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.

Tuesday, February 26, 2013

MACLA Medical Mission Part 2

The first day of the MACLA mission was a short one. We each picked out two sets of scrubs (to which I whimsically referred for the duration of the week as, “fancy doctor outfits”) and spent some time to getting to know the medical team and the facilities. The portion of the hospital we were to occupy consisted of five operating tables in three different rooms as well as a recovery room with four beds and two additional rooms containing eleven beds where patients were prepared for surgery and seen by doctors and physical therapist when they finished.

Fellow volunteers Alyson and Dustin

After our orientation, a group of MACLA people informed us that they were heading to Juan Dolio, a public beach on the south coast about half an hour east of the capital. Having never been before, I seized the opportunity, and soon found myself eating lunch there with a group that included a handful of other volunteers along with Katrina, a resident at Research Medical Center in Kansas City, Danielle, a fourth-year medical student, and Kevin, a GIS specialist whose dad founded and runs MACLA.

Volunteers Dana and Jose with medical student Danielle

Despite the restaurant’s awful food and trademark Dominican service (we couldn’t get anyone to even acknowledge us once we’d been served), it was nice to be at the beach and get to know each other. I hadn’t had much opportunity to hang out with volunteers who have gotten here since I arrived in the country. I was also excited to learn more about our visitors from MACLA. While we ate, a group of about ten more of them arrived and went straight to the beach.

Occupational therapist Eileen with volunteer Ashley

The rest of the afternoon we spent lounging on the beach and dipping in the sea. Unbelievably, we were hassled over and over for bringing our own rum and coke and even forced to dump out some ice that somebody went and bought at the nearest convenient store about 20-minute walk away. I tried to imagine the same scenario playing out amongst Dominicans at any other beach without resulting in fisticuffs. It was impossible. I resolved to never again visit that particular beach.

Friday, February 22, 2013

MACLA Medical Mission Part 1

I arrived in the capital not quite knowing what to expect. For almost two years I had been hearing on and off from other volunteers about their experiences assisting medical teams that come to the Dominican Republic, but there is only so much you can learn without seeing for yourself. The mission I was volunteering (MACLA; Medical Aid for Children of Latin America) for is one of the most coveted by volunteers. For a week, I would get to stay at a hotel in the capital and spend my days at a hospital translating for patients, surgeons, doctors, and anesthesiologists before and after the many surgeries that would take place.

Left to right: Volunteers Dana, Jose, Ashley, and Matt hold yours truly

My first stop in Santo Domingo, as usual, was the Peace Corps office in Gazcue. Having decided that I would conclude my Peace Corps service in July, I am acutely aware of the stockpile of possessions I’ve acquired over the past 23 months and, determined to be prepared when the time comes to vacate my apartment, I have begun discarding worthless items and hauling with me boxes of things to give away to other volunteers.

Copy of P2110010
Left to right: Patricia, Del, Me, and Katrina

The Peace Corps office was especially busy that day. PCV’s from all over the country had descended upon the capital for one of the semi-annual three-day stretches of planning and coordinating of national initiatives known as CORPS Forum. My jaunt into the volunteer lounge delivered more than its usual burst of social anxiety as well as excitement and happiness at being briefly reunited with friends I so rarely get to see.

Arrive before dawn in the courtyard at Hospital Bellini

After jettisoning my payload of hand-me-downs and running a couple of errands, I called a cab to the hotel and was on my way. I was the first to my hotel and welcomed my first hot shower in months, along with a luxurious rest on a bed not filled with air.

Thursday, February 7, 2013

The Rocky Coast Part 2

I decided to walk up the coast in the direction of the sugar factory, inspecting the drop-off all along the way for signs of a promising handhold. I saw a few spots that looked alright, but they tended to be covered in crabs. Finally, I could see in the distance the dividing wall that delineates the boundary of the sugar factory and the gated community that surrounds it.

Andrew jumps into a charco (natural pool) in Punta Cana during his visit last summer

As I approached the wall I cold see some figures coming toward the ocean along it. Before long there were about a dozen Dominican teenagers, poking around a certain spot along the rocks and making talk of jumping in. I didn't know what to think, since some of them sounded apprehensive. But right about the time I began to conclude that they were all going to chicken out, one of them stripped to his boxer and turned a somersault from the highest point into the brine.

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Playing Dominoes with Clínica staff at a party the med students threw at the guest house

I watched with a bit of trepidation as he made his way back toward the rocks and, to my surprise, DISAPPEARED INTO THEM at the water's edge only to reappear a moment later inside a sinkhole a few feet back from the sea. After watching a couple of other come ashore by more conventional means, I decided to give it a try. The water could not have felt better. The kids were so stoked to see the gringo doing it too. I think they were used to seeing foreigners who were too afraid to get off their tour buses, let alone hang out with them at the swimming spot.

Monday, February 4, 2013

The Rocky Coast Part 1

There's this neighborhood down by the ocean called La Caleta that I explored on my first visit to La Romana, when I tried to bushwhack my way through the thick brush down to the sea. That time, I ended up getting stung by wasps, so I turned back early, but I discovered a path and had been wanting to explore it ever since.

The crowded counter and sink in the tiny kitchen of my new apartment in La Romana

I was resolute, but not entirely optimistic about my prospects when I went a second time today, since I didn't know how many people knew about the trail or even whether it made it all the way to the coast, but my hope was to get a nice little stretch of ocean all to myself. Well, it turned out that was just the case. Apparently, if it's not a beach here, nobody hangs out there.

The view of Sagrada Corazón de Jesus cathedral from the balcony I where I used to live in Moca

The whole rocky coastline, from what I could tell, was made up of fossilized coral and went out maybe 50 feet from the brush and trees before abruptly dropping about 10 feet into the churning water below. I had just walked for about 40 minutes and the thought of a nice dip sounded divine, but there didn't appear to be a safe spot where I would have good prospects of climbing back out.