#9 Friday 8/23: Rain, Ultrasounds and Bubble gum
Good morning, Familia! Hope you're having a great back pain-free morning complete with no mosquitos, body rashes, or sweaty stinky places. BM update. So I've had to eat more vegetables because things just don't want to move as well when you're on the other side of the world. I'm trying real hard, guys. Real hard. Maybe I have malaria. That could be it. Or maybe my body wash really is some crazy tropical disease/parasite that gives rashes and doesn't give bowel movements. Veggies might just be the key. Stay tuned on that and my possible malaria update.
So last night's dinner was amazing. I have to tell you about it because I wrote yesterday's post, which is really tomorrow's post for you all, but today, for me yesterday after, I had already posted it yesterday. Ya follow? Anyway, I had this amazing soup called coconut and sweet potato soup. What's crazy is their sweet potatoes aren't like our sweet potatoes. I discovered this when I asked for sweet potato fries/chips. Here, they are called chips because they are white, so they look like normal potato fries. So I asked the lady about it and she said that is their sweet potato. Anyway. They are amazing, and the soup is amazing and white, not orange, like our sweet potatoes. Anyone who knows me well knows I always have menu questions and can't decide on food. This is extremely challenging when the description of the food doesn't line up with my sense of reality. Needless to say, I am surprised every time I order food. The expectation never matched reality, yet I am still so pleasantly surprised by it. The food is delicious. Hamburgers are weird, though, but delicious.
So, I'm not sleeping well. My mattress feels like a wooden crate mixed in with overly large springs. My back hurts like crazy and I can't figure out the temperature. It's so hot and humid outside, but my room is freezing. At night, I feel like I'm sleeping in the northwest territory wearing a loin cloth. Anyway, I don't mean to complain, but I am, and you're reading this regardless, and American beds are amazing. Count your lucky stars, people. Count them. All of them. That's really the point I'd like to make here. Beautiful place with beautiful people who can't quite figure out the heating cooling bed situation. Awesome!
Ok, so we had a rather eventful day today. I found out that it is monsoon season and it lasts for one month. This month. Just this one. The one I came on! It rained all day and night, which made for an interesting day at work for the team. You see when it is raining or looks like it might rain or if people think the word rain then they just don't go out or go to work or whatever so they also don't go to the hospital or get their teeth worked on so the dentists had zero patients and went home by 1030 and just hung out with me the rest of the afternoon. I had one patient who weighed 1.5 kg, which is 3.3 pounds. You read that correctly. A little over 3 pounds was my patient today. Here's how that all went down. First we got to the hospital and a driver picked us up because again it was raining. Jill (the OB GYN) and I went to the pharmacy to check on Rip (the new ultrasound I built the day before) because we wanted to move it to the radiology room. We found 3 strong like bull guys and hauled it down the road and installed it in the rads room. Eno came in and told me that he was told by Dr. Ray to be trained on using the ultrasound machine. I thought great! Someone to teach. I spent all day with this guy and still have no clue what kind of credentials he has to run an ultrasound machine. No joke. He's just some guy who learned some ultrasound "stuff" on some pregnant women at some time who is now going to learn more ultrasound "stuff." It's how things are done here. Anyways. Dr. Ray also came to learn some skills but said he needed to discuss with me about a patient who needed some attention. That was this baby. She is 9 days old and was a low birth weight baby that was delivered to term apparently. Over the past day, her belly started getting big, and she stopped pooping (I feel ya kiddo!!!) Big deal for low birth weight babies. It's not as big a deal for a big grown man. They also couldn't get an IV. So I said we'll bring her here and I can scan her belly. So they brought the mom and baby to the rads room and used our brand new ultrasound machine to try and figure out what is going in with this baby. Took one look and about hit the floor. With the new ultrasound, I was able to see a bunch of free air in the belly. Not good. This means most likely a perforated bowel, which also isn't good. We don't have a pediatric surgeon or and OR even, and I'm not a pediatric anesthesiologist. We'd thought about placing a peritoneal drain in her belly using the ultrasound and also placing an NG tube, but they didn't have any drains, so we told them she needed to go to Honiara. It was the same hospital I was at the first day. They also don't have pediatric surgeons per se, but they had surgeons. So she's flying there today. In fact, she left about an hour ago. Stay tuned. It was pretty cool to have that new machine diagnose a problem right when it was built and right when we needed it at the time. Super crazy coincidence.
After that, we spent the day with Dr. Ray and Eno (whatever he does) and Willie, the intern. Willie is so great. Very meek like the rest of them and one of the hardest working people I've met. He works almost every single day. He'll take 4 days off in a month. That's it. Anyway, I trained them on using the new ultrasound from about 10 to noon and 2 to 5 today. I taught them FAST exams, which are scanning the body areas after trauma, basic cardiac scanning with their new phased array probe, and then I taught them 3 nerve blocks. My favorite. So because we don't have a functioning operating room, we have to be creative in doing procedures. There's a lot of diabetes and diabetic foot here. Something my dad knows all too well, and 2 patients came in with some infection on the big toe, then goes all the way to the bone, so we have to cut off the big toe. They have been doing it under some crappy sedation because they don't know what their doing there and some crappier local infiltration and they expressed interest in learning better ways to numb a foot so I taught them some lower extremity nerve blocks to accomplish that and we're going to operate on those toes on Monday after I have them do the blocks I taught them and then I'll cut off the toe. Should be fun. I'll send lots of pictures. This is definitely a story you are not going to want to miss.
I also programmed their new rads computer and set up some software and workflow things for them to move saved images from the ultrasound to a storage drive on their new computer. It is going to be interesting to see how they utilize this going forward. It's one thing to have someone come down. Build a machine. Teach them one or two times and then leave and have them fly solo. It will still be like swimming in the deep end for the first time for them. But they are extremely resilient and resourceful people, and I'm sure they'll figure it out.
So I think I told you about Shauna and the gum? Well, I've been passing out loads of gum. I even (believe it or not) got our dentist Julia to take one today! I know. Shocker! Anyway, I had a little surprise when I got back to the hotel. There on l of the hotel lobby (if you could even call it that) benches and chairs were a bunch of kids lined up sitting. I went up to them and saw that they recognized me, so I asked one of them why they were there inside the lobby. None of them talk. They never talk. They're too shy and meek, so I asked if they were waiting for me, and they all giggled and buried their heads in their arms and nodded. Melted my heart. I gave them all the rest of the gum I had in my pocket.
Another cool incident happened right after lunch. We went to drop off our dental friend, but the dental office was closed. Still raining. No patients, so they decided to tag along with use as I taught ultrasound. As we were driving away, I felt like having our driver stop by the kids' pediatric ward so I could go in and give some gum. I went there yesterday if you recall and gave some gum. When I went in there. One of the kids was screaming because they were decreasing a massive burn she had received when a giant pot of boiling food spilled on her. Burned 30% of her body. I had given her some gum yesterday. Today, however, she was getting her dressing change and a wound debreadment. Very painful. She was about 3 years old. So I went up to her, and she immediately stopped crying and held her hand out. Told her how big and brave she was, gave her some gum, and told her if she was brave, she could have more gum, so she held her hand our again. I wound up giving her 5 pieces of gum! And she stopped screaming. So stoic. Even the kids!! It's crazy. Something is just so different about them. Very cool to see.
Anyway. Long update, I know. Lots of cool things are happening. Be safe and be grateful. Tomorrow will be an incredible update. I'm not going to spoil anything but be ready. You're going to want to read the next one!
Stay tuned for another adventure with LTC Teames tomorrow! Enjoy the pictures.
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