Tuesday, September 8, 2009

Never Cry

July 7, 2009 - Entry on Death of CR, 5:10pm, Holy Child Hospital

“Never let a patient and his family see you cry…”

One of my teachers back in internship year told us that a physician was not supposed to shed tears, or to show weakness in front of the patient and his family in the event that he/she was right with them when they died.

You were the doctor, she said. You were therefore expected to show composure, and be onjective when everyone else was emotional and not thinking rationally. However, if you couldn’t help yourself, the best thing to do would be to excuse yourself into some back room, where you could cry privately, preferably alone, with no one around to see you. And then when you’re done, you go back to your patient’s room and face everyone, acting as if nothing ever happened.

Call it coldness, call it being stoic, but when it really comes down to it, the patient’s folks would appreciate it if someone were more in control. Calm and collected under the intense pressure, giving orders as needed.

To be objective is to avoid clouding one’s judgement with sentiments so one can focus on the task at hand and act on it effectively. Problems that arise from medical management are settled more easily when one decides from a perspective unmarred by emotional entrapments.

(Meaning: DON’T get too emotionally attached /involved. :-p)

I was thinking this actually, when I was standing there at the foot of the bed of my friend’s father, Uncle Dodong, as he lay dying.

Three days earlier, he was working, as usual, driving his cab around. His co-drivers saw that he had pulled over to the side and then was seen to have lost consciousness. They thought he was just taking a nap, so they left him alone, and almost one hour after, they noticed that he had begun to turn blue (medical term: Cyanotic). They then rushed him to the nearest hospital where resuscitation was done. He was said to be pulseless when they examined him initially, and a defibrillator was applied to charge his heart back to pump, judging from the burn marks on his chest.

He was revived somewhat, admitted to the ICU and maintained on medications while being attached to a mechanical ventilator to help him breathe. There were times when he’d open his eyes and seem to glance about things in the room, but he never really gained consciousness. His attending physician explained that because of the delay in getting help, he had already suffered massive damage to his heart and brain due to lack of proper oxygen deliver y to these tissues. The chances of a full recovery were therefore nil.

In the end, his family decided to let him go, after much tearful discussions. They could no longer afford to pay for the prolonged time in the ICU.

And so, I’m writing this while I sit in a coffee shop here in the city,because just a few hours ago. I kept on asking myself whether it was okay to cry in front of the others. My instinct in situations like these is to keep up a stiff upper lip so I can , hopefully think straight.

But then, I realized that I wasn’t there as a physician, I wasn’t there to examine him and he was not my patient.
I was there as a friend. I was there, in the last few minutes of his life as a friend of the family, as an adoptive niece, as a person who cared and mostly as a person grateful to have known such a good and kind man. He was a good father to his children, and a loyal and faithful husband to his wife, Auntie Sonia.

Here was a good man, a person who I respected in our community, and someone who always supported our group of friends when we were putting together our community projects some years back. He would offer his house for our club meetings, as well as give me a ride home when I needed one (he always had good timing, passing by school during the busy rush hour.) He was quietly, a strong presence in our community, an honest man who did an honest day’s work all the time.

I was there too, standing at the foot of his hospital bed, quietly brushing away tears that I could not keep from falling. Saying goodbye always, always gave me a reason a sense of profound sadness…”

(Goodbye, Dear Uncle Dodong, thanks for everything! We will defintely miss you.)

Rest in Peace, Carmelito Rojonan

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