Atheista -

Though I’m still a shade under two years away from completing my medical education, the current curriculum already allows students like myself to be in the frontlines in various parts of the Philippine General Hospital. In five weeks as a clerk – that’s Learning Unit VI for those familiar with the UP College of Mecidine — I’ve rotated under the departments of Anesthesiology, Emergency Medicine and Surgery. It’s been physically-tiring as well as mentally and psychologically taxing for the most part but in the end, it’s been a rush.

 

Death is the great equalizer. We will eventually face it one day and no matter how much we romanticize the esoteric beliefs on life-after-death, death will continue to remain as a concrete and irreversible termination of somebody’s life. It’s like having nature remind us that the phenomenon of life was never meant to look after the welfare of the individual. It was never just about man. We die – just like everything else that is living. The difference of course is that our species have figured  out ways to challenge the natural order after years of practice and research.

 

Imagine just how many women died during the neolithic era because of childbirth. Can you fathom how people used to die in their 30s and 40s due to epidemics that swept entire continents just a few centuries  ago? Now, we can fight back. We still see a high rate for mortality for women giving birth and we still see an alarmingly high number of HIV patients  in Sub-Saharan Africa but it has definitely improved dramatically from where we were as a species a millennium ago.

 

 

Emergency Medicine 

 

It was my first time to work in the Emergency Room but I’ve been always familiar with its notorious ambiance. Though the complex is relatively new, the air conditioning conked out a couple of years ago. This has made the ER a very hot and smelly place. The ER at the Philippine General Hospital challenges your conventional view of what an emergency room should be. Because of the immense number of patients already holed up in the charity wards, dozens of patients get stuck in limbo in the beds inside the Acute Care Unit. It’s a rich and often overwhelming combination of sweat, feces, necrotic material, pus, burns and just about anything you can think about. It’s a challenge but your nose will get used to it. You’ll realize you stink big time after you leave the premises though.

 

As a clerk, we given the following responsibilities during our two-week rotation:

 

Pre-duty 

Schedule: 730 AM – 500 PM (weekdays) 730 AM – 12NN (weekends)

As the name suggests, it’s the day before your duty day. Clerks who have this status are tasked to man the Triage Table. All patients that enter the emergency room are assessed by those in Triage. Based on the chief complaint, history of present illness and vital signs, the triage officer (usually a resident from the Department of Emergency Medicine) makes the call whether the patient falls under the emergent, urgent or non-urgent category. Due to logistical reasons and lack of resources, patients who could afford to move to another hospital are politely asked to transfer to another center. Some patients also consult the ER for the weirdest of reasons – non-emergency cases like slight fever, fungal infections or even requests for physical check-ups! These patients are advised to visit the Out-Patient clinics or arrange a consult with a private practitioner.

 

Duty

Schedule: 730 AM-400 PM; 400-7AM. (Weekends and Weekdays)

Clerks on duty stay in the Acute Care Unit to execute orders for the patients. It’s an amazing learning experience! You will  literally get all the chance to learn and perfect your techniques for intravenous line insertion, blood extraction, foley catherization, arterial blood gas interpretation, nasogastric tube insertion and even radiographic plate interpretion. When a patient goes into code, the duty team is also expected to provide basic life support by doing chest compressions and monitoring the critically ill. It’s tiring, but again, it’s definitely a rush! You’re definitely challenging death and the gravity of the situation – the sheer drama, crying relatives, adrenaline in your bloodstream – makes you want to give it your all and something extra to give the patient a fighting chance despite fatigue and sleep deprivation.

 

Post-Duty

Emergency Medicine is one of the most human rotations!  What do you do when you’re on post-duty status? NOTHING! You get the rest of the day off!

 

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I’ll post my more EMO entry about Emergency Medicine in the coming days. Thanks for reading.

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