Anna Santos

Graduation is one of the rare moments in life when I find myself looking back on where I used to be, while at the same time looking forward to what lies ahead. Behind are the precious memories of experiences that I will never forget, heartfelt emotions that may fade in time but will never disappear. Without my past, I have nothing on which to build my future with, and without the future, my past would have been irrelevant.

Residency training for me was demanding and difficult. I have often seen myself in the middle of situations that required both courage and sacrifices. To bridge the silence, I must have the courage to risk rejection from my consultants; to be efficient, I must sacrifice my time with my family and bear the pain of leaving my loved ones. Often, I am standing at the crossroads thinking to opt for the easy and well-trodden road out from this miserable life, but instead, i chose to venture further down the world of internal medicine where I realized how fragile life can be, minutes , if not seconds counts.

I have known the pain of failure, frustration, disappointment and defeat, because I have taken a chance on winning and succeeding. Surviving disappointments awakened me to see that I have made it through the difficult times. Soon I discovered that real success is conjoined in loving relationships. What matters is people, as what lasts is love. What counts are true people that molded us into who we are now.

Thus, I am grateful to my seniors who made my training rough and tough, for there I learned to struggle and forge myself to a new horizon. I am also thankful to my co-residents which made my residency training bearable and memorable; to my consultants who shared their art of management to us; the nurses who in one way or another worked hand-in-hand with us in saving lives,the basis of unity despite some of our differences; to my friends who understood the reason for my non-appearance but supported me in various times though; and to my family, my inspiration, who despite my absence in our home most of the time, backed me up in my decisions.

Thank you for the people who believe in me, but most of all,thank you dear Lord and Mama Mary bacause as I looked back and smile at what had passed, I asked myself "How did I get through all of that?". Well, its just putting in mind to never let go of hope, to never quit dreaming, and never let love depart from our lives.

I would like to say that residency training is one of the best chapters of my life, (though I didn't say it's easy), and I thank all of you for being a part of this painfully wonderful memory.

To my fellow residents, never stop growing and never stop learning, put in mind values of persistence, discipline and determination because we are meant to be whatever we dreamed of becoming. Remember to stop and take a breath. Life is not a race to be won. The only way to enjoy all of it is taking it one moment at a time. And you'll see the task at hand is already done. As the saying goes, "Success is not measured by how well you fulfill the expectations of others, but by how honestly you live up to your own expectations".

To my fellow graduates, there are a lot to be proud of, the obstacles that made us stronger, the determination that has remained steadfast, the willingness to keep on path, to stay and not quitting.Dreams really do have a way of coming true...this is the moment we have worked for. Lets move on and take a leap for the next challenges ahead.

Anna Santos
Have you ever argued with your thoughts? Did you feel like every decision you are about to take warrants a counter-reaction more destructive than before? Just because you are a physician, did you ever think you are so sure of yourself so arrogantly that you can keep your cool and strong enough to doctor your own relative's battle against the grim reaper we called DEATH? It happened to me three months ago; the gruesome truth left me barefaced. I was thrown out of the sizzling lava, remained blankly motionless, and thawed like there’s a nuclear meltdown.

“Ate, nahirapang huminga si Gladys” (sis, Gladys have difficulty breathing). These were my brother’s worried words as he tried to search for understanding on his wife’s fatal situation. His tensed voice and uncontrollably trembling hands were the unspoken gestures of how much he cares for her. When I saw him nearly bursting to tears, desperately clinging on for hope for his wife and their first born, never knowing what to do nor what to expect, I felt a humongous burden in my chest. I never thought I couldn’t handle the sight of him pacing the corridors back and forth, treading the nursery ICU seeking comfort from his newborn, then back to the room, then to the prayer chapel, then back to the room again. His eyes unable to fix mine, and with restrained emotions he tried to conceal it with casual talks. This wasn’t the cheerful and comical Allen I know, and it just ripped my heart apart to see him so lost and exhausted.

My sister-in-law successfully delivered to a preterm baby girl. Though her infant was placed in the incubator due to prematurity, everybody thought she would be discharged right away. However, two days after that normal delivery, she began to bleed profusely. Worst, her OB-GYN went out-of-town for a convention. What's more? She was left under my care as the internist. Yes... me, her husband's sister. And in that terrifying night, something went wrong...

Less than 16 hours of intermittent blood losses, she gradually deteriorated. Her blood counts dropped so low, she had no blood pressure, no urine output, and her skin was as cold and pale as dead (hypothermia). Her eyes turned yellow (jaundice), and her abdomen bloated. No matter how much we ordered for stat laboratories, boluses of emergency drugs, fast dripping of fluid challenges, and ASAP request for blood transfusions (whole blood, FFP, platelets), there were new episodes arising every hour like cliff-hanging chapters of events waiting to unveil its scene in just a moment.

As test results arrived one after another, I stared and stared in disbelief. I was facing a stormy battle for her life. Findings showed sepsis (a blood infection) and DIC (a blood clotting problem). I tried to keep my cool but being a doctor doesn’t help me from harboring unwanted thoughts knowing its pathophysiology, or the disease progression. She was in impending shock and coma and I know her shallow breathing entailed possible ventilator, her status… an ICU settings. The decreasing urine output might lead her to dialysis and low blood counts may bleed her to death . I have to be one step ahead. Because one false move, one second short, few minutes delayed on rescue treatment, she might then be irreversible. It dawned on me that a lot of women with this condition did not survive due to delayed recognition of a fatal encounter. What if she dies? What will happen to my brother and my niece? I don’t want to regret this for the rest of my life. For the first time, I got scared.

Maybe the priests can be a priest to their own family. And lawyers can be a lawyer to their own brood without hesitation. But can doctors deal the life of their own bloodline? I don’t know. Perhaps, that’s why the Oath of Hippocrates was made.

(TO BE CONTINUED…. read on and click When Life is A Relative - Part II)
Anna Santos
(CONTINUED FROM When Life is A Relative – Part I)

Flipping the charts with quivering hands, I glanced at Gladys' semi-conscious state of mind and gazed at Allen's bewildered appearance. My eyes surveyed the gloomy room, our relatives were there, entirely clueless of what I have in mind. I wanted to burst into tears and scream “She may die anytime!” but I haven’t uttered it in blur and confusion. How do I prime my family to expect the worst? I used to do that to patients, unrelated to me. How do I say to them to be prepared of a possible death when I myself wouldn’t accept that dreaded idea? I had to get out of the room, evaded the pressure, and stayed at the nurse station, for if physically, she was in agony, emotionally, it was torture to me too.

Perhaps it was too heavy to bear that I couldn’t write any medical orders anymore, for fear I might push her to death, or be blamed by my brother, or worst, by myself. So I asked the Lord why her and why me. It’s hard to pretend in front of the people who expected too much from you that everything is in control when you know only the Lord knows if He would like her to respond well to our treatment. And it’s also lonely to cry alone, never letting your family see you cry because you should be the last man standing strong.

As a doctor, when dealing with life itself becomes a routine day to day encounter, we become detach to maintain grace under pressure. We cling to our defenses to think clearly and objectively. But I got stuck in the danger zone, unable to create a detached attitude. My judgment was already clouded. I couldn’t be a doctor to my sister anymore. I tried, I thought I am strong enough, but I failed.

I have earlier called in the Hematologist and the Infectious specialist. With HELLP syndrome versus Postpartum HUS as a consideration, they continued with the treatment I initiated and worked their brains out in saving Gladys until she was out of the ICU. I thanked my colleagues for understanding how I bothered them in my crisis. And I thanked Dr. Amy, my cousin, for the support she gave in that crucial day. I never thought how noble my profession is until this time, when I had a hands-on experience of their camaraderie.

Learn to quit when you are supposed to. Do not push yourself and be stubborn if you think you can’t. Step aside and be a relative. These I learned well.

So I step aside and been feeding my little niece with my breast milk at the nursery while my colleagues deal with the mom at the ICU. For a while, I’ve been the surrogate mother for baby Mickey up till she was roomed-in.

My brother’s family is now out of the hospital enjoying the life together. Last week was baby Mickey’s christening, and I thank the Lord to have been constantly guiding my thoughts and the hands of all the physicians who attended to Gladys.

As for me, I guess, I’ve been a better relative than a doctor to my relatives. But the pleasure and contentment to have saved one relative is, after all, more than the money could give.





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