Dress Code

Before going to the first day to work in the hospital, I thought to myself how should I dress? Of course, I have to dress comfortably and decently. And so I dressed the way I normally do, the way that defines my character, I dressed with a unicolored poloshirt with white pants and a white coat. No sweat with the dress code because we have to wear a uniform. Bbut what when I will be a doctor with no defined uniforms to wear? I thought about this for some time and this is what I found recently in the web about a research on doctors attire...

Conclusionsof the research state: Patients prefer doctors to wear semiformal dress and are most comfortable with conservative items; many less conservative items were, however, acceptable. A smile made a big difference.

(from Judging a book by its cover: descriptive survey of patients' preferences for doctors' appearance and mode of address;
Marianne M Lill, medical student1, Tim J Wilkinson, associate professor. Web: http://www.bmj.com/cgi/content/full/331/7531/1524 Accessed June '09)

Code 88 II

CODE 88.

During the first several yells of Code 88 that I hear, I would usually pretend not to hear it, do something else or worst run out of the room. Kasi if you hear the code then you must respond. Whoever responds to the code first is the Captain of the Ship. Pero after several more Code 88s... iba na.

When I hear the Code, my adrenalin rushes up to the top floor. Hinahanap ko agad kung saang ward o floor yung may code. Ewan, but the perspective have changed. It's no longer somebody's dying or going to die but it's a chance to revive a patient. Optimistic?. Not really, more of ego boosting. Siempre, you have something to brag kapag may na revive ka na patient although after 20 or 30 minutes or kung susuwertehen 1 hour after that patient you revived goes into arrest again and eventually die. Plus the pride and fame of being the Captain of the Ship kung ikaw ang nauna (it only occured to me once though but that's another story) sa scene.

Code 88. After a few more codes, nag-iba na naman ang perspective ko. This time sa patient. The secret para hindi daw maging emotional when you are doing CPR to a patient is to is to see the patient as JUST another patient. Distance yourself from the patient, from the folks and... just don't make yourself attached. So, Code 88. Ahhh ok, Otso otso. Time to exercise. An oppurtunity to stretch and flex some unused muscles. An oppurtunity to use some stored energy and force. An oppurtunity to do the Otso otso dance. (Di ba, kuhang kuha ang otso otso ni Bayani?) And para kay Kristian, an oppurtunity (kung babae ang nag respond sa Code) to well...

The Code has evolved from just being a code to something else and more. Then you asked, bakit ang mga doktor parang walang puso at pakialam sa namamatay na patient nila? My answer...

Well, my Code 88 record is 11 of 21.

Code 88

Code 88.

That's the code you yell when somebody goes into arrest and needs CPR. Code 88. Other hospitals call it CODED, ARREST, CODE RED, etcetera. Just the same, the patient's heart beat and breathing stopped and as an intern, I need to resuscitate the person.

But imagine this, I am only in my first week in the hospital. Well, the patient has long been a "gulay". Siempre na-apraise na rin ang folks (the relatives) sa condition ng patient. As a new intern, ang sa isip ko lang ay patient ito that needs treatment and then gagaling siya.

So all I have to do is do my best and treat him... Ibigay ang reseta ng gamot sa folks and administer the meds... Monitor and assess the patients condition and watch out that he won't deteriorate... Ibigay ang reseta ng gamot sa folks and administer the meds... Monitor and assess the patients condition and watch out that ... uh oh... sheiks... "doc..... DOC... DDDOOOCCC...."

Patients has no pulse, no spontaneous breathing... Doc? (looking at my resident). "Start CPR." Yea, of course! Ano pa ba ang gagawin ko... 1... and 2... and Breath! 1..and 2... and Breath! "Pabigay ng Epi(nephrine)". Five minutes later... Doc, still no pulse and breathing. "Continue..." (My resident turns to the folks and says blah blah blah)

Thirty minutes and 5 epis later... "OK, Neki check the Vitals." "Wala doc". "Get the ECG" Tinawag ko yung Technician. Long Lead II... flat line. "Neki, chart. Time of death 9:45 AM." Then everybody walked away. Ang nanay umiiyak. Ako? Ewan ko.

Learning from Doggie Howser MD, that the patients death was not my fault but of the disease, took away any guilt feeling I may have. Pero I still cannot understand how easy it is for the Doctors and even nurses to stare at death with a "wala lang" at "pakialam ko" attitude. Hello, may namatay. Tao yung namatay. "Ano ngayon, buhayin mo?" Well, I tried... "Yun nga, you tried and you failed. Kasalanan mo?" NO! "So let go..." Ok.

What about the dead patient? "Hindi na patient yun, cadaver na. Find a patient that you can help and not a dead body!" Ganun? OK....

To be continued...

Getting ready...

Getting ready for the Big Day in the Hospital.

Lahat excited. Pati ako.

The other day we had an orientation about the internship (or clerkship to some). Binigay na din ang groupings namina at ang mga designated departments kung saan kami magrereport. Sa Pedia ang una kong rotation. Tapos ang "status" ko daw ay "FD" at ang "post" ko ay sa "ward".

Ano yun?

FD ang tawag sa kagagaling sa 24 hours duty or "from duty" while the "post" is the designated place of responsibility, at sa akin ang ward or the admitted patients.
So kung FD ako, hindi na ba ako papasok sa April 1? "Tangek!" Siempre papasok pa din daw ako sabi ng resident in charge nakin. Kasi I have to receive the endorsements from the outgoing interns. OK

April 1.

Araw ng unang pasok. Siempre excited. I have never stayed long in a hospital. I haven't even been admitted in a hospital since birth. The only times na nasa hospital ako are for mandatory physical exams and the preceptorial sessions during the undergraduate years.

Pagpasok ko sa entrance, sabi ng guard "Doc, sa emergency room ka dapat masulod kay karon pang 9 AM ma-open ang main door".

Doc? Ako ba yun? Nakakapanibago ah. Doctor na pala ang turing sa amin. Nakakatakot. Do I feel like a doctor? Do I even look like a doctor? Bata pa kaya ako; ang doctor matanda na, di ba? This internship thing is getting more exciting.

Saan ang ward? Yes, hindi ko alam ang ward dahil hindi man lang kami ti-nour during the orientation. Actually, the orientation was just a mere welcome talk and introduction of the residents. Yun lang. Hindi kami tinuruan kung saan ang mga deparments. Hindi sinabi kung ano ang gagawin naminsa pagpasok sa hospital. Kung ano ang dadalhin. Kung ano ang dapat ihanda namin. Hindi nga inorient ang scope ng trabaho namin bilang intern. we were just welcomed as the new LOWEST FORM OF MAMMALS IN THE HOSPITAL KINGDOM...