Reversing Repercussions

“Inubos na namin lahat ng naipon namin para makalabas ka nang maaga. Sana, magbago ka na,” she said.

I was doing rounds in the Post-Anesthesia Care Unit (PACU or recovery room) when I overheard these words — a compelling request that was deliberately calm, in a tone with no vestige of anger, almost bordering on affectionate. I momentarily stopped writing doctor’s orders and looked up to see who was talking to my patient.

It was a woman in her early 20s. On top of her white t-shirt and black leggings, she was wearing the compulsory surgical gown with the label “PACU Use Only” and yesterday’s date across the breast. Her shoulder-length hair was on a ponytail, covered by the similarly required thin blue surgical cap. She held a small plastic bag, presumably containing pain medications and antibiotic vials. No, she was not crying.

The patient was a 30-year-old male, on whom my co-resident performed surgery to remove part of the skull bone and underlying damaged brain, sustained when a tricycle hit him two days earlier. Without the operation, he would have died from severe brain swelling. Bereft of any emotion in response to what had just been said, he stayed still and silent. I knew he could speak; I examined him just a few minutes ago.

“Kayo po ang asawa?” I asked the woman instinctively.

“Hindi po, Dok.”

“Ha? Kaanu-ano po kayo ng pasyente?”

“Ako po si Ofelia Reyes, Dok. Asawa ko po ‘yung nakabangga.”

Quick to reply, she must have sensed the confusion in my facial expression.

“Kayo po ang gumagastos sa lahat ng kailangan ng pasyente?”

“Opo, Dok.”

Curious, I finished writing my orders and put down the chart, “Ma’am, paano ba siya nabangga ng asawa mo?”

Ofelia narrated that she and her husband sold lugaw on the street. They owned a tricycle that they converted into a mobile lugaw stand by removing the top part of the sidecar. Daily, Ofelia would help her husband buy the ingredients and cook the lugaw early in the morning; it was her husband who did the vending in their puwesto, situated near a college campus and rented at 3,000 pesos per month.

The ingredients cost about 3,000 pesos. On a good day, they would have a gross income of 5,000 pesos, but most days, they earned a little above their overhead, just enough for their household expenses. They have two children, four and six years old. Her husband once tried working as a tricycle driver, but the income from selling lugaw offered much more promise and was less susceptible to fluctuations in prices and fares. Theirs was an earnest family trying to make a decent living.

Her husband was on his way home that night, driving the tricycle that had been loaded with the emptied pots and dirtied bowls and utensils, the remains of the day’s work, when his tricycle sideswiped my patient. He was not driving fast, Ofelia said, and I was inclined to believe her.

“Lasing na lasing po kasi po kasi ‘yan, Dok. Naglalakad sa gitna ng daan. ‘Yun po ang sabi ng lahat ng nakakita.”

When my patient was taken to PGH, he indeed smelled of alcohol. He was restless, that we attributed then to the severe brain injury. But even after the surgery, we had to put him on restraints; he kept getting out of his bed and pulling out his IV line.

Ofelia and her husband had been forced to withdraw their savings to pay for hospital expenses. It was fortunate that they had been allowed to get their tricycle back. Otherwise, they would have no source of income. But they had to send their two children to live temporarily with Ofelia’s parents in Bicol. She had to be in the hospital 24/7, and she was not sure if they would have enough money left to raise them when all this was over.

Ofelia then mumbled something, which I failed to understand, and then I realized that she was trying to show me a message on her cellular phone.

“Sbi mismo ng tatay nya nggamit dw po ng shabu anak nya nung araw na mabangga xa.”

I let out an involuntary sigh. My patient could hear my conversation with Ofelia, of that I am sure, but whether he could comprehend the repercussions of his actions on the night of the accident, perhaps not. He remained motionless, as if catatonic.

“May panggastos pa ho kayo?”

“Eto nga po, Dok. Naghahanap pa po ako ng pambayad dun sa mga ginamit sa operasyon.”

She showed me a prescription of operating room needs.

Working in a government hospital, we could not refuse to do emergency surgery in patients, just because they did not have money to buy medications and supplies. To be able to operate on our charity patients, we would often resort to our stash of OR needs, being kept by our junior residents. This stash we replenished, Robinhood-style, by getting the excess medications and supplies of patients who underwent elective surgeries.

“Kami na po muna ang bahala sa gamit,” we would tell our patients’ families. We would then advise them to get money over the next few days, and try to replace what had been used during the operation before the patient is discharged. “Palitan niyo na lang po bago kayo umuwi.”

But we never do an accounting just to check if each item had actually been replaced. Most of the time, they aren’t, and sometimes, nothing is replaced at all, especially if we have to prioritize the purchase of expensive antibiotics, which are harder to come by in the hospital.

“Sino po ang nagpapabili sa inyo niyan?”

“Hindi ko po alam, Dok. Inabot lang po kasi ito sa akin nung mga kamag-anak ng pasyente, kailangan daw pong palitan. Nasa halagang 10,000 pesos din po nung pinapresyuhan ko sa pharmacy.”

I removed a page from the patient’s chart and wrote, “Wala na pong kailangang palitan sa mga nagamit sa operasyon ng pasyente,” after which I stamped by name and put my signature.

“Sige, Ma’am,” I handed the piece of paper to Ofelia. “Huwag ni’yo na po iyan bilhin. Ipakita niyo na lang po ito sa mga kamag-anak ng pasyente. Siguraduhin ni’yo na lang po na maibibigay lahat ng gamot na kailangan bago siya makauwi.”

“Talaga Dok? Thank you po.”

Seeing gloom transform into relief in her face was heartwarming. It was the least I could do to help. It was clear that she and her husband, too, had been victims in these circumstances.

Often, we fail to realize how our actions irrevocably and interminably affect the lives of others. Who is to blame? We are all caught up in this maelstrom of anger, pain, and desire for retribution. Our lives intersect and we curse and we crash and we hate and we hurt.

Ofelia prepared to leave.

“Sige, Kuya. Aalis na ako. Magpagaling ka ha?”

There was no response, only a blank stare in return.

She then looked at me and said, “God bless po.”

I just smiled. We all move forward through the kindness of others.

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21 comments

  1. Probably one of my favorite posts of yours, Sir Ronibats! It’s written with so much simplicity, but with that stark reality and honesty that just bites. And as I go into clerkship I am finally meeting these characters of your stories. Unfortunately, there are just too many of them, day in, day out, that sometimes, during those very few hours of utter peace and silence before the break of dawn, I cannot help but sigh.

  2. Kristine apple galera

    May the God bless u always doc!

  3. Ofelia Reyes was and spouse were victims of a screwed up provision of the law that criminalizes motorists involved in an accident even if the “victim” is the one who should not be in the road.
    If they did not help the “victim” then their means of livelihood would be impounded indefinitely and criminal charges filed.

  4. LOREZA MARGLLO

    alam mo doc dyan sa PGH madaming istorya.. sa loob ng 1 week na naka confine si bella dyan pagsulat ng istorya ng bawat ward ang libangan ko.. iba’t ibang storya ng buhay .. my lungkot, may hirap, may galit,may pag asa , may saya, at higit sa lahat na pinaka importanteng nakita ko at nagmulat sa mata ko tungkol sa pinaka importanteng bagay sa mundo … pagmamahal. Pagmamahal ng ina at ama sa anak, ng kapatid, ng asawa, ng kaibigan, ng kamag anak, ng mga anak sa magulang, at ng doktor sa pasyente.. eto kasi nagbibigay ng pag asa sa pasyente.meron kasi akong kasabay na pasyente minumura at minsan sinasampal pa ng bantay na kamag anak.. yun ung masakit parang gugustuhin mo na lang matuluyan pag ganun ang bantay mo.. anyway doc thank you pa din sa inyo pati sa ibang mga doctor at nurses na kasama mo sa ward 6..

  5. Aaron Delapaz

    Thanks for sharing this sir. I’m not sure maybe this is either the 2nd or 3rd works of yours which I read. Tama un isang ng comment, your work is very simple but does touch the heart. I am very happy to know people like you exist. Makes me feel at home, blessed and happy. Salamat palagi doc and God bless.

  6. You have such a big heart. I just hope and pray that all doctors will do the same as you do. pls do continue your good deeds and God will definitely bless you….

  7. Jennifer Corre

    Am glad that there are people like you Doc who are one of a kind. You have a big heart and I know you will be bless a millionfold because of your goodness. I have been following your blog. You have been an inspiration to all of us. God bless you always Doc Ronibats!

  8. Wow. I have just recently started reading your blog and people can learn a thing or two from your posts. 🙂 I just started clerkship last April and I still have a lot to learn. Empathy, bedside manners, and a good heart are still the most important traits to have. God bless po sir. 🙂

  9. hi, you have a wonderful blog right here! you’re one of my idols na, i wish i could meet you when i go to ed school 😉 btw you remind me of derek shepherd from greys anatomy, hahahaa ‘It’s a beautiful day to save lives ‘ God Bless!

  10. S-A-L-U-T-E- …God bless you Dok…

  11. I really admire you Doc. Actually, nacurious lang po ako about you. I was informed by other patients I met on ward na you and ur siblings are valedictorians. Then they also told me na lahat ng inoperahan mo, masswerte. All I said to myself was “Yes! Nasa mabuting kamay and kuya ko” haha! It may be selfish for other doctors but yeah.Lol. I think, crossing on ur blog is the most priceless thing I could ever get. You stories never fail to inspire me :’) I have witnessed the situation at ward and indeed, it was heart breaking BUT people like you ease all that heart breaks. Very understanding, very patient, never masungit, lahat na! 🙂

    Ps.
    Sana Doc., makwentuhan mo din kame ng lovelife mo haha jk! GOD BLESS YOU! 🙂

  12. good day doc, hve read ur article in inquirer just what i hve in mind. how could they used taxpayers money. SHAME ON THEM. My youngest sis is also a doctor, from ur school too.. reading ur blog, WOW…KEEP UP THE GOOD WORK. Your a hero… GOD BLESS YOU……

  13. very heartwarming story… God bless you!

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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.