When things get exciting

So needless to say, things got exciting. Just a quick disclaimer, I'm here on a medical mission and this post will probably be more about the medical stuff, so if you are feint of heart, here is a link to a video of cute puppies to make you feel better. I can't vouch for the video, however, as Youtube is blocked on the Mbingo internet.

Just a little casual musing first. Why is it that we fixate on our failures and not our successes? Is it because we really want to better ourselves and think that by working through lapses in judgment we can avoid them in the future? Do we feel the need to punish ourselves even when no one else condemns our actions? Maybe our pride demands that we expect more from ourselves than we are capable of and failure is an affront to inflated self-esteem. Still trying to understand this reaction...

That said, I have had a lot of successes here. My first patient is looking great and smiles and waves every time he sees me. That's an emotional boost! I feel like I've connected pretty well with the residents and have been able to do some teaching and some learning from them on cases that I'm unfamiliar with. I've taken on some surgeries that I've only read about, with the help of some very competent, experienced residents and some friends from home weighing in by text message. I'm not sure how it will turn out, but on Sunday I operated on a 2 kg 5 day old baby whose intestine failed to develop correctly leaving it in discontinuity. After discussion with the residents here, a panicked text to a friend (who just happens to be a stellar pediatric surgeon) and a consultation with my lovely wife (who knows WAY more about turning sick babies into healthy babies than I do), we charged ahead and managed to get through the repair feeling pretty good about things.

Yay! Fireworks! Cigars! Champagne! (except there is a ban on tobacco and alcohol on the hospital grounds) so... Orange soda! Granola bars!!

And then the next day, I was signed up to take a kidney out of a 2 year old for cancer and the cancer turned out to be too advanced to remove. The worst part is, I didn't realize it until we were most of the way through the operation.

That kind of stuff happens in medicine, but it happens a lot less when you have good imaging studies and specialists and seemingly endless resources. A simple CT scan would have shown us the tumor was too advanced to operate, but all I could think of was why I wasn't more careful early in the surgery to determine if proceeding was a good idea. I'm not sure, but I'd like to think I could have figured that out much sooner than I did and saved the child unnecessary trauma. I feel like after an experience like that you should get a time out and everything should stop until you're ready to forge ahead, but that was about 4-5 surgeries ago and somehow you just keep going.

I wonder sometimes how hard it would be to raise a bunch of money for a noble cause. I really like to think that I could get up on a podium somewhere and tell a really inspiring story and people would be so excited that they would just start donating like crazy to some charitable cause. There's a family doc here who is a really great guy and some one who doesn't sit on an idea long before taking action. When we talk about things that we are worried about, he is always the first to say, "Well let's just pray about that right now!" and proceeds to do so. I was talking about this case with him and he just suggested that we raise the $125k that the hospital would need to buy a CT scanner. I love that idea. They already have a room under construction and a guy training to be a radiologist and there would be immeasurable good done here by the addition of CT capabilities.

To illustrate and tell one more medical story, a guy with a head injury came in over the weekend and rather than getting a CT scan, which we would normally do, to guide treatment, we took a hand drill and drilled a hole in in his skull to see if there was any internal bleeding causing a problem. There wasn't. The patient didn't have much of a chance even at initial presentation, but it sure would have been better to know what we were getting in to than going in blind. This guy was probably more the rule than the exception unfortunately. This place sees a ton of trauma and a CT scanner would likely be working 24/7 assuming it didn't break down. I'd love to tell you where to donate to help this place get one, but I haven't been able to figure that out. Hopefully I will before I leave.

I feel like the tone of this post was much darker than I intended, but as I said, I think we tend to focus on our failures more than our successes. I'm having a great time here and will be leaving in a few short days. It has been awesome to reclaim that feeling of inspiration to get outside my comfort zone to try to do some good in the world. Being here is making me a better person, a better surgeon and a better follower of Christ and I'm incredibly grateful to be here.