It was Saturday morning, and by force of habit, I woke up early even though I had nothing scheduled for the day. It was the end of my second week in private practice. Lying in bed, staring at the circular lamp set on a deep blue background which is my bedroom ceiling—meant to simulate a full moon on a starless night sky—I wondered if I had made the correct decisions thus far.
It was elective surgery day and I was the pediatric neurosurgery fellow assigned to the operating theater. After scrubbing my arms and hands with antiseptic in the anteroom that served as our washing area, I walked into the operating room with both arms held up in front and politely requested a sterile towel from the scrub nurse. From across the room, it was our head nurse Shelley who noticed the grazes on both of my forearms.
“Oh, what happened to you Ron?” her tone filled with concern as if I were her own son.
“I got into a fight in a bar over the weekend,” I said with as much seriousness I could muster while patting myself dry.
As a student, I was the stereotypical academic achiever. “Consistent honor pupil” was how family members would invariably introduce me to acquaintances then, and how most of my former teachers would remember me now. At the end of each academic year, it was no surprise to my parents receiving a letter from my school, inviting them to bestow medals upon the eldest of their five children.
In February of this year, I had the rare opportunity to assist a world-renowned neurosurgeon as he clipped three intracranial aneurysms in a patient on the same sitting. Dr. Michael T. Lawton led his medical team from Mission BRAIN Foundation on a three-day visit to Philippine General Hospital, to give lectures and workshops for Filipino neurosurgeons and nurses, and to demonstrate surgical techniques on different neurovascular cases.
It was a cramped courtroom, filled with wooden tables and benches that appeared much older and heavier than me. I suppose the weight was intentional, to prevent any plaintiff or defendant from hurling any of the benches in a moment of outrage.
I had been served a subpoena to testify in a case of frustrated murder. The plaintiff was a patient I operated on three years earlier and it was my first time to perform my civic duty as expert witness. I picked a seat in the middle of the first row.
This is the beginning of the end.
2014 is the year I expect to finish training as a neurosurgeon. Except for 2009, when I taught in medical school and practiced general medicine, I have spent most of my waking hours from June 2001 until today in this government-run university-hospital complex. That is 12 of the last 13 years.
Earlier today, I saw two of my brain tumor patients follow up in the Neurosurgery outpatient clinic. While both have made good recovery from their operations, their families’ worst fears had just been realized with the piece of paper that they brought with them, bearing the official pathology report stating that the tumor removed from the patient–as suspected from the start–was brain cancer.
“Sir, pababa na po kami sa OR.”
“OK. Nasa office lang ako. 10 minutes,” I said, then quickly hung up on the junior resident. I would be operating on a 70-year-old male with a chronic subdural hematoma overlying the right half of his brain. Resulting from a vehicular crash two months earlier, the blood clot had gradually accumulated, causing progressive weakness of the left side of his body. During the last 24 hours, he became increasingly difficult to awaken, indicating that the brain swelling and compression from the blood clot were worsening. He needed emergency surgery.