General Surgery Clinic
June 6-13, 2009
|Participants: Surgeons Drs. A.D. Smith and Jerry Smith(no relation); Anesthesiologist Dr. Steve Shulman; CRNAs Jan DeHaven and Eddie Milam; OR Nurses Tim Pethel and Jeanne Trammel; Surg Techs Brian Barrows and Richard Yates; Floor Nurses Alice Bush, Ashley Bourke, Sharon Depmore, Morgan Fox, Naomi Heye, Lauren King, Sheri Kretzschmar, Sarah Sizemore; ER Tech Kaci Hood; Respiratory Tech Andrea Penn; Med Students Luke Norman; Michael Farris and Patrick Owens; Chaplain Charles Campbell; Translators Katie KellyDimaggio, Emily Anne Latta(also pre-med) and JoLee Thayer; Sterilization Crew Adam Cotter, Steve Cotter, and Jesse Pettengill; Pre-Med Students Josh Farris and John Nuelle; Non-Medical Volunteers Cody King, Truda Milam, Sarah Smith, Jared Smith, Sharron Smith, Gary and Linda Tabor, and Team Leader Marie Agee.
Everyone arrived as scheduled (on 4 different flights!) except Eddie and Truda Milam, who were delayed by cancelled flights, and Morgan Fox, who didn’t make it to the Houston airport on time Saturday because of the closure for repair of the highway she was to travel. They all arrived on Sunday along with one of my bags that didn’t show up on Saturday. Fortunately, it only contained HTI scrub tops.
Upon arrival, we had to endure the new scrutiny imposed by the Guatemalan Ministry of Health that required pre-approval to get supplies and medicines into the country without paying a tariff. Due to the discovery of this new rule by Rick when he’d gone down two weeks earlier for the supervisor’s meeting, the team scrambled to compile a complete list by individual suitcase of what we were bringing. Alex then put forth extreme effort to get it all approved before we arrived. He succeeded! I received an email with the letter of approval attached at 10 pm the night before I left my house at 4:30 a.m. the next morning! Alex did an excellent job because we sailed thru customs!!
Charles Campbell, current HTI president, served as chaplain for this trip. He presented a short devo on Saturday evening then we proceeded into our “getting to know each other” session. I was happy to introduce Katie Kelly, daughter of Dr. Mike and Julie Kelly, who’d been medical missionaries in the area for ten years. I explained to the group that the reason HTI was doing surgery there at all was because of Mike’s suggestion years before. He had explained just how difficult it was for the Maya to receive any kind of surgical help at all due to a wide variety of reasons that included discrimination, economic, language barrier, etc. Because of Mike’s encouragement that HTI offer a surgical ministry, more than 4,000 Mayans have since received physical relief in the form of surgical care…in the name of Jesus!
Shortly after our arrival at Clinica Ezell, patients scheduled for Sunday surgery began to arrive. The surgeons completed all the pre-op exams on Saturday evening, so Sunday’s schedule was lightened somewhat. By the end of Sunday, the surgeons had completed seven surgeries, which included two children. The last case was a gallbladder case via laparoscopy that removed a gallstone as big as a pecan! I know that patient felt better!
On Monday Violeta Campos and Alex Gonzalez showed up to deliver ABC supplies. Before they arrived, Luis had loaded one pickup and he and Charles Campbell, Josh Farris and John Nuelle went out to Guatalón. When they came back for lunch, they all went out again with Violeta. Since they were all exhausted when they returned that evening, including Charles, I asked Dr. Jerry Smith, to present the evening devo. He graciously obliged and did a marvelous job. (Charles was very grateful!)
Since we had several students on the team, I created a rotating schedule for them to be in the OR. Emily Anne Latta worked with Silvia part of the day as well.
The gallbladder case today resulted in at least a 1/8 cup full of BB-sized gallstones. The patient was a 20-yr-old young woman from Nicaragua, who was a cousin of Jessica Romano. She did very well and was very grateful for the help she received.
By the end of Monday, the surgeons had provided care to twelve patients. All did well.
On Tuesday Violeta took four of the students out with her to deliver supplies. When they returned at lunch, in an effort to allow as many as possible the opportunity to go out, I asked them to stay and sent three others. Everyone loves to share in the excitement of this effort!
Since there were only nine surgeries scheduled for Wednesday due to the elimination of some for various reasons, we scheduled a trip to the “chocolate farm,” as Carlos calls it, for the late afternoon. Since vehicles were in short supply because of MET and repair work, we hired a local bus and driver to take the team the short distance to the farm. They returned fascinated at the Garden of Eden atmosphere there. Jesse Pettengill, born in Maine and now in New York, was openly excited to see fruits growing that he’d never seen growing before, like coconuts and pineapples. In fact, he said he thought pineapples grew on trees!
One of the patients on Tuesday was a precious little 3-yr-old boy who was in for hernia repair. Someone had given him a beach ball to play with, and he had a ball, literally! He played and played with that thing, mostly kicking it like a soccer ball. He kicked so well that I asked his mother if he had older siblings, and she said yes…an older brother. The little one had evidently learned the kicking skill early from him! Such a charmer he was!
On Wednesday the last of the ten cases was a very sad case. A Mayan woman named Justina came in for what she thought was a bad hernia. When Dr. A.D. Smith opened her up, however, he discovered she was full of cancer, likely ovarian, with obvious liver involvement. He just sewed her back up. Walter was going to send her to the city for chemo.
All the while the surgeries were going on, Sharron Smith, wife of Dr. A.D., was busily painting a mural in the dental clinic. She worked on it for three days and finished up on Wednesday afternoon. Using the blank wall across from the dental chairs, she painted a colorful “window” surrounded by bunny rabbits armed with toothbrushes! It was quite a pleasant addition to the room décor. See a picture of it below.
On Thursday we had 14 cases scheduled, one of which was a suspected lymphoma case. Another was a breast mass. I assisted Dr. A.D. Smith in removing the little “wicks” from an umbilical hernia repair on a 6-yr-old boy that he’d done earlier that week. The child would still have to return in a week for Dr. Sierra to remove his stitches. After it was all done and he’d quit crying, the little boy asked me for a toy. I hunted around and found a toy flute to give him. He was thrilled…but I don’t imagine his parents were!
Late in the evening, after our final devotional when we thought all was well, we had what was potentially a crisis. Fortunately, it turned out not to be so. One of the last surgical patients for the day had some bleeding that caused quite a stir. Even though her blood pressure never dropped, to be on the safe side since we were leaving the next day, the docs took her back into surgery. It turned out that she simply had some oozing that collected in a layer of fatty tissue in her abdomen. Few of our patients are heavy, but this one was heavier than most. Through it all, she remained stable, and the doctors were reassured that there was not a problem.
As we were preparing to leave the next morning, a young man showed up seeking help for his badly infected foot. It seems he'd step on a thorn about ten days ago, and now he was in bad shape. The surgeons examined him and agreed that the situation was too serious for Clinica Ezell and urged Dr. Walter Sierra to get him to a hospital in the city immediately for surgery. They said it was imperative to act quickly so as to prevent amputation of his leg.
The total number of patients receiving care during the week was 52. God was once again faithful to see us through the week in the protection of His almighty hands.