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I don't think I could ever be a surgeon. No, I just can't be. I was truly fortunate to have been invited to come along on the medical mission organized by a local rotary club. The 6 hour boat ride landed us on the beautiful Camotes islands.. Breathtaking views! The local government, apparently unable to furnish enough vans or jeepneys to transport 60+ people, kindly provided us two garbage trucks, which hauled us to the local hospital where we slept a few hours on the hospital beds in the ward before the morning onslaught of patients.
And what a stampede it was! 150+ circumcisions, almost 60 surgeries (including 2 thyroidectomies), dozens of internist consultations, and a live birth, all completed before 5PM that day. Understaffed and overwhelmed, the organizers put everyone to work, even us - first year medical school graduates - myself, and 2 of my frat bros. We performed several circumcisions (we, i mean mostly my bros as this was my first mission, and they've done this before). I assisted, I sutured, I cut a few times, but I think my hands are just too awkward for this kind of work. I mean, I did what had to be done. But I lacked the grace, the precision, and I would describe my work as barely adequate.
Afternoon we were placed to assist surgical residents in performing operations. My job was retracting tissue, wiping the surgical site in order to keep the view free from blood, and passing instruments. There were two especially interesting cases I've got to assist in. One was a neoplasm of unknown origin on the hand of a teenage boy. The tough palmar fascia, the involvement of tendons in the tumor, and the proximity of arteries made this operation somewhat challenging for a field setting. About 90% of the tumor was extracted; the remainder could not be touched without injuring the tendon. The sad part was, we had no biopsy capability. The tissue was thrown out.
The second procedure was something that cannot be witnessed in the first world. It was the last surgery of the day, and an older man came in with a 12 year aged cyst on his upper posterior thigh. I understand the surgeon's desire to operate - if he hadn't the man would wait another 12 years to seek medical assistance again. However, we were all out of surgical blades. So, the operation was performed without a scalpel. A sterile needle was used to cut superficial tissue, while scissors were used to cut deeper. To make matters worse, the sebaceous cyst turned out to be larger internally than visible on the surface. It was fluid filled. What was supposed to be a 10 min procedure under lidocaine local anesthesia became a 1 hour ordeal for the patient. After a second shot of lidocaine, the doctor did not want to risk overdosing with the third. The last 15 minutes the operation was done on the sensitive patient.
There is no doubt that this procedure needed to be done. The fluid filled cyst could have burst internally. It could turn malignant. And the man clearly had no resources to go to a big city to have this surgery. But I don't think I could handle this situation, as a surgeon. My stomach still twists in knots. Maybe some day ill put the good of my patients above my personal stress levels. But if I go on this mission again, i think i'll stick to IM clinics, at least the next time.
And what a stampede it was! 150+ circumcisions, almost 60 surgeries (including 2 thyroidectomies), dozens of internist consultations, and a live birth, all completed before 5PM that day. Understaffed and overwhelmed, the organizers put everyone to work, even us - first year medical school graduates - myself, and 2 of my frat bros. We performed several circumcisions (we, i mean mostly my bros as this was my first mission, and they've done this before). I assisted, I sutured, I cut a few times, but I think my hands are just too awkward for this kind of work. I mean, I did what had to be done. But I lacked the grace, the precision, and I would describe my work as barely adequate.
Afternoon we were placed to assist surgical residents in performing operations. My job was retracting tissue, wiping the surgical site in order to keep the view free from blood, and passing instruments. There were two especially interesting cases I've got to assist in. One was a neoplasm of unknown origin on the hand of a teenage boy. The tough palmar fascia, the involvement of tendons in the tumor, and the proximity of arteries made this operation somewhat challenging for a field setting. About 90% of the tumor was extracted; the remainder could not be touched without injuring the tendon. The sad part was, we had no biopsy capability. The tissue was thrown out.
The second procedure was something that cannot be witnessed in the first world. It was the last surgery of the day, and an older man came in with a 12 year aged cyst on his upper posterior thigh. I understand the surgeon's desire to operate - if he hadn't the man would wait another 12 years to seek medical assistance again. However, we were all out of surgical blades. So, the operation was performed without a scalpel. A sterile needle was used to cut superficial tissue, while scissors were used to cut deeper. To make matters worse, the sebaceous cyst turned out to be larger internally than visible on the surface. It was fluid filled. What was supposed to be a 10 min procedure under lidocaine local anesthesia became a 1 hour ordeal for the patient. After a second shot of lidocaine, the doctor did not want to risk overdosing with the third. The last 15 minutes the operation was done on the sensitive patient.
There is no doubt that this procedure needed to be done. The fluid filled cyst could have burst internally. It could turn malignant. And the man clearly had no resources to go to a big city to have this surgery. But I don't think I could handle this situation, as a surgeon. My stomach still twists in knots. Maybe some day ill put the good of my patients above my personal stress levels. But if I go on this mission again, i think i'll stick to IM clinics, at least the next time.
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