Operating Room – Day 1

I think it’s safe to say that when we woke up Sunday morning and headed over to the hospital to begin our surgery “clinic” – we weren’t entirely sure what to expect.  Did the patients think they were just being evaluated for surgery, a final yes or no as to whether they were appropriate candidates?  Or did they think they were coming to be operated on immediately?  We were certainly prepared for both possibilities but Alyssa, Jim, and I were not entirely sure.  Would anyone even show up?

When we arrived, the triage area was packed full of patients.  Immediately, I began to panic.  There were easily 50 people in the triage tent.  triageThere was no way we would be able to get through 50 surgeries in one day; we might not even complete 50 surgeries in a week!  As it would turn out, not all of the patients were for us to operate, many were there to be evaluated by the urologist (Mitch) in the clinic.

We walked into the surgical suite and sprung into action.  I began setting up for our first case while Alyssa and Jim assessed the patients.  Our first case turned out to be a patient who had a previous hernia repair, but his hernia had recurred.  Great… way to start out easy.  Given the amount of scar tissue from the prior hernia repair, his case took the longest of the day.  Alyssa brought some Prolene mesh with her from Arizona, so we were able to perform a Lichtenstein repair (I realize I lost some of you on that one.  A little background first: hernias are essentially holes in the tissue that holds our muscles together known as fascia.  Many people think a hernia is the lump or bulge that they see or feel, but in fact the hernia is just the hole.  Traditional hernia surgery involves sewing muscles/ligaments together in order to cover the hole, however this has a high rate of recurrence.  A Lichtenstein repair basically uses the mesh in order to cover the hole.)

Because this man’s repair took so long, we ended up performing only 3 surgeries before lunch time – another hernia repair and a huge lipoma.  The morning had started off slow both in the operating room and just logistically trying to coordinate patients in pre-op and post-op.  We went back to Villa Francesca, inhaled lunch, and returned to St Luke’s recharged.

The problem we had in the morning was that the air conditioning was only working in OR #1 but was broken in OR #2.  Despite attempts to fix it, OR #2 was stifling hot.  We figured if we left the doors between the ORs open, that some of the air would flow from OR 1 to OR 2.  We decided that major cases would be done in OR 1 while minor cases would be performed in OR 2, given that it still wasn’t all that cool in there.

I think it’s safe to say that we then kicked some ass.  We ended up doing another 7 procedures that afternoon – 4 more lipomas, a neck mass, an unknown leg mass (which we sent to pathology out of concern it might be cancer), and a large epigastric (above the belly button) hernia.

We finished up and headed over to the candlelight mass at 7pm.  Father Rick had returned from Canada, which meant church was back on.  After a long first day, it would be a good moment to sit and reflect.

Filed under: Haiti, medicine Tagged: travel

Posted in Clinical Experience, Haiti, St. Luke's Hospital

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