Doctor Series 1: Soren Tiu

Chapter 6

"We'll start by closing the hole between the left and right ventricles. If the mitral regurgitation persists after the VSD is blocked, we'll fix it as well." sabi ko sa mga magulang ng pasyenteng o-operahan ko ngayon.

"We expect that it'll take about five hours. Don't worry too much." patuloy ko.

"Okay, thank you for everything in advance, Dr. Tiu." sabi ng ina.

"Thank you, Doctor." sabi naman ng ama.

Tumango ako sakanilang dalawa, "No problem, I'll see you later." sabi ko at tuluyan ng pumasok sa OR.

"I cut through it again." sabi ko at bumuntong hininga.

"How many times have I done this already?" tanong ko saaking sarili at napa-pikit.

"The valve is so delicate, prof." sabi ni Daryl na siyang assistant surgeon.

"Get me a smaller nylon." sabi ko sa nurse at binigay sakanya ang hawak kong needle holder.

Ascending aortic and bicaval cannulation was used in the operations. Intermittent aortic cross-clamping was used. Induction of cardiac arrest with crystalloid cardioplegia was used for myocardial protection. Mitral valve repair was performed directly through the left and right ventricles. I followed the criteria of Rowlatt and associates in the reduction of the annular dilatation. The VSD was located at the perimembranous region. The operative techniques used to repair MR are unilateral annuloplasty and unilateral suture of commissure. Asymmetric annuloplasty was also performed. The cleft was initially sutured using 5–0 nylon, but because to its fragility, I switched to 0–3 nylon and the advancement of the posterior mitral leaflet with autologous pericardium was done. To increase the mobility of the mitral leaflet, I incised the papillary muscle and removed adhesive chordae and detached adhesive chordae from a leaflet in another. When the coaptation of the mitral leaflet after asymmetric annuloplasty on one side did not improve, additional annuloplasty was performed on the other side.

Paglabas ko sa OR ay agad bumungad saakin ang mga magulang ng aking pasyente. Agad kong nasulyapan si Syrhane dahil lumingon ito paglabas ko. Naka-abang sila ng kanyang pamilya dahil ngayon ang operation ng kanyang kapatid kung saan si Siobhan ang head surgeon.

"It took longer than we had expected." panimula ko.

"I even wanted to cut my hand off." sabi ko at bumuntong hininga kaya siniko ako ni Daryl na nasa aking gilid.

"Pardon?" tanong ng ina.

"After repairing the ventricular septal defect, the mitral regurgitation was quite severe, so I tried to fix it. But the regurtation continued to worsen because the tissues kept ripping." sabi ko.

"Right. But in conclusion, everything went well." singit ni Daryl kaya napalingon ako sakanya.

"I see, thank you Dr. Tiu and Dr. Ocampo." sabi nilang dalawa.

"My son is okay, right?" pahabol na tanong ng ina.

"He bled quite a bit halfway though, so we struggled a little but the surgery went well." tinignan ko si Daryl habang siya ang nag-papaliwanang.

"We managed to minimize the regurgitation, so your son is stable now. And as I explained before, we'll put your son to sleep for the next three days." sabi ko.

"You'll be able to see your son shortly in the PICU, so don't worry." singit ulit ni Daryl kaya nilingon ko siya at tinaasan ng kilay.

Dumiretso ako sa changing room upang mag-bihis dahil naisipan kong umuwi muna saaking condo.

"Professor, you need to state the conclusion first." pangaral sakin ni Daryl habang hinuhubad ko ang aking suot na scrubs.

"Start with the conclusion, whether it went well or not." patuloy nito.

"Doctors must inform the guardian about everything that happens in the OR, from the end to beginning in a calm manner." sabi ko sakanya habang sinusuot ang aking slacks.

"You're so insensitive sometimes, professor. If you keep doing that, every guardian will get a heart attack. I'm not telling you to sugarcoat. State the facts. But first, you need to ease their minds." patuloy nito.

"Hey, my mom never scolded me like that even when I was a five." singit ni Pantaleon na kakalabas lang sa banyo at pinupunasan ang buhok.

"He's right, can you be more considerate when you talk?" tinapunan ko lang siya ng tingin at nagpatuloy sa pag bubutones ng aking long-sleeves.

"Dr. Ocampo, well done." sabi ni Pantaleon kay Daryl kaya napa-iling nalang ako.

"Don't you have to go home? You took a shower, so go home already!" sigaw ko kay Pantaleon.

"A baby got a surgery for enteroclysis earlier, but there was some bleeding so I want to monitor the baby's vitals tonight." sabi nito kaya pinuri siya ni Daryl dahil sakanyang kabaitan.

Tinignan ko ang aking sarili sa salamin at inayos ang buhok, sinuot ko ang aking salamin pagkatapos saka nilagay saaking bulsa ang aking cellphone.

"Mauna na ako." sabi ko sa dalawa saka nag-tungo sa opisina para kunin ang aking mga gamit.

"Oh? Uuwi ka?" napa-lingon ako.

Tumango ako kay Siobhan, "Oo, kamusta ang operation?" tanong ko.

Tumango siya, "Oo, walang naging problema kaya marami pa akong ma-ooperahan na pasyente." sabi nito at tumawa.

"Mauna na ako, may hindi pa ako nahuhugasang pinggan." sabi ko.

"Since last week ulit?" tanong nito kaya tumango ako at tumawa.

"Sana hindi pa yon inu-uod!" sigaw ni Siobhan nang naglakad na ako palayo kaya nilingon ko siya at tumawa.

Pagdating ko sa parking lot ng hospital ay agad akong nag-tungo kaliwang bahagi kung nasaan ang aking sasakyan.

"Ako na nga dito, Ellie said you have a photoshoot today, sige na!"

"Pwede namang i-cancel."

"Pansin ko lang ha, bakit parang gustong-gusto mong dumito sa hospital?" rinig kong pag-uusap ng dalawang babae.

Pinatunog ko ang aking sasakyan, "Excuse me." sabi ko sa dalawang babae na nakatalikod at nakaharap sa pintuan ng van.

"Dr. Tiu!" napalingon ako sa nagsalita at nakita kong si Syrhane ito.

"Uuwi ka?" tanong nito.

Tumango ako, "Oo, bakit?" tanong ko pabalik.

"Wala lang naman." sagot nito malapad na ngumiti.

"Siya yon?" rinig kong tanong ng kanyang kasama.

Binuksan ko ang driver's seat ng aking sasakyan at nilagay sa katabing upuan ang aking bag.

Habang naka-hawak sa pintuan ay lumingon ako sakanilang dalawa na nasa aking likuran.

"Mauna na ako." sabi ko habang naka-tingin kay Syrhane.

"Ingat ka." sabi nito kaya tumango ako at tuluyan ng pumasok sa loob.