All smiles

I HOPE I’m not preempting anything, but when I visited my 70-year old patient—now with a tracheostomy tube, hooked to an oxygen mask instead of a mechanical ventilator—I saw a smile. He smiled back at me: he, my remarkable patient whom I had taken care of for a month or so. It’s nothing short of a miracle. I first handled him at the Medical ICU, where we treated him for a difficult-to-treat lung infection—the first he got before he had been admitted, the subsequent infections (the harder ones to treat) he later acquired during his stay at the hospital.

We had difficulty sending him home. I knew he was going to be one of those patients who were going to stay longer than our run-of-the-mill STEMI cases. It was hard to wean him off the mechanical ventilator. His chest muscles were extremely weak; after prolonged intubation, he had become deconditioned—a common problem among admitted patients. In order to liberate him from the vent, we had to increase his muscle mass, treat his infections, make sure his electrolytes were in order, and optimize his general condition.

I always have a soft spot for old people—in a way, they remind me of my grandparents. Lolo Mauro passed away when I was in kindergarten. He brought me close to the chickens and geese in his backyard; I remember fearing for my life. I couldn’t understand then why he was laughing. Lolo Polding took us to daily walks after he had his morning tea. He’d leave us in the swing or see-saw, or he’d look after us while we played in the grass. Lolo Mauro died of lung cancer; Lolo Polding died of diabetes. I wonder if that’s a reason why I took on Internal Medicine. Would I have helped them, if they had lived to see me, their grandson, as a doctor?

But enough of me.

I asked my patient how he was doing this morning. He smiled at me again. I told him that if he was going to be like this—comfortable, breathing normally like we do just before we sleep—I’d send him home in two or three days. Yesterday he celebrated his birthday; his children gave me and our team pansit and sodas. They didn’t think he’d survive this long.

But I have stayed too long at the Wards to know that anything can happen, anything is possible.