Indexing Title: HTURINGAN's Medical Anecdotal Report [04-4]

MAR Title: All In A Day's Work

Date of Medical Observation: July 14, 2004

Narration:

I was woken up the night before by a call from the hospital informing me that a patient of mine who underwent gastric surgery became unstable and was eventually intubated. I called the service consultant and relayed to him the condition of the patient.

Earlier that day after informing him that the patient developed enterocutaneous fistula, he told me to pray that the patient will eventually recover despite the odds. Seeing the patient deteriorate despite supportive care was depressing.

At three in the morning I was again informed that the patient eventually expired. I couldn’t go back to sleep, thinking I should have been there to comfort his wife. I found myself grieving.

At 4:30 am I dragged myself to go to work, I was on duty and had a breast surgery scheduled as first case. At the operating room, the chief resident of Anaesthesia told me I was the senior house officer (SHO) of the day, needless to say I forgot.

She endorsed nine patients from different departments under the director’s office. No big deal, the number of patients was fewer than what I was used to.

In the afternoon I again went to the operating room this time to perform gallbladder surgery. There was no water and the nursing aid had to manually pour water as we scrubbed. After the operation, as the SHO I was informed that the limited water was now non-existent, hence only extreme cases can be operated on.

Being the team captain on duty I assessed the cases for the day, we had one pediatric and adult incarcerated hernia, and two cases of acute appendicitis. I decided to direct the pediatric hernia and secured 5 gallons of purified drinking water for the operation to push through.

Again with no water available operation in the radiology department was halted, processing of films can not be done without water. I contacted Gat Andres and they agreed to process the films provided that a radiology technician (rad- tech) will be provided by the hospital.

This would mean that our ambulance and rad-tech will be going back and forth from one hospital to another, as this was tedious I decided to accumulate first at least five patients for radiography before sending the plates for processing, this would save time, manpower, and energy.

I informed the director of the situation and went about calling the fire station for two fire trucks to transfer water to our tank to temporarily remedy the water shortage. The firemen responded quickly and the hospital was operational again at least for the duration of my tour of duty.

A call came from the office of the director, they accepted a radio interview on my behalf to be held the following day I was supposed to talk about varicose vein. For this I have to read and review the topic for tomorrow.

The day hasn’t ended yet there were ICC forms, ambulance conduction to sign, and social service classifications to make, and so here goes another sleepless night.

Insights (Discovery, Stimulus, REINFORCEMENT):

There is no other specialty in Medicine that is more demanding than surgery.

No field more taxing and emotionally draining.

A surgical resident must always be on his toes because the field of surgery not only demands from the intellect, it demands from the spirit as well.

Being innovative, resourceful, and being adept in problem solving are a few of the qualities one must possess to survive a day in this craft.

And yet there is no other field I would rather be in,
no title I would rather be called, other than a surgeon.