Uganda, Day Five, 8/15/07

I guess it's true that the harder you work, the faster the day goes by. Well, we needed that to be true today. It was another long one. I scrubbed a few cases, and one of the nurse anesthetists actually let me intubate a patient! The off-the-wall new experiences just keep coming. If you had warned me ahead of time that I might be seeing or doing or just being in the same room as some of these events, I'd have called you crazy (among other choice words), and would mostly likely have tucked-tail and run from the trip like a present-day John Mark (an early-church missionary who left Paul and Barnabas to return home to Jerusalem, Acts 13:13). However, on this day, I'm afraid that I've been jaded by such experiences; they've stopped seeming so earth-shattering, so incredible. But, having returned home, sinking backwards into old routines, I have a hard time wrapping my mind around all that happened (and continues to happen) there.

We've all begun to experience the different approaches of those at Mulago looking for "help." ...Not medically speaking, but help nonetheless. Some come in the form of letters, others come right out and ask without inhibition. Today, I was having a snack in the "tea room" when a young man came in and started making small talk. Before I knew it, he got up, looked around, and closed the door to shut us in. I was a little aprehensive to say the least, but that's when he began to pour his heart out to me.

"Please come and meet my family! Just 10 minutes!" he said. "You could walk to my home on your break and meet my wife and son!"

I knew then what he wanted. I would end up meeting his family and becoming attached. He might be able to use this attachment in a desperate attempt to get them over to the states.

"I am a very good worker...I can clean, scrub, fix things...I work very hard."

I felt so awful. I knew there was nothing I could do to get this man and his family to America.

As for the cases, they went well. I got to scrub a spine case with Dr. Haglund: a posterior cervical decompression and fusion, C3-7. (I'd been doing mostly general neuro cases in the pediatric theatre until now). I had brought a ton of spinal fusion hardware--instruments, implants, allograft, etc.--and I was finally getting to use it in surgery. This was so weird; in the states I'm only allowed to point at things and tell the surgeons and scrub techs which instruments they needed. I end up "miming" the way the instruments are to be used with my hands. By no means could I EVER scrub in or contaminate the sterile field as an OR consultant in one of my hospitals in the US. There was a little voice in the back of my head saying, "You're not supposed to touch that drill guide!!! What are you doing?!?"

The cases went well, but we were so tired when we got back. I felt terrible for our folks in the ICU and for Senthil, our PA, and for our surgeons. They still had hours to go.