Wow

Wow.

“Whirlwind” doesn’t even begin to describe the last two days.  Dr. Kelly Holder (a former resident of “mine”, now all grown up and rocking out her career), Dr. Suzy Schulte (a pediatrician I’ve known since my Houston residency days that married Matt’s best friend) and I arrived safely here in Guatemala late Saturday evening.  Luckily, we rested fairly well that night.

Sunday, there were nearly 40 patients waiting to see us!  The ladies at the hospital had started a list they were turning away after the first 20, but we vetoed that plan when we caught wind of it (which in retrospect may not have been the brightest idea—we were there until nearly midnight seeing over thirty!)  It was a little frustrating that we only scheduled nine of them for surgery of the bunch, but at least we can help those nine and were able to reassure quite a few others. 

I know 30 doesn’t sound like a lot, but you have to remember that many of these patients need translation from Spanish to Quiche language, are all new to us, and are often very poor historians so it takes a while to get to the real chief complaint—here’s an example:

How can we help?

My feet burn.

OK, anything else (hoping the gynecologic complaint will be next)

Really bad—like, super bad.  I can’t sleep at night.  And all the way up my legs.

OK, anything else (same hope)

Both sides!

OK, we are here for gynecology problems. Do you have anything wrong with your uterus?

Well, “they” say it’s my uterus causing my feet to burn.  They really hurt bad (rubbing feet) And my arms. They really hurt, too!  And, oh how my uterus hurts my arms and head too!

OK, how do “they” say it’s causing these problems?

Well, they say I need surgery because of my tumors…

[5-10 more minutes of this non-sense generally passes before an ultrasound is generally presented diagnosing fibroids that are either (1) tiny and don’t need to be operated on or (2) ginormous and should have been removed years ago but the patient couldn’t afford it.  There’s rarely an in-between somehow.]

Then you also have to remember that this visit is also the initial visit, the pre-op visit, the financial counseling visit, and the pre-op labs, so it’s hard to hurry much.

And then all of that has to be fully documented.  In—you guessed it—Spanish.

We thankfully had the help of two nurses from the freshly minted class of 2017 (?) in Canilla, Ever and Mica this week—they are here to try to learn some OR nursing skills but so far have probably given more than they have received, unfortunately.  They did scrub with us today and are hopefully gaining quickly in skills so we can get the OR up and running out in Canilla soon!  They are wicked smart and have great surgical instincts.

Today, we saw about 10 more patients in clinic in between three major and quite grueling surgeries.  Everyone did great and kept great attitudes (OK, except for maybe me…) up through around 11 pm again.  We. Are. Exhausted. 

I will try to post some pictures soon; I promise!

Wow.

“Whirlwind” doesn’t even begin to describe the last two days.  Dr. Kelly Holder (a former resident of “mine”, now all grown up and rocking out her career), Dr. Suzy Schulte (a pediatrician I’ve known since my Houston residency days that married Matt’s best friend) and I arrived safely here in Guatemala late Saturday evening.  Luckily, we rested fairly well that night.

Sunday, there were nearly 40 patients waiting to see us!  The ladies at the hospital had started a list they were turning away after the first 20, but we vetoed that plan when we caught wind of it (which in retrospect may not have been the brightest idea—we were there until nearly midnight seeing over thirty!)  It was a little frustrating that we only scheduled nine of them for surgery of the bunch, but at least we can help those nine and were able to reassure quite a few others. 

I know 30 doesn’t sound like a lot, but you have to remember that many of these patients need translation from Spanish to Quiche language, are all new to us, and are often very poor historians so it takes a while to get to the real chief complaint—here’s an example:

How can we help?

My feet burn.

OK, anything else (hoping the gynecologic complaint will be next)

Really bad—like, super bad.  I can’t sleep at night.  And all the way up my legs.

OK, anything else (same hope)

Both sides!

OK, we are here for gynecology problems. Do you have anything wrong with your uterus?

Well, “they” say it’s my uterus causing my feet to burn.  They really hurt bad (rubbing feet) And my arms. They really hurt, too!  And, oh how my uterus hurts my arms and head too!

OK, how do “they” say it’s causing these problems?

Well, they say I need surgery because of my tumors…

[5-10 more minutes of this non-sense generally passes before an ultrasound is generally presented diagnosing fibroids that are either (1) tiny and don’t need to be operated on or (2) ginormous and should have been removed years ago but the patient couldn’t afford it.  There’s rarely an in-between somehow.]

Then you also have to remember that this visit is also the initial visit, the pre-op visit, the financial counseling visit, and the pre-op labs, so it’s hard to hurry much.

And then all of that has to be fully documented.  In—you guessed it—Spanish.

We thankfully had the help of two nurses from the freshly minted class of 2017 (?) in Canilla, Ever and Mica this week—they are here to try to learn some OR nursing skills but so far have probably given more than they have received, unfortunately.  They did scrub with us today and are hopefully gaining quickly in skills so we can get the OR up and running out in Canilla soon!  They are wicked smart and have great surgical instincts.

Today, we saw about 10 more patients in clinic in between three major and quite grueling surgeries.  Everyone did great and kept great attitudes (OK, except for maybe me…) up through around 11 pm again.  We. Are. Exhausted. 

I will try to post some pictures soon; I promise!