The Last Mon Standing

Ever since I
learned to utter the few notes of the Philippine National Anthem it has
been an SOP for me to bring my right hand to my left chest and feel my
heart beating… my Apical Pulse pulsating.

I found it really funny when our obese patient who had undergone a
mastectomy, removal of her left breast, because of a breast cancer told
us to auscultate for her heart beat on her right breast.

She is too fat that we cannot find her brachial pulse; her wrist had
too much plaster tapes sticking around it to support her Intravenous
Infusion that we cannot check for her radial nor her ulnar pulses. We
tried her temporal and carotid arteries but she was too fat and the job
is as achievable as climbing the Mt. Everest… not impossible but
extremely difficult.

We could try her left wrist but it was too far and we cannot move
the right arm or else risk her right extremity to inflate because of
edema.

So Lallaine grabbed her stethoscope and tried to listen at her left
chest. She tried to eavesdrop on the upper portion, careful not to
touch the part that has bandages, the previous location of the breast
that was removed.

No matter how hard she pressed the stethoscope against the woman’s
oily skin, still not a single beat was heard. So the woman told us,
“Why don’t you try listening here?”, as she pointed on her right chest.
She specifically directed us to a precise location, telling us that
that was where the morning shift of student nurses pressed the
stethoscope for her Cardiac rate. I almost laugh at the idea, but
Lallaine just smiled and pretended that she was trying to listen on her
right chest. I knew that Lallaine and I have the same thing going on in
our minds. The morning shift Student nurses could not auscultate for
her cardiac rate so they just pretended to get it on her right chest
and then guessed her cardiac rate and  recorded the false result on our
patient’s record.

The patient’s relatives stupidly agreed with the idea. They even
told us how they were impressed by the two student Nurses that made
their “scientific” assessments on our client.

“They were really smart”, they exclaimed. I swore under my breath.

But of course we cannot tell them the truth that they were
hoodwinked by the two nasty Students lest we want to humiliate our
school’s name. Lallaine just told them that she cannot find the “RIGHT”
apical pulse that the two students successfully listened to. So I just
reached out for the left wrist, cautious not to move the arm. It was
pretty difficult but I still managed to get her  cardiac rate.