On what was supposed to be a restful weekend Smoketh’s father handed her a key to a safety deposit box, something that Smoketh never knew existed. She couldn’t fully grasp the concept of having valuables tucked away in some bank, as she had always assumed that The Mansion itself was one gigantic safety deposit box.

I would rather be napping, she sneered in a two-second act of defiance, then got out of bed, took a shower, and drove straight to the bank. The staff ushered her inside the bank vault, and Smoketh’s first thought was that she seemed to have walked into a room full of library card catalogues.

With sufficient emotional fortitude Smoketh turned the key and found an assortment of rings, silverware, small knives, pearl necklaces, and so on. She was mostly disappointed, having expected something macabre like a stuffed hamster, or an artifact that nobody could find because her father had stolen it in his youth, like the real severed head of St. Catherine of Siena. Or at least something profound, like a hand mirror, as a metaphor for finding herself. The last item in the box, at least, was something she could wear: a masquerade ball mask that looked like it was formed from gold poured on the face of a tortured Ecuadorian. All the friends she would narrate this story to would exclaim how thrilling it must be to discover such a treasure, but Smoketh was dreading the task of getting the items appraised, listed in websites, and sold. All she wanted was to hibernate in her room just for this weekend and temporarily escape her obligations to her patients, her family, the church, and the society at large.

Upon returning from the bank Smoketh was then informed by their househelp, Maricar, that a truck with a crane was on its way to the mansion. Some rich collector from White Plains had finally purchased the bronze cannon sitting on the garden, and as per their agreement the buyer would be in charge of picking up the merchandise. Smoketh watched in terror, bewilderment, and overwhelming relief as the cannon was being hoisted in the air by the crane. She stared at the empty space vacated by the bronze cannon and did not feel an ounce of separation anxiety. What was left was an impression of the cannon’s wheels on the flattened grass, as that darn naval weapon had been in her family’s possession all her life. One cannon down, four to go, Smoketh thought. Small wins.

It was not exactly the weekend she had in mind, but she survived it. Before she knew it Monday came, and her phone was ringing at 5 am. She assumed it was the hospital, but she was jolted into wakefulness upon seeing that it was her friend, Morrison dela Peña. Dr. Morrison is a friend from the college of medicine and is now a practicing intensive care specialist in Quezon City. Must be a referral for an emergency dialysis of his patient, Smoketh thought.

“Hi Smoketh, sorry to wake you up,” Morrison said weakly. “I’m having an arrhythmia,”

“I’m coming,” Smoketh said as she jumped into her car and teleported to Morrison’s house in Commonwealth. Angelica, the house help, was sobbing. Morrison was in bed, sweating profusely and looking very pale. Smoketh listened to his chest with a stethoscope while feeling his pulse, and in panic almost had an arrhythmia herself.

“Oh no pwede syang mamatay,” Smoketh muttered under her breath. His pulse was very weak, and this was the type of irregular heartbeat that would warrant immediate shock to the heart. With Angelica’s help she hauled him to the backseat with surprising superhuman strength. Smoketh was determined to fly through traffic, which was impossible to do during rush hour in Quezon City. While on a standstill Smoketh called up the emergency room and ordered the residents to prepare a defibrillator and all the emergency heart medications, trying to keep her voice as calm as she could. So far she was doing great in trying to remain zen. She had to maintain this state, otherwise Morrison might get more anxious, or she might crash the car through roadside barricades straight into a man-made ditch. This veneer was immediately shattered, though, when she heard thumping sounds from the backseat: Morrison was hitting his own chest with his fist, ie, he was performing the precordial thump on himself! The maneuver, which involves swiftly hitting the sternum with a closed fist, can theoretically deliver a few joules of electricity to the heart to restore normal rhythm in the absence of an automated external defibrillator. It is rarely successful.

“Please don’t die!” Smoketh said out loud.

“If I die, please do full CPR,” Morrison said. “I want the tube, I want the mechanical ventilator, I want the epinephrine, I want it all!”

They were welcomed by four nurses wearing full level 4 PPE’s. Smoketh was supposed to endorse the history and all that, but she had to find parking.

“Ma’am, just ask the patient what you should do, he’ll tell you everything!” she yelled to the nurses.

While on the stretcher, weak and diaphoretic, Morrison screamed. “Give me amiodarone 150 mg slow IV push now!”

Nurse Ida pushed the drug into the vein.

Linda, the young resident doctor who was trying to keep sane through all of this, showed Morrison the cardiac monitor.

“Monomorphic ventricular tachycardia!” Morrison yelped. “Prepare the defibrillator. Charge the paddles to 100 joules!”

Linda was about to press the charge button when Morrison suddenly yelled: “Wait! Wait! Stop! Sedate me first! Give me morphine 2 milligrams IV and midazolam 3 milligrams IV stat!” Smoketh arrived after having successfully parked the car, right on time to take the paddles away from the rattled resident. She squirted cold KY jelly on Morrison’s chest.

“Morphine given? Midazolam given? Will cardiovert now, clear!” She slammed the paddles against Morrison’s chest and felt the slight twitch of his trunk as electricity was delivered. She would still get surprised that the electricity only elicits a very soft movement, unlike in the movies where the body would jump 3 inches from the bed after a shock. She looked at the cardiac monitor, waiting for the restoration to normal rhythm. The rhythm became worse. It was now…

“Ventricular fibrillation!” Linda yelled.

Smoketh wanted to tell Linda: Get a grip.

Later on Smoketh admitted that she was probably more annoyed that the resident had yelled it first and kind of stole the moment from her.

By this time Morrison was completely knocked out from the sedatives. Smoketh had to think of the next steps herself. She tried to recall the ventricular fibrillation algorithm chart that she last saw when she had applied for her ACLS re-accreditation, about two years ago, and hoped that she hadn’t gotten the arrows all jumbled up. She ordered Linda to start chest compression. She gave more medications, turned off the synchronized button, and set a higher dose of electricity. She applied the paddles on his chest. “Clear!” she said, pressing the defibrillate buttons. Morrison’s chest twitched for a few seconds as electricity surged through it.

“Resume chest compression,” Smoketh ordered Linda.

One more cycle of electric shock and cardiac medications later, Smoketh saw the p-wave on the monitor, followed by QRS. The relief was such that she felt like she had given birth to overweight twins after hours of labor.

“Normal rhythm! Normal rhythm!” she quickly yelled upon looking at the cardiac monitor, her thunder not to be stolen this time. “There’s a p wave! Normal rhythm! There’s a p wave!”

More doctors and Morrison’s family members arrived, and Morrison was wheeled to the ICU. Smoketh thanked herself for her fantastic performance, but had to fight the urge to run to the ambulance parking lot and ram ten lit cigarettes in her mouth in pure stress. To debrief herself, she called me up, and ranted. There were a lot of details, and I told her I would take down notes so I could write about it faithfully in the future.

Smoketh’s was the first face that Morrison saw when he regained consciousness in the ICU. Eyes bleary, Morrison’s first words were: “Na-video mo?”

“I should’ve taken a video,” Smoketh lamented as she shoved salad in her mouth. It was two weeks after the incident. We were having lunch with JP Bowzung and Aia at Sonya’s Garden and I brought the minutes of the event for cross-verification. The details were accurate, Smoketh said, but she had to correct certain dialogue that made them sound like caricatures instead of real human beings. She claimed that she only said “Morrison are you OK?” and not “Please don’t die!”. And that Morrison definitely did not go “I want the tube, I want the mechanical ventilator, I want the epinephrine, I want it all!” while snapping three times in the air in the shape of a Z.

JP Bowzung reminded Smoketh that this was not the first time she had been involved in an incident that required superheroics. Almost a decade prior, as they were driving to PGH from Katipunan she saw a man lying on the road, blood pooling under his head. She asked her driver to pull over, and they brought the unconscious stranger to the PGH Emergency Room. “Trauma!” she screamed as they wheeled the stretcher into the emergency room. The man apparently fell from the bridge, the one that bears the sign “Lagusnilad”.

“St. Thomas Aquinas, St. John the Beloved, St. Catherine of Siena, Mother of God, Tower of Babel, and all the saints and angels in the multiverse: I pray that nothing of this sort happens again!” Smoketh said, shoving more salad in her mouth.

“You forgot Toreng Garing,” I said.

Later that year Smoketh visited her sister, Engineer Morgana in New Hampshire for Christmas. They went to the church grounds for a fundraiser presentation of The Nutcracker, and Smoketh’s task was to help out with her nieces, Chelsea and Hannah, in selling food. Smoketh had cooked a cauldron of American Chopsuey while Engineer Morgana baked sixty pieces of pork pies. The parish priest, Father Mark, approached the parishioners and shook their hands. Morgana and Smoketh entertained themselves by gossiping about the people passing by, making sure that Father Mark was out of earshot.

While taking orders for the food and badmouthing people, Smoketh and Morgana heard a loud thud. They thought that the tubs of pork pies had dropped on the floor, but it turned out to be an elderly woman who suddenly fainted face down on the ground. Everyone started to scream. The elderly woman was last seen normal a few minutes ago by the fruit stall, squishing oranges and other produce to check for plumpness and freshness.

“Doctor! Doctor!”, Smoketh heard her nieces scream.

“Oh fuck it,” Smoketh murmured. After a quick eyeball roll she went on full doctor mode, jet lagged and all. She went down on her knees and felt for the lady’s pulse. No pulse. There was no movement of the torso to indicate spontaneous breathing. Smoketh flipped the woman over and started to do chest compression on the ground, while onlookers screamed and panicked.

“Mouth-to-mouth! Do mouth-to-mouth first!” a man cried behind her.

Smoketh wanted to lecture him on the updates for basic life support. The mnemonic used to be ABC, meaning you have to secure Airway first, then facilitate Breathing by delivering breaths, and then ensure adequate Circulation by doing chest compression. The new guidelines, however, now espouse the new sequence CAB, with circulation being the initial priority. And once available, adding D for Defibrillate. Smoketh wanted to explain this to the onlooker, but by this time her tongue was already sticking out of her mouth from pure exhaustion.

A man ran to Smoketh and introduced himself as Dr. Greg, a urologist. He had just called EMT on the phone and told Smoketh that he would take over in doing the chest compressions. Smoketh moved aside, stretched her neck up, and inhaled as much cold air as she could. Chelsea started to cry, but was immediately comforted at the sight of a middle-aged woman walking towards her, probably to hold her hands and tell her it will be okay. The woman then told her, “hija, do you still have American Chopsuey?”

The EMT’s arrived and rushed the grandmother to the hospital. She was alive. Dr. Greg was still on the ground, panting, leaning forward and using his arms for support. Smoketh started to catastrophize that he would then have a heart attack, or an emphysema exacerbation. She also started to worry that they might get sued for pulverizing the poor grandmother’s breastbone and ribs.

“There’s a Good Samaritan law here, and the important thing is that she’s alive,” Morgana later explained. “By the way, Dr. Greg is so handsome! Don’t you think so?”

“Is he single?” Smoketh asked. “Is he?”

“So was he single?” I later asked Smoketh. JP Bowzung and Aia waited with baited breath. It would have been the most romantic thing, falling in love after an episode of shared breathlessness, leading into more days and years of blissful breathlessness.

“Well, famished after that unexpected workout, Dr. Greg bought five pieces of pork pie. To share with his wife and two kids,” Smoketh said. “So definitely not single.”

“Not even superheroics can get us a man these days,” Aia said.

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