It's almost 2 a.m. in the morning here. I can't sleep. My mind is busy with what-if scenarios. And, despite last night's preparations I'm not really able to comfort myself. I'm wide awake and looking at this two foot stack of folders that represent my work today.
My part today is by all accounts simple. I have to: greet every patient when presented to me by the helping local Rotarian's one by one; assign them a number and one of my pre-prepared charts; enter the first chunk of their basic information into the computer file; write the chart number and the patient's name on his or her forearm so that he/she cannot be lost in the process; and have each photographed by Dave, our photojournalist. From there, they are escorted with their new documentation through a process of pre-operative screenings with the surgeons, anesthesiologists, pediatricians, and orthodonist/dentist. By the time they are individually pushed through this process, they are pretty much destined for some kind of care -- or not.
When the files come back to me, I'll know which ones will have surgery although not which day until the head nurse, Carolyn and I figure that out later in the day. We have a dot system: green means that they will come back for surgery or some other service (each has a priority number of a 1, 2, 3, or 4 on it, indicating the level of need as assessed by the medical team); red means that the patient is temporarily or permanently not eligible for services, which is heartbreaking to imagine. Many of them will have traveled a long way, waited months and even years to be seen. The thought of them being turned away really is hard to comprehend. But the truth is that we only have so much resource for so many days. We have to have priorities and be realistic about whether a patient is the right age and is healthy enough to make it through surgery (people arrive sick sometimes and cannot undergo anesthesia -- that's a risk we do not take). Further the surgery must produce improvement and be within the scope of our mission.
About the scope of our mission. I learned yesterday that Rotaplast actually does more than just cleft palate and lip surgery. I found out that since we have plastic surgery, dental, orthodontic, and pediatric specialties on our team, for some missions the team will also take in severe burn cases where a person needs to have skin grafts and scar tissue removed. For this mission, there will also be patients needing specialty dental and orthodontic care or other things not offered locally or even regionally. I was surprised by how much the medical staff take on. They are the real angels on this mission; their hands give each patient a new chance at a good, healthy life.
This is all really good stuff. So why am I awake in the pre-dawn hours of the morning crying and fumbling with file folders? No, it's not jet lag -- I'm afraid of what I'm about to see. In the last 24 hours, I've had pictures put in front of me illustrating the severe condition of some of the patients; I've heard graphic descriptions of some of the kinds of cases the veteran team members have seen in the past. And, so far, I've had to look away and tune out the things that go beyond my abilities. The medical team, particularly some of the nurses, have been very encouraging understanding my fears in this. They are the other group of angels in this with jobs for holding children as they awake from anesthesia without their parents; comforting mothers who are seeing their children (limp from anesthesia) with stitches and in temporary discomfort. And even others who are preparing the children for surgery and playing with those in the ward after surgery before they are released to go home. These people have the biggest hearts. If only I could have a fraction of what they have.
My prayer is simple. Lord, let me see beyond each person's afflictions. Let me see the possibility and beauty for each patient's future. Give my mind and hands speed in my work. Give me a smile of confidence and hope that they will see a better tomorrow because of what we are all doing here together. Let love and compassion, not fear, shine in my eyes. And, please, please stop these silly tears.
My part of the mission is ready to go. I just need strength in my heart.
My part today is by all accounts simple. I have to: greet every patient when presented to me by the helping local Rotarian's one by one; assign them a number and one of my pre-prepared charts; enter the first chunk of their basic information into the computer file; write the chart number and the patient's name on his or her forearm so that he/she cannot be lost in the process; and have each photographed by Dave, our photojournalist. From there, they are escorted with their new documentation through a process of pre-operative screenings with the surgeons, anesthesiologists, pediatricians, and orthodonist/dentist. By the time they are individually pushed through this process, they are pretty much destined for some kind of care -- or not.
When the files come back to me, I'll know which ones will have surgery although not which day until the head nurse, Carolyn and I figure that out later in the day. We have a dot system: green means that they will come back for surgery or some other service (each has a priority number of a 1, 2, 3, or 4 on it, indicating the level of need as assessed by the medical team); red means that the patient is temporarily or permanently not eligible for services, which is heartbreaking to imagine. Many of them will have traveled a long way, waited months and even years to be seen. The thought of them being turned away really is hard to comprehend. But the truth is that we only have so much resource for so many days. We have to have priorities and be realistic about whether a patient is the right age and is healthy enough to make it through surgery (people arrive sick sometimes and cannot undergo anesthesia -- that's a risk we do not take). Further the surgery must produce improvement and be within the scope of our mission.
About the scope of our mission. I learned yesterday that Rotaplast actually does more than just cleft palate and lip surgery. I found out that since we have plastic surgery, dental, orthodontic, and pediatric specialties on our team, for some missions the team will also take in severe burn cases where a person needs to have skin grafts and scar tissue removed. For this mission, there will also be patients needing specialty dental and orthodontic care or other things not offered locally or even regionally. I was surprised by how much the medical staff take on. They are the real angels on this mission; their hands give each patient a new chance at a good, healthy life.
This is all really good stuff. So why am I awake in the pre-dawn hours of the morning crying and fumbling with file folders? No, it's not jet lag -- I'm afraid of what I'm about to see. In the last 24 hours, I've had pictures put in front of me illustrating the severe condition of some of the patients; I've heard graphic descriptions of some of the kinds of cases the veteran team members have seen in the past. And, so far, I've had to look away and tune out the things that go beyond my abilities. The medical team, particularly some of the nurses, have been very encouraging understanding my fears in this. They are the other group of angels in this with jobs for holding children as they awake from anesthesia without their parents; comforting mothers who are seeing their children (limp from anesthesia) with stitches and in temporary discomfort. And even others who are preparing the children for surgery and playing with those in the ward after surgery before they are released to go home. These people have the biggest hearts. If only I could have a fraction of what they have.
My prayer is simple. Lord, let me see beyond each person's afflictions. Let me see the possibility and beauty for each patient's future. Give my mind and hands speed in my work. Give me a smile of confidence and hope that they will see a better tomorrow because of what we are all doing here together. Let love and compassion, not fear, shine in my eyes. And, please, please stop these silly tears.
My part of the mission is ready to go. I just need strength in my heart.
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