Sunday, December 27, 2009

A Very MICU Christmas

MICU stands for Medical Intensive Care Unit.

In our hospital, the second-year residents go on duty every three days at this section -- the last bastion for medical management in the critically ill.

Due to certain unexpected leaves, absences, resignations, and a lot of crazy, gaah, I don't even have a word for it, I found myself answering the phone at around 7 am to a directive to go on duty for 36 hours at the ICU.

A day after Christmas.

Not exactly my idea of the perfect Christmas gift, but here I was, standing in the doorway of a full ICU with a lot of critical patients.

MICU 1: Really bad case of Pneumonia and Pneumothorax in septic shock. Her X-rays showed really bad lungs that I could see the fissures (Normally it'd be dark and black).

MICU 2: A case of sepsis (really bad infection) due to an infection of the urinary tract and pneumonia coupled with hyponatremia (really low body sodium)

MICU 3: Admitted a case of non ST elevation MI. Glad to see her not in pain, and in pretty good spirits

MICU 4: A renal patient with weird breathing. Congested X-rays and treated with aspiration pneumonia as well.

MICU 5: Hypoxic ischemic encephalopathy + Seizure disorder and underwent tracheostomy earlier in the day.

MICU 6: Dilated cardiomyopathy probably due to doxorubicin cardiotoxicity after undergoing chemotherapy for Hodgkin's lymphoma and with weird drainage coming out of her nasogastric tube.

MICU 7: A massive right middle cerebral artery infarct and underwent decompression with a right frontal craniectomy. Glad to see him responsive and doing actually quite well post-op.

MICU 8: Cholelithiasis with cholecystitis who underwent open cholecystectomy coupled with bilateral pleural effusions secondary to hospital-acquired pneumonia.

MICU 9: Myasthenia gravis in crisis

MICU 10: Cardiac dysrrhythmia, non-sustained ventricular tachycardia. (I hate arrhythmias)

TELEMETRY 1: Severe infection due to UTI and pneumonia

TELEMETRY 2: Another case of a non ST elevation MI.

These are the cases I greeted at the outset of my skeletal duty at the ICU. My first ever.

I transferred out 6 patients, but sadly lost one to overwhelming infection and its complications.

All in all, I survived.

I'll enjoy these last few days where I don't have to go on duty at the Intensive Care Unit because in all probability, I'll be doing it regularly starting next month.

Surviving that will be another achievement worth blogging about.

Gulp, pray I don't mess up.

Friday, December 18, 2009

Life is short. Life is beautiful.

Three days ago, I was reminded of the reality of how short this life truly is by a 24year-old patient who had just been out with his father, plying their trade as jeepney operators. Due to mechanical problems, they had to bring it in early and forego the rest of the day's trips. It was late afternoon when they finally solved the problem and went out to a machine shop to buy the parts. The father went down to buy the pieces and on coming back to the parked jeep, he was told that his son was out cold sleeping on the floor of their jeepney.

He was unresponsive.

He was rushed to our ER.

He was dead on arrival.

We had no idea what to put on the death certificate. We barely had anything to go on for our final diagnosis. No symptoms. No previous medical illnesses. Nothing.

It seemed like he just fell over and died.

I didn't quite grasp how his father reacted - seemingly unattached, seemingly afraid he'd be blamed, seemingly unbelieveling of what seemed to be another workday afternoon -- most likely in a state of shock. His mother wailed and fell to her knees when she arrived, exclaiming, "Wake up. Wake up, " vigorously shaking her son's body, "You said you'd just be out to buy food. Wake up."

That all got to us. Everybody at the ER felt for this family -- no parent should ever get to bury their child (John Q, beautiful movie!), let alone the prospect of having a very sad Christmas.

I took off the gloves, got my clipboard, and turned to go back to work.

24 years young. Now gone. Life is short.

As I went through my ward chores and charts, I kept thinking of life in general (profound noh?)- what I've done, who I am, how I've been - until I came to sit in front of my open laptop at our office. On the front screen of articles I came to read how Seal described his life as "the perfect life." (Hey, the guy is married to Heidi Klum, how can that not be close to something perfect? Haha.) But he described it as something happy, and having worked hard to get where he is today.

I sat back and looked at my own, and in another of the countless introspective sessions I've had with my own inner psychiatrist, I realized, I'm happy, I'm relatively healthy, I have a nice family behind me, I love the work that I do, and in a relationship where I'm unconditionally loved in return.

Perfection is hard to achieve and likely nobody will ever achieve it, but in all respects, like Seal aptly put it, it is the perfect life.

I didn't know that boy who died that day. There I was hoping he was happy, and that he had his own perfect life -- not the kind we have dreams of, but the kind, that considering everything around us, would be the life of happiness, contentment, shared with those that matter to us.

Life is beautiful but short.

No, life is short but beautiful.

Friday, December 11, 2009

Bits and pieces

Christmas time is here...
Happiness and cheer.
Fun for all
What children call
Their fav'rite time of year...


Forgive me for there is a lot of angst in this post


It just hurts when people disappoint you. Just when you think, you have people around you who have the same direction, the same set of ideals and the same purpose, they go around and do otherwise.

Just when you're ready to prove all the speculation, skepticism and the negative pub about your group, they just go and prove all the critics' points.

Prove yourselves.

You're there for reasons, which right now escape my understanding (maybe I'm just a little disappointed and mad right now, but I'm sure you guys are all more than capable of thinking, and willing yourselves to make something out of your abilities).

And when that happens, I'll be as proud to be a friend as I am when I'm defending you.

I don't claim to be perfect, but let's just say that a fair share of the blows I take during evaluations are blows meant for other people, and it hurts a bit when you get blamed for the actions of others.


Wants and needs are set apart this Christmas.

I wish I could get my hands on the money to buy a new piano/keyboard, but some stuff you just don't need. Maybe I'll get to buy my own grand piano someday, but for now, maybe I'll just save it up for something else.


There are times when the Philippine culture/nation/government/people disappoints me. Enough to make me say I belong to a stupid race (yup, that's how depressing we get sometimes).

Maguindanao is under martial law for some stupid government official who thinks he is above the law. The press is all up in arms about protection of the press people (why? should being a press person exempt you from a madman's massacre? How about all the other people? Shouldn't they be spared?) It seems like the media is all up in arms about the killing of several media people, but let's keep it on the human side and say that it's not about what the profession of the people killed but condemn the killing itself.

Second, on the recent furor in Maguindanao. There is this something called martial law.

Well, people are protesting this seemingly well-intentioned declaration to facilitate justice for the murders. Sure, when you're apparently "safe" (that is assuming we are, right Madame President?) here in the cities, it's easy to protest right? But when you've just taken a bullet and lying face down in a ditch somewhere in Maguindanao, I'm sure you'd want the law to put its proverbial giant foot down on somebody, preferably the one who pulled the trigger.


Candidates. Schmandidates.

Off with the lot of you.

People protesting our current president, when they should be looking at who is waiting in the wings. GMA is not that stupid. She won't risk an obvious grab at power since we've proven that the Filipino people are very very powerful when they come together. But it's just that, nobody among the gazillions of Filipinos will satisfy all the others in terms of leadership and good governance.

A really smooth talker politician playing on his rags to riches story (but you're rich now right?), a reluctant son who is riding a colorful family history of leadership, a cutthroat strategist and economist, a prayer rally leader, an unknown who just happens to have a brain and no viable party opponents, and a fat, washed up actor who was once powerful, got overthrown by the Filipino people from whom he obviously stole from (c'mon who are we kidding here right Velarde?) and he wants back in?

And there happens to be this national hero who wants to hurt his stature in Philippine history by meddling in politics just because he has the money, the women, and the fame. Tell me, what actual laws are you planning to pass? You kno?

I might as well run this country myself....

Now there's an idea.....