The Code Blue

"Everything was fine until few hours after,
 patient bled inside her head."

I ended up my rotation in the ICU with a Code Blue--a patient arrested.

The night prior, patient A succumbed into a cerebral infarct. As what doctors usually do, they provide antithrombolytics and all. Patient stabilized for a while. Vitals were normal. There were no signs of respiratory distress. Everything was fine until few hours after, patient bled inside her head. From this point forward, everything went in a down slope pattern.

Patient was ordered a stat craniotomy to drain the hemorrhage. In total, patient was under the knife for about 5 hours.

There was a call from the OR that patient A is desaturating and that she'd be transferred to the ICU for stabilization. Patient was brought to the ICU by the surgical team. At first, i thought everything was okay until one of them shouted: "We're on code blue"

"Patient went asystole for 6 minutes"

That was the first time that i'd really felt a patient's soul trying to leap out of its body. Asystole. Everything was being done to her but to no eventful results. Arterial and venous lines were added, blood transfusions were given stat. A central line was placed. Boluses of epinephrine, bicarb, and atropine were given. Cardiac resuscitation was being done simultaneously until a pulse of showed up. Patient went under arrest for over 6 minutes. That, i must say is long. That, according to studies is tantamount to brain damage.

The patient survived; however, stepping back, I would say the life of the patient may have only been prolonged for just days. I hope she lives longer. I hope she can fight-off her illness. I hope that one day, she'd be able to function again. And I hope, that after all these things, I'd never see her again in my entire practice.

Death is just around the corners of the ICU or should I say around us. We can never know when a patient or when we will expire; what we only know is that living is a slow process of meeting our end, inevitable  goal-- death.

The Intensive Care Unit

I'm currently rotating as a junior intern at the ICU. Being a junior intern is no joke. As they say, this year would be the worst year of my medical-student-life and this is just the second week of my rotations. It is difficult, i tell you. Not only does lack of sleep  pushes you to your limits; the agonizing emotional and psychological aspects does, too, contribute to the difficulty of being a junior intern.

Let me tell you what the routine is in the ICU. Everyday (morning and afternoon), we do rounds on all our patients. We have at least 15-20 patients a day. The team of doctors includes two consultants, three fellows, 5-6 residents (neuro, cardio, infectious, et. al.), 1 senior and 4 junior interns. The team discusses the cases one by one- from one room to another. It is like doing window shopping; however, a lot more intimate and requires more of intelligence. We discuss the cases in front of the patient; however, they can'thear us because the person of interest  is separated by the glass panel from us (and yes, i think they are sound protected). Here, we try to predict the future of the patient- will he live or die. Questions are always raised by the consultant. Usually, all these questions are addressed to the junior interns. Which makes the lives of junior interns toxic.

The junior interns are what they call the lowest breed of doctors and as of now, i am part of this. We are the ones who usually get challenged and ridiculed. We are the ones who, literally, do not have anything to offer. We are the "slaves" of the team. This may sound devastating and saddening; however, this has been how the system has been going since time immemorial. I myself, have already been humiliated in front of the team. But oh well. Our curriculum tries to defy this; however, it can only do as much, as of now.

I call their ICU team as the Team of Extraordinary Brain Cells. For heaven's sake, the team consists of intelligent, highly reasonable, objective, and very competent doctors. They can throw multitudes of differential diagnoses and can defend such in just few seconds. I am amazed how these doctors were trained. I was owe-struck on my first day of rotation on how they are able to memorize all lab values of their patients down to the last decimal. Believe me, they are really that good. Here i saw the pseudogods they are telling. Downside, what I personally think is, they purposely detached themselves from the souls of their patients.

Tomorrow would be the last day of my rotation there. I'm not sure if i'm gonna miss the team, the pride, the angst, or not. I'm not sure if i'd like to go back there. I really don't. I'm happy about the rotation; however, i think, i was caught in between intimidation and self-preservation.

     

Medesina

Going into medical school isn't just a "one-night-stand" decision. It must involve a thorough investigation of one's own strengths, weaknesses, passions, and desires. It is a lifelong process of rediscovering one'self and being open minded to all things in life. Once you enter med school, you willingly embraced a lot of heartaches, disappointments, and sacrifices. Once you finish med school, you opened gates for a lifelong journey with science, religion, and human epitome.

Insensitive

It's plainly BS that you still talk to my relatives and closest friends while you continuously hurt me.

Happy 6th Anniversary

Today, I lost everything that I had. It could have been easier that I’ve lost all my material possessions in life than me losing this—the person who gives me life.

Today is our anniversary, our 6^th anniversary. I was studying in my unit. I told her that I won’t make things possible for this day because I need to cram for tomorrow’s exam. Well, she surprised me.

I heard a knock on my door. First, I ignored it. The second time I heard the knocking, I stood up. I looked into the pin hole and saw no one. I opened the door and there, I found her.  She brought dinner for me.

Yes, I was surprised that she was there but I’m the bastard who doesn’t appreciate surprises. She brought dinner for the both of us. She had a liter of coke on her left hand and a yellow cab pizza with a brown bag on the other hand. She entered the room. I did nothing.

I kissed her. She kissed back. She was still the same—same sweet perfume, those beautiful eyes.  She walked inside. I took the seat of my table. She sat on my bed. I did nothing.

I opened the last three pages of one of my readings. I studied without acknowledging her being there. She stood up, said something like: “it’s hot”. I smiled at her then returned my glance to what I was reading.

She walked near the balcony of my windows. I glanced at her. She pulled her black straight hair up. She was searching for a breeze of air. There was none. I ignored her.

As I finished what I was reading, I called her. “Baby!” I screamed. There was no response. She was still looking outside my opened window. I called her twice, no answer. I stood up, came closer to her and asked: What’s the matter? “Nothing”--a soft wimping sound broke. I took a look at her. She was crying.

I’m no good when I see people cry. She knows this. So I sat down, back to my table. I tried to do something. I panicked.  I got my stash of cigarettes, went to the bathroom, turned on the ventilator, turned on the faucets and the shower. I stayed there for about 15 minutes. I lit a cigarette as I calmly hear the rustling of the flowing water.

I went out. I asked her, now sitting on my bed, “What’s the matter?” She replied in a soft tone: “I wasn’t expecting that kind of reaction from you” I frowned and felt a lot more uneasy.

I took a sit. I tried to mutter a word but nothing came out. “I just want to surprise you” she said. Still, no words came out from me. She stood up. She grabbed her bag, pulled a book and left the book right in front of my nose—The 48 Laws of Power, my favorite book. She left.

Now, I’m fucking angry at myself. I hate the whole of me. I hate myself. I don’t want to be this kind of person anymore. L

Sembreak's Over

I wanted to stay with my family... but then again, goodbyes must be made. This has been my pattern and this will always be the cycle of my life. This is fucking terrible.

I think I have an anxiety problem-- separation anxiety. I feel down right now. I feel sick. Post a differential-- somatization.

Oh well, life must go on. I have to be strong. I have to live strong. Mantra repetition: I will make this, I will live this, I love this.

Power Play

There are a lot of times when you feel that you are not doing anything. Doing nothing as if everything just goes like you just wished it to go your way. But no, sometimes, you unconsciously pushed the button and entered the game of: "power play."

I just realized that I do some kind of power tripping/ playing in my life. I never thought that I actually do this. Things in life, as they come naturally, may be accounted for the fact that they just occur. Sometimes, we really just have the power to play the cards of life.

I haven't thought of stuff like getting someone into trouble and eventually, you would end up benefiting. Yes, I cannot vividly recall any of these things happening. Things just fall into pieces because of the "animal instincts" that we have. These are just... inevitable.

Power play is a skill, an art. It is something that everyone must have to learn in order to survive this weird world. I say, this game is purely exciting. It is funny.

You ask so many questions. :|

Blame Yourself

I have repeatedly acknowledged the fact that one cannot blame others because of the injustices done to him or her. It is just selfish.

You know what, I lied to you because I know that one day, you'll blame all things to other people. I don't want this to happen. But here you go, asking me, begging me to tell the truth. There, I told you the truth.

Months have passed and you still can't get over what I've told you. You do not blame me because I know you love me but you blame the person who did nothing wrong to you. She doesn't even know that you're angry at her or you're bitter of her. Here's the thing, I was the one who committed the error. Ergo, I'm the one to be blamed.

With these, I'd rather continue lying than telling the truth. Why? Cause, it isn't helping you.

If you were to blame me, I'd accept it. I'd try to understand and absorb all the sufferings these events have brought you because I'm the one who fell off the covenant that we've made. I'd ironically say sorry to you. Yes, I said sorry to you.

I'm not mad. I understand how you feel; but, are you not mature enough to still think this way? I mean, you are too intelligent to think this way. You even broadcast stuff to the world. How can this be fair to me or her?

I ask you: "what's wrong?" You say: "there's none." How can this be? Girls have this default answer of THERE'S NOTHING when in fact THERE IS SOMETHING!

You always think that you're the protagonist of life when in fact, you're just a speck of this world. It isn't bad to think that you can rule the world; but, it is docile to think otherwise. You are not alone. You can hurt others. You can hurt even the person whom you love because of what you are doing.

One can be angry, I must agree. But prolonging such anger makes you a lot weaker and a lot vulnerable. You appeal to pitty, you appeal to what's right. You seek agreement, you seek fairness. You seek comfort to relieve your pains. These are but human nature; HOWEVER, these are not reasons why you can consciously hurt others and be selfish and insensitive to them.

Blame yourself when it's due your cost. Blame yourself when you feel that there's no one to blame. Blame yourself for not understanding the whole picture. Blame yourself when you view the world as an idealistic map where you can play your cards along. Blame reality for it doesn't conive with you. Blame your expectations. Blame your dreams. tsssssssssssss.

Inevitable

Some things are better left ignored.

There are moments where things go beyond the capacity of logical thinking and emotional balance--Events where we are left with life enveloped by harsh reality where one cannot do anything but to wait in suffering and resentment.

Gaia's bitterness aims to balance our ambiguous paroxysms of electrical charges within our body. There are things better left ignored. There are things better left static. There are things only the core of the earth can manage.

This bothers.