December 1

IT IS A minute past midnight. My intern shows me her proposed correction for some deranged electrolytes. She tells me one patient's serum sodium levels are going up. I ask her to compute for the total body water deficit. She scrambles hard for the answer but eventually gets it. I ask the nurses to carry out her orders. She'll make a good internist one day.

Some friends come over to ask me if I want coffee. I order a cup of Americano, hot, with nothing else on it. I like my coffee strong and pure, especially if I have to stay up late.

Right across the charting table where I'm sitting are intubated patients, hooked to the mechanical ventilator. Some of them will be liberated from the machine in a few days, a few will probably never survive. It is the bittersweet story we are living. We'll all die anyway; we just don't know when or how.

A few meters away is my own patient, now sleeping, his oxygen levels picking up. He was referred to me for tremors. The intern thought it was a seizure, but the movements seemed to me like tremors. I don't know how I'm going to send him home. His family can hardly afford an oxygen tank, and he'll probably need one.

My past interns come over to say hi. My, how they've grown—in skill, maturity, and knowledge! "How's the ER?" I ask, because that's where they're stationed now. It's brimming with patients, I learn—patients who can't be transferred to the ward because there are no vacant beds here either.



It is my last duty as the Ward Admitting Physician on Duty (WAPOD). Just a little over a year ago, I was afraid of going on 24-hour shifts. I still get anxious occasionally, but in a healthy kind of way, the kind that always keeps my feet on the ground. Some things that are bound to happen just do. The past year has taught me a lot. The learning curve has been steep. I've been brought to situations when I've reached the end of myself and sought for the strength and wisdom of God. A bittersweet year it has been. For that, and for the many things I've learned and experienced during my WAPOD duties, I'm forever grateful.