State-of-the-art. That's how "he" (referring to a guy who doesn't need to be named INMHO, seeing as to how much he and his brethren put godly efforts to promote it) likes to call his toys. I'm talking about the linear accelerators, ct-scan machines, brachytherapy laser unit, portable x-ray and all the other newly-acquired gadgets he's keeping in his *ahem* "prestigious medical center. Don't get me wrong; these diagnostic babies are so convenient that, were they available 40, 50 years ago, people with diseases difficult to diagnose with the clinical eye can be managed efficiently and effectively...IF. Yes, 'If' these were available to every sick person.

Enter the narrative. I, clerk Villafania was summoned to the ICU to follow-up on the abdominal ultrasound request made by my superiors for an admitted patient co-managed by the department of surgery. By protocol, patients inside the Intensive Care Unit should be kept under strict monitoring and under the most ideal environment, to ensure stability of their vital signs. Now this particular patient in the ICU has most of his orifices intubated, save for his ass. He has a nasogastric tube with bilous secretions, an endotracheal tube connected to a mechanical ventilator that controls his breathing, a tracheostomy outlet, several intravenous fluids hooked to both arms and finally, a ventriculostomy shunt on his superior frontal bone. He almost looks like Neo inside the Matrix. This guy has anasarca (generalized edema), making him 4x heavier than the Nutty Professor. Ideally, as in a perfect world this dude would remain inside his cubicle and one of the medical center's sleek and portable ultrasound machines would be brought inside the ICU to provide the needed diagnostic imagery. Again, we're talking about a perfect world.

What actually happened is this: two orderlies came up to me and said that the department of radiology asked for us to transport the patient to the ground floor for ultrasonography. I called them up and asked them why they aren't sending the portable ultrasound equipment along with an operator instead, since moving the patient provides a certain risk of arrest during transport. They asked me to come down instead, saying they cannot explain over the phone.

When I got to the ultrasound room, the radiologist, a professor of mine, put his hand over my shoulders and said "You know, there's nothing wrong with using the portable ultrasound machine...it's just that, well, kid, this thing costs 5 million pesos. That's a lot of money. The hospital wouldn't just use it just so some patient can have his convenience. I mean, who's gonna pay for this if get's damaged? You get what I mean?"

I was dumbstruck by what he said. Like about after 10 seconds did I get to compose myself and say "but doc, didn't we buy this thing for exactly that purpose? so patients can be given what they need?" he turned around, shook his head as he chuckled a bit then said "oh, Mitch, you still have a lot to learn. Now go get the patient".

Now, lemme tell ya, THAT IS THE MOST STUPID THING I HAVE EVER HEARD.

G&ddamit it was a PORTABLE ULTRASOUND MACHINE. SPECIFICALLY MADE FOR THE PURPOSE OF PROVIDING ACCESS TO PEOPLE WHO CANNOT BE AMBULATED.

To my dismay, he WAS telling me the truth, what I've always known yet never acknowledged - that in this world things have become more important than people. It's like saying "it's alright for a patient to suffer as long as the machine doesn't get a scratch." BULL$H!#!

I went back to the ICU, instructed the orderlies and the nurse to prepare the patient for transport, and proceeded to the ultrasound room. That particular moment, I hated technology. Neutral as it is in terms of right and wrong, it is, more than ever capable of widening the gap between the rich and the poor. What a shame.

I am not the first to have been disillusioned by this and many other examples of corruption. It stares us in the face daily, from the moment we open our eyes until we close them. It's there. I dunno if there is much I can do to loosen its grip in society, much less loosen its grip on me. As hypocritical as it may seem, for me it's the struggle to free ourselves and others from it that matters. I pray that being a physician empowers me to do just that, even amidst an imperfect system.