The Chinitos Files

These are the Chinitos Files, named after the infamous gimik place in Canelar Airport area. Where unavailable men bring their current flavors of the month. Where indecent proposals are born. Where good doctors become half-assed versions of themselves. Where frustrations with current "special friends" are forgotten. Where ZCMC residents become IWs.

Read on if you dare...


Lame Excuses To Tell Your Friends During Inuman When the BF/GF is Telling You to Come Na... Now.. Or Else


The gf/bf is horny. He/She is texting you incredibly steamy messages. But you're caught in a late night inuman session with your friends who know you inside out and will never let you out of your sight. So what do you do?

Here are a list of lame excuses you can tell your friends. Match the following excuses with the people most likely to say them (Jay-ar, Elgie, Doc Bastero, Choie, Van-van, Jackie, Janet, Mae):

1. "Paload lang ako."

2. "Di pa dumadating yung load. Sabihan ko lang yung may-ari ng loading station."

3. "Pa-gas up lang ako."

4. "Bili lang ako ng cheesebread."

5. "Bili lang ako ng yosi."

6. "Bili lang ako ng Snow Bear."

7. "Susuka lang ako sa labas."

8. "Gusto ko ng kwek-kwek."

9. "Hanap na ako ni Uncle."

10. "Hatid ko lang si Jackie."


The Medical Representative


He comes in, dressed in his striped brown and white 3/4th sleeved polo shirt and black slacks. He smelled great, looked great and he knew it. Surrounded by his friends, casual in their jeans and shirts, he looked like THE MAN.

"Pa-cover lang ako... Maxxx candy, indicated for sore throat and acute laryngeal infections. With the bioefficacy comparable to other brands but has lesser side effects. It is available at a cheaper cost, sold only 3 for P2.00 and available in cherry, lemon, orange, eucalyptus and calamansi flavor. It is now available in all groceries and sari-sari stores nationwide."

Inom pa, Jay. Inom pa.


The Dean's List Awardee


Bwaaarrkkkk...

"Hoy pare, okay ka lang?"

Bwaaaarrrkkkk...

Sprawled out in the unclean floors of the public comfort room, she hugs the toilet bowl as if it was her long-lost friend.

Bwaaaarrrrkkk...

The disgusting and eclectic mixture of tacos, beer and the night's dinner are spread out on the walls of the tiny comfort room, like an unappreciated work of art. The renowned ZCMC-IM senior resident grabs a mop and morphs into an IW as he cleans up his friend's vomit.

Bwaaarrkkkk...

"Net, okay ka lang diyan?"

Bwaaaarrrkkkkk....

The Dean's List Awardee has finally met her match.

And his name is San Miguel Strong Ice.


*** To Jackie, Van-van, Janet, Doc Bastero, Elgie, Choie and Jay-ar, I had fun last night, mga pare ko! Let's do that again sometime soon... Pero, hinay-hinay na Jan, sa inom. Bakit kasi kailangan pang habulin sa inom si Jay-ar? Kung nagpasahan kayo ng candy sa bibig, eh di sana, mas matutuwa pa kami niyan sa inyo. Wahahaha...

CPR

Elbows stretched

Sweat beading as it falls down my cheek

I push

And push

And we hold our breaths

As we await for the throbbing of your heart.

I am tired

Still the cycle repeats itself

For the girlfriend you have left.

For the mother you have not said goodbye.

For the brother you have not told you were proud of.

For nothing.

... Alas, you are gone.

The ER Rotator

Being the only non-Muslim member in my IM team, I was left all alone in the ER by the time 6 PM arrives, which is about the time all the other doctors in my IM team leave the ER to break their fast, the buka, I think that's what they call them. I sit in my chair, burning in the heat, my legs trembling as I wait for the barrage of patiernts to arrive. One by one, they come in. The wheels of stretchers deafen my senses. The unconscious, the ones screaming of pain, the ones reeking of their own vomit, the ones smelling like they have no idea what deodorant was. Like the obedient intern faking her way through IM, I was forced to attend to all of them, juggling the taking of vital signs, the history-taking, the making of prescriptions, the writing of laboratory requests, the search for the elusive nasal cannula, the phone call to the laboratory, answering the demands of the resident on duty. Of course, who the hell was I kidding? I couldn't do all of them at the same time. Therefore, to add to the toxicvity of the job, I have watchers screaming at my face, because I was too slow in attending to their patients' demands.

Stop me, Doc Bastero, before I strangle this watcher. Please lang! Ilayo mo sa harap ko yang antipatikang babaeng yan!

And on top of all that, I have people repeatedly calling me "Nurse".

Arghhh!!!

Being ER rotator these past few days has been the most excruciating thing that has happened to me in IM. Too many times I have just wanted to walk out. Walk out from the ER and leave all these behind. Go and make out with some guy, just to release all that anger and tension.

And forget.

Forget about everybody waiting for me and just run the hell away from the hospital. Forget abouty the one million and one things I have yet to do. Forget about the patients waiting for me to attend to them. Forget about all this crap. When everything else sinks in, and I feel like I am drowning, suffocating, I have to fight the urge to scream. To scream so loud that everybody in the entire hospital can hear me. Hear of how I am starting to hate my job. Of how I hate it with such hatred that it burns a spot right through the pit of my stomach.

"Punyeta kang watcher ka! Hindi mo ba nakikitang bumabagyo ang mga pasyente
dito! Kasalan ko ba kung di niyo sila binibillhan ng gamot sa bahay o dinadala
kaagad sa doktor?! At ngayon kami ang tinotoxic niyo dahil hindi kayo marunong
mag-alaga sa pasyente niyo? Bwisit! Sana kayo na lang ang magkasakit at hindi
yang kamag-anak niyo! Mga punyeta kayo! Wala kayong karapatang mambwisit ng
doctor! Leche!"

Of course, I never said to that their face. But I was thinking about it. Hehehe...

The conscience gets me and I hold my tongue as I am being forced back to reality.

I have no choice. This is what my four years in medical school has tried to prepare me for. Despite the fact that I am slowly turning into the kind of doctor I hate, the kind of person I promised myself I will never ever become, I have to constantly remind myself that my selfish concerns are trivial and mundane compared to those of the loved ones of the patients I am supposed to be taking care of. So, I just have to bear it, paint a smile on my face and suck up all that bitterness.

So, to the watchers I have been impatient with and the patioents who deserve but I have not given my very best care, I am sorry... It's time I learn to accept the fact that this is what I do. This is what I'm made for.

This is who I am.

How To Survive Your OB-Gyne, Pediatrics and Ophthalmology Internship Rotations

Internship Objectives

Obstetrics and Gynecology

At the end of the month, an intern is expected:

1. To be able to run as fast as your black shoes can get you as you wheel the stretcher with the pregnant mother with the crowning baby to the DR.
2. To be able to transform magically in less than a minute from your uniform to your scrubsuit and vice versa.
3. To be able to retract the bladder for three hours or more using the same force, despite the lack of sleep, the eyes that can’t seem to keep themselves open and the hyperglycemia from not having anything in your stomach except for water during your 24 hour duty.
4. To be able to have the patience of a saint when explaining to G1 patients that a 2 cm dilated cervix doesn’t mean you’re going to have your baby right now, or that an induced delivery doesn’t mean it’s going to be less painful, or that just because you’re so tired, doesn’t mean you have to stop pushing or that you can choose to have your baby delivered via CS. You are not in a private hospital.
5. To be able to grow 10 hands and be at three places at one time as you IE one patient, make the history of another, admit another patient, call the lab for your stat CBC, secure blood for your CS patient at the blood bank, deliver the baby in the DR and assist in the TAHBSO at the OR.
6. To be able to pray for a miracle that one will pass Kong’s post-rotation exam.

Pediatrics

At the end of the month, an intern is expected:

1. To be able to keep yourself from screaming obscenities when you are barraged with mothers in the ER bringing in their children because of 1 day colds, or severe weakness due to diarrhea when the child is happily playing and smiling at you, or two-week history of cough and fever and the child looks like he’s practically in his deathbed, at 2 o’ clock in the morning.
2. To be able to juggle carrying two babies, both with O2 face mask, and look after another intubated one carried by his mother, and not trip nor stumble, so as to manage time efficiently when bringing in NICU babies for X-ray.
3. To be able to fight the hypoglycemia and the dehydration. Let’s face it. You will not be able to eat nor drink anything.
4. To be able to charm your way with the medtechs and the radio technicians, particularly, to avoid giving your cellphone number, in order to get what you want from them, such as giving you priority and faster service (I miss you, my curly-haired medtech na parang hanger ang katawan. Where the hell are you?).
5. To be able to supply the correct answer to Doc BJ and Doc Balido’s bedside rounds questions whose answers we were apparently and supposedly already knew, like the gastric capacity of a 5-month old baby, the actual caloric content of Bear Brand, Al-110, Simelac and S-26, the rationale of giving folic acid to your AGE patients and cross-infection of Dengue and Malaria. Heller! Like you already knew that when you were interns back in 19kopong-kopong.
6. To be able to look like you were not from duty, when you actually are from duty.

3. Ophthalmology

At the end of the month, an intern is expected:

1. To be able to shell out your hard-earned savings and feed the department at the end of your rotation.
2. To be able to assist in the OR by turning on the airconditioner, searching for plaster, preparing the gloves in the prep table, looking for stuff in your resident’s tool box, opening the vent of the IV and holding his cellphone as he makes an intra-op referral to his senior resident. That’s about it.
3. To be able to see something abnormal during a funduscopic examination. Seriously, I’ve never seen one. I only say “Yeah, I see it,” when the truth is, I can only see blood vessels and ¼ of the freakin’ fundus. The trick is not to look like you don’t know shit.
4. To be able to use those skills you learned playing family computer back in Grade 3 when maneuvering the slit lamp or the refraction machine.
5. To be able to pretend you don’t notice that Ma’am Pilar and Doc Vanessa are not speaking to each other and to have the tact and sensibility not to ask either one of them about it. Deadma, ika nga.
6. To be able to suture a patient’s eyelid without poking her eyeball with your needle.
7. To be able to avoid answering the “Ms. Top 1, ano nga ba yung…” questions without looking like you don’t know anything at all.


The rest of the objectives for the other rotations will be given as soon as this intern finishes her rotation in the other departments and is able to find the time to squeeze important Friendster blogging time in her very busy schedule.

Top 10 Most Frequently Asked Questions to Interns During Internship

10. From what school are you?

Like it would matter. They all treat us the same anyway. Semi-slaves to the residents, the unofficial IWs the consultants would ask to buy their Coke in can and siopao outside the hospital, the one they would scream obscenities with if the lab results were not pasted in the freakin’ patient’s charts, the one they would pimp to the technicians in the X-ray room to get the films of their patients, the one they would blame their irresponsibilities with if the patient dies because they weren’t able to answer to the referral soon enough since they were too busy cavorting in the other wards when they were supposed to be in the ER. Di ba, Allen? Hehehe…

Although in fairness, some residents lang naman. Hehehe…


9. How old are you?

Oo na. So maybe I look like I’m 15 parading around in my white blazer and pretending to be a doctor. It’s not my fault I came from a good genetic background and I look younger than you by, say, 10 years. Go to a spa and get a facial and a massage on your days off, for god’s sake. Nang hindi ka naman mukhang toxic and 40 all the time, when you’re standing next to me.


8. What are you planning to specialize on?

Isn’t the point of internship to make me think about what I wanna do for the rest of my life? Stop convincing me to go into your specialty, just so you can have the opportunity to boss me around for a longer time. I’m a freakin’ scholar for god’s sake! I’ve got four more years to think about what I wanna specialize in. Not to mention, I’m still trying to survive these next few months in this hospital. Quit it!


7. Kumain ka na?

What a stupid question! How the hell am I supposed to eat when you’re not in the ER to take my post? Am I supposed to close the ER and stop taking patients for 20 minutes so that I can eat? Maybe I can ask the pregnant woman with the fully dilated cervix to stop screaming and wait for me to finish my meal before I start rushing her to the DR, or the seizing baby to stop convulsing and foaming in the mouth so that I can get my three spoonfuls of rice in my already cachectic body. I’m so freakin’ hungry, I may just start eating my stethoscope.


6. Anong rotation mo ngayon?

Smell me. Ano sa tingin mo?


5. Admission yan, doc?

No, we just enjoy poking and hurting little babies by putting them in an IV. And I’m just using these filled up history sheet, admitting orders sheet and discharge summary sheet as a fan to keep myself cool while I slave away my hours in the ER… Heller! Ano sa tingin mo?


4. Toxic kayo?

Not really. I just enjoy looking like crap. I just don’t like to comb my hair, I just enjoy the sensation of oil in my face, I just love the smell of lochia in my clothes, I particularly cherish those huge dark bags under my eyes and I don’t like sleeping at all.

Yup. Hindi kami toxic at all.


3. Are you a doctor?

So wala pa akong lisensiya. Kung aangal ka, get the hell off my face.


2. Do you know what you’re doing?

Deadma.


1. May boyfriend ka na ba?

Wala. Bakit, mag-aaply ka?... O, yan ang hirit ng intern na walang magawa sa buhay. Tulad ng mga nasa Optha, Psych and Radio ngayon. Wehehe…

Medtech Boy 2007

Maybe it's because I am trapped in a place for the next few months exposed to no other type of guy except for those who are connected to this hospital, my hormonally-challenged self (who has been starting to miss the dating scene) started scoping the incredibly few picks to choose from. Being in the middle of a severely dry spell, I found myself crushing over another Medtech.

Still, like the low self-esteemed girl that I was, I could barely find myself to make a decent conversation with him that lasts for more than one minute. I am not a seasoned femme fatale unlike most people think. Plus the toxicity of my being a medical intern and his being a medtech most likely makes it incapable for us to flirt for more than the few alloted minutes that fate or rather our jobs had provided us. The most that I got aside from the usual, "Sir, pwedeng pa-CBC si ____?" is this:

Me: Oh, di ba dapat nakawhite pants kayo? Bakit nakablack ka ata? Bawal yan
(spoken with a saucy little teasing grin in my face).

MTB2007: Okay lang yan, ma'am. Kasi gabi naman (with an embarassed grin on his face).

And that's it... God, I'm so pathetic.

Humanda ka sa'kin next time, bata ka.

Hahaha...

Oxygen Blues

The sound of metal crashing on the ground.

Psssssssssssssttttt....

People started yelling. Hordes of screaming people can be seen running towards the OPD, away from the ER. IM patients started hyperventilating. Secluded in the Pediatrics area, surrounded by screaming babies and annoying parents, a children's party for the sick, I found myself torn between saving myself or acting like a hero and convincing everybody to be calm and walk out of the room in a single file.

But then, who was I kidding?

My heart was racing. I had no idea what to do. I kept thinking, shit! If this hospital explodes in the next few seconds, and I die, no boyfriend would even come and cry in my funeral.

Yes, even faced with an impending death, I was still a hopeless romantic. So? Sue me.

So, what did I do? LIke the little scared girl that I was, I froze up and ended up just covering my ears, as if waiting for the impending doom, which anti-climactically did not appear. Sir Hermano straightened up the oxygen tank, recovered the tank knobs and closed the O2. So much for the heroics.

And thus ends the story of the day the RHD patient from IM tipped over the O2 tank, accidentally openned up its gas knob and caused chaos in the ER.

Acting Superior

It's funny how life throws you these really weird curve balls.

I've spent the past month working as a medical Intern at the OB-Gyne Department of ZCMC. I've been busting my ass off trying to please my superiors, doing all the dirty work, sticking my two fingers into incredibly rancid orifices, skipping lunch and dinner, running madly towards the laboratory to secure blood, and still I get insulted by/screamed/yelled/ at by my superior resident for something so mundane.

And contrary to the rumors flying around, no, she did not tell me na sayang ka lang naging most outstanding student (heller! sino ba nagkakalat ng balitang yan!).

And then lately I realize that it's really not her fault. She is my superior after all. We are all someone's junior and someone's superior. This is simply how the world works. So I made my superior resident wait for quite some time. For her, that was a sign of disrespect. She had the right to get mad. And I already paid for that with an hour of embarassing sermon during CS at the OR, amidst the student nurses and anesthesiology team, but who cares? Someday, I'm probably going to end up doing the same thing to my intern or junior resident.

No, wait, I already did.

The unlucky victims of my act of superiority? The student nurses at the ER who take too much time doing the TPR when all I really want from them is the BP and for them to shave the patient's pubes.

Hehehe... Yes, ang sama ko talaga.

A Clerk's Guide To Hot Spots For Making Out in ZCMC

They barrage us with a million and one insults, consume our well-needed sleeping time with OR assists, Cytotec insertions and RBS q4, use up our tired little bodies until we are nothing but skin and bones. We deserve to be treated like humans. We too have animal urges. Therefore, between delivering babies and intubating patients, we also need that quickie fix. Thus, I decided to enlighten you with, not one, not two but 15 top spots to get that quick booty action in between 24 hour duties in our so-called home away from home, the ZCMC hospital.

1. The Minor OR across Room 13 (Optha OPD).
You can use the gigantic microscope to look into each other's eyes, literally, an check out for your partner's pterygium, corneal laceration, cataract, etc. And if that bores you, you can always make use of that big OR bed.

2. The Ward 8's Doctor's Quarters at the 2nd Floor.
The darkly unlit staircase leading to the 2nd floor is a foreplay-magnet already by itself. You can surprise your man and come into the room wearing nothing but your patient's chart, strategically placed infront of your best-kept secrets.

3. The OR.
For a truly aseptic environment. Best for guys and girls with poor immune systems (asthmatics, comatose, Bubble Boy)... who want to get dirty.

4. The PGI Male Quarters.
Predictable, yes, but still useful for those quickies. Just make sure to lock the door, okay? Not all of us are open to the idea of looking at some girl's boobies or some guy's hairy ass at 2 o' clock in the morning.

5. Room 1 (OB-Gyne OPD).
You gotta have a kick out of doing the deed in a place where woman who have done the deed are checked out. Unfortunately, the strange contraption of a bed might stifle your creativity seeing that not a lot of positions can be done in here... Still, there's no harm in trying...

6. The dark corner between Room 10 (Pedia OPD) and Radiology.
It's dark and isolated. Enough said.

7. The Chapel.
It's sacrilege, I know, but you can't blame a girl who has spent most of her life in Catholic schools from thinking about it =)

8. Procto Room at Ward 4.
Only you and your man will know what you guys did with the proctoscope. And I'm sure it wasn't pretty...

9. The IE Room at Ward 1.
After receiving all sorts of insult and demerits from your favorite OB resident, you can defile their holy ward by inviting your man for a quick "Internal Examination."

10. The ZCMC Quadrangle, aka Zamboanga's version of UP Diliman's Sunken Garden.
This place is great because there are a lot of places to do the deed in, whether it's at a bench, the grass, the fountain, under the tree... And the scenery is not bad either. Watch out though for security guards because there are plenty just around the area. This is highly recommended for guys and girls who secretly want to get caught.

11. ER Supply Room.
It contains plenty of gadgets that can be used as sex paraphernalia. You might even unleash your creativity with all the things that you can grab onto this minuscule of a room, whether it be a Betadyne-soaked cotton balls, stainless steel containers, rolls of gauze, plaster, etc.

12. The stairs leading to the 2nd floor of the Ward 2 Doctor's Quarters.
Just think about the possibilities... The place already looks like a stockroom that no janitor has cleaned for millenniums so you don't need to clean up afterward.

13. The ICU.
For a well-sanitized environment. And if your man is about to have a Myocardial Infarction with all the excitement (which means that you're probably screwing with someone thrice your age, you dirty, dirty girl!), you'll have an O2 tank and Intubation set on hand.

14. The PE Room at the Blood Bank.
You can pretend to be the doctor and him, your patient, or vice versa, and proceed to do an extensive Physical Examination on each other.
Him: "Oh, doctor, do I have to remove my pants?"
You: "Well, you can't donate blood if you have a history of STD, you know?"
Him: "Oh, doctor, I'm sure I don't."
You: "Let me check so we can be sure about it."
Him: "Okay, doctor. But can you please remove your shirt as well?"
You: "Sure... I'll even throw out my pants as well. After all, the patient is always right."

15. The Conference Hall.
Just for kicks =)

DISCLAIMER: I am too much of a conservative - Yes, Me! A Conservative! Don't you dare laugh! - to actually try one of these places myself but I have actually heard from people who tried. I swear to God this is true. You're free to try them yourself, you know... But if one of these days, we see each other in the said places, just mind your own business and don't say a word... Atin-atin na lang 'to...

Saying my Goodbyes

Yesterday was the last day of our clerkship. I'm done with hospital duties for now. As I was walking home Iast night, I realized that despite all the hardships we encountered during our 6 months in the hospital, I enjoyed the experience a lot and I would definitely be missing a lot of things/people/situations in the hospital. So, let me take this opportunity to say my goodbyes to the people and places that have kept me sane during my 6 months of hospital duty and made these 6 months one of the greatest experiences an aspiring medical doctor could ever ask for.



Goodbye residents... To Doc Alawaddin, my yosi buddy and tong-its mastermind. Ang landi nyo, Doc! Hehehe, joke... Doc Akalal, ambait-bait nyo talaga! I very much enjoyed being one of the Akalal babies... Doc Bastero, inom tayo ulit nila Janet one of these days. And be faithful to your wife!... Doc Miranda, salamat sa gimik sa Ground Zero. Tama na ang paghahang-over... Doc Amilhasan, wer u na?... Doc Barrios, behave po kayo. Maraming kumakalat na sakit ngayon. Hehehe... Doc Balido, salamat sa mga lunch sa Dietary, kahit bawal ang mga clerks doon... Doc Bravo, thanks for considering me a good friend to keep your secrets. Touched naman ako... Doc Buena, no comment. Mahirap na. Ayokong madagdagan pa demerits ko... Doc. ST, kahit na may pagka-palautos kayo, thanks po sa pagpapasensya sa amin... Doc Rojo, Daddy! Ambait-bait nyo! ... Doc Lim, I mean, Papa Lim, ang crush ng mga Ortho Angels. Hahaha... We'll miss you!... Doc Cuevas, thanks for the craniotomy experience. Pwede na po ba ang beauty ko as Future Neurosurgeon? Hehehe.. Doc Mangkabung, okay lang yan, doc. Ganyan talaga ang buhay. Makakahanap rin kayo ng mas nararapat sa inyo... Doctora Akalal, pasalubong po namin, doc!... and to the rest of the residents as well as consultants, thanks for everything.

Goodbye Interns... To Sir Eric, my yosi buddy during my IM days na laging natutulog. Faithful daw kuno!... Sir Allan, bati na kayo ni Jackie. Hehehe... To Sir, este, Ma'am Joji, ang reyna ng paghahada. Hehehe. Ang saya niyo kasama! No dull moments!... and to the rest of the interns, thanks!

Goodbye nurses... whose names we used to confuse. Sensya na po!... who knew we smoked but never ratted out on us... who most likely talked about us behind our backs. Ano kaya ang nickname niyo sa akin no? Curious tuloy ako.

Goodbye IWs... salamat po sa pagpapasensya nyo sa mga pangugulit at pag-uutos namin... Hermano, el bendisyon di amun y el reso para di amun futuro!

Goodbye Friendship, we will miss your yema and spicy peanuts! Yum, yummm...

Goodbye Momsie sa Harvest, na nagprovide ng aming daily sustenance for the most part of our clerkship. Thanks for keeping your food safe.

Goodbye PGI Quarters Male... my favorite tambayan, hang-out ng mga walang magawa sa buhay, nebulizing area, sleeping area, taguan ng mga maiskandalong sekreto, library, grocery at motel in one... I will definiely miss my home away from home.

Goodbye Medtech interns ... you were all very nice and accomodating to us... Medtech Boy, thanks for the kilig during my Pedia days. I guess I needed that. Kaso lang, feeling guwapo ka masyado... To Hema Boy, you have the nicest eyes I have ever seen in a guy. if only one of us got the nerve to talk to each other sooner... Who knows? Hehehe. As if!.. Kain ka ng marami at magweights ka, ha?

And finally, goodbye Maroon 5, I will surely miss you. I will treasure whatever semblance of a boy-girl relationship we had in my mind and think of you fondly always. At least now, there's no more reason for you to keep on playing mind games with me... If we were meant to be, then destiny will find a way. Naks! As if! Ilusyonada ka talaga, Mae...

Clerkship Bloopers

I am going to come clean with my clerkship bloopers today. For all medical students out there, let's face it. Clerkship really is the time to make mistakes. I haven't met any clerk yet who hasn't done at least one blooper during her clerkship. For the past 1 month and 1 week, these are my own confessions...

1. Surgery rotation: Saw a px classified as Vehicular Accident victim. He came in, ambulatory, and said to have stumbled accidentally while driving a motorcycle. He had several abrasions, nothing too serious, didn't like to lie down on the stretcher and was even able to refuse me when I suggested for him to have an X-ray of his leg. I dressed his wounds with Betadyne and discharged him w/o referring him to our resident. He was a known hypertensive and his BP during the incident was 160/110. According to his wife, a doctor in their health center gave him a few Calcibloc pills which he should take during hypertensive episodes. I advised them to have the px take one and then, discharged the px without even referring him to our resident or to the IM department. A few minutes after, the px came in again, this time carried by his relatives and having a seizure tonic-clonic episode....

Jesus Christ! Why did I not refer the px to our resident nga uli? Arghhh!!! Our resident ordered an IV line for the px, infused him with Diazepam and in a few minutes, the man was okay again...
Shiyet... I couldn't face the px's relatives and tried to hide behind the surgery desk. My resident scolded me for not having the px brought to X-ray because it would have bought us some more time. If the px had the episode while he was already at home, he might not have been able to be managed right away. Thank God, he was okay or else, arggggghhhh! I don't even want to think about it.

2. Internal Medicine rotation: Saw a px complaining of inability to urinate. She has been unable to uriniate for a few hours. This was her first episode. There is no history of fever, chills, dysuria, flank pain, hypogastric pain. Upon examination, her bladder was distended. I called our PGI, who was at Ward 6 that time, to refer the px but he wasn't there. Based on my previous experience during Surgery wherein I encountered the same case except for the fact that the px before was male, when I referred the px to our Surgery PGI, she suggested catheterization. The Internal Medicine PGI was also there that time and she suggested catheterization as well. So, based on my previous experience, I cathetherized the current female px as well.

Big mistake... After having endorsed the px, Dr. Abubakar, the chief resident for IM, saw the px and asked who was responsible for cathetherizing the px. I'm sure if I was there that time, I would have been scolded so many many many times for the mistakes that I did.

Mistake #1: I did not refer the px to the PGI nor to Dr. Miranda, before cathetherizing the px.

Mistake #2: Females are prone to UTI and cathetherization will further promote UTI in the px. I forgot that.

Mistake #3: I did not refer the px to the PGI nor to Dr. Miranda.

According to Doc Abubakar, I should have applied warm compress on her hypogastrium instead, before even considering cathetherization. Warm compress? Eh, distended na nga yung bladder niya! Well, sige na lang. I am only a clerk. What do I know, ika nga?

In fairness, I did relieve the px of her ssx and she was thankful to me for it. Hehehe... Consolacion de bobo... Well, if she develops UTI, I only hope next year pa iyon and not while I am still rotating at Internal Medicine nor at any of my major departments. Hehehe...

Doc Abubakar hasn't talked to me nor to my partner about that case yet. I'm still waiting for the long lecture. Hope that ax never falls and he forgets about it... Ha! As if! I'm sure may demerit nang katapat yun. Wish me luck! =)

Freeeeeeeeaaaaky...

Very weird things are happening at the Obi-Gyne Department. Although I am a Surgery clerk as of now, because the Obi-Gyne Department is just one wall away from ours in the Emergency Room, I had the opportunity to witness the most strangest things yesterday.

A woman, gravida 3 ( meaning she has been pregnant three imes already) gave birth right then and there on the floor of the Emergency Room. Under ordinary circumstances, women immediately about to give birth are initially seen at the ER-ObiGyne Department and rushed immediately to the Delivery Room at the next building via stretcher. This woman came to the ER-ObiGyne, talked for a few minutes to the ObiGyne clerk and in the few minutes that the clerk turned her back to the woman, she kneeled on the floor, and right then and there, she was already trying to push her baby out. Just as the clerk began yelling "Hermano, ang stretcher!", amniotic fluid and fecal material was coming out of the woman. The worried father put his hand out between the woman's thighs and tried to catch their baby. The next thing we heard was the sound of the newborn baby crying, "Ungaaaaaa... ungaaaaa.... ungaaaa...."

The whole thing was damn over in less than three minutes.

The next thing I knew, the baby was wrapped in clean rags (the same rags, we Surgery clerks use to clean our bloodied patients, hehehe...) and brought to the Pedia Department for incubation. Because the baby was delivered in the ER instead of the Delivery Room, it is considered unsterile and therefore, not qualified to be put together with the other neonates at the nursery. The mother was put into a stretcher, her umbilical cord hanging with a straight clamp on its end between her thighs, and brought into the Inspection Room for the manual removal of the placenta.

Cool. But at the same time, gross...

A few hours after, as I was trying to review for the endorsements tomorrow, Ice, the Obi-Gyne clerk on night duty called me and showed me the freakiest thing I have ever seen in my entire life. As she pulled me into the Obi-Gyne Inspection room, I thought she was going to show me a cute newborn baby.

Well, it was a baby all right.

Lying in the middle of the disposable gloves wrapper was an 11-day old newly aborted fetus, taken fresh from the uterus. Its mother was still lying right there in lithotomy position... It was, like I said, incredibly freaky. You can actually see its eyes (or something that resembled it) and limbs. It reminded me of those grade school days when I used to go to the Adoration Chapel at ICES and lining the hallway to the chapel were various posters on abortion, including graphic photos of aborted fetuses in various months of gestation.

Hmmm... at this rate, I'm kinda looking forward on to what other freaky things will be in store for me during my own rotation as medical clerk at Obi-Gyne Department on February next year. Hehehe... So, NOT!

A List of Things You Don't Want to Hear During Surgery:

Oops!

Has anyone seen my watch?

Come back with that! Bad Dog!

Wait a minute, if this is his spleen, then what's that?

Hand me that...uh...that uh.....thingy

What do you mean he wasn't in for a sex change!

Damn, there go the lights again...

Everybody stand back! I lost my contact lens!

Well folks, this will be an experiment for all of us.

What do you mean, he's not insured?

Let's hurry, I don't want to miss "Bay Watch"

What do you mean "You want a divorce"!

FIRE! FIRE! Everyone get out!

...from thedoctorslounge

Mr.X


I was never comfortable with the concept of death.

Yes, I dabbled on thoughts of suicide and dying young during my turbulent adolescent years, like any other ordinary teenager. But hello? No one at the age of 15 is really that serious about it!

As a matter of fact, I am afraid of looking at dead people inside open caskets. For many years, I have managed to maintain a two-feet distance between me and the casket whenever I am dragged to look at corpses inside caskets during wakes. I have also managed to maintain a brave face whenever faced with a cadaver during Anatomy Lab, instead of running away from the room in a speed of 80 miles/hour.

But this was obviously something that I had to face.

At 4:00 this morning, for the first time in my life, I had seen a man die right in front of me...

An unknown elderly man that we had named Mr.X was brought to the ER. There was no watcher with him and he was said to be found, lying in the midle of the road, a supposedly victim of hit and run. As the crowd of student nurses dispersed from around his stretcher, I finally saw him in all his tragic splendor: Both legs were splinted, from the hip to the ankles, a variety of wounds decorated his skin like unwanted medals of valor, and with gurgling sounds coming out of his throat, fresh blood oozed out of his mouth like a red water fountain. Both pupils were dilated, blood pressure was 20 palpable and his heart rate was barely perceptible.

We did massive suctioning, intubation, Ambu-bagging, even CPR yet despite our attempts to keep him alive, eventually, he died in the E.R. This man, who could be someone's grandfather, father or husband, has died alone with no relative to see him for the last time and with no name to identify him in his death certificate. For all we know, some daughter or wife or granddaughter is looking for him right now and they aren't even aware that he is already dead.

I have never witnessed a sorrier event than that.

Mr. X was now nothing but a corpse lying under a white sheet. I kept thinking how bad it must feel to die, without a name, without your family, without an identity.

Mr. X, may you rest in peace.

Top 10 Ways to Kill Time during the 24-hour duty at the ER

Under ordinary circumstances, life for a clerk assigned at the ER-Surgery Dep't is TOXIC. We provide first-line management for those who come at the Emergency Room due to animal bites, stab wounds, trauma, falls, vehicular accidents, for those who are allegedly mauled, raped, beaten etcetera. But that Friday evening, business was really slow and by 1:30 in the morning, we were freeto do whatever we wanted. Sitti, my team partner and I went to sleep for about two hours at the OPD-Surgery room, afer which we couldn't stand the cold anymore and so we decided to hang-out at the ER instead. The clerks from the other departments were there as well, with nothing to do, since it was a pretty slow night for them as well... except for Ice, from the Obi-Gyne Department. Blame it on all women who decided to conceive a month afer Valentine's Day...

Anyway, I decided to compile the Top 10 best things to do at the ER, as a guideline for future clerks who will be assigned to do 24-hour duty soon and will have the luxury of a slow night. Enjoy!

1. Fool around with the weighing scale. Make girls and very vain guys cry when they start weighing themselves and see that they have gained an additional 20 pounds.

2. Eat the lunch and dinner that you have skipped the night before. Follow-it up with a very early breakfast just in case you won't have time to eat anymore in the morning with all the incoming patients.

3. Try catching Hepatitis B and AIDs by washing the used instuments at the sink without wearing any gloves. And on that note...

4. Unsterilize the sterilized instruments by secretly inserting your unwashed hand inside the aseptic trays.

5. Put your bare feet up on the table just because your resident doctor is not there to scold you from doing so.

6. Make fun of the resident who scolded you the night before.

7. Practice voodoo on the resident who scolded you the night before.

8. Practice flirting on the resident who scolded you the night before. Who knows? It just might work!

9. Try to escape for a few minutes and buy some caffeinated drinks outside the hospital. A can of Diet Coke costs P15. The price of few minutes of fresh un-Lysoled air: priceless.

10. Sleep. Best thing to do!

S.O.A.P.


Arevalo, Mae Angelica
24 y/o female
Putik, Zamboanga City

S:
(+) fatigue, varicose veins, and sleepiness x 8 hours during first day of clerkship, feeling dumb more than ever for not being able to know what duct is at the submandibular gland (Am I supposed to know that?), feeling stupid for wearing my paporma shoes with the 2.5 inch-heels, with associated (+) weight loss from all that walking and running around

O:
(+) pale, palpebral conjunctiva,
(+) drooping eyes (ano to, ptosis?) from lack of sleep
(+) pale buccal mucosa
(+) varicosities on (B) feet from standing too long
(+) pallor of both palms and soles
(+) erythematous soles of (B) feet

A:
Burnt-out clerk on her first day of clerkship; ready for her second day of torture at the ER tomorrow on her first 24-hour duty

P:
1. Bring scrub suit, water, baon, lots of Extra Joss and Baby Schwartz.
2. Bring candy to combat hypoglycemia.
3. Try to get on Doc Alawuddin's good side. Sharpen your flirting skills.
4. Take multivitamins, stresstabs, and ferrous sulfate.
5. Don't forget to put a little make-up to bring color to your face. Clerkship = mukhang losyang!
6. Sleep early.
7. Eat plenty.
8. Be happy =)