Today was a much busier day as it was a combination follow-up clinic day and surgical screening day. About a third of the kids we saw were there for a follow-up on the operations they had done a year ago. A few turned out to need minor revisions and were put on the schedule, but most were fine. The other two thirds were there to be screened for surgery this week. It made for a very hectic day, but it was the first time I've had a chance to see the longer term post-op results from a mission. The kids looked great! Generally, when I leave, though the changes in the children's faces are dramatic, there is swelling and the stitches are in place and often there is tape obscuring part of the lip or nose. Also, the kids are generally in pain and unhappy. It was lovely to see smiling happy kids with minimal scars chattering away in the hall. It was also really nice for the parents of the babies who were there for their first evaluations to see the results first hand.
We started today with a Mass that was arranged by the hospital in our honor. Attendance was optional as Op Smile is not a religion-based organization, but I think nearly the whole team attended out of respect for the hospital administration. I've only been to Catholic Mass a couple of times, for first communion of a nephew's daughter and for a friend's wedding. They were fairly formal affairs and my main memory of them is that they were long. Although this one followed the usual format, there were a few things about it that made it very different for me. The first was that they had a "Moment of Peace" similar to what I've experienced in Protestant churches where everyone turns and greets the people around them and offers wishes for peace. The next was that the priest walked all around the conference room where the mass was held, dipping an evergreen branch in a silver vessel of ? holy water and flicking on us while repeating a phrase about anointing. If he missed anyone in a row, he would stop and grin and dip the branch and fling more water to be sure everyone was anointed. It was clear he was having a good time as well as performing the ritual. Next, I was sitting beside Alessia, the anesthesiologist from Italy. She said that she loves to go to Mass in Spanish speaking countries because when the priest talks about the "lamb of God," he uses the word, "cordero" for lamb. In Italian, there are apparently two words for lamb, one for the animal and one for lamb you eat, which is cordero like the Spanish. So when the priest said "Cordero de Dios," Alessia started smacking her lips and saying, "Mmmm, cordero," under her breath.
The real highlight of the Mass, however was the priest's homily. He spoke about trying to really think about what an ideal world would be like if all obstacles were gone. Ask yourself what your dream world would be. He said that of course, some might right away think of being a basketball star or a billionaire, but that those were fleeting. Instead, he meant to try to imagine what the world could be like. He imagines a world with no hunger or war where everyone treats one another with kindness and respect. Then, he said, each morning when you get up, try to live just that day in the image of your dream world. When he's downtown and there are beggars or people at intersections trying to sell him trinkets, he always gives a little and always greets them. He said he knows that giving a few cents to a person here and there doesn't really affect the world in any great way, but it is consistent with moving toward his envisioned world. He tries to make each action he takes each day reflect his dream, and feels if more people did this, the world would move toward peace..
I found myself captivated by what he was saying. There are many times when I second guess what I'm doing, particularly when I go to a village in Guatemala and give a child a month's worth of vitamins or treat his current pneumonia. Neither action will have much effect on his ultimate health, nor any on the health of his community. The community gardens we're facilitating will have a sustainable impact on the people whose villages receive them, but there are hundreds of villages whose members will continue to go hungry. The priest's words, however made me realize that even small actions have meaning, even if you only help a handful of people. Enough philosophizing.
A volunteer from Canada presented the priest with a candle that has been passed from church to church on medical missions, starting at a Russian church. There's a photo in Picasa of the priest with the volunteer.
I also posted some photos of the surgical scheduling. I have only been in on that process one other time as it's usually done by the clinical coordinator and the surgical and anesthesia team leaders. This time it just turned out that all the surgeons and three anesthesiologists and I were together in a room when the clinical coordinator came in with the scheduling boards and charts, and we all did it together. There are some unwritten guidelines - try to get the babies on the tables first so they don't have to go without eating so long, balance lips and palates so the surgeons don't get exhausted, alternated longer and shorter cases, etc. This time, there were also some controversial cases that we had to all agree on if they were to have surgery. One was a 17month old boy who weighs only 8 pounds. He has a syndrome of some sort with some hand and foot deformities and mild hydrocephalus, and a cleft lip and palate. He doesn't walk or talk and has difficulty eating due to his cleft lip. The family lives in a very remote village 8 hours away by bus and saved up money since he was born to come today. Some people didn't want to do his surgery as he looks frail and has all these other problems. One of the anesthesiologists and I felt strongly that he should have it in order to be able to eat and to get the family accepted back into the village. We eventually won the rest of them over and he's on the schedule. I was very impressed with how thoughtful the discussion was around scheduling the patients. I posted a couple of photos on Picasa of that process as well.
There are also some of the Child Life people playing with kids outside while they wait to be called for registration. It's a very long day for the kids and their families, and the Child Life team members do a great job playing, supporting parents, demonstrating masks, IV's and other OR paraphernalia and just easing the kids' way in general. I put up a photo of a child and Mom in traditional dress and then the same couple with Igor, the pediatric intensivist from Russia. And finally, a couple of photos of kids having their pre-op photos. They get fairly precise photos done before, during and after surgery to track their progress. The younger kids hate it as they have to be held in precise positions.
Well, I'm drifting so I'll stop now. Tomorrow is team day at Antigua and then Sunday, the surgery begins. I decided to wait on pre and post op photos until the surgical days to try to keep order more easily.
We started today with a Mass that was arranged by the hospital in our honor. Attendance was optional as Op Smile is not a religion-based organization, but I think nearly the whole team attended out of respect for the hospital administration. I've only been to Catholic Mass a couple of times, for first communion of a nephew's daughter and for a friend's wedding. They were fairly formal affairs and my main memory of them is that they were long. Although this one followed the usual format, there were a few things about it that made it very different for me. The first was that they had a "Moment of Peace" similar to what I've experienced in Protestant churches where everyone turns and greets the people around them and offers wishes for peace. The next was that the priest walked all around the conference room where the mass was held, dipping an evergreen branch in a silver vessel of ? holy water and flicking on us while repeating a phrase about anointing. If he missed anyone in a row, he would stop and grin and dip the branch and fling more water to be sure everyone was anointed. It was clear he was having a good time as well as performing the ritual. Next, I was sitting beside Alessia, the anesthesiologist from Italy. She said that she loves to go to Mass in Spanish speaking countries because when the priest talks about the "lamb of God," he uses the word, "cordero" for lamb. In Italian, there are apparently two words for lamb, one for the animal and one for lamb you eat, which is cordero like the Spanish. So when the priest said "Cordero de Dios," Alessia started smacking her lips and saying, "Mmmm, cordero," under her breath.
The real highlight of the Mass, however was the priest's homily. He spoke about trying to really think about what an ideal world would be like if all obstacles were gone. Ask yourself what your dream world would be. He said that of course, some might right away think of being a basketball star or a billionaire, but that those were fleeting. Instead, he meant to try to imagine what the world could be like. He imagines a world with no hunger or war where everyone treats one another with kindness and respect. Then, he said, each morning when you get up, try to live just that day in the image of your dream world. When he's downtown and there are beggars or people at intersections trying to sell him trinkets, he always gives a little and always greets them. He said he knows that giving a few cents to a person here and there doesn't really affect the world in any great way, but it is consistent with moving toward his envisioned world. He tries to make each action he takes each day reflect his dream, and feels if more people did this, the world would move toward peace..
I found myself captivated by what he was saying. There are many times when I second guess what I'm doing, particularly when I go to a village in Guatemala and give a child a month's worth of vitamins or treat his current pneumonia. Neither action will have much effect on his ultimate health, nor any on the health of his community. The community gardens we're facilitating will have a sustainable impact on the people whose villages receive them, but there are hundreds of villages whose members will continue to go hungry. The priest's words, however made me realize that even small actions have meaning, even if you only help a handful of people. Enough philosophizing.
A volunteer from Canada presented the priest with a candle that has been passed from church to church on medical missions, starting at a Russian church. There's a photo in Picasa of the priest with the volunteer.
I also posted some photos of the surgical scheduling. I have only been in on that process one other time as it's usually done by the clinical coordinator and the surgical and anesthesia team leaders. This time it just turned out that all the surgeons and three anesthesiologists and I were together in a room when the clinical coordinator came in with the scheduling boards and charts, and we all did it together. There are some unwritten guidelines - try to get the babies on the tables first so they don't have to go without eating so long, balance lips and palates so the surgeons don't get exhausted, alternated longer and shorter cases, etc. This time, there were also some controversial cases that we had to all agree on if they were to have surgery. One was a 17month old boy who weighs only 8 pounds. He has a syndrome of some sort with some hand and foot deformities and mild hydrocephalus, and a cleft lip and palate. He doesn't walk or talk and has difficulty eating due to his cleft lip. The family lives in a very remote village 8 hours away by bus and saved up money since he was born to come today. Some people didn't want to do his surgery as he looks frail and has all these other problems. One of the anesthesiologists and I felt strongly that he should have it in order to be able to eat and to get the family accepted back into the village. We eventually won the rest of them over and he's on the schedule. I was very impressed with how thoughtful the discussion was around scheduling the patients. I posted a couple of photos on Picasa of that process as well.
There are also some of the Child Life people playing with kids outside while they wait to be called for registration. It's a very long day for the kids and their families, and the Child Life team members do a great job playing, supporting parents, demonstrating masks, IV's and other OR paraphernalia and just easing the kids' way in general. I put up a photo of a child and Mom in traditional dress and then the same couple with Igor, the pediatric intensivist from Russia. And finally, a couple of photos of kids having their pre-op photos. They get fairly precise photos done before, during and after surgery to track their progress. The younger kids hate it as they have to be held in precise positions.
Well, I'm drifting so I'll stop now. Tomorrow is team day at Antigua and then Sunday, the surgery begins. I decided to wait on pre and post op photos until the surgical days to try to keep order more easily.
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