Becoming handsome – Surgery Day 4

Note: I'm running behind a day or two. I'll catch up with my postings but need a few days...

Waiting area in the hot hallway. Parents sit here by the hour waiting
for their children to wake up from surgery.

I’m getting stronger as the days go by. Perhaps a little desensitized by all of the pictures I have to look at each day working on the medical charts. Not in a bad way, though. Each case is very personal. Having met every patient and his/her family, AND written each name, ID and various information over and over on dozens on forms, I feel like I know them.

Take a couple of cases finished last night. Yesterday was an extraordinarily long day and I’m told more typical of these missions. Our first couple of days were only cleft lip repairs, which the surgeons seem to prefer – they are easier soft tissue work and the results are much more obvious even in the recovery room. Cleft palates are described as back-breaking surgeries with more possible complications.

I've learned more about cleft lips and palates. Basically, it is a malformation. Sometimes the lip or palate (roof of the mouth) are not completely formed in one or two places.These malformations can really give a bad start to an infant's life -- often they cannot breast feed because they cannot attach correctly to a mother's breast. As they grow older they become an embarrassment for some families and a target for others who are cruel. In some cultures the boys get the surgery first as they are considered more important; here, that's not the case. While there are more boys this time, it's not by many. I've also taken some tme to understand why these deformities happen -- is it environmental or genetic? While a lot of research is still underway, what is known is that it starts with nutritional deficiences during pregnancy. As meat is more expensive, the poor often go without creating a deficiency of folic acid. That often compromises a fetus in many ways, but one is cleft lips and palate deformities. Then, as time has gone on, the deformity becomes part of the genetic coding, which is why there is higher occurance in many third-world countries. It's amazing to me how economic, social, and environmental issues connect with genetics.

Anyway, yesterday a little two-year-old mop of black curls stole everyone’s hearts and gave us cause for some concern. After a cleft palate early in the day, Megan, went into recovery and later down to the ward for the night. By about 4:30 pm, the ward had called and were sending her back to the OR. She apparently was bleeding a lot. If anesthesia was tough the first time, you can bet she wasn’t very happy to see Christina (the anesthesiologist) for a second time on the same day. But the team got the bleeding under control and dispatched her back to the ward for the night. As of this morning, she’s doing much better. I plan to head down to the ward this afternoon to see her. I'd share pictures, but I was told that I'm not supposed to do much of that -- at least not without the parent's consent.



Ron, who is responsible for sterilizing instruments
between each surgery. He said the he wasn't a very
good wrapper to start, but it appears he's gotten
the knack for wrapping up the surgery packages.

One of the last surgeries yesterday was an older patient: 35-year-old Angelito. I remember him when he attended the pre-op clinic last week. Without an ounce of disrespect, he was quite possibly one of the hardest cases for me to look at. Really, a mess with teeth growing in places they shouldn’t be, no upper lip, unattached and malformed nostrils. I’ll spare you the full details. It was bad. When asked why he had waited so long to get repaired, his response was that it had taken him many, many years to save the money to make the trip to the city. He lives five hours away. Any of you reading this cannot imagine living as this man has for all of these years. Everyone is interested in Angelito’s case because it’s very extreme. During the pre-op clinic, with a huge smile on his deformed face, he asked one of the surgeons if he would finally be handsome. The surgeon’s reply was perfection: “You will be more handsome.”

I’m blessed to be working alongside such big-hearted talent who are bestowing life-changing gifts on these grateful people.

Quartermaster, Steve, who has the job of maintaining
our supplies and transporting them, finding things that
need to be purchased, and stocking our hospitality
room.