ULOG #13: Reminiscing: Observing nurses and patients during a visit to the Animal Bite Treatment Center some years ago
(Disclaimer: This was written a few years ago, right after I visited the clinic. Some of my thoughts written here may no longer reflect the person I am today.)
Realizing that I was bitten by our cat
It was a normal day. I woke up in the heat of the morning sun and had breakfast with my aunt and cousins. We were sweeping the floor when I realized something - I was awakened the previous night because I felt something sharp lightly piercing my big toe. When I got up to see what it was, I saw that it was our cat.
He was apparently sleeping at my feet; I might have accidentally kicked him while I was asleep, hence his defense mechanism to bite me. I know our cat well; he never bit or scratched me. He's kind and loving, so there's no reason for him to do it randomly.
I knew that I shouldn't have second thoughts, so I went to the Animal Bite Treatment Center (ABTC) at Dr. Jose N. Rodriguez Memorial Hospital, a public hospital located in Tala, Caloocan City.
Waiting to be called in the animal bite clinic
It was 11:45 in the morning and I was sitting on a bench, reading a book in front of the door where a large sign was posted, “Animal Bite Treatment Center”. Beside the room were the orthopaedic, psychology, and ECG rooms. There were a lot of people waiting in line, particularly orthopaedic patients; one could tell by their wheelchairs, arm and leg casts.
“Patients can sign on the list starting 12 noon."
This was what the nurse said when I last came in for my first anti-rabies shot. Apparently, new patients were set to visit at 8:00 to 10:00 am, while old patients, i.e. those who have received their initial shot in the clinic, are scheduled in the afternoon, 1:00 to 3:00. I came early so I could be first on the list; I did end up being first.
Cheerful and compassionate nurses made me think of shifting to BS Nursing
Lunch break came. There were still a lot of patients and I could see how eager they were to get the treatment at low cost. “Crisostomo” one of the nurses called. A young lady, probably in her late teens to early 20’s wheeled in a man who looked in his mid-50s. Both his legs were covered in gauze, and one had a long metal attachment to it.
“How are you?”
The nurse cheerfully asked.
“Has your wound been dressed properly?"
The nurse was inspecting his leg with the metal brace.
“It’s bleeding.”
“It’s not blood; it’s Betadine.”
The patient insisted, referring to a brand of povidone iodine, a solution used in cleaning the wound.
“It’s blood. Betadine is different from it. That one is blood; this part marks the area with Betadine.”
I was amazed at the nurse’s ability to distinguish between the two. I myself would’ve easily confused the two as well; after all, that solution does look like blood. I remember a friend of mine used to fake having a wound by dabbing a cotton ball on povidone iodine solution and then securing it in place with a tape.
“Okay, you may now go inside.”
Said the nurse as she smiled at the patient.
The nurse’s friendly personality made the atmosphere feel light, despite the inevitable tension that is almost always present in hospitals. Once again, the thought of shifting to BS Nursing entered my mind. “It’s too late.” I thought to myself.
“Pascual”
The nurse called again. This time, a child with his mother and older brother walked to the nurse’s desk. His arm was wrapped in a gauze.
“What happened to him, mother?”
She asked.
“He fell on the chair while playing.”
The nurse looked at the child and asked,
“Does it hurt?”
to which he nodded. He was then asked to go inside the clinic.
Moments later, he came out with a blue sling on his arm. The joy on the child’s face was evident. The nurse asked him again if it hurt, and he said no. The nurse smiled.
Lunch break!
I became too preoccupied with watching the nurse and the patients that I haven’t noticed that it was already 12:30 pm. I was getting hungry so I got up and walked to the door. I was surprised to see the many patients waiting outside – ill, financially challenged people who desired to get well and depended on the hospital’s affordable health care.
I walked past the people and took the back door to get to the newly renovated building where the new cafeteria was located. I didn’t want to eat anything heavy, so I opted for some siomai and a cup of iced tea. I ate quickly so that I could return to the bench where I had been sitting for an hour.
Reading a book while waiting for my turn
It seemed that the nurses took a break when I returned; there were still many patients inside and outside the large room where the clinics were located. I took the book from my bag so that I could continue reading. The book’s title was “Making Sense of Research: A guide for complementary practitioners”. It was one of those books I bought on a bargain in a small bookshop at a mall.
Ah, books. I’ve always loved reading books; my cousin even made fun of me whenever we pass by bookshops because she knew that I’d enter and go straight to the reference books and textbooks. As I was skimming through the book to find the page I last read, I felt someone sit next to me. I looked at the stranger and saw that it was an old woman with a child.
Answering queries of fellow patients
“Where is the clinic for those who had been bitten by a dog?”
She asked around. I didn’t usually talk to strangers, but I felt that I should at least make some effort to conquer my social anxiety, so I took the first step and spoke,
“are you also a patient at this clinic?”
as I pointed to the door of the ABTC. She turned to me and smiled, creases on the corner of her eyes forming.
I felt warm as I looked at her; she reminded me of my late grandma.
“Yes, she was bitten by a dog at the computer shop. I told her not to go to the computer shop, but she insisted.”
She sighed as she was telling me the story. As I initially thought, the child was her granddaughter.
She was holding a referral form issued at the Surgery Clinic.
“Have you been to the Surgery Clinic?”
I asked her. I sensed that she didn’t quite understand what I was talking about, so I framed the question differently.
“Has she gotten a shot earlier? For tetanus?”
She answered in the affirmative. I asked if I could see the papers that she was holding. Those were the referral form to the ABTC and the prescription for the anti-tetanus shot. Stapled with it was the receipt from the nearby pharmacy, showing that they had already bought the medicine. She was a new patient.
New patients were scheduled at 8 to 10 am; while for old patients, the scheduled visit was 1 to 3 pm. It was already 1:16 pm, but the nurse hasn’t come back yet. I knew that the grandma should come back early the next day because her granddaughter would no longer be assisted.
Indecisiveness gets in the way!
I was conflicted, however. I wondered if it was right to tell her that she should just come back the next day or let her stay and talk to the nurse personally. I sighed as I pondered my indecisiveness; this had always been my dilemma. I knew that if God truly willed for me to become a doctor, I would have to conquer this weakness; rather, God would make a way for me to conquer it.
Talking to Nanay Lily: Witnessing compassion for fellow patients
I ended up talking to the grandma for a little longer until the nurse came. Her name was Lily and people dearly called her “Nanay Lily” (Mother Lily). She was a resident of Tala, Caloocan City. She told me that her daughter didn’t know what to do about the dog bite and asked her to accompany the child to the hospital for the shots. She was disheartened when I told her that she would have to return the next day at 8:00 am because that’s what the clinic’s schedule says.
She told me that she has a lot of things to attend to; she needed to be at a hearing concerning a physical injury she sustained from the informal settlers at her lot.
“One of the men threw stones at my home and I was hit.”
There was also a delivery from a fast food chain that she needed to receive.
I eventually found out that her children weren’t too concerned about her, and that only one of them, the eldest, had genuine concern for her. She said that she plans to move to Greenhills, San Juan after the case is closed. I asked her if she had a companion in that house,
“no. I’ll live by myself.”
She answered. It was the typical life of an elderly, at least in the Philippines. It’s either they’ll live alone or be with their children and take care of their grandchildren. Once again, I felt sadness came upon me.
Orthopaedic patients arrive
More orthopaedic patients came and we had to inform them that there was no doctor to attend to them. One of them was a mother who was with her badly injured son. According to her, the boy was playing with his classmate when he collided with him, resulting in a broken shoulder.
She said that she brought his son to a hilot – an equivalent of a massage therapist in provinces, usually unlicensed. Fear was evident in the child’s face; he looked as if he was scared of the pain while supporting his left arm. There was a large scab on his left shoulder.
“Did you go to the emergency room?”
I asked her. She told me that the child hadn’t seen a doctor yet. Nanay Lily was also concerned,
“the hilot might have worsened it.”
She said. We told her to go to the emergency room right away. I saw Nanay Lily’s kindness – she even left her seat and went to the opening of the building where we were just to point the direction where the ER was located.
My turn to get an anti-rabies shot
As I followed them outside, I saw the nurse earlier, with a clipboard apparently holding the list of ABTC patients. She was talking to one of the patients. I was walking past her when I heard her call me,
“Ma’am De Guzman”.
I turned to look at her,
“as before, please pay this at the cashier then come back to the clinic.”
She smiled as she handed me a small piece of paper with letters printed on it – Injection Fee P30”. I admired the nurse for her cheerfulness despite her busy shift in multiple clinics.
Feeling bad for not doing what I thought was the right thing to do
I immediately told Nanay Lily that the nurse had already arrived. She entered the door leading to the clinics. I followed her inside and told her that the nurse was still outside and was about to go in too. As expected, the nurse told her to come back the next day. I felt bad because it was like I made her wait, knowing that her grandchild would not be given treatment.
“Is that so?”
Those were the last words I heard from Nanay Lily, spoken with sadness, as I left the room to go to the cashier for payment. I felt like that incident was added to a bucket list of guilt that I carried on my back.
After paying the injection fee, I went to the clinic to have the shot.
Our dog bit me too a few years back!
Ouch >.< Getting those anti-rabies shots are really a hassle!
Yes! I was bitten on a Sunday and Calamba didn't have clinics for anti-rabies back then so we had to go to RITM in Alabang. And they were closed on Sundays so we had to go back the next day. It was stressful and scary at the same time.
:O It must've been time-consuming and expensive. That's why we have to be extra careful with animals, even our own pets!