DOCTORS SHARE BOTH THEIR PATIENT'S JOYS AND PAINS

DOCTORS SHARE BOTH THEIR PATIENT'S JOYS AND PAINS

I was called to scrub in to the OR of a difficult infected case - to evaluate whether we could save a uterus or proceed with pelvic clean up.  With both fallopian tubes removed due to a previous ectopic pregnancy and now due to a tubo-ovarian abscess, we conserved the uterus so that our patient might still try to get pregnant through in-vitro fertilization (IVF), an artificial reproductive technique. Highly desirous of pregnancy, definitely, post-operatively we will have to deal with issues of infertility.  A lot of psychological and emotional issues go with infertility.

As I passed by our jampacked PACU, I met a guy lovingly holding a baby in his arms. Obviously his newborn baby, I joked that he should remove his shirt for skin to skin contact, to comply to the essential intrapartum and newborn care program. The nurses informed me that the mother is being prepared for transfer to the wards, and the baby was entrusted to the father for safety reasons.  He couldn't keep his smile from his face, pure joy reflected in his eyes.  Even the mother seemed happy despite her obviously tired state.

Such is the life of a doctor. We share in our patients' pain of loss and grief. We try our best to comfort those who suffer. We sacrifice sleep, rest and physical comforts to make sure our patients live. It is when we see our patients smiling that we feel affirmed in our work. It is when our patients pray for us that we know we are doing the right thing.

#HAWMC Day 12: Day of Rest

#HAWMC Day 12: Day of Rest

I have a number of blog posts piled up to be written and published, mainly because I was out of town somewhere in Dumaguete City where there was erratic internet access.  I thought it would be sort of a vacation, sight-seeing and putting my feet up to rest.  Unfortunately, work seems to catch up with me wherever I go.  

Mark, a colleague at the conference, asked me "what do you enjoy doing in your spare time?"... I stared at him, flabbergasted.  I had no answer to his question.  He laughed and added "so, do you have spare time?" and it was then that I realized that I am a workaholic.  I tend to accumulate all these activities that I want to jampack into 24 hours of a day.  There is so much I want to do in my life yet, it's like I might run out of time.  Carpe diem seems not able to capture the way I've led my life.  It's not even sufficient to suck the marrow out of life - there seems to be a restlessness in me that will not rest until some unknown goal is achieved.

Fortunately, I am able to enjoy the scenery and it is these sights that relax me the most:

Whether it is sitting on a beach, enjoying the sand, sun, wind and sky...

Or driving down country roads and exploring new places, beholding the beauty of the Philippines. Have you ever seen such blue like that?

Or cherishing the rare times I can arise with the sun, kissing the sea across the horizon... simply thanking God for a new chance at life and for giving us all these bounteous blessings.

There is beauty in a new day.  There is hope for the future.  So long as I wake with my beautiful roses blooming, I am happy.

Helen Madamba, traveller, happy with nature, pretty little rosebud.

#HAWMC Day 11: Pet Pal

#HAWMC Day 11: Pet Pal

I consider myself a dog person, and one memorable dog I had before was Trixie.  She was originally named by my auntie Annie as Patrixia Procorpia - "Trixie" for short.  She was the offspring of my auntie Nina's spaniel Lady and my auntie Rissa's Japanese spitz White Fang, so you'd imagine a short blond dog with white whiskers on her ears.  

Trixie was a faithful dog.  Throughout high school, she would sleep with me in bed.  I didn't really mind the dog hairs, but I had to be sure to bathe her before bedtime.  I was lonely in high school. Trixie kept me company.  There were times I would come home in tears, I would lock myself up in my bedroom and blast Miss Saigon on my earphones.  Trixie would lay down her paws on my chest, seemingly saying "it'll be alright, I'm here..."  Trixie was my faithful dog.

When I went off to college in Laguna, I had to leave home and board with a family.  I would come home on weekends and Trixie would be all excited to see me.  Because of the demands of college life, I would come home less and less.

I remember being the only one in our block to have a cellphone at that time - that big radio-like receiver with the long antennae.  It was using that phone that my dad called me one time.  My mom told him to be direct and to keep his message short, so he said "Helen, I need your blood!" -  what a shock that was, so I dropped everything and hurried home.  It turned out my dad was diagnosed with lung cancer and needed blood transfusion for severe anemia.  Even Trixie seemed depressed.  She was no longer trailing behind me, but was following dad wherever he went.  Nine months after diagnosis, my dad died quietly in the master bedroom of our house.  Everything seemed pretty quiet at home after that. Everybody felt at peace that dad was no longer in any pain. 

However, Trixie would not be consoled.  She kept staying in the garden outside the window of dad's room.  She kept digging among the plants until she made for herself a comfortable nook of earth.  It was about two weeks after dad's funeral that I found Trixie there, in perpetual slumber.  Trixie had found a way to follow after my dad.  Trixie had become my dad's pet dog.

Helen Madamba, dog lover.  In remembrance of Trixie.

#HAWMC Day 10: Comfort Food

#HAWMC Day 10: Comfort Food

Disclosure: I don’t cook.  I used to cook our simple inexpensive meals back in college to economize, but after that I realize that I am too absent-minded or too preoccupied to pay attention to cooking.  One time I set out to boil an egg, I left it cooking on the stove thinking that it’ll be done in 10 minutes.  So I left to do something else.  When I came back, the kitchen smelled of soot and smoke and burnt egg.  The pan looked like a dry charcoal-grill and I resolved never to cook again, for the safety of my family – both from fire hazards and from carcinogens found in burnt food.

One time I remember joining the summer camp in Badian, Cebu, organized by the Cebu City Taskforce on Street children.  I love soup, so I volunteered to cook one dish – to make Chinese oriental egg drop nido soup from scratch, so that the kids would know what “fine dining” tastes like.  It turned out ok since I put in my full attention so that we don’t waste the ingredients.  It was really good, if I might say so myself – one of my rare culinary achievements!  I proudly scooped up the soup into the kid’s bowls as they lined up for their share of dinner.  To my horror, they crinkled their noses, took a teeny weeny sip then poured the soup into the “lamaw” (left over scraps for pigs) bin… so that’s that.  I vowed never to volunteer to cook for streetkids again.

So we’re supposed to talk about comfort food.  My primary comfort food is sashimi and other Japanese cuisine – it’s healthy and yummy and fresh, and NOT “bawal” (prohibited) according to whatever diet I am on… I don't know technically how to prepare sashimi, but it seems easy to prepare because you can buy a slab of fresh or frozen salmon from your friendly grocery store, bring it home with wasabi and kikoman, cut into strips and enjoy! Good thing that Japanese restaurants abound also so that when I don’t feel like tinkering in the kitchen, I can just order it like fast food…

Helen Madamba, sashimi lover.

#HAWMC Day 9: Challenger

#HAWMC Day 9: Challenger

Overcoming a daunting challenge

If I had to choose among all the things I’ve gone through which I would never want to go through ever again, it would be first year residency training.

1.      

1. Blind obedience.  We were expected to behave like foot soldiers, nay slaves!  You are lower than the scum of the earth.  You are expected to follow orders with complaint and without question.  The words “wala po” (there is none) and “hindi po” (no) were erased from our vocabulary and replaced by “gagawan ko po ng paraan” (I will make a way) and “yes mam”.  If your senior issued you an order, follow it first before you ask questions.
2. Physical exhaustion.  In my eyes, first year residents must be super humans to survive extreme physical trials: functioning several days without sleep; learning to eat whatever food bites you can get your hands on in secret hiding places like even the toilet; walking around the hospital like zombies running on autopilot; being dead to the world enough not to feel it when robo-rat nibbles on your chocolate-smeared finger; learning to beg for blood at the blood bank for your patient utilizing all your God-given drama talents, or worse donating your own blood even if you’re post-duty just so your senior would agree to send you home…
3.  Emotional abuse.  Always being absent in family gatherings and having to endure the many sermons and public humiliations because you have not been able to perform to expectations.  I never got to see my mom and brothers, been out of circulation from my social life.  I would cry almost everyday because of the oppression.  You don’t eat so you lose weight.  You lose weight drastically, so much so that your parents wonder if you have tuberculosis or uncontrolled diabetes mellitus.  Suddenly, you need to buy a belt to keep your pants up and you hurry by Pedro Gil to choose from the wares of the street vendors because you never catch Robinson’s department store open. You suddenly get whiter from lack of exposure from the sun – you leave the house before the sun rises and drag yourself home long after the sun has set.  Several times you wish you could quit, but realize that your batchmates would have it so much more difficult if you leave.
4. Heirarchy of Needs.  As a first year resident, you are bottom rung.  Even if the second years are only one year ahead of you in training, you are still inferior to them hence you need to follow what they say.  The second years answer to the third years and the third years answer to the fourth years and the most senior answer to the chief resident and the consultants.  The buck stops with you though.  If there is anyone to blame, blame the first year.  You are taught to just bow down your head and accept.
5.  Forced donation.  When your patient does not have money and she needs a mechanical ventilator to breathe, automatically your batchmate collects your atm cards to withdraw money for the downpayment.  Thankful that you have salary, because a big chunk of it pays for whatever the patient needs to stay alive.  You swallow your pride and call home to ask mommy to send money.

But thankfully, first year residency is only one year long.  After this, there will be new residents to traumatize and to bully.  With less physical exertion, you start to gain back all the weight you lost and add a couple more pounds for good measure…  You realize that graduation from residency is all the more meaningful because of all the difficult experiences you had to go through, and that friendships with your batchmates run deep because you’ve been through thick and thin…When you’re going through tough times, remember this:

• Keep your head above the water and remember to keep breathing.
• Know you self-worth.  Nothing anybody can do to you will decrease your worth one bit.
• Draw strength from people who care for you the most.
• Be humble to accept the blame when you make mistakes, so that you learn from them. 
• This too shall pass.  There’s a rainbow always after the storm.

Helen Madamba, first year residency survivor.

#HAWMC Day 8: Things Remembered

#HAWMC Day 8: Things Remembered

ROSEBUD - that's what I call my car.  Papers have my name on it. It is a second-hand red 2010 Toyota Vios, which my mother bought for me upon my final (hopefully, my last ever) graduation from all the training in my life.  It reminds me of my mother and how far we've travelled from the old flaxen Toyota Corolla that we have in Las Pinas, which saw us through medical school, residency and fellowship training. 

#HAWMC Day 7: World Health Day

#HAWMC Day 7: World Health Day

Daily nutrition and diet.  How do you maintain a healthy regimen?

Aha! This hit a sore spot with me as I have always been struggling with diet and nutrition.  Ok, so I admit that I am fat.  The weighing scale and the BMI charts say that I need to lose somewhere around 50 pounds... and I notice that whenever I go on a diet and count my calories, I feel deprived and end up gaining more weight!  So I just stop stressing myself and just eat what I can, when I can and just avoid the evil food...

My mother read about the alkaline diet and how it addresses all the health problems I am experiencing - bloatedness, burping, bone and teeth problems, etc.  Sounds like a cure-all and how food can be your medicine.  I googled images on alkaline foods and I am sharing here some useful images that I found to guide eating habits:

In general, I try not to restrict myself and just try to select food choices that are alkaline.  When we have buffet, I generally stick to the salad bar and sashimi station.

One habit that I am able to follow is to drink 5 freshly squeezed calamansi first thing in the morning. I even planted calamansi in our garden in the hopes of growing them myself.  If you want alkaline water, Dr Willie Ong says adding calamansi to a liter of water will do just as well as lemon water, as is usually served in restaurants.

I probably am the last person to tell you about how to diet, but these are the tips that I think I can personally follow.  I've tried different diets to lose weight, but most are not sustainable, expensive and stressful.  So basically I don't think about eating to lose weight, but eating healthy to maintain general health.

Helen Madamba, struggling dieter.