Stories Untold Behind Every Barcode
By Mark Laurenz Handayan
The days are long yet the nights are short. I woke up ecstatic and jittery, eagerly looking forward to my first day as a public health intern at the Philippine General Hospital (PGH). Within the next few weeks, we were bound to immerse ourselves in the role of medical technologists — drawing blood, processing laboratory results, and dipping our toes as novices in the country’s leading tertiary hospital.
I walked along Lara Hall to meet my co-interns who exuded the same enthusiasm as I did. As we took our steps to PGH, we reviewed the protocol of venipuncture–arguing if we would follow the circular or back-and-forth motion of disinfection.
In hindsight, this might have been the most mundane yet innocent chatter we had regarding PGH. Little did we know that stories of grief, laughter, and sorrow await us along the hospital wards.
Many firsts
Our assignment began in the outpatient department (OPD), notorious for its lengthy queues that spanned two floors. As we traversed along the long line, I felt their keen eyes on our maroon scrubs. All are awaiting to get their samples drawn in the swiftest way possible. Most of them had lined up long before we were awake. Some were even from distant provinces who had laid their slumber outside PGH.
“Kuhanan niyo na ako, parang awa niyo na. Babagsak na sugar ko.”
The OPD welcomed us with the anguished cries of an elderly woman, pleading for her blood to be drawn urgently. Her screams emanated in the room, yet the silence of patients in queue staring at her miserable state was more deafening.
Upon hearing the dialogue between her daughter and the staff, it appears that the diabetic old lady had not met the minimum hours of fasting needed for her blood sugar test. I stood there with a red vacutainer in my hand as the patient’s temper gradually became red.
The assigned phlebotomist respectfully instructed her to wait an hour more, citing that protocol must be followed for a more accurate result. It was at this instance that I realized how agony could supersede reason.
“Diyos ko, kung patayin niyo na lang ako.”
Her wails became more prominent. I saw her daughter grin at the phlebotomist, a non-verbal cue asking for their utmost patience. Her daughter apologized for the scene and carefully pushed the wheelchair of her mother in pain. I listen to the old lady’s tantrums fade as they exit the door.
No one really teaches you how to handle such situations in a classroom, nor did we have the time to process a heartbreaking scene. All we knew was that hundreds of patients remained accommodated by only three medical technologists–something considered a norm in PGH.
“Okay, back to work,” our senior staff mumbled.
She said it in the most nonchalant tone as if no old lady begged to have died moments earlier. As much as I want to console the old lady in anguish, we had so much work to accomplish before the department cut off after lunch.
The remaining hours went swiftly. We had our first time probing patients, collecting specimens, and processing results. I even experienced my first rejection from patients who were skeptical of getting their blood drawn by an intern.
“Ayoko sa estudyante. Pagpa-practice-an lang ako.”
A statement that holds a little truth even I cannot deny. I felt guilty knowing that my limitations as an intern could mean slight discomfort to the patient. But I suppose that is how professionals are honed. We are waxed and waned by countless attempts until we are capable of giving the best care possible.
The longer I stay, the more I understand how dehumanizing interacting with humans in need can be. It never gets easy looking patients in their eyes–knowing very well that even science could only do so much.
When Deaths become your Breakfast
Nothing could have prepared me for my first encounter of death. Immediately after our first day in the OPD, my co-intern and I were assigned to the ward and extracted samples from inpatients. Our senior phlebotomist warned us that, unlike patients in OPD, inpatients were more arduous to collect from as most cases are debilitated.
His foretells were true. It was my first time to encounter severely edematous patients. Some even had arms as thin as their humerus. All of which are cramped in a charity ward whose uncanny smell is a mixture of putrid flesh and disinfectants — a room so humid and crowded, filled with patients whose last hope lies in PGH.
My regret of not having a proper breakfast became more apparent as we rushed along wards carrying our heavy tackle boxes. I wondered how this condition is deemed a norm for the country’s premier government hospital– a thought that no longer baffles the seniors who have worked there for decades.
“Go ahead and start preparing the next patient,” said our senior.
I scanned the whole ward to look for Bed 17, my first inpatient encounter. My partner and I pushed a cart whose squeaky wheels caught uneasy eyes from a distance. The patients knew what that sound meant for them, and a bag of syringes has certainly never been a delightful sight despite the long time they have been admitted.
We have finally arrived at Bed 17, a memory that will forever be ingrained in me. I checked the laboratory request form and prepared the vacutainers. I internally rehearsed my script only to find it later obsolete. My first patient, whose pulse I was supposed to find, was already covered in white cloth. The grim reaper came earlier than us that day–bringing with him an old man whose weeping wife was left behind. She held his cold hands and wished that she could have arrived sooner.
It was my first time to encounter death so proximal. Suddenly, the ward filled with grunts of bedridden patients became silent. All that was audible were whimpers of his wife and a flatlined heart monitor. He was an ‘expired’ patient, said our senior. I froze for a minute, a luxury of time that our remaining lab requests cannot afford. Out of disbelief, I asked if they ever get used to this gut-wrenching feeling with time.
“We never truly do. We just move on,” our senior answered. “Minsan pangalan at birthday na lang tinatanong ko sabay tusok,” he said.
Some patients looked so feeble that it felt inhumane to inflict even the slightest pain. I experienced this first-hand in the wards with my successes and failures. I saw it in every comatose, pediatric, trauma, and cancer patient we encountered in the next few days. I heard it from every patient’s companion whose only prayer is to take their mama, papa, kuya, or lolo home.
My stay in PGH changed me in ways I never anticipated. I came in with a checklist of procedures to be done, yet I will forever bring with me the stories untold behind every barcode. To this day, my memory serves the wails of the old lady at OPD, the white cloth that covered bed 17, and the rest of the patients whose last hope lay in PGH.
When empathy becomes a commodity, it is easy to reduce patients to mere samples. But then I learned to look at their eyes, hear their tales, and understand their sorrows — stories from both the living and the dead that no amount of lecture could supersede.
