Lost Saturdays

“Inday, kakalbuhin ka muna ha?” Eric Reyes said to her 13-year-old daughter Ofelia as she lay restless on the operating table. I sat at the head end of the table, scissors in one hand while the other adjusted and focused the light on her shoulder-length black hair. Her hair was dry and full of tangles. Grit and oil clung to my fingertips as I parted and divided her hair into locks, making the strands more manageable to trim. But it was full and thick nonetheless.

“Tatay, mas gusto mo bang kalahati lang ng buhok ang tanggalin ko, ‘yun pong sa kanan lang, o uubusin na lang natin lahat para pantay ang tubo?” I asked Eric beforehand, as we wheeled her daughter into the OR.

“Kalbuhin mo na lang Dok, para mas madaling linisin.” This response was not unexpected; he worked in the army’s reserve command, he told me. Still, I could sense regret in Eric’s eyes as he watched the strands fall in clumps to the trash bin underneath Ofelia’s partly overhanging head.

Ofelia was diagnosed to have multiple congenital anomalies at birth, among which was hydrocephalus, for which a ventriculoperitoneal shunt was inserted when she was three months old. At age two, she also had to undergo open heart surgery and a series of limb operations to release the contractures on her legs and feet. She only finished kindergarten and stopped schooling afterward, but she could communicate intelligibly with her family. She could not walk but she could feed herself, and for the most part, required assistance for daily living, provided by cousins, uncles, and aunts while her father worked as a gardener in the army camp.

Friday morning however, she suddenly complained of severe headache followed by intractable vomiting. By the time she was taken to our hospital, she was barely awake, muttering incomprehensible sounds with new-onset weakness of her left arm and leg.

Imaging showed a large cyst in the right side of her brain. It did not appear to be malignant, but it needed to be drained to relieve her brain of compression, hence the referral to Neurosurgery.

“Pang-ilan niyo po siyang anak, ‘Tay?” I asked in the wards during history taking.

“Nag-iisa lang po iyan, Dok.”

He kept staring on the floor and his shoulders hung low, far from the snappy military stereotype. He walked with a limp, too. But one only needed to notice the burnt skin and the calloused hands to unravel the story of paternal sacrifice.

“Kailangan po niyang operahan, ‘Tay. Magkano po ba ang dala ninyong pera? Libre po kasi dito ang kama at wala pong bayad ang mga doktor, pero ang mga gagamitin po sa operasyon at ang mga gamot, sa inyo po lahat iyon.”

“Limanlibo lang po, Dok.”

“Kung makakakuha po ba kami ng libreng shunt (which costs Php 12,500), papayag po ba kayong ipaopera siya?”

“Opo, Dok. Tulungan niyo po kami.”

That was Saturday morning. I was not on duty and had been anticipating to go someplace quiet in the afternoon, to finish my long overdue research protocol and shorten my list of unread books, neurosurgical or otherwise. Perhaps I could go home at night or share frustrations with good friends over alcohol.

But seeing Ofelia, I knew outright that the plans would have to be put off. Among all neurosurgery residents in the hospital, I was the one who knew her best. I took her history, I examined her, I talked to her father and explained to him the risks and benefits of our contemplated procedure. In the words of one of my consultants, “I am now the world expert on Ofelia Reyes.” There was no question about it. I had just made an implicit commitment to operate on her in the soonest time possible, lest she deteriorate beyond medical care.

Ofelia was lucky: the Pediatric Neurology service had one remaining piece of the type of shunt she needed. But due to the heavy traffic of emergency cases in the OR complex, it was already past 10 pm when we finally had the chance to bring her up for surgery.

No doubt, I was dismayed. It was another free Saturday lost, just like many other weekends that had come before. Despite being on my fourth year of residency training (“Senior ka na, big time!” my classmates would often exclaim when we pass by each other in the wards), I was still bound to the hospital when duty called for it.

“Wag ka malikot, Inday,” Eric tried to restrain his daughter’s non-purposeful flailing of extremities. I was not sure if she could understand him, but from experience I have learned that the sound of a familiar voice eased the pain and anxiety of patients drifting in and out of wakefulness.

Ordinarily, I would have waited until the anesthesiologist had put my patient to deep sleep before shaving hair, but the assigned resident at that time had to run to an emergency case in another wing of the OR complex. Since Ofelia barely moved her head, I decided to start. I wanted to finish the procedure as fast as I could, so that I could minimize the risk of infection later on.

As I put down my scissors and reached for the knife blade to shave Ofelia’s now trimmed hair, it occurred to me that I forgot to ask Eric one question.

“‘Tay, nasaan po ang asawa ninyo?”

“Wala na po, Dok.”

I stopped, left hand on Ofelia’s scalp and right hand with the blade in mid-air.

Suddenly, I realized that this teenage girl lying before me was the only remaining family Eric had. He could not afford to lose her, not after all the surgeries she had to undergo, not now, not this soon, not for something that could be remedied in an otherwise ideal health care system.

“Ano po ang ikinamatay niya?”

“Komplikasyon po ng diabetes, Dok. Dito rin po namin dinala pero malala na raw po.”

I continued shaving, exerting just enough force and pressure with each definitive stroke, calculated by experience to remove hair without wounding the scalp — an ancillary skill learned only from years of hard work training to be a brain surgeon. “Ofelia, pasensya ka na ha, konting tiis lang. Aalisin lang natin ang buhok mo para malinis tignan pagkatapos.”

“Game na tayo?” I asked the anesthesiologist.

“Yes sir.”

“Sige po, ‘Tay, tatawagin na lang po namin kayo sa ward kapag may kailangan po kami. Huwag po muna kayong aalis ha?”

“Kayo na po ang bahala, Dok,” like what all family members say before saying goodbye, which they know — though they would not say out loud — could be their last.

I started at 11 pm and finished a little past midnight. As I wrote my post-operative orders in the chart, I had to remind myself that the date had changed.

When I did rounds in the morning, Ofelia was more awake, able to answer questions and follow commands.

“Dok, pwede na daw ba siyang painumin? Nauuhaw daw po kasi siya,” Eric asked, still in the humblest of voices.

“Sige po, susubukan po natin. Titignan po muna natin kung kaya na niyang uminom ng tubig paunti-unti.”

Ofelia’s bald top and crown reflected the sunlight which shone through the ward’s wide open windows. Sunday morning, and I could hear Bono singing in my head.

It’s a beautiful day.

 

 

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38 comments

  1. Chalk one up for you doc!

  2. It may be a “Lost Saturday” for you Doc Roni, but it was another Saturday gained by Ofelia. I admire you and your passion for the medical field Doc Roni. I hope more healthcare providers are as passionate and compassionate as you are. The article you have written before in Peyups was what kept nagging me the whole time I was deciding whether I should pursue a career in medicine. Even now that I am married and have kids on my own, I am still haunted by what ifs. But having a special needs child reminds me of my priorities. Anyway, I just wish that the specialists we are currently consulting with are like you… Making time for us patients, even if it meant sacrificing your personal time. May you continue helping people and may you be genuinely, continuously happy in doing so.

  3. Kristina Balmes

    Scheduled for an interview in PLM-CM tomorrow, your entry is exactly what I need to ease my anxiety. That’s where I want to be 10 years from now – out there losing my weekends for something worth every second of it.

  4. Hi Doc! I just wanted to say that you have inspired me in magnanimous ways. And I’ve only come across your blog recently–the “two hours ago” kind of recently. I’ll have my interview for WVSU-COM next week and my fears and anxieties have momentarily disappeared. Thank you so much and I hope you inspire more people.

  5. The lost saturday is not of a compromise, but a gift given to you. You see that there may be time lost, but in exchange a life was gained back.

    Naiiyak ako sa entry na ito Doc. You have that compassion to save lives, considering this is one profession that you really like. Treasure it, and it will bear good fruit in the end. :)

  6. doc i am so touch by most of yoru articles and your dedication to your chosen career. i hope to encounter a doctor like you or better yet work alongside you

  7. I saw the link to your site in FB because of the Five Valedictorians article. And now I am hooked.
    It has been 2 articles so far, and alot of tears shed.
    Thanks for such touching write ups.

  8. Hi, I came across your article and it made my heart melt. I’m at the waiting area of naia 3 when I was reading your article. I had to pause on some paragraphs, otherwise, tears would fall from eyes and people would think I am crazy. lol

  9. i’m now officially a fan… hats off to you Doc.

  10. God bless you,Doc!

  11. Your articles are touching and inspiring..i admire your passion in your work.Idol kita, doc. Gusto ko ring magneurosurgeon. I’ll be graduating medschool next month (Cebu institue 0f medicine). I hope you can help me on how to apply for a residency program in neurosurgery and what to prepare so that i’ll have high chances of being accepted soon. Next year august na ako mag boards.. Thank you! God bless you!

  12. I saw your article : Five Valedictorians , and it inspires me a lot :)

    And in this article, you are dedicated to your career and gave the readers an inspiration to pursue their dreams and other’s dream :)

    God bless you ! :)

  13. Hey, Roni, your stories continue to inspire me… Just breaks my heart reading this, quite ironic, actually. Our exposure in PGH makes us more aware of the harsh realities in Philippine medical care, but at the same time, instances such as this shows there is still hope. Sometimes, being a doctor overwhelms me too much. I’m happy I get to read your blogs, helps in coping up being overwhelmed. :)

  14. Omg it’s you, Ronibats! I used to visit your blog when I was in high school, and you were still a med student back then. I frequented your blog because you were really good in Adobe Illustration (it was Illustration, right?) and in web design; also, I enjoyed your stories then. And now you’re a Doctor already! So happy for your family, Doc. Your family’s story is truly inspiring.

  15. this is so inspiring.

  16. Lourie Mendoza

    Hi Doc Roni,

    I salute your parents for the kind of parents they are! Not for the 5 genius children that they raised and am sure continue to guide but for the hearts that they nurtured on you guys.

    Just like the other reader, I learned of your blog through the article in Inquirer. This is also my second of your many articles. I will certainly find time to read the others as well.

    Doc- the son of my sons’ previous nanny had a brain illness since birth. Am not sure if it is hydrocephalus. I know that they had been in PGH but they seemed not to be getting the much needed attention. Am hoping if you could help them. Kindly email back your contact info and schedule in the hospital, if okay with your. Thanks. God Bless!

  17. Doc, you are one of a kind… God Bless and I hope your younger siblings will follow your footsteps. Congrats to your parents for having you as their son.

  18. *wipes tears* Great time to have read this on Easter. My brother wanted to be a doctor but we could not afford it. But he thinks about it now and then though he loves his job as a marine biologist…

  19. That was a very inspiring story. May your tribe increase, Doc. The world needs people like you, your parents and siblings. I read your other article “Five Valedictorians” just some minutes ago, and I continue to be heart.warmed by your story. You give hope, and serve as a living proof that God truly watches over us, that no obstacle cannot be overcome with determination, sprinkled with gentle parental guidance and familial love. Kudos, will be following your posts. :)

  20. Sir, i wish i had read your blog a month ago.. Baka hindi ako nagquit sa residency. Na-overwhelm kasi ako ng pagod, but now ithink it was the biggest mistake I have done. But, you inspired me to go back… Salamat! Hindi pala ako nag-iisang nalulungkot every weekend na on-call pa din.

  21. you’re an epic doc! saw your story in one of the segment of kapuso mo jessica sojo.. i’ve been reading your blog, you never fail to amaze me :) great stories!

  22. Erick Nisperos

    You are such an inspiration doc :) i salute and admire you sooo much :) God bless you :) you are a blessing :)

  23. Hi Doc, I just started reading your entries and I applaud you and I want to give you a huge huge hug. You are such an inspiration.

    You are a blessing. Your parents raised you well.

    Sana lahat ng tao kagay niyo!

    Thank you for sharing Doc.

  24. Romer J. Tubongbanua

    Dear Doc Roni… I can really relate with the situation of Ofelia. I’m Romer, diagnosed having HCP when I was at Gr.5. And it’s a long story how I was diagnosed with that. But then, according to my Military Neurosurgeons, I had Cerebral Aquedactal Stenosis, causing Severe headache and other symptoms. My father is also a Military. That’s why my parents brought me at AFP Medical Center, way back (2002). That was very frustrating to me, but also to my parents. I’m the eldest among there 3 children’s. As the time goes by, after a year, my shunt malfunctioned. That’s why, need to revised 2nd VP shunting(2003). I passed my Elementary years. It’s also my intention to continue study and I never considered to be the reason this surgery and this disorder for me to stop in my study. I remember before my 1st operation, I have doubt but also my parents for me to undergo surgery. Because it’s new to us, specially it’s really unexpected happenings in our family. Also, there comes a moment, need to go at DSWD at AFPMC for us to get discount in my MRI, due to financial prob. My 1st shunt was free. But the others, we bought for almost 25,000php.
    And then, when I entered High School, my shunt dislocated. Same signs and symptoms arrived few months before 1st year end(2004), 3rd VP shunting. Yearly I’m at AFP Medical Center- 4A Neurosurgery Ward/ICU. Because I had also VP shunt revision during 2nd year(2005) and 3rd year(2006). Until when I realized and had interest regarding my health condition. I studied my Health Condition and took care my health as well as my shunt. It continued and really took care my shunt when I entered Nursing School (2007-2011). No shunt revision happen. Thank God! He guided me at put me here in this Career/Profession for me to understand deeply my health condition. As I graduated in College batch 2011, I also took Board Exam(July 2 and 3,2011)and passed it. I immediately went to AFP Medical Center and told to my 4A Family(Nurses and Doctors) and advised to trained there(RN Res). I grabbed the opportunity and luckily assigned at the same ward/ICU where I confined. I’m really happy with that. Cause I given a chanced to serve and of course to had returned service in my 4A Family.
    Doc, sorry for my long comment. Just want to expressed my side. Specially this time, I’m still looking for answers and advises if I will continue in Medicine. It’s due to some reasons and conflicts in our Family. Specially in my Parents side. Thank you Doc for inspirations. You and your family are my idol! Thank you so much.

    • Romer, I’m glad that despite having undergone multiple shunt revisions, you’ve been able to succeed in your undertakings. It’s hard to live with a VP shunt. I can only imagine your plight and that of my patients. If you want to pursue Medicine because it will bring you fulfillment, then go ahead. The VP shunt should not be a hindrance. Good luck to you and thanks for reading! :)

      • Romer J. Tubongbanua

        I’m not expecting for your immediate reply Doc. But then, you did. Thank you very much Doc. And Yes Doc, for me, I really want to pursue in Medicine. I’m already 22 yo now turning 23 this year. I’m thinking that, I don’t want to comes to the point na medyo may edad na ko mag Medicine. Specially yun po, may shunt ako. I know darating yung point of Intellectual Limitation ko. Is in it Doc? Tama po ba yang naiisip ko Doc? I’m just an average person, but hard working person as I did during my Nursing School. I really want to enlighten my mind to have strong decision upon entering Medicine hopefully next year, even though still my parents not agree and can’t support me to my plan regarding Medicine. Is it possible they will support me soon?
        Actually Doc, like others said, it’s my parents choice I took up Nursing. This time, I really want to decide by my own. But still I really need their support. Thank you so much Doc.

        • I don’t think it should be a deterrent. Having a shunt should not hinder you from going into and finishing Medicine. ;)

          • Romer J. Tubongbanua

            I’ll do my best to enter Medicine next year. Since it’s the one I really like. To become a Doctor. It’s suicidal, weather I convince them for their support or not. Most important, I satisfy and fulfill my self.
            Again, Thank you very much Doc Roni! Your such a blessing to me with your stories. Thank you for you convincing power.:)

          • Do well. Do your best. :)

          • Romer J. Tubongbanua

            Thank you very much Doc Roni.:)

    • finally found someone who‘s about my age with hydro ! most of the hydro patients i read about are infants and toddlers. i had mine since birth and has been living with a shunt my whole life. it‘s hard to deal with it, lots of pain and weird sensations. in fact i came across this post coz i was looking if im the only one who hears ‘ringing‘ along the shunt. im glad you‘re also doing well despite the challenges

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