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YOUNG BLOOD

Critical care

By: Hazel Encarnado - @inquirerdotnet

04:10 AM September 17, 2019

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“I don’t think I will take your elective next year,” my groupmate rotating in TPDH-Surgery tells me on our
way home.

For the past week, we’ve exchanged stories about our experiences for the day. Her stories range from
horrific vehicular accidents to funny things people do that get themselves injured. My stories mainly
involve double codes, intubating patients, crying relatives and preparing death certificates.

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“I think if I were you, I would cry every day,” she continues.

I laugh out loud, and if I sound a bit hysterical in the end, I can’t really blame myself. “I do cry every day.
Like, inside.” But once, I did find myself in the bathroom, crying. I wasn’t as strong as she thought I was.

This conversation would replay in my head on my last day in TPDH-Med. It was the first time I didn’t have
to bring a death certificate for my consultant to sign. It was the first time no teary-eyed relative would
approach me asking where they could get a CF4.
But I remember the last patient I saw before I left. He was a 73-year-old male who came in for tremors
associated with falls and a month’s history of weight loss and anorexia. His CT scan showed an
intracranial mass. He was losing parts of his cognition, but every time I would pass by and ask him how
he was, he would give this wide toothless smile I found so endearing.

There was a small part of myself that was grateful that my rotation was over. He could get a stroke. It
could be a neurosurgical procedure they couldn’t afford. He could develop pneumonia, then an acute
respiratory failure, then instead of sitting gaily on his wheelchair, he would be GCS 3 (Glasgow Coma
Scale) hooked to a cardiac monitor and a mechanical ventilator,

surrounded by weary-eyed relatives.

Did I want to witness something like that for the nth time? Not really.

But critical care fascinates me. There is a certain happiness that comes when I watch my patients get
extubated and “downgraded” to the Medicine area. There’s an even greater satisfaction when I tell them
they can finally go home after several days of confinement.

When the opposite side of this spectrum occurs and the patient’s relatives look at me for comfort, there
is a bittersweet feeling in my heart. It moves me when they look for me to tell me what had happened
(since I’m not always on duty to see to every code). It moves me when they hold my hand, and in silence
I nod my sorry. It moves me when they find comfort in my words.

ADVERTISEMENT

I learned about the comfort in words from the consultants I made rounds with each day. During one
particular toxic day, there were three simultaneous codes. My consultant was commanding the code and
using the ambu bag while I performed the chest compressions. One nurse was administering the doses
of epinephrine. The other doctors and nurses in the ER were focusing on the two other codes.
On our side, the patient’s daughter was crying hysterically, telling her father to fight for his life. As the
fourth cycle of CPR commenced, she held his hand and begged him to stay a little longer.

The whole time, my consultant talked over the noise in the ER. He explained how what we were doing
should help the chances of a return of spontaneous circulation. Gently, he told her about the destiny of
human beings and the limitations of modern medicine — that at the end of the day, it’s “the guy
upstairs” who will decide when a man’s life will end.

He spoke to her with so much sincerity that when he finally called the time of death, the daughter
rushed to my consultant’s side and hugged him tightly, thanking him for what he did.

It was an irony I can imagine myself living in every day — that sometimes we can still heal people even
when the actual patient dies.

Maybe this means I’ll pursue that field someday. Maybe not. But either way, I learned a lot of valuable
lessons in that rotation.

Kindness isn’t something dictated by a patient’s socioeconomic status, or whether we’re working in a
public or a private hospital. Kindness is always a choice. No matter how toxic the duty days can get, good
people are still good people, and I hope we always choose to be an example of all the good we have
seen.

***

Hazel Encarnado, 22, is a junior intern from St. Luke’s Medical Center College of Medicine.
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View comments

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menusearch

COLUMNS

YOUNG BLOOD

Critical care

By: Hazel Encarnado - @inquirerdotnet

04:10 AM September 17, 2019

We're loading your content ...

“I don’t think I will take your elective next year,” my groupmate rotating in TPDH-Surgery tells me on our
way home.

For the past week, we’ve exchanged stories about our experiences for the day. Her stories range from
horrific vehicular accidents to funny things people do that get themselves injured. My stories mainly
involve double codes, intubating patients, crying relatives and preparing death certificates.

ADVERTISEMENT

“I think if I were you, I would cry every day,” she continues.

I laugh out loud, and if I sound a bit hysterical in the end, I can’t really blame myself. “I do cry every day.
Like, inside.” But once, I did find myself in the bathroom, crying. I wasn’t as strong as she thought I was.

This conversation would replay in my head on my last day in TPDH-Med. It was the first time I didn’t have
to bring a death certificate for my consultant to sign. It was the first time no teary-eyed relative would
approach me asking where they could get a CF4.

But I remember the last patient I saw before I left. He was a 73-year-old male who came in for tremors
associated with falls and a month’s history of weight loss and anorexia. His CT scan showed an
intracranial mass. He was losing parts of his cognition, but every time I would pass by and ask him how
he was, he would give this wide toothless smile I found so endearing.

There was a small part of myself that was grateful that my rotation was over. He could get a stroke. It
could be a neurosurgical procedure they couldn’t afford. He could develop pneumonia, then an acute
respiratory failure, then instead of sitting gaily on his wheelchair, he would be GCS 3 (Glasgow Coma
Scale) hooked to a cardiac monitor and a mechanical ventilator,

surrounded by weary-eyed relatives.

Did I want to witness something like that for the nth time? Not really.

But critical care fascinates me. There is a certain happiness that comes when I watch my patients get
extubated and “downgraded” to the Medicine area. There’s an even greater satisfaction when I tell them
they can finally go home after several days of confinement.

When the opposite side of this spectrum occurs and the patient’s relatives look at me for comfort, there
is a bittersweet feeling in my heart. It moves me when they look for me to tell me what had happened
(since I’m not always on duty to see to every code). It moves me when they hold my hand, and in silence
I nod my sorry. It moves me when they find comfort in my words.

ADVERTISEMENT

I learned about the comfort in words from the consultants I made rounds with each day. During one
particular toxic day, there were three simultaneous codes. My consultant was commanding the code and
using the ambu bag while I performed the chest compressions. One nurse was administering the doses
of epinephrine. The other doctors and nurses in the ER were focusing on the two other codes.

On our side, the patient’s daughter was crying hysterically, telling her father to fight for his life. As the
fourth cycle of CPR commenced, she held his hand and begged him to stay a little longer.

The whole time, my consultant talked over the noise in the ER. He explained how what we were doing
should help the chances of a return of spontaneous circulation. Gently, he told her about the destiny of
human beings and the limitations of modern medicine — that at the end of the day, it’s “the guy
upstairs” who will decide when a man’s life will end.
He spoke to her with so much sincerity that when he finally called the time of death, the daughter
rushed to my consultant’s side and hugged him tightly, thanking him for what he did.

It was an irony I can imagine myself living in every day — that sometimes we can still heal people even
when the actual patient dies.

Maybe this means I’ll pursue that field someday. Maybe not. But either way, I learned a lot of valuable
lessons in that rotation.

Kindness isn’t something dictated by a patient’s socioeconomic status, or whether we’re working in a
public or a private hospital. Kindness is always a choice. No matter how toxic the duty days can get, good
people are still good people, and I hope we always choose to be an example of all the good we have
seen.

***

Hazel Encarnado, 22, is a junior intern from St. Luke’s Medical Center College of Medicine.

READ NEXT

Lacson: Senate probe about drugs and corruption, not De Lima

01:26Albayalde Lukewarm On SOGIE Bill: Bald Folks Need Protection Vs Discrimination, Too02:12Dela
Rosa: Probe On Missing Minors Not Meant To Harass Duterte Admin Critics01:00Russia's Floating
Nuclear Plant Sails To Destination01:57Philippine Military’s Joint Forces Train To Retake Island01:22DOJ
Prefers No Arrest Of GCTA-Freed Inmates While Review Is Pending01:18Why Some Freed Inmates Prefer
To Stay In Jail03:27DOJ: 2,009 GCTA-Freed Prisoners Have Surrendered02:13Pagasa Weather Update As
Of 5 P.M. Of Sept. 2001:42Duque: PH May Lose Polio-Free Certificate

LATEST STORIES

Garcia stands firm on banning Luzon pork products in Cebu

Seniors in Japan flock to gyms as govt seeks to curb medical costs

WATCH: Paul Rudd sees double in ‘Living with Yourself’ trailer

Danielle Collins fights back to beat Venus Williams at Wuhan Open

MOST READ

Philippines overcomes Vietnam in 5 sets in Asean Grand Prix

Man drowns after underwater marriage proposal to girlfriend

Samar teen’s family turns tragedy into gift of sight

Countries backing Iceland resolution never gave PH anything worthwhile—Locsin

Don't miss out on the latest news and information.

View comments

Subscribe to INQUIRER PLUS to get access to The Philippine Daily Inquirer & other 70+ titles, share up to
5 gadgets, listen to the news, download as early as 4am & share articles on social media. Call 896 6000.

RECOMMENDED

People's Republic of China's 70th anniversary demands honest reflectionSponsored

People's Republic of China's 70th anniversary demands honest reflection

Nikkei Asian Review

Cheap Powerful Smartphone Is On Sale In PhilippinesSponsored

Cheap Powerful Smartphone Is On Sale In Philippines

Next Tech

TAGS: critical care, Hazel Encarnado, Young Blood

For feedback, complaints, or inquiries, contact us.

FROM AROUND THE WEB

GMA 7 celebs dominate ‘beauty contest of choice for show biz denizens’

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Milan Fashion: J-Lo struts updated jungle dress at Versace

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Behind the scenes of ‘The New Pope’

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It’s still paradise in Coron, despite the rains

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Recommended by

Disclaimer: Comments do not represent the views of INQUIRER.net. We reserve the right to exclude
comments which are inconsistent with our editorial standards. FULL DISCLAIMER

THE INQUIRER CHANNELS

NewsSportsEntertainmentLifestyleTechnologyBusinessOpinionGlobal Nation

SERVICES

MobileRSSEmail UsArchiveContact UsNews LetterJob Openings

THE INQUIRER COMPANY

About INQUIRER.netAbout the INQUIRERUser AgreementLink PolicyPrivacy PolicyArticle Index

PARTNERS

LibreHinge InquirerBanderaCebu Daily NewsDZIQ990 AMMotion Cars

© Copyright 1997-2019 INQUIRER.net | All Rights Reserved

Read more: https://opinion.inquirer.net/124014/critical-care#ixzz61x3vi7aJ

Follow us: @inquirerdotnet on Twitter | inquirerdotnet on Facebook