Turning in my keys...

I don’t even know where to begin with this post.  I’ve talked directly to a few key players at the hospital, and word is slowly making its way around the hospital and around town that “Doctora Heydi” will likely not be coming back to Chichicastenango…

With Dr. Hoak’s deciding recently not to regularly return to Guatemala for general surgery care, and the upcoming retirement of the hospital administrator who has been so supportive of us for years, and the upcoming retirement of Alma our scrub nurse, and the likely departure of our beloved and trusted nurse Angelica who does much of our follow-up care after she finishes her professional nursing degree… PLUS the completion of the operative suites at the Hospital Adonai out in Canillá which I’ve been privileged to be a small part of from the time we were literally sketching it out on napkins about five years ago—well, long story short, after much prayerful consideration—I’m packing up my clinic here and literally moving it out to Canillá starting February of 2020! 

This is incredibly bittersweet—sweet, absolutely, in the sense that I will get to spend more time with my dear friends in the Ficker family (read more about them at adonaiinternationalministries.com, those of you who don’t know them!  They were a second family to Matt and I when we lived here in Guatemala and have mentored us in every possible way from the birth of our son to the rebirths of our souls…)   But certainly bitter in that I will no longer be visiting every few months with the amazing and generous and loving staff of the Good Samaritan Hospital here in Chichi.

I’m not even sure I realized how hard this would be, y’all!  And there will be rebuilding, and relearning, and re-teaching of the new staff at the new hospital, and it will all be in God’s perfect timing, we trust.  It will be wonderful and hard and everything that Chichi has always been and then some… Will you please continue to pray with me as we make the transition? 

Tomorrow I will turn in these keys for the last time—the ones with the ten year-old piece of tape on the back of the Lord’s Prayer keychain that says “Dr. Heidi Bell clinic”—the ones that I pray have opened doors not only for me to practice my craft, but also for patients to feel safe and cared for and—dare I say—loved with just a tiny foretaste of Jesus’s love for them—the ones that I have to ask to “borrow” for the week every. single. time I come down here, when they again open the door for me but don’t leave me the key for the week—the ones they have kept in a drawer for 11 years now, just waiting for me to come down in another three or four months and trusting that I would. 

I snapped this picture tonight when I looked at them and couldn’t hold back my tears.  Isn’t it funny how the littlest things can bring on such on onslaught of memories and emotions? 

So yes—tomorrow, I turn in my keys again for the last time here in this town.  And I look forward to seeing how God continues to open doors—with or without physical keys!—in other parts of His kingdom.

Keep Praying Please!

Ugh.  Today was a long day.  To those of you who were praying for us today, THANK YOU.  We could definitely feel it, and we definitely needed it! 

We started off OK in the OR, and fairly calm in the clinic—three patients we saw before starting our cases, which was nice.  Our first patient, Esmirna, did quite well in her long vaginal case and should have a great outcome and recover well.

The second surgery, which we thought would be the easiest (a “quick” abdominal hysterectomy), was a nightmare.  Literally.  You know those nightmares or horror movies that involve blood spraying across the room or being collected in bucketfuls?  Yep, that kind.  Lost probably at least 2 liters of blood (likely close to half of her blood volume) and clearly had a heck of a time getting the 12 cm fibroid out from under the uterus.  (For you medical/gyno folks, it was a 12 x 8 cm fibroid essentially growing retroperitoneally off the back of the cervix… huge, ginormous, bleeding mess!)

Again, thanks for those who got the word during the surgery to be praying for Dominga, and please keep it up overnight!  She looks fairly good right now, about 2 hours post-op, and we will go check on her again in another hour or so before any of us will be able to sleep. 

These cases always serve to remind us how much we have to respect the privilege of being surgeons.  I’m so thankful to be here this week with two other amazing gynecology surgeons.  It is definitely a privilege not to be taken lightly, and one I am honored to have.

Good night and sleep well, friends—we are exhausted and happy to have only one surgery scheduled tomorrow.

Getting Started in the OR

Today, as usual, was a whirlwind of operating, getting new folks oriented to the OR and hospital, and seeing patients in the clinic in between surgeries.  We saw an additional 11 patients and got our three scheduled surgeries done.  We were able to schedule two more patients for a current schedule of three major surgeries tomorrow and one on Sunday.  There were also a few clinic procedures we were able to get done.

Thankfully, all of the OR cases today went smoothly—please continue praying for Natalia, Maria, and Manuela in their continuing recoveries.  We will check on them again after our dinner and then hopefully crash for a good night’s sleep! 

Probably our cutest patient today was a little old lady—like, in every sense that phrase drums up in your heads!  She was 81, all kinds of stooped over and slow-moving, and cute as a button.  We ended up doing a quick biopsy on her that we are hoping will come back with good news.  But the cutest part was when Denise handed her a maxi pad since there might still be a little bit of bleeding—and she had no idea what to do with it!  I’m sure those types of things were not available when she was still needing them 😉

The quote of the day is probably when I told our scrub nurse that I knew it had been a long day, but falling asleep during the case really is not OK!  Sad but true story. 

Speaking of scrub nurses, though, those of you who know our sweet friend Alma, do please pray for her!  For those of you who don’t, she is the scrub nurse that has worked with me for 13 years now, and at the hospital for 36 years!  She’s not fast, super-great about sterile technique, or very safe with the needles and other sharp things on her table—but she will never, ever fail to show up when you need her!  And she will never fail to pray for the patients and truly care for them. 

She is working but didn’t scrub today, and really looks quite horribly ill.  The only thing she has been diagnosed with is severe gastritis despite many tests and seeing many doctors.  I actually asked the lab to draw a hemoglobin on her today because she looked so bad and was dizzy!  It came back OK, but definitely on the low side for women here at high altitude (we are at about 6900 feet).  Tom has looked at her as well, which makes me feel better.  But I really do worry about her. 

First Day in Clinic

So, it occurs to me now that the second post of the trip is almost always called, “Long Clinic Day” or something of the sort… and today is no exception, of course!  We started our day around 7 with the trip to the grocery store we missed out on last night.  Then we got fully started in clinic by about 9, finishing up tonight around 6:40.  Not the worst day I’ve had by far, but still pretty long!

We only saw a total of 24 patients, but we hear there are lots more coming tomorrow!  We also only scheduled 5 surgeries so far, which we hope increases also. Tomorrow we will begin with two big hysterectomy cases and a smaller biopsy case.

There were a lot of great patients in clinic to pray for today, though—my two favorites (I know I’m not supposed to have those… 😉) were on opposite ends of the spectrum—the first was a sweet lady that had been told she had very large fibroids and needed surgery.  When we told her that her fibroids were actually quite small, she was 100% convinced that God had worked a miracle and removed them.  She said they were all the way up to the top of her stomach, which I’ve definitely seen, but not today!  She literally wailed her gratitude out loud (very loud, actually) and was unbelievably relieved.  It is such a privilege to be able to give great news!

The other lady, sweet Maria… can you please pray for her with us?  She was diagnosed in June with endometrial (uterine) cancer, and has traveled all over the place looking for care.  Quiche sent her to Quetzaltenango, Quetzaltenango sent her to the cancer hospital in Guatemala City, the cancer hospital sent her back to Quetzaltenango and said she needed surgery, Quetzaltenango sent her back to The City for a CT scan, then scheduled her surgery.  Then postponed it.  TWICE already.  Once because they had too many patients scheduled or something, and once because the doctors were in some kind of meeting?  She is currently scheduled for December 2^nd.  I’ll be a little surprised if she lives that long, to be honest.  She appears to have quite a bit of cancer in her belly, and definitely has metastatic disease that we don’t know the extent of.

Unfortunately, she has more disease than we are capable of operating on as general OB/Gyns—we debated this long and hard, but eventually had to come down to “first, do no harm”—we would definitely rather leave the patient the same instead of worse!  Hard to turn them down, but they were so gracious and understanding—almost made it worse.  We prayed with them; they are in a good church and have faith that whatever happens is God’s plan.

The only thing we were able to offer her was a little bit of help for her anemia.  Y’all, her hemoglobin was 5!!!  Usually here in the mountains, 14 is even on the low side.  So since I’m O negative, I could at least offer her a bag of blood.  The lab technician was kind enough to come in to our clinic to collect the blood while we kept seeing patients, so that worked out nicely… At least she can have a little more energy for a bit.  We also gave her meds to try and control her bleeding and some iron to help build her back up.  These are the hard parts of medicine whether here or in the US, though. 

So please pray for sweet Maria.  She and her husband are so sweet and adorable in their tattered clothes but beautiful souls.  And pray for us as we face another very busy day tomorrow in the OR and seeing the 15 or so patients that got turned away this morning to come back tomorrow… fingers crossed for good rest tonight and some more surgeries to schedule tomorrow!

"Meet the Team"... again ;-)

Yup.  You guessed it—“Meet the Team” time!  Sorry I’m just not very original…

But I’m thrilled to have with me on this trip two other OB/GYN surgeons—what a blessing!  Many of you will remember Dr. Kathryn Pool, who is now on her THIRD trip down with me since last summer!  She hails from Columbus, Ohio where she practices full-time and raises three teenage and young adult girls with her Internist husband.  That’s a busy life to sneak away from for even a week and I’m so glad she did.  She could use some extra prayers this week for strength and some rest as she had to go to Australia less than two weeks ago to help her parents—her father fell ill on the first day of a planned 53 day cruise there!  Thankfully he is home and doing better now, but I can’t fathom that level of stress and jetlag…

Dr. Denise Tukenmez joined us here at the Guatemalan airport all the way from California!  She, like Kathryn last year, just “met” me online through a Facebook group for OB/Gyn Moms that we are all in.  I’m completely awed every time someone new just up and volunteers to come down sight unseen!  Her oldest daughter is currently starting out a year in Spain, and her youngest is missing her at home.  I’m so thankful for supportive families at home that make these trips possible.   She works at a county hospital in the Bay Area and has a lot of administrative duties.  It was a tough time for her to leave (they just went live on a new EMR system!), so please pray for her to have a great week as well.

Then there’s me, for those of you I haven’t met—I’m Heidi Bell, another OB/Gyn who lived here in Guatemala as a full-time missionary doctor from 2006-08.  I’ve had the privilege of coming back down three to four times a year for a week each time to grow a surgical practice here.  It’s been nothing short of amazing and miraculous how God has continued to sustain our efforts here over the years.  I could tell stories for days (and I have!), but for now I’ll just let you look forward to hearing the stories from this week for starters…

Unfortunately we (well, I) had some struggles with customs today for the first time in forever—but that means a late start getting up to where we are staying and possibly no time to get groceries tonight.  That makes for an even tougher start to a long day in clinic tomorrow.  Pray for supernatural strength and great attitudes please!  (I must admit I didn’t have the greatest attitude in customs today :-/)