Fragmented Angelita

Dear Angelita,

It's been a week since the last time I saw you. You were lying in your bed at the MICU. The tubes have been removed. Only the JV catheter's in place. There's a kind of peace in your face. Your beautiful face.

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You remind me of my mom when she was first brought to the ICU a year go. She looked terrible. Her face was swollen from all the beating she took. She's got dried blood in her hair and bruises all over her body just like yours. There were tubes connected to her all over. Just like yours. Yes, just like yours.

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I feel for your daughter. I know how she must be feeling the night everything went wrong. Did you remember that night? It was my first day at neurosurgery. It was also my first duty in that rotation. Tinie had a new admission that day. The patient's kinda in a bad shape so she was assigned at bedside. Cay was busy doing rounds. I was basically helping both of them. I remember the hour before you became toxic. I was the one who took your vital signs. Your BP that time was 110/80 mmHg. It was within the normal range. You didn't speak to me when I said hi. Your daughter was at your side, offering you a drink. I chatted with her for some time then went on my way. I didn't have any inkling of what was in store for all of us that night.

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I remember receiving a call from Cay an hour later. Your BP's going down after she took it at three intervals. She was panicking. I called the intern. we were at your bedside that time. You were complaining of stomach pain. We were considering MI, since it was noted at your chart. Possible MI. I referred you to the Med resident on duty. I remember vividly how it all happened. From a stable patient, you've become someone in need of 6 bags of blood. We were still clueless at what's happening to you.

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Your ECG's were fine, we've placed all sorts of stabilizers so that you're BP will go up. The residents were thinking of having a CT scan done to determine where you're bleeding. I went back to the lab to get more blood. I remember seeing the sky turn light blue as I walk back and forth from one building to another.

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I remember that morning at the CT scan. The first time I saw melena. My head's floating in the air that morning. I didn't get any sleep and you were toxic. Instead of bringing you to the ward, we brought you to the MICU. I endorsed you to our alternates and then I went home.

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I remember the day we referred you to psychiatry. You told your attending physician that you wanted to die. He wrote an order asking that you be evaluated by a psychiatrist. I was the one who interviewed your children as well as your sister. I even interviewed your husband and friends. You were at the ICU that time. You were still bleeding internally.

I visited you at the ICU that same day. You were awake. There were tubes attached to you. You look helpless, but I know it's what's keeping you alive. You were smiling at me. I said hello. You held my hand and told me that you wanted to get well. Remember? You said, " Pagalingin mo ako, I'm very hopeful, galingan mo ha". I didn't kow what to say. I just held your hand tight and smiled back.

That day at the ICU, I felt we formed a bond. You shared your life story with me. You told me about your apo's and how much you missed them. You even promised me a taste of the Pancit Malabon which you cook so very well. You recounted your days as a teacher at Makati. You don't know it that time, but you were a teacher that day to me as well. You taught me about psychiatry and how important it is to know you well, to look beyond you as a patient but as a functional individual, with relationships and value beyond which we at the hospital can just imagine. Yes Angelita, I became a student of yours that day.

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I will never forget the way you held my hand when you told me that you thought I was a snob. You were smiling. You were explaning to your clerk-in-charge how we first met. At the end of your story, you called me charming. Then you smiled. It was the same smile that greeted me when I enetered the MICU. It was the same smile that greeted me your entire stay at the ICU.

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There were times when your name will come up during our conversations. Out of the blue we'd remember how well you were before you took a turn for the worse. There were days when we'd discuss the procedures as well as the labs that were ordered for you. We would discuss the things that should and should've not been done in your case.

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We were the clerks who took your vital signs. The ones who ran your labs and got your blood. We were the ones who pushed your stretcher when the residents requested for a CT scan and endoscopy and RBC tagging. We were the ones who pumped your ambubag as well as suctioned your secretions. Somehow, we can't seem to shake you off of our head. I can't get you off my head.

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I hope you're in a better place right now. I'm writing this to say thank you. Thank you for being a teacher to me. Thank you for sharing with me your life; for inspiring me to do better in the field I've chosen.

Love,

Eugene