Clerk's Notes 5: Wrath of the Vaginas

       Just came from my first duty in VKMC, a government-owned tertiary-level hospital near where I live. For the record, VKMC is a fake name that I'm using for confidentiality purposes (I just googled it; there is no such thing as a VKMC in the Philippines [at least as far as the first page of the search results shows]).

        Anyway. We'll be rotating in VKMC for three weeks under Obstetrics-Gynecology, a particularly special rotation known for making interns out of clerks. The hospital is notorious for being a "baby factory," where hordes of pregnant women come to expel tiny humans out of their bodies. With two or three mothers sharing a single bed, you're watching over at least 30 patients at any given time, but this number differs depending on who you ask. Some will say they've done 100 patients at once. Some 200. Some 15 (which is pretty believable given the Pseudomonas outbreak in the hospital some months ago that resulted in some wards being closed).

       Managing the crazy workload is only half the battle. The other half is internal. The OB rotation in VKMC is a test of willpower and strength. You're basically expected to work around the clock for 24 hours. You don't sleep. You don't eat (well, a 10-minute biscuit break is acceptable). You don't rest. Aside from the hundreds of patients you need to attend to, or the tired residents who just want to go home, you need to deal with the human being inside of you that just wants to quit.

      Or so they say.

       My first post was in the Labor Room (LR) and the Delivery Room (DR). If you're a clerk there, your job is to do basically everything except for the actual delivery of the baby. You do the basic clerky things like blood extractions, line insertions, urine collection, vital signs monitoring, and boring paperwork. And you also do housekeepy things like changing the patients' sheets and taking out their bedpans. Sound simple enough, ish. But it really isn't.

       Here's a quick run through of what happened yesterday, in bullet-sized pieces for faster reading (and because I'm too lazy to write paragraphs):

• When I got there, I received the shock of a lifetime. 30 moms, giving birth at the same time.

• All are naked, with their legs spread, so that when you walk into the room you see 30 vajayjays staring unabashedly at you in laborious glory. 

• Because there aren't enough beds and not enough space, two moms have to squeeze into one bed. They're both sweaty. They both in labor. They both need to pee or poop or something in between. 

• Sometimes one of them does pee, and the pee just seeps into the sheets beneath where the other mom is lying. It admixes with all other previous fluids on the sheet- blood, amniotic fluid, unidentifiable discharge, possibly feces - to create a twisted, smelly cocktail of human suffering.

• The moms are told to push, or ire. VKMC moms are rarely quiet when they do this; with the pushing comes grunting, moaning, screaming, or crying. When the moms do this at the same time, the LR sounds like a slaughterhouse (and with all the blood-soaked sheets, it could very well resemble one too). 

• Moms aren't seen as human beings anymore; they're really all vaginas serving as baby tunnels. I say this because it's normal in VKMC culture to shame mommies for their behavior, even though the way they're behaving is entirely normal. For example, yesterday when a mom was screaming from the pain of her contractions, a doctor told her, "Ano ba mommy bakit ang ingay ingay mo ha? Papalabasin kita nang ganiyan kung di ka tumigil sige ka." 

• The doctors are tired and overworked, so of course they won't have the patience to go "Mommy, pwede paki-hinaan ang boses kapag umiire?" I'm absolutely not blaming the doctors here; the system is just set up so that efficiency takes priority over patient care.

     So yeah... That was my morning basically. This next part is some "thinking out loud" stuff that I'm writing for myself, and you might not want to stick around to read it and that's okay. 

• At around 3 am this morning, I fell asleep for around 15 minutes while at a patient's bedside. I woke up to the sound of the patient's husband calling my name. She had finished her norepinephrine drip, he said. It was due for a refill.
• Through the fog in my brain I felt a sharp pang of self-hatred. How could I have let myself go to sleep, and why wasn't I mindful enough to watch the drip in the first place? How could I be so lazy, so stupid? I'm the worst. 
• Then a flash of clarity: Wait. How can I call myself lazy if I'd been awake for 21 hours, working around the clock?
• Then, some nuanced humility: No, I wasn't working around the clock. I'd taken a 15-minute snack break and then a 30-minute dinner. 
• Some Gollum-ing: Mike's snack break was 10 minutes and his dinner was only 20! You selfish bitch! 
• Some Smeagol: I'm sorry, I'm sorry, I'll be quicker next timeses...

I get a lot of mini-breakdowns these days, and they all turn into one big breakdown at the end of the day when I have time to reflect on my feelings. I admit it, I cried buckets before writing this, just from the sheer tiredness of my first day and the feeling of never measuring up to the standard of what a clerk should be. 

People say they've been having a lot of fun in clerkship, but honestly I feel like I can never be at home in my own skin. I'm always on edge. Always ruminating on my flaws. Always apologizing for my mistakes. Always apologizing for non-mistakes. Always repentant for merely existing.

To be honest, I find no joy in what I do.

It's like I'm at that part of the video game where, in order to progress, you have to fight monsters until you gain enough experience points to level up. It's called grinding. There is no joy in grinding. It's just battle after battle, one monster after the next, until one day - poof, you're a level higher.

But until then, it's monsters for me.

Monster after monster after monster.