Expectations

I’ll start by quoting a song: 

              Novices have expectations
              because they think they should.
              Experts have their revelations
              Like they knew they would.

The name of the song is “Trouble”  (Artist: Over the Rhine, Album: Trumpet Child – Buy it, you’ll love it).  Now I don’t yet fancy myself an expert at this stuff, but I’m not a novice either.  Given the choice however, I felt duty bound to have at least some expectation of what we could do on Monday.  So call me a novice still. 

                If you read yesterday’s post, you know I went into Monday with the hope of pulling off five cases.  I don’t know why I thought this would be possible – on most my past projects we have not even made incision on the first case before lunch -  there are still machines to set up, supplies to organize and sterilize, processes to iron out, and all this with a new team, a language barrier.  Some of our team only arrived last night after 40 net hours of travel, including missed connections in Mexico and Peru.  We have 6 North Americans and 9 Bolivians [this includes our cook and our bus driver] – all this for a combined Surgical, Medical, and Optometry project.  I should be happy just to fix one or two navels. 

                We arrived at the hospital to see quite a crowd gathering.  The lobby already smells of sweat and sounds like a collective toddler melt-down.  The line goes far out the door.  Today will be all about multi-tasking for me as I try to see a bulk of the week’s surgical consults, fill out the schedule, and also make sure the first cases get going safely and that everyone else is settling into their roles (some of which have yet to be defined).  It helps that this is project #3 for Dr. Klatt (anesthesia) and #2 for Dorothy (preop/ postop nurse) – they are proactive, organized, and flexible.  Dorothy’s sister Elaine is here on her first project and really helped glue processes together as combined ciruclator and patient communicator of our needs to the local staff (I think she secretly speaks Spanish). 

                It’s late, so I’ll cut to the chase (no surgical pun intended).  I’m not sure how it happened but I’m pretty sure who was behind it.  We managed to pull off five cases (two open gallbladders, two hernias, and a large scalp mass/ cyst) with the first case starting at 10:00am.  Between them, I managed to see 20 consults.  None of them spoke English and I still don’t speak Spanish.  The Clinic team (with two Bolivian doctors – Franz and Alex) saw ~60 patients.  Most of them also received integrated health counselling and spiritual support and encouragement as well.  The eye team did 55 exams, including giving them  their glasses.  And everyone even ate lunch.  The patients are doing well so far and the team is in very good spirits, especially given how hard they worked.  Everyone is primed for tomorrow (and I’m pretty sure they’re all in bed too). 

                Feel free to read my previous posts about project Mondays.  They usually make inefficiency an art form and always manage to bring me to my knees.  I proactively went there today.  I’ll admit to feeling a bit of pressure and isolation on this project – this is my first one as sole surgeon, and it’s my smallest team yet.  Should I really try to do so much on the first day?  How many operations should we schedule for the week?  How hard can/ should the team work?  How hard and late will the local staff work before they go on strike?  What if we take on too much and have to break promises to patients who have waited months for their operation?  I’ll admit to both fear and guilt in even having expecations.  I gave this over to God this morning – His message back came out of Psalm 28:13-14

     “I believe that I shall look upon the goodness of the Lord in the land of the living!
      Wait for the Lord; be strong, and let your heart take courage; wait for the Lord.”

When something is repeated in Scripture, it is usually to highlight both its importance as well as our tendency to overlook it.  What was repeated this time?  “Wait for the Lord.”  But I’m a surgeon.  I hate waiting.  Waiting is time wasted.  Waiting is inefficiency.  The one place I almost never go at work or on project is called the “waiting room” – I do not belong there.  But there it is – “Wait for the Lord.”  It was as if He was telling me to make Him my expectation. 

                He made good on this message – both to me and to everyone else.  Any slow-downs were reflexively taken as opportunities to do something else productive or to enjoy a relaxed word or smile with our patients, their families, or our co-laborers.  And everything got done.  We set our expectations on God showing up and He did just that, cloaked of course in the garb of our patients, co-laborers, and the agape-space between them. 

Now bring on Tuesday.  Hasta Manana.