Sunday, January 6, 2013

A Non-medic on a Medical Mission

For all of the detailed details about the medical mission, check out the International Extremity Project blog or Facebook page
I'm in Vietnam on a medical mission. My primary role in Vietnam is keyboard jockey for the International Extremity Project. Given that I'm not qualified to provide medical care, it seems to make good sense.

I spent the first two days working with an interpreter to start each patient's medical chart for the intake process. I spent Friday in scrubs -- in the operating room during surgeries helping prep, observing, and reassuring a patient. I've been blogging since we started preparing for the trip months ago -- and doing much more now that we're here.

Everything is an experience -- inside the hospital and beyond. I've now been here a full week. In some ways it feels like I've just arrived and in others it seems I've been here much longer. I can find my way to the vegetarian restaurant for pho and know we'll likely be the only westerners there.

Can Tho is a very busy place. I've learned to cross the street in a world without stop signs and where those dotted lines down the middle of the street are often merely suggestions. Here's the trick. Ready? Once you start across, DO NOT STOP. The 17 scooters zooming around you are calculating their routes based on your path of travel. Stopping? Bad idea more likely to net you tire tracks and a Honda or Yamaha tattoo.

I saw helmets, and I use that term extremely loosely, at the giant wal-mart-ish store today, co-op.mart. They come in all sorts of colors with characters on them, or Nike logos, or you name it. Most everyone wears them -- the adults anyway. A steal at 149,000 dong and up. Sounds pricey until you realize that it's $7 US. Needless to say, my full-face Arai Vector-2 was considerably more. And thank you, I think my gray matter is worth it.
Wanna buy a birdie?
At least 20 birdcages by my count,
with who-knows-how-many birds within.
  • Most people I've seen on a single scooter: 5
  • Most dogs I've seen on a single scooter: 2
  • Most birds I've seen on a single scooter: too many to count
  • Common but amazing sight (to me): Adults on scooters who are texting and smoking while carrying helmet-less toddlers
There are a lot of patients in the orthopedic ward of Can Tho General Hospital with lower-leg injuries. My guess is that the percentage of injuries resulting from scooter accidents is high and is only increasing as the scooter population continues to soar.

I spent the first half of Friday at the hospital in the operating room. Right there, just feet from feet. I saw an achilles lengthening to repair equino cavus (toe walker) and a much more intense surgery that involved removing an extra tendon, cutting and fusing bone, and wiring bone to position the foot. AMAZING. There is not much blood because of the tourniquet above the surgery site. I thought I might get queasy -- especially when the bone saw started up -- but I refrained from returning to the green hue that haunted me on my travels to Can Tho.

IEP's Wing Ip, DPM
I spent close to an hour just having my hand on the shoulder of the young man (27) getting the more complex surgery. The patients are not under a general anesthesia -- just a spinal block and a dose of fentanyl to calm them. They hear everything. I noticed that his heart rate stayed lower and more consistent when I was there and occasionally made eye contact when he opened his eyes upon hearing drills and hammers (yes, hammers).

At this point, I'm glad I was out cold when I was receiving my titanium toe. So far, the patient wards are the most intense aspect of this experience for me. They're entirely unlike the hospital rooms at home. Imagine four patients to a room -- kids or adults -- on rather simple cots against the wall. No monitors, no fancy equipment, no air conditioning. It's definitely not the sterile environment of U.S. hospitals.

Families handle most of the post-operative care: food, meds, bedding, etc. Many patients come from a distance to receive surgeries, so their entire families are there as well. People set up camp on bamboo mats in hallways at the stairwells or on the floor in the patient room if there's enough space. It's hot and chaotic.

I know from personal experience that foot and ankle surgeries are very painful. I can't imagine trying to recover and manage my pain in that environment. But I met several of the patients from previous missions. IEP is truly changing lives. And somehow, I'm fortunate enough to play a small part along the way.

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