Saturday, June 16, 2012

Stories from Internship Part 03: On Pockets of Kindness in This Dismal Place (Or Why I Loved My PGH Experience)


It's no secret that a hospital isn't the best place to be at anytime, maybe except when you have this life-threatening condition that needs immediate remedy.  It's teeming with all sorts of drug-resistant germs (be prepared to get at least one MRSA infection during your tour of duty or rotation despite the best efforts on hygiene and sanitation), it smells awful (hello ACU when there are three diabetic foot patients crowding around the table, the smell of blood mixed with alcohol, the macromolecules of sweat hanging in the air, and the smell of unwashed bodies crammed together inside a room designed for 20 patients), it's dark (guess how much the power bill is), it's maddening (ever been to the ICU where machines beep and whoosh and hum 24/7 to the point that even you, a doctor has this perpetual sort of tinnitus or auditory hallucination of the soundtrack of the ICU invading your not so sweet dreams?), it's depressing (not enough to go around and patients sometimes die in the most desperate of circumstances), and people eventually get on each other's nerves because of the exhaustion and stress.  There are so many more negative things or experiences that a hospital brings to the point that it seems like this huge dump of negativity.  No wonder health workers seem to be fixated on getting out of the place at any given time.

On the very first day of internship, I was ready to throw in the towel.  Why would I make the rest of my 366 days of internship miserable in what seemed to be a special circle of hell?  Among the things that made me stick it out in what turned to be the greatest place to intern were those little pockets of kindess that were found in and around the hospital.

Being blessed with great co-interns, and residents was one thing.  For starters, I loved that my blockmates would look out for each other, help each other out in the hospital and outside, keep our spirits up, and just work together as a good team.  Sama sama sa hirap at ginhawa, sa pag-gastos at pagtitipid, sa kalungkutan at saya.  Joy, Gina, Nikki, Richelle, Alex, Jeleen, Mickey, and Patty are the best blockmates ever. No contest yan.  Other co-interns also made the work lighter because we would also share in the workload, swap funny stories about our rotations and experiences, and generally likewise cheered each other on.  Residents are another special bunch of people worth mentioning - I could safely say that 99.9% of the residents I encountered were the good kind.  I'm thankful that there was no additional drama or emotional abuse that I encountered during my internship year.  Pagod lang kung pagod pero di ka iiyak or paiiyakin for no good reason.  I felt that they understood how it was to be among the people who had to do the scut work for such a large number of patients.  They treated us as part of the team, not lackeys or people they could bully because they were bullied/scolded by fellows or consultants.  What I admire more is that the residents had tremendous workloads but managed to teach us practical stuff, look out for our welfare, treat us to food when they felt like it, or join us in celebrating on post-duty or pre-duty days.  

I'm also thankful for the nurses, NAs, manongs, social workers and guards whom I encountered on a regular basis in the hospital.  Sure, some of the hospitals' paramedicals were really cranky or sometimes outright rude, I encountered the ones who were kinder and professional.  There were nurses who would offer me coffee and pancit ("Sige na doktora intern, di ka naman matotoxic kapag lahat tayo kumain nito") during the long lonely hours in the cancer institute, those who would help me scrounge around for the much needed IV-cannulas or syringes during codes or true emergency situations, those who would treat me to an occasional stick of ice cream or halo-halo in the sweltering ER, the ones who would hold down the fort while I ran for food or a quick hygiene break, those who would keep me awake while assisting in long ORs either by asking a million questions about the love lives of my colleagues or relating what happened to what soap opera the night before, those who would offer to serve gloves in the OR or volunteer to cover the strands of my unruly hair that managed to escape my gap before the attending noticed, those who would give me the 411 on certain patients whom I just inherited for a night or for a service when I had no clue what to do or where to start, those who would offer an extra hanger in the OR changing rooms so that my coat wouldn't get creased, those who allowed me to shop for extra supplies for the truly indigent patients, and those who would still smile and joke around with me even if patients were toxic that night.  There were the NAs who would gladly give out balls of cotton, packets of gauze, or whatever I needed for a procedure in the ward or the ER.  There were lab techs I could ask for results that weren't printed yet because my seniors needed the values stat. There were the manongs who would offer to help me conduct the patients to wherever, especially when they noted a discrepancy between my build and that of the patient(s) I was to push through the corridors or load into the creaky elevators.  There were the elevator operators who would joke, "Ma'am saan kayo? Cashier, lab, NICU, ABG?" while I was on 'manong' duty.  There were the social workers I could always count on for extra food rations for the bantay, waiving of fees, procuring medications, or helping locate relatives of certain patients.  There were guards who would always greet me kindly, no matter how haggard or polished I appeared, or those who would protect me from the combative and rude patients or relatives at the ER.

Another was getting to experience taking care of kind patients and encountering even kinder bantays.  Sure, I was probably among the most toxic interns to walk the halls in the past year, but I got patients whose niceness made up for the workload and for the rudeness of 90% of my other patients.  There was this family whose patient expired due to cancer, but never kept on forgetting to text me to take care of myself because they knew I had asthma.  There was this woman who kept thanking me and promising to pray for my exams because I called a priest to bless her dying husband's body.  There was this young man who kept on updating me about the progress of his dad's treatments and how his dad finally overcame the fear of needles after I struggled with multiple blood extractions when he was under my care.  There was this woman from the MICU who would seek me out in whatever rotation I had to update me about how her heart was getting better.  There was the bantay in the medicine ward who had given birth a mere few weeks prior and had leaking breasts and asked me if she could donate her milk to the babies in the pediatric ward, to the gratitude of three mothers whose breasts produced very little.  There was the bantay who would tell me that this certain patient's parents fell asleep again and that the kid looked very ill.  There was the lola who kept needling another bantay to go to PCSO and get the necessary funds for a scan that the somewhat negligent bantay's patient needed.  There was the woman who kept insisting that she wanted to pay for the "consult" at the triage area.  There was the young man who kept thanking the triage officer for suggesting an OPD consult, even if it meant huddling in the cold air for another 8 hours.  There was the newly married woman who left a pack of cookies because I attended to her abnormal bleeding and got her up to the ultrasound area.  There was this cervical cancer patient who never failed to tell me that she wanted me to marry a good man.  There was a lady who accompanied a complete stranger to the Ambu because she noticed that the stranger was thisclose to a massive attack of asthma.  There were the random bantays who would help us load (onto stretchers) or unload (from whatever vehicle) the heavy, unconscious, bloody, smelly, drunk, MVA patients who found their way to the ER at 3:45 AM.  There was the old man who surprisingly was able to put a combative patient on a choke hold when he noticed the patient trying to attack other patients.  There was the patient who was offering a towel to wrap around my skirt when I bled out (long story) in the Fam Med OPD. There was the ortho patient who left a banana to "keep my energy up" during a ward duty.  There was the patient who kept on hugging me every chance she got, psychotic episode and otherwise.  There was the post-op patient who told me I needed to sleep more because my eyebags invaded half of my cheeks that fateful day in PACU.

Moving away from the kindness I received, I observed still that people around the hospital benefitted from the kindness of strangers and colleagues all the time.  Despite the overwhelming feeling of helplessness most often than not, we would find ways to give the care that was needed by the patients.  I think there is this certain beauty in the despair and poverty (but I'm not one for romanticizing it) of PGH in general.  While one may be rubbed raw (hopefully not to the point of just deciding not to care) by the challenging work environment, it is in the toughest of times that one learns to appreciate the people/things/events that are so easy to overlook yet so beautiful in their simplicity.  While there is a shortage of funds, equipment, supplies, manpower, food, and sleep, the inherent kindness of people keeps the hospital going.