aggiepie's tabulas

With the hundreds of patients I’ve seen since I got into medical school, most of which I saw when I started going clinical in clerkship and internship (and still MORE to come), it is impossible to remember them all.  There are those whose names ring a bell. Several whose faces I would recognize. And then there are only *some* whose names AND faces I won't forget, whose diseases I remember, and my interactions with whom I can vividly recall. They are the ones whom I've spent more time with, because they stayed longer in the hospital (as in-patients, vs. the 15-20 minute interactions I have with OPD patients). Their cases were interesting (not just your common cold, but exotic ones like Gauche's disease). And their personalities were colorful (like my manic-depressive patient who was extremely chatty).

But the people who impress more on me are those who are nice and pleasant to deal with (this family who was very supportive of their patient’s condition, never once succumbing to "watcher fatigue", despite the odds—financial, physical, mental, emotional, spiritual—to be so). Because they had admirable character (like the little boy who would bravely offer his arm for blood extraction and IV insertion, who at the mere age of 4 understood the need for these needles to make him well, who struggled to live, and whose disease failed to daunt his cheerful spirit).

One of those unforgetable people was a patient I had at the Medical ICU. She was the longest patient we’ve had at the MICU, being under my care for the whole 2 weeks of our MICU rotation (and 2 weeks under a previous intern, and still another 2 weeks before that...) While many others have been discharged/transferred/died, she remained at the MICU, attached to the cardiac monitor, awaiting her pacemaker (there was even one day when she was the only occupant of the MICU). She didn't look like she was sick. And even before she got admitted to the hospital, she made herself productive; she delivered vegetables to the market, and drove a motorbike. And she is 70 years old! Lorraine and I called her "The Groovy Lola". And she was nice and pleasant. She eventually got her pacemaker and was subsequently discharged a few days after I shifted out of MICU rotation. And I thought I would never see her again.

Until Ophtha OPD today! The charts were piled, queued, and I got the next one on top. The name in front of the chart glared at me, and I immediately recognized it as belonging to a patient I had in Med. The details didn’t come automatically though, and at first I thought she was the unstable angina patient I had at The Wards. When I called out the name, and she stood up, it was Groovy Lola! Looking even groovier, with a permanent pacemaker, and a brand new lease in life. (But with an expired driver’s license she failed to renew since being admitted at the hospital, so she hasn’t been driving her motorcycle yet.)

It was nice seeing her again; the rest of the block was glad to see her too. We have seen so many patients but very seldom do we learn what has become of them afterwards. We breeze through our rotations, as much as many patients—people—come and go into our lives, leaving behind footprints, some etched deeply, while others are shallow, but all having made an impression.

A few (unknowingly) go back and retrace their steps. Just like Groovy Lola! It is wonderful to see a former patient, alive and well. It is a confidence booster, knowing that I have played a role in restoring her to health. It is a reassurance that the many sleepless nights weren’t in vain. And despite the codes (I recently had one and I’m still hung up over that), there are still more patients who live and get well. And in the face of toxicity, it is an encouragement to go on.

I seldom dream these days, since the narcoleptic that I am almost always just plops down in bed, falls fast asleep and wakes up the following morning, without any recollection of the previous night's events, much less falling asleep in the first place. I just open my eyes in a daze, and in chronological order, wonder: 1) What time of the day it is ("Is it morning yet?") while staring blearily at the alarm clock and trying to make something out of the blur of numbers. 2) Where I am, since I sometimes plop down at the foot of my bed and the bedroom looks different from that viewpoint. 3) What happened the night before, trying to recreate the events leading to my current state. After a while--a looong while--the clock's face and our room's interior finally come into focus. And the smell of unwashed hair and the uncomfortable stiffness of the previous day's med whites jolt me awake. It's another day.

But I digress. Anyway, the point of it all is that I barely remember the events of the previous night, much less the workings of my unconscious, the things we call dreams.

But last night I had a dream, and I remember it so clearly. In my dream, I was afflicted by a virulent fungus that was eating my face. Purportedly, I got it from a patient with multiple fluctuant masses on the face, on whom I performed an I & D to drain the pus out (it was a given, something of a flashback, but not part of the actual dream sequence). I wasn't wearing gloves and some of the contagious fluid spilled on my hands, when I accidentally scratched my face.

The lesions did not appear until several weeks later (and this is where my dream kicks off). I went to the bathroom to wash my face when I noticed a small mass on my R ear, just outside the ear canal. It was fluctuant, filled with yellowish fluid, and surrounded by erythema. It kept growing with each time I looked at the mirror. And then on my R lower cheek appeared a similar lesion. The 2 masses kept growing and they coalesced to form a fungating, fleshy mass (resembling a freshly extruded placenta, cotyledons and all), with black necrotic areas and with a most repulsive smell. I decided to seek consult at the hospital. I wore a bandana to hide the lesions.

The mass kept growing bigger, and by the time I reached the hospital, the fungus has eaten away half my face, including my R eye. Poline saw me in front of the ER's main entrance and asked what the bandana was for. When I showed her the monstrosity, she exlaimed, "Ewww... YAAAKKKKK!!!!!" (trademark Poline "yuck" ). I was mortified and hastily wrapped my face again. I entered the main ER lobby; Angie was at the triage table. The second set of doors (the one leading to the treatment areas) slid open, Harvey stepped out. He noted my bandana which was already drenched in blood. I entered the second set of doors, and into the ACU. It was a benign sight, and my intern batchmates-on-duty were congregating at the center table. RV and Marven were with Ophtha; Thea and Raoul, with ENT; and Mamay and Dee with Surgery-trauma. I approached them. And cried.

And then I woke up!

I have been lying on my right side the whole time, and that side of my face was starting to feel heavy. I was intantly stricken with panic, and the first impulse was to touch my face, anticipating the irregular surface of the mass. To my relief, it was just my face. And it was whole. I felt so relieved.

What a very very weird dream. Lol! The things that seep into my unconscious.
* * * * *

I had a roommate in college, a Chemistry major, and she had a dream about being chased by an acetate ion.

Had the PM off (as part of post-duty status), and I just slept. Had another dream, not as bizarre as the one featuring a face-eating fungus, but still pretty way-out.

Hi. I'm Aggie. And (in my dreams) I'm an alcoholic.  I see patients at the OPD, and in between consults, I would take out a can of beer from my drawer and empty it before proceeding to the next patient. Like a chain-smoker sneaking a puff or two when he gets a break.

LOL

And I don't even drink in real-life (Note: I didn't say "I've never drank nor tasted alcohol."  )  . Nor do I wish to be drunk. Though I am sometimes curious to know how I would act when I'm drunk, how un-inhibited I would be when I'm intoxicated... If only there was some other way of finding out.