Friday, March 8, 2013

MACLA Medical Mission Part 5

I had never seen a cleft palate before. It looked like someone had taken a knife, cut down the middle of his uvula, and continued another half-inch into the soft tissue attaching it to the roof of his mouth. The surgery is basically the opposite of the finger separation. The outermost layer of tissue along the cleft is removed and then the two sides are sewn together. I watched as Matt deftly hooked a tiny needle through the pink tissue and tied a suture that looked like fishing line. My job was to cut the needle from the suture and cut off the excess line while using a little suction device to clear the area of saliva and blood so he could see what he was doing. Before we were done there must have been about a dozen sutures.

Dana, Ashley, Norma

When the surgery was finished, the Dominican doctor assisting the surgery began reversing the general anesthetic. Little by little, the patient came awake and finally began to gag on his breathing tube, a normal reaction. Unlike some of the others, he didn’t jerk much when we lifted him from the operating table to the gurney that would take him to recovery. Later we got this one patient, a teenaged girl who would have been flailing and kicking while she came out of anesthesia if we didn’t have me, a nurse, the surgeon and a couple of orderlies holding her down. I’m told this is just what happens with some patients. Wow.

Alyson, Dana, Jose, Norma, Dustin, Ashley, me, Paul

The last day was short. It was just a morning for patients from earlier in the week to come get their dressings changed and get medication and advice. At the end of the day, when the surgeons, doctors, nurses, and therapists began to trickle out, I couldn’t help feeling a pang of heartache at the realization that it was over and though I could keep in touch, we would never be assembled like this again. Over the course of the week I had really come to like these visitors from the US and however little the time we’d spent together, I’ll be damned if it didn’t hurt to see them go.

Tuesday, March 5, 2013

MACLA Medical Mission Part 4

PCV's from left to right: Dana, Jose, Paul, Ashley, Norma, Dustin

After another day in pre-op, it was finally my turn to put on foot, hair, and mouth covers and go back to the area where the doctors were actually operating. The first surgery I sat in on was of a little girl with two fingers that had grown together who was having them surgically separated. I piece of skin was removed from her belly and sewn to the sides of the fingers that had grown fused together.

During the procedure, Dominican staff and Americans exchanged conversation through me about the technical minutia surrounding things like LMA’s versus breathing tubes, oxygen saturation in the blood, and so on. I was glad that medicine names are usually easily understood in both languages and that most anatomical words share the same Latin or Greek root in both English and Spanish.

I continued to translate throughout the morning until finally Matt, a surgeon in his sixth year of residency in Chicago told me he was going to let me assist in an actual surgery! Encouraged by the fortitude I had shown thus far, I decided to face a long-standing fear I have of blood and gore and join him in the operating room. After thoroughly sterilizing my hands and forearms and donning latex gloves and a paper gown, I took my place facing Matt, standing over an anesthetized man in his 20s or 30s with a cleft palate.

Dana, Matt, me

Friday, March 1, 2013

MACLA Medical Mission Part 3

On the first day of surgeries, I was assigned to pre-op. This was a room with six beds where people came to be seen by Katrina, the resident physician, as well as Del, the anesthesiologist, and whichever surgeon was expected to do their operation. Katrina speaks decent Spanish and really only needed sporadic help with the occasional difficult question. I mostly helped translate questions from Del such as, “Have you been ill this week or last week?”, and, “Do you have allergies to any medicines?”

Jose, Dana, and Alyson in pro-op
The whole time, another volunteer, usually Norma Ochoa or Alyson Davidson, maintained an elaborate chart that contained the status of every surgery planned for the day and corresponded via walkie-talkie with Del’s wife, Patricia in the Operating Room (OR). Whenever a patient went to surgery, we brought in another one from the waiting area in the hall. Periodically I was sent to the storehouse on the roof for supplies or on some other errand. With all that was going on, the day went by remarkably quickly.

The next day I was assigned to post-op and recovery. This was a little more of a dramatic position since some of the patients, especially the younger ones, weren’t happy campers coming out of surgery. My understanding is that it can be a little off-putting to come out of general anesthesia, even if you’re not too young understand why you’ve got some body part all wrapped up in gauze. Luckily, almost everyone we helped was numbed in the part of their body where they were operated on, so the pain was at a minimum. For the most part I just helped the physical therapist communicate with patients who were getting splints and braces for the limbs and digits the surgeons had worked on.

Peace Corps volunteers and MACLA volunteers in the lobby of the hotel

I was paired to Jose that day. He stayed back in the recovery room most of the time, since he hopes to go into medicine and this was more relevant to his interests. I got to spend some time in recovery too. It’s where patients go once they begin breathing for themselves but haven’t fully come out of anesthesia. Some people in this stages jerk around and have spasms as part of the process. I was glad that Jose wanted to be the one to hold down this room.