Hospital de La Merced
La Merced has one main hospital located right off the center plaza. It's pretty small but much more organized than the hospitals we saw in Huancayo.
We were assigned to different wards and I lucked out with ER and Trauma! The ER had no patients when we arrived at 8am so George and I went upstairs to the Trauma ward. Dr Ballardo had us examine two different patients. The first man had symptoms of appendicitis but the lab results were inconclusive. Most likely (according to Dr Franćois) the patient doesn't have appendicitis but it's a very common diagnosis here. Dr Ballardo spoke some English and taught us how to check for bloating using a finger tap technique. He also was quizzing us on 1st year med school info so we failed miserably. The second person we saw was a lady with gallstones. Her gallbladder was very inflamed and the only option for her was to have it removed. Her surgery time was set for 12pm today.
I think Dr Ballardo got tired because he sent us to go find another doctor. As we waited for Dr Argandoña to arrive we met Dr Latana. This guy was awesome!! He was a general surgeon from Lima and we talked with him about his life for about 45 minutes. He had been married 3 times and has 6 kids. He loves surgery but used to pass out at the sight of blood when he was younger. Dr Latana also told us about Hoja de Coca. It's part of the coca plant and has many medicinal qualities once pulverized. Out of any natural substance it has the most Vitamin B and A, iron, frolic acid, and calcium. Apparently we can buy it at Highland Coffee so I need to check it out!!
Emergency Room
Finally Dr Argandoña arrived and the day got started. We headed down to the ER and found a young man whose face was severly lacerated. He had a cut from the corner of his left eye all the way to his ear. It was 1" wide and 1" deep. There is a major artery that passes right in front of his ear, which this man had sliced open during his injury. He had other cuts on his face that were bleeding a lot. Turns out that Dr Argandoña is the head plastic surgeon and Dr Latana is the on-call surgeon today. George and I definitely lucked out!!
Anyways, this ER patient had gotten into a fight last night and was still intoxicated so the doctors decided to use this liquor blanket (and massive blood loss) to help him pass out instead of using medicine. They applied a local anesthetic (I think) and began sewing his face back together. Dr Latana demonstrated a "pack" suture which is when you hook wide on either side and then again on the inner wall of the cut before tying off. This procedure works well for areas that don't have to heal "pretty".
One thing I noticed is that the sanitary habits we saw were horrifying... I never once saw any doctor wash their hands between patients or before doing procedures. The surgeons did put on gloves to suture but there was no other sterilization. There also was blood dripping onto the floor as the sutured him back together.
Gallstone Removal Surgery
The excitement in the ER dwindled after the bar fight man so we wandered around looking for things to do. I happened to come across our same two surgeons an hour later prepping for surgery and asked if I could scrub in. They were super nice and said okay!!
I was allowed into the sterile cirugia (surgery) environment and given new sterile scrubs to change into. I was also given a hairnet and booties. Dr Latana then taught me the proper hand washing technique and we were ready to go in!
The gallbladder removal procedure lasted about 1.5 hours and it was very interesting to watch. There was an anesthesiologist, 2 surgeons, 1 surgery nurse, 2 other surgery techs, 1 intern and myself all present in the room. It was really cool to watch how everyone interacted in the room and how fluid the surgery process went.
The doctors made a 6" incision on the top of the abdominal cavity. They used a laser to cut through the skin, fat, abdominal cavity wall, and finally the gallbladder. It smelled like burning fat in the room for the rest of the time which was not very pleasant. All in all I was very intrigued by the surgery process and have started to consider it more as a possibility. The hours are pretty bad but the cases are very hands-on and can be challenging.
**also funny thing that happened... The anesethiologist was prepping for surgery and realized he didn't have enough of a certain medicine so he sent a family member down to the pharmacy to go get more for him! The culture here is SO different than in the States but it's pretty cool!
No comments:
Post a Comment