We arrived in main theater 4 to see the neuro team setting up shop and I was honestly giddy with excitement for the day to come! The neuro team was INSTANTLY so accommodating and welcoming to our little curious selves! We were busy making ourselves flys on the wall (so as not to get in the way) when the head honcho walks up to us "Hi my name is Jose"
From there we chatted with him about their mission. They are spending a total of three weeks away from Spain –their first week was spent in a big hospital in Nairobi, now they are in Mombasa for the week, and next week they will continue on for a week in Zanzabar.
I’ve always thought about ‘brain surgeons’ as the most respectable, brilliant kind of people. And I guess I expected that they’d have arrogance to them –and I would have granted them any degree of cockiness without an ounce of judgment. Jose was as down-to-earth as possible. He asked us about our lives and our experiences here in Kenya. He was very very genuine and it went a long way!
That’s what is so great about Elective Africa. I’ve gotten the opportunity for unmatched exposure. There may have been things that differed from my expectations but once I adjusted mentally to the way things were here in Kenya, it was so great! Regardless, I’ve been able to come in contact with doctors/nurses that make you think “I never ever want to have that trait as a physician.” A firsthand experience of the repercussions of different qualities is a very, very impactful experience! I have been completely frustrated by the lack of personal care. The standard here is to provide exclusively physical health care with no attention on the emotional or mental aspects of health coverage.
Alternatively, I’ve met doctors like Jose! …He had arrived at the hospital, ready for action, before 8 am. He wasn’t actually able to begin until 10:15 am (this seems to be the norm around here; inefficiency). To keep a neuro team waiting on a simple blood transfusion, clean scrubs, equipment or the anesthesiologist is not exactly how I imagine things are done in the states. But here, it happens, time and time again.
The first patient was a gunshot wound patient. He had been shot through the anterior protion of the skull and the bullet was lodged nearly smack dab in the middle of his brain. The MRI scans were unbelievable. You could see all the lobes of the brain with a nice bullet shaped object hanging out right in the center of this intricate control center.
As they rolled the patient in, Jose explained to us how the superficial portion of the wound had become massively infected (the actual incident occurred over a week prior). Their goal, he explained, was to clean up/remove the infected tissue and remove the loose shards of skull. “we don’t even try to remove the bullet” he explained, “as it is too dangerous to poke and prod in those regions of the CNS.”
It would only seem natural that he would have severe loss of mental capacity, coordination, sensation, or ...something! -with that foreign piece of metal in his brain. “He got lucky” Jose said. He will most likely walk away with, at most, epilepsy. A condition that simple medication can treat! If ever put in a similar situation (heaven forbid), I’ll simply point my scalp towards the barrel and PRAY that the bullet will have the exact same location of impact. On second throught, I think I’ll spare the neuro team the inconvenience of traveling to my rescue and I’ll just pray for avoidence of that situation.
Regardless, the surgery was amazing but MUCH less intrusive than I had imagined. The next procedure was the implementation of a VP shunt. This was a patient with a brain tumor in an area that compromised the draining of the cerebral spinal fluid from the ventricles of the brain. The added volume within the non-expandable skull causes catastrophic pressure buildup. So the procedure involved:
1. Drilling a hole through the skull (no big deal)
2. Making an incision in the abdominal cavite
3. Threading the tubing under the skin from the inside of the skull down through the neck and into the peritoneal space
Simple as that. The fluid then had a path it could travel if the pressure built up (and we could instantly see the draining of the fluid through the tube. It was absolutely amazing.
During the surgery the neuro surgeon would motion for us to come get a closer look. Afterwards Jose happily answered any (and many) questions we had.
The last surgery was a laminectomy. The ‘lamina’ is a part of each vertebrae and ‘ectomy’ means to remove. A calcified tumor had grown on the vertebrae and into the spinal cord’s cavity, causing compression of the spinal cord (leading to paralysis). Jose told us that the procedure was about 20 years out of date and would never be administered in Spain or the US but this hospital lacks much in terms of chemotherapy or radiation so it’s the only option here.
By removing the tumor that clung to the lamina of a vertebrae (literally ripping out the bone protecting the spinal cord) they would remove the problem causing paralysis and the patient could walk again.
This was hands-down the most amazing day spent in the hospital –and we stayed past dinner time! We were given lunch and tea in the doctors lounge and got to interact with some amazing healthcare staff. (both Kenyan’s and Spanyards!)
Hi Ann!
ReplyDeleteI happily was not having breakfast while reading your most recent day's events!! My goodness you have seen and done so much!! I love knowing where you are and what is going on over there!