Sunday, December 25, 2011

December 24 ER Scene at Metropolitan Hospital

I had hoped to just sit at my comfy couch and get ready for Noche Buena but my septuagenarian dad had a medical emergency. I was angry and sad at the sight of a swollen nose and right cheeks. I had to be extra careful when asking questions because dad may just explode in anger.

When I was eight, I cried myself hoarse trying to explain to dad that my right arm was swollen and I couldn't move the whole arm after a bad fall, from a roller skate ride around our apartment building, knocked me into a concrete wall. Dad took off from work and got home to take a look at my condition. I instantly felt better. I knew that when my dad was around, everything will be better.

Years of physical injuries from hobbies, sports activities and a few street fights always had a common denominator--my dad. He didn't want me to feel it alone. His presence and reassuring voice had always soothed my aches and pains.

It was one of those times that I cringed in fear of what would happen to my dad if this condition went on without medical attention. "Dito, masakit!", he said. My heart raced and my brain automatically processed this info and the best way to deal with this was to be beside him and schedule a hospital visit asap.

Off we went to the Metropolitan Hospital along Masangkay Street in Tondo, Manila. We were met by men in avocado green scrub suits where my dad was wheeled into the Emergency Room. Another guy in blue scrub suit quickly stood up to ask, "Ano po ang nangyari..?" This male nurse was about 6'2" and calmly assigned a bed in the ER. I felt safe in the ER, for one reason or another.

I had my fair share of bumps and bruises where all except one were treated on outpatient basis. One of those ER visits had me confined for five (5) long days for a fractured elbow with dislocated radius. A knife wound was stitched together in just 45 minutes. A bloody gash across my left eyebrow was mended in less than two hours. A couple of dislocated fingers, broken ribs, busted knuckles, and swollen wrists were likewise treated in a jiffy. I am a veteran of several hospitals in and around Metro Manila.

Dad was wheeled to Bed#6 and two blue scrub suit nurses, one male and one female, asked a few questions and gave me some papers to fill out and sign. A pint-sized doctor introduced himself as Dr. Sosa (yes, namesake of Sammy Sosa). His friendly voice shot a series of questions and issued some instructions to the male nurse.

We were told that blood pressure will be measured, a blood test will be done and probably an ECG will be administered. I agreed to the first two procedures but declined to subject my dad to ECG for a swollen nose. I am neither a doctor nor a rocket scientist but my gut feel was to let my dad rest at the ER and let the doctor issue some oral medicines so that we can go home for Christmas Eve celebrations.

This male nurse came back and forth. He took the BP of my dad and smiled to say it was 130/80. "That's a good bp, right?", I quipped. The male nurse smiled back as he took the pulse. I saw his eyebrows meet and then ..suddenly, he left bed # 6. When he came back, he said: "Sabi po ng doctor ay mag-pag ECG daw po si Lolo." Well, I believe that the doctor knows best and I need his professional advice too. I could not process this at that moment in time, instead, I moved to another question, "Bakit kailangan ng blood test?" "Kasi po para malaman ung level ng infection.", said the male nurse. "OK sa akin yung blood test pero kung pipilitin niyo ung ECG, uuwi nalang kami. Baka magwala ang tatay ..." was my reply.

The male nurse came back with a form "Refusal of ...." stating the fact that I am refusing an ECG as recommended by the ER doctor. I read and reread the contents of the form and signed it. I was told to wait for one to two hours for the blood test result/s. I nodded in agreement. It was 3pm at this point.

Meanwhile, I had to entertain my dad with my exploits at work and some bits of news from my closest friends. He looked at me forlornly, as if to tell me that he was uncomfortable at the hospital. I can feel my dad's pain but I had to seek the medical advice of the ER doctor.

I liken dad to myself who has survived countless physical injuries like dislocated right shoulder, sprained and dislocated ankles, broken hands and others. He is tough as nails! To see him writhing in pain is just unbearable for me.

At around 345pm, I dangled an idea for coffee and club sandwich at the hospital's lobby around 100 steps from where we were. I asked permission from the nearest desk where nurses where stationed. We were calmly told by a pudgy nurse that we are not allowed to go out of the ER because if anything happened to my dad, they will be held responsible. I reiterated my request saying the coffee shop was just a spitting distance to the ER and that we need the oral meds prescription and that I will take the responsibility of handling my dad. A guy in white doctor's jacket, fair-skinned with coiffed hair butted un the conversation by saying: "Hindi naman po namin sinasabi na tatakasan niyo ang pagbayad ng bills dito sa ER pero talagang bawal lumabas ng ER kung hindi babayaran ito bage lumabas." My mind was computing fixed costs per visit and assumed that going out of the ER and then coming back would incur two fixed costs. I never figured out if my "fixed cost' assumption theory was right. "Ipasok niyo nalang ang food dito...", said the pudgy nurse. I smiled and walked towards my dad.

I went the nearest coffee shop and brought back a club sandwich and bottled water. Dad ate it with gusto. I ate what's left from the hospital bed and saw a warning on the wall that food and drinks were not allowed inside the ER Bed area. I wonder why they instructed me to bring in food.

I followed up the blood test results with the male nurse and Dr. Sosa at 4pm. At 430pm, I followed up the blood test again with a taller female nurse with a mouth/nose mask strapped on her face. A few minutes later, I was told by this taller female nurse that I had to pay the bill at the cashier and then go up to the laboratory to get the blood test results myself. i asked two more nurses and they said the same thing. I paid my bill at the ground floor cashier beside the hospital's ground floor pharmacy and asked another lady (in uniform) if this was the SOP that I should be the one to get the blood test results myself. She nodded and smiled.

So, this was a partial self-service ER where blood tests should be retrieved by the patient's companion?

With my long strides I paid the bill and walked up to the laboratory to retrieve the blood tests of my dad. In less than 5 minutes I was back to the pudgy female nurse to submit my dad's blood test reports.

I didn't see their urgency to help us at that moment. People at the nurses station seemed to be waiting for a follow-up or a request or a call before moving to treat or assist my dad. Maybe they have become immune to seeing people in pain. Maybe they have Christmas plans to discuss among themselves. Maybe they had other patients in the ER to attend to (yes, I counted two other patients in bed 1 and bed 2). Maybe they didn't like the way I talked to them. Maybe they didn't like the idea that I disagreed with the doctor's recommendation to have an ECG to find out what's wrong with an inflamed nose and cheeks. I can go on and on.

The coup de grace came towards the end of our ordeal at the Metropolitan Hospital ER when the pudgy nurse sat beside the pint-sized Dr. Sosa and chimed in to say, "OK naman po ang blood test ni LOLO. etc., etc." We were talking about the medicines cloxacillin 500mg for 7days--4x a day and paracetamol 500mg if there's fever. The pudgy nurse butted in again, "pwede na pong umuwi para sa pasko..." What were they trying to say? I can't speculate. I was just holding back my tongue to avoid any untoward incident.

I was glad that my dad doesn't have any special infection that the blood test could have determined. Given the fact that I didn't agree to the ECG test, they could have determined that my dad had this or that bacterial infection only from the blood test?

I commend the doctors, nurses and staff of Metropolitan Hospital during the holidays. But I hope they realize that patients are people who might be below their aptitude levels but are still human beings who should be treated right.

I hope to NOT go back to that ER anytime soon.


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