Thursday, May 18, 2006

An Exhausting, and Exhilarating, Week

I returned on Tuesday after my volunteer program in Honduras. I had no idea what to expect before I left, but was absolutely and without a doubt thrilled with the whole experience. I learned so much about medicine, which was really interesting, and we really helped a lot of people, and we all felt really good about what we were able to do.

This was my group: 6 surgeons, 1 pediatrician, 4 anesthesia staff, 5 nurses, 1 scrub tech, 1 physical therapist, her 16-year-old daughter, a professional photographer and myself. Besides me, only one anesthesiologist and the pediatrician spoke Spanish, so I was very busy during the week translating for the patients and their families. Overall, we treated 80 patients in five days!

On our first day, Sunday the 7th, we went to the hospital around 8 AM, where we were greeted by around 100 patients, all with hand and arm problems, who had all been waiting since 6 AM to see us. We divided up and began screening the patients. I sat at one table to translate for two of the surgeons, and two other bilingual Hondurans sat at the other two tables. As each patient came in, the doctors diagnosed their problem, discussed what could be done to fix it, and if the patient wanted to go ahead, we scheduled them in for surgery that week. Before long I got into the rhythm of the questions to ask: what happened? when? can you move your hand? can you bend/straighten your fingers? what bothers you most about the problem (lack of movement/use/feeling)? have you already had surgery? And by the end of the day, I could recite the pre-surgery instructions in my sleep: be at the hospital by 6 AM day of surgery, and don't eat or drink anything after midnight the night before (not even water!) We saw patients of all ages with all kinds of problems. Here's one crazy one: a man had been hit in the elbow with a machete more than 20 years ago. The bones were broken and separated at the elbow and had never grown back together, so they just flopped around freely, unrestrained by the limits normally imposed by the elbow joint. However, his muscles and tendons were mostly intact, so he had movement and use of his arm, and even a very strong grip! He had wrapped a bandana around the elbow for support, but had been living and working this way for more than 20 years! Actually, that's one patient we didn't treat, because the only fix that could be done would involve fusing the bones together, which would mean he would lose all movement in the arm.

One of my first impressions was how patient the Hondurans were. The screening day stretched on throughout the day until around 4 or 5 PM, so by the end the people still waiting had been there for 10 or 11 hours, waiting in the 100-degree heat to see us. But there were no complaints or protests, no angry people demanding to be seen, indeed very little obvious irritation. The children were well-behaved and very few cried. I would see more evidence of this kind of patience and endurance of hardship throughout the week, in such stark contrast to what I can imagine would happen in the U.S. It was impressive and yet sad as well, because it shows that life is often hard for these folks, and they have had to learn to accept and deal with the discomfort and difficulty that life deals them.

In the next few days, I'll write more about some of the most interesting cases we saw and I'll have some photos to show of the hospital, the doctors I worked with and some of the cases we saw. And if you're interested in seeing what a cyst excision, spaghetti wrist reconstruction, Hunter rod implant, burn scar revision, PIP arthrodesis, or bilateral thumb partial duplication repair looks like, I'll have some photos up very soon. In the meantime, here's me in my scrubs.