Losing Count

Losing Count

     I would like to extend a half-hearted apology to those who expected more frequent updates on all that is happening in Santa Rosa del Sara.  Alas, there has been so much happening in this metropolis of the Bolvian heartland and I have had precious little time or bandwith to record and share it all.  Even now, I only have time to put down these thoughts by waking earlier than the rest of our team (though the roosters of Santa Rosa have been up for a couple hours already).  It is already our last day – I can’t believe how fast a week can go.

    Now, I am the first to admit that I am no accountant.  I did carry a math minor for a few semesters, but dropped it like a bad habit after it took me an entire semester to “prove” that 1=1 (apparently, writing “duh” on an exam does not cut it at the college level).  Nonetheless, I do come from a numerically obsessed profession, which can be both a good thing and a bad thing.  Though we measure success in less concrete ways, at the end of the project I will still be able to tell you how many procedures we performed, how many consultations were seen, and how many prescriptions were written.   Though we can say that it’s “not about the numbers”, the numbers are, in the end, individual people, and it is indeed all about the people.  Each of them are a singularity of infinite importance, neither greater nor lesser in value or in substance than another.  On this particular project, God has chosen to shower His blessings upon us with both people and numbers, with both quantity and quality of interactions with both our patients and our partners in service.  It has been wonderful. 

     One specific application of numbers in the field of surgery is that of making sure that our “counts” are correct.  That is, we want to make sure that we finish an operation with same number of needles, scalpel blades, instruments, and gauze pads that we started it with.  This is a good idea due to the dangerous consequences of leaving something behind in a patient.  Though a healthy idea in the operating room, I would contend that there are other areas of life where neurotically keeping such counts is neither possible nor advisable.  Now I am very happy to say that we kept very good count of our instruments and supplies in the operating room, but I am equally happy to tell you that I have completely lost count of much more important things through our week here in Santa Rosa. 

    I have already lost count of how many operations we have done – I believe it is around 30 over the first four days – For a two surgeon, one week project, this will be a record pace so far as my own projects go.  Today will be a bit lighter as we will be packing up the anesthesia machine and most our supplies while repairing a hernia and removing some lipomas (small fatty tumors) under local anesthesia.  We were originally going to head back to Santa Cruz tonight for some sightseeing/ souvenir shopping, but the mayor of Santa Rosa has planned a barbecue for us and the hospital workers as well as an official ceremony at the downtown square.  I hope they don’t make me give a speech; all I can really do in Spanish is ask for a scalpel and tell you how many ibuprofen tablets one should take after I use said scalpel. 

     I have lost count of how many belly-laughs we have shared as a team.  Everyone has a great sense of humor and irony.  The language barrier, along with the often-embarassing moments that make up healthcare have provided plenty of fodder (as have my tampons).  Everyone has had a turn at being harassed by their teammates.  One would think the medical director (“Del Medico”) would be spared such harassment, but alas he has not. 

     I have also lost count of the number of times I have been encouraged by my teammates down here – not flattered or patronized, but truly encouraged.  Surgery in this environment can be quite easy one moment, and then can become an immense stress when a case gets difficult.  The lighting is poor, the equipment old and limited, and the ancillary resources are few with which to manage a complication should one occur.  It can get difficult to maintain one’s cool in a hot operating room with two cases going on at once. When I wear that frustration on my sleeve (I may have stamped my feet once or twice), the others have been quite forgiving and gracious with me.   Our helpers, whether they be our North American volunteers, our Bolivian volunteers, or the local hospital staff working unpaid overtime (and hence volunteers in their own right), have bent over backwards each time to enable me to complete the task at hand.  After a difficult case, I am offered words of encouragement, a drink of cold water, a five minute break, prayers of encouragement, and sometimes a mood-lifting laugh.    

     I’m sure the clinic team has also lost count of the number of patients they have treated, as well as the number of pot-holes they have had to drive Ruben’s 1984 Land-Cruiser through to get to their locations.  Long lines always await them followed by long hours in hot, humid exam rooms.  In spite of their daunting task, it is quite uplifting to hear about the amount of time they manage to spend listening to their patients. The chief complaint may only be a headache or arthritis, but instead of quickly moving on to the “more interesting” patient, they have taken the time to sit with, listen to, encourage, pray, and share the love of Christ with their patients.    Our translators have been instrumental parts not only the medical care, but also in our ability to personally connect with people whose lives are so different than our own. 

     I have lost track of how many times our wonderful recovery room nurses Dorothy and Freddie have gone back to check on our postop patients, even long after they have left the recovery room.  We did a component separation (huge hernia repair that involves separating out the muscle layers of the abdominal wall) the first day on a sweet little lady named Modesta (and by sweet I mean incredibly stubborn).  At first, we would ask her to take a deep breath (to prevent postoperative fevers and pneumonia) – she would just shake her braided head and say “no” – no discussion, no excuses, just “no.”  It has been a real joy to see Dorothy visit her a few times each day to attend to her needs and to see her soften up in response.  By Thursday, we were laughing about her “bad hair day” and were recruiting her to help on next year’s project. 

     We are told (and are tempted to try) to count our blessings.  I think this is so that we will appreciate them appropriately, though the temptation is often to formulate ways to pay them back or to “pay them forward.”  It is human nature to try and make sure that our “counts are correct.”  The reality is however, that I can never adequately pay anyone back for the blessings I have received.  Even the attempt serves to insult the giver, to spoil the gift, and to oblige the recipient towards reciprocation based in guilt rather than joy.  In the end, sometimes all we can and should say is a heart felt “Thank You” and to happily lose count of both what we have given and have been given.  So to the people and government of Santa Rosa, to the staff of Hospital Dr. Melchior Pinto Parada, to the bevy of Bolivian MMI staff and volunteers, and to everyone who came (or enabled us to come) from the States – Thank You.  I cannot ever hope to pay you back.