We Will Remember

I join the world in mourning as we lay rest to Michael Jackson.

I still vaguely remember, I was 8 years old running through our living room and my dad's stereo was blasting "Off The Wall" and "Wanna Be Startin' Something." We all had our favorite Michael Jackson song -- "Man in the Mirror" and "Human Nature" comes to mind -- mine will always be "Rock With You."

His death makes me feel, among other things, old.

His death renews my fear and my strength in my mortality.

We can only hope to be remembered once we pass, and Michael Jackson will live on in his music.

Thank you Michael, you made all of us who heard your music moonwalk together.

Getting Through the Day

One of the best things about being in medicine is that I get to meet people -- some I get to like and even get to be friends with, while some I just can't stand to see the sight of.

As I arrive around 6:45 am and get off the elevator, I enter the ward rooms I give a smile to Lolo G who is finally going home after spending nearly a month in the hospital. Their family is pretty remarkable as they've pulled together to get Lolo G through obstruction, intussusception surgery, post-op stroke and hypokalemia, to finally going home. They aren't the richest patients, but as people they are just as wealthy as most people. They've never grumbled about the costs, or the treatments, but trusted us to do the best thing. Now I'm just happy to see Lolo G smiling, toothless as he is, as his wife and daughters share a laugh around him. We go through a hundred wars with disease, dilemmas, and treatment failures, but I'll take them all on to have even just one victory such as this.

I leave to go on with my rounds, I see Mr D's family. Their outlook is not as good. His disease is an intracerebral tumor bleed and with alcoholic liver cirrhosis, makes it impossible to operate on, not counting the money they don't have for the surgery. The hemorrhage, plus the encephalopathy has gradually taken over his consciousness and is slowly bringing him to the brink. I look at his mom, every so often tears flowing down her face at her beloved youngest son, and pleads to me to help her. My heart breaks knowing full well the prognosis. I give her a "hang-in-there" smile and move on. Mr D would pass away that night.

Each patient has his or her own story, his or her own life, and happenstance has made me a part of theirs.

I'm just amazed at this job sometimes -- I guess, it's just me realizing all over again, I love what I do.

There are times that I just feel really really tired, burdened by responsibilities and the demands that the residency program and the profession brings, but at the end of the day, when I get the chance to lie down and sleep, I realize, I wouldn't have it any other way.

Sabbatical Recall

Today is the last day of my 1 week vacation leave -- a week where I didn't have a life in my hands, nor did I have to call and update any consultants on the condition and lab results of their patients -- and it nearly isn't enough to recharge the past 7 months of toil, sweat, and tears, and to come back and do it again for the next couple of months.

But it's definitely better than nothing.

My co-resident Mushar has his leave planned out already (though he did take a one-day "leave" to contemplate his life plans last month) and it consisted doing utterly nothing on the first day but a DVD marathon, the next day would be touring his hometown, the third would be a visit to the beach, and you get the picture -- relaxation and nothing remotely related to medicine.

Well, I'm a different animal, I guess.

June 1

I took a plane home, which was probably the more cost-effective way to travel, but there is always something relaxing, something spiritual with a long and quiet drive home. But after the reverie of Erving's wedding the day before (my heartfelt happiness and joy to Erving and Kay), I did not have time to prepare, so the plane it was.

I settled into my room, and brought out my reading stuff (yup, part of my idea of a vacation is doing some work without the pressure), and did what I sought most of the week to do...sleep.

And I did mostly that, and watch a little bit of TV now and then.

June 2

Frequently checked with all the blogs I follow, and it seemed everybody was taking the week off as well, except for Doc Ness of course. I attempted several times to write but nothing really came to mind (I failed in the attempt to make up for all my unblogging times by blogging everyday during this week), so I just let it go, content to browse the web for news and sports rumors about my beloved Pistons.

I got to starting on reading about my case, a supposedly rare case of Thrombotic Thrombocytopenic Purpura (everybody I've mentioned this to seem to be of the opinion that this isn't as rare as I thought it was, but well, it's incidence is 3.7 per million, I'd say that definitely isn't run-of-the-mill). I got to see SUMC again, and see a couple of friends.

Saw Kea as well, and she's pretty big now. We went to Manong Roy's despidida party, as he's finally off to Canada to join Manang Rhea as immigrants. See you guys when you come home.

June 3

Smoke tested the right car.

Pored over the charts of my case.

Transferred some notes into my trusty notebook.

Rode the afternoon away on the motorcycle -- gassed it up to a full tank and took a quarter off just riding around the city. It is another way to get a tan in Dumaguete without going to the beach. Sadly, Taster's (Home of the world's BEST BURGERS) is closed temporarily for renovations, as is much of the city's asphalt roads.

June 4

There's nothing like wind in your hair zipping through the city streets on the motorcycle. Couldn't find Ver or check if Aning was really pregnant na. Congratulations.(Though I've been hearing she is, she vehemently denies it. Nothing wrong with that Ann.)

Ai-ai arrived today. I missed my little sister (hehe, she's big time now)

June 5

The Magic got dumped on in Game 1. I've always rooted for the underdog, except when the Pistons are playing, but 25 points? In the NBA Finals? Jeez, c'mon Howard you can bowl over Bynum and Gasol on your off-days.

Jassen and Carol arrived. She's a cool girl, and I'm happy for my brother. Anybody who makes my brother happy is all right by me.

Most of the family got together to pray, and celebrate all of our birthdays. I saw my nieces and nephews running around all night, and the food was as sumptuous as always.

I'll be leaving in the morning. I have Tonette's Date and Walnut cake, Sans Rival for the people at the hospital, and Pianono and Chicharon all around (I think they ate the Pianono at the time of this writing na, Mama Gaya, next time na lang).

June 6

Back in Cebu. I got to ride on the extension all the way to Cebu and my back ached all over. Got some work done on my census, and took Tonette out to dinner.

The week is almost over.

June 7

The last day of freedom. I did my rounds of my ward and saw what kind of patients I'd be up against once I sign my name into the attendance logbook tomorrow.

I laughed quite a bit on the rumor that went around the hospital that I'm quitting residency (don't tempt me, haha), and was touched that a couple of friends (yup, brothers and sisters in arms, if you will) would call you up (wake me up, for that matter) and asked me to stay. Sorry if I played around a bit, but I'm stuck with you guys for the next couple of years, (or you are stuck with me, deal with it), that is until the next time I go on leave.

Right now

My back still hurts.

I feel like I'm still on the bus.

I lost to the Hornets while playing NBA 2K9.

I think I'd better get a good night's sleep so I can get up early.

The week was definitely good while it lasted.

On The Lighter Side...

In my last conversation with my mom, she said she got scared while reading my last entry, (somebody has to do it, ma) but she also said she had a laugh at the juicy fruit comment. Whoever says that being an ER doctor or any doctor for that matter is a cool, profitable, and easy job, is dead wrong. It often comes to the point of arduous toil, and yeah sure you get some money out of it but not often commensurate to the effort unless you get a really really big practice and it is a big responsibility to have another 's life in your hands, yada yada.

Anyway, I've posted so much about medicine, residency on this blog, I guess I'd like to turn the attention of you who read this blog (however few you guys are, hahaha), to something, well, light...

Like:

Archie finally gets to choose!

Between Betty and Veronica that is. Yup, we all read the strips once or twice, and personally I'm a fan. I read in an article linked on msn.com that publishers are gonna make him choose between girl-next-door Betty Cooper and sophisticated-sassy Veronica Lodge.

I say he really can't go wrong.

And how about:

This guy.

Kris Allen pulls off the ultimate idol upset by upending apparent favorite Adam Lambert for the American Idol crown. Not to take anything away from the cool laid-back sound of Allen whose stylings I can definitely agree with, but I'm thinking there were a whole lot of people who didn't want Adam Lambert to win, than actually voting wholeheartedly for the eventual winner. Personally, I liked Danny Gokey's voice and got to appreciate the sound of Allison Iraheta's voice, but Allen's victory definitely sits well with me.

And finally:



Good night!

Hehe

ER Forays of A Newbie

Our training program here has one quirk not found in other hospitals in Cebu (or so I think) -- first year residents get to go on duty at the Emergency Room.

Yup, First Year.

The reason given to us was that it would double our exposure to ER duties, and we get to see more cases, and get experience on how to handle these patients first-hand.

I get the logic, but that doesn't make the anxiety of being alone at the desk fronting the Emergency Room doors any less stressful. It takes triple the testicular fortitude to survive and conquer the fear of what comes in through those two swinging doors. So scared am I on nights prior to ER duty that I fear and depression drives me to my knees in prayer that everything would go smoothly (but it rarely does) and that He will be with me every step, order, and IV insertion of the way.

One thing for sure though, ER duties certainly have given me so many moments:

WORST: There was one time when, the outpatient consults were endless into the wee hours of the morning and right up to endorsement time, and after I got received (the next shift comes in) I literally had to run from room to room, ward to ward, get all my X-rays and scans, ECG's to get ready for endorsement (grilling time), and needless to say, I got fried to a crisp.

BEST: Just recently, at my last ER duty, we had someone come in, in severe respiratory distress. He was brought to the hospital by two of his neighbors after they found him knocking on their door for help, all blue and air hungry. We didn't know what he had because of a really poor medical background given to us, all the neighbors knew was that he smoked and drank a lot, was admitted the year before and a handful of medications in his bag. It was a cross between respiratory and cardiac, which is which we didn't know. He flatlined for about 5 mins. We treated him as best we could and revived him to full consciousness. To see him writing his name on a piece of paper, considering he was probably walking towards whatever light at the end of the tunnel he was in, is joy immeasurable to me. Now he has a second chance to be able to make peace with a family he has left behind, and that is just gravy.

FUNNY: An order on a referred patient's chart: "May eat juicy fruit - not the gum."

SCARY: There was a time where I had no activity at the ER whatsoever for the whole afternoon of a weekend duty, the calm before the storm if you will. Then it got crazy as first an arrested patient came in, probably a massive heart attack, followed in seconds by an electrocuted patient in ventricular fibrillation (a really scary heart rhythm). Needless to say again, everybody got plenty of action and exercise that night.

DRAINING: You get to take on really demanding patients from expats who think they deserve top billing because they earn dollars for a living to aristocrats and the psychologically-off patients who think they are the only ones in the ER.

COOL: I once said that if I could not become a surgeon, I'd be the one at the foot of the bed manning a code, shouting lines like "We need an ABG stat," "Start Dopamine 400/250 at 10 cc/Hr," or "This ECG shows an ST Elevation in Leads II, III and AVF, Morphine 2 mg now, O2 at 2 Lpm, ISDN drip at 10 cc/Hr, and Aspirin now."

And now I'm getting to do that.

Maybe not as confident, not as fluid nor as collected as I make it to be, but I'm definitely working on getting there.

It's been so long since I last posted that I'll be going on another ER duty in the next couple of days, so, gulp, here we go again.