55 Word Trios
These 55 word short stories were written after a month long rotation in an emergency department in Manila, Philippines. This developing nation was beautiful in many ways, but the things I saw in the ED gave me a lot to think about. Some of these experiences make me ashamed to relate – ashamed of how I acted and what I thought. Ashamed of how little I could do. Each story is just a blurb in the whole experience, and there is much more behind each one.
Blood, Sweat and Tears
Shannon poked him three times. We just don’t perform phlebotomy back home, we’re unpracticed. Finally the syringe filled with dark maroon blood. No time for gloves. As I held the vials for her all I could think about was the HIV and Hep B that is rampant here.
“You’d better not stick me.”
She had no pulse. Code.
Hands locked together, pushing down 2 inches required.
My sweat was dripping on her, I was embarrassed.
I felt her breast through her thin shirt and knew it was in the right spot, over the heart. She shouldn’t have to die like this.
More sweat dripping. Still embarrassed.
“They just don’t show any emotion.”
Most of us observed this. We’re used to patients who yell, scream, complain. Families who cry, beg, annoy. These patients were different – accepting, grateful, stoic.
But, when the CPR was over, I realized her daughter was crying. The family had lost a matriarch. They felt loss. They had tears.
Open air wards. Cats slinking in the alleys, in the halls. Peeling paint, hand-painted signs, broken chairs. Hard steel cots, unpadded wheelchairs. Family members crowded around in hallways, on cardboard mats – not visiting but vigilant. Responsible for labs, transportation, ventilation, feeding, laundry. 5 nurses for 60 patients.
“What’s your hospital like?”
“What’s your hospital like?”
“It’s not like this.”
The old man needed oxygen. Septic. There was no tank nearby. The tubing didn’t reach, he leaned back. No IV pole so he shared, arms outstretched. Uncomfortable.
The woman behind him became pulseless. CPR for 20 minutes, to no avail.
For the first time I thought it: “She’s dead. Now he will be more comfortable.”
“Have you ever seen a breast cancer?”
“She stopped chemo in April. Hasn’t walked since December.”
Angry, red volcano on her chest, putrid liquid pooling.
I wore my mask to avoid the smell.
Her husband leaned down to carefully wrap it back up. Hide it. Lovingly. He didn’t even wear a mask.
I’d never seen anything like it before. No one in the US would let it get this bad. The goiter on her neck was completely overshadowed by the large, red, tense, tender parotid cyst. Disfiguring.
“Masakit?” – Tagalog for pain.
A mild head nod.
“Six days” she said. “I can’t eat.”
Later, she couldn’t breathe either.
1 and 2 and 3 and 4 and…..
“Staying Alive” running through my head.
Hands locked, I kept my eyes and ears on the monitor, seeing how effective the compressions were.
When 20 minutes were up, and she was dead, I thought “ Oh good, I wanted my first time with someone who would die.”
“Are you ready to intubate?”
“Yes, I’m ready. When will they start coming in?”
“Oh, they’ll be in alright. “
The first was dead when I intubated her. We worked for a while, then quit. Her husband leaned down to cry, say goodbye.
“Excuse me, sir. You need to sign this form.”
I walked away.
A taxi winds through the narrow, curving, crowded streets Various transportation modalities crushed together. Roosters crow. Houses made of tin, scraps of wood, cardboard. River beds dry, filled with trash. Smell of urine, feces, sweat, sun-rotting garbage. High end shops next to dingy produce stands.
Children dart between traffic.
“They’re renewable resources” the residents said.
Walking down the street we passed the children every day. The girl about 12, the boy a toddler. Siblings? Mother and son? God, I hope not. The same cardboard mat every day. The same dirty grins. Reaching hands. Begging. Playing games on the sidewalk. A smile, a coin, a cupcake. Accepted, but still not enough.
I felt guilty using their supplies. Stopping at the pharmacy on the way to work seemed strange. Vials cost mere pennies, IV catheters even less. I bought $30 of supplies – two large shopping bags full. It would keep the ED going for a day, maybe two.
“Did you get any Foleys?”