It was our last day in Medical ICU (MICU) and in our shift, we were only 2 trainees. I was assigned to manage two patients — both were suspected to have PTB but the other one has episodes of hemoptysis (coughing out of blood).
He was actually extubated or the endotracheal tube that assisted him to breathe has been removed. He was being prepared to be transferred to the ward because he can already breathe on his own. He though has nasogastric tubing or NGT for feeding.
I started monitoring the patient hourly until 7:00 p.m. I fed him and gave him his antihemorrhagic drug via NGT with strict aspiration precaution. I was asked to have my dinner since he was stable. The patient was talking with his wife when I left. I was starting to eat my dinner when my groupmate came to the pantry and told me to rush to my patient’s room as he was having another bout of hemoptysis. I ran to his room and the resident was already trying to intubate him. The patient continuously coughs out enormous amount of blood with fragments. The attendings have been paged. Emergency drugs have been pushed — Atropine, Epinephrine, fast drip IV fluids but the patient coded. His vitals deteriorated despite efforts to revive him. The attending and the nurses took turns giving cardiac massage but the patient remained on flat line.
I wanted to tell the code team to try reviving the patient.
Time of death was called.
We have given him post mortem care in order for his relatives to see him in resting state.
It was a sad night. The patient was okay when I left. His wife was joyful talking to him. The joy was replaced with moans and outburst of emotions as she was allowed to see him.
I tried to hold back my tears and went out of the room.

It’s 12:00 am. I am here in the office fulfilling the last graveyard duty for the week’s schedule. I will be out at 6:00 a.m., Monday. It’s marked as my rest day and soon Tuesday I am scheduled to report for work at 1:00 p.m.

I don’t want to complaint about the sked. In fact, I should be thankful to have a decent job amidst the global recession.

I don’t want to but my body is manifesting rebellion. It blows the whistle for me to stop.

I feel a bit fussy. I want to take a nap, but I cannot go to the decompression room to lie down. I am scared. Seriously, 12:00 midnight is the scariest time of the day for me. I am trying to snatch a nap here in my post but I feel uncomfortable.

I do not know who to blame for catching an autoimmune disease like this.

When medicine cannot seem to explain the cause of a disease, which they call idiopathic, they blame it on stress.

I think I am to blame primarily if this is stress related. I have decided to live a stressful life sticking it out here in call center for the past 9 years. I was not contented with the stress that the schedule and type of work bring I decided to take up nursing full time for three years.

If the illness is not stress related, maybe it is a punishment from God for being a disrespectful daughter.

All my life I have been blaming my father (in my mind) for not having an ideal family or a life that is generally well off.

My training at LCP will start on June 15 and I cannot quit my job as yet, as much as I want to. I need my job to pay for the house mortgage.

I feel awful.