Tuesday, August 21, 2012

Bright Orange Envelope of DEATH!

Recently gave Helliza an orange plastic envelope containing around ten 10000IU enoxaparin syringes. Helliza was in a state of severe emotional distress brought about by strange happenings in the wards we used to call S.A.T. An S.A.T is a patient's medical condition for which we have no explanation whatsoever. Smoketh and I used to scream this in the ER (secretly, in our heads) when we could not figure out what was happening to a patient, so all together now: Shet, ano to!!!

Frantically Helliza ran back to the wards with the bright orange plastic envelope. "Be warned, Helliza," I warned her. "Whenever I used the enoxaparin from that envelope, the patient died. Three people used that and in a day or so they met their maker!" Lightning, thunder, muzak. Of course it could be argued that in all the instances that we've used the drug the patients were already deteriorating, necessitating the drug in the first place, but still, we could not discount the notion that this could be the BRIGHT ORANGE ENVELOPE OF DEATH!!!

But truly there was no time for superstitious nonsense, specially since enoxaparin is quite expensive. If I remember correctly a 6,000 IU preparation of the brand Clexane costs around a thousand. There used to be a cheaper brand, called Clexa, which sounded like it would go well with Mineropenem. The ones I had were donations I think from overseas, and the preparation would allow each syringe to be used in two doses. With this in mind Helliza dashed to the patient, then accompanied the patient to the 2d-echo, intubated her, started her on inotropes...

That night Helliza called to say that the patient died. For more, she said that in the hurly-burly of things the envelope disappeared. She searched all over the wards, in every nook and cranny, every crevice, but the bright orange envelope could no longer be found. She was able to get only one syringe.

"Let it be. It is an orange envelope of doom that should never be found," I said.
Which suddenly reminded me, written on the orange envelope is my name. If anybody found it don't return it to me, throw the damn thing away. THROW IT AWAY!!!!!!! Or donate it to patients with excellent prognosis to begin with.

Thursday, August 16, 2012

Research Rules!

I've recently deactivated my Facebook account, following in the footsteps of Uni-Horned Beef Jerky Alanis Whore and HTGOF (How To Get Over Facebook). Interestingly, it was Uni-Horned Beef Jerky Alanis Whore who started the Facebook trend in our residents' call room when we were first year residents back in 2008. In fact it was Uni-Horned Beef Jerky Alanis Whore who created my account, because I was lazy like that. Eventually, maybe in just a few short days, I might realize that I want to get back into the thing again, but for now, I seem to be already reaping the rewards of having deactivated the damn thing.

1. Less aggravation. Admittedly I have followed some people specifically because of their infuriating, embarrassing status updates. Obviously there should be no basagan ng trip in Facebook, but there are those updates that we just find infuriating and embarrassing, and we continue reading those for sheer morbid fascination. Like there's a level of masochism, but we now realize that the less aggravation the better we actually feel during the day.

2. Less time on the internet. Like in the past few days I would just check my email, blog, read comic book news, and in 30 miutes I am done. And can hence do worthwhile stuff like lie down, stare at the ceiling, or rant with friends. I've stopped clicking at endless links and the comments on the links and links in the comments, because I no longer know what links my friends recommend. Fun!

3. More time to do research- is what Uni-Horned Beef Jerky Alanis Whore said. She has recently exhibited magnificent skills in research paper writing and statistical analysis, because there was nothing to distract her from realizing her full potential as a Researcher, a Statistician, and a Sub-Investigator of huge clinical trials. We should all emulate Uni-Horned Beef Jerky Alanis Whore.

Aroint Thee, Self-Aggrindizitation

A few years ago my contribution to the Sagip-Buhay projects, mostly headed by Hurricane K, Jing, Papa Ruter, and Fulet, has been limited to being... a ghost writer. While my co-residents were running around looking for money and stuff, admittedly I knew that I did not have enough socializing abilities, not enough drive to do strenuous leg work, and not enough rich connections. In fact I don't have any rich connections that I know of, otherwise I would have asked for some money--for myself. Knowing this I asked if there were alternative ways to help with the project, so I wrote press releases, some supposedly tearjerking, rather manipulative write-ups of patients' kawawa stories, and my favorite: ghostwriting for the really important people for their greetings page in the souvenir programs. I knew, or at least I hope, nobody ever read them because they were horrible.

Eventually the three years worth of events requiring souvenir programs spawned regurgitated greetings. People who knew me caught a few of the inside jokes:

"Let us shine the Blue Lantern of Hope..."- Because it was 2009, and the hottest comic book of the time was... DC cross-over Blackest Night series starring Green Lanterns of Will, Red Lanterns of Rage, and... Blue Lanterns of Hope!

"Sagip-Buhay enables us to walk the extra twenty miles to save a patient..."- Because at the time, the residents have been admonished for not exerting enough effort to get the biopsy results of a patient in a high profile case, and, to quote, "have not walked an extra mile"!

"But despite all these, there is no self-aggrandizement, no Messiah Complex..."- Because guess what was competing with DC comics' Blackest Night at the time... Marvel Comics' Messiah Complex and Second Coming storylines featuring the miraculous mutant birth of Hope, the mutant messiah!!!

Self-indulgence notwithstanding, though, that is the one trap some of us tend to fall into, some more frequently than others: self-aggrandizing, Messiah Complex. Working in this public hospital with poor patients, not being adequately compensated, having to sometimes shell out our own money, having to innovate in our management to fit into the square peg of abject poverty of the patient, we sometimes tend to feel like we are these heroes who do these things from the intrinsic altruism of our hearts, conveniently glossing over the fact, specially when we tell these stories to our friends outside the business, that most of these things are required or would incur punishments if unfulfilled, in the form of mortality reports, reprimands from consultants, audits, and even the most basic form of sanction: guilt. We like to rant about how the patients' poverty becomes our burden, then later spin the story into a wonderful success story with us as the heroes, and when they tell us we're such heroes we sheepishly say in faux humility that no no no, I'm just doing my job. Well if we indeed are then we wouldn't mind doing them without ranting, or the opposite of ranting, which is decidedly quite horrendous: over-dramatizing the story and amping up the kawawa factor of both us and the patients.

But having said all of that pretentious crap which is worse than a rant because it is a pretentious rant, ranting can be so much fun. Specially if you have the right audience, who would rant back with an even bigger rant. You would try to out-rant each other, with long maniacal cathartic laughs between rants, and you would all end up feeling much better and ready to wake up the next day and serve the country like the good, respectable doctors that we are.

Conclusion: Ranting is healthy and fun. So rant away!

Friday, August 10, 2012

Cairo

Apparently there is a resurgence of debates about the RH Bill in the news. I am not aware, as unaware I am of the extent of the destruction caused by the recent storms, the Olympics, political news, showbiz news, generally everything. My excuse is that I have no television, no radio, and no interest to spend money on newspaper. I occasionally have access to the internet, during which I blog, read comic book news on Newsarama, and download stuff that kill the brain.

I therefore have, as of yet, no position on the RH Bill. If it were as basic as artificial method of contraception vs no artificial method of contraception it would have been easy, but surely, to quote high-strung aktibi-aktibistahan people during recitations and meetings, "HINDI ITO ANG ISYU!!!!" It's not like people can't buy condoms in 7-11 for decades anyway, so clearly hindi ito ang isyu. There surely is a lot of legalese and a lot of money involved, and since I have not read or probably will not bother to read the fine print, I am therefore being the hateful apathetic citizen and declare that I have no stand on the issue. Better this than storm the streets with no clear vision other than it's fun and cool. I am still embarrassed that I walked along Edsa during Edsa 2.

The whole RH Bill thing reminds me of when we were in high school, when we were met by the nuns and told us that the Cairo Conference is baaaaaaaad. None of us bothered to read about it or ask about it, our interest was just piqued by the nun's declaration: "Gusto nyo ba ng Cairo Conference? Pag natuloy ang Cairo Conference, lahat ng tao magsesex. Pag recess may makikita kayong mga kaklase nyo na nagsesex sa lobby!"

Obviously The Cairo Conference pushed absolutely none of our classmates to fuck in the open. In fact, I've just googled that The Cairo Conference has nothing to do with sex, sex in the hallways, or our prurient classmates. In fact, it was not even about reproduction. The conference, in fact, happened in 1943, and it's about alliances in World War II.

See, we have so many, so many things to unlearn. So much clutter, to be cleaned away and swept under the rug by... Wikipedia.

Sunday, August 5, 2012

Safe

You are 8. There is a storm raging outside. Your parents close the store downstairs and bring you to the upper floor. The winds are getting really strong and any minute now they can bring down the walls of your old, poorly maintained wooden house. The electricity is shut down, and initially all you can whimper about is how hot it is, but your mother admonishes that you cannot open any of the windows or the winds will destroy the house.

And although the howling winds are a little bit scary, you are more incensed at the discomforts: the heat, the humidity, the boredom. That is, until the storm intensifies further and water starts coming in through the cracking wooden walls and you start fearing for your parents' life. You see your father carrying a long, heavy beam all by himself. He climbs up the ceiling unmindful of your mother's protestations and jams the beam against the two walls of your house. The house is stabilized for now, and thankfully the storm starts to calm down a little.

To entertain you your father brings out a couple of boxes containing his huge collection of vintage comic books from their room. These things are precious--you've always wondered where he keeps these things, just how many there are, and just when he would let your grubby hands touch them. The wind starts howling again, the brief calm has already passed. Your father leaves you the boxes and goes back to working on fortifying the house.

You start reading, and you read and read for hours on end. You marvel at the adventures of the 1960's Superman, with the Superman 80-Page Giant as your favorite. You laugh at Lois Lane's endless attempts to prove Superman and Clark Kent are one and the same, her own comic book Lois Lane proving to have the highest comic index amongst all. But your ultimate favorite is Adventure Comics featuring Superboy and the Legion of Superheroes. Your love story with these characters begins, a love story that will be tested repeatedly, but will endure, for the decades to come. While in the other room, your father continues hammering away at the walls assisted by your mother, still trying to thwart the threat of the raging winds.

And so, while in your own little universe with these fictional characters, you forget about the storm. You forget the danger. You feel safe, and when your father comes back to you unscathed by the storm that has thankfully completed its course, you feel that you are truthfully, completely safe. 

You are in your 30's. A storm no longer fazes you, but you are fazed by the upcoming rent deadlines, your own health, the well-being of your family, your dying patients, the joys and tortures of your father's memory. But amidst these personal storms, this particular memory of the storm decades ago is the memory you keep coming back to, because in this memory you are at your safest, and you know that somehow you'll be okay.