laugh.

“A joyful heart is a good medicine, but a crushed spirit dries up the bones.” —Proverbs 17:22

My first patient on neurology department was a sixty-year-old man with tetanus. He was on his 21^st day of medication when I first saw him. I read his medical record, this man came with a general seizure and fever, has spent weeks at the ICU, went through an operation, having a tube placed on his trachea—we call it tracheostomy, and I held my breath as I turned the page after page, imagining what kind of days this man has been going through. Those were days of torture I bet.

This is the first patient I saw on neurology department. A dark-skinned-thin man lying on his bed, with both of his hands fixated to the bed. His eyes were shut. He barely can’t talk because of his jaw spasm and the tracheostomy tube placed on his throat. All I could hear was the sound of his heavy-uneven breath due to the thick sputum on his tube. He coughed a heavy cough occasionally—kind of cough that makes you feel sorry for him.

He was progressing when I was on my sixth days at the hospital. He started to talk though his voice was still unclear. He didn’t have seizures anymore and his medicine was tapered off. He began to take his food via nasogastric tube instead of I.V line. Everything was better, and I felt happy for him. Until one night.

A friend of mine was going to help me to do the sputum suction for this man. We did it regularly to clear his airway so he could breathe easily. But that night, my friend came to me with a terror on her face; she told me that my patient took his tracheostomy tube off by himself.

We freaked out. The tube was his only airway, without the tube it meant that nothing held his trachea and it got a direct exposure to the outer world. Both of us panicked, and suddenly it became a long and sleepless night. We have to observe his respiratory rate, temperature, and oxygen saturation every hour, plus took a good care of his opened wound, and do the suction whenever his sputum blocked the airway.

It supposed to be a quiet night, I kept telling myself. I am tired. And now I have to sacrifice my sleeping hours for this patient. I was mad. I want to blame the patient, I want to blame his family for not accompanying him and let him do this stupid thing. I was exhausted. But on that suffering and cruel night I was stunt.

My friend and I was taking care of this man, when he tried to speak to us. His voice was hoarse, it was mere a whisper and unclear. We couldn’t understand what he told us. He tried. Again and again. And we desperately want to understand him, until my friend said to him that we were sorry, but we couldn’t get it. Then the man gave up, but he laughed. He laughed at us for trying so hard to be able to understand. In the middle of his pain and heavy breath he laughed. He smiled a faint-smile. And for a second my exhaustion washed away. And I laughed.

We laughed.

In the middle of sufferings.

We still can laugh.

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