Finally, I get a chance to sit down and reflect on the trip that took place and share our experiences with you all. We flew out of O'Hare on Saturday morning, and the trip started out with great success as I was able to talk to the manager at the JetBlue check in counter and get all of our second bags packed with medical supplies checked onto the airport for free -- saved us about $600-700. We connected in San Juan and arrived in the DR that evening. The medical team from the prior week was on their last day, and we were able to meet up with them for lunch and discuss a bit about what they did and the patients they saw. Sunday morning we left Santo Domingo and drove about 3 hours to Peralta, where we spent a bit of time sorting through our supplies and started pre-screening patients for the surgeries in the coming week. The general surgeons will be doing things like hernia repairs, mass removals, hysterectomies, tubal ligations, etc. and the orthopedic guys will be working in a hospital in Azua. Sadly, we didn't have a great deal of supplies as far as orthopedic stuff goes, so we had to turn away some people that could easily be fixed in the states. Things like plates and screws are not cheap, and they are hard to come by in the DR. Motor vehicle accidents are common around here, especially motor bikes vs cars/vans/trucks, so lots of broken bones. We saw one guy right off the bat Sunday morning who had previously shattered his femur and had some plates put in, but reinjured somehow and came to us with metal hardware sticking out of his knee -- basically have to amputate here because otherwise we would need 5-6 surgeries with a total process of about a year -- impossible here. He never showed up for surgery, I guess he was keen on the idea of keeping his leg, though the infection that he has will kill him at some point.
That afternoon we worked in a clinic in the main part of Peralta, and I lost count on how many patients we saw, but I think we scheduled about 40 surgeries, and declined quite a few cases or deemed them non-surgical candidates for one reason or another. The masses were gathered outside and we sadly had to turn away another 50+ people that we just could not possibly see. At some point you realize that we can't fix everyone....though that doesn't make it any easier. Having to walk through the crowds and apologize that we had no more space....words don't quite describe it. Some of these people travelled several hours, and waited all day long to see us....and we couldn't help them. Again, you have to realize that there is no way that we could see everyone, and there will always be more to patients to treat. But, that's the benefit of working with a group like this that returns to the same area over and over, year after year.
We scheduled about 6-7 general surgery cases a day, and a gen surgeon who does OB/GYN stuff who is from the DR came in to volunteer and do hysterectomies and tubal ligations, and he has a good number of those scheduled each day.
Monday morning we started our surgical cases. I started out helping in the pre-op area, getting IVs placed and all that. Then I started to circulate the OR with our two gen surgeons, scrubbing in on a few cases throughout the day to help assist or close the patients. Surprisingly, things ran fairly smoothly for being the first day. We did 6-7 gen surg cases, 2 hysterectomies, and 6-7 tubal ligations. Every surgery went well. We had one patient several hours later who spontaneously went into respiratory distress and was found cyanotic and not breathing. She ended up doing ok - though we monitored her throughout the night and made sure she continued to breathe. She ended up having some strange narcolepsy disease, but it had been going on a long time. So, as soon as she was ok to go home, we discharged her.
The group I'm here with is absolutely amazing - gen surgeons, ortho, nurses, PA student, CRNA, and our fearless leader Dr. Stephanie Wang, who started this whole process at Rush and makes all this possible. She's an incredible inspiration to me, and proves to anyone and everyone that it's possible to do global health in a way that really partners with communities and empowers them. I'm privileged to learn from her and honored that I get to be part of this experience. it will be invaluable for my training as a doctor and in global health. The entire group is just a joy to be around though and in the evenings, after the work is done, we have a good time. The bonds that form between people while doing medical service work is like none other -- and maybe it's the "I haven't showered in a while and I'm standing in surgical gear super close to you sweating like crazy and changing people's lives".....but everyone pretty instantly connected and the celebrations at night make all the hard work of the day that much easier.
In the past I've sent these posts out to you nightly and asked for prayer requests and such at the end, sadly as I am posting these all at once at the end of the trip I cannot do that. However, for all of you who had been praying for our success during the whole trip, thank you so so much. Knowing that you all are back home in support of this is wonderful, and helps me to keep going. I ended up not getting to write down each night as much as I had hoped during this trip, but now that I am sitting back home I will recap a little more for you.
The entire week was an amazing success. We ended up doing 92 cases in total, with about 80 of those being major surgeries. This included the general surgeries, orthopedic surgeries in Azua, and the assistance of the Dominican surgeon. It was really amazing how much we got done in just 5 days. Every day we worked hard, long hours. But everyone kept such an amazing attitude and worked so hard, it was inspiring. I spent one of the days in Azua with the ortho guys, and I have to say, I saw some of the most bizarre things in my life. People that had been in accidents years before, with horrible fractures healed wrong, walking on legs that looked they had two knees.....just crazy. We were fortunate in that the hospital there ended up having some hardware that the ortho guys were able to use, and we were able to do some tibial and fibular nails to repair broken bones. Normally you would do these with constant x-ray, but not in the DR as they just don't have it. So we did a lot of it blind, and I prayed. It was amazing that every surgery went smoothly and there were no complications. I just returned from my second trip as well (read the later blog postings) and everyone is doing just amazing. No post-op complications, even in the conditions we were in. There was one point where this fly was buzzing around the OR, and even during the surgery landed in the open surgical site......one of the nurses squirted some antibiotics in there and we moved on. It reminded me of that episode of breaking bad where the guy is hunting down the fly for the whole 45 minutes.....yeah, that was us. I think I scrubbed out at one point and tried to find that fly. No such luck. But, he didn't infect our patient, so thank God for that.
I will be posting some pictures on the website, so please check them out. Also, on the next trip I went on I was able to blog each night, and all those are now posted as well, so please read. I was able to type more about the area and such too. Thanks for reading, and thanks as always, for your support!
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