Humble Pie

So every now and then, I make the grave mistake of starting to think that I kind of have some stuff together.  I start becoming confident in my surgical skills, or my parenting tactics (ha!), or sometimes even in just my ability to be a “good person”.  Those are the times that God, in his grace, steps in to humble me before I really manage to get out of control!

This week—and especially today—was clearly one of those times.  I’ve been going along nicely for a while now, without really getting in to anything scary or nerve-wracking or starting to feel like something I couldn’t handle in the OR.  I’ve also been going along nicely for a while without encountering any really major surgical complications in my patients.  Do you know where this is going yet?

So this week, I got to take not just one but TWO former patients back to the operating room for repair of a surgical complication—one from earlier this year and one from three years ago!  I’ll spare you the details since you aren’t all gynecologists, but suffice it to say that neither of their conditions was at all pleasant to think about living with.

Dr. Hoak was ready, willing, and ABLE—as always!—to help us repair a fistula, and I thank God that he and I were finally down here at the same time (I haven’t seen him in about a year!) when this lady came in so I didn’t have to put her off until further help could be found.  Her surgery took us several hours yesterday, but she looked great this morning.  She is in for quite a long recovery, but we are hopeful that she will be feeling much better soon.

Today we took another lady back, who had a repeat of “things falling out” after we did a hysterectomy and fixed those things three years ago!  This is a known risk of the surgery, but heartbreaking when it happens.  I’m very hopeful that she will feel much better now after her re-operation today (colpocleiesis for you gyn-curious folks—if you don’t know what that is, suffice it to say you do NOT want to Google it!)

Our second case today was a very sweet and very bright young lady who wanted to wait until today to operate because she has University classes on Saturday.  We knew her case was going to be challenging, but neither Lee Ann nor I has ever encountered the amount of bleeding that we did on starting the case as a vaginal surgery.  Every single clamp we placed after the first few seemed to only make the bleeding worse, when anatomically they “should” have stopped it easily!  

It wasn’t long until I asked the nurses to start asking the family to gather up some blood donors for the patient as it looked like we were headed towards the need for transfusion.  I’ve always felt I had a bit of a safety net since I’m a universal donor in case of emergency, and after a few minutes I asked them to actually send someone in to use my foot to collect a unit of blood from me while I operated with my hands!  

THIS was when I finally learned that today, apparently, there is no one available in the hospital lab who can perform the studies needed for a transfusion.  Umm, this would have been good information to have before we were in the process of losing what turned out to be about two-thirds of her blood volume!  Thank GOD Dr. Iris Gamez, a REALLY good anesthesiologist, was here today and on top of it!

It was clear by now we needed to open up the abdomen emergently to get the bleeding stopped, which we did quickly—but the damage was definitely done.  Dr. Gamez struggled with meds and fluid for several hours before someone arrived at the lab that could make a transfusion happen. Her family members stepped up like I have never seen a family here step up before, and long-story-short, she has now received two of three total bags that she will end up receiving. 

There is nothing quite as humbling, confidence-shaking, and exhausting as realizing how close you came to actually killing a patient by operating on them.  May we never forget to properly respect the privilege granted to us of operating on another human being.  It is indescribable how cool it is to know you can cut things open, fix them, sew them back up, and cure a patient’s problem. But let us not forget that with great privilege comes great responsibility, and let us continue to pray for Ester’s recovery.

The hospital we work at here, the “Good Samaritan” hospital, is truly a place that I believe is blessed by God’s hand.  For all the faults and missing equipment, and for all the grievous errors or breaches of “sterile” technique, we have almost inexplicably good outcomes.  I believe with all my heart, and have for many years, that it is only a result of God’s grace being poured out due to the people working here with true hearts for the patients and in obedience to The Lord.  

So tonight we will go to bed exhausted—physically, mentally, and emotionally—but resting assured in God’s love and provision for us as we bumble along in this world trying to make the most of it.