What keeps me up at night?

I get this question a lot. My friends would randomly chat me in the wee hours of the morning, asking why I am still online. My workmates would mention in passing that they saw me like a post at 2 in the morning. And my generic response would always be something like: “My mind’s awake at night” or “I drank coffee at the wrong time”—phrases that are not entirely false, but don’t hold a lot of truth, either.

I work as a nurse in one of the most sought-after hospitals in the Philippines. I am writing this piece at 2:17 in the morning, not sure what to do with it at this point. But my racing pulse and my inconsolable thoughts are pushing me to do so. Write, write, write, until it forms something, until you form a sensible thought, until you sleep to exhaustion, my mind says.

Am I not exhausted from work? you may ask. I am. I am sleep-deprived; I work long hours, I stand and do seemingly endless chores. Like a charade of some sort—except when the curtain closes, no one’s giving me a standing ovation. Sometimes, not even a single clap can be heard.

My shift starts at 6 a.m. I go to work at 5:30. I don’t go to work late; I like respecting people’s time, I like following rules, and I like abiding by a system.

What do I do? I work at the recovery room. Many say it’s a chill place; they say it’s better to be assigned to the Pacu (post-anesthesia care unit) than anywhere else in the hospital, such as the wards or the intensive care units. But is this really the case?

We work with people who have gone under the knife, under anesthesia. Patients wake up, groggy, sometimes almost fully awake, but more often screaming in pain, crying fat tears. We reassure patients that they’ll be all right. We guide them to consciousness. On good days, we receive thank you’s. On other days, we get vomited on—lots and lots of it.

You get to handle loads of different cases. And when you’re lucky, you get rotated to a more sophisticated care area, such as the cardiovascular post-anesthesia care unit. I guess luck is a bit on my side.

In the CV Pacu, you get to talk to the patient before surgery. You will explain the setting, what the patient should expect, the team that will handle him, the contraptions in the room, and every little detail the patient has to do when he starts to wake up.

Immediately after the operation, with a new and upgraded heart, the patient will see us, but we’ll see him first. He is at his lowest point, striving to breathe, fighting for his dear life. We’ll monitor his hemodynamics, his blood gases, the different cardiac rhythms of his heart. We’ll see him first, and we will see no other important person but him.

It is intense, yes. But it is fulfilling—seeing him open his eyes, grab our hands and be stable. From seeing him in unimaginable pain to having tolerable pain, from being hooked to the mechanical ventilator until weaned off and the device taken out; then having to wheel him out of the CV Pacu to the coronary care unit for monitoring—it’s surreal.

The patient seeing his family after the successful operation, the silent prayers uttered and answered, the cries of relief… It’s been a long day, but all seems worth it. It makes me feel like I’m part of something bigger than my existence. That it’s my purpose to be here, and, as cliché as it may sound, that I help save lives.

It’s now 02:36, and I’m still wide awake. What keeps me up at night, really? The thoughts, the bottled-up feelings inside me that I can’t unleash—though writing this piece made me feel a bit lighter and unloaded some weight.

But, yeah, I have to sleep now. I barely have time, but I will be on time for work. I will try to save lives, to make my patients smile more. I will try, until I make this world a little better, in my own little way.

Klarissa B. Velasco, 26, is a nurse.