Aching

It's past 5 pm, and our patient is tired. He is in his early 40s, in adult diapers, his hands held by his wife standing beside him. As we meet him for the first time, we see tubes inserted in his nose and left-hand vein. His eyes are shut. He is holding his temples. His face forms a grimace, as if to say, "I am in pain. Please leave me alone."

Earlier this afternoon, he underwent a lumbar puncture—that, among a series of medical procedures. He came in for severe headache, and the doctors are still in the process of discovering what caused it.*

"Gutom na siya (He's hungry)," the wife tells us. "Kakain muna siya. Sabi ng nurse, pwede na raw (He'll be eating first. The nurse said it's okay)."

We wait for a few minutes. We're supposed to take the medical history and perform a thorough neurological exam. We've done this a couple of times back in first year, but it's a skill that can be only perfected after years of experience. Unlike our mentors, we still fumble with our questions, and we can't survive without our notes. Such is the fact of life. We have a long way to go.

And so we enter the room, introducing ourselves as medical students from PGH. We greet him with our best smiles, hoping to reassure him that things will turn out right, that we'll do the best that we can to know what's wrong with him. He doesn't respond much, but he says he will cooperate.

We do the mini-mental exam to check his sensorium. We check his reflexes and cranial nerves. As we perform these maneuvers, we try to check if we've missed anything. None so far. We proceed.

As we go on with our physical exam, a classmate hears him say, "Tapos na ba kayo? Gusto ko nang umuwi sa pamilya ko. (Are you done already? I just want to go home to my family.)" And we have barely even started.

The headache is clearly taking its toll on him. It's so painful he gets teary-eyed. He hardly opens his eyes because the glare adds to the pain.

As my groupmates—such wonderful people to work with—deliberate on whether we should postpone the exam for tomorrow or continue with it tonight, I stand at the opposite side of the bed, looking at him, trying to be in his shoes.

And then I realize how inadequate I am: I can't do much at this point to help him. Quietly I pray: that the Lord heal him, that He help this man's family overcome this dark moment in their lives.

I'll be seeing him again tomorrow. I hope things will get better, and he will come out a new man.

*As a rule, I don't include the medical and personal details to protect the patient's privacy.