I'm sitting here laughing to myself as I read back over that last entry, the one where I said I had no idea how I was going to walk away from all of this. I really should stop saying things like that, because this time it resulted in a couple of twelve-hour work days, ever since I hit publish on that entry.
This week, we have a German cranio-facial surgeon on board, Dr. George. When I looked at the surgery schedule last Friday, the boxes marking out his days for yesterday, today and tomorrow were nearly empty, each one saying simply All Day Case. We were waiting to see if we'd be able to get the one neurosurgeon in Togo to come and operate alongside Dr. George and make those cases possible, and right up until Monday, we weren't sure we'd be able to say yes. But those boxes have names now. Rudolph and Maurice and two more waiting to find out whether they'll be able to go to the operating room tomorrow, and as a result our ICU is busier than it has been all year.
Rudolph is four and was born with extra space between his eyes and two holes in the front of his skull where his brain and spinal fluid poked out. Yesterday, Dr. George took apart Rudolph's head and put it back together again correctly, an admittedly meager explanation for an incredibly complex, a ten-hour operation. Rudolph spent the night breathing with the help of a ventilator, but as of this morning we've removed his breathing tube, and now we're just trying to walk the fine line between letting him wake up and keeping him calm enough that he doesn't hurt himself in his quest to get out of bed (something he'd very much like to do, apparently).
In the next bed, three month-old Maurice is snuggled up in his mama's lappa, all seven and a half pounds of him. He was also born with the hole in the front of his skull, but because of the placement, his surgery was much more straightforward. All Maurice has to show for his long morning in the operating room is a little incision curving around his nose, held together with steri-strips and a few IV lines giving him fluids and medications for pain, but he still needs to be monitored very closely to make sure his brain agrees with its new, smaller living space.
Tomorrow at least one of the babies who wait next door in D Ward will join Rudolph and Maurice in the ICU, having also had surgery to reshape their skulls. And I sit here and shake my head, because who would have ever thought that such a thing were possible here in Togo?
I used to work in an incredible PICU back in New Jersey where we had a neurosurgeon who would do cases like these on a fairly regular basis. In fact, when I saw the screening sheets for tomorrow's patients, I just had to smile because craniosynostosis isn't just a jumble of letters to me. But when I quit that job, when I got on a plane to come to West Africa for the first time, I had no idea that I'd be part of that type of surgery over here.
Just outside the ship are dirt roads and tin-roofed houses with no running water. There are six million people in Togo and one neurosurgeon. One, and even if our patients could have found their way to him, the cost alone of an operation like this would have put that dream to death.
Down in the ICU are two little boys who have been given the impossible blessing of having surgery that will give them a chance at life, a chance to look normal and to grow into young men who don't have to worry that their lives will be cut short because of the way they were born.
For once, we get to thumb our noses in the face of that often-repeated lament, that where you're born shouldn't determine the reason for your death. For once, we get to hold out the promise of life to the ones we'd normally have to turn away. I love that I get to be here for this, that in my last days on the wards I get to bear witness to transformations like these.
Esther went outside to Deck Seven for the first time since her surgery today. I can't wait for Rudolph and Maurice to join her out there.
This week, we have a German cranio-facial surgeon on board, Dr. George. When I looked at the surgery schedule last Friday, the boxes marking out his days for yesterday, today and tomorrow were nearly empty, each one saying simply All Day Case. We were waiting to see if we'd be able to get the one neurosurgeon in Togo to come and operate alongside Dr. George and make those cases possible, and right up until Monday, we weren't sure we'd be able to say yes. But those boxes have names now. Rudolph and Maurice and two more waiting to find out whether they'll be able to go to the operating room tomorrow, and as a result our ICU is busier than it has been all year.
Rudolph is four and was born with extra space between his eyes and two holes in the front of his skull where his brain and spinal fluid poked out. Yesterday, Dr. George took apart Rudolph's head and put it back together again correctly, an admittedly meager explanation for an incredibly complex, a ten-hour operation. Rudolph spent the night breathing with the help of a ventilator, but as of this morning we've removed his breathing tube, and now we're just trying to walk the fine line between letting him wake up and keeping him calm enough that he doesn't hurt himself in his quest to get out of bed (something he'd very much like to do, apparently).
In the next bed, three month-old Maurice is snuggled up in his mama's lappa, all seven and a half pounds of him. He was also born with the hole in the front of his skull, but because of the placement, his surgery was much more straightforward. All Maurice has to show for his long morning in the operating room is a little incision curving around his nose, held together with steri-strips and a few IV lines giving him fluids and medications for pain, but he still needs to be monitored very closely to make sure his brain agrees with its new, smaller living space.
Tomorrow at least one of the babies who wait next door in D Ward will join Rudolph and Maurice in the ICU, having also had surgery to reshape their skulls. And I sit here and shake my head, because who would have ever thought that such a thing were possible here in Togo?
I used to work in an incredible PICU back in New Jersey where we had a neurosurgeon who would do cases like these on a fairly regular basis. In fact, when I saw the screening sheets for tomorrow's patients, I just had to smile because craniosynostosis isn't just a jumble of letters to me. But when I quit that job, when I got on a plane to come to West Africa for the first time, I had no idea that I'd be part of that type of surgery over here.
Just outside the ship are dirt roads and tin-roofed houses with no running water. There are six million people in Togo and one neurosurgeon. One, and even if our patients could have found their way to him, the cost alone of an operation like this would have put that dream to death.
Down in the ICU are two little boys who have been given the impossible blessing of having surgery that will give them a chance at life, a chance to look normal and to grow into young men who don't have to worry that their lives will be cut short because of the way they were born.
For once, we get to thumb our noses in the face of that often-repeated lament, that where you're born shouldn't determine the reason for your death. For once, we get to hold out the promise of life to the ones we'd normally have to turn away. I love that I get to be here for this, that in my last days on the wards I get to bear witness to transformations like these.
Esther went outside to Deck Seven for the first time since her surgery today. I can't wait for Rudolph and Maurice to join her out there.