“Red Spots” by Lisa Kyle Young

Pulmonary Embolism, the cost to survive, and the near-death experience


When I found out I was seriously sick last November 4, 2016 inside the pulmonologist’s clinic, it felt surreal. My worst fear just came true, I thought, shell-shocked.

The doctor instructed me to go to the E.R. immediately.

You see, I am a hypochondriac, and finding out that you have have a life-threatening illness is like winning the lottery of horror. It’s the grand prize of all my fears.

When I asked the pulmonologist the dreaded question: “Can this illness kill me?” When she nodded, I cried. I ugly cried in front of her and my mother.

“That’s why you have to go to the E.R. now,” she said. “Don’t worry, I will make phone calls to the Philippine Heart Center.” I could see the worry in her eyes.

I didn’t have a terminal illness; I just had a life-threatening illness — a curable one that needed emergency treatment.

Time is of the essence.

I was a ticking time bomb that night, the seconds counting down to my death. In Hollywood movies, or in TV series, you see the digital clock of a bomb, the seconds running out, fast, and you wait for the hero to detonate the bomb before it’s too late. It’s the kind of heart-stopping suspense when you’re mentally screaming for Jack Bauer to hurry up and save the day.

The problem with my case, I couldn’t see the clock. I didn’t know how much time I had left. So I cried while the doctor made arrangements with the Philippine Heart Center, scribbling a note to the fellow who will attend to me in the hospital. I was going to be sent as a charity case — and a medical case study. A young female with pulmonary embolism.

I was a charity case because we didn’t have the money for the emergency CT chest angiogram with contrast — a super expensive diagnostic test to confirm the existence of blood clots in my lungs, which was necessary before I receive any form of treatment.

(Now I realized she should have just told us to go to the nearest ER and worry about the money later.)

I was panicking inside while she spoke over the phone. The phone call felt like forever. Would I make it alive to the Philippine Heart Center? I had been sick for 17 days. Blood clots had been existing in my lungs for 17 days, hiding quietly from many previous doctors, until that Friday, when a genuinely attentive and a brilliant pulmonologist spelled it out to me: you have pulmonary embolism.

So how many more minutes will God let me live?

***

We came out of the clinic, my crying spell over. My mother paid for the doctor’s fee through the cashier window. And I couldn’t believe I was standing there, waiting for the cashier to hand my mother the change when my life was in danger.

I looked around at the waiting patients in the Health Cube Clinic. No one knew I had a fatal illness but me, my mother, and the doctor inside the clinic, who was already waiting for her next patient.

***

Not knowing when the bomb will explode, there was nothing else to do but to try and live. So I booked a Grab to the Philippine Heart Center. The driver made a wrong turn, so we had to walk far to where he was. The driver had no idea I could die any minute. The delay caused by his poor navigation skills could actually cause my death.

It was a Friday night. Rush hour. Past 6 in the evening. There was traffic on the way to the Philippine Heart Center.

(Now I wonder why the doctor did not call an ambulance instead to take me to the nearest hospital, which was Cardinal Santos Medical Center. Is it because my mother told her we didn’t have the money for the CT scan? Or maybe because I could still stand and walk and talk?)

I sat inside the car, looking out the window. Terrified. Bursting into tears every now and then, talking to God every now and then. Reaching for my mother’s hand, telling her again and again that I was afraid. She would comfort me, hold my hand, and calmly tell me not to be afraid. She was not panicking. She was quiet.

So I sat still, waiting for my fate. Waiting if I will collapse right then and there inside the Grab car — right in the middle of Manila traffic — or reach 79 years of age a spinster. At that very moment, I was fully experiencing the crystal clear truth that you don’t own your life. I watched the cars, bumper to bumper, outside my window. Who knows if it’s the last time I’d see a Friday night traffic?

Maybe it helped that I couldn’t see my life ticking away. Because if I could see the “10, 9, 8, 7….” it would be more frightening. Let death surprise me. Let the miracle of survival surprise me. I didn’t want spoilers. Let me see how this ends.

***

Philippine Heart Center wouldn’t do the CT chest angiogram with contrast because my case had to be approved first by the Social Services. That meant interviews and paperwork and a Social Service officer’s judgment whether you get to live or die.

That night, the Social Services office was already closed. And no one was attending to me in the crowded hospital despite the note from a specialist that I was under high suspicion for P.E. That night, Philippine Heart Center was Code Black. With all the beds occupied, half-dead patients were slouched in waiting room chairs, eyes closed and tethered to blood bags and IVs.

It was a nightmare.

I waited, prayed, calling for a doctor every 15 minutes or so to help me. After an hour of waiting, I finally argued with a random doctor, demanding that she explain to me why I was being ignored despite the emergency note from the pulmonologist.

I could die any time, I told her. I have blood clots in my lungs! Can you at least tell me what time the fellow can see me?

She looked at me, highly irritated, and kept telling me to be patient, providing vague information and a bunch of lame excuses why I cannot be attended to at that very moment.

Then it suddenly dawned on me. The horrific truth behind her messy explanations for the delay in my diagnosis and treatment.

I asked her directly: “Tell me the truth: if I am not a charity case, if I am a patient with cash right now, will you start testing and treating me?” I asked her.

“Yes,” she nodded, looking away.

I nodded. I knew I will die if I stay another minute in that hospital. No time to argue with the system the doctor had no control of.

So I asked her, “If I were to travel right now to a different hospital, will I make it there alive?” I asked.

“Yes,” she said confidently, and I could almost see her eyes mentally rolling. She added: “You are not in distress, Ma’am. You are even capable of talking. I don’t believe you have pulmonary embolism.”

I knew in my gut, that despite the fact that I could stand on my feet and that I could talk, that I had pulmonary embolism. There was no other explanation for my very strange shortness of breath. Breath that felt like it would expire any minute. Shortness of breath that I, an asthmatic since birth, had never experienced in my entire life.

I didn’t waste any more time with the impatient doctor, who clearly didn’t give a damn whether I survive, and told my mother that we had to leave. Immediately.

***

After about two hours of wasting my life at the Philippine Heart Center, my mother and I booked another Grab and traveled to a private hospital. Cardinal Santos Medical Center. At that point, I was already calm. And angry. I was thinking, How many poor, or broke, people will die with the kind of healthcare system that I just witnessed?

I sat inside the car, looking out into the night, ready to die. Wanting to die. Afraid to die. Waiting to die. Waiting for a miracle.

I sat inside the car, looking out into the night, ready to die. Wanting to die. Afraid to die. Waiting to die. Waiting for a miracle.

At the Cardinal Santos Emergency Room, an hour’s drive later, the doctors doubted the specialist’s note that I was possibly suffering from pulmonary embolism. Because I didn’t look distressed. Because I could communicate articulately with the doctors.

A doctor, skeptical that I couldn’t breathe because my oxygen saturation was 98%, finally sighed, “If you say so. I’ll go get a D-Dimer test for your peace of mind,” she said. “But it would cost a lot,” she warned.

I told her to get the test. She shrugged and ordered the test. I didn’t even know what a D-Dimer was. It wasn’t the test that the pulmonologist recommended — but sure, whatever test you think I would need to verify if I was seriously sick — or I was just horsing around and wasting the time of the entire Philippine medical community.

***

The D-Dimer test came back an hour later. And it came back extremely elevated. Positive for blood clots, the embarrassed doctor told me, smiling apologetically and sheepishly.

I was immediately treated. Injected with enoxaparine in my stomach. Confined in the hospital for three weeks. The money came pouring in soon after — from friends, loved ones, people I didn’t even know. Generous souls pitching in to pay for my colossal hospital bill.

I had three blood clots: one in my cephalic vein, left arm, revealed by the doppler ultrasound. And two in my lungs, as revealed by the ultra-expensive CT chest angiogram with contrast. The doctors said the cause of my blood clots was birth control pills.

***

Eight months later, here I am writing this piece. Clot-free. A blood clot survivor. Done with my anticoagulants. I survived. God let me live. He decided that it wasn’t time for me to die last year.

But life is still a ticking bomb whether you’re healthy or not. Death is real. Death is the end of us all. Enjoy good health while you still can, fix your life, make an inventory of your spiritual life, and get ready. *

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This piece also appears in Concept News Central, where the author has a movie review column.