Steak and Rye

It was late afternoon of New Year’s Eve, and I was rounding on our patients in the ICU. I came to one room and the patient was sitting upright in his bed. On his bedside table was a tray with a large piece of steak on a plate, a drinking glass, and a bottle of rye whisky. What? Is this a restaurant or hotel? Is this the new hospital food?

Most of our patients in the ICU are not awake enough to eat food, let alone have a solid meal like that. We provide nutrition through a tube in their nose that goes to their stomach and they feast on liquid feedings. Or if their gut is not working, we give them “gourmet” nutrition through their veins. In fact once patients can eat solid food, most of the time they graduate out of the ICU.

But what about this patient? A slab of steak? And is alcohol sanctioned by the hospital now? Here’s the story.

He presented to the hospital with worsening shortness of breath. After some imaging work-up, he was found to have a large tumor in his chest. I saw him several days ago when he was admitted in a regular room, not in the ICU. We were consulted for the lung mass and I scheduled him to have a bronchoscopy (a procedure putting a flexible scope to the lungs) and biopsy.

However before the scheduled procedure could be done, he suffered a cardiorespiratory arrest, got intubated, was hooked to a ventilator and was moved into the ICU.

Good thing was despite the circumstances, he improved enough that we got him off the ventilator. Yet we don’t have a tissue diagnosis to confirm that what he has is cancer, even though the signs indicated that it was malignant. But we needed to be sure.

So I proceeded with a bronchoscopy and got a biopsy, and finally established a diagnosis. It was lung cancer alright.

Unfortunately his condition got worse again. He again required ventilator support, though a non-invasive type, which is like a CPAP machine. I told him that the final pathology proved that it was cancer. And based on its extent, plus with his grave condition, he was an unlikely candidate for any surgery, or chemotherapy, or radiation to treat his cancer.

That’s when he decided that he wanted to go on his own terms. His own way. Like Frank Sinatra’s song, “I did it my way.”

He requested that we discontinue the non-invasive ventilator, even though he was struggling without it. He asked to have a New York steak and a bottle of rye whiskey for his last meal. So in between labored breath and heavy heaving, he chomped on his steak and sipped on his rye.

When I came to his room that afternoon, despite his terrible situation, he was even smiling while having his last supper.

After he had his meal, we transitioned him to full comfort care per his request. No more ventilators, nor machines, nor any more interventions. Only comfort medications. And while he was watching TV in his ICU bed, waiting for the ball to drop in New York’s Time Square, he quietly slipped into a blissful sleep.

Just before the old year ended, our patient went out peacefully into the eternal night. He exactly did it his way.

For us who made it through another year, may we find new aspirations, new hope, and renewed zeal for life, as we face this new year.

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Waiting in Line

It’s 2014. Happy New Year!

During the New Year celebration in New York City, a million or more people flocked in Times Square to watch the fancy ball drop and ring in the new year. It was reported that many people began waiting and standing in the streets in TImes Square starting around noontime, to get a good location to see the ball drop, the fireworks, and the rest of the show. That’s about 12 hours of waiting and standing in the cold! Was it worth it?

In our recent trip to a theme park, it was so crowded as it was the holiday season. It was jam packed that we could hardly walk anywhere without pushing, shoving, or trampling somebody. It could rival a walk in Divisoria. And the lines to the attractions were ridiculously long that can push the limit of patience in any human being.

The only consolation in these long lines was that they post how long was the wait time – like 45 minutes, or 120 minutes, or gazillion minutes (!) – to the ride or show, so that you have some idea of how long your agony would be. They should post the wait time in the restrooms as well, as there were long lines there too!  How could this be the “happiest place on earth?”

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In one popular ride of the park, our resolve was tested when we stood in line for it. We tried to get a *fast pass, but the time it gave us to return was close to midnight! We may not even stay in the park by then, so we took our chances and waited in line. And we waited. And waited.

The line was long and winding. On top of this, a long portion of the wait, we were cramped in a dark, enclosed place, with hardly any “personal” space. If the theme of that particular attraction was going to outer space, they were succesful in mimicking that environment, as I felt there was not enough atmospheric oxygen for me to breathe. Perhaps more people got dizzy and light-headed while waiting in line than in the ride itself.

After standing in line for more than 2 hours, we finally got to experience the “thrilling” ride. All the 2 minutes of it. Yes, you read it right. A measly 2 minutes! Was it worth it?

Our real life experiences though involves the humdrum of waiting in line. We stand in line for the bus or the train to take us places we want to go. We wait in line when we apply for a certificate, or a license or even for a job, so we can do things we want to do. We stand in line in stores or groceries so we can get things we like or need. In almost anything we do we wait in line.

In truth we have even mastered the art and science of waiting in line. When you line for the check out counter, do you count how many people are lined up in the different lanes, or better yet even count how many items each person have in their grocery cart in front of you, to make sure you line up in the shortest and fastest lane? Guilty, huh?

Then, there are people who wait in line for their destiny to come. Like princes and princesses, waiting for their moment of prominence.

Prince Charles is standing in line, to be the next monarch for more than 60 years! And that is if his mother, the current queen, will not outlive him. Some even feel that he should give way the throne to his son, Prince William, who is younger and more popular. But that is a different issue in itself.

What I am trying to say is this: in this life we wait for something grand to happen. Most of the time the wait is long, and the exciting event can be fleeting and short. Was it even worth it?

I don’t know what you are standing in line for. Maybe for that dream job. Or for your special someone. Or for that memorable occasion. Or that fateful event. Or your appointment with destiny.

I hope that this new year will bring in that event you are waiting for. And if not, just be patient. For I believe we are all destined for greatness. And it is worth the wait.

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(*Fast pass ticket allows a guest to avoid the long line by giving them a pre-set time to return to the particular attraction.)

(** photo taken with iPhone)