Day One of Surgery is Over

Well, day one of surgery is behind me—at least my part.  Anita and I admitted the patients, which means that we checked their blood pressure, checked for any ordered blood work—there is very little— temperature, respirations, pulse and listened to their  lungs and heart.  None of the kid’s parents knew how much they weighed or how tall they were—they have never been weighed or measured at ages 12 months to 13 years.  The same with allergies—the parents looked puzzled since none of them had ever had any medication.  In fact, by asking, it lead to a long explanation of what an allergy is!  Tomorrow, I’m skipping the allergy question to make life easier for all of us.  Informed consent?  Nada.  I asked if they had any questions and that would be no.  I asked parents if they are worried or anxious, no again.  This certainly ain’t Bellevue!

After the admit, we give each mom or patient a small bar of soap, a washcloth and send them to the bathroom to wash their faces FIRST since that’s where they are operating and then the rest of the body.  Teaching them to put on a gown is truly laughable.  They are so sincere and want this so bad and try to be so compliant and helpful.  The ward is full even though we only do 3-4 surgeries daily.  Many are from so far away, have no place to stay and some have never seen a city before and there is also the concern that they won’t come back if they leave. This is the first time many have seen beds, sheets or toilets.  There is a problem with sending some of the patients to the shower since they have never seen one before and defecate in the shower and wash up in the sink!  Our ward is on the second floor with stairs leading out to the dirt yard.  It is strung with clothes lines since the families of all patients are living on the grounds and need to wash clothes, people are cooking and resting on mats in both sun and shade—and it’s hot.  All the women look like they’re ready to go out—the dresses and headgear is beautiful and it is impossible to tell economic class by their dress.

The admit and post care area is together in a big room on the second floor of the pediatric wing.   We walk the patients down our hall, down the stairs the operating room is across the street and down a long hall.  After they recover—today on a mattress on the floor outside the OR since someone took the stretcher (and left the mattress pad), they are carried or walk back to our unit.  The person in recovery is a Norwegian general practioner who is quite a funny guy and it’s good to have him in case anything goes wrong post op.  Also, he is big enough to carry the patients down the hall, past the masses of people in the lobby, the entrance, across the street, through security again to get into our building.

I haven’t seen the operation yet, but during the first and second surgery today, the anesthesia machine stopped working, which for most surgeons would cause a big problem, but I guess surgery went on!  The surgeon, anesthiologist, and recovery doctor have done this before and seem unfazed by all of the problems.  All three are men of unshakable faith that believe that God sent them here and will help.   Before every surgery there is a prayer to keep the patient safe and help the surgeon, anesthiologist, and assistants. 

The real reward came when Abduman, 12 years old, came back from surgery with a horrible cleft lip closed.  I passed his grandfather walking out onto the fire escape with tears in his eyes.  I don’t know if he was worried or just so happy to see his grandson’s face look more normal.  With their cleft lips unrepaired, these kids are extremely discriminated against in addition to the eating and drinking difficulties that they have.  Hard to believe that this little boy got to be 12 years old with such an obvious and severe problem.   

As I'm finishing writing this, one of the Mercy Ship volunteers knocked on our door to tell us that, patient #3, Nassim, 12 years old is in surgery, the cautery machine isn't working and the doctors can't stop the bleeding.  Her husband is an engineer and he ran over to the hospital to see if he can fix the machine that cauterizes Nassim's blood as they operate.  I really hope God truly is watching over all of this because the equipment, electricity, sterility, and lots of other variables make this a very difficult job!