Remembering my last duty day for the year

I'D BEEN SLEEPING for more than three hours at the call room's upper bunk when the intern woke me up at 3:55 am, asking me if I could give the fluid boluses to the newly admitted newborn noted to have faint pulses and sudden onset pallor minutes ago.

"Sure," I said, squinting, yawning, and getting up all at the same time.

I rushed to the nurses's station to get plain normal saline solution. I stole a 10-cc syringe from one of the cabinets and rushed to the bed where the resident immediately told me, "Give him [the patient] 30 cc. Make sure you do it slowly, over three to five minutes."

"Yes, Sir," I told my senior. Where I train, we call everyone "Ma'am" or "Sir," regardless of rank or profession.

The baby wasn't improving. He had faint breath sounds. We were suspecting pneumothorax, a condition where the lungs get leaky, the air goes out and accumulates inside the cavity, eventually crushing the lungs because of increased pressure.

I was instructed to get a butterfly needle (something I hadn't seen before), cotton balls soaked in povidone iodine, sterile gloves, and micropore tape. We were going to do needling, a procedure that involves puncturing the chest at the space between the second and third rib, so that the trapped air could escape.

The baby wasn't responding. No air came out. The mother was getting hysterical, crying at the bedside, holding her child's hand. The baby was due for a chest X-ray to confirm the presence of pneumothorax. It was not pneumothorax apparently; it was something else. The residents were huddled around the bed, listening to the chest with their miniature stethoscopes, checking oxygen saturation, and writing prescriptions and other notes. When you see scenes like that, you know something's terribly wrong.

Four o'clock was my ward monitoring schedule. Thankfully the rest were doing well. Blood pressures weren't shooting up or going down. The feverish were being adequately managed. The secretions were being suctioned on time. The entire ward was asleep—which is always a good thing—and my seniors finally figured out what happened to that baby.

I said my goodbyes to the patients, particularly my own patients' parents, who told me, "Buti ka pa, Dok, may bakasyon. Sana makalabas na rin kami dito." I told them I'd be praying for them. Nothing is impossible with God, I assured them.

Surprisingly last night's tour of duty didn't tire me as much as before. Maybe because I was expectant that the hardships I've faced in clerkship was coming to an end, albeit temporarily. Maybe because I was excited to finally see home after all these months, to sleep on my own bed, to eat home-cooked meals, to fellowship in our small church in Marbel. The expectation of good things, joyful things, to come gave me hope and urged me to continue.

How many times since June had I thought of quitting Medicine altogether? I've had my moments, I confess, especially when I felt so bogged down with sleepiness and stress, but I've always looked on to my Father who promised that He'd be me "my rock and my salvation; I shall not be greatly shaken" (Psalm 62:2). At this point in my life I can't imagine myself doing anything else than what I'm doing now—doing all the hospital scutwork, going on 24- to 36 hour-shifts every three days, preparing case reports, and taking exams without the benefit of an eight-hour sleep. Sometimes, though, I wonder what would have happened to me had I pursued my initial plan to take up Law. Or what if I continued on with biomedical research, trained abroad, and grew brain cells on plastic plates? Is Medicine what the Lord has called me to do? I think so. I pray that He continue to increase my desire to glorify Him through this track, that He would sustain, if not increase, my joy in taking care of the sick.

As I was packing my bags, I was humming "Great is Thy Faithfulness," one of my favorite hymns of all time. "Morning by morning, new mercies I see; All I have needed Thy hand hath provided; Great is Thy faithfulness, Lord unto me." Why I'm still here—alive, joyful, and expectant—is all because of God's grace. And what a lavish grace it is.