Screening and Operating

Day One!

We woke up bright and early this morning, and the hotel had prepped a beautiful breakfast for us. We feasted on eggs, bacon, hash browns, fried plantains, and fresh fruit before boarding the bus to the Hospital Nacional General. The screening teams are made up of surgeons, nurses, PAs, anesthesiologists, and hospitalists, who have the difficult job of checking patients, reviewing charts and radiographs, and assessing general health to make sure there are no health issues that would preclude them from surgery. The screening teams rank the patients in terms of health and need, and after a group conference, the patients are chosen. As we've planned six surgeries for today, we needed to choose  those six early on. William, the Salvadorean surgeon who trained in Salt Lake for a month to prepare for our trip, was ecstatic to find a hip patient for us. After closely examining the patient's radiographs, the team determined that his deformity was too severe for the implants we have available, and we would not be able to do his surgery.

It's heartbreaking watching the potential patients with their families and knowing many of them will go home. The hospital has celebrated the occasion by decorating the doors and waiting areas with blue and white balloons. They also sprang for lunch and coffee for the families, but despite the cheery atmosphere the air is mixed with both fear and hope.

While the screening teams screened, the rest of us unpacked, and unpacked...and unpacked. The hospital staff is AMAZING, and we had a great team of helpers moving boxes, grabbing us carts, and showing us shortcuts through the hospitals. HUGE smiles from everyone. We could not have done it without them!

The rain has been on and off all day, and with the windows open on the third floor for the OR and recovery, the weather is perfect. We broke for a quick lunch in the two adjacent outdoor cafeterias despite the downpour, and enjoyed rice, chicken, veggies, and fresh tortillas under the awnings and a tree heavy with bright green avocados.

The goal going into conference was to have fewer than 50 patients (because some will have bilateral surgery). Two hours later, the team made it from 57 to 56 knee patients. KNEE. We still have our four hip patients. We are recounting supplies and planning to purchase extra anesthesia from the hospital to make them all happen. A team deadset on sticking to 51 surgeries is now doing 61, which means we are trying to knock out 21 surgeries tomorrow. 21 surgeries in 3 ORs. It will be grueling, but totally worth it.

Our six surgeries went well today, and in addition to some groggy patients, we got to see a new baby enter the world! Obstetricia is right next to the room we are using for our storage and break room, and after watching a young mother struggle through labor for most of the day, we watched her wheeled through for a C-Section. One of the nurses took the new baby on a tour of the OR so we could greet him on his way to the nursery. If he could open his eyes we`d put him to work cleaning instruments.

We`ll try to get some pictures up tomorrow. Good thing we have a 100-cup coffee maker ready to go!

On a final note, it's earthquake season. More on that tomorrow!