Category Archives: medicine

A Beautiful Night

11 April 2020

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I did two overnight in-hospital ICU call in a span of three days lately. This has obviously derailed my circadian rhythm. Normally in our group of intensivists, a doctor only do 24-hour duty once a week or less. But this is not normal times.

So on the day I was off after my back to back calls, I woke up in the middle of the night and cannot sleep anymore. My body was fatigued yet my mind was awake. Instead of tossing and turning in bed, I got up and went to another room so not to disturb my wife who was fast asleep.

I pulled up a chair and sat by the side of the window and stared outside. The night was still and the moon was halfway through the horizon in the sky. The warm glow of the moonlight bathes the whole surrounding and it was quite enchanting. It was after all the super pink moon – the biggest and brightest full moon of this year 2020.

Ah, year 2020. Who could have predicted that this year would be this challenging? At my work we have more than 30 ICU beds, but with the predicted patients surge from COVID-19, our hospital has a contingency plan that we could convert other parts of the hospital into temporary ICUs and that we could potentially take care of 90 critically-ill patients on ventilators. The good thing is we have not seen that kind of surge like what is happening in New York City and New Orleans. At least not yet. I hope we never will.

We do have several confirmed COVID-19 patients on ventilators though, and they are pretty sick. But they are getting better, and the truth is many of them are getting off ventilators after a few days. Even our first ever confirmed COVID-19 patient that ended up on mechanical ventilator improved and got off of it after almost three weeks.

There were deaths though from this virus, even in our ICU and we cannot deny that. In fact the other night that I was on call, there was one patient that was a COVID-19 suspect and I placed him on a ventilator that night. Of course I had my full protective gear when I intubated him. Yet despite of our best efforts he died. But testing came back later that it was not the novel corona virus, but he had positive blood culture for a bacteria and he died from an overwhelming sepsis. People die from other causes as well, not just COVID-19.

As I gazed outside the window, I uttered a prayer for strength and protection not just for me, but for all the healthcare workers that continue to fight this battle. I also prayed for my family and all the families of frontliners who are at continued risk of contracting this disease from us when we come home. More importantly I prayed for the patients and their families that are going through such a woeful and difficult time.

The saddest part of this pandemic is that patients in hospitals are going through their ordeal alone, as family and friends are not allowed to visit them. And for those people who succumbed from this COVID-19, they die alone with nobody to hold their hands even in their last dying breath. It is really heartbreaking.

I looked at the radiant full moon and it was glorious. I observed that the light of the moon cast long shadows on the lawn from the trees. I was unaware on how the trees around us had gone so big and tall now. The evergreens that stayed lush and strong through the cold months and had survived many bitter winters. The deciduous trees that were currently barren but the leaf buds were beginning to appear for it is spring time after all, reminding us that life begins again. I also noticed that there were faint stars in the sky, though their light were subdued by the bright moon, yet they were twinkling whether we see them or not.

All in all, it was a beautiful night.

Photo by David Besh on Pexels.com

Then a thought came to me as if God was answering me. Even if we are going through the night, if we don’t dwell on the shadows and focus on the light, there is still beauty around us. Many times darkness heightens our senses to appreciate the light and other lovely things that we may have taken for granted. Yet the most reassuring thought is that even how dark the night is, morning is surely coming and a new day will emerge.

Yes, we may have lost many in the night and we should remember them, but for most of us, we are going to be alright. Have a blessed and meaningful Easter everyone.

Coming to the Dark Side

7 April 2020

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Because of this COVID-19 pandemic, as a defense it is now advised that everybody wears a mask when going out. However, there is a shortage of masks available and other personal protective equiptment in many hospitals. Dark times indeed.

Thus, I’m wearing my own respirator mask to work.

“You are unwise to lower your defenses.” – Darth Vader

(*Warning: not a true protective mask. Rest assured for I am donning an officially prescribed PPE when dealing with patients.)

To Immunity and Beyond

29 March 2020

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(I was asked to do a 5-minute health talk for our local congregation. Of course our church is doing virtual service now, so it was on-line using Zoom platform. Here’s what I presented.)

In this time of pandemic scare, we can wear a mask to prevent the virus from entering our system. In the hospital where we have confirmed or suspected cases of COVID-19, besides mask, we also don gown, eye goggles, and gloves. But what happen if the virus breaks through these barriers and invades our body? Since we really don’t have good medicine to fight the virus, we have to rely on our immune system to fight it.

How can we then boost our immune system? Here are some basic recommendations that we all can do. Let’s talk about the NEWSTART.

N– nutrition. That means eating the right kind of foods. Scientific and medical studies have supported that eating vegetables and fruits can improve our immune system and of course our health in general.

The more colorful the fruit and vegetables – like red, purple, yellow, green -the better, which means they have more anti-oxidants. Antioxidants help repair damaged cells and tissues. Vitamins are antioxidants.

There’s some pilot studies that they are giving mega-doses of Vit. C intravenously in COVID-19 patients. For us, we don’t need Vit. C intravenously, just eat the whole orange or some strawberries. That will taste better too.

There’s also some data that N-acetylcysteine (NAC) helps boost our immune system. NAC is needed for our body to manufacture gluthathione which is a premier antioxidant. NAC is found in legumes, like lentils, beans and peas. You can get NAC supplement in stores too.

E– exercise. Now that it is not too cold outside, go for a walk. Use common sense though and follow the recommended social distancing. Still practice the 6 feet distance from the crowd or don’t walk in a crowded area. But we are in Iowa, we have lots of open fields to exercise. 30-60 minutes of moderate vigorous exercise can release extra immune cells into the system. Exercise will make you look good too.

W– water. The best and the only hydrating fluid you really need. Our body is about 60% water. The brain 70% water. So if they call you airhead, that’s bad. Waterhead? That’s fine. We constantly lose water in our sweat, urine, even through our breath. We lose more water when we have a fever. When we fight an infection, we need to be properly hydrated. Many of our systems needs adequate water to be functioning properly, including our immune system. It is recommended to drink 2 liters of water a day, roughly 8 of 8-ounce glass of water.

S– sunshine. The sun rays can boost our immune system. Besides helping us produce Vit. D, the sunshine can also kill germs. That’s why we place that stinky shoes under the sun to kill the germs and the smell. OK, you don’t have to give that look to your family member, just tell them nicely – how about let’s go out in the sun.

T– temperance. In other words self control. I don’t have to tell you that smoking and alcoholic drinks can be detrimental to our health. As you can surmise, smokers are more susceptible to lung infection.

A– air. Fresh air. Stale air has more CO2 content. We need to replenish the stale air inside our home. Go ahead open the windows. Or go outside and breathe in fresh Iowa air. I hope you’re not near a cattle or pig farm. Or not near somebody who is coughing. Oxygen which in air of course is essential not only for the immune system but for us to live. Practice taking deep breaths. Better yet exercise and so you’ll breathe deeply.

R– rest. We need to have adequate rest or sleep. It is recommended that an adult person sleeps 7-8 hours a night. I know many of us are not getting that. Teenagers who think they don’t need sleep, actually needs 8-9 hours of sleep. Younger kids even need longer hours. Sleep deprivation can weaken our immune system.

T– trust in God. Many scientific studies have shown that people who believe in a higher power, recover faster when they are sick. But we don’t need medical or scientific studies to tell us that. We know that our God is bigger than our world’s problem.

There’s a story in the news about an atheist Italian doctor, and with what’s going on in Italy, he became a believer in God. As the saying goes, there’s no atheist in a fox hole. It’s important that in times like these that we put our trust to the One who is still in control.

Stay safe and healthy everyone.

**********

PS: To get a glimpse of how our immune system fights a virus, you can read my previous post, “A Battle Within,” (read here).

(*image from astroyard.com)

Fearless

23 March 2020

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I am fearless. But that’s not true. It’s not that I’m scared of spiders or cockroaches. It’s more than that.

I think we all know that we are in a middle of a war. The casualties from this COVID-19 pandemic continues to rise and it is devastating. More devastating are the news that healthcare frontliners are becoming casualties themselves. The news of doctors – from China, Italy, France, Indonesia, Philippines and more – dying from getting infected with the novel corona virus from patients they are trying to save, sends shivers to my spine.

I know there are risks from my chosen profession. From being overworked and being sleep deprived to being cursed by patients and being sued, that goes with the territory of our duties. I can live with that. But to risk your own life from contracting a possible deadly disease and even worse, to endanger your own family from passing on the illness at home makes me afraid. Very afraid.

For those people who are not taking this pandemic seriously and continues to party or not follow the recommended social distancing and community quarantine, or for those who think they are strong and invincible, please think again. If it’s not you who would be severely affected, it may be someone that you love that could suffer, because of your foolish actions.

Today, I came face to face with only my mask in between, with this deadly disease in our ICU. As I place an endotracheal tube to the patient’s passageways to hook her to a ventilator, I can only pray that my personal protective gear will be enough shield from this invisible enemy. Though I pray even more that heaven’s hand will be my shield.

I know this is only the beginning of my daily battle and confrontation with this foe. And it is expected that the worse is yet to come.

Fearless or not, I swore an oath to do this job. So help me God.

(*photo taken at Jardin du Palais Royal)

The Hero Who Told The Truth: A Tribute

10 February 2020

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The Wuhan coronavirus, also known as 2019-nCoV, has claimed its ultimate victim. Chinese doctor, Dr. Li Wenliang, the first one to raise the alarm of the spreading epidemic, died on Feruary 7 from the virus that he tried to warn the world about. Instead of heeding his warning, the authorities tried to silence him, as back in December last year, he was arrested for being the whistle blower who is ‘spreading rumors’ about a mysterious virus. Now we can only speculate if the course of the epidemic could have been different if his government had listened to him.

Dr. Wenliang continued to care for patients in Wuhan until he himself got infected with the virus and paid the ultimate sacrifice for his work.

I found a poem in Chinese that was translated in English circulating in the internet, claimed to be penned by the doctor himself. Though I cannot confirm its authenticity, yet I’m sharing it here in honor of Dr. Li Wenliang.

“The Hero Who Told The Truth”

我不想當英雄。
我還有爹娘，
還有孩子，
還有懷孕臨產的妻，
還有許多的病人在病房。
盡管正直換不來善良，
盡管䢛途迷茫，
可還是要繼續進行，
誰讓我選擇了這國這家，
多少委屈，
等打完這仗，
垂淚如雨仰天遠望。
“I don’t want to be a hero.
I still have my parents,
And my children,
And my pregnant wife who’s about to give birth,
And many of my patients in the ward.
Though my integrity cannot be exchanged for the goodness of others,
Despite my loss and confusion,
I should proceed anyway.
Who let me choose this country and this family?
How many grievances do I have?
When this battle is over,
I will look up to the sky,
With tears like rain.”

我不想當英雄。
只是做為醫生，
我不能眼看著這不明的病毒，
傷害著我的同行。
還有那多無辜的人們，
他們盡管已奄奄一息，
可眼睛裏總望著我，
帶著生命的希望。
“I don’t want to be a hero.
But as a doctor,
I cannot just see this unknown virus
Hurting my peers
And so many innocent people.
Though they are dying,
They are always looking at me in their eyes,
With their hope of life.”

誰成想我競死了！
我的靈魂分明在天上，
望著那張白色的病床，
床上分明是我的軀體，
軀體上還是那熟悉的臉龐。
我的父親母親在哪？
還有我親愛的妻子，
那當年我苦苦追求的姑娘。
“Who would have ever realised that I was going to die?
My soul is in heaven,
Looking at the white bed,
On which lies my own body,
With the same familiar face.
Where are my parents?
And my dear wife,
The lady I once had a hard time chasing?”

天上有一道光！
那光的盡頭是人們時常說起的天堂。
我寧願不去哪裏，
我寧願回到武漢我的家鄉。
那裏有我新買的房子，
每月還要還貸的賬。
我怎能舍得，
我怎能舍得！
沒有兒子的爹娘，
該有多麽悲傷；
沒有了丈夫的寶貝，
該如何面對這未來的滄桑。
“There is a light in the sky!
At the end of that light is the heaven that people often talk about.
But I’d rather not go there.
I’d rather go back to my hometown in Wuhan.
I have my new house there,
For which I still have to pay off the loan every month.
How can I give up?
How can I give up?
For my parents without their son,
How sad must it be?
For my sweetheart without her husband,
How can she face the vicissitudes in her future?”

我分明死了。
我看見他們把我的軀殼，
裝進一個袋子。
在袋子的近傍
有許多死去的同胞，
象我一樣，
在黎明時分，
被推進火的爐堂。
“I am already gone.
I see them taking my body,
Putting it into a bag,
With which lie many compatriots
Gone like me,
Being pushed into the fire in the hearth
At dawn.”

再見了，難舍的親人。
永別了，武漢我的故鄉。
但願你們在災難過後，
還記得曾經有人，
努力地讓你們盡早知道真相。
但願你們在災難過後，
學會正直，
不再讓善良的人們，
遭受著無盡的恐懼，
和無奈的悲傷。
“Goodbye, my dear ones.
Farewell, Wuhan, my hometown.
Hopefully, after the disaster,
You’ll remember someone once
Tried to let you know the truth as soon as possible.
Hopefully, after the disaster,
You’ll learn what it means to be righteous.
No more good people
Should suffer from endless fear,
And helpless sadness.”

“那美好的仗我已經打完了，
應行的路我已行盡了，
當守的道我守住了。
從此以後，
有公義的冠冕為我留存。”
《聖經》提摩太後書4．7
“I have fought the good fight.
I have finished the race.
I have kept the faith.
Now there is in store for me the crown of righteousness.”
2 Timothy 4:7

Hospital, Cafeteria, and Sanctuary

26 January 2020

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I was in charge of the ICU that day and it was quite busy. Though it was not that up-to-my-eyeballs hectic for I still had time to go down to the hospital’s cafeteria for lunch. Many times I would grab meal to-go and head back to the ICU work station and inhale my food while doing some computer charting. That day I had the luxury of eating my lunch more leisurely in the cafeteria itself.

Our hospital’s cafeteria is by no means a fancy place to dine in. It is after all a cafeteria serving hospital food. Nothing against hospital food, but if I have time to spare, I will eat somewhere else. Our cafeteria though has a section that has glass wall and ceiling that gives you an atmosphere of being outside. Yes it is still winter and there’s snow on the ground, but the sun was shining that day, so I went there so I could soak up the sun for a change.

However if the hospital cafeteria is as inviting as the photo below, once I settled there they have to pry me like a barnacle from my seat for me to go back to work.

(photo taken in the Philippines at Manila Bay, a few years ago)

Besides the obvious of getting food to eat, there is another reason I stay a while in the cafeteria. That is, it gives me a chance to be away, even for a short time, from ICU work and from the constant hounding from the patients, residents, nurses, and other doctors. Though almost always, when I’m on a lunch break that is when I am called to the Emergency Department for a new admission.

But that day was different. I was enjoying my lunch alone and my phone was unusually silent. I guess the cafeteria gods were smiling at me. I consider these lunch escape my sanctuary – away from the chaos and the harsh reality of the ICU.

The hospital has a chapel too. But that is not the kind of sanctuary I am talking about here. I just needed a place to take a breather.

Then while I was savoring my food, but more so my silent interlude, a man approached me at my table. How dare him interrupt my break time? Who was he to disturb my lunch? Of course I did not react that way and instead I looked up and gave him a smile. It may be forced, but a smile nonetheless.

The man introduced himself and said that he recognized me from a previous ICU encounter. I learned that I took care of his mother in the ICU several months ago. After he gave me some details, I remembered her mother – she had cancer and became septic after receiving chemotherapy. She got very ill very fast and stayed in our ICU for several days. But she recovered.

The man then pointed to his mother, my previous ICU patient, who was sitting in a table a few paces away. They have an appointment with their oncologist at the Cancer Center and that’s why they were in the hospital.

How many patients have we taken cared of in the ICU who was as sick as she was, and have a chance to meet them later after their discharge and were doing relatively well? Sadly to say, that is a rarity. For many of them even if they get out of the ICU, they were never the same. And some don’t even get out at all, I mean not to the world of the living.

This man just stopped by to thank me. It was an interruption that I would appreciate after all.

Then when I was about to leave, a man that I met in the ICU earlier that day sat in a table near me. He was absorbed in his thoughts while eating by his lonesome. Like me he was also taking a break. Perhaps the cafeteria was his sanctuary too, an escape to the sobering truth in the ICU.

Though this man’s predicament was much different than mine. His daughter was our patient in the ICU, and she was not doing well. She had a tumor in her brain that was surgically removed, but even after more than a week post surgery, she remained on life support. Her life was hanging in the balance with uncertain future. Worse part is, she was only 20 years old.

It is very understandable for her family to be heartbroken. No wonder her father rarely leaves her bedside, except for a brief cafeteria break. As a father who has a daughter with similar age, I can only imagine the agony he’s going through.

I needed to go back to the ICU. We needed to help this young lady and her distraught father.

Auld Lang Syne: A Look Back

31 December 2019

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I am reposting an experience I had several years back. Original piece published December 2013.

**********

I was on-call that New Year’s Eve. As I remember it, even though it was the holiday season and no patient wants to be in the hospital, it was still very busy for us.

It was a time of a bad flu season and our ICU was full. In fact there was even a pandemic that year of a bad strain of influenza A, the H1N1, or otherwise known as “swine flu,” and we had confirmed cases in our hospital. The hog farmers here in Iowa detest the name “swine flu,” as it was detrimental to their trade.

Despite of my toxic duty, I was able to finish my rounds and saw all our hospital patients for the day (took me 12 hours or so), and made it just in time to a gathering of some Filipino friends for the New Year’s party.

I was only warming up with our friends when I was called for a “stat” consult that I have to see right away. Before I left, my friends told me that if I finish the consult and it was still before midnight, then I should come back to the party. It was around 10 o’clock when I drove back to the hospital.

The patient that I came back for was a woman in her 40’s. She had breast cancer and sad to say, despite all the surgery, radiation, and chemotherapy that she underwent, the cancer had spread to the lungs and pleura (covering of the lungs).

The patient was obviously struggling to breathe when I examined her. The chest x-ray that was done that night, which was requested by the oncologist showed hydropneumothorax. That means there was collection of fluid and air in the space surrounding the lungs. And that was the reason I was consulted, to surgically place an additional chest tube (as she already had one in place) to drain the fluid and air.

After reviewing the chest film and comparing it to the previous chest x-rays, I determined that the finding of hydropneumothorax was old. In fact the chest x-ray was unchanged compared to films from few weeks ago.

That meant that the worsening of the patient’s respiratory status was not from the collection of air and fluid primarily. Placing another chest tube would not matter as the lung was trapped and would not expand further. I surmised that her further deterioration was from the advancing cancer itself.

Maybe the patient and her family was hoping against hope that there was still something that can be done. Maybe they were grasping for straws for a possibility that she could see another New Year.

I explained my findings and I then solemnly, but respectfully told them that in my viewpoint, placing another chest tube would not matter, and that would not relieve her breathing difficulty.

Right after hearing my opinion, that was when the patient and her husband made the somber decision that it was time. Time to end it all. Time to let go. Time to transition to comfort measures only. It was time for her to rest.

The patient’s husband went out briefly, maybe to talk with other family members who were outside the room. When he came back, I bid them goodbye and left.

As I went out of the room I saw two girls, both were probably not older than 12 years of age. They were crying, while an older woman was comforting them. I assumed those young girls were the patient’s daughters. I think it would be safe to say that they were not having a “happy” new year’s eve.

I looked at my watch. It was less than an hour to midnight.

By that time the rest of the world was partying while waiting for some fancy ball to drop. At that time most people were celebrating while waiting to welcome the New Year, while another family was also waiting – waiting for suffering to end. Waiting not to welcome, but to say their final goodbyes.

I did not go back to the party. I went straight home to reflect, while the song Auld Lang Syne (translated as Times Gone By) echoed in my head.

Should old acquaintance be forgot,
And never thought upon;
The flames of love extinguished,
And fully past and gone:
Is thy sweet heart now grown so cold,
That loving breast of thine;
That thou canst never once reflect
On auld lang syne.

**********

Post Note:

For us who will be welcoming another new year, may we face it with hope and optimism, and embrace with reverence this precious life we are given.

(*Auld Lang Syne is traditionally sang to celebrate New Year at the stroke of midnight, but it is also sang in graduations and funerals; photo taken at Musée d’ Orsay.)

Electric Outlet Plugs and Precious Memories

17 November 2019

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I am taking a break from studying. I took two re-certification exams from American Board of Internal Medicine for different subspecialties this year. One in May and another this November. Next up is for another subspecialty, but it’s not until September next year. So I’ll chill out for now.

Because of the preparation I did for the boards, I have spent a lot of time reading and studying. I chose to review in my daughter’s room. Since my daughter is in college now and her room was empty, I took residence there and used her study table which is near the window. It was nice and quiet there plus it has a great view of the outside.

I also downloaded my favorite music for studying in Spotify and had it playing while I was reviewing. My go-to music when I’m studying is Jim Chappell’s. I discovered him back in the early 1990’s when I was preparing for my Philippine Medical Boards. His music is calming and perfect for quiet reflection. It puts me in a right mood too, I guess.

As I was studying in my daughter’s room, I was surrounded by her articles and effects – the stuff toys she had in one corner, the favorite books she read in the book case, the medals and trophies in the shelf, and other sort of things. Lots of memories tied to all of these items.

Then I noticed that some of the electric outlets in her room still has the plastic plug covers. We child-proofed our home and placed these outlet plugs when we moved into this house years ago. She was still a little girl at that time. Obviously we place those covers to protect her from being electrocuted in case she stuck her little fingers on those electric outlets.

But time has passed so quickly it seems that she has grown up and we have not noticed that she don’t need those outlet plug covers anymore. She probably left some outlets covered as she did not need them anyway. The wallpaper in her room may also require some updating as it was from the original owner of the house. But my daughter said she liked them, so we let it be.

I took out the plastic outlet plugs now for there were no use for them anymore. Besides I have to plug my laptop, my phone, and my portable speaker near her study table.

My daughter will be finishing college this year with a degree in Music. In fact, a few nights ago we attended her cello solo recital at the university. In a few months she’ll be performing in her final senior piano recital which will be a bigger event, since piano is her major.

It seems not too long ago that she was sticking her fingers in the peanut butter jar, playing dirt and picking dandelions in our yard. Today, those beloved beautiful fingers are electrifying musical instruments. We are glad we protected them from harm, including injury from electric outlets.

Below is a photo of my daughter during her recent cello recital. She was accompanied by her piano professor.

It is kind of funny that even the simplest of things like an outlet plug cover will evoke such precious memories. Or maybe it was the music that I was listening to that made me.

Alright, I’ll blame it all on the music.

********

Here’s Jim Chappell’s song, “Precious Memories.” (video from Youtube)

He Checked Out

10 November 2019

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It is a lonely world out there.

Yes, we have this modern technology of all the world being connected and wired through broadband networks, internet, Wi-Fi, and all platforms of social media, and yet the proportion of the population suffering from loneliness and depression is on the rise at a rate that we have never seen before.

A couple of weeks ago, a man suffering from Parkinson’s disease presented to the hospital for progressive weakness and failure to thrive. He needed to be placed on a non-invasive ventilator (BiPAP) for respiratory failure. He was admitted to the ICU by my partner the night before.

I went to see the patient the next morning. Before going in to the patient’s room the nurse at the station made a comment to me, “I think he just has no more will to live.”

I examined the patient and I spoke to him. Despite him on the BiPAP mask, he was still able to communicate. After learning more about him, he expressed to me that he wanted to be DNR (Do Not Resuscitate), meaning, to let him go peacefully if his heart stops.

I learned from the patient too that his wife passed away recently. He also had a son that lives in the area but he did not want him contacted. His next of kin that he put on record was his church pastor.

I tried to get him off the non-invasive ventilator but his oxygen saturation dropped so we had to place him back on it. But I told him that we could take him off the BiPAP mask briefly to let him eat, however he said that he had no appetite.

After our initial work-up, his condition was still a conundrum. He was not in congestive heart failure. He had no apparent pneumonia. He had no viral or bacterial infection. He was just unwell.

I think the nurse’s assessment was spot on. The patient simply gave up on living.

That night, a little past midnight, my phone rang. It was one of the ICU nurse telling me that our patient went bradycardic (low heart rate) and then went into PEA (pulseless electrical activity). The nurse commented, “He checked out.” He gave up the ghost and died.

The saddest part as I learned later, was that there were no friends nor family that visited him. There was nobody around, except for our hospital staff, when he died.

I don’t really know what was the story behind this patient. What I know is that he was lonely and that he did not care to live anymore. What if somebody was there for him? Could it have made a difference?

Please take time to show people, specially our loved ones that we care.

(*photo taken from here)

A Warm Lunch

11 October 2019

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I have been back to work this week after a brief break when I went to California to visit my aunt.

(photo taken when we drove to the airport to fly back home)

I have been seeing patients all day in the hospital for the past few days and it has been hectic. We have already seen the first case of the flu admitted in our hospital this season and we are bracing for a more brutal time ahead as the wintry air have started to blow.

I don’t like to bash hospital food, but if I have a chance to eat somewhere else besides the hospital cafeteria, I would do so. I wish there is something like the Manila Sunset Grille (see previous post) in the hospital grounds for that would be bliss.

But I have a busy schedule, and going out of the hospital to get lunch is much of a hassle plus I don’t have much time to spare. So regularly I just go to the hospital cafeteria to grab something to eat just to avoid hypoglycemia. I don’t care if it tastes like cardboard as long as the food is edible. Usually I would inhale my food and then continue my hospital rounds.

Yesterday I was in the hospital cafeteria to get lunch. It was still not that bad as I still had time for lunch for there were rare times that I don’t. The lines were long when I went there. As I head down to the cashier, I was getting impatient as the line was not moving as fast as I wanted. In front of me was an old frail lady who moves gingerly slow. She was taking a longer time as she dug deeply into her purse. It was like watching the character of the sloth who moves in slow-motion in the Disney movie Zootopia.

After the old lady handed her money to the cashier which felt like an eternity to me, she took a look at me. I was wearing my white doctor’s lab coat with my to-go box on one hand and a bottle of water on the other. Then the old lady softly told the cashier that she wanted to pay for my food, as she appreciates people who works in the hospital.

I felt like ice-cold water was poured on the fiery coals on my head. I was having unpleasant mood and yet this lady showed me goodness. Shame on me!

Since I knew the cashier as I am a regular in the cafeteria, I told her not to let the lady pay for my meal. I thanked the lady though but politely declined her offer. I told her that I should be the one paying for her meal, and that I really appreciate her gesture.

Yes, there is still goodness in this world. This old lady made me believe again in human kindness.

I still quickly gulped down my food. But I leisurely savor the warm affection I was served.