Monthly Archives: May 2013

Saving Lives

The following article is not mine, but I am reposting it here so that we may be reminded that it’s not only us doctors who save peoples lives. Here’s to the other unsung members of the healthcare profession.

all in a day’s work.. well done

Get up when the alarm goes off, shower, and put on fresh scrubs. Relish the moment, this is the cleanest you are ever going to get today. Eat heartily because nursing is not only for the strong of will but the strong of gut as well.

Feel the odd urge to want to get to work a few minutes earlier. Know that being early will not be acknowledged on your pay slip but will shape the quality of your work. Get to work early, anyway. Accept the endorsements of your coworkers with a smile. Their shift has just ended, do not expect them to be clean, thorough or in good spirits. Smile, anyway. Be patient and give them time and your undivided attention.

Don’t wish for an easy shift. This will lead to disappointment and frustration when the inevitable walks in, which could be anything from the common flu to a multiple gunshot wound. Wish for fortitude and being able to eat on time instead. Check and prepare your equipment and medication conscientiously. This will save you time, and a day’s worth of mental and emotional anguish. You are here to mitigate bodily disasters. There is no other way to go about it.

Quickly assess patients as they come in. Use your intuition. You will become instinctively attuned to the workings of the human body when you keep an open and inquisitive mind. Pain matters. It tells you something is wrong. It gives us the chance to fix, transcend, and heal.

Physical pain is easy. You run diagnostics and give pain medication while figuring out what has gone awry. It’s the other kind that’s hard. It’s the widow weeping in the corner, the bruised child sitting still, and the father staring into space. There is no textbook manual on empathy. Be human, that is all they really need from you. Listen and always try to understand. The people we meet at work are in the middle of what could probably be one of the worse days of their lives. They will not be rational, polite or calculated. Organs fail, systems go haywire, bones break, and people hurt. Know that at any given moment it could have been one of your people lying on the stretcher. It could have been someone you love. It could have been you. Never look away. Keep your head above the water. Tread the fine line between the surreal and the random cruelty of life.

In a nutshell, the healthcare industry is institutionalized compassion. Healthcare workers are the determination of divine goodwill in a man’s world. There is bound to be friction. We operate within a framework and the bureaucracy of that framework. Wade through the turbulent currents of policy and practicality. Never forget your own voice, especially when you discuss issues with your coworkers and superiors. You are a nurse first and an employee second. Sometimes the two will be at odds with each other. Give the former a bigger voice. This is what the strength of will is for. There will be days when you will doubt yourself. This is fine. It means you still care enough to want to be better. The moment you stop wondering and wanting is what you should be afraid of. At its most basic, the greatest challenge of a registered nurse is to be charitable and selfless in a world that is not charitable and selfless by nature.

Strike the balance between precision and compassion. Insert IV lines and defibrillate. Don’t be afraid to pierce skin and draw blood. Keep your hands steady. Saving lives requires a measure of detachment from human sentimentality while sustaining the earnest belief that this person loves and is loved and that it is your job to keep that cycle running.

Most of the measures we take to save lives seem grisly and almost violent. Don’t flinch. Remind yourself every time that you are doing them kindness. You will get better at this as time goes by. There are some things you can only learn from repetition. The unpredictability and wanton disregard of change has never seemed so palpable as that in the small window of opportunity in a crisis. Time is critical. Life is fragile. People fall apart so easily. The body can stop trying in an instant. Hope for the best and prepare for the worst. Close curtains. Recognize your own powerlessness when the end comes. Sometimes, the best form of kindness we can give to another person is a dignified death. Remove tubes with care and wipe away body fluids. Dress open wounds. Cover the body with a sheet.

It is a curious position to find one’s self in: Close encounters of the wondrous and harrowing kind make us acutely aware of how terrible and extraordinary people can be, how terrible and extraordinary things can happen, and how terribly and extraordinarily we can do. Being within arm’s length of other people’s tragedies is a privilege reserved for the courageous few. In that singular moment we hold in our hands the power to save. Do the kind of work that will make you proud by day and sleep well at night.

Make your presence count. The only way to save a life is to go beyond your own. In saving others, we save ourselves.

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[NB: The following appeared on the opinions pages of the Philippine Daily Inquirer April 18, 2013 issue, the online version can be found here. It was written by Isabel Manalastas, 25,  an emergency care unit nurse at Manuel J. Santos Hospital.  All copyrights remain with their respective authors and the Philippine Daily Inquirer where this article first appeared. no copyright infringement intended]

I remember

[I had a conversation recently from an acquaintance who was non show biz (read: non-medical) and he commented that I have it so easy being a doctor and all. I would have rebuked him, but left him to his misconception of who I am and how I got here. The following are compiled blog posts from my now archived and semi-retired personal blog which I’d like to share in the hope of shedding some light in the life that I have now]

aftermath

February 22, 2007  –    The Aftermath

“Sometimes you just have to forget the rules,

follow your heart and see where it takes you…

Never apologize for saying what you feel

because that’s like saying sorry for being real…

Never regret anything you said or did because at some point,

it was what you wanted…

True strength is being able to hold it all together

when everyone else is expecting you to fall apart…”

I received this message vis SMS as I was getting ready to go to Manila.

I received two messages just as I was boarding the bus, but the clincher was this one from jimbo summarized in ten characters:

“bok, ok k lng?”

When it rains, it pours. For unknown reasons (or have the mighty gods once again conspired against me?) as my laptop computer just went dead. Had this happened on any other day, I would probably have gone berserk, but now because of the news about the board exam results, it pales in comparison (now that’s relativity for you).

My plan to teach biochemistry at school is now momentarily put on hold.

And so has everything else for that matter.

 

April 3, 2007 –    Strike Out

“Say not in grief ‘He is no more’ but live in thankfulness that he was” — Hebrew Proverb

Now the story can be told. It’s been two years since my sister died and about a month since my father passed away.

Strike one was when I flunked the medical board exams on the first take. It was the 22nd of February. That one I’ve recovered quite easily from. Having blocked everything else, the hardest thing was actually letting my parents know that I failed. It took me some time as I was waiting for the right moment I kept telling myself. Unfortunately, time would be the one thing that I was to be short of. Finally I was ready I said to myself, it was the morning of March 2nd, I was even happy that someone sent me a text message that morning.

“People don’t always get what they deserve in this world” – Lemony Snicket

Good morning! Have a great day ahead 😉

Little did I know that it was to be an ominous sign. I dropped by a friend’s place and he even teased my why I was in such a hurry, “Nami-miss na ako ng tatay ko” (My father misses me already) I told him. “Paano mo naman alam?” (How would you know?) he teased back. “Kasi pinasabi niya sa nanay ko” (He told my mom so) On my way home I received a phone call informing me that he was on the hospital. I rushed back to find him in the emergency room. “Masakit” (It hurts) was all he said when I asked how he was feeling. But despite of all the pain that he was in he was still anxious to tell me that he heard the results of board exams already came out. I told him we’ll talk about it later when he gets better. “mawala ya ing sakit, muli ta na” (as soon as the pain goes away, lets go home) he insisted. I’ve seen a countless number of cases similar to what my father had, but nothing in my four years of med school would prepare me for what was to follow. My mother came in just as they where taking him to the ICU, I whispered into his ear that my mother was here and he opened his eyes to look at her. It was to be for the last time. An hour after he was brought into the ICU, he was proclaimed dead. My tears have been falling long before they told me. I had to be strong. I was still hurting, I have let the tears fall, its time for healing.

That was strike two.

Barely three weeks later, my mother got sick. She was hospitalized for a week and by the time we got out she was half a finger short of her former self. The only consolation was that it could have been her arm, worse still, it could have been her life. Even though some of doctors who were my consultants back in senior internship waived their professional fees or substantially reduced it, still the hospitalization entailed a lot of money, money that we didn’t have. At one point I just wanted to break down and cry. After the hospitalization she still needed antibiotic treatment for two weeks in the very least. Each vial of the medicine costs about P800 each and I needed two vials to be given four times daily. I don’t know how we survived that crisis, but apparently we did. Thank God.

That was strike three.

How am I holding on? I don’t know. I’m supposed to be studying again for the upcoming physician Licensure Exam in August, but I’m also taking care of a ton of paper works for my father’s death benefits. I’ve seen a lot of red tape in the government before, and I’m seeing it all over again.

So perhaps I do have a reason to be unhappy. But then you realize that this isn’t the end for me just yet. Hindi lang ikaw ang may problema sa mundo (you’re not the only one with problems in the world) someone reminded me. It’s difficult I must admit. With my father gone I am now the one expected to make the right decision for us. They may not always be the most popular one as I am beginning to learn, but I do try to do what is right.

In time, this too shall come to pass.

 

August 16,2007 –    Vindication

I woke up the usual time. I had a restful sleep the night before but I just had the urge to open my fone. A flurry of messages came in. The first message I read was from lizzie. Then from jojo. My heart must have skipped several beats. I told my mother that I was going out for a while. I immediately bought the day’s newspaper. No news about the exam until I realized that I had the wrong newspaper so I bought another one. Then there it was, my name under the list of new physicians. Then I searched for their names, no it can’t be possible, but it was. Their names were not on the list.

I then proceeded to go to church to offer a prayer of thanks for myself and another one for those who didn’t quite make it.

I felt like a call center agent, answering one call after another. Among the many calls I got that day went “Dapat masaya ka” (You should be happy) the voice on the other end of the line told me. “Oo naman” I told the voice on the other end of the line, but deep inside I felt that the battle was only half won.

I wondered to myself why people are so quick to congratulate those who passed and yet it so conveniently forget there are still those who did not make, and they are it that need our support even more.

“Sometimes we lose but we are not losers. At times we fail but that does not make us failures”

How can one bask in glory all by his lonesome? One can argue that this is because it’s a personal win.

“Kakuswelo nang tatang mo nung mabie ya mu” (your father would have been proud of you if he were still alive) was the generic greeting of most of my relatives and neighbors who heard.

Looking back, I think I was more relieved when I passed biostatistics exam that I almost flunked back in college than passing the medical board exam.

It was always a matter of when I pass the exam, not if.

And now the next chapter in my life begins.

* * * Epilogue * * *

I came home just in time for lunch but I was still to tell her about the news. So as my mom and I were watching TV when I told her about the results of the board exams. The following is a record of what happened when I told her I passed the exams:

Me: Ma, linwal ne in resulta ning board exams (Ma, the results of the board exams already came out)

Mom: O nanu, ikwa me? (So, did you make it?)

Me: Wa. (Yup.)

Mom: (continues watching TV without batting an eyelash)


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