It had been 14 months and six days since the World Health Organization declared the 2019 novel coronavirus outbreak a Public Health Emergency of International Concern, and since the first confirmed case of this CoViD-19 virus in the Philippines. It was declared a pandemic on March 11 last year.
Dumaguete is now the epicenter of the Province’s worst surge of CoViD cases since the pandemic began. The five major hospitals in the City have reached full capacity in terms of dedicated CoViD beds, with at least 20 CoViD-related symptomatic cases frantically on the ‘waiting-list’ needing hospital admission for better medical management.
As a stand-alone outpatient eye clinic and surgicenter, our management decided to impose a two-week closure of our clinic to help ease the rising CoViD cases, and to stand as one with our colleagues who are fighting the war against CoViD in the frontlines. This was the least we could do for our frontliner colleagues at this time.
But this decision was also a much-needed, urgent break for me, my body, my mind, my heart.
Just five days into our two-week clinic-imposed community quarantine closure, I received a call from a dear friend, a pediatric pulmonologist and medical frontliner — one of those in our profession who is in the thick of it all.
With her endearing, yet concerned voice, she asked me on the phone to come into the pits as an ophthalmologist, and examine an admitted pediatric CoViD patient Ysa, who had not been able to open her eyes for days since her admission.
The working diagnosis was that of a serious condition associated with CoViD-19 in children, Multi-system Inflammatory Syndrome (a severe form of cascading response of the whole body).
It is not everyday that one is called to arms by a colleague in our medical profession. I took it as an honor and a privilege to be able to help our exhausted walking-wounded medical frontliners, most of whom I share genuine friendships with in and out of the hospital.
After packing my whole clinic into a suitcase, I headed out to the hospital. There was a feeling of ambivalence as I drove towards the hospital. I was excited because I would finally put my Ophthalmologic skills to good use in helping my medical frontliner-friends fight CoViD-19 in ground zero of the Province’s epicenter.
But I was also anxious because I felt like I was going into the unknown. I did not even know if I could handle myself being in the real battleground.
Despite the assurance of donning myself with the complete Level 4 personal protective equipment, the reality of being directly exposed to a confirmed severely-symptomatic CoViD patient in an enclosed room was daunting. My heartbeat started beating faster than usual, excited and anxious, as I approached the entrance to the CoViD ward. 
Breathing heavily under my 3M half-face silicone respirator, I peeped into the double swinging doors that led to the eerie-looking yet, well-lighted CoViD ward hallway, waiting for someone, the full- geared pediatric resident on duty, to prompt me in, and assist me in donning my Level 4 PPE. After wearing the shoe covers and head cap, I donned the blue and white hazmat suit, hoodied and zipped up, wore my face shield, and then fitted my clean gloves, tucking in the sleeves of the suit. By this time, sweat was starting to build up in my armpits, forehead, my back, and inside my respirator.
With Level 4 PPEs, the Pedia Resident and I entered a room where a weak and distraught six-year-old Ysa was struggling in bed with her hoarse breathing, and eyes tightly shut.
Her mom, Milanie, was at the foot of the bed, stroking back and forth Ysa’s left leg — a mother’s helpless effort to comfort her ailing daughter. I could see the despair and worn-down look in Milanie’s eyes as our eyes met for a quick second before I introduced myself.
I slowly opened my suitcase, and arranged on the table the equipment I brought to examine Ysa’s condition: There were multiple violaceous skin patches [violet blotches]all over her face, arms, and chest. Her lips looked like it was scalded, severely swollen, cracked with blisters, and necrotic [dead] black tissues, seeping with serosanguinous fluid in the raw areas in between.
The Pedia Resident whispered to me that Ysa’s tongue and airways were also swollen, thus, her hoarse breathing.
Her eyelids were swollen as well, and apposed with matted [entangled and oily] eyelashes.
I struggled to approach Ysa, and attempted to engage with her; explaining to her that I was assigned in taking care of her eyes. She winced and started shaking her head in disapproval as I started dropping ophthalmic topical anesthetic drops to each of her eyelids, wetting the sticky lashes.
At this point, I asked the mom and the Pedia Resident to double down, and hold Ysa’s flailing arms who was obviously in pain, as I started to remove the gunk that had caused the matting of the lashes, using a set of wet cotton applicators. Debridement, a painful process of removing debris from her lashes and eyelids (not for the faint of heart). My heart started to bleed as the skin of her eyelid margins started to slough off with the gunk that I removed.
Then I apologetically proceeded to pry her eyelids open, by using a bladed pediatric eye speculum.
Alas, I should expeditiously examine her eyes. Hearing her weak and hoarse cry in the background, I mentally ran it through my head: matted lashes, macerated/sloughed off eyelid margins, conjunctival injection (redness), no ciliary injection, clear corneas, soft eyeball, full extra-ocular muscle movements, no relative afferent pupillary defects.
Removing the speculum, I begged Ysa to stay with me, and then for her to try to count the fingers that I held infront of her. With her weak voice, she struggled… Fiiiiveee… Ttttwwoooo… Fiiiiiiveeee.
Then I heard the mom’s cry with tears of joy, saying; “Thank you, Loooooord! Thank you kaayo, Dooooc!”
There was a strong tug in my heart, and it seemed to bleed some more. Teary-eyed now, I wanted to hug Milanie but I knew I shouldn’t. I paused for a moment, and squeezed her arm instead.
To be thorough, I opened the Ishihara Color Vision Chart in front of Ysa’s line of vision. As I tried to cheer her on, I asked her to read some of the numbers embedded in the round color plates. She slowly muttered, “Pizzaaah!”
My tears flowed like a river, and I couldn’t even wipe them off as they rolled down my cheek. Struggling to keep a “high-spirited” mood, I told her that we will get her a pizza when she gets better.
As I slowly gathered my equipment back into my suitcase, Milanie repeatedly said “Thank you kaayo, Dooooc!”
I assured them both that I will prescribe medications for her eyes, and monitor Ysa closely with the help of the Surgical Resident. I told them that I will pray for their full recovery, and sadly left the room.
Carefully doffing the PPE, I endorsed to the Surgery Resident on how to apply the eye medications for Ysa every four hours.
As I was heading towards the parking lot, I felt my heart tighten, getting heavier than my whole-clinic-in-one- suitcase. After removing and disinfecting my respirator with Lysol wipes, I turned on my car AC, and bluetooth stereo; Spotify was playing Don’t be Afraid by Nico & Vinz on repeat.
With head bowed down, I just kept crying and crying at the parking lot. What a humbling experience: For a doctor like me, it was “nothing”, almost casual to pry eyes open like that. But to Ysa and her mom Milanie, it meant the world.
I couldn’t stop crying. And praying, Lord, thank You for giving me this set of clear eyes, this pair of stable hands, a keen brain to remember all that I have learned, and a heart to be able to make people cry tears of joy amidst the suffering in this pandemic.
That opportunity to help Ysa gave me some sliver of Hope.
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This article was written and published with the full consent of the parents of Ysa who is still fighting for her life in the hospital. They are in need of financial support from the community. For donations, please deposit directly to their Union Bank Account No: 109652974764, under the account name of the mother Milanie Tavera. Her GCash No: 0997-382-3627. You may also contact Ysa’s father, Feliz Bustamante on 0967-735-4434.
Author’s email: ikayapmd@yahoo.com
