A Cardiac Arrest in the Boondocks
by Dr. Godofredo U. Stuart Jr.

amona, of course, not her real name, was a 17-year old village lass who worked in Pulang Lupa. Her parents were farmers, so thankful that I took their child into Pulang Lupa, extricating her from their hand-to-mouth existence, relieving them of a mouth to feed. A high school graduate— an uncommon accomplishment in the village— she took on various chores with zest: uncluttering the clutter my life, secretarial filing and record keeping, fast tracking to hors d'oeuvres and scrumptious dinners, laundry service, to boot—she could, in fact, qualify as a rural female butler, a general factotum, or, hands down, a girl-Friday.

A high school graduate, she read fairly well in phonetically disabled English, but comprehended little — just individual words, barely the gist of a sentence. So, there it was, recurring dinner scenes from Pygmalion: I, the Professor and R. the village girl, reading through children's books while I chewed through dinner meals, correcting pronunciations, asking word meanings and Tagalog translations of what she read, in-between gulps and sips of wine. A session would end with homework list of ten English words to use in a sentence.

Alas, at 17, her hormones were starting to surge, her body filling up in places, and heretofore tomboyish fondness for paper airplanes and toy robots were starting to flag. I watched the staff of young men following her with lascivious looks, the red lights were blinking warning signs all over, and the cautionary lectures proved to be worthless. Soon enough, it happened with one the men—married, precluding a shot-gun wedding. Threatening him with rape charge, and as my berating was turning violent, he skedaddled. Of course, it was consensual, and she confessed: Gusto kong maranasan. I wanted to experience it.

I sent her back down the village.
She texted daily with apologies, asking to come back.
With her parents consent, she did.
Barely back a week, on a Sunday when all the men were gone
while we were sorting through a box of medical samples,
she said: Doc, nahihilo ako. I feel faint.
A look of dread and beads of sweat on her face.
Within seconds, she slumped forward, passing out in my arms,
I guided her to the floor, between the cramped spaces
of table, chairs, wall and litter of medical samples.
Took her pulse, found none.
Went around the table, dragged her out by the legs.
No pulse. No carotid.
She was in full cardiac arrest.
Almost a minute gone.
I did a fist thump on her chest and started CPR.
Pumping on her chest, 120 per minute.
Fuck, fuck, fuck, in cadence with every 2 compressions.
After a minute, a pulse check. Nothing.
I broke away to get my stethoscope.
A cavernous emptiness in the chest.
No heart sounds. No breath sounds.
Started compressions again, fuck, fuck, fuck, in cadence.
I was starting to sweat. My arms, starting to ache.
Another minute went by. Still no pulse.
I started thinking fuck she's not coming back.
Then, an arm moved.
Oh, sweet Jesus.
Then, she opened her eyes, bleary, confused.
Oh, sweet sweet Jesus.
She asked: What happened?

She said she had passed out once, frequent spells of faintness and not feeling well. Lots of times, she'd just lie in bed, wake up feeling so tired. Her mother chided her for being lazy, feigning illness to avoid work. In the absence of audible heart sounds, I suspected a ventricular rhythm problem, or perhaps, episodes of prolonged heart block, her heart beat spontaneously reverting normal, the prolonged external cardiac compressions preventing permanent damage or complications. Her EKG and 24-hour holter monitoring showed nothing. Her parents and the staff were given CPR courses. While considering further workup, I severely restricted her activities, not allowing her unattended trips or hazardous chores. Alas, her interest in boys soon returned, and to my dismay, learned that during my absences, she was taking trips to meet a boy friend. On one of her trips, she had another spell, not quite passing out, but almost. She left Pulang Lupa again. A month later, I heard she passed out during church service, unresponsive for a minute or two, even wet herself, which the barangay tanods saw as a sign of imminent death. But she again revived. She has left her village to work elsewhere, and continues to have occasional attacks of passing out. The family never consulted the big city specialists. The needed workup is extensive, treatment predictably expensive, unaffordable. The poor, often, chose to do nothing, other than resign their lives to God's will. Perhaps, by hormonal chance, she'll outgrow the episodes.

by Godofredo U. Stuart Jr.                                                                                                           September  2012
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