In the Interim

Wanting to write but not having the words come feels like wanting to cry when there are no tears to shed.

This blog has been idle for a good part of this year. At first, I thought the problem was Time. But I spent a relatively benign OPD month and a restful 2-week leave still in a disturbingly protracted writing slump.

So being able to write again, typing these words as the Beatles are singing about how Penny Lane is in their ears and in their eyes, sipping a good cup of coffee I leisurely brewed without having to rush -that is a Happy Thing.

No matter what I went through in the past, I always had Writing to make sense of my own Experiences, both good and bad. To lose it at a time my soul needed it the most was frightening. At some point, I wondered if the words have completely left. The anguish from the looming threat of Emptiness was beyond words.

But in the stillness and Silence of these quiet in-betweens, I found myself listening more than ever. I listened to the Stories of the people around me. To the soundless words they could not speak but their weary eyes too often reveal. To the trail of signs the Universe left for us to chase after.

They told me one thing:

That this is a Beautiful Existence to live, and what a wonderful privilege it is to stand witness to this exquisite narrative unfolding itself every single day.

Over the past months, I have been blessed with experiences that molded me into what I’d like to believe as a better version of myself. Though the tears felt infinite, the exhaustion otherworldly, the self-disappointment overwhelming, I always end up with the same conclusion: I wouldn’t have it any other way.

And so, here are the lessons we will take away from the gruelling months of 2021, picking up right where I left off:

MAY NICU: That a Heavy Heart is also a Full One

We suffered through literal and figurative fires this year, the month of May taking the literal one. It was a logistical nightmare in every aspect, but as always, people’s Kindness always comes through. There was an outpouring of love and support – from breast milk we couldn’t fit in our milk bank fridges anymore, to diapers that would last until these kiddos turn 6, to food that kept arriving days after the tragedy. That month, I was reminded of people’s inherent generosity – that giving without counting the cost is the natural human condition. If we are to survive any misfortune that comes our way, it will be because others are willing to lend a hand when ours are struggling to hold on.

Personally though, my most memorable experience for the month of May is being the RIC of a baby born with a rare condition called ectopia cordis.

The miracle of childbirth always fascinated me. As doctors tasked to be part of the whole process of mothers giving birth, we help bring out life into this world. It should be a Happy Occasion. If I had it my way, the whole world should pause, and listen to sound of a baby’s first cry. Very few things sound as pure.

And so, if you tell a mother that the angel she just brought into this world does not have long to live, and when you begin the painful conversation of how she wants to spend the last days with her child, you begin to wonder why the world is unjust in its arbitrary cruelty. But you keep struggling to make those few moments worthwhile, to the best of your ability.

A heavy heart is also a full one – it allowed itself to expand and be filled with a vast ocean of love. Sometimes, it is enough that it only does just that.

JUNE GEN PED: That it is hard to be a Good Doctor, but even harder to be a Kind one. But that’s who we are called to be

It’s cool to be as smart as Dr House or have the diagnostic prowess of Shaun Murphy, but to be a truly great doctor requires us to connect with our patient in a much deeper and intentional way no textbook or journal can teach us how. Every day I am struggling with this. I only hope to master kindness and to practice it in every opportunity that presents itself on a daily basis – even when it is hard, especially then.

A few days ago, I was in our Outpatient Department to get my annual flu vaccine. On my way back to the wards, there was a familiar face calling out to me, “Doc, good morning po” I’m not very good with memorizing names and faces. So there was an awkward few seconds of pause as I struggled to place the face with a memory. “Ako po yung tatay ni Angel*,” he volunteered. I remembered instantly.

Angel was my patient last June who succumbed from overwhelming sepsis. Her father worked as a custodian in our hospital. Every day, I would update him and his wife on Angel. It wasn’t always an optimistic update. If anything, it was to tell them that things are turning out for the worst – that we are doing our best, but the organs are failing from the severity of the infection. Every day after his shift, he would religiously visit the wards. I felt bad that after struggling to do his job despite what is happening to his daughter, I didn’t have happier news to offer. Eventually, Angel passed away.

Kamusta na po kayo?” Okay naman po ngayon Doc. Maraming salamat po sa inyo.”

I always saw my patients’ death as an unforgivable personal failure, so I didn’t understand why this father whose child died under my care was thanking me. “Salamat po sa pag-alaga kay Angel.”

I was speechless that moment.

If we can be anything towards our patients and their relatives, we must be Kind. We will not always get the outcome we want, but people appreciate the effort we put into making sure our patients receive the best version of care we can give them.

I am grateful for Angel and her family for teaching me this valuable lesson.

*changed the name for privacy

JULY HEMA ONCO: That Grief is the Price we pay for Love

Dodong* was admitted under my care in the wards during my June rotation, but was eventually transferred to our Hema Onco ward. So I met him again last July as a Hema Onco rotator in charge of patients in that ward. He was a kind 14-year old, with a sensitive heart. A conversation with him brings a smile to his doctors’ faces because his wisdom was beyond his years.

In his last minutes, he asked for a C2 red. He was on NPO, but I ran all the way to Bayanihan to buy him a liter of his requested drink, even if I was sure he wouldn’t drink it. He passed away shortly after that.

I thought at this point I have mastered the art of containing my emotions in front of patients and their relatives. But I bawled as we declared his time of death. I cried so hard, it was his mother comforting me instead of the other way around.

After being my favorite drink for years since Elementary, I stopped drinking C2 red back in College after promising myself to only drink it on a very bad day. I almost drank C2 red that day. Almost.

*changed the name for privacy

AUGUST OPD: That Perfection is a Myth in this Profession

This month, I was baptized into the LU 7 monitor club. It’s easily one of the greatest challenges I faced in my first year of Residency. It involved talking and coordinating with lots of people using up time you don’t really have. It was basically a throwback to my stint as our block’s Pedia LO both in clerkship and internship, but the responsibilities were suddenly on steroids! HAHA

But if there is a silver lining to this experience, it would be that I am so, so proud of these stellar interns for making it seem like it’s not their first rotation back in the hospital after enduring months of home-based learning prior to this!

They soaked up feedback so well, the second time I encountered them in their OPD case endorsements, I practically didn’t have to edit their history and physical examination. By the time they shift out of OPD, they volunteered their own assessment and management for patients!

I remember how my seniors were super kind, patient, and helpful to me back when I was a struggling clerk and an equally struggling intern. I told myself I will pass on that uniquely Pedia attribute of promoting learning in every opportunity. OF COURSE, I still struggle with this. I wish I had patience that doesn’t run out, and that I had more time to spare. My only wish is that every intern that rotates with us gets to experience the Happiness I (and I guess I wouldn’t be wrong to assume, my batch mates too!) experienced during our own Pedia Internship rotation.

If I were to give an advice to my internship self, it would be that “Perfection is a myth in this profession”. Of course we will all make mistakes in the course of our patient interaction no matter how hard we try not to. So we must constantly forgive ourselves as we persistently strive to become better and better physicians.

SEPTEMBER LEAVE (and also GEN PED): That the Learning Curve is steep, but the Growth is Statistically Significant

After months of being stuck in what felt like an endless cycle of pre-duty-post interrupted by short bouts of rare 2 days off or biyaya Golden Weekends, I finally got to go home for my 2-week leave! While my batchmates spent their own leaves going to the beach, traveling, and basically going out, I spent mine inside our house, going out only once! The next time I got out of our house was to leave for the airport HAHAHA

But it was refreshing to be Home even if it was only for a short while 🙂

The other half of September I spent back at Gen Ped, my fourth for the year. Even if I make “Ayoko na” my GenPed mantra, I can honestly say that GenPed is the rotation where I have the most growth and learnings. Always grateful to spend it with seniors who never tire of teaching me!

OCTOBER GEN PED: That we can’t please everyone in this life, but more importantly, that we shouldn’t make it our life mission to

I cried for so many reasons in Residency, half of them I just laugh at now. This month is no exception with regards to the tears. But what I’m grateful for is the people that help me process my personal experiences and convert them into learning moments!

If you get to sit across someone you look up to, tell them about an experience you had trouble putting into words, and they make you feel understood in a genuinely deep way, I think that’s when you know you’re in the right place to be.


So that was the past 6 months in the interim. In brief, I fell even deeper in love with what I do.

I am just extremely happy to be writing again. and grateful for the persistent Courage that allows me to keep hitting the Publish button each time.

I’m pretty sure the next 2 months will be challenging, but I am surrounded by the most amazing set of people to face November and December with.

So here’s to living our Dreams, and never forgetting that we are exactly where we prayed hard to be in not so long ago! xxx

s/p COVID Ward Rotation: Of Pandemics and Pantries

The past month went by like a blur! I was too busy having fun in this rotation, I didn’t notice the month passing by too quickly!

Here are my random #ThoughtsAndFeelings on this rotation, for posterity’s sake.

APRIL: The Fastest Month This Year

If this month were summarized into a tweet, it would probably be this:

To paraphrase myself,

“It was a good month to be Human

(but a bad month for my backlogs and to do’s)”

I remember crying (HAHAHAHA) because for the first time in 3 months, I overslept and woke up late, and I didn’t even have to feel guilty!!!!

I spent my first day of “Freedom” scheduling Zoom calls with friends whom I ignored the past months (hahahaha I am so sorry, I will be a better me!)

I was able to do things I didn’t have the luxury of doing in the previous months like,

  • brewing coffee!

Ordered my coffee gear last January, excited to be a proper coffee nerd.

Imagine all the Scientific Principles involved in making a good cup of coffee! From the Laws of Thermodynamics that explain the accurate temperature that best extracts the flavor, to the Chemistry of coffee beans interacting with water molecules, to the Physics of the manual grinder converting beans into granules with the ideal surface area!!! Coffee really just makes me happy!

  • reading Nelson in peace!!!

I think this is a personal record for the most number of Chapters I’ve read in Nelsons in terms of preparing for an exam (don’t ask me how I managed to survive med school HAHA)

For Context, here are true stories of personal #NelsonAnecdotes (Probably too late to ask, but might as well try: “Please don’t judge me!”)

Funny Nelson Story #1:

One of my greatest achievements in life is finally owning a hard copy of Nelson I can read whenever I want (which is not very often hahaha)

When I bought it early this year, I was pretty proud of myself for the maturity to “invest in the right thing”

until I found out that there has been a 21st Edition for quite sometime, and because it’s me, of course I got the 20th Ed HAHAHAHAHAHA (Halatang di nagbabasa!!!!)

Maybe I can buy the 21st Ed when I’m done with the 20th!!! (Tapos may 24th Ed na by then HAHAHA)

***

Funny Nelson Story #2:

About mid-January, in an attempt to make the most out of my money from the aforementioned Nelson purchase, I started reading it during my free time. One time, when they saw me reading, Kim and Maris really took their time to make sure I had adequate lighting and that I was situated comfortably while reading! They would even set up a reading lamp even when I didn’t even ask for one!

(First time yata nila akong nakitang nagbabasa ng Med Textbook! I guess they were worried I didn’t know how to do it HAHAHAHA)

//end of your Judgement

  • enjoying meaningful conversations with friends!

This month, I also had the fortunate privilege of engaging in meaningful and deep conversations with friends. The best part is, they don’t have to be rushed! I can be as honest and vulnerable, and I don’t have to fear being judged.

Maybe these people don’t notice it, but when I find myself in the middle of an engrossing discussion, I spend a few seconds willing my brain to take it all in – to really be there and take a snapshot of that precious moment in my brain. That way, even when our conversation is over, I have a happy memory in my pocket I can save for a rainy day! I think this explains all the random goofy Maryan smiles even as I am walking alone.

What a great Blessing it is to be able to sit down with special people in our lives and do nothing else but talk. I don’t ever want to take this for granted.

INFINITY WARDS (NO MORE)

As soon as schedules were released for April, I got multiple “Congratulations” for not being assigned in the Wards again! HAHAHA (thank you for the support, friends!!! Chineck po talaga nila ang schedule ko hahaha)

But to be perfectly clear, I loved my time in the Wards! I grew a lot (mga 120 years!) and learned a lot! There is no substitute for the distinct fulfilment you get from surviving a challenging rotation. But more than that is the Confidence you gain in managing patients because you already encountered this same case before! And if that means I can better manage my patients in the future, it is a blessing to be handed that opportunity.

Plus, I’m also taking baby steps in reframing my perspective!

Towards the end of March, I had a sudden epiphany. I was able to accept my inherent toxicity as a Resident!

I discovered that if you have already come to terms with your own toxicity, getting one benign day in a week feels like a blessing. But if you remain in a state of denial, you will be overwhelmed with the 6 (out of 7) toxic days!

IT WAS SUPER LIFE CHANGING!!!!!

Basically that’s really just Einstein’s Theory of Relativity in action!

I am happy to say that for this month, the Universe decided it was time to get off my back. My Lineage is super Lucky and duties are smooth-sailing (save for the couple buzzer-beater code and intubation here and there)

Kung Album siya: April 2021 (Taylor’s Version) HAHAHA

Special mention to this powerful #BenignMagnet for countering my balat sa pwet!!!!

SHAlamat sa lahat ng pa-learnings!!! At sa pag-guide sa Lost Kid na to!!! Thank you for not judging me HAHA

Ito pala yung feeling na di gumagawa ng mort slides at the end of the month! HAHAHA

Of Pandemics and Pantries

On a more serious note, this rotation saw me managing our actual COVID positive cases. This experience is highly insightful especially as I observe how different the role I play inside a hospital compared to when I was in the Community a lifetime and a half ago.

Because I knew our fifth class Municipality didn’t have enough funds to take care of positive cases, our efforts were focused on prevention. We had to be strict about quarantine measures, and contact tracing had to be immediate! As a result, we were the second to the last municipality in the whole province to get a confirmed case. All thanks to the efforts of a Community willing to help each other out in a time of crisis – from BHWs actively taking part in contact tracing efforts, to citizens volunteering as manpower in our designated checkpoints!

In comparison, working inside the hospital means managing positive cases. It requires a different set of skills and resources – which includes a resilient workforce!

Once, while donning, I was able to talk with the NA on duty, who told me, “Doc, akala ko talaga saglit lang tayong ganito. Isang taon na rin pala. Yung mga PPE, pag naubos, napapalitan. Pero, yung tao, hindi.”

I started my duty that day with a pang of sadness, and maybe anger too.

Our healthcare team is exhausted from a battle that shouldn’t have extended this long if only we had a competent leadership to address this!

Instead, we are left with a government that actively antagonizes the public’s efforts to help each other out!

A viral Facebook post narrates how Anthropologist Margaret Mead was asked what, to her, was the earliest sign of Civilization. To everyone’s surprise, her response was a “15,000-year old fractured bone that had healed”. Explaining further, Mead elucidated that thousands of years ago, a broken bone was tantamount to death. Injured, Man had no means to protect himself, or gather food. But the fact that this broken femur had the opportunity to heal meant that somebody else had tended to this Person while he was hurt. In Mead’s immortal words,

“Helping someone else through difficulty is where civilization starts,”

The underlying Context behind Community Pantries lies in the inherent human tendency to care for the next person. A 15,000-year old fractured femur is proof.

So when people come up with Community-led initiatives to help each other out in these trying times, you have to be a special kind of evil to want to stop these efforts. 

We’ll take all the wins we can get

This Pandemic took away a lot of things from us – both tangible and intangible! It took away Happy Places we would frequent. It separated us from loved ones. It took away the sense of control we have over our lives – where to eat or where to go next. So, when a happy thing comes our way, we have every right to celebrate them!

Like when we get to send a patient home after an extended stay in the Hospital.

Or when we successfully survive moving on to “more mature roles” like referring to a Consultant,

Or when we finally have the time to go out with our favorite people, and not be guilty about spending a whole day Happy

Or having amazing seniors as duty-mates!

The best Ate and Kuyas, “May kailangan ka?” q2h “Toxic ba admission mo?” “Need mo ba ng help?”

So, so grateful for this Team for making every duty a balance of learning and #self-care

Really, really appreciate that we can talk about clinical cases one second, and chismis the next! We can recommend management plans for our patients,but also recommend books to read, movies and anime to watch, and songs to listen to!

#TeamBudol din minsan!

Grateful as well for the people I worked with in this rotation!

To my “lineage-mates” for the perpetual “Anong thoughts natin dito?” Thank you for the rare benign magic! At least I can claim I wasn’t always toxic as a Resident hahaha

To our Fellows, thank you for really taking the time to teach me! For being kind enough to entertain my “side referral” You know you’re in the right place of Learning when a fellow sits down with you for 2 hours discussing the diagnosis and differentials of your patient! 😭😭😭

I am extremely thankful for the constant reminder that I am now part of this Family that watches each other’s back!

#Learning Points

If last month’s lesson was about being Kind to the self, this month is about recognizing Happiness as it unveils itself in the moment.

It can sometimes be fleeting and temporary, but always it is Real.

It’s harder to find Genuine Happiness these days. 

So when you stumble across Happiness that doesn’t worry about its ending, that doesn’t worry about the sun finally setting, or the drive finally reaching its destination, or the conversation finally reaching its conclusion – take it all in. Be Present in that Moment.

Where I am now and where I was a year ago are vastly different.

It’s so easy to take our Dreams for granted – especially when we are already living them.

But I can’t allow myself to forget how grateful I am to be here. To find Happiness again when I thought it was permanently lost.

And I know the days are not always good, and there will be days I will scoff at how cheesy I am and chastise myself for Romanticizing this profession way too much.

But right now I feel an overwhelming sense of Contentment, so I will bask in that.

Like I always say,

Until the next Heartache!

xxx

s/p Back-to-Back Wards Rotation: Major in Conferences, Minor in Hyponatremia

2014 Maryan once wrote:

“Someday, I’m gonna be brave enough to publish my thoughts.

Even if it means the possibility of scrutiny.

Because the things we choose to do, should be things that aren’t selfish.

There must be something within all of us that others can partake in.

Of course, the entirety of this piece remained unpublished. HAHAHAHAHA

7 years after, hitting the “Publish” button is still a great source of anxiety. What if I don’t get my point across? What if people who read my thoughts misunderstand me? What if I write something offensive? What if this comes off as too cheesy? Too uncool? What if my attempts to contain into limited vocabulary the unlimited richness of my experiences succumbs to the perpetual problem that is the Poverty of Language?

It is a very tiresome sequence of overthinking, and the easiest solution is to not even attempt it at all. Problem solved.

But buried deep inside me is a genuine Desire to sit down with my thoughts, wrestle with them, look for the best-fitting words that give justice to my Experiences, and to give the Stories back to the World that first gave them to me.

And there are days this Desire does not wish to be ignored. Today is one of those days. So against my better judgment, I will write.

I will write about the past 2 months, and hope I have the right Words to convey the immensity of my experiences in the last 59 days. Because if future Marianne dare look back to this moment weeks, months, or years from now, I want her to remember she survived even when at some point she didn’t believe she could.

So here are the salient points of my February and March, a preview of my Back-to-Back Ward Experience from now on we will call The Longest 2 Months of my Life (Yet), hahahaha:

FEBRUARY IS THE LONGEST MONTH

Fresh off my Neonatal ICU Rotation Back in January, I was welcomed by February with a Ward 9 Rotation.

Back in Clerkship and Internship, I was always assigned in Ward 11. I only got to rotate in Ward 9 during Pre-residency, and it was only for 5 days. As a Routine-Person-Who-Hates-The-Slightest-Bit-of-ChangeTM, I was stressed out not knowing what to expect from this Ward. But based on previous experience in med school, Ward Rotations always give me an unparalleled sense of Fulfilment. In fact, as a surviving-med-school-life-hack, even as I have moved on to other rotations, I still go back to our Pedia Wards just to watch my previous patients get better and eventually sent home.

This excerpt is taken from a previous post It Is Personal

And while I hold on to these happy moments, I also know that not all of our patients will be sent home well. One of my greatest fears entering Residency is knowing that at some point I will have to deal with a patient’s death. I’m not very good at that. I don’t think there is getting used to the Pain of not being able to save a patient’s life. There is no getting used to the sound of parents’ distinct wails as you declare the death of their child.

And while you do everything you can in your power to make sure patients get better, Death perpetually remains an inevitable Reality of this profession.

Last February, I had my first patient mortality as a resident. I was there when he presented with distress. I was there when the whole sequence of resuscitation was activated. I was there when we had to apprise the father of the limits of CPR. Sometimes I wonder if there is a switch to turn my feelings off. Maybe if there was, it wouldn’t hurt that much.

Afterwards, I was talking with the Father, explaining to him what happened. I know about Objective Distance. I know that the professional thing to do is to keep a straight face on, answer whatever questions relatives have, and offer Comfort. As Physicians, we know our role when a patient is sick.

But what is the role of a Doctor in death?

As my tears started to fall halfway through the conversation, I realized maybe the answer is simply to be Human.

To allow Humanity to seep through the Facade. To Cry. To Remember. To Be. To constantly reject that the inherent human condition is Suffering. Even in Death. Especially in Death.

I could not bring my patient back to Life, but everything I learned from him I will use for my next patients. The Price of our Learning sometimes comes at the invaluable Cost of our Patients’ lives. That’s how precious every interaction is with our patients, and we must never take these Learnings for granted. I am infinitely grateful for my patients that always serve as my best teachers in this profession.

“SAYO NA NAMAN, MARIANNE???”

Back in Internship I would deny all claims made by Seniors of my alleged toxicity, but now, I have reached the Stage of Acceptance! HAHAHA

In fact, at some point, some Fellows are just assuming certain toxic patients are mine, (cue “Sayo na naman, Marianne???“), and 90% of the time, they are right! LOL

But that also means more opportunity to learn. My “refer to the World” patients mean interacting and learning from co-managing services. I am aware that I have so much more to know, but I also gained a lot of knowledge and insights from our fellows and consultants! I always get reminded of how lucky I am to be training in a place where I could maximize my learning experience especially with the support of seniors. If I am learning this much in just 3 months of Residency, I can only imagine what 3 years of that Learning Experience will teach me!

BUT WHAT IS MARCH IF NOT FEBRUARY PERSEVERING?

Somehow, I got through February, and saw myself entering March, still rotating in the Wards. This time, I was assigned in Ward 11.

Looking back, the only reflection I have for March is that I don’t know how I managed to survive it

To be honest, there was a point it felt like I was drowning, and that I was disappointing everyone, even people I looked up to, and people I didn’t wish to disappoint. It’s not a feeling I would wish on anyone. And it’s not something I’d like to feel again.

But what got me through was the Kindness from People.

In my most trying time (thus far!), I had an amazing support system that believed in me when I couldn’t do it for myself

Appreciation post for this amazing support system!

I was part of an amazing team that didn’t judge me at my worst!

#NeverForget GP 1.5 (Di namin alam paano ba yung 1.5 HAHAHA)

So I guess the bad moments can be survived with the People that will help us get through them. Because no matter how much we wish those moments do not happen, or that they will magically disappear, there will be terrible days nevertheless.

I managed to survive the past month not because of me, but because of the People who helped me gapang my way through. I am so, so grateful for them.

LEARNING POINTS

If there was one Learning Point I get to keep with me, it is the need to be kind to ourselves first and foremost.

I had this mistaken notion before that the selfish choice is always the bad choice. The truth is, it isn’t.

I had to learn this lesson the hard way, not too long ago.

If you don’t choose yourself, you end up becoming the shell of the person you used to be. You will lose the flame in your soul.

And the thing is, your patients need you to be selfish. Patients need you to be happy. To eat. To sleep. To be Human.

Because if you pretend you are a robot immune to exhaustion, one day, your system will not be able to take it.

And you compromise your ability to serve.

Every single day, I struggle with being kind to myself. I make mistakes I regret, and I blame myself for not knowing better. But unlike correcting hyponatremia, these things cannot be learned from UpToDate, or read from Nelson. The opportunity to learn kindness towards oneself presents itself in our day-to-day activities. There is no quiz or exam that we can answer to help us measure how kind we were to ourselves today. There is no OSCE that will ask us if we have forgiven ourselves yet for our shortcomings. Years of medical training have conditioned us to believe that the important lessons in life come from lectures, journals, textbooks, and exams. But the things that truly matter – the things that allow us to be Human – we are also learning them as we go along, even if we don’t always notice.

They are harder lessons to master because we are led to believe that the Doctor ought only be Perfect. We learn early on to put a facade of Perfection to please others, and it frightens us that one day, we will not be able to sustain this act. Medicine will ask you to be both Human and Superhuman – at the same time! An impossible task that only guarantees failure. Yes, you will fail. Of course, you will.

Medicine is never good for one’s ego, every day is a lesson on Humility. The inconvenient truth is that we aren’t supposed to be Perfect or Superhuman. The Reality of the Physician’s Humanity – our Vulnerability and Imperfection are crucial parts of who we are that we need to recognize as well. We are not Heroes fighting a War. We are victims too of a system that continues to fail the Health of Filipinos amidst a pandemic.

And while we are pouring our 110% to ensure that our patients are getting only the best version of care there is, we must also ensure that the cup is not emptied.

This bit I haven’t figured out yet. Pretty much like how I still haven’t figured out how to correct hyponatremia (HAHAHA, sorta kinda half kidding hahaha)

But there is plenty of time to learn that. And plenty of amazing people to learn it with.

And while we’re at it, there’s also plenty of Publish buttons to be hit.

xxx

s/p NICU rotation: the first (and definitely not the last of many NICU rotations HAHAHA)

Paulo Coelho’s The Alchemist tells the story of Santiago, the Shepherd Boy, on a quest to pursue his Personal Legend. 

In a stroke of pure literary genius, Santiago’s search for his treasure leads him back to the right exact spot he first began his journey.

And speaking of going back to a Place you thought you already had left behind, here’s me trying to process my first month in this Hospital (HAHAHAJK!)

To start of, I think this tweet is to be blamed for the sudden NICU affinity:

(NOTICE HOW THIS WAS WRITTEN AUGUST 2020!!!!!!! I HAD NO IDEA!!!!)

That is, during preres, NICU was also my first rotation (first blood duty team pa!) My Case Presentation was a NICU case (HAHAHA, I think this in itself deserves a separate blogpost of its own, maybe in the future!!!!)

I remember my case presentation as an intern was also a NICU case. Hypoxic-Ischemic Encephalopathy, one of our catches during the rotation.

Who could ever forget the series of Ayoko Na duties with the most toxic team there could ever be HAHAHA

It was so toxic, more than a year after internship, during pre-res NICU endorsements, one of our NICU fellows stopped me as I was about to endorse only to tell me,

“Naalala kita. Kayo yung toxic na duty team” HAHAHAHAHA

Maybe that’s why the most shocking revelation I learned from this rotation is that, statistically speaking, only 1% of newborns will require major resuscitative measures. I did the Math for our 2-week Internship catcher stint with Ivy and Aprille, and I’m sure as hell we were betraying statistical probability with our toxicity! (Read about that here!) HAHAHA, good times!

Kidding aside, I think all the growth from that Experience helped me a lot in getting through my first rotation as a resident!

My first month in this job had been full of insights and realizations. In one of my walks on the way home, I was feeling pretty proud for doing my first surfactant administration. I saw the repeat babygram which showed an almost magical resolution of the opacities. And then there was a sinking feeling as it dawned on me how maybe in the future, I might take this feeling for granted. It’s just another procedure I have to do. So I uttered a silent prayer to the Universe, wishing that I may always treasure each learning moment, and never ever take for granted all the kilig I get from what I do.

And speaking of kilig,

Back when I was a student, my seniors used to ask me “Magp-Pedia ka ba?”

Now, the golden question several seniors have repeatedly asked me (but also a mystery as to why this comes up often) is

“Masaya ka ba, Marianne?”

If I were to be honest, it scares me that the answer is an overwhelming “SOBRA.”

The backstory of this tweet is a bembang day I thought would discourage me. I didn’t want to announce to the world that I was happy because I was afraid this Happiness will be taken away from me. But ironically, the more mistakes I make, the more I want to show up the next day. The more I want to try again. The better I want to be.

I used to be disappointed with each mistake I make. If I couldn’t do it perfectly, then why bother at all. But I am in a place where growth is encouraged, supported, and nurtured by the best set of seniors and support system one could ever ask for. And for that, I am grateful!

I guess my greatest struggle for this month is coming to terms with the knowledge that “the cost of my learning is shortchanging another human being” – a point I have previously made, a long time ago (Read here)

I would readily accept all the grilling, the Q&A, the physical exhaustion. But the knowledge that my own limitations or my lapses in judgement could delay crucial interventions for my patients, that’s the harder consequence to take.

I want to unlearn years and years of conditioning that has put premium in Perfectionism. But I also want to ensure that my patients only get the best version of care because that is what they deserve. I’m still in the middle of finding that blissful balance between both realities. I know it’s not going to be easy, but I might as well try my absolute best!

Because I really wanna make this right. I am now more careful with my thoughts, kinder to myself, more forgiving of my mistakes. Yet it remains to be a daily struggle. It is not a linear path, but the desire to persevere is constant. I have to remind myself every waking moment that the goal is to learn rather than be perfect.

And though it may seem to be a Sisyphean task, unlearning perfectionism is a must in this profession. It is a truly Humbling duty to be given the chance of taking care of another Human life – and to understand that “we will not always be able to save all lives we are privileged to serve”

The past month felt like a giant Conspiracy of the Universe to let me know that I am right where I am supposed to be – no matter how much I doubted (and sometimes, continue to doubt) it.

But this is the Season to write about Shepherds stumbling their way through Treasures.

Because in the end, the Truth remains:

The Universe Does Conspire to lead us to our Personal Legend. xxx

#Eventually2020 : s/p The Year that Was

It started as a joke way back 2018. I would coin personal hashtags for the incoming year in lieu of year-ender essays I’m too shy cool to write. #StepUp2018 became #Kakayanin2019. What started out as #BeHappy2020 became the more appropriate #Eventually2020

This year, I’m back to writing year-ender essays mainly because this feels like the year to make exceptions. And maybe because I have finally accepted that I’ll never be the cool kid I picture myself to be. HAHAHA.

When I entered this year, I had no idea it was gonna end this specific way. Where I am now is vastly different from where I imagined myself to be in last January – that is, a lifetime and a half ago. And if you know me, you probably know how much this unexpected Change drove me crazy.

You see, I entered 2020 carrying a Happiness that springs from finally living a Dream I fought so hard for.

At the beginning of this year, the night before my deployment to the Community, my parents and I were dining with Jesuits at the Loyola House.

True to the spirit of Communitas ad Dispersionem, I was being sent where there was greater need. I only had one prayer: that wherever He sends me, may He use me as an extension of His healing hands.

So when He first revealed His will to me later in the year, my response was (a very reverential and respectful)

“Are You crazy???”

The debater in me had 10 layers of rebuttals for this Plan. It comes at a very poor timing in the middle of a pandemic.

“Do You know what that will mean for me and the people around me?” “You know I’ll do what You will, but maybe not this one”

Every day, my prayer was for Him to change His mind.

“Are you sure this is what’s best?”

I would beg Him to reconsider, reminding Him of all the unintended consequences of this course of action.

Until one day, a line from The Prayer of Rupert Mayer hit me,

“To ease Your burden brings no pain
To forego all for You is gain”

I was being asked to surrender like I never had before. To forego everything – riches, honor, and pride – in what was a call for a genuine Suscipe. A complete and total surrender to a God that loves us above all. In prayer, I asked Him to

“Take all my will, my mind, my memory”

For a person who was so used to being in control even of the tiniest detail, it was a real challenge. But by His Grace, I was able to surrender to Him knowing full well that

“All that I have, You have given all to me, Now I return it, to be governed by Your Will. Just say Your Words to me, at once I will obey.”

It took tears, lots of them, to even be where I am.

There are burdens we will carry with us for the rest of our lives. Failures we will forever bear. The what ifs that will haunt us perpetually. Dreams we have to let go of no matter how much we still want to fight for them.

And there is a God we will offer them to.

Being Human means accepting that there is no Perfect.

But there is Love.

And sometimes, even when it is hard to believe, It is Enough.

So maybe this is also a message to another soul struggling to have things make sense. Because not so long ago, I was there too. And as Robert Frost aptly wrote,

“The best way out is always through”

You just have to hold on long enough to get to your plot twist, and once you do, you will realize how elegantly everything was written by the same Hand.

I speak from a place of gratitude. I recognize that not everyone enjoys the same Happiness I am lucky enough to have found again, especially in these trying times. And sure, I did doubt the Process. At some point, I didn’t know if I will ever survive the Pain.

In the midst of my decision-making, I imagined how difficult it would be, for others more than for me. For the people I love who believed in me. For the people I care about who needed me there. But Love, in its purest and genuine form cares enough to understand. I am forever grateful for my support system who never tired of staying with me and supporting me through all these.

So here’s to the year that was, for all the heartaches, the lessons, the growth. For leading us towards becoming the Person we were meant to be. And I genuinely hope that no matter how hard it may be, how seemingly impossible, we’ll find it in ourselves to forgive the Person we couldn’t become, to let go of Dreams we couldn’t fight for anymore. Eventually.

And for tradition’s sake, looking forward to #Kaligayahan2021!

xxx

s/p Hospital Playlist Episode 12

And just like that, this 12-episode Season of a truly heartwarming KDrama comes to an end. I know this show had been on for a while, and that people have probably watched this way before I did. But on a personal note, it was one of the few Happy Things that happened to me in the middle of this pandemic.

It reminded me of the last 5 years of medical school, and the past few years of hospital life. It allowed me to write about what I felt in the past, and made me reflect on recent experiences.

It made me laugh out loud even on minor details, think deeply on unremarkable scenes, and it also made me understand a few things about myself too.

On weekdays I thought I couldn’t survive, I had this series to look forward to when the weekend finally arrives.

Now that I’m writing my last piece (for the Season, I hope), I can only ever be grateful for this privilege! It has been fun being invested in the lives of Song-hwa, Ik-jun, Jung-won, Jun-wan, Seok-hyeong, and all the other characters of Hospital Playlist!

Song-hwa is still Perfect

Of course, Song-hwa is still perfect. Even residents from other departments ask her for advice. She’s amazing with patients, and she can manage her time well.

Initially, I thought she was gonna be paired up with Jun-wan, which I wasn’t too enthusiastic about. Then there’s the Chi-hong ship I also do not approve of.

But this Ik-jun + Song-hwa ship is PERFECT! Looking back on previous episodes, Ik-jun came with her on the day she was gonna get the result of her biopsy even if she explicitly stated that she didn’t want anyone with her. I know appreciating this action would largely depend on the kind of person we are. Some would probably think Ik-jun didn’t put premium in Song-hwa’s request to be left alone on that momentous day. But to me, the thought of someone going out of their way to be with you in a vulnerable moment – to just sit there and not say anything – that speaks volumes on how much they love you.

Song-hwa was also the person Ik-jun calls to take care of U-ju when he was sick. And remember that pony tail scene way way way back – in fact, the first time they meet each other and Ik-jun already got Song-hwa’s back!

But I think I also get the whole “I’m afraid we’ll damage our friendship” hesitation from Ik-jun. He spends years being one of Song-hwa’s best friends. In itself, that relationship is more than enough. They get to eat together, be in a band together, share with each other how their days went, and call on each other when they need someone. Betting the whole thing just seems crazy!

So I don’t really know if I want this ship to sail, but I do hope they get to keep this whole amazing friendship they have!

Jung-won’s Final Decision

Speaking of ships I don’t want to sail (HAHAHA), Jung-won eventually chooses to stay as a doctor. One of the main reasons is because he falls in love with Gyeo-wool. I don’t know how to feel about this. On the one hand, I guess it’s a happy thing that Gyeo-wool is not so sawi anymore, and as a bonus, Jung-won continues to be the awesome Pediatric Surgeon that he is! But on the other hand, that means another year of KBBQ restaurant breakdowns. Plus, isn’t it a bit weird for a resident to be dating a consultant?

But as I’ve written before, I only hope Jung-won chooses what ultimately makes him happy!

A relatable scene in this final episode is Jung-won asking Song-hwa, “How do you guys know my patient is doing well or not?”

I’m a lot like Jung-won (a point I have previously made before) in that my face and body language show if my patients are doing well or not. Also, I don’t shut up when my patients recover and are finally sent home after being admitted for a while! That’s a truly happy thing and I understand Jung-won completely!

Seok-hyeong is the Cutest!

Seok-hyeong’s deadpan expression is one of my favorites because underneath that is a truly caring doctor! He doesn’t wish to be in a relationship with Min-ha in order to protect her from possibilities of hurt! He also managed his APAS patient so well she has reached term pregnancy – which means there’s less propensity for complications from her disease!

He also let a patient cry during outpatient consults, even if there was a long line of already irate patients outside. Sometimes you make judgment calls that will not make others happy, and you won’t even get to explain your side of the story, but as long as you know you’re doing the right thing, I guess that’s enough.

Jun-wan’s character development is exquisite!

Jun-wan has been consistently portrayed as a surgeon with a temper, but in this last episode, he seeks the advice of Jae-hak on love and relationships. He wanted to know if he should give Ik-sun a ring even when she explicitly said she didn’t want to receive gifts like that. I love that he takes that preference seriously! In the end, Jae-hak tells him to ask Ik-sun. Long-lasting relationships are built on open communication. I hope we can be honest about our feelings with the people we love!

In the same scene, Jae-hak talked about the difficulty of decision-making in this profession. In your practice of Medicine, you will be asked to make impossibly many judgment calls. It won’t be easy, and you will be accountable for all the consequences that arise from that decision. Jun-wan tells Jae-hak to ask him for advice when he’s having a difficult time reaching a decision. Similarly, if you find yourself overwhelmed by a clinical dilemma, remember that you can always refer to people you trust. You will still have to make the decision, but it helps to be informed by the perspective of others!

Ik-jun is the Sana All doctor we all aspire to be

He can sing, he can dance, he is super smart. He is friends with residents, fellow consultants, and he is super kind with medical interns! His patients love him, and he is the best transplant surgeon of Yulje Medical Center! Ik-jun, the ultimate Sana All!

In this episode too, he uses sign language to speak with the child of his patient!

Which brought back a memory from a lifetime and a half ago!

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This final episode shows the gang celebrating Christmas together, of course after having to spend time in the Hospital! In this job where you are perpetually on call, weekends and Holidays hold little value. But you will learn to live with that!

In my internship year, I had to celebrate Christmas away from home for the first time. But I celebrated it with the best people, so I have no regrets! It was a simple celebration, but it is one of the Happiest Memories I rewind in my brain when I am sad. It was then that I realized “Home” is not so much as a place as it is the people that make you feel that you don’t have to be anywhere else.

I hope you meet people like that in your journey inside the Hospital. Often, they are the ones that will help keep you going even on days you don’t feel like getting up. Go find yourself your own #HospitalSquad!

xxx

s/p Hospital Playlist Episode 11

I am feeling extra nostalgic writing this piece, mostly because it means I’m about to watch the last episode of the Season.

I’m also really happy about this decision, and proud of the Courage to keep hitting the publish button even when everything in me tells me not to.

As a Routine Person Who Hates The Slightest Bit of Change, incorporating this into my weekly routine has initially been daunting. The will to be consistent with publishing each piece is extra hard to muster. And yet, here we are.

I know this has become pretty repetitive, but that’s only because I mean it so much: Thank you everyone for your kind words and generous feedback!


This episode features Chi-hong going back to the Hospital on his birthday to check on a patient. It sounds pretty miserable, but in reality, it just becomes a normal occurrence in a doctor’s life – that your birthday is just any other day in the series of days you have to spend in the Hospital. I think that’s also one of the difficult parts (there are many!) of this profession: our  social lives become collateral damage in our pursuit of this Dream.

A year ago on my birthday, I was in the middle of taking the most important exam of my life (No less than the Board Exams!!!) My parents had to fly in all the way to Manila only to watch me sleep when I arrived from the testing site. I didn’t have much of an appetite that day (throughout the whole Boards season actually), so I ate the only thing I could manage to eat that day:

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This Hawaiian Pizza also served as my Birthday Cake haha

Two years ago, again on my birthday, my parents flew in to spend my special day with me, but I was on duty as an OB intern, so I had to eat a quick breakfast with them and stayed in the Hospital for the next 24 (++) hours.

My past 7 birthdays were spent away from Home. I’m so grateful that my parents didn’t just cancel it (I would understand if they did, to be honest HAHA).

Our Dream can sometimes take its toil on our personal relationships. We spend what feels like infinitely many days with strangers, at the expense of momentous occasions with our loved ones. And on days we can actually show up, we are too tired to even be there mentally.

That’s one of the many Human Costs of our Decision. It will never feel right the moment you realize you’re missing out on the most important moments of your life. And no amount of these realizations can bring those instances back.

So here’s an unsolicited advice (you know by now to expect from me), don’t let Medicine get in the way of your being Human. 

Going back to Chi-hong being in the Hospital, of course he finds Song-hwa already there! Despite her having to wear a neck brace, she still makes it a point to visit her patient to make sure everything is alright.

I guess that also becomes some sort of a universal doctor thing – checking in on your patients even when you’re on a “break”. Personally, it bothers me to not know what’s happening to my patients – especially when their condition is delicate, so I understand Chi-hong and Song-hwa completely!

I remember once, as a clerk, I had a patient diagnosed with Hemophilia A. Getting Hema patients can be difficult especially with the chronic scarcity of blood supply! You could spend your whole shift begging Blood Bank for a bag, and they really could give you nothing. This is when I subsequently learned that supplies become available at night. So I would get back to the Hospital around that time, and end up securing blood for my patient! Eventually, we were able to send him home healthy!

Another time, as an intern, I would attend the 14-day Misa de Gallo in our hospital’s chapel. I had this patient who was deteriorating clinically. As I go home each night after my shift, I worry that my patient’s condition will take a turn for the worse when I’m not there. So after the early morning mass, instead of going back home and get extra sleep, I would head straight to my patient to make sure she’s doing well. This patient eventually expired while I was in the middle of a conference. She left when I wasn’t there. Over a year later, and I still don’t have the words for that kind of Pain.

I hate telling these stories because I’m afraid I won’t get my point across. I feel like they might only be reduced into a personal account of “heroic deeds”. They aren’t. 

More than anything, they are Stories of People whose lives intersected with mine, even for the briefest time. These are stories of the never-ending struggling in this profession. Some days we send our patients home healthy, and some others we won’t be able to. More than missed birthdays, that’s an even heavier burden to bear.

May your heart be able to take that Pain. And on days it couldn’t, I hope you know that you did your best.

And I sincerely pray that it is enough to keep you going. x

s/p Hospital Playlist Episode 10

I’ve been trying to avoid the whole romance angle in my reflections like the plague because the show is already great in itself without having to rely on pairing up the characters.

In fact, I’m highly against the Chi-hong/Song-hwa ship mostly because I don’t think anyone ever deserves our perfect Song-hwa! I mean, look at her have her own coffee grinder in her office! Who has time to brew their own cup of coffee as a doctor, and a neurosurgeon at that!

But after this episode, I am rethinking my whole stance because 10 episodes in, and I suddenly realize how an Ik-jun/Song-hwa pairing is pure genius!

Did you also feel the kilig during that breakfast scene?

“What about you? What do you do for yourself?”

Having a meal with you like this. Eating with you and drinking coffee together

MY HEART. I CAN’T. I JUST CAN’T!!!!

Sometimes, the most simple activities with the people we love – like eating breakfast and drinking coffee – are enough 🙂

And while we’re at it, my favorite ship is Jung-won’s mom and Hospital Director Ju! They’re so cute! Especially that scene in the car when they were deciding what to eat (don’t we all have that moment? HAHA) In the end, Rosa just confessed that she wanted a drink (These days, who doesn’t?) I know they’re not officially a couple (yet!), but I have a feeling they’d end up together when the Season ends (I hope!)

Speaking of “couples”, Gyeo-wool is still hopelessly in love with Jung-won. Maybe we’ve all been there, desperately pining for someone who doesn’t like us back and ignores us. But if Jung-won did lie to her about not being free on a weekend, and if he constantly ignores her efforts, we all know she deserves better. She does.

In Jung-won’s defense though, maybe he was just wary of a potential relationship with a junior, or maybe he really wasn’t interested in one given that he wants to become a priest. And maybe he’s afraid that rejecting Gyeo-wool will hurt her. And that is why he pretends to not notice all of her efforts towards him.

See? This whole love thing is so complicated and tiresome. Who wants to fall in love these days, in this economy? (HAHAHA JUST KIDDING, GO ENJOY YOUR LOVE LIFE IF YOU HAVE ONE)

Lastly, on complicated love, Jun-wan finds out Ik-sun got accepted for a postgrad scholarship in Europe. I really admire how mature he was in handling this despite the obvious pain this caused him. I hope they find a way to make this work, and if they don’t, that’s all right because what they have now is amazing in itself!

You can spend a lifetime looking for The One, and it might never show up. So if you find yourself in an encounter with Great Love, I hope you have the Courage to not walk away.

Whew, this is sounding like a love advice column more than a Hospital Playlist reaction. So before we all get carried away, I will do us all a favor and go back to talking hospital (You’re welcome!)

Really one of the strongest points of this Series is how accurate and realistic it is. Do you notice how much Song-hwa massages her shoulders, neck, and back throughout the entire Season? If you are a Surgeon expected to maintain a certain position during the whole length of a procedure, you will get these muscle pains! I am not a Surgeon, but my back pains have been bothersome of late. This is saying something because I have, baseline, a high tolerance for pain. My trapezius are hard as rock! A quick Google search and remnants of MSK learnings tell me the trigger is stress. This only means I’ll have to bear this pain for quite a while. HAHAHA

And speaking of accurate things, another truth bomb dropped in this episode is,

“Moms are better than doctors”

This is true. No one can contest this. They just know better than us – in all aspects.

That’s why the “IV insertion scene” spoke to me on a personal level. After failing to establish a line, the phlebotomist (I guess?) commented, “This is harder on her mom, probably.”

One of the things I hate in the Hospital is the task of inserting intravenous lines to patients, especially on kids. I hate hearing them cry in pain, and I hate looking at their parents eyes knowing that it hurts them too to see their child in pain.

That’s why throughout medical school, I practiced this skill a lot. I would volunteer to do insertions so I would get better at it. Eventually, my friends would refer to me “difficult insertions”, and somehow I manage to establish a line. Of course, there are really exceptions to this – the really hard ones that need a jugular central venous catheterization!

It shouldn’t be a surprise therefore when I say that my favorite scene in this episode is Jung-won visiting his patient and ending up carrying her.

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Being able to carry a patient is one of the happiest privileges afforded by this profession. And if they trust you enough to let them carry you, be prepared to fall in love with what you do. x

s/p Hospital Playlist Episode 9

Before anything else, can we please take a moment to appreciate the witty scene in this episode that references an amazing movie – Oscar winner Parasite! The “Jessica,Only Child, Illinois,Chicago” scene was super cute and as expected from this series, funny too!

At this point, we’re getting to know the fictional doctors/nurses/staff of Yulje Medical Center better. You probably have your own favorites, and even invested in the growth of their characters!

Song-hwa is still an all-time favorite, and a role model I try to emulate. Whenever I run out of EQ in the middle of consult, I’d ask myself “What would Song-hwa do?” And so far, this newly discovered calming strategy has worked miracles!

We still don’t know if Jung-won will eventually turn away from the profession and become a priest instead. I know I said in an earlier post I want him to continue being a doctor, but now my only wish for him is that he chooses what eventually makes him happy! Also, it’s always a favorite moment whenever he acts all giddy about a patient getting better. That’s accurate! Our greatest contribution in conversations with friends are usually stories of patients recovering. We’re boring, but at least we’re genuinely happy.

Seok-hyung has that unique endearing charm that appeals to me. I don’t know if that’s just because he’s an OB/Gyne, and I’ve been conditioned to have mad respect for these doctors, but each scene with him always brings a smile to my face.

Jun-wan is happy with his love life. I love how they show him laughing like crazy whenever he gets to talk with Ik-sun which is a stark contrast to his personality inside the OR. I guess we also share a mutual interest in golf…

…which is also something I really miss! One time, I was cleaning up my clubs, I asked Papa when I can possibly play again. He said when I have time for it. Which means, of course, after a gazillion years! LOL

Ik-jun still has the most heartwarming moments. He’s super kind to medical students, even to residents, and most especially to patients!

For this particular episode, we saw him reflecting deeply after an encounter with his patient’s father who tried hard to lose weight just so he could donate his liver for his daughter. It’s really one of the greatest blessings of this profession – to stand witness to the miracles of life, to get a glimpse of the most Human moments, and sometimes even, to become a part of that. So when you find yourself in one of these moments, make sure to not take it for granted.

This episode starts out with a familiar scene in the OR: a momentary rest afforded by a frozen section (it’s when they do a biopsy of a specimen in the middle of an operation, and wait for the result real time!) I knew early on that I wasn’t going to be a Surgeon, perhaps the only compelling reason for me to try out to be one is that I can choose the playlist during the whole procedure!

Among the plethora of reasons why I couldn’t be one is that I have very very very low tolerance for cold temperature! In fact, when I get cold, my hands feature a condition called cutis marmorata! It’s a benign mottling of the skin that we usually see in newborn babies. This only confirms our suspicion that I am a baby indeed. HAHAHA

The “Hot N Cold” OR scene was also pretty hilarious! It’s really true that varying operations differ in their temperature! For instance, when we are trying to deliver a preterm baby (usually via CS), Pedia asks for the AC to be turned off (Sorry OB!) (Rare high yield moment coming up! That’s because we want to reach optimum thermoregulation! Also the reason why the first step in EINC – Essential Intrapartum and Newborn Care – is thorough drying and stimulation!)

And speaking of EINC, there was a brief scene when a newly-delivered baby was placed beside the mother without skin-to-skin contact! The future Pedia in me is screaming!!!

Another nostalgic moment in this episode is Ik-jun telling Song-hwa that there’s braised pollack in the cafeteria. Since the Mess Hall provides free breakfast-lunch-dinner for clerks, interns, residents, and staff, we usually look forward to knowing what the menu for each meal is. It is a love language to tell someone what the Mess Hall meal is without them having to ask!!!

At some point, we knew to avoid the Mess Hall when the viand is the Classic “meat with brown sauce”. If you’re lucky, sometimes breakfast is served with cranberry juice!

I can’t believe I’m saying this, but Hospital Playlist is making me miss the Hospital Life! The workload is crazy, the physical exhaustion is inhumane, but there’s something about surviving each battle with friends by your side! Looking back, every “ayoko na uwi na ako” was only survived because I had an awesome support system that knew how to laugh at the ridiculousness of our whole situation.

So I am infinitely grateful for this series for stirring up all the memories – both good and bad! They remind me of the things I survived throughout the years – the small things I took for granted, and the big things that shape who I am today.

In your darkest moments, when there seems to be a lack of good things to hold on to, you find comfort in the fact that the memories were real. Once upon a time, the memories were real. x

s/p Hospital Playlist Episode 8

I just found out today (!!!) that Season 1 of Hospital Playlist only has 12 episodes!!!!!! I assumed there were 16, and I thought I was writing a halfway-through-the-Season post.

But it’s really like that sometimes. Our expectations and assumptions do not align with reality, so we’ll just shrug our shoulders and make the most out of what we have.

So here’s my two-thirds-through-the-Season post! HAHAHA

This episode focused largely on the hardships of Residency that very much applies to real life!

  • From Jae-hak’s personal (financial) problems affecting his work
  • To the reality of working with “scums”, and shouldering the burden they leave behind
  • To the unjust system that leaves healthcare workers vulnerable to rude/entitled patients/relatives

So it’s not really a surprise to see them wanting to leave the profession they once dreamed of having, and are fortunate enough to be in right now.

I myself have been on the receiving end of undue blame. This is also a story I already recounted in a previous post (read here ), but bringing this back up because episode 8 was relatable in ways I couldn’t accurately put into words.

In one of my duties, the words of an irate relative rang loud, “Sana hindi yan mangyari sayo!” she screamed at me.

A neonate was admitted at our ER even before I reported for our duty. Before long, the relatives called our attention – the baby was having a seizure episode. We approached immediately, a battery of quick assessment, stat management, the works. “Dok, ilipat niyo na po sa ICU, kawawa naman” “Pasensya na po, wala pong availability sa ICU. Nakapila po kayo

I took time to explain the state of our hospital, the “closed” ER (and yet brimming in its overcapacity!), the limited resources, basically the standard “pasensya na po” speech we have come to memorize.

The baby had another episode of seizure, I rushed to manage him, but this time was met with a more insistent request to be transferred to the ICU. Long story short, the relatives were directing their anger at me because they couldn’t be transferred to the ICU. “Sana hindi yan mangyari sayo!” they quipped

Was I mad? Did I want to retaliate? Did I want to lash back in anger because of their misdirected rage?

I am only human.

And yet thankfully, I didn’t.

My voice was calm when I said, “Mag-usap na lang po tayo pag kalma na kayo.” My senior came to my rescue and talked with them. I left to attend our mandatory Interns’ Hour.

The day that it happened, that scene was on replay in my head, each time I think of a different plausible ending, but there’s always that feeling of frustration.

At some point, the words become a blurry mess until they rearrange themselves to come up with a new meaning. “Sana hindi yan mangyari sayo” becomes “Wala kang malasakit.”

You understand where all of this anger is coming from: it IS  a problematic system that takes its toll on the poor. And yet, every single day, doctors are still left wondering “Saan ba AKO nagkulang?” Kung kaya ko ilipat lahat sa ICU diba inilipat ko na?

Our own frustration opens the floodgates for even more frustration!

Why are they angry at the doctor for problematic hospitals and still vote for the politicians whose concept of “health care” is an ambulance with their faces painted wide? Bakit sa Doktor kayo galit?

I went back to the ER after our Interns’ Hour. The scene kept repeating on my head. Inside the emergency room, there are more patients to be seen. I smiled.

***

That wasn’t a favorite story. It was a human story. I typed that on my laptop the day that it happened. I didn’t post it then. I’m posting it now because it affected me deeply. One of the relatives eventually apologized. I wanted to say it wasn’t their fault.

We are all victims of a broken system. There are days when this realization hits painfully hard.

It took me a while to recover from the feelings of that moment. Just trying to recall that memory still carries a certain sting. There are even more similar stories to tell, but the point is one and the same: if we can be anything in this world, let us be KIND.

It goes a long way. Especially for those who are about to give up on their lifelong dreams.

Like Min-ha in this particular episode.

Left with a scum co-resident who would deliberately leave her to deal with all the workload, she was on the verge of quitting. Even going so far as searching for the template of a resignation letter.

And then in the middle of all that, there conveniently appears a Class A emergency (an abruptio placenta, no less! It is the premature separation of the placenta from the uterus, which means the baby has to be delivered immediately because it wouldn’t be able to receive its supply of oxygen and nutrients without the placenta!)

I understand Min-ha’s panic during that moment! She’s only a second year resident who probably hasn’t done a CS on her own. But this was an emergency, and the lives of both the baby and the mother depended on her! And I know it was a serious moment, but my reaction during that scene was:

“Wow, that baby’s too big for a 30-weeker! Where’s the vernix caseosa? They didn’t even follow the protocol for EINC! No drying? Where’s the stimulation? Pedia why are you so relaxed??? That’s a 30-weeker!!!!” HAHAHA

But on a more serious note, what Seok Hyeong said afterwards was true. I bet Min-ha would have resigned if they weren’t able to save the baby and the mother. I imagined the huge sigh of relief that probably happened afterwards in that OR. The indescribable feeling of gratefulness after knowing that actual lives were saved. And I know, personally, that it is enough to make someone stay and try again another day. The privilege of witnessing miracles, of being part of that miracle, is enough to forget about all those moments of wanting to walk away.

So we sound like a broken record: deciding to quit on a daily basis, and all the while staying anyway. So yeah, I did laugh out loud at the absurdity and accuracy when Jae-hak said,

“I sure can’t quit, I’m working the night shift today”

We find the most absurd reasons to not quit, and no matter how ridiculous they sound, these are the small things that help us get through. We’ll take them.

In between, we’ll take the slightest bit of rest we can get – like Min-ha trying to sleep on a table, covering herself with a blanket. It’s another laugh out loud scene if only because we’ve all done that. Sleep is sleep no matter how much your back ached afterwards. I guess.

But of course, I’m trying to learn how to take better care of myself now. I figured I won’t be of much use as a doctor if my own sickness prevents me from fulfilling my responsibilities. This realization is inspired by the scene when Ik-jun accidentally burned his hands. That’s a big deal because he is a surgeon!

As someone who does minor surgeries in our Community, I’ve also resolved to take better care of my hands. After finding out months ago that the simple sutures I do for patients presenting with minor lacerations cost at least Php 5,000 in private hospitals, I try my best to manage these cases as much as I can. I am thankful we were equipped with the necessary skills in our Surgery rotation. That also meant I’ve become more mindful with my actions because if I injure myself, especially my hands, that means I will have to refer cases I could have handled. Most of my patients in the Community wouldn’t be able to afford the cost of management!

So once again, this is a reminder to take care of yourself! Take a break, and remember that it’s okay to be selfish once in a while. You are human too, and that means you’re not invincible. Life without having to deal with a pandemic is hard in itself. We’re on some boss-level adventure, and you’ll have to be healthy in all aspects to survive!

I am grateful to be able to write, and to have the courage to share this with others. It’s always a challenge to me, but I’ll keep trying! Thank you for the kind words too! It really really means a lot to me 🙂 x