This letter was inspired by this image in the following news article:
1-2-3-Pump. 1-2-3-Pump. 1…2…3…Pump…1…..2……..3…….Puuuuump. 1………..2……..
WAIT. NO, DON’T FALL ASLEEP. MRS. X, NO, YOU MUST KEEP PUMPING. I KNOW YOU’RE TIRED AND YOU JUST WANT TO PUT THE MANUAL RESUSCITATOR DOWN FOR JUST A SECOND – EVEN JUST A FRACTION OF IT – BUT NO, I’M SORRY, YOU ABSOLUTELY CANNOT DO IT.
Mrs. X, you must keep pumping – OR ELSE YOUR HUSBAND IS GOING TO DIE. Don’t you see, your tired, numb arms are doing the job that his now-surrendering lungs cannot do. You are HIS ONLY WAY OF SURVIVING NOW. Every pump you make ensures a gush of oxygen still goes into his body. Every pump – now such a huge effort because you have been doing this for 3 straight days now and you have not had any bathroom breaks or food or liquid intake at all – decides if he will make it for the next few minutes or not.
I know, Mrs. X, you just want to cry in anguish and drop the damned bag-valve mask and quit pumping because 3 days is simply too long to be a human respirator. You are not in your right state of mind because you are also dizzy from lack of sleep and nauseous from the decaying smell of his infected limb, now dead after days of being crushed under the falling trunk of a coconut tree. It breaks your heart, knowing this limb will be amputated today, as soon as the medical and surgical supplies arrive.
You are also anxious, thinking of how your children are faring at the evacuation center, your mother’s instinct itching to go them at this time they need you the most, but you cannot leave your husband. At this moment, accept that you are a part of his body, you are his most vital organ now, bringing much-needed ATP to his brain, his heart, and his kidneys. For the time being, those are what we will prioritize. He is already in sepsis, and we must fight to keep him from shock.
We are already out of IV fluids, so God forbid, if he reaches a state of shock. Not to scare you, Mrs. X, but as one of the last few medical interns on duty at this hospital, it is my job to keep you awake and to motivate you to keep on being a human respirator.
I know, I know, you just wish for someone to replace you and relieve you, even for only a few precious minutes. But I’m also running around the hospital, that screaming teenager over there is about to give birth any minute now, her contractions are already getting stronger. I can only hope that her pre-term baby will make it, even if our incubators are all destroyed.
There is no one else to cover this whole ward here and I only have this few minutes to tell you to hold on.
I want you to know your pumping IS THE ONLY THING THAT MATTERS RIGHT NOW. Not what would happen after you get out of this hospital. Not the unrecognizeable rubble that had once been your home, not the loss of your farm and your life’s savings (which would have been sufficient to send your eldest to college in Manila), not the looting and raping going around the city now, what with people fighting tooth-and-nail to get scraps and morsels just to quiet their raging stomachs and delirious minds. All of these things, no matter how devastating, should be irrelevant for now.
Because when you have to survive, you have to harden your heart for a while and focus on one thing only: 1-2-3-pump.
Yes, this might seem callous, insensitive even. But Mrs. X, this is what I have to do every second. I cannot function as a doctor here if I didn’t do that. I have to make sure all of the patients here – the fortunate and blessed enough to even make it to this hospital without dying on the way – are given the care they need, even if all hell has broken loose.
I have to squelch my urge to cry because I have to learn to function, despite the burning pain in my heart. That is the first step to resilience.
You, as one of the last living members of your family, need to be strong now. Your husband’s life is in your hands.
– Dr. Z, fictional Medical Intern, Divine Word Hospital