Tuesday, November 24, 2009


i have three patients. the first one is this man in his early thirties with a huge rectal mass. the mass obstructs 95% of the rectum. his abdomen grows exponentially in size thanks to the "ascites" which is a complication of the cancer. he can't eat because his gut is obstructed. his stomach bleeds whenever he drinks the smallest amounts of water. he needs several blood transfusions, but he doesn't have enough money for all the processing fees. his brothers have no jobs. surgery refuses to touch him as long as he hasn't been "optimized" for surgery.

the next patient is a 69-year-old woman who has been in the hospital for 47 days. she has been hooked to a ventilator for more than a month. her severely malnourished frame seems inappropriate for her spunky attitude. she waves at me whenever i pass buy. we have conversations consisting of my questions and her wild gestures. they've been trying to wean her several times, but her muscles have become so weak that she can't breathe on her own. imagine, having to rely on a machine to do something as simple, but vital as breathing. it looks like she will be on ventilator support for a very long time - maybe for the rest of her life.

my last patient is 56-year-old woman who has breast cancer. she has been abandoned by her family. as her intern-in-charge, i go to the social service to beg for free labs, go from one administrative officer to the next to have papers signed, wheel her to radiology to have her x-ray taken, nebulize her when coughing becomes too difficult,beg her to eat her lunch, wipe the sweat off her face.

i've never cared for strangers. it exhausts me. but at the end of the day, after failing to answer my residents' questions, after forgetting to update my labflow sheet, after realizing that i suck at co-managing... i go to sleep knowing that i did something right.

for the first time in my entire life, i feel like i'm finally what i've always wanted to be - a doctor.