Kaleidoscope World (ctan's random musings)

[Lakandula]

^^ you think so? what's your impression Lakandula?

adolescence period

[maykel]

OF WALKING AND FRIENDSHIP
by ctan (063007)

Walking has always been my haven each time I am emotionally urged to think over things that happen in my life, a.k.a. the hustles and bustles of life. When I walk, I get to see little things... things that might be trivial to some people yet for me have proven to be profound in some ways. From these detailed observations of my surroundings, I gain insights about myself, about people around me, about my life experiences, and about life in general.

One theme that came up during my latest "walking session" was about friendship. I realized that it is true that friendship is universal. Many of us have known or experienced the satisfaction, security and benefits of good friendships. Many of us have also known people who we thought were friends, only to have them betray us, hurt us, or disappoint us. And if we were brutally honest with ourselves, most of us would have to admit that at sometime in our lives, we too have betrayed, hurt or disappointed our friends.

One very interesting aspect about friendship that I've thought about concerns with two words: having and being... that is, having a friend and being a friend. The difference in perspective is paramount. When I'm concerned with having friends, my focus is on myself and my own needs. But when my desire is to be a friend, I'm thinking about other people -- I'm thinking about how I could be caring and how I could love them more than myself.

I remember a passage in the Bible in Proverbs 17:17. It says, "A friend loves at all times, and a brother is born for adversity." This verse gave me three realizations. First, a friend is someone who continues to love, and to show that love, whatever the circumstances. Second, a friend is born for adversity... not his or her adversity, but mine. In other words, a test of a friend is whether or not he or she is there for you in the bad times, the tough times. Third, a friend is like a brother... parang death, you can never get rid of him. Sometimes it's tough to be a friend. But a real friend does not shy away from the abrasiveness that comes from rubbing iron against iron, as Proverbs 27:17 describes it. Though it may grate on our nerves, we have to take a risk and hope that our friend of today will still be our friend tomorrow.

I so admire David and Jonathan's friendship as recorded in the Bible. Jonathan loved David as himself. He risked his very life to be David's friend. We read: "Jonathan got up from the table in fierce anger; that second day of the month he did not eat, because he was grieved at his father's shameful treatment of David. In the morning Jonathan went out to the field for his meeting with David. . . . Then they kissed each other and wept together—but David wept the most. Jonathan said to David, "Go in peace, for we have sworn friendship with each other in the name of the Lord, saying, 'The Lord is witness between you and me, and between your descendants and my descendants forever'" (1 Samuel 20:34-35, 41-42). Later, when Jonathan was killed in battle with the Philistines, David lamented his passing: "I grieve for you, Jonathan my brother; you were very dear to me. Your love for me was wonderful, more wonderful than that of women" (2 Samuel 1:26).

Few are people blessed with such committed friendship. And that's what I wish for in every friendship I am involved with... Friendship is not a flippant relationship. It is consistent and unfailing love. Walang iwanan!

Wow.. this is nice. this makes me think what kind of friend I have and what am I to my friend. Hope that you will post more of your articles.

And also hoping that you are in good condition and everything is fine.

[joshgroban]

naisip kita dito bilang isang doctor din ....hehe



        45 Seconds: Memoirs of an ER Doctor from May 22, 2011

3 45 Seconds: Memoirs of an ER Doctor from May 22, 2011
by Kevin J. Kikta, DO on Jun 01, 2011 in Featured, Those in Need
       

My name is Dr. Kevin Kikta, and I was one of two emergency room doctors who were on duty at St. John's Regional Medical Center in Joplin, MO on Sunday, May 22, 2011.

You never know that it will be the most important day of your life until the day is over.  The day started like any other day for me: waking up, eating, going to the gym, showering, and going to my 4:00 pm ER shift. As I drove to the hospital I mentally prepared for my shift as I always do, but nothing could ever have prepared me for what was going to happen on this shift.  Things were normal for the first hour and half.   At approximately 5:30 pm we received a warning that a tornado had been spotted. Although I work in Joplin and went to medical school in Oklahoma, I live in New Jersey, and I have never seen or been in a tornado.  I learned that a  "code gray" was being called.  We were to start bringing patients to safer spots within the ED and hospital.

At 5:42 pm a security guard yelled to everyone, "Take cover! We are about to get hit by a tornado!"  I ran with a pregnant RN, Shilo Cook, while others scattered to various places, to the only place that I was familiar with in the hospital without windows, a small doctor's office in the ED. Together, Shilo and I tremored and huddled under a desk.  We heard a loud horrifying sound like a large locomotive ripping through the hospital.  The whole hospital shook and vibrated as we heard glass shattering, light bulbs popping, walls collapsing, people screaming,  the ceiling caving in above us, and water pipes breaking, showering water down on everything.  We suffered this in complete darkness, unaware of anyone else's status, worried, scared. We could feel a tight pressure in our heads as the tornado annihilated the hospital and the surrounding area.  The whole process took about 45 seconds, but seemed like eternity. The hospital had just taken a direct hit from a category EF5 tornado.

Then it was over.  Just 45 seconds.  45 long seconds.  We looked at each other, terrified, and thanked God that we were alive.  We didn't know, but hoped that it was safe enough to go back out to the ED, find the rest of the staff and patients, and assess our losses.

"Like a bomb went off. "  That's the only way that I can describe what we saw next.  Patients were coming into the ED in droves.  It was absolute, utter chaos.  They were limping, bleeding, crying, terrified, with debris and glass sticking out of them, just thankful to be alive.  The floor was covered with about 3 inches of water, there was no power, not even backup generators, rendering it completely dark and eerie in the ED.  The frightening aroma of methane gas leaking from the broken gas lines permeated the air; we knew, but did not dare mention aloud, what that meant.  I redoubled my pace.

We had to use flashlights to direct ourselves to the crying and wounded.  Where did all the flashlights come from?  I'll never know, but immediately, and thankfully, my years of training in emergency procedures kicked in.  There was no power, but our mental generators were up and running, and on high test adrenaline.  We had no cell phone service in the first hour, so we were not even able to call for help and backup in the ED.

I remember a patient in his early 20's gasping for breath, telling me that he was going to die.  After a quick exam, I removed the large shard of glass from his back, made the clinical diagnosis of a pneumothorax (collapsed lung) and gathered supplies from wherever I could locate them to insert a thoracostomy tube in him.  He was a trooper; I'll never forget his courage.  He allowed me to do this without any local anesthetic since none could be found. With his life threatening injuries I knew he was running out of time, and it had to be done.  Quickly.  Imagine my relief when I heard a big rush of air, and breath sounds again; fortunately, I was able to get him transported out. I immediately moved on to the next patient, an asthmatic in status asthmaticus.  We didn't even have the option of trying a nebulizer treatment or steroids, but I was able to get him intubated using a flashlight that I held in my mouth.  A small child of approximately 3-4 years of age was crying; he had a large avulsion of skin to his neck and spine.  The gaping wound revealed his cervical spine and upper thoracic spine bones.  I could actually count his vertebrae with my fingers.  This was a child, his whole life ahead of him, suffering life threatening wounds in front of me, his eyes pleading me to help him..  We could not find any pediatric C collars in the darkness, and water from the shattered main pipes was once again showering down upon all of us. Fortunately, we were able to get him immobilized with towels, and start an IV with fluids and pain meds before shipping him out.  We felt paralyzed and helpless ourselves.   I didn't even know a lot of the RN's I was working with.  They were from departments scattered all over the hospital. It didn't matter.  We worked as a team, determined to save lives.  There were no specialists available — my orthopedist was trapped in the OR.  We were it, and we knew we had to get patients out of the hospital as quickly as possible.  As we were shuffling them out, the fire department showed up and helped us to evacuate.  Together we worked furiously, motivated by the knowledge and fear that the methane leaks to cause the hospital could blow up at any minute.

Things were no better outside of the ED. I saw a man crushed under a large SUV, still alive, begging for help; another one was dead, impaled by a street sign through his chest.   Wounded people were walking, staggering, all over, dazed and shocked.   All around us was chaos, reminding me of scenes in a war movie, or newsreels from bombings in Bagdad.  Except this was right in front of me and it had happened in just 45 seconds.  My own car was blown away.  Gone. Seemingly evaporated.  We searched within a half mile radius later that night, but never found the car, only the littered, crumpled remains of former cars.  And a John Deere tractor that had blown in from miles away.

Tragedy has a way of revealing human goodness.  As I worked, surrounded by devastation and suffering, I realized I was not alone.  The people of the community of Joplin were absolutely incredible.  Within minutes of the horrific event, local residents showed up in pickups and sport utility vehicles, all offering to help transport the wounded to other facilities, including Freeman, the trauma center literally across the street.  Ironically, it had sustained only minimal damage and was functioning (although I'm sure overwhelmed).  I carried on, grateful for the help of the community.   

Within hours I estimated that over 100 EMS units showed up from various towns, counties and  four different states. Considering the circumstances, their response time was miraculous.  Roads were blocked with downed utility lines, smashed up cars in piles, and they still made it through.

We continued to carry patients out of the hospital on anything that we could find: sheets, stretchers, broken doors, mattresses, wheelchairs—anything that could be used as a transport mechanism.

As I finished up what I could do at St John's, I walked with two RN's, Shilo Cook and Julie Vandorn, to a makeshift MASH center that was being set up miles away at Memorial Hall.  We walked where flourishing neighborhoods once stood, astonished to see only the disastrous remains of flattened homes, body parts, and dead people everywhere.  I saw a small dog just wimpering in circles over his master who was dead, unaware that his master would not ever play with him again.  At one point we tended to a young woman who just stood crying over her dead mother who was crushed by her own home.  The young woman covered her mother up with a blanket and then asked all of us,  "What should I do?"  We had no answer for her, but silence and tears.

By this time news crews and photographers were starting to swarm around, and we were able to get a ride to Memorial Hall from another RN.  The chaos was slightly more controlled at Memorial Hall.  I was relieved to see many of my colleagues, doctors from every specialty, helping out.  It was amazing to be able to see life again.  It was also amazing to see how fast workers mobilized to set up this MASH unit under the circumstances. Supplies, food, drink, generators, exam tables, all were there—except pharmaceutical pain meds. I sutured multiple lacerations, and splinted many fractures, including some open with bone exposed, and then intubated another patient with severe COPD, slightly better controlled conditions this time, but still less than optimal.

But we really needed pain meds.  I managed to go back to the St John's with another physician, pharmacist, and a sheriff's officer. Luckily, security let us in to a highly guarded pharmacy to bring back a garbage bucket sized supply of pain meds.

At about midnight I walked around the parking lot of St. John's with local law enforcement officers looking for anyone who might be alive or trapped in crushed cars.  They spray-painted "X"s on the fortunate vehicles that had been searched without finding anyone inside. The unfortunate vehicles wore "X's" and sprayed-on numerals, indicating the  number of dead inside,  crushed in their cars, cars  which now resembled flattened  recycled aluminum cans the tornado had crumpled  in her iron hands, an EF5 tornado, one of the worst in history, whipping through this quiet town with demonic strength.  I continued back to Memorial hall into the early morning hours until my ER colleagues told me it was time for me to go home.  I was completely exhausted.  I had seen enough of my first tornado.

How can one describe these indescribable scenes of destruction?  The next day I saw news coverage of this horrible, deadly tornado.  It was excellent coverage, and Mike Bettes from the Weather Channel did a great job, but there is nothing that pictures and video can depict compared to seeing it in person. That video will play forever in my mind.

I would like to express my sincerest gratitude to everyone involved in helping during this nightmarish disaster.  My fellow doctors, RN's, techs, and all of the staff from St. John's.  I have worked at St John's for approximately 2 years, and I have always been proud to say that I was a physician at St John's in Joplin, MO.  The smart, selfless and immediate response of the professionals and the community during this catastrophe proves to me that St John's and the surrounding community are special.  I am beyond proud.

To the members of this community, the health care workers from states away, and especially Freeman Medical Center, I commend everyone on unselfishly coming together and giving 110% the way that you all did, even in your own time of need. St John's Regional Medical Center is gone, but her spirit and goodness lives on in each of you.

EMS, you should be proud of yourselves.  You were all excellent, and did a great job despite incredible difficulties and against all odds

For all of the injured who I treated, although I do not remember your names (nor would I expect you to remember mine) I will never forget your faces.  I'm glad that I was able to make a difference and help in the best way that I knew how, and hopefully give some of you a chance at rebuilding your lives again.  For those whom I was not able to get to or treat, I apologize whole heartedly.

Last, but not least, thank you, and God bless you, Mercy/St John's for providing incredible care in good times and even more so, in times of the unthinkable, and for all the training that enabled us to be a team and treat the people and save lives.

[judE_Law]

doc, kulit mo kagabi ah!

[MaRfZ]

Hi kuya Caloy!
Kumusta?

Gustong gusto ko yun sinulat mo about walking and friendship.. ang ganda!

[ctan]

^^ you think so? what's your impression Lakandula?

adolescence period

he's passed that stage.

[ctan]

@jm and paul
matagal ko na isinulat yan, noong 2007 pa. friendship crisis din. hahaha. :-)



@jong
hahaha! natatawa lang talaga ako sa mga jokes. pinost ko pa a FB kasi sobrang benta sa akin. hahaha!




@monch
grabe yung article. thanks for sharing!!!

[maykel]

kuya caloy....
wala lang. hehe.. kamusta na?

[ram013]

hey....daan lng

[darkstar13]

good morning cee. few days to go. focus!

[marvinofthefaintsmile]

yey, akalain mong nagpass aq sa stage n un! haha!

hmm, cancel ang idea to meet some pro and get some psychotic pills.. I think manage myself muna.. tsak yoko gumastos. hehehe..

[ctan]

Hi guys! To all who prayed for my lola, thank you so much. She died yesterday. May our families be comforted in this time of grief.

[MaRfZ]

Kuya caloy.. 
condolence po.. 

[niceako]

My deepest condolonces for you, ctan.
Try to be strong for your folks there.

[eLgimiker0]

condolence doc.

You lola is already with Him na din. wag na ganong malungkot.