Doctorita Emily, orthopedic surgeon.

Hello again dear friends! This time I am writing to tell you I have decided on a career change.  I recently participated in yet another medical brigade, and had the rare experience to assist some surgeries, and based on my performance, I will now be doing surgeries in the jungle of Ecuador.  Ok, so not quite. Not at all actually, but wouldn’t that be amazing!? J Okay, so here’s what really happened…

In July, my birthday weekend, to be exact, a group of doctors/surgeons/techs/dentists/everything came from the big private hospital in Quito to do a philanthropic trip to the jungle for 2 days at the local Catholic hospital in Archidona, the next town over from Tena.  This hospital is where Nicole made her start here in Ecuador, so she is in with all the docs there, and arranged to have some of our kiddos checked out by the pediatric orthopedic surgeon.   Here is a perfect example of when you are probably assuming that it was a smooth, uneventful process to have our kids seen by the docs… and yet again, you’d be wrong. Besides, that doesn’t make for a very interesting story, does it?  See, since the last time we talked, our clinic in Tena was moved to a new location (I’ll explain that later), which means some of our kids haven’t been coming to therapy- Some of whom we had hoped to get hooked up with this brigade.  But since Tena is a fairly small town, and Nicole has been closely involved in these kid’s lives for the past 7 years, we spent a couple days driving around town, trying to track down some of the kids to give their parents the information on where and when to show up.  Again, it would have been a lot easier if everyone had cell phones, to which they provided us the number, but AGAIN, wishful thinking.   One of the kiddos was the little sister of Marlon (remember the tear-jerker entry about the kid and the wheelchair?), whose name is Maite and she has club feet so she isn’t able to walk.  Thankfully for that amazing experience with Marlon, I knew where they lived, so one day, Nicole and I jump in her car and head off for an adventure. J As we were getting closer, I was starting to doubt that my memory was going to serve correctly. What I remembered was that it was the first road after passing Archidona, then follow the road passed the soccer field after it curves left.  I know what you’re thinking. “Yea right, you’re never gonna find it”.  But as I have always been pretty good with directions and visual memory, I did in fact lead us the right way. And seriously, folks, that’s as good as directions get around here. No one knows street names, and why should you when they are rarely posted anyways.  All directions are given by landmarks and geographical references.  Just another example of how I am more and more “Ecuadorean” as the days go by. ;)

Okay, back to the story. The good news is that we arrived and Marlon’s parents were both home. We told his mom to hop in the car with Maite since we could take them down to the hospital now to be seen. The idea would be to have Maite admitted that afternoon so that she would already be there to have surgery first thing in the morning.  Mom was eager and willing, so with Maite in tow, we were back on the road heading back to the hospital. Great, success… for now.  On the way to the hospital Maite’s mom informs us that they have a type of social security insurance and, in order to get the costs of the surgery covered,  we needed to go to their hospital in Tena to get them to “transfer” Maite as a patient to the Archidona hospital. Well, this then lead us on another chase around town to figure out which place was the correct place to get the correct paperwork for all this to happen.  Somehow, still unclear to me, it all got worked out and Maite was ready for surgery the next morning when we arrived at the hospital for the big day.

Okay, so here’s where it got fun! J Since this was not our brigade, one of the questions I had for Nicole before all this was, “what is our role in this brigade, particularly, today?” she just informed me that we got the kids there (about 10 of our kids got checked out, and 4 kids had surgery), and after that we could just hang out and observe the surgeries, if possible.  Great! I’m in! Since I went to a junior college for my prerequisite classes, I never did get to do any cadaver work in my anatomy classes, so I’ll admit, I didn’t know what my physiological response was going to be to seeing someone actively cut open, but my curiosity was far too peaked to skip out on this chance! As usual, we were on Ecuadorean time so by the time our first kiddo was prepped and being put under anesthesia, Nicole had to leave to pick up her daughter, leaving me to stay and watch the surgery.  Let’s be really clear here, my understanding was that I would just watch, but I didn’t know what any of the procedures or protocols are for this kind of thing. My closest relatable experience would be watching Grey’s Anatomy on tv…. And in that OR, everyone scrubs in.  So here’s how it goes: we’re all standing around chatting, and then the surgeon says “ok, let’s scrub in”. Well, I didn’t want to be the ass who didn’t know what to do, so I just followed everyone over to the sink, imitated their techniques the best I could and scrubbed, scrubbed, scrubbed.  Walked back into the OR and was dressed and gloved by the surgical tech. Man, this is cool. It’s just like on TV, I’m official! Now what?! Well, once I was all gowned up, I just stood where I thought I would be able to see but also stay out of the way. At this point I realize that there are still people coming in and out of the room, standing around, there to observe… who aren’t scrubbed in. Uh oh.  Then I realize they are a gown-set short. Double uh oh.  Well, it’s too late at this point (and the tech sent someone off to get another gown-set), and then the surgeon is asking me “are you going to help?” to which I respond “whatever you would like”.  Triple uh oh.  “Come stand here”, he says, and motions me to his right side between him and his assistant (an actual med student, who actually does know what he’s doing, of course).  Now I’m nervous. My plan to gracefully exit if I start to feel queasy is no longer an option.  The gum I am chewing in hopes that it will supply me with small amounts of sugar to keep me on my feet is starting to lose its flavor.  I just watched one my kiddos be put under anesthesia, flipped over, legs put in tourniquets, body covered in sterile drapes, all with such detachment from the fact that this is one of my little kiddos.   I do my best to look comfortable and confident, and inside I am telling myself, keep breathing, slow and steady, this is a chance of a lifetime, don’t mess this up!   Ok, everyone’s ready and it’s go time… I hear the surgeon so that infamous word, “scalpel”. 

It. Was. Amazing.

Here’s where I am going to get a little bit graphic, so the queasy folk may want to skip on down to the next paragraph.  This particular kiddo had clubbed feet, which basically means that the ankle joint is malformed and the muscles and tendons surrounding the joint have adapted accordingly. So my job during his surgery was to hold his feet in whichever position the surgeon needed.  Thanks to the tourniquets, there wasn’t much blood, but I got an up close and personal view as they sliced, cut, clamped, repositioned, screwed and re-sewed nearly all parts of the joint.  3 hours later both feet had big screws sticking out of them to hold them in their new found correct position and the muscles could accommodate. 

And the best part of it all… I didn’t faint!! I didn’t even get queasy. I was far too distracted by how incredibly strong and intricate the human body is, how accurate and precise the surgeons were, how smooth the whole choreography of the surgery was between these 5, now 6 thanks to me inviting myself in, people.  When it was all done, the surgeon turned to me and said “so are you a med student?” To which I responded, “no, I’m just his occupational therapist”, pointing to the kiddo whose feet I had just man-handled with all the strength I had, “and I’m proud of myself that I didn’t pass out”.  “Wait, have you ever been in a surgery?” Gulp.  Turns out the surgeons knew I was a volunteer, and that I worked with Nicole in some capacity, but that was the extent of their knowledge of me.  “Well, you were a natural. You did well” he concluded.  Perhaps it was only flattery, but I’ll take it. Only in Ecuador.