On the first duty night, I was monitoring the patients in the floors. One patient was a post-op patient and her fluid output was what we were focusing on. It was consistently becoming low. Sometime after midnight, our residents gave us the go signal to do a fast drip on her, giving her adequate urine output for an hour. However, 2 hours later, she again had a low output. Our resident told us to monitor for another hour.

An hour later, we were horrified to find that her urine bag was full and that her fluids were on fast drip! None of our group mates did the fast drip, especially since we were instructed not to. There was no order in the charts so the nurses never did it. The patient and her husband said it was one of us (medical students) who did it – a tall mestizo medical student dude with colds. Not one medical clerk on duty that night fit that description. We just dismissed the incident, just thankful that nothing bad came out of it. The patient was fine. We were even kidding around that we should’ve passed a message to that mystery student to take the vital signs and note the urine output next time.

Three nights later, on our next duty night, Chris and I were the ones left in the ward that evening. Chris was doing labor watch and I was again doing the monitoring of our patients. Chris volunteered to monitor the other patient in the same ward (whom we shall call Lauren) and take her urine output since he was in the same room anyway. I was grateful, hence, I told him I’d still check up on him.

A few hours later, I went back down to check up on the patient and on Chris. I noticed there was no monitoring of Lauren’s urine output for 2 hours. We might get questioned on this. I asked Chris about it. He was uneasy telling me that for 2 consecutive hours, Lauren and her husband told him that a tall mestizo medical student dude drained the urine output. Oh, and he had colds. He wasn’t sure how to react, but just remained calm and proceeded to take her vital signs. Lauren said that the same guy already took it and told her that her BP was 110/70. Chris did it, nonetheless; it was indeed 110/70.

Interesting.

Again, 3 nights later, on our next duty night, the same tall mestizo medical student dude with colds took vital signs and output for a new patient.

It would’ve been really better had he been recording what he was monitoring.

The most interesting here was that all 3 patients he monitored on 3 different nights occupied the same bed.

Last night, a mother delivered a pre-term baby. He was only 6 months in her womb. He was mostly developed, except that the eye slits still could not be opened. He was limp and blue. And he only had 2 hours of life before he passed on.

The mother knew this before she even delivered, but had to go through with it with the hope that she could save that tiny child. It took (a lot) of courage and she was blessed with that life, even if it were only for 2 short hours.

I, thus, re-learned something today: that at 23-24 weeks AOG (about 6 months), the eyelids could not open yet.

Oh yeah, and that a person’s a person no matter how small.

Image from Anne Geddes which I got here.

“C.S. stands for civil status. That means it’s asking whether you are single, married, a widower, etc.”
He smiled. Then he looked pensive. So I told him, “Just put ‘single’ there.”
He had this knowing smile again.
“You mean you’re already married?”
He was blushing when he replied:
“No. ‘In a relationship.’”

Duty night, Dec 31, 2008. This was not my first time to go on duty on a New Year’s eve – it’s actually my 4th.

I knew from way before medical school that New Year’s eve in the Philippines equates to a toxic E.R. where the interns would be stitching injuries and residents would be saving a life in the O.R. However, in the 4 times that I have been on duty on a New Year’s eve, I have yet to experience this.

How was that possible?

My 1st was during clerkship (which was 4th year medical school). I celebrated it with clerks from different medical schools in that happy happy place called The National Center for Mental Health. We theorized that there will be an influx of the crazies on New Year’s eve, and we were correct. Even the Acute Care Unit was teeming with patients persistent on having their BP’s checked and looking for someone to listen to their delusions. Heck, some of them were already talking with their imaginary friends. However, them psychotic cases know when to stop because by 11pm, the clerks were fixing our round table with our feast whilst facing the skies where we were anticipating the fireworks display from The Fort (we guess).

Verdict: No injuries. Just the crazies and fireworks, ergo, a normal New Year’s.

The 2nd time I went on duty was during my Internship. I was rotating in OB-Gyne then. Obviously not expecting the amputated fingers, the gun shot wounds, and the vehicular accidents. Hours before midnight, the interns had an ongoing water pistol fight, and every time you came across a co-intern, you just might get wet. By midnight, all the residents and interns on duty went to the rooftop jumping, shouting, dancing, and watching the fireworks. And sometime in the middle of this, I know there were some tequila shots… but what I was sure of was that I wasn’t drunk.

Verdict: Nada, not even a pregnant woman in labor.

My 3rd duty was during my stint as a surgical resident. Now this was where I dreaded the anticipation. However, by midnight, we were feasting in the office and the whole surgical team went floor to floor doing the traditional kissing rounds. I know I spent the early morning in the O.R. but it wasn’t for a pyrotechnic-related injury. I think it was a ruptured appendix.

Verdict: Not even while being the front liner for the injured!!

The latest was a couple of days ago. I manned the E.R. from 12mn of Dec 30 till 12mn of the 31st. After which, I manned the floors. By midnight, the hospital staff was outside watching the fireworks display in this little town I was in. There was food on the table just outside the E.R.

Verdict: Oh there were patients, alright – 3 cases of indigestion, and that was it.

I guess life in the hospital is a paradox – you’ll get it when you don’t want it, and won’t get it when you’re asking for it.

Back during that New Year’s eve duty when I was an OB intern, I recall we were watching the news and the female news reporter was eagerly awaiting the inpouring of carnage in a certain government hospital in Manila. In the background, the hospital staff was considerably carefree and you see the occasional young doctor either making faces, or shadowing the reporter. Apparently, not much was going on. Ironically, the reporter’s tone was aggressive and panicky. The moment she identified a patient, she immediately ran to his side. Here she could get the gory bit she was craving for, even more entertaining was the fact that the patient was about 10 years old.

The reporter asked what the kid was in for.

“Dog bite.”

She disregarded the kid, as though she never saw him in the first place. She proceeded to another kid seated not far from the first kid. Ah, this was a 15 year old! Someone more reckless. Someone who would show off. Someone who had easier access to fireworks than a 10-year-old. Someone whom she was probably waiting for. You can feel it in her voice.

Again, she asked what this new kid was in for.

“Dog bite.”

In that instant, the reporter cut back to studios.

And the rest of us was rolling on the floor laughing!