Husband and Wife

Sustaining severe injuries after his motorcycle collided head on with another motorcycle, Eric Reyes was in semicoma when I first saw him at the Emergency Room. He would not open his eyes no matter what I said or did. He moved his arms and legs only if I put pressure on his ribcage or pinched his fingernails. Although he could still breath on his own, his airway was in danger of obstruction so the trauma team intubated him on arrival at our hospital. Compressing the Ambu bag and having a hard time keeping up with the rhythm of Eric’s breathing was an obviously distraught Ofelia, his wife. Noticing that Ofelia also had scratches on her forehead and arms, I asked, “Bakit sugat-sugat ka rin?”

“Ako po ‘yung angkas niya, Dok.”

If Eric were awake or simply lightheaded from minor head trauma, the impulse would have been to proceed to my obligatory sermon on the dangers of riding a motorcycle. “Maswerte ka, buhay ka pa,” I would tell my patient, who either grins or looks down in shame at this point. If my patient belonged to the helmet-lacking, drunk-driving population, I would, in addition, turn to the parents, the spouse, or the children at bedside. “Pangaralan ni’yo ‘yang pasyente ni’yo. Sa susunod, hindi na ‘yan makakaligtas, maooperahan na ‘yan sa ulo.” As a government physician, I feel duty bound to castigate our motorcycle-driving public, one reckless driver at a time.

But seeing that my patient was on the brink of death, I felt no need to reprimand anyone. In these instances, grief would teach them their lesson.

I began to examine Ofelia’s husband in detail as I continued to ask her questions.

“Lasing ba ang asawa mo?”

“Hindi po, Dok. Pauwi po kami galing bayan.”

“Naka-helmet kayo?”

“Opo, Dok, pero natanggal nung tumilapon kami pareho.”

“Huwag masyadong mabilis ang pagbomba, Nay. Sabayan mo lang ang paghinga niya.”

I grabbed the Ambu bag momentarily and showed her how to do it properly. “Ilan po ang anak ninyo?”

“Tatlo po, Dok.”

Eric and Ofelia were in their early 30s; their children would probably still be in elementary, perhaps high school if they married in their teens. It eluded me how both father and mother could risk their lives in a two-wheeled killing machine, knowing that they would leave behind three young orphans.

Now, we had a breadwinner to save. You would not want three children growing up fatherless.

I looked at Eric’s CT scan films. There were scattered hemorrhages all over and a small hematoma on one side. There was no indication that he needed surgery; he was in semicoma because his brain was diffusely injured.

“Nay, sa tingin ko po, walang kailangan operahan sa utak ng asawa ninyo.”

“Naku, salamat naman sa Diyos.”

“Pero hindi pa po siya ligtas, Nay,” I was quick to caution her when I saw her worried expression evolve into that of relief. “Alanganin pa rin po ang lagay ng asawa ninyo. Hindi pa siya gumigising dahil sa tinatawag naming diffuse axonal injury. Ibig sabihin, nabugbog po ‘yung buong utak niya dahil sa pagkakabagok ng ulo sa aksidente. Marami pong bahid ng dugo at namamaga ‘yung buong utak, pero wala po kaming kailangan operahin.”

“Ganun po ba, Dok? Ano po ang pwede nating gawin?”

I then explained that our treatment for these cases was mainly supportive: assist respiration via mechanical ventilation, fluid resuscitation to avoid hypotension, adequate nutrition, and prevention of infection from pneumonia, urinary tract infection, or bed sores. I would ask my team captain to admit him to the intensive care unit, but I also needed to assess whether she would be able to provide the necessary financial and family support.

“May pambayad po kayo ng ventilator, Nay?” That amounted to 2000 pesos for the first two days, and 400 pesos every day thereafter.

“Wala po akong hawak sa ngayon, Dok, pero sige po, tatawag po ako maya-maya. Gagawan ko po ng paraan.”

That was a good answer.

“Sige po, Nay. I-aadmit po natin sa ICU ang asawa mo. Gagawin natin lahat ng makakaya natin, pero kailangan mong maghanap ng pera ha? Libre dito ang kama at walang bayad ang mga doktor, pero ikaw pa rin ang magbabayad ng mga laboratoryo, CT scan, tsaka gamot. Tawagan na lahat ng kamag-anak. Mangutang na kung kailangan mangutang. Kapag nawala ‘yang asawa mo, hindi na maibabalik ‘yan.”

“Opo, Dok. Gagawin ko po lahat mabuhay lang ang asawa ko.”

That sealed our agreement.

Working in a large government hospital, it is a reprieve to hear of family members willing to do their part in patient care. Often, people come to us not expecting to pay a single peso. In an altruistic society, we could try to pay for every one’s health expenses to save every valuable life, but that is impossible. It is hard enough to formulate a management plan and execute an operation without complications; family members should at least exert some effort to support their patient financially.

For a week, our team took care of Eric in our ICU. Ofelia did as she promised, procuring needs and medications as we requested. I learned later that they were mountain miners who sold small gold pieces in the town proper; it was a good thing they had some savings.

“Siya ang pinakamagaling na minero sa kanila, Dok,” she told me with pride.

I did tracheostomy and was eventually able to wean her husband from the ventilator. His neurologic status improved gradually; by the time we transferred him to the wards, he could already open his eyes and move his arms and legs spontaneously.

After another week, Ofelia already knew how to feed her husband through a tube inserted in his nose. She could clean his tracheostomy tube and suction it without fear. She also did stretching exercises for Eric’s arms and legs. We could now send him home.

“Ready ka na umuwi, Nay?”

“Kayo po ang bahala, Dok.”

“Basta ituloy mo lang ‘yang ginagawa mo ha? Hindi ko pa masasabi kung gigising siya nang tuluyan, pero hintay ka lang ng 6 months to 1 year. May mga pasyente kaming ganyan na pagbalik, parang walang nangyari.”

“Salamat po, Dok. Ang mahalaga po, buhay ang asawa ko. Hamo, Dok, pag-follow up namin, dadalhan kita ng sugpo at alimango, marami noon sa amin.”

“Naku, kahit hindi na po.”

But I did not see Ofelia at the Neurosurgery outpatient clinic.

Instead, we met two weeks later in one of the hospital’s pay rooms. Ofelia consulted a neurologist and was admitted for progressive headache, numbness of the arms, and blurring of vision.

“O anong nangyari sa ‘yo?”

“Hindi ko nga rin alam, Dok.”

Her mood was somber, far from the energetic wife I was used to seeing. The children were being taken care of by the in-laws, she said.

I reviewed her CT scan films and saw blood clots on both sides of her brain. Small blood vessels must have ruptured because of the head impact during the vehicular crash. The blood had gradually accumulated, and she only became symptomatic when the blood clots had become large enough to compress her brain considerably.

Unlike her husband, Ofelia needed brain surgery.

Knowing that they had limited funds, we transferred Ofelia to the charity service and I operated on her the next day.

Back in the wards, four beds away from the one she used to stay beside, Ofelia was glad to tell me that her husband was doing well. He was more awake at daytime, now able to swallow liquids and recognize family members.

“Pwedeng-pwede ka na palang maging Family Physician,” my consultant remarked when I told him about Eric and Ofelia.

Though I would never meet their children, it brings satisfaction to know that I have given them a chance to grow up with both parents.

As for Ofelia, I discharged her three days later with no complications. Looking back, perhaps she already felt symptoms in the days following their vehicular crash, but being the caretaker of her husband, she must have dismissed them, or hoped the symptoms would resolve on their own while she ran around the hospital to facilitate lab workups or buy medications.

Indeed, the self is forgotten for love of another.

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24 comments

  1. I love/hate this story. It depicts how women in our country tend to be–which is a strength and a weakness in itself. sigh..

    Good to find you again though..I used to follow your blog when you were still studying medicine. I remember its wallpaper (if thats the right word) being a male student with a backpack. I think you said you drew it yourself. And now here you are..well, here we are 🙂

    • Hi Alenaire! Yes, that used to be my homepage — the one in med school uniform and sitting on a bench. I don’t have that much time to draw and create illustrations anymore, so I had to make do with customizing ready-made templates. I’d like to believe that people visit this site to read, and not just to ogle. Hehe.

      It isn’t necessarily a weakness. It just shows that Filipino mothers aren’t used to assuming the sick role. 🙂

  2. I first saw your blogs on Facebook, on one of my friends’ wall. I became curious and followed through your website and read some of your blogs. I admire your compassion for your patients, and most especially your desire not to be like most of the physicians today, just going through the rituals of assessing, diagnosing, and treating patients just because Hippocrates told them so. Keep it up Doc! Our country needs more physicians like you. Someday, I hope and pray that I will also be that compassionate and kind doctor, very willing to be used by God to minister to our fellowmen who are in need.
    This blog increased my admiration for your skill, especially since you have been able to do a brain surgery on a patient, and then discharge her after three days without complication. My exposure to the field of neurosciences, ever since I was a nursing student until now that I am in medicine, gave me only unpleasant memories about the neurosciences. I really pity neuro patients because most of my exposure to them end up witnessing their death, or if not, witnessing their inability to return to their premorbid level of functioning. My end point is, I am encouraging you to continue to be the kind and compassionate doctor that you are, even as you reach the status of being a consultant in the near future. Stay humble; the country needs doctors like you, who are not only compassionate, but most especially, skillful. Bihira ang doktor na magaling na, mabuti pa.

    • Hi Regina! Thanks for the message. Just trying to be good here. 🙂

      And there are a lot of neurosurgical interventions with good outcomes. It is probably just unfortunate that you have been exposed to patients with poor prognosis to begin with.

      Good luck with med school!

  3. I really loved this, it’s a good story, and you’re a very good story teller. 🙂

  4. akala ko naman may mangyayaring kung ano dun sa asawa hehehe. dok, bakit palaging tagos sa mambabasa yung mga kwento mo? nakakatunaw 🙂

    • Andoyman, sabi ko nga sa ibaba, “The stories will always be theirs. I’m just the storyteller.”

      Hehe. Salamat sa pagsubaybay. Next time, gawa tayo ng komiks!

      • waaaaa!!!! kaiisip ko lang nung isang araw na kung saka-sakaling magka-collaborate tayo, yung “palimos ng kulangot” pipiliin ko. hahaha.. asteg! salamat salamat salamat dok! hahahaha 🙂 sure thing dok!

  5. first time ko po dito, nakita ko ang link mo sa wall ng isang friend. nacurious. at nagbasa. hindi ko inakala na ganito ang mababasa ko dito, medyo madrama pero punumpuno ng inspirations. salamat doc. sana madami pa yong mga katulad mong hindi lang isang doktor para sa pasyente kundi isang taong may puso nagbibigay ng makataong serbisyo sa pasyente. 🙂

  6. nakaka-teary eyed naman ito…. good job. 🙂 It’s nice to know that they both turned out okay in the end… parang suspense kasi, I was thinking while reading na baka hindi happy ending, na after all of “Ofelia’s” and your hard work, si “Ofelia” naman ang namatay. :))

  7. ARNIE JOY GILO

    commendable blogs doc,just came across your site and I already wanted to finish reading all your blogs in one sitting.. this story made me teary eyed too..

  8. Autuminmymind

    I first read your article about the 5th valedictorian in your family and I guess it was a natural progression to move on to your blog. Thank you for these stories, they are very heartwarming. It’s great to read about a Dr. Isko who is doing his bit for the nation, your compassion shows through. Sana you stay on and help do something to make available exemplary healthcare even to the ordinary Filipino.

  9. love your heartwarming stories Doc especially about PGH patients and scenarios, it brings me back when I was a nurse sa ER during 2004-2007. I’ve probably have worked with you when I was still there.. 🙂 Keep it up Sir! God Bless

  10. Your story in Rappler brought me to your blog. I’ve read 4 or 5 entries so far.

    You sir, brought back my faith in humanity.

  11. You’re such a good person Doc. It would be nice knowing you in person. I’m an accountant but I’m so engrossed with all the entries in your blog.

  12. My first encounteer I had in your homepage was the Five Valedictorians posted in facebook by a friend. That story helped my survive the day. I read more the following day and this article. You are not just a doctor but also a writer. Your experiences are good for many especially for those who are far from our country like me. It give colors to our day. Godbless Dr. Ron.

  13. You should write more! Good Job!

  14. Thanks Doc. You’re such an inspiration. I have just seen your family in Jessica Sojo’s episode a while ago and hurriedly browsed the net to read your blogs. I hope that many would follow your steps. It seems like you have such a great understanding of life and its sacrifices. Sa perps din ako nagtapos ng highschool. More power to you!

  15. nice story…:-)

  16. nahanap ko ang blog nyo dahil naghahanap ako ng mababasa ng anak ko hinggil sa INTARMED. Naghahanap ako ng makakatulong sa kanyang pagpapasya hinggil dito. Talagang nakakapagbigay inspirasyon ang mga sinulat nyo. Sana mabasa ito ng mga nasa INTARMED at iba pang kumukuha ng medisina para magsilbing inspirasyon sa kanila. Kailangan ng ating bayan ang marami pang duktor tulad nyo.
    Binabati ko ang mga magulang nyo at nakapagpalaki sila ng mga katulad nyo.

  17. This made me cry. I remember, earlier this month my father was hospitalized. He was confined for almost a week. During that time, my mother barely leave his side except when she needs to attend to things related to my father’s confinement. She don’t eat unless i forced her to eat with me. Maybe that’s what true love is, you’re willing to sacrifice your own good for your loved ones. By the way, thank you for sharing your stories. God Bless.

  18. Please allow me to say that you are a doctor of the people. And I kid you not!

    Salute!
    Respect!
    For you and your entire family!

    AnitoKid

  19. Inspiring!! itutuloy ko na talaga mag Med, hindi na ako magpapatalo sa takot.

    Nersnersan.

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Names, dates, and events may have been changed to protect the identity of patients. The stories are not meant to provide medical advice for specific illnesses. The author neither accepts online consults nor gives medical advice online. Please consult your trusted physician.