The Wedding

The young couple looks gorgeous that day. He looks impressive in his impeccable Marine Corps Dress Blue uniform. While she looks beaming in her gorgeous flowing white dress with a beautiful bouquet of flowers in her hands.

The minister was ready. The most important guests were in attendance and ready. The place was basking in radiant lights and ready. It was time for a wedding.

Many would dream to have their wedding in a big historic cathedral. Others would prefer in a more Edenic scene, like an enchanting garden. While some would choose a more relaxed yet romantic place, like an exotic beach.

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photo I took in a beach at Ilocos Norte

But the wedding that I witnessed did not happen in any of the above special places. Instead it happened in one of our mundane Intensive Care Unit (ICU) room.

Yes, you read it right, a hospital ICU room.

At least the room has a big window with a view of an old nearby church. At least the room was warm and bright, as it was gloomy and cold outside in that wintry afternoon. Not to mention that it was a very expensive room to be in. A day’s stay in the ICU is far more costly than a night in Ritz-Carlton Hotel in New York City.

The groom’s mother had been sick for a while. She had been in and out of the hospital for several months for a variety of medical problems. And now she got seriously ill and had been lingering and languishing in our ICU for about a month. She had been on mechanical ventilator and we were unable to get her weaned off of it.

The groom’s father had been sick as well. In fact, he was admitted also in the hospital and just got out a few days ago.

But the young couple wanted to commit to their vow to each other, whatever the circumstances may be. Perhaps they have been planning for their wedding for some time. The groom even came home from overseas where he was stationed. And I’m sure that the original plan was not to get married in a hospital. But you roll along with what life offers you. It must go on.

So in the presence of their parents and choice guests, in that cramped hospital room; there was no bright glare of church’s grand chandelier, but instead a glow of ICU floodlights; no wedding¬†bells were ringing, instead intravenous pumps were alarming; no melodious birds were singing, instead the constant chirping of the ICU monitors; no sounds of ocean waves lapping on the sand, just the low hum of the ventilator: where the two lovers exchanged their sacred “I do’s.”

There is no such thing as a perfect place for a wedding. No such thing as a perfect day to get married. There is no perfect circumstances. Not even perfect couple. Just perfect love.

In the midst of sickness and suffering, when life hangs precariously in a dance between life and death, in a world of uncertainty and unclear tomorrow, love still conquers all. It always will.

May you all have a meaningful Valentine’s.

*****

(*This is the second ICU wedding I witnessed; read the other one here.)

Angel’s Wings

It was a dreary snowy day in January. I drove to the hospital with snow coming down and with strong blowing winds, that it was almost a blizzard-like condition. Unlike schools and other offices that can close down for a snow day, hospitals runs business as usual, with or without blizzard. Besides, I am in-charge of the Intensive Care Unit (ICU) that month. I got to be there.

I knew I had a very busy day ahead of me. I had 17 ICU patients to take care of, 5 scheduled bronchoscopy* I need to perform, and 1 new consult for hyperbaric oxygen therapy** I need to dive. It would be a long, long day.

Our ICU was bursting in its seams. It was the height of a “bad” flu season. We were always pressed for beds, and we had to juggle patients, sending them out of the ICU as soon as we stabilized them, only to replace them with more sicker patients.

Then during the course of that day, as if my plate was not yet full, I had 4 more additional admissions to the ICU: 1 coming from the operating room, a patient who had a cardiac arrest while in surgery; 1 coming from the medical floor, a patient who had received a lung transplant years ago and was now in respiratory failure needing mechanical ventilation; 1 patient coming from another hospital who had an advanced liver disease and was on liver transplant list, and now with fulminant hepatic failure; and 1 patient who was brought to the Emergency Room (ER) with fever and chills.

Since there was no more available ICU bed, the patient in the ER had to stay there, until we open up some beds.

That was when I went down to see the patient in the ER. I brought along the senior medical resident with me.

Our patient was in her 70’s. She was diagnosed with malignant melanoma several months back. Unfortunately the melanoma had metastasized to her bones and lungs. She had received several treatments including investigational therapy. In fact, she was involved recently in a clinical trial in Mayo Clinic, and according to them the drug seems to be working, but the study was discontinued and she stopped receiving the said therapy. Needless to say her cancer continued to advance.

Now she presented to our ER with a high-grade fever, shortness of breath, low blood pressure and worsening confusion for 2 days. I reviewed her labs and radiographic tests, and it was consistent with severe pneumonia. Due to her immunocompromised state (from cancer and chemotherapy) she cannot adequately fight the infection. She had an overwhelming sepsis and was in septic shock, a very serious condition.

I swiftly examined the patient, who was barely awake, confused, and was incognizant of her condition. After that, I approached her husband and introduced myself (even though my name and specialty was already clearly embroidered on my white hospital lab coat) and told him the severity of the situation. I gently laid the facts to him that she was indeed critical yet we will give her our utmost care, but mortality can be 50% or higher.

The patient’s husband silently broke down in tears. He told me that she was his best friend, his life’s partner, and wife for 48 joyful years. “Please take care of her and treat her as your own,” he stated submissively.

I politely told him that we will take care of his wife to the best of our ability. That’s when he patted my shoulders and said: “I know you will, I can see your angel’s wings.”

I paused for a moment. Never have I heard those words spoken of me before. I was really touched with his remark. I looked at him straight in the eyes as I respectfully and whole-heartedly thanked him.

I then quickly excused myself. Perhaps he noticed I have tears in my eyes too.

I am not sure I deserve the compliments (frankly, I received a chilly reception on my next patient), for I am merely human as anybody else. But it surely made me fly through a long and difficult day.

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(Photo of the hospital’s center courtyard that I have taken with my iPhone later that day. Please take note of my reflection on the glass window: I have no wings.)

* see related post about bronchoscopy here

** see related post about hyperbaric oxygen therapy here