Atheista -

This won’t be your last breath, I know
I could see the tears form in your eyes
But we’ve almost made it
It will break my heart to see you go
Because we almost made it

- You’re Killing Me, Chicosci

For the past six weeks, I’ve been regularly sacrificing an entire night’s worth sleep to man my post at the Philippine General Hospital. It’s been a story of fatigue, mental anguish, twilight zone moments and stolen naps recurring every three days for four weeks running. Most students go into an entirely new setting when they’re up for a 24-hour tour of duty in the emergency room. The amount of work can be very daunting and at times, it can seem that finishing all tasks with an acceptable level of efficiency and competency is close to impossible. But I manage, we all manage. This early we’ve already figured away to circumvent challenges  to our alertness, energy level, heart strings and various bodily functions to be awake enough to triage patients, put intravenous lines, extract blood for diagnostic purposes, insert all sorts of catheters, suture nasty wounds and allay fears of nervous relatives. How do we do it? It’s part-adaptation, part-mind control and part-paradigm shift into this no-nonsense-yet-not-cold mode that we all are refining with every duty.

During the first few times that I was on duty, I never really experienced things that would jar me to reality. Prior to this year, I’ve never really seen a patient die before my eyes. There’s plenty of fight in everyone of us, but with disease, depression and financial constraints, this ability to resist and delay death becomes highly unlikely and somehow pointless. Three days ago, six patients arrested and were coded in a span of five hours. As soon as the call for code was made,  Jose (my ever trusty duty mate) I scrambled to the patient’s bedside to perform basic life support. We alternated for several minutes but after almost half an hour of fruitless bagging and chest compressions, the attending physician decided to pronounce the time of death. Being revived after the declaration of code isn’t necessarily a good thing either. The brain incurs irreversible damage after just four minutes  of being starved of precious oxygen. Each minute past four just  compounds the  likelihood of having  permanent complications arising from such an event.

I’ve seen people die. Some of them even died while I tried my best to revive them and give them another shot in living. Some of them were already in bad shape when they arrived in the hospital. By the time they reached the resuscitation area, they didn’t stand a chance against the clutches  of the reaper. It’s hard. It’s frustrating. Death crushes the ego of man like a delicate twig despite human intelligence’s tenacity to keep on holding it at bay. In the end, nature wins.

As I’ve said so many times before, working in a hospital has  made me realize how the universe is not meant to be man’s playground/gift like how most religions would paint it. Humans are a mere blip on the vast expanse of possibility in the mysterious substrate wherein all of us are suspended upon. We are the products of the process called life – a selfless pseudo entity that puts the proliferation and persistence of the species ahead of concerns of the lowly individual. Nature doesn’t really care about death. As far as life is concerned, the phenomenon doesn’t really take into consideration the quality of the life of the individual past the reproductive age. Actually, it seems  like life makes sure that the older individuals die for sure through degenerative diseases and brutal forms of aggressive neoplasia and other cancers.

 I see this drama unfold before  my eyes every day. On one hand, it’s hard to see the anguish and sonorous wails of relatives and friends when they find out of their loved one’s passing. At the same time, it’s also somehow easy because I now accept that death  is an inevitable outcome. Doctors can’t save everyone. I try my best every single time I try to compress a heart to beating to life once more, but I can only do so much. Death starts in the cellular level – a stratum that we don’t really appreciate outright. It’s amazing that the death of these cells sets up  a multitude of other events – from death to the emotional response (modulated by various molecules and neurotransmitters) that other multicellular organims manifest.

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