Getting into a groove:

It’s Wednesday and we are finally settling into somewhat of
a routine. Monday (read earlier posts)
was a flurry of activity and awkwardness as we tried to set up our supplies and
learn our boundaries here at the hospital.
It is a different arrangement working in a private Japanese hospital
than it was working in a Bolivian government hospital last year in Santa
Rosa. Here, we
are one set of guests treating yet another set of guests. The Japanese have more stringent customs and
we are trying hard to honor those, avoid offending our gracious hosts, but
still to get our work done in such a limited time.

To summarize, Monday we only did two operations – recurrent umbilical
hernia (myself) and repair of a tibial plateau fracture (Dr. Henry). Yesterday, we managed to do an orchiopexy and
rectal biopsy on an 11 month old (Dr. Pendse), release of congenital syndactyly
on a one year old (Dr. Henry), an inguinal hernia repair on a 74yo female
(myself), debridement of femoral osteomyelitis on a 12yo (Dr. Henry) while the
local staff did some procedures on their own. I have come to accept my low volume of general
surgical cases at this point as I am busy enough with directing things and
making sure Dr. Henry has a chance to squeeze in as much ortho as possible
during his only week here.

Today, we have a few hernias to fix (if the patients show
up), and Dr. Pendse has already done a circumcision for phimosis. I am seeing more consultations and trying to
defer elective gynecologic procedures to future projects which might have a
surgeon better equipped to do them.

We found out that Monday has been declared a national
holiday (it’s the Aymara new year). Though
neither the Japanese, the Americans, nor the bulk of Bolivians celebrate this,
the local Japanese hospital staff are planning on taking the day off
nonetheless. We have arranged to work
Saturday and they will grant us enough staff to do that. This means our weekend will be Sun-Mon
instead. We may get to make a road trip
to do some sightseeing – will see. There’s
not much to do in San Juan (other
than surgery and sit around and sweat a lot).

Will try to keep posted as often as possible. Thank you all much for your prayers and
support.