On servanthood and life

I’ve had a few days to get some much-needed rest and to begin the work of processing all of the things that I saw and did while serving on this 2011 Cebu City Rotaplast mission. It’s hard to capture it, really, but hopefully my journal over the weeks give some context and insight into these my final thoughts, my post-mission manifesto of sorts.

Above all else, with the ups and downs of the 10 days we worked, I believe in the mission. We accomplished a lot despite the obstacles, shared grief, laughed, and learned together. If my record keeping is correct, we saw 104 patients; our surgical teams delivered surgery to 65 patients with 80 procedures; our dentists and orthodontists provided 404 services to these patients. All of this in seven days. That’s something to be proud of. We were successful together as a team – a group of 26 virtual strangers who assembled within hours and dispersed almost as quickly when the work was finished.

Individually, I’ve taken a lot from this experience. Hopefully what I gave measured for more than what I received. My first thought is of how small I feel. I work hard at my job, try to contribute positively to the world – donating to charity, recycling, staying healthy so I’m not a drag on our weakening healthcare system. Genuinely trying to leave the planet, when it happens, better or at the very least not compromised by my presence on it for this short borrowed time. But after seeing what I’ve seen, I feel really insignificant. Each of us is but a speck on the earth. I think at this point in my life, I’m seeing this most clearly for the first time. And more than ever before, I want my speck to mean something more than being a responsible tax payer, a consumer, a person who is giving more than she’s taking…something more than just a nice girl.

Another thought is how far I’ve gotten in life being something of a coward. I’m strong – physically, emotionally, intellectually (I don't say this with an ounce of cockiness; I also know my weaknesses). And like many I have endured some extreme lows in life. But in my day-to-day living things come relatively easy. I have a good job, work in a clean comfortable, low risk environment. People don’t die if I don’t finish my work. The truth is that if life were at stake in my work, I couldn’t do it. I’m just not brave like the medical professionals I’ve served with. Their work has left an indelible impression on me that will last through the years ahead. They’ve got guts to face the risk and obstacles presented to them each day. You don’t choose their line of work for the money; it’s the satisfaction that with two hands in tandem with a sharp mind you change lives. They live outside of their comfort zones, throughout their careers fearing the worst and working for the best; I lived it for a mere two weeks.

Each year, 2,300 new cases of cleft palate and cleft lip are born in the Philippines alone. In another posting I explained the reasons why this happens and what it means for a person should they have to live their entire lives with such deformities. But, so many new cases each year? How do you begin to address that kind of a situation? Well, organizations like Rotaplast for starters. I know there are others doing similar good work. And while all are making a dent, there’s still more need than we can comprehend. Despite the week’s low point, the passing of a child patient, the mission—this mission in Cebu City—must continue. Period. We can’t be discouraged by the numbers.

I learned a lot about myself and while I still don’t have all of the answers of where my place in the world truly is, I know I can’t go back to life without a stronger element of service being a part of who I am. Service is now defined differently for me, though.

Service is about teamwork and support. I saw this first hand in my teammates who came together and went to work almost automatically. We descended on Cebu City from the four corners of the USA, Canada and Australia. Together we suffered through a loss yet pushed each other along to continue the important work we came to do. I saw the best in people pulling together, through sweat (yes, it was hot), tears, and laughter. One person couldn’t do what the collective “we” did. Medicine and service take a team to do the work and survive it.

Service is about embracing one’s humanity. It’s that part of us that recognizes that we’re all alike more than we are different. We all have the ability to experience and share the full range of human emotion: pain, pleasure, joy, outrage, success, failure. We all will eventually die—one of the more sobering connections humans share. Our differences and circumstances are the intersection where opportunities for each of us lay. For those of us who by accident of birth or fortune ended up with more, it’s really not because somehow we’re better, more deserving. And when we entertain those self-centered thoughts, it’s a shameful moment. It’s an accident, dumb luck really that many of us enjoy our stations in life. And it’s our obligation to step up with what we have to serve those who didn’t win the family lineage or geographic lottery. I’m not saying that we shouldn’t enjoy some of what we work for. But each time we feel short-changed by life ask the question: do I want this or do I need this? These are two very different concepts, and I believe we give in to want more than we should. It’s about calibration. And, everyone has something to offer. Maybe it’s time. Maybe it’s money or other goods. Humanity isn’t experienced in designer clothes sitting in the Starbuck’s drive-through in our luxury cars; it’s where the average person exists. And the world’s average – its standard – is far lower than we realize. Try living on less than $10 a day as a middle class citizen.

I’ve seen things I couldn’t begin to describe well and have had the thought that any one of these scenes imprinted in my mind could have been me or anyone I know in my normal day-to-day life. Unforgettable street scenes that I can’t give adequate words to or photograph. I’ve witnessed the highest forms of human grief—a mother’s screams, a father’s mourning, a sobbing man shaking his beloved on the curb willing her to wake up as a fluffy white puppy rolled from her lifeless lap into the street. I saw tiny young (certainly not "legal" by U.S. standards) girls dancing, trading themselves for a few pesos to Westerners who cheapened their existence for their own pleasure. I’ve watched a team of medical experts give everything they had for hours trying to save a young life in a situation so rare it’s inconceivable, and then robbed by reality. I saw a soul leave the world despite the dedication, the work. The injustices of all of this make my head spin.

But that was the worst; that’s what shocked me. But it doesn’t overshadow the tremendous good and beauty I’ve seen. I’ve watched many lives change. Fresh new smiles appeared where split lips, gaping mouths, malformed nostrils, and random teeth once were – a chance at a longer healthier life. The new hope that discrimination and shame will not lead them to the worst of poverty where they have no options but crime, sex trade or begging. I’ve experienced the hospitality and generosity of the local people – willing to give anything to us, their guests, to ensure our safety and comfort. Outside of the immediate vicinity of the city where we worked, I saw breathtaking waterfalls, brilliantly colored sea life, mountain top vistas that made me forget it all, if only for a minute. The people, nature, the culture – a rich blend of sensory delights.

The good and the bad. And despite the worst of what I witnessed, the best of it tips the balances in our favor. We made a difference on this mission. The scenes play over and over in my mind even now. I looked humanity straight in the eye and it stared back with blunt realness. And in those moments I saw my own reflection – a small speck on the earth willing to try to make a difference.

It’s ironic that when I prepared this blog before heading to the airport in Pasco, I named it “Mission Possible.” It was more of a question in my mind at that point. Several events threatened to make it impossible: the shortage of surgery rooms (we should have had three but were reduced to two), which challenged the talents of our surgical teams, yet they forged ahead. The tragic loss of a patient that made some of the team question themselves, their work, their sense of belonging in such a high-risk medical environment. Yet through it all we overcame the impossible. This mission was possible because people were willing to give their best: their time (in some cases limited vacation time), their talents, their money, their hope for others. For several, including myself, this was a first. If I were a betting person, I’d guess that for many of us it will not be the last time we serve like this.

I think at this point, it’s important to say thank you. My family, friends, and colleagues back home who prayed and supported me with messages/notes along the way. Those who know me best, know that I was frightened as I left town -- fear not being a common emotion for me. My fellow Rotarians who gave to the mission and pushed me forward with confidence. The local Rotarians of Cebu Port Center Club and the Rotaract volunteers who tirelessly served us as we put our all into the mission work. My new-found “cousins” at Club Serena Resort who helped me relax, laugh, and pull it together my last week in the country. And, my fellow volunteers who consoled me when faced with too many emotional real-life firsts. But more importantly, they walked the talk – giving me the best example possible of what it means to team and prevail in service. Motivation and hope for a better tomorrow.

On the ride to dinner the last night of surgery, tucked in the back of an SUV, Carolyn (our head nurse and my mission mother as described in earlier posts) asked me directly “Would you do this again?” I didn’t think and responded immediately with “yes.” It wasn’t until seconds later that I realized in my answer I’d turned a corner in my life.

Our last night in Cebu City at the closing banquet as I said goodbye to this incredible woman of faith, she held my arms firmly as she did on our most difficult day when she told me I belonged in this place on this mission as my own confidence failed me. Once again she delivered a lasting blow to my soul. Looking deep into my eyes she told me how proud she was of me; she admitted that my “yes” response to her question about another mission was the best thing she’d heard all week.

“This is who you are. Be true to yourself,” she encouraged me. Indeed. In that moment I realized a servant was humbly born in Cebu City.

Video tribute to my fellow servants on this mission

Time for a break...

I’m tired. This will be a short post. I’m leaving the city for the southern part of the island where I’ve rented a small beach house for the week. I need some time to rest and collect my concluding thoughts on the past two weeks. I’ll create a final post in the next few days. In the meantime, thank you thus far for taking this journey with me and for your consistent comments, thoughts, and prayers along the way…they’ve meant the world to me. xoxo Lisa

Thank you, congratulations, farewell -- closing ceremony

With the post-op clinic behind us there was nothing to do with the rest of the day except fill the time with shopping, sight-seeing, or in my case, napping to catch up on last night’s deficit. The evening ahead would be another late one with the closing ceremony and some time to say our goodbyes.

This one's for my dad (no, I didn't eat any part of this animal; I don't
eat pork). What shocking way to be displayed post mortem! :)

The hotel conference rooms were opened up and decorated with nice linens and yellow-bowed chair wraps. Two roasted pigs, a Filipino tradition for celebratory feasts, were perched on a table. A few opening words from the Cebu Port Center Rotary Club president and the buffet was open for business.

Following dinner, there were a few speeches praising our collective efforts and the overall success of the mission despite the tragic loss of one patient. It was communicated that the father of the deceased boy, while extremely upset, had chosen not to take his sentiments to the press concerned that it might prevent the mission from serving other needy children. Even in his grief, he managed in his own way to give back and allow the mission to continue unhindered.

Certificates of appreciation were handed out and a video of our mission was shared. I’ll try to figure out how to post it when I get back. It’s great. Then it was time to say goodbye. Many people were leaving early in the morning and we’d not get the chance to see them off. I was leaving for some R&R around noon while the rest of the team headed to the airport shortly after that, so I knew this was my last shot. And it was over. 

Exchanging a club flag with the Cebu Port Center
Club president. I'll carry this back to my Club as
a token of our mutual interests and friendship.



Two weeks ago, a team of 26 people descended on San Francisco from all over the country and even the world – Australia, Canada, Georgia, Hawaii, Pennsylvania, Arizona, New Jersey, Colorado, Arizona, Idaho, and my home state of Washington. Many of us strangers but with a common goal. We worked hard and became a family. But as quickly as we assembled and got to work, we dispersed in all directions to go back to our lives. No matter where we go and what we do, only this group will share the personal and life-changing experiences of this mission—the highs and the lows, the laughs and the cries. This group of veritable strangers is bonded forever in service.

Last goodbyes -- with Carolyn (head nurse and my mission mother) and Frank (her
husband and the mission's medical director) -- two of the most amazing servant
people I've ever met.

Post-operative clinic -- the results of our efforts

Despite too much sake and not enough sleep the night before, the unrelenting daylight peeked through the window and woke me at my normal rising hour: 5:30 am. But today was different – this was the day that we would see the results of the team’s work.

The team pauses for a photo before the post-op clinic starts

Arriving at the hospital, we quickly went to work setting up a post-operative clinic in the main lobby of the hospital. Already there were a few parents there wanting to be among the first in line to have their children checked and to say thank you again to the team. I was told that turnout for the post-op clinic is typically low – about 50% show up even though we ask them all to come.

I’d barely gotten my files and computer out when I looked up to see Ryene and his mother coming in my direction. Yay! I’d get to see my little friend one more time!! As he approached I took him in a big bear hug and told him how handsome he was. He seemed pleased. This little guy doesn’t say a lot but communicates a ton. We took some pictures and while I set up my desk and took out the gifts I’d brought for the children he watched intently. Of course, he got the first of my goodies:  a watch with a puzzle in it, a rubber bouncing ball, a magnifying glass, a yo-yo, and a coloring book and crayons. While happy with the gifts he seemed content to perch halfway on my lap while I set up the computer and printer.

Suddenly it was 8 am and clinic was starting. I told Ryene that I had to work and quickly checked him in for his check-ups followed by 63 other patients and their guardians, mostly parents. Each was doled out some trinket and a smile: bracelets, beads, more watches that also served as rattles for the babies, crayons, yo-yos, coloring books, and more. I was glad that my $100 shopping spree at home went so far to make them happy.

A happy family asks for a photo with their son
and Ryene squeezes in -- not willing to let
anyone else claim me



More than what I handed out as I checked them in was what each gave me while passing my station – what a priceless gift to see the incredible transformations and hear the thank yous. Most of the children were happy too but a few were still wary of the same white people who poked and prodded them days before. So of course there were more crying kids. But, wow what a sight to behold. So many lives changed for the better. Of our 66 surgical patients over the past week only two did not return today – that was an unbelievable turnout.

Towards the end of my admitting work, Ryene came back after his check-up to supervise my work. I continued with him more or less on my lap. Finally, his mother came over to get him. It was time for him to go. He argued with her; he didn’t want to leave. I cry now thinking about it again. It was hard to say goodbye knowing I’ll probably never see him again. But, I’m grateful to have forged such a bond with a complete stranger in a matter of days – to have him trust me to lead him safely to his surgery, hold him and comfort him, and to reward me with his presence and friendship afterwards. But again, there were more patients eagerly awaiting an energetic smile and confirmation of how wonderful their sons or daughters looked, so I hugged him tight and told him to be a good boy; to listen to his mama. Yes? He nodded and started to cry. His mother then stepped behind my desk, looked into my eyes and said “thank you so much” as she leaned for a hug and asked me for my address. I told her that she has a special son and I was glad he was my friend. A lot was communicated again with few words and holding each other's hands tightly.

Cameras were going off everywhere. The surgeons, pediatricians, anesthesiologists, and dentists moved them all quickly through the process, offering final instructions for aftercare, a few of them receiving ointments and other simple treatments to aid the continuing healing process. I couldn’t have been more proud watching them all unless I’d done the surgical work myself. This truly what it was all about.

The medical staff finish their post-op check ups and await any final
patients. The relaxed poses demonstrate the success on
everyone's minds -- the hard work is over.

While we all rejoiced in the success, I had a few moments of pause about the little friends I’d made throughout the week. Where would life take them? Who would they become? I hope in my heart of hearts that this hand-up with surgery leads them down a road that improves their lives. Education. A better job. A happy marriage. Children of their own brought into circumstances better than they started with. That will be my prayer for these kids. That what we did will continue to give them more and better.

The families hung around for a while taking pictures of us, visiting amongst each other, almost like they weren’t ready for it to be over either. But it was. We packed up our remaining boxes. Our work here was finished.

Final picture with my special little friend Ryene...
and then a very difficult goodbye.

Volunteer nurses -- locals making a difference

Another important contributor during this mission has been the local nursing staff. I didn’t get to meet all of them, but I think there was about 20 of them. Almost all of them were not paid for their efforts during the mission, not that they complained about it. It's their way of giving to a profession they love and connecting with their own community. I learned that it’s hard to find nursing jobs; several mentioned having taken jobs at local call centers to make ends meet.

Allen, me, and Gigi -- they look like they should be related, but they
aren't. They do make great music together in the OR, though!

Throughout the week, these young angels rose to every challenge to support the medical team – and even a few of us non-medicals became attached. Every now and again, music would come from the recovery room with a few of them singing aloud and harmonizing with each other beautifully – Allen, Gigi, and Mikko. These kids are genuinely beautiful inside and out.

Allen, in particular, was a tremendous support during the emergency situation earlier in the week. Gentle and kind, he went right into ER mode bridging communication between our medical team and that of the hospital, getting new orders from the pharmacy, and keeping things flowing as new information came in. While doing all of that, he offered supportive smiles and shoulder squeezes even as his own eyes mirrored the gravity of the situation. And in the days that followed, he was always one of the first to check in with me as I settled into my paperwork for the day.

Head nurse, Carolyn, has done medical mission for decades. While she’s worked with great teams all over the world, it was her summation that this team was a standout bunch. Anyone working with them echoed the sentiment.

On the final day of surgery before we packed up the OR, the room seemed to fill with young nurses, proud of their work with our group and eagerly offering their cameras for any passing by to snap pictures of us all together. It was all very well documented for years to come. We were there and they were our critical support team.



A crew of scrub nurses jump behind my desk for a quick photo op



Appreciation abounds -- artwork and letters

One of the treats this week in addition to seeing children's lives change before our very eyes has been the deep appreciation expressed by all. This post is about sharing some of that. Some of you generously donated funds toward this underfunded mission -- you should relish in these sentiments as much as any of us here. There's no way to do it without the financial support.

Anonymous letter posted on our Rotaplast message board



More handwritten notes and artwork from parents



Children's coloring pictures -- some of them got as competitive as the parents wanting them
posted on the board.

When in Rome -- or the Philippines

Orthodontist Rosie reaches in for some yummy sushi --
the presentation was gorgeous!

With only the post-operative clinic left on our to-do list, the local Rotarians were ready to relax a little. So at the last minute, one of them opened up his beautiful home for an evening barbeque, which was quite unlike any I’ve ever experienced – and one of the best meals I had while here.

Arriving into the gated community, it was hard to remember that we were still in the same city where scenes from earlier in the week continue to play in my mind. With tents erected in the yard surrounding the pool and a fresh sushi station, we settled right into the generous hospitality. Wine was quickly poured and refilled as soon as you took a sip. Uh-oh – gotta pace this one.

I’m not a sushi eater, but I’ve got to say there was one that I really enjoyed – a fresh prawn stuffed full of rice dipped in wasabi-infused soy sauce. OMG! I think I ate all of them at our table and then set out to barter with the other tables for some of their’s (no one was selling). Then came some terrific tempura – Carolyn and I were at the same table and zeroed in on those babies pretty much until we felt full -- and that was only appetizers. Not that I’m complaining.

After dinner, our host came around pouring sake. I’ve only had one other experience with this powerful little beverage and he was determined I’d have my share, putting two glasses in front of me. Unfortunately it was as thirst-quenching as water and along the way I probably ended up having nine of those little glasses. It’s important to note that while I probably wasn’t road worthy, I wasn’t a stumbling mess either – respectably coherent (Mom, this is mostly for your benefit…I do know my limits!). You would have been very proud of my manners though; I consumed almost everything set in front of me.

Double-fisted sake



After that, he brought out some Japanese whiskey, which I carefully passed down the table to our mission director, Brian. He’s the real man on this trip – taking more hits for the team than anyone with a smile on his face. I just couldn't drink anything more. Even water would have pushed me over the edge.

A contingent of the group moved on from there back into the city at a casino near our hotel where a local band was playing. There we learned that one of our anesthesiologists, Christina is not only smart, beautiful, and fun, she also has a trained voice and was invited on stage to sing a few songs. She also attracted the attentions of a Michael-Jackson inspired patron who wanted to dance with her over and over. He husband, dubbed J-Lo earlier in the week, was a great sport – he’d already gotten in some good cha-chas with his wife earlier to the cheers of the audience. It was a fantastic cap to the week.

A dinner party to remember

Triple-threat anesthesiologist (smart, beautiful AND talented) Christina
and her chef-husband J-Lo

As the Rotary wheel turns...

Throughout the mission, Rotarian leaders have been on-site, opening their
homes, hearts, and wallets to any needs. Following the tragic events on day
4, they steadfastly served the needs of the team and the family involved.

The mission has been hard on everyone due to events earlier this week. One would easily expect that the medical and volunteer staff would take it really hard given that this is a first for Rotaplast and most of them have done multiple missions all over the world. But the quiet heroes this week have been the local Rotarians of Cebu Port City Club and the many Rotaract volunteers who have been a constant presence throughout it all. In fact, in the days following, they were quick to ask us how we were doing, offer a kind touch on the arm, and always a "thank you" for sticking with the mission. Truly committed servants.

From the beginning, they welcomed us and have done everything to keep us safe, comfortable, and well-fed – many of them cooking from home and bringing in favorite dishes for us to sample and enjoy.

They are the ones who really get a mission started, too. While we all book our trips and plan to leave our homes and jobs, they’ve already been working already for months, promoting our arrival and finding the families who we will ultimately serve. They’ve grown close to these people, learning their stories and making plans to host them in the city, feed them while they wait in long hot lines, and tend to and pay for any other needs – most which the patients’ families cannot afford to cover themselves. The generosity of these Rotarians is as present as the rising sun.

Following the tragedy earlier in the week, these same fine people continued to quietly serve despite their own sorrow. In the wake of it all, they stepped up to be an extra support to the family. As of last night, it was reported that they hadn’t left the sides of the family members, mourning the loss with them. They’ve set-up scholarship funds for the child’s two siblings, purchased a private and permanent burial plot for the family (typically plots are not permanent resting places due to cost and space) – the funeral is Saturday at 9 a.m. I’m told. They also have arranged to hire the father into a new line of work including retraining so that their lives can be that much more improved. They want to maintain a connection with this family and demonstrate their own grief by serving.

This is the way of Rotarians as I’ve learned since joining my club in February. The values run deep and true – even halfway around the world. This truly is a good organization and I continue to be proud of my membership.



Picture with most of the Rotarians leading the charge for the 2011 Cebu City Rotaplast mission



Wrapping up - Surgery Day 7

A father in the pediatric ward created a make-shift hammock that he
rocked all night to calm his son to sleep. At 16 months, JB had a
tough start being 22 weeks premature his father tells me. They lived at
hospital for 4 months. "He's strong," his father tells me. He's adorable,
too -- big dark eyes lined with long lashes.

Today feels different than the other days. It’s our last day of surgeries and when it’s all said and done we will have seen 104 patients, provided surgery on all who we could help (66). Many lives have been changed already and we’ve seen the happy faces leaving the pediatric ward. I’m told we’ll see many of them tomorrow at the post-operative clinic when they come for a final check by the surgeons, pediatricians, and dentists and receive any final instructions.

It’s been a long week and everyone is tired but pushing, offering the last of their energy, smiles, and love to the final patients.

Severall non-medical team members took the opportunity to watch the final surgeries. I declined the offer -- not out of disrespect or disgust, but rather, I know my limitations and I've seen more than I'd planned or hoped for this week. It's cool to see them come out after the surgeries feeling more connected to the patients and wearing expressions of impressed appreciation for our talented surgeons.

As the last patient, 19-year-old Jonathan, was wheeled out of the recovery room, he held up both thumbs and the remaining staff in the OR let out a cheer. The surgical work was complete, and our final patient was happy.

JB hangs out in his hammock

Next, the operation was mobilized again but with a new purpose – it’s time to pack up our things and prepare for tomorrow’s clinic. The huge boxes in which our supplies were shipped over with us from San Francisco started to appear again. I’m a little sad to see this. Within the hour we’ve repacked our boxes and are ready for tomorrow. The knowledge of what we face tomorrow gives everyone that last little boost of energy. The mission that felt impossible at several junctures is wrapping up. And, many of us will be returning home changed forever.

Our final stop at the hospital for the day is in the breakroom where a cake has been prepared and we again hear words of appreciation for all of the week's efforts.

Mission director Brian conducts "surgery" on the
celebratory cake -- no anesthesia or nurses.

Abegail

Later in the day (6^th day of surgery) I awaited Abegail’s arrival upstairs to the waiting area for surgery. She’s the young girl I spoke with earlier in the day down in the pediatric ward.

Needing a cold bottle of water, I left my station and headed through the hallway to find her seated in the waiting area with her mother, crying. I went to her thinking she was afraid. Her tiny body wracked with tears and unable to speak, her mother told me that she couldn’t have the surgery today. It turned out that she had a cough and cold coming on and the pediatrician and anesthesiologist concurred that it wouldn’t be safe to proceed. These are the kinds of tough decisions the medical team has had to make all week; it breaks their hearts to say no, but the safety of the patients must and always does come first.

Abegail is very disappointed. She’s been waiting to have her palate repaired, and the sadness that she must wait another year consumes her. I try to console her. I talk to her more about the possibility of coming to America as an exchange student. A good student, I’m really hoping I can find a way through my club or district to make it happen for her. I tell her I want to keep in touch and offer her my email address. She agrees to write with a nod, but has no words for the time being. I hug her repeatedly hoping that she knows my heart is sincere—I want to be her friend.

Later that evening after finishing the day of work, I log on to find that she has “friended” me on Facebook. We are indeed friends. Once again, I am blessed. A co-worker later gives me Abegail's artwork, a doodle page, where she'd written my name with a heart beside it.







Lynn was our jack-of-all-trades but helped a lot with transport
and entertaining the children as they waited their turn for surgery.

The man, the mystery -- Dave, our mission
photojournalist, doing what he did. This
is about all I got of him. :)

“Old babyface” – Surgery Day 6

The team is getting stronger with each day. The pain is still there under the surface, but people mask it to focus on the new cases walking through the doors. I arrive excited to see Ryene and hope that he’s happy to see me too.

Ryene commandos my iPhone

I set up my desk and pull the day's charts for Carolyn, asking her if it’s okay to go see my little friend. Of course – go! Coming into the recovery side of the pediatric ward, I see tired parents and children everywhere – some of the parents taking over the cots for a little shut eye after a long night comforting their children. I again stop and visit with each, looking at the amazing transformation of each child. Some see me in my scrubs and start to cry – us white people in medical uniforms are now something to be feared. I get it. I don’t really love medical stuff myself, but I do have a newfound appreciation for the people who give themselves to this profession.

About halfway through my stops, I feel some arms wrap around my waist and look down to see Ryene. His cot is at the far end, but he saw me and came over. His mother, a little embarrassed, is trying to pull him back to wait his turn, but he’s not having it. I let him hold my hand as I greet the remainder of the patients and families. It’s breakfast time and he’s supposed to be eating, but he wants to see “Caesar” again. I tell him to eat his breakfast first, to listen to his mama. I’ll come back in a few minutes.

Artists Ryene and Shenen hard at work, creating masterpieces
for me to bring home

I head over to the other side of ward to see the waiting patients -- those who will have surgery today. Shenen is there; she was part of our balloon game yesterday. She runs over and tags me on the leg to make sure I see her and then runs back to her cot. I say “hello” to the parents and the children before settling down on Shenen’s cot. I begin to show her pictures of my pets, family, and friends on my iPhone. Other kids start to gather around us looking at the pictures. We sit there for a little while and then the kids start fussing; I look up to see Ryene pushing them aside to get to me. He’s saying “Caesar!” over and over. I tell him to be nice and we all arrange in a circle while I continue to flip through the pictures. He’s letting the other children know he’s claimed me; we’re special friends.

Being an auntie, I keep a lot of children’s games on my iPhone. I whip out a few of them for the kids. Bug Squash is a favorite; this game has a screen with bugs racing across and the goal is to touch them (squish them) before they run off the screen. I’ve got about six kids all pounding on my iPhone and quickly realize that this little device won’t survive unless I find a less violent game. I pull up the matching game that has the kids using memory to turn squares over and find the matches. It’s really cute as they each take a turn, one after the other. They cheer when they finally make a match. We do this for about an hour and then I realize how much time has passed. I have to go back to work. Coloring books come out and the children go to work on their art. Ryene has to go change clothes so he can go home; he doesn’t want to go back to his mother. He pulls away from her grasp and insists on making me a picture first – a colorful horse, which he signs with his name before adding mine.

Me and Abegail having a little chat

As they color, I engage 16-year-old Abegail who is waiting for surgery later today. I ask her if she likes school. Yes, she answers shyly. What do you like to study? Math? No, she wrinkles her nose. She likes to read. Fiction, at that. I ask her if she as a boyfriend. Yes, again shyly, her eyes go down. Her mother jumps into the conversation and adds that grandfather is unhappy about this development. I then ask her if she wants to travel to America or somewhere else. Her face lights up – yes, she wants to go to America. Anywhere in America. I tell her to study hard at school and get good grades. Perhaps she can do an exchange. Maybe even with Rotary. The mothers hover around wanting to understand student exchange – one mother whose English is better explains it to the others. They all nod and smile together, and tell Abegail this is a good idea. I focus on her again and hold up three fingers and repeat three themes for effect: 1 – finish high school; 2 – go to university; 3 – then a boyfriend is okay. She smiles. She knows what I’m saying.

The mothers start asking me more questions. Do you have a husband? Children? Are you a doctor? No, no, no. I explain that I do business work, knowing I’ll never be able to explain what I do. They tell me they think I’m smart, and ask me how old I am. 44. Several shake their heads and start talking amongst themselves. They ask again. Then they ask me to write it down with a crayon as if something is lost in translation. They see the number and shake their heads in unison. One mother points to herself and says 44. Then another points at me and says “old babyface.” I have a new nickname from the moms.



Gift from my favorite Cebuano artist



My little Ryene – Surgery Day 5

So re-entry to the hospital was a little tough earlier today, but after playing in the ward this morning, things were back on track for me. I’m still thinking about "Ronny"; I’ll probably always think about him and wonder what he might have grown up to be. I’ve formed a connection with my Casanova friend, Ryene, though, and was able to spend time with him before his surgery. You could say that we have kind of a bond. It’s ironic that he’s the same age as "Ronny" and they look somewhat alike.

His and her tattoes (Ryene and me)

He’s brought up from the pediatric ward to the waiting area where we tattooed each other (he was careful to select a "girl" one for my while he opted for a fierce cobra one), played tic-tac-toe, he wrote my name, and then we played with my iPhone for a while. He loved the pictures of Caesar (my Chihuahua) and every time he flipped through the pictures would exclaim “Caesar!” Carolyn, seeing the connection, came to the waiting area when it was time and asked me to be the person to escort him to surgery and be the last person he saw before he went to sleep. Hand in hand we walked into the OR, and I picked him up and set him on the table.

The anesthesiologists started administering gas and after a few deep breaths, he decided he didn’t like it and started to fight a little. I rubbed his dark little legs while the team held him down and watched him give way to the gas, me fighting back tears.

I went back to my desk with his flip-flops in hand, pulled it together and proceeded to the waiting area to give them to his mother. Worried eyed, she asked me if he was okay. I told her he was sleeping and fine. She pointed to the OR and said “you go” wanting me to go back and be with him during surgery. I wasn’t prepared to watch a surgery, but I did go back into the OR as she’d asked so she would be comfortable knowing I was close to him. Carolyn later told me that when we went into the OR, Ryene and I, the mother began to cry. It’s hard to think about how these mothers feel letting go of their children and entrusting them to total strangers. Carolyn held her and told her he was fine and that I would be with him and that knowledge calmed her.

Back at my desk, I prepared tomorrow’s files waiting for Ryene to emerge. At one point a scrub nurse opened the door and starting calling out for things I didn’t understand. I panicked thinking that this might be a re-run of yesterday. Things settled down, thankfully, and I was assured my little friend was fine. And then, it was time to wait.

Phenomenal Fiona (anesthesiologist) and me

An hour later, he emerged from the OR fighting the anesthesia, literally. He’s a tough little guy. His mother  told me the story of how his father was murdered in their home. Ryene has two other siblings. He’s the youngest. When a mad-man came into their home, he stabbed the father. His mother instinctively put herself over her child and was stabbed herself in the chest. She showed me the large scar. Fortunately she survived. The father had been against Ryene getting corrective surgery; there are many people here who believe that’s how God made them and that it shouldn’t be changed. Without him to consult, the mother came to clinic and today he got the surgery. She is pleased that the other children will no longer make fun of his deformity.

Ryene's mother (grandmother in the background) - taken by Ryene

After we’d settled him down in the recovery room, I was asked to go get Ryene’s mother. She sat in the hallway alone – all of the other parents had already collected their children and been moved down to the pediatric ward for the night. Her face lit up with a question when she saw me. I told her he was more handsome and very strong. She was pleased and said “thank you” over and over as we walked into the OR.

In the OR she rushed to hold him and I’ll be darned if that little guy sat up and said he wanted to leave, shouting it at her. As she ignored him, understanding it was the drugs talking, he screamed at her “Are you deaf?!” He’s her baby and has been through a lot. Even with his post-anesthesia anger, he is my little friend. I’m excited to visit him tomorrow.



Ryene in recovery (if you look carefully, you can see that his lip
will be very attractive making this special boy even more
handsome)



Back in the saddle – Surgery Day 5




Recovery side of the pediatrics ward

I’m not saving lives here, but there are people counting on me. So I awoke at my usual time (5:30 am) and joined everyone in the breakfast room. Not really hungry, I ordered a scrambled egg. When it arrived, I could only guess that it was from an ostrich or penguin. Too much food. That’s been the theme this week. Not that I’m complaining. Everyone is doing all they can to take good care of us whether it be with food, security, or transport.

Picture with Ryene (pre-surgery)

Arriving at the hospital, it felt sad to be coming back to where there was so much pain and sorrow, but we were all encouraged to bring smiles today and focus on the work at hand. Digging into my charts, the first two patients of the day walked in with their OR nurses, much like "Ronny" did yesterday. It pulled at my emotions again, and Carolyn seeing it told me to focus on today and to push the images of yesterday from my mind for now. It’s been heartwarming to see everyone caring for each other throughout the day with a quick hug or “how are you doing?” – even a high five when "Ronny’s" surgeon emerged from his first case of the day – back in the saddle giving his best. The undeniable focus is on seeing this mission through.



S

Playing with Shenen, Ryene and pediatrician Mary

Mid-morning, the pediatricians (Mary and Sheila) encouraged me to visit the ward to see the progress of the previous day’s surgeries and meet those awaiting their surgeries today. It was the best thing I could have done. Arriving in the hot pediatric ward, I saw it split into two sections: one side for those waiting for their surgeries to start and the other side for those waiting to be discharged.

Ryene scoots in for a hug

I first took a walk through the side where surgery patients were in various states of recovery. I stopped to look at each child, spoke to the parents, smiled and winked at the kids. I have to say the transformations are amazing in such short time. I’m told I’ll see all of these kids again in a few days at the post clinic. The only dark moment was thinking to myself that I wished "Ronny" was down here laying on a cot in this hot, humid room.

In the waiting area, I was quickly greeted by the little flirt from the other day, Ryene. At six years old, this little guy has a solid future as a lady killer. Well, I’m smitten anyway. He led me over to his cot where his mother and grandmother were sitting, having me sit down and patting my leg as if I was doing the right thing by leaving the other children and joining him. I haven’t really had many pictures with the children so I handed my camera to Michelle, the ward coordinator, to snap a picture of us. After looking at our picture, Ryene grabbed the camera and shot a picture of me and then one of his mother and grandmother. Very pleased with himself, he led me to the play area where Mary was already playing with Shenen (a little girl who was rescheduled from yesterday and will have surgery tomorrow) and a yellow balloon. We joined the game of trying to keep it in the air; I played for about 30 minutes. Drenched in sweat, it was exactly what I needed. Ryene and Shenen’s happy faces made my day, and Ryene, true to his affectionate personality kept coming over to me for a confirming hug ever few minutes. As we were leaving the play area, I’ll be a four-legged fish if that little fellow didn’t goose me on the bottom with both hands!

While those kinds of moves aren’t really why I’m here, it’s good to be back. The kids really are a good reason to keep our commitment and press forward with the mission.

Lean on me

Important note:  This post, as with all on this blog, are my observations and experiences only. They do not speak on behalf of Rotaplast, any member of this mission medical or otherwise, or others on site. This is my unofficial blog only. The name of the patient has been changed out of respect for those involved.

Grief is an awful thing. Everyone does it differently. I tend to go find my hole, cry alone, and summon strength to face what’s next. Others sit quietly in small groups. Others talk about the situation or anything to take their minds off of reality. A few keep busy – asking what they can do, serving water and Kleenex. Tonight’s pizza party offered me new insight into how medical professionals do what they do.

What was supposed to be a fun after-hours event in the hospitality room turned into a somber support group. I had already holed up in my hotel room and tucked into bed after eating some ibuprofen, a pain killer and a sleeping pill to try and rid my mind of the mini-movies playing over and over. Fiona, the anesthesiologist from "Ronny’s" surgical team, had other ideas for me. She knocked on my door and when I opened it she said “Everyone is upstairs.” I say I’m not into a group scene tonight. “The team needs each other right now. You’re part of us.” I stare blankly at her red-rimmed eyes. She thanks me for my words earlier as we sat in the OR; I saw her sitting, head in her hands, and went to her. I offered a hug and told her how impressed I was with her during the events earlier, still feeling lame and useless, but speaking and acting from my heart. From my desk, I had watched her:  determined, professional, and willing the child to live. She told me that she’d only lost one other patient in her career – an elderly woman. And while it shook her then, she admitted that a child was a quite different feeling. “There must be a better way to make a living,” she said her eyes welling up. I didn’t feel like I could offer anything useful to her but sat by her and told her how phenomenal a person I think she is. But standing at my hotel room door hours later, she’s telling me it helped her and she’s asking me to be part of the team right now. To step-up, not only for myself, but for the others. She is right of course.

I quickly dress and head up to the hospitality room. Everyone is there and fresh hot pizzas have just arrived. I realize I hadn’t eaten all day given the events so manage to push in a couple of slices of pizza in…followed by a huge glass of wine. And another. The damn medications still unable to take hold of my busy mind.

Medical professionals are special. They know the risks of their work. Every patient deserves and gets their full attention – I’ll remember this the next time I impatiently sit in a waiting room for my turn. And when they lose a patient, they band together. There doesn’t have to be a lot of words. They seem to know what each other is thinking and feeling. And, they pass out hugs and reassuring looks amongst each other freely. Over pizza and drinks I watched them unwind from the day’s events and recommit themselves to pushing on with their important work. It’s not that the emotions aren’t there. They absolutely are. It’s just that these servants have learned that they can’t serve again and again as their jobs demand if they spend all of their strength and emotions on the things they cannot control or change. They came with a mission in mind and will see it through. So will I.