Friday, June 15, 2012

Sharp shooter

"I hate blood extraction," says Lennie as she enters the cramped Surgery call room where we all await the dreaded phone call from the OR. "I'm not a sharp shooter. I don't know how some people do it so effortlessly."

On her face are beads of sweat—her post-procedural facies, I call it, because she looks wet whenever she does something stressful in the wards. She tells me her patient had huge, superficial veins which, after a couple of attempts, were useless, forcing her to use the other edematous arm whose veins were hardly visible. She was successful on that last attempt—one of life's many ironies.

"In my case . . . I guess I'm getting the hang of it," I say, explaining to her that the more I convince myself that I won't get it the first time, the more I feel confident that I will. "But inserting IV lines is still a big hurdle for me."

As clerks rotating in the Surgery Department, we're expected to monitor ward patients, assist in long surgeries at the O.R., write clinical abstracts and discharge summaries, rush to far-flung departments for referrals, and do procedures.

Those procedures generally require: 1) that the patient is hurt physically or temporarily put in a state of discomfort, 2) that there is involvement of blood, urine, or other infectious bodily fluids, and 3) that one is expected to get better with practice (the corollary statement being that when one does not practice, one does not get better).

Aside from my summer rotation at Bethel Baptist Hospital, I haven't had much practice with bedside procedures. The interns who come to our rescue assure us it's going to be okay, we will get better with time. I love how encouraging they all sound, especially when I listen to their own personal struggles with failure, but looking at their skill—how they hit the veins as easily as pressing the keyboard, for instance—and comparing it with mine make me doubt that I could be as good as them.

To seasoned physicians, doing those procedures may be trivial, brainless even, but for neophytes like us, it can be quite a challenge.

I'm just hours away from leaving the hospital to catch up on sleep when I spot a tray full of syringes and vials on the nurses' station. I volunteer to extract 3 cc of blood from a patient I haven't seen before. I drag my classmate Franco to help me out.

"Kukunan na naman ba ako ng dugo?" the woman in bed 34 asks me.

"Kayo po ba si Constancia1?" I ask, my voice a notch deeper than usual, hoping to establish some form of authority. To this day people still mistake me for a kid playing make-believe.

"Ako nga 'yun," says the 70-something lady, diagnosed with rectal cancer, wearing a red, floral daster. Beside her is her 64-year old sister, urging her not to be too whiny.

She interrupts me as I explain to her what I'm going to do, "Siguraduhin mong one shot lang, ha?" How she reminds me of my grandmother!

"Di ko po masisigurado 'yan. Na-chemo na ho kayo kaya marupok na ang ugat ninyo. Pero gagawin ko po ang best ko."

"'Yung dumaan dito, 'yung payat na kalbo, mas matangkad lang sa 'yo . . . isang turok lang naman siya. Heto nga o, hindi nangitim." She points to her right arm fold, some parts of it covered with a cotton and micropore strip.

From my small pouch bag, I take out a blue tourniquet, rinse my hands with alcohol, and prepare the syringe, cotton, and vial. I ask Franco to extract the blood.

"Ang laki naman niyan!" She points to the syringe. "Bakit 'yung kanina maliit lang?"

After Franco's two failed attempts, I volunteer to do it. Her veins are hardly visible. I palpate for a straight vessel, tap on her arm fold, until I feel a small area that collapses with pressure. "This is it," I thought.

"Hinga po nang malalim," I instruct her as I push the needle inside. No blood flow. With the needle inside her flesh, I fish for the vein, not minding her aray, blocking any thoughts of her being in pain.

I fail after a couple of tries.

I know she won't stop complaining, so I humor her, taking her mind off the fact that she is in the hospital. I ask her about her family, how many kids she has, what food she likes to cook, to which she replies, "Pinakbet."

"Ay paborito ko po 'yun."

"Masarap ako magluto niyan—Ilokano kasi ako."

She warms up to me eventually. Any sign of her irritability has disappeared.

"Alam mo, kamukha mo si Aiza Seguerra. Carbon copy talaga," she says.

"Marami na pong pasyente ang nagsabi niyan," I reply, amused. She is perhaps the fourth—or is she the fifth?—random person who told me that, including my friend's aunt who wrote the same comment when she saw my picture in Facebook.

"Ang pagkakaiba lang, ikaw may lawit."

We howl in laughter.

I spot another classmate walking towards us, and I ask him if he can do the blood extraction instead. He picks a huge vein from the patient's wrist and hits it on the spot. Whoever said sharp shooters are made and not born must be mistaken.

I thank my classmate, rush back to the ward station, and accomplish the lab request forms. As I look back at bed 34, I see the old woman waving at me. On her lips I can make out the words, "Doctor Aiza."

1Patient's name and other details were changed to protect privacy and ensure confidentiality.

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Anonymous Anonymous said...

I can tolerate it when it's my own blood which is being extracted but when it comes to my baby with several failed attempts? - the killer maternal instincts starts to kick in..

Fri Jun 15, 08:41:00 PM GMT+8  
Blogger Lance said...

Which is why it's harder to have pediatric patients in the wards—their veins are smaller, and you will have parents to contend with. Hehe.

Fri Jun 15, 08:44:00 PM GMT+8  
Blogger Schubert said...

aiza! ;)

Sun Jun 17, 04:58:00 PM GMT+8  
Blogger Lance said...


Mon Jun 18, 05:32:00 AM GMT+8  

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