Sunday, May 12, 2013

Out-of-town

THE SLEEP-DEPRIVED neurosurgery resident instructed me to accompany a 60-year-old patient to the Philippine Heart Center for a CT angiogram, which our hospital cannot do, as it does not have the necessary equipment. Heart Center is in Quezon City, about 40 minutes away from PGH, and very near my brother's apartment.

Because it was my first out-of-PGH patient conduction, I had no idea what to expect. Inside the ambulance I studied the patient's history, just in case I'd get asked. I didn't want to embarrass my home institution by displaying my ignorance to the world. The patient had an aneurysm in the brain; unless surgical intervention was done, the vessel could burst any minute, possibly causing irreparable neurologic and mental function, even demise.

The ride was smooth and fast, but I was praying that nothing untoward would happen to the patient: no seizures, decreases in sensorium, or rebleeds. I had read about them, but I had no first-hand experience of managing those situations alone.

I dragged my new blockmate Charlie to come with me. He studied medicine in Davao and was just as excited as I was. He had no surgeries to attend to, and he wanted to explore Metro Manila. Imagine his disappointment when he realized the ambulance had no windows—so much for sight-seeing. He resorted to checking the GPS on his phone, tracking the route we were taking in real-time. I liked his calm.

That patient's daughter sat beside me and asked what an aneurysm was.

"An aneurysm?" I said, "It probably looks like this." I took out the sinegwelas, the "professional fee" a patient gave Migz, one of our blockmates, that morning. Charlie stifled his laughter. I went on with my mini-lecture, the contents of which I had learned from our case discussion with Dr. Rivera the day before. She thanked me profusely. So it is true, after all: patients like it when doctors help them understand the disease they're dealing with.

When we got to the Heart Center the hospital staff there thought I was a real, licensed physician—white coat and all. It felt weird. Orderlies were pushing the stretcher bed, and nurses were monitoring the vital signs for me.

The CT angiogram, a fairly quick procedure, went by quickly. The radiology resident was kind enough to invite us to see the console. He explained his findings to us.

Before we knew it we were on our way back to PGH. The patient's relatives were so thankful they asked me if we could have a stop-over.

"Bakit po?" I asked.

"Kain po muna tayo."

"Ano?! May pasyente tayong kasama, tapos magsa-Starbucks tayo?"

I liked them instantly.

Over all the trip was uneventful, which was just as well—for the patient and myself. Never mind the fact that Charlie and I were at the brink of vomiting—there were no windows, and our vestibular systems were acting up.

And no, just in case you're wondering, we didn't take the offer to have coffee.

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