Surgical day at St. Mary's, Saturday

Surgical Day at St. Marys

Emmanuel, our main interpreter, told us a story this morning that brought tears to many of our eyes. Last night, Friday night, he received 3 telephone calls (everyone here has a cell phone). Every one of the calls were from people we had treated in clinic that day and they wanted Emmanuel to tell “the American doctors” that they felt the Holy Spirit and saw Jesus standing beside our doctors during their clinic visit. That is the reason that we are here: so that others will see Jesus through us and our actions.

When we committed to 5, possibly 6 surgeries for Saturday, we knew we were committing to a long day. Although we had some concerns that the anesthesiologist and the OR tech did not understand us when we told them how late the work would go, our fears proved unfounded. We arrived at the hospital at 9 am, after a stop at the local bank to get money. All of our surgical patients were sitting on the slatted wooden benches lining the hall at St. Mary’s.

Pre-op care is very different here. When the doctors are nearing time for the surgery, the patient is taken back to a bed, told to disrobe and wrapped in a sheet. Then an IV is started. For all of you medical personnel, the IV is very simple—a tube line with a black plastic butterfly-shaped paddle at the end, followed by the needle. The needle is inserted into the vein and the butterfly paddle is taped to the arm. No syringe is used.

Once the doctors are ready for the surgery to start, the patient walks down the hall and into the OR, gets up on the table and lays down. The table is covered with a heavy green canvas, which is topped with a red rubber sheet. Almost all of our surgeries are being done with a spinal, not general anesthesia, so they are awake and alert during the surgery. Also, there is no monitoring of the patient like we are accustomed to in the US. They are not connected to any device, other than their IV. We have continued our buddy system and the person who was their buddy/helper/advocate through their clinic visit is in the OR with their patient. We stand at their head, where they can see us, and hold their hand, smooth their hair, pat their arm, and murmur to them encouragingly. Of course, they do not know what we are saying, but we believe they take comfort from having the same person with them.

After their procedure is finished, the patient is lifted onto the (only) gurney by grabbing the edges of the green canvas. The gurney is wheeled down the hall to the room where the patient will receive their post-op care and, again, lifted from the gurney and carried into the room using the green canvas. This usually requires 4-5 people: two on each side and one to hold the head if the patient is not awake. The buddy is then in charge of post-op care, taking vitals every 15 minutes, then once at 30, then a final an hour later. All of our non-medical helpers are the buddies and have been taught to take vital signs. It gives the team a strong connection to the patient. The RN or the doctor comes to the buddy to ask questions about their patient, so the buddy sticks pretty close until the final vital is taken and we know that they are doing well.

Unfortunately, Barbara’s foot worsened overnight, so she was one of the 6 procedures that we did yesterday. The general surgeon drove here from Dar es Salaam (3 hours) and we used general anesthesia for Barbara so he could lance her wound and drain it. That bumped our 6th (now 7th) case to Sunday morning, so two of our doctors are going to St. Mary’s this morning to do that procedure and to assist in the surgery for the two little boys, which the general surgeon is doing.

By the time we finished our last procedure last night and made sure all of our patients were stable, it was 8:30—far too late to get dinner at LJS. We opted to revisit the Acropol Hotel and invited the general surgeon, the anesthesiologist, Emmanual, and our driver to join us as our guest for dinner. The food was wonderful and we all enjoyed the treat of the American-style bathroom! By the time we were delivered to our beds at 11 pm, we all felt it had been a very long, but rewarding day.