Patient: I started coughing this morning doc. It’s disturbing my sleep. Can you give me my antibiotic for this?

Me: Did you have fever? Difficulty of breathing? 

Patient: No I don’t have. But I usually run for an immediate consult and my doctors gave me antibiotic every time. 

Me: Well, based on my physical exam, your lungs are clear. You do however have fine tremors, a palpable thyroid gland, though only mildly enlarged, Your heart rate seemed a bit fast, your BP is slightly elevated and… Did you just say it started just today? 

Patient: Yes. I always have that seasonal cough and colds. But I have a transplant patient at home. 

Me: Oh I see. Then you should get flu shots yearly. We have a lot of vaccinations now for your age. I fear you might develop antibiotic resistance if you keep on taking it. 

Patient: Yes I know but I’m running out of budget after all the costs we've been thru. Next visit maybe. I just want the antibiotic. 

Me: Yes ma’am, unless there is a clinical indication, I can give you that.  What I’m saying is, you might have a thyroid disorder, and your cough might be cardiac in origin. 

Patient: But I already have a cardio doctor that deals with my heart. He gave me the medicine for blood pressure. I came to you for the antibiotic. 

Me: I mean your present problem may be hyperthyroidism with a thyrotoxic heart disease. It’s a problem in your thyroid gland hormones which gives a problem in your heart. Now if you want some antibiotic lets run these test and lets see if you have an infection.

Me: The tests confirmed my suspicion of a thyroid disorder. Here’s the medicine for your thyroid, and here’s for the heart. You take this every… 

Patient: I did all your tests doctor, now can I have my antibiotic and attend to a post transplant patient?  

Me: You’re a care-giver now? 

Patient: Yes, a care-giver, at home, to my only daughter..I don’t want her to get this cough. 

Me: May I ask what organ ? 

Patient: Kidney. It got injured in a car accident and she’s diabetic, type 1, on insulin since 10 years old.

I woke up 4am in this irksome morning, awakened by Egan's singing Elmo songs while sleeping, It was followed by his loud burst of "dede ko! dede ko!" in the tune of jingle bells. It signaled the end of my happy slumber. It was time for me to get to my feet, as I sluggishly paced thefridge for his milk.

Silent as this crack of dawn, my mind was wondering of how his thoughts came to be so vibrant even in his sleep. My two year old son amazes me sometimes, if not all the time.

He could sing his choice of songs to you even if you didn't ask for it for he loves to entertain people. Or he could ask you again and again in his own language which only he could understand. He may dance to you or sing to his version of medley nursery songs (and the APO's Heto Na in a rock-and-head-bang-your-head state).

His exploration of things is more than his curiosity could be, he could slam the keyboards with his grandpa or strum the guitar with his tito, but he dances when I play the keys or he sings with papa, and he's not out of tune. I am curious how come he knew the next note when he only heard the music just once. He is not afraid to run and fall or bump himself up on a wall. Though he cries so loud when he's hurt, an ice cream will sooth his ailing body parts but still dares to do it again.

Was it too much TV? Maybe yes, or maybe not, he just may have inherited the best from both of us.

I recalled as I looked down his plump body while he lavishly savored the last few drops of milk, of how he survived in my womb , taken out barely 37 weeks AOG (age of gestation).

I was on my senior year of residency when I got pregnant. I may have a 36 hours shift duty, but making rounds was just fine, most of the time I only get a hold of ICU and command for codes outside.

Being in command during code blue and code red, was supposedly all right. But for Egan inside my womb, it may be music or noise as that of the beeping cardiac monitor, in a way, relatives were shrieking, doctors were shouting epinephrine!, intubate!, ambubag!, Defibrillate 200 joules!,300!, 360!, clear!, CPR again...

Inside, Egan was using his tiny little feet to thrust my tummy, whether it meant to say "hey mom its noisy out there", or it meant an out-of tune music, I don't know. All I knew, as I get to go back home and take my rest, I played Bach and Mozart songs and he stomped his feet inside my tummy, this time he was thrusting to the beat. He was always moving, most of the time. No wonder he's been singing and dancing nowadays.

Wandering inside the hospital while I'm still pregnant gave me a sense of security, and that taking a leave off is not in my agenda. I could go straight up to the labor room to hear any of my contractions, or I could go to my friends in the radiology to check my baby on sonogram, call them my "pasilip" (kapal muks).

Apparently though, these friendly "pasilip" gestures lead me to save Egan just in time. One day, my friend called my attention and immediately asked for 2nd opinion from the sonologist. Egan had no water!!(Amniotic fluid gone dry). It was not my due date yet, and I have not felt any labor pains, nor a leaking bag. But an emergency CS was done. Egan was taken out, and dry enough to have caused the amniotic sac to cover him without the fluid. Truly, we were just in time.

Developing postpartum BP rise made me stay in the PACU longer than expected; it was some pregnancy complication we once again prevented. What would have happened had I not known my status sooner? Or if I had gone into labor I may have preecclampsia, and other possibilities.

I may be lucky, but what about our less fortunate women who do not have this kind of privileges, worst, who do not have any idea at all of maternal mortality and morbidity? I could just imagine how that could be if I am one of the unfortunate ones. Looking back, Adriel Egan is one great survivor.

And he is one great kid too. Just yesterday, we had a long drive with Egan and friends. He did not sleep during the travel course; he was just awed by the beautiful scenery. Driving at 100 kmh, he was so sweet to keep his hands laid in my arms just that, enough for me to consider driving carefully. And we made it back home, safely...my angel and me.

Now, as I am about to return to my interrupted sleep, I took one last look at him before I close my eyes. Egan was back sleeping, still smiling though, and never loosening his grip from his feeding bottle.

The gift of life the Almighty gave is as precious as the ones I get to be His steward.

And I am constantly grateful.