It was around this time of the year in 1995 when he was admitted to the surgical wing at the service ward of the Pediatric Department in the Philippine Heart Center. His name, Jun Fullero, 12 years old, male. Diagnosis, Mitral Valve Stenosis secondary to Rheumatic Heart Disease. I was on duty the afternoon he was brought up from the ER... he was having cardio-pulmonary congestion, was in moderate distress and was very irritable. The last condition, in itself, was good. What would have been bad was if he was stuporous.

We added another IV line for his dopamine drip administered by pump infusion so his heart rate would be regulated, started him on oxygen inhalation, gave Furosemide IV push stat to relieve the congestion and requested for his lab works. When I was inserting the abbocath for his IV (I just finished the Critical Care Nursing Course where they trained us on IV Therapy. Incidentally, I finished 3rd in my class... bow), he asked me a question, with eyebrows drawn together and an eternally pissed off expression on his face.

"Magaling ka bang nurse?"

I just kept on doing what I was doing while I countered, "Depende. Ano ba sa isip mo ang magaling na nurse?"

If it were at all possible, my questions seemed to make him even more irritated. "Yung ano... yung kuwan!... Aalagaan mo ba ko?"

I finished inserting the cath, connected the IV, taped it in place and regulated the drip. Then I sat at the side of his bed, smiled down at him, took his hand where I just stuck a needle to him and hooked my little finger to his. "Pramis."

He never winced from that IV insertion but it's not because of any skill I had... a needle is a needle and it stings when it pricks. But Junjun, as we would learn to call him later on, was busy asking his question and waiting for my answer that he was oblivious to what was being done to him. That was lucky for me cause from that incident, he came to know me as one of the painless nurses.

In the following weeks, I would find Junjun breathing easier, eating with more gusto, becoming more cheerful and making more friends with the other patients, parents and nurses in the ward. Whenever I came in for duty, I would stop by his bed and we would talk for a couple of minutes. Sometimes, I'd bring him a fruit or a slice of cake and he would thank me profusely. I had to do this around midnight, when most of the patients would be sleeping. No need to let the others know I was having a favorite amongst them.

When Junjun's condition was stabilized, the doctors scheduled him for cardiac catheterization. They would be insering a catheter from an artery in his groin, all the way to his heart and across chambers, in part to provide a way for his blood to flow in the direction that it should, and in part to determine what could be done to correct his heart on more permanent terms. It was a routine procedure and would not even be done in the operating room. Still, he was to be prepared as we would prepare a patient for surgery. By midday, he was admitted back to the ward and was kept at close monitoring. Junjun pulled through it quite uneventfully and after a couple of days was back to being his old self.

"Junjun, bukas, tatanggalin na natin ang isang IV mo."

"Pramis Ate Jet?"

"Pramis."

Duty hours at PHC went on 12-hour shifts; 7am - 7pm or 7pm - 7am. Sometimes though, our duties would be broken to 7-hour shifts... 7am - 3pm, 3pm - 11pm and 11pm - 7am. If I would come in at 11pm, Junjun would already be asleep, but his mom would still be wide awake, watching over him. On one such night when business was particularly slow, I stopped by Junjun's bed and kept his mom company. She told me how, when this all started a couple of years ago, they had Junjun admitted to the Pay Ward. Theirs was quite an affluent family and Junjun was quite a brat. When the boy had to stay in the hospital for weeks on end, they saw that they had made a mistake. His hospitalization had taken its toll on their finances and soon enough, they were selling properties one after another. On the day Junjun came home, he did so to a house that was more bare than the one he remembered. He never said a word but they knew that he had a pretty good idea where everything went. His mom said he was quiet for weeks and hardly complained about anything... not even about an occassional pain here and there.

And then she asked me about my life... if I was married, if I had children, if I liked my job and if I had plans of going abroad. I said yes, I was married and no, I didn't have any children. Yes, my job was pretty ok and yes, I had plans of working abroad. In fact, my application was underway.

The following morning, when I passed by Junjun's bed to say goodbye for the day, he asked me, "Ate Jet, aalis ka nga ba? Bakit pa e ang ganda na ng trabaho mo dito?"

I was struck dumb. How do you explain to a kid about 'greener pastures' when the only green he has seen for the past 3 months was the color of the oxygen tank beside his bed and the alternate uniforms of the nursing aids? How do you tell him about a 'better life' when his own little life was currently being measured with every breath he draws, literally? I kept my silence.

"Ate Jet, marami pang susunod sa akin."

One time, coming from a 12-hour morning shift, I was dismayed to learn that I had to stay on for another 12 hours because the night shift would be understaffed. I was dead and beat because the morning had been simply awful. I had been assigned to the medical wing, which was always a toxic wing, and we've had 2 cardiac arrests in a span of 12 hours. The tough thing about having a cardiac arrest happen in the ward was that aside from resuscitating the patients, of course, you had to keep everybody else calm... and that sure was a breeze in a roomfull of people with heart problems, huh... I had no choice but to stay on for the night, and as a concession, they put me in the surgical wing so I'd have a quieter time.

I saw that Junjun was sleeping so I carefully took hold of his wrist to take his pulses, which, in PHC standards, had to be counted for a full minute. Suddenly he spoke, "Ate Jet, ba't ang tagal?"

"Shh... wag ka maingay. Inuulit ko kasi nakatulog ako e."

"Kawawa ka naman Ate Jet... pagod ka na siguro 'no?"

That was our little secret. After that, everytime I'd be assigned to his wing and would be taking his pulses, we'd be exchanging knowing glances and burst out in laughter.

"Junjun, bukas tatanggalin na natin ang dopamine mo. Last dose na yan, Tapos wala ka nang IV.'

"Pramis Ate Jet?"

"Pramis."

After 3 months, the doctors have finally decided what to do with Junjun. They would be correcting his stenosed valve, which, after all that's been done, remained as stiff and unrelenting as a sun-dried board and would not let a single drop of blood through. However, they would be trying a new approach. What this approach was, I never learned about.

The day before Junjun was to go to surgery, I was on night shift and would be giving him his pre-op early the following morning. I woke him up at 11pm so he could take a little food before I put him on NPO at 12mn. At 6 am, he was bathed on his bed and shaved. I started another IV line, gave him his pre-op meds and put him back on oxygen. While waiting for the call from OR to bring him down, I reviewed his chart to make sure I've covered all the pre-op orders. At 8am, the call came and we wheeled him to OR.

When we got there, the nurse was a bit irate cause Junjun was still wide awake. Before the OR nurses and attendants wheeled him to one of the operating halls, Junjun weakly grabbed my hand and said, "Ate Jet, paglabas ko ng RR, nasa ward ka pa rin?"

I held his hand tightly and whispered, "Oo. Pramis."

I promised Junjun I would be there after his surgery but that was not going to happen. Something went wrong with the operation and he was brought into RR attached to a heart-lung machine, remaining unconscious till the end. I was on 2 days off following my night shift and when I got back, he was gone. They told me he went in the night... peacefully.

I never went to his wake although some of the nurses did. A week after, Mrs. Fullero went to the ward to visit me. She said she understood why I didn't come and that it was alright. I was there for her son when he was alive... that was enough. She told me, the night before his surgery, when Junjun learned that I was going to do his pre-op, he said with a smile, "Buti na lang si Ate Jet."

For some reason, it was never the same for me. Whenever I passed by or attended to the patient at Bed No. 3 of the service wing, I felt an erring little resentment at whoever was there... in my heart, it was still Junjun's bed and the one occupying it was taking his space. I still did my job as usual but for the sake of self-preservation, I kept my distance. The following year, I resigned from my post at the Heart Center.

After all, there were no more promises left for me to keep.