It was the worst headache of his life.

And he came to me in a dazzling display of pain, anguish and uncontrollable rage. Like the travesty of losing your own mind, the travesty of having an unstoppable bleed moving through the crevices of your brain is enough to make anybody seem crazy.

It was 7pm and as I was going to my usual rounds at the ambulatory care in the Philippine General Hospital when I met him. A 75 year old male who has been drinking for sometime when it happened: a headache so profound he seemed like he was losing his mind, described of course perfectly by Adams textbook as "the worst headache of his life".

So I stood looking at him trying to dissect him, identify the other symptoms and enumerate the differentials, browsing through what I learned in neurology, anesthesia and psychiatry when it hit me - it was subarachnoid hemmorhage at its most profound presentation.

I was lucky, I thought at first. Not all physicians will be able to see what I just witnessed. Recognizing the symptom before the diagnostics and the laboratories.

CT Scan confirmed finding of a subarachnoid hemmorhage probably from the tip of the basilar artery to explain the massive involvement.

Nice, I thought. Then halfway through transfering the patient and following him up at the Neurosurgery ICU, I remembered the epiphanies, the lessons and all the other whatnot's that made me want to become a physician.

For before the oaths and the unbearable responsibility, I wanted to become a physician because I wanted to alleviate pain and suffering.

Referred to ACU, Neurosurgery. Scheduled for aneurysmal clipping.

And hopefully with this small token, I would have done my share in alleviating his unbearable and indescribable experience.