At A Price

I have to admit, I wasn't too excited about having a Toyota Altis instead of another Honda Civic to replace the car that I wrecked a few months ago. At first glance, it's not as eye catching as the Civic. The Civic screams innovation and youth, while the Altis--- because of the very few changes made through the years, it looks a bit dated...truth be told, it looks like a family car, a car your dad would drive. The fact that Orlando Bloom is endorsing it--- the epitome of uncool and everything BLAH these days, definitely isn't helping (what the hell was Toyota thinking, getting him as an endorser?!). But when the car was delivered two days ago... WHOA. It didn't look too bad at all. It looked great actually. I just had to bring it out for a test drive ASAP. LOL. Although I miss the futuristic design of the Civic, with its digital odometer and all, the Altis actually packs a lot more features underneath its conservative design.

Yesterday, my grandmother said that we should bring the car to church and ask the parish priest to have it blessed... to make the car "accident proof". O---kay... as if dousing the car with holy water can make it accident proof. So we brought the car to church, because saying NO would only lead to a string of never ending arguments. As expected, we had to pay a HEFTY sum first, before the priest would bless the car... because nothing is FREE these days, not even religious services. So much for the virtue of charity. I managed to keep a straight face as various religious quotes were spoken, even as the priest turned to me and included me in his prayer and blessing... but my eyes nearly popped when even the interiors were doused with holy water. Never mind if the water was probably unclean and it would most probably stain the seat covers... apparently holy water couldn't damage the electronic components in the dashboard simply because it was miraculous and therefore defied the laws of matter.

Contrasting religious beliefs aside (or lack thereof), at least I have a new car. I can pretend to be a devout catholic for a new car. No big deal. Going to work wouldn't be such a chore again. Say goodbye to the hassles of public transport--- Overcrowded buses and trains, taxi drivers who refuse to take you to your desired destination because it's out of their way. Every good thing has several strings attached, we just have to determine whether or not the benefits outweigh all the undesirable things that come with it.Having a car of my own is great... but at what price? The very moment my dad gave me the car keys, he reminded me that application for residency WHERE I USED TO WORK starts in July. I was a fool to believe that the issue has been settled. My new car wasn't just a gift. It was a BRIBE.

Looking back at my entries this time last year, I begin to wonder... Am I ready to go through all that all over again? Do I even want to? Is having a new car worth giving up the contentment and relative happiness that I seem to have now?

Neutered

Where i used to work, I used to complain that there was a severe lack of essential supplies. We ran out of essential drugs. We ran out of intravenous fluids. Reagents for several essential laboratory exams are sporadic. The list goes on and on. And I always complained how the whole system sucks, how the whole system was so rotten.

I never thought that I had it so much better back then.

Frustration. I want to be able to do something... I want to help... but I just can't--- because certain circumstances wouldn't allow.

I've been working simultaneously in a private hospital and a public hospital for a few months now. I don't know which is more frustrating--- Not being able to treat patients because they couldn't afford the high fees that they have to cough up up front before they could be treated, or not being able to treat patients because you don't have the needs to properly attend to them.

The essential stuff are rarely available. We rarely have sterile gauzes available. We don't even have unsterile ones. Can you imagine the scenario when trauma patients come in profusely bleeding, and we have no gauze to apply on the wounds for immediate hemostasis? We have to ask their companions to buy supplies at the nearest drug store! The intravenous fluid of choice for trauma patients is also not available. And speaking of laboratory exams, one night there was none available. X-rays? Many times we couldn't even x-ray our patients because they ran out of films. Empirical treatment becomes the rule, we treat our patients even when we do not know what their ailments are exactly. The hospital where I used to work had a budget provided by the national government, hence they had more funds for supplies. Now I work for a hospital with funds provided by the local municipality only, hence the bare bones supplies--- and the word BARE is an understatement. I often wonder why they don't just close down the whole damn place if they couldn't provide adequate health care.

And speaking of rotten systems? Apparently I was wrong for thinking the the system in the place where I used to work was the most inefficient. I was wrong. Sure there's the whole bureaucracy, red tape, and occupational blackmail and threats rampant in any government institution... but everything is magnified in an institution with a lesser budget. I don't know how having lesser funds can lead to an increase in inefficiency when creating a system only entails effective communication between human beings. And it's not like those employees have a right to complain about their salaries, making their wages as excuses to slack off--- their salaries are actually at par with employees at other hospitals, even private ones. I could go on and on about how everything is inefficient, but what really pisses me of is the way the hospital handles OBgyne patients.

It is the only hospital that I know where Obgyne patients do not head straight to the Obgyne department for examination. They head straight to the emergency room together with medical, surgical, and pediatric patients. Patients with gynecological complaints are tolerable... but obstetric patients do not have a place in the emergency room! Why is that, you ask? It's fine when we only have to do initial examinations... but obstetric patients need continuous monitoring, something that we could not afford to do in the emergency room! For crying out loud, that's what labor rooms are for! Last week there was an incident when one obstetric patient had to wait at the emergency room for 2 whole hours while her husband was completing the needs for operation, because they have this STUPID policy that patients cannot be brought up to the labor room until they've bought all the needed supplies. That means that if the patient's cervix suddenly becomes fully dilated, she has to give birth at the ER. How stupid is that?! The emergency room also has no supplies available, wouldn't it be better if the patient gives birth in the operating room where the environment is sterile rather than giving birth at the ER since we have no supplies also?!

The end result, the baby was dead upon delivery. And the pediatric resident upstairs called us, saying that we were also partly to blame because we didn't monitor the fetal heart rate regularly. I was trying very hard to keep myself from shouting at her. We had so many patients that time, no one had the time to check on their patients regularly! Even the nurses had their hands full! That's why OB patients should be brought straight to the Labor room since there are people there who could check on them regularly! Let those patients wait for the required supplies there!

What takes the cake is how most of the Ob residents talk to ER residents as if they're already consultants. Granted, some are already finished with residency training, but at that hospital, they are still employed as residents making us equals. They have no right to act so superior and treat us like losers. They're already finished with residency yet they have to take jobs as residents because they have no patients in their private practice? They are the losers, not us! Some even call us, in the midst of the melee in the ER, scolding us about certain erroneous orders we've made. If they have a problem with the orders, they should just correct them themselves! The patients are already upstairs, they should be the ones to call the attending physicians! And don't they dare complain about their work load. We know how much work they are doing and we know they are just sleeping upstairs during the wee hours of the morning because all their patients have to go through us! We are lucky to get two hours of sleep because patients continuously arrive in the emergency room, even for the most stupid and unnecessary reasons! Sometimes I feel the urge to define the word EMERGENCY to each of these patients!

The whole system is typical for every public hospital, and the lack of supplies can make everyone conclude that it is a public hospital--- but that hospital seems to be more of a private hospital in the guise of public hospital. In truth, it is a death trap. Sure, there's a huge discount for the residents of the municipality, but that doesn't include ER consults. They even charge a huge amount for professional fees, even if we barely do anything. Drugs are even cheaper outside. The tetanus vaccine alone costs more than three times the amount sold in drug stores! That's highway robbery! What makes it worse is the fact that most of the patients seeking consult don't have much money to begin with, that's why they seek consult at a "public" hospital. It's like robbing from the poor, taking away what little they have left. And they are "imprisoned" in the waiting area until they could settle their bills, a practice that I thought was already illegal these days.

Many times I'm tempted to just pay for their needs, pay for a portion of their bills, give a little cash so I could help... but I've learned that such a practice opens up a can of worms. Once I start giving money to one patient, I have to give money to all the other patients because word gets around--- fast. Besides, I've been doing that practice for most of the past year, at times because I was forced and required to, but many times because i wanted to. It's about time I spend some of the money I earn for myself. Even if I wanted to help, the bills that they accumulate seem pretty high even for me. Gone are the days when I could spend half of my salary on one patient alone and not care at all afterwards. Before, my parents still gave me an allowance, this year I'm on my own. I couldn't afford to be as helpful and giving as I was back then.

After each tour of duty, I have time to reflect during the long ride home. You really do see how fucked up this country is just by looking at the health care system. In this country, health care is a privilege, not a right. The poor have no right to get sick, because when they do they have very little to turn to. When they get sick or when they have an accident, it's as if they're already counting the hours until their death. It's as if they already died. The government labels trivial matters as their priority. They are blind to the necessities. I can only imagine how detached they are, how insensitive they are to the needs of the very people that they are supposed to be serving.