Ronibats.PH Stories of a Filipino neurosurgeon, teacher, and writer

You Work Hard for Moments Like This

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I never liked going on duty on Sundays. Sundays are never quiet in the hospital. Somehow, people get into all sorts of trouble and find a convenient excuse to drag themselves to the hospital on a day that used to be dedicated to attending mass, rest, and mellow music on the radio.

On Sundays, I receive the most number of ER consults for head injuries from vehicular crashes and heated arguments during drinking sessions. They get shot, stabbed, hit, and mauled, when they could have avoided all the trouble by staying home with their families. Children of all ages fall, slip, and trip on Sundays, as if wanting to evade attending class the next day. Private patients scheduled for elective surgery during the week usually opt to get admitted on the preceding Sunday. And residents from all departments have the propensity to refer patients and request for all sorts of diagnostics on Sunday, in an attempt to make up for the lag time during the last two days.

I’d trade any Sunday duty for a Friday, even during payday weekends.

Last Sunday was no different. It was late afternoon and I was at the nurses station of ward 11, one of the pediatric wards, looking for patient charts that I needed to review before doing ventricular taps, a delicate bedside procedure in which I would try to get brain fluid from baby’s heads. Now locating charts would have been easy if students, nurses, and co-residents put back the charts on the shelves after writing on them, except they usually don’t, and thus—depending on the time of day—it often takes longer to look for a chart, than to actually examine a patient and formulate a diagnostic and surgical plan.

In my mind I was running out of places to check for charts. Nurses station, residents callroom, interns callroom, patient’s bedside, where else could they be? Thinking was made even more difficult by my wanting to go out and eat my long-delayed lunch. I still had to see three ER referrals, one admission in the pay ward, and six patients for surgery the next day. The anxiety of having to do so many things in so little time was building up. My patience was trickling.

And then I heard somebody call out, “Dr. Baticulon!”

I looked up. It was a man and a middle-aged woman. They were smiling at me. I was sweating profusely from frustration and hunger. I have never been good at remembering patients’ names and faces, so I just politely asked, “Sino po ang pasyente ninyo?”

“Si Reyes po.”

It took a second for the name to register. Reyes. Of course it had to be Reyes, the patient I operated on two days ago. Then I remembered: they were his son and wife.

“Dok, thank you po,” he said, “OK na po si Tatay.”

When I admitted Mr. Reyes to the ER, he was bedridden, speaking very few comprehensible words. That was the effect of the liquefied blood clot compressing the left side of his brain, brought about by a motorcycle crash two months prior. I drilled a 25-centavo-sized hole (“burr hole”) on the frontal portion of his skull to evacuate the blood that had accumulated.

Putting a burr hole is a relatively simple procedure for neurosurgeons, in the same way that first year surgical residents perform uncomplicated appendectomies.

“Salamat, anak, nakakausap na namin siya,” the wife said. “Congratulations, very successful ang operation.”

She reached for my hand.

I heaved a sigh of relief. After the surgery, despite having read about the procedure and having reviewed the CT scan multiple times, I still kept wondering. Should I have put the burr hole more anteriorly? Should I have used more irrigating fluid? Should I have left a negative-pressure drain? What if he does not recover as expected? One thing I have learned early on is that there are no certainties when you operate on a patient, only possibilities and probabilities. Anything and all things may go wrong when you least expect them to. The moment I incise with my scalpel may be the only chance I get, so I’d better get it right.

With profuse joy and gratitude in their faces, Mrs. Reyes and her son standing in front of me relieved all fatigue, anxiety, and hunger in an instant.

I could only thank them back. They weren’t even supposed to be in that ward because their patient was in the recovery room in the 3rd floor. Mother and son recounted how Mr. Reyes finally recognized them, even expressing the desire to have his foley catheter removed and to go back home immediately.

When they left, I still had the same number of things-to-do, with no patient chart in hand, but that did not matter. I would see them again two more times before I discharged Mr. Reyes.

Just before they went home, his wife sent me a message:

“Gud am doc. C tita ofelia reyes to maraming maraming salamat utoy god bles u. pag check up nya ay magkikita tayo ok. again tnx so much gud luck Anak.”

And thus I am reminded: I work hard for moments like this.

About the author

Ron Baticulon

Ronibats is a pediatric neurosurgeon, teacher, and writer. In 2018, he won a Palanca award for the title essay of his upcoming book, "Some Days You Can't Save Them All" (UP Press, 2019). You can follow him on Twitter @ronibats.

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Ronibats.PH Stories of a Filipino neurosurgeon, teacher, and writer

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