weeks that consisted of rough ER duties, seemingly endless OPD charting, and solo Minor OR stints.  

 

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Bringing a little dose of sunshine into the gloomy ACU! Team Sachi-TeeDee-Angeli-Biel, reporting for SOD! :D Photo grabbed from Biel Faundo (C)

 The Emergency Room can be a pretty tough place to handle, what with the need for quick and systematic action in facing what may be the difference between life and death. This is especially true for the UP-Philippine General Hospital, where patients come in overwhelming numbers on a daily basis.

And when you happen to be among the Surgery interns on duty at the SOD, you have to be prepared for the rush. Wounds of all sorts of shapes and sizes. Abdominal pain of varied character, severity, location, and radiation. The different shades of jaundice. Vomit there, vomit everywhere. Bleeding love. And there never seems to be a shortage of mauling cases. All these and more, and before you know it, it’s already 7AM or 7PM – shift over!

Tale 1. What Really Matters

Two patients arrive at the SOD, both sustaining multiple injuries after a vehicular crash. Our four-man intern team quickly divides into two and takes action – fast-chart, insert IV access, extract blood, prepare imaging requests, do skin tests for tetanus shots and antibiotics, and clean wounds. History reveals that our patients, who I shall pertain to as Girl and Boy from this point on, are sweethearts who were on an afternoon drive, and a mistake on Boy’s part caused their unfortunate accident.

Girl’s most obvious injury is her forehead laceration and Sachi goes to work on suturing. With the injury not so deep and not so long, the repair is easily finished, the wound cleaned and dressed. Meanwhile, I grab a 1L bottle of plain LR, a macroset, and an IV cannula and proceeded to insert an access on Boy.

“Naku, Doktora. Tatahiin niyo na po ba ako?” Boy asks, clearly a bit nervous about getting stitched up, as I tie a tourniquet (actually a tourni-glove) around his left hand. I reassure him and say that I’d only be inserting an IV line for now.

Holding up his hand as I try to look for the ideal vein to puncture, Boy takes a deep breath. “Masakit po ba ‘yun?” 

“May anesthesia naman po, sir. Pero siyempre, may kaunting sakit pa rin sa umpisa,“I reply. I get the IV cannula inserted with no problems and set up the line.

Eh, yung kasama ko po? Kumusta siya?” Boy asks, peering outside the suturing area where his girlfriend was stationed.

Ah, OK na siya. Natahi na ‘yung sugat niya.” 

He sighs in relief. “Mabuti naman. Ang mahalaga kasi, siya…” 

Amazing how love can make a person think so much of that special someone to the point of forgetting himself. Boy’s thoughts are so concentrated on how Girl is that he failed to recognize that he’s the one in a much problematic state. While Girl only sustained an easily repairable forehead laceration, Boy suffered what appeared to be an intense hit to the inguinal area, causing gross swelling and erythema of his scrotal area. One can imagine just how much that hurts, but what really matters most to him at that moment was how Girl was.

#TrueLoveAtTheER How sweet! Pa-CBG naman po ‘dyan! 

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No task is too great for this awesome duty team! :)

Tale 2. While I Can

One of things I like the most about OPD clinic days is the fact that you get to sit down, talk and examine patients at a relaxed environment. In contrast to the super fast-paced and confusing ER environment, the OPD actually allows you to take time to build rapport, the first step in any history-taking and physical examination lecture I’ve ever attended since I started medical school.

My team is relatively toxic when it comes to OPD days. Our new patient numbers always approaches or even exceeds 50, meaning charting galore! On one particular day, everyone seemed to have urinary problems, requiring me to do the digital rectal examination more than a couple of times. Oh boy…

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The feeling when you finish charting a patient only to find 10 more new charts freshly piled on the nurse’s desk… Sigh. Chart pa moooore! || The aftermath of 53 OPD consults

My patient encounter with a 80-year-old grandmother, who we shall call Lola in this story, was particularly memorable. She comes in unassisted, shuffling towards the seat in front of my desk, looking a bit winded from walking, but with a smile pasted on her face nonetheless. I greet her with an equally enthusiastic smile and proceeded with “Ano pong pinunta niyo rito sa PGH?”.

I still find it a little striking how patients can put so much trust in their doctors, especially ones they have just met, as to immediately reveal parts, if not their entire, life story. This is especially true when you actually succeed in building rapport in that short period of introduction. Lola immediately begins telling me about this mass she noticed on her left shoulder, a mass that started out small and that she ignored until it became big enough to catch her daughter’s attention. The conversation then strays away from her medical problem – the mass – and towards what I suspect is her more pressing problem, her family situation.

With times being as hard as they are right now, Lola is the one taking care of her grandchildren, even the one who brings them to school and cooks their baon. They were the real reason why it took her so long to consult about her shoulder mass. In fact, she wouldn’t be consulting at that moment, had it not been for her daughter’s insistence.

Sabi niya sa akin,  baka kung ano na ‘yan, ‘nay. Ipatingin mo na…” Lola narrated, her eyes a bit watery. “Lumalaki na. Hanggang kaya natin, ipatingin mo na at ipa-opera…”  She dabs at her eyes before continuing. “Ang sa akin naman, OK lang kahit anong manyari sa akin. Matanda na ako eh. Pero para sa kanila, hanggang kaya ko, sige. Magpapatingin na lang ako…”

I did my best to reassure Lola, that we would do our best to help her. Physical examination points to a simple cyst and excision seems to be an easy option for her. She looked relieved to hear that it didn’t appear to be anything serious and thanked me for taking time to see her.

Our patients truly are our greatest teachers, more so than any textbook, trans, reviewer, or lecture. Life can be a very confusing journey, with its endless ups and downs, twists and turns. But as Lola said, for the people we love the most, we must do what we can while we can. No one knows what lies ahead, so we have to cherish the present.

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Hooray for the clingiest SOD duty team ever! Hanggang sa Radio, nagpunta para sabay-sabay pa ring uuwi. Thank you to our SODs, Dr. Joan Flor, Dr. Denor Sotalbo, and Dr. Kat Guillermo, for everything. On to the wards~!  Photo grabbed from Biel Faundo (C)