MOMMY, SPARE ME FROM CHORES; I AM BURSTING WITH META-COGNITION.
So this comes in the aftermath of possibly the hottest day I've experienced this 2011.
From 10:50 am til 3:30 pm (the height of sunshine and heat and ugh) I was out of the house with my mom and dad, because we visited my grandma and went shopping for groceries. Roughly half of that period was spent in the van and the traffic was horrible and the heat was everywhere and I hate Pasig in the afternoon, ok, all concrete and air-conditioning exhaust fumes and stuffy carparks.
So whatever sentences I say from here on out, I would blame on being subjected to the globally-warmed sub-equatorial ultra-polluted Metro Manila summer heat. And being brain-deep-fried.
~
My sister just started her fourth year in med school. She goes to UST-FMS. Or, The Pontifical and Royal University of Santo Tomas, The Catholic University of the Philippines, and its med school, the UST Faculty of Medicine and Surgery. It's the oldest university in Asia, with a pretty massive population (seriously; they choke up approximately five city blocks from their epicenter, in every direction, with their traffic) and their med school is the oldest in the country. So big deal, etc. etc. They didn't accept me, so I kind of hate them a little bit. (My coursemates told me that maybe it's because I'm non-Catholic and I got my BS degree from Ateneo. Booyah. UST is unfair. And also, maybe because I have no connections -- apparently the admin really, really pulls that legacy crap. My friends might have just been trying to comfort me, of course.)
It looks nice, no? That's their main building. BUT HEARKEN; THEY ARE AS ANTIQUATED AND POLITICS-RIDDEN AS THEIR 400-YEAR-OLD ARCHITECTURE MAKES THEM OUT TO BE. YES, UST, I AM CRITICIZING YOU.
I didn't start out by wanting to rant, however.
So my sister, and her fourth year. She's a clerk/junior intern now. Praise God, I swear, because it costs a bomb to pay for her education and it's not like she's the most scholarly person I know (first thing she does when she gets home: sleep. Then facebook. Then she plays some computer games. At around 11 pm, that's when she starts studying. And she sleeps at 12. She's insane[ly smart.]) so her grades have been in danger more than once.
But fourth year, and hospital duty, and actual rounds. Fun tiemz, probably.
She started last Saturday, and from what I understand, her schedule went a bit like this: April 16, pre-duty from 7 am to 7 pm. April 17, duty from 7 am to 7 am of April 18, with a hygiene break from 5:00-7:00 pm on the night of April 17. Then from 7 am to 2 pm of April 18, post-duty. She goes home and gets an actual night's sleep one day out of three. So 12 hours, a break, and then 30 hours on her feet, from now on. Then the cycle repeats. It must be the life, for my sister whose optimum level of functioning is maintained with a requisite 8 hours of shut-eye.
I told her she will now lead the life of the typical clerk. Upon Googling, I realized that this means someone who is chronically deprived of sleep, time and money (she says she will begin to live on fast food from here on out), and basically at the bottom of the physician's food chain.
Because today is the only day I've spent a significant amount of time around her, since Saturday, I took the opportunity to ask my sister (harass?) about hospital duty over tonight's dinner of dumplings, beef stew and pearl milk tea.
(She came home from school with two giant tumblers of milk tea, because she knows how much I love them. Even though she hasn't slept since Sunday afternoon and it was Monday evening already and she's the one who needs to be plied with lovely beverages. ATE I LOVE YOU SO MUCH SOMETIMES. :D)
Anyway, so she has that complicated schedule, and she has to spend seven more days in the GI ward of the Internal Medicine department. She says the junior interns have quarters and they can have McDo delivered up until the hospital lobby and in their downtime, all other junior interns are napping, studying Harrison's or doing paperwork. My sister also said that today, they had a patient who was put under Q15 monitoring scheme, because she just came from a critical surgery and was chronically hypotensive. The patient was 32 years old and had a daughter, and also Stage IV breast cancer and hepatic encephalopathy. (I had to Google hepatic encephalopathy. According to Wikipedia, it is "the occurrence of confusion, altered level of consciousness and coma as a result of liver failure.") Q15 meant that my sister checked up on the patient every fifteen minutes, especially with the lady's unstable condition.
The patient died.
And then my sister described the other departments, the other wards (CV, Hema-Onco-Rheuma, Pulmo, OPD, ER, OB, Neuro, etc.), where the crankiest residents were rumored to be (OB) and where the residents were supposedly the most elitist (Neuro). I don't think she's had enough exposure to form an actual opinion on what clerkship is like, but I will ask her in the coming months. It's an entire year of clerkship, after all.
And so listening to her, it hit me, while I was being asked to wash the dishes that -- humans. Capable of being so many things, but limited by our bodies so incredibly. Do you see that? Our university's graduating class valedictorian has three different major awards and this stellar career as a med student ahead of him and he was the president of an org and at the end of the day, we have to ask, does he still have a heart beat? Mark Zuckerberg has billions at 26 years old and does he still have a heart beat? The Philippine president managed to seal a deal with UN aid and does he still have a heartbeat? Those Ph.D.s in school and their published researchers and do they still have heartbeats?
At one point or another, we all end up in the hospitals. After, or in the midst, of all these credentials and relationships and accolades we try to build up in our days of utmost health and vitality -- we all end up sick, sicker, sickest, in emergencies, in accidents -- dead. Life will be the death of us. People and life and death and hospitals. It's like a concentrated corner of the human ecosystem, a marketplace, where we bargain for more time and push edges of what our bodies can handle and try to feel out new merchandise (skin, limbs, organs, blood, life). There will be so many people and sick people and dead people. My sister will be surrounded by them all year. My sister will learn a lot.
I'm pretty sure the 32-year-old patient had a lot of things going for her. There would be people in the reverse isolation ward, with leukemia, who have lives outside of cancer, who are hoping to get back to it, who are wondering if they will be able to get back to it. There are children who are getting treated for meningitis on their month away from school. It's incredible that people can have all these things and lives outside, you know, the actual matter of their basic physiological processes, and that they have to pause their lives when they get sick to make sure that they're still alive tomorrow.
Steve Jobs had to undergo surgery for pancreatic cancer, too.
I think what I find so stunning here is how, at the beginning of everything -- we are humans, are capable of accomplishing and doing and thinking so many things. A constellation of possibilities. And at the end of everything -- we are only humans, and limited in so many ways, constricted by the prescribed ways in which organ systems should function. A template for finiteness.
We will all need a doctor at some point. I suspect that in the olden times, before there were doctors, they had to invent doctors. (What? [Yes; deep-fried brain, remember.]) I think we will always need doctors. I think doctors get to deal with so much s*** on a daily basis, deal with the the split-hair edges of things that are deceptively simple but impossible to navigate. Flat line/one with bleeps. Critical/stable. Life/death.
Maybe this is what will make me sit up in lectures in med school, or try to absorb just that next bit of information, read further just one page. The information learned from medical studies is currency for life. It's going to matter some day very soon, I would think, and it's going to contribute to how much longer a person will get to live. I mean -- doctors don't get to decide who lives and who dies, that's not what I'm saying. But they will have knowledge on what can best kill a particular person, what can best allow another patient to live longer. Or at least, the doctors ought to have that knowledge. Because they studied it, because it was taught to them, because that information is vital.
It will be such an adventure, learning how to help save people.
And, and at the end of the day. I am human, and am only human. I will try to attempt so many things, I will attempt to become a good med student and a good doctor and throughout I will be carrying out those dreams with my chronically under-rested and over-burdened body. One day, being a doctor will kill me, for all the nobility of its objectives. And I will end up in a hospital, most likely. And I will think, maybe I can explain how I will die. I think I know what's wrong with me. But I will be unable to treat myself. Or no one will be able to treat me. And then I would've learned how to save people, and all those other things, but I am only human and so I would have to die.
And somewhere else in the hospital a mother will give birth to a child.
And it would be the beginning for that child, and she would be human and so capable of anything, and human and limited by everything. She will begin to live and die at the same time, right as I end up finally, finally dead. She will begin learning the first time she expands her lungs to breathe, when I and other dying people's brains will shut down.
And that will be the piece of knowledge that will make most sense, after all.