The Federated States of Micronesia is a group of Islands in the Pacific Ocean east of the Philippines. FSM was once a part of a United Nations Trust Territory under the US administration.
As they do not have tertiary hospital to cater to their special health care needs, most of them are flown to our institutions for consult, work ups and treatments through their local insurance there.
While English of is a common language there, there still some folks there that do not speak the language, hence the barrier.
A 26-year old small built female was admitted for mitral and atrial valve repairs, left atrial thrombeectomy and intraoperative transesophageal endoscopic electrocardiogram. She was accompanied by her mother who also barely understands English. Communicating with them is like playing charades as you need to act out and exaggerate hand gestures. Good thing is that there were other Micronesians admitted making them as our interpreter.
After a few rainchecks due to down payment issues, the little girls’ operations have pushed through. A good starting point until, yet again, another problem came up. This time is it more serious. The girl’s body was not able to keep up with the operation. She was hooked to cardiac pump and ventilators in the recovery room. The mother was summoned to the recovery room to discuss with her her daughter’s present condition. The interpreter, another Micronesian had a concern about interpreting the whole thing because he said that his understanding about medical problems is limited. The man and along with another Micronesian were discharged making it for us difficult to get an interpreter.
Knowing the need for a reliable interpreter, the insurance company has provided for us an interpreter via phone. Thing is, if there are some things that the mother is concerned about, it is hard for us to attend to it immediately.
Before the shift endorsement, the mother approached our charge nurse begging for her to purchase a call card. It was almost 7:00 pm and the concierge office is already closed. She, being admitted to the hospital, (the insurance company opted to have her admitted instead of checking her in a hotel so that it would be easier for her to come to her daughter to the recovery room), is not allowed to roam around the hospital on her own. I volunteered to buy her the card.
It is really hard to look at the face of this woman who always smiles and I do not know if she really understands how critical is the condition of her daughter. She was very thankful and even held my hand. She always waves at me whenever she passes by the stations.
Around 1:00 am right after I finished eating, she approached the stations asking me to come with her in her room. She opened the fridge and took out a bucket of chicken and some cups of rice. She handed them to me, I was refusing telling her that I have eaten already but remembering a Micronesian couple saying that it is their culture to give someone something as token of appreciation, I took them in.
Around 10:00 in the morning, the liaison officer came in with an interpreter who happens to be a doctor in Micronesia. I, together with the outgoing charge nurse, volunteered to go with them to learn about the girl’s condition first hand.
We learned from the interpreter that the mother opted to take out all the life support hooked to her daughter. But after hearing the good news from the girl’s attending physician that the girl has been taken out of the cardiac pump because her heart has started to pump on her own and that her urine output is remarkable, the mother has decided to fallow her daughter to fight for her life.
I pray that the girl will continue to take her road to recovery.

My birthday is coming and I cannot prevent it. So instead of worrying about the year that will be added to my existence in this world, I try to focus on blessings that I received in the past year. The most important of it all it being on remission for the longest. I am praying that this will last forever. I still have so much things to do and I need to be in the pink of health to carry them out.
I know it would not be too much to ask from Him.
On the other side, I would also like to receive some good coach gifts

I admitted him the other day, he’s still a bit strong and get up on his feet with littlet assistance until the last night when started to detetiorate physically and neurogolically.
A large mass was found in his brain and the doctors would like to find where it started. Tests were run and revealed that he has adrenocarcinoma in the liver and has metastasized to his brain. An adenocarcinoma is a different type of cancer, it originates from outside of the liver. Adenocarcinoma means a malignant tumor in epithelial tissue, specifically in a gland.
I don’t know if I could ever learn how to hold back my tears in times like this. I was at the bedside when the doctor broke the news to the patient and relatives. They all burst in tears and only a person with no emotion could not be affected.
Last night, he showed no signs of improvement. He is vomiting coffee ground subsstance. We call that hemoptysis. A sign that he is bleeding in the gut which is a sign that the liver is giving up. A nasogastric tube was put in place but he cannot still be fed. He’s complaining of hunger but we cannot him food or fluid by mouth as yet.
Before the midnight strikes, he was moved to medical ICU for close monitoring and we all felt that something bad is waiting to happen.
A few hours after he was moved to ICU, code blue was called there.

After the first blow to my nursing career another one comes in. I just got word from my headnurse about the medication error I have committed. I can sense her frustration in her voice and she actually voiced it out. As the tears were about to escape from my eyes, she grabbed my hand and brought me to the locker room. She asked me how I feel. I just sobbed. I feel so frustrated about myself. I am beginning to think, am I really fit for the job? What if the panel has made a mistake in choosing me over a thousand of candidates?
How am I supposed to save lives?
I feel like Kelly on Hawthorne. I lack the confidence but shall I give up? Did I buy myself one-way ticket to hell? Even if I did not, there’s no use to cry over the mistakes in the major decision that I have made about my career change. I have to move on. I promise myself that I will rise to the occasion. I will not be a failure. I owe it to myself more than anyone else. I just need some gut.
God help me.

Right after the endorsement, I did my usual morning rounds to check on and assess my patients. I was surprised to learn that one of my patients was out of bed, out of the room actually. He was at the penthouse hearing mass as he was among those who received the first communion invitations This event would not be up until lunch time so I had to take a raincheck on carrying out on my responsibilities to him.

The only drawback of my resignation from my post, if there would be any, is the insurance coverage that I have lost. I know that there is always affordable life insurance around but still, my faith is stronger than ever and I know that God would be my shield against any danger in this world. He knows that my heart beats for something else and the pulsation of this reality has been trying to escape my chest for the longest.
I have my mindset. I have my dreams. I have my desire. I had to breakaway.

My prayer has been answered. My resignation was signed by my manager before he left at around 9 p.m. last night right after the chaos in the office has been resolved.
It is my last scheduled rest day today and usually, I am up and about running errands during my off. This time was different. I stayed in bed the whole day as if there was no tomorrow. I slept like a baby.
I feel worry free about where by big decision in life would bring me. There were things that need to be considered before I tendered my resignation and it is mostly financially. But these never crossed my mind when I made my decision. I prayed and I have longed for this day to happen. For all its worth, I am really happy and I do not worry about my future because I asked God to guide me all way through it.
I thank Him for giving me the chance to breakaway.

Calamities after calamities happened in just a matter of one month. Typhoon Pepeng has left many people lifeless, homeless or displaced in the northern part of the country. The prices of agriculture supplies and crops including horse supplies have doubled up since the roads to and from the production site have been closed.
I am hoping that we manage to get over this in God’s grace.

My classmate in college has written this on a styro cup and he gave it to me during our overnight group study sessions.
Since then, I have not forgotten the phrase. I was actually inspired to watch the movie because of it.
The HR has finally approved my immediate resignation and the Program Manager has signed my resignation.
I feel so happy not just because I finally got the nerve to pull the plug but because I am now off to doing the thing that I really love fulltime…and get paid. Well, the pay is just enough to get me to the hospital everyday to have lunch money to buy me decent meal when on duty.
Sure, thinking about my health maintenance is always there, but I have two good reasons not thinking twice about my decision:

1. God is with me and He will take care of me
2. If it is really the end of the line for me, at least I will be dying with a smile on my face.

I am really excited.

Another blow has hit the nation.
Typhoon Ondoy might have left the country and although the flood has subsided, it has left indelible memory to almost all of us, a very horrific one.
Many people were displaced as 80% of Metro Manila including Marikina and Rizal was submerged in muddy water. CNN reports that more than 100, 000 are homeless and there are about 100 people died.
People are left with hope and the will to move on and start their lives anew. Many hospitals were also affected as I have seen on TV that include the UERM hospital on Aurora Blvd. and Amang Rodriguez hospital in Marikina. Much as they want to open their doors and lend assistance to those who need medical treatment, their medical equipment was also soaked in and damaged by muddy water.
Everyone in the metro and nearby areas are looking forward to faster recovery through immediate relief and rescue operations.