Saturday, September 1, 2018

Spiderman Says

Spiderman says "With great power comes great responsibility." 

I tell my medical students that with great privilege comes great responsibility. And it is truly is a privilege to do what I get to do. It's the reason I work long and hard hours.
Bed Overflow

When I signed up for a surgical residency, I didn’t do it for the money. I certainly wasn’t looking for a life of ease. To be honest, I was slightly naive at the time of all that it would demand. But I knew that surgery was an invaluable tool that could be used to impact the the world around me.

Covering the ward this week, I start my day seeing all our inpatients. This last month the surgery department was the busiest it has been in the history of Kibuye with more surgeries, more consults and more hospitalized patients than ever before. Yet we had below-average numbers of deaths. This week alone we had over 50 hospitalized surgical patients at one point. 

BEFORE
AFTER
As most of our patients speak Kirundi and my medical students speak French and Kirundi, all bedside care is performed in at least 2 languages. Unfortunately for me, the medical students prefer my french to my english. 

At several minutes per patient, if we add some bedside teaching, rounding on every patient can take around 4 hours. Then begins the daily tasks of checking X-rays, wound care, fracture reductions, casting, discharges, and new consults that arrive in emergency and clinic throughout the day.

My students have quickly learned that surgery life is not easy. It requires long hours of patient-care while studying outside those hours. 

This week included rounding on one of the medical students who was sick - in his dorm bed. His student colleagues put on their most serious faces and presented him as they would any other surgery patient. We even offered him a surgical bed so he could complete his work while being sick, although for some unknown reason he politely declined. Surgery life is hard but we find ways to laugh during the day. 


My kids often pray for my patients and I am so grateful for this. For several weeks a young boy, who fell 5m onto his head while playing, has been hospitalized. He presented after 1 week to our hospital, paralyzed on one side and unable to speak since the accident. I wasn't too hopeful for him when I took him to the OR to discover multiple skull fragments floating around the back of his head in a sea of infection, although I couldn't find an obvious reason for why the speaking part of his brain was not working. These are the times when from behind my surgical mask I truly cry out to God. Not only because of the injured child on the table before me, but also because a paralyzed child in Burundi has a very challenging life ahead of him.

Over the next days we continued caring for him and did our best to protect his fragile head. This week on rounds his father, who has been at his bedside each day feeding, carrying and moving his son, nearly leapt for joy as he showed me how his son could move both his arm and leg at will. When I offered the boy a sucker (which I regularly I stock in my white coat pockets) he was almost able to speak the word "urakoze", meaning "thank you!" And while he is not completely out of the woods yet, I believe that God is the great engineer and healer of the human brain and I am grateful for his amazing work.

What gets me out of bed early in the morning and keeps me up late at night is the impact of surgery, hope and compassion which can not only bring about healing but can also give dignity to those who are suffering. Demonstrating the compassion of Jesus in this setting though quality surgical care is truly a privilege. It's what we at Kibuye Hope Hospital want to model to our patients and medical students. It's why we are here!








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