Singing in the rain

Today was a bit lacking in luster. There was major traffic getting to the clinic because a body had washed up under th bridge we took. We only had 4 surgeries on the board and I opted out of them because again we were crowded (new med student from UK). I observed the consultation doctors for a while and saw some tragic cases come in. One case was this little 5 kg (~10lbs) girl with a bilateral cleft lip/palate. She was so tiny and cute but after looking at her chart I noted something strange. She was 2 years old!! Even by Cambodian standards that is way too small. In fact, the doctor asked the mother several times if she was actually that age. Another gentleman came in that had be burned severely by acid, his chin had melted to his chest, his teeth were severely miss aligned, he had no ears or eye lids. His eyes bugged out from his skull and looked sickly dry. He had been burned in 1994. I almost could not bare to look at him... I can't imagine anything more tragic than his situation. After sending him to a special consultation the doctors took me to lunch. Later, after waiting around for several hours I gave my presentation to the entire staff on Spondylolisthesis. It sound horrifically boring (I know). Most of the other presentations have been huge failures in attempting to hold the attention of the Cambodian medical staff here. It is something I am very acquainted with; while in the Peace Corps, Spanish speaking presenters were nearly impossible to follow let alone they weren't using large medical terminology. But, I had a secret weapon (other than my passion to teach) I opened with a game of siamon-says and offered chocolate (the expensive kind) as prizes. I had the whole staff stand up, doctors and secretaries, and tested their English listening skills. It was a HUGE success. Dr. Lang won the first round and his eyes lit up at the sight of his chocolate prize. Everyone was laughing and energized for my presentation which followed. Again I find my self with a unique ability to captivate any audience but severely lacking in sufficient intellect to pass on valid information. I would make a great career in politics. Two of the Chinese students followed me to the grumblings of a tired staff. What their presentations lacked in vigor it certainly made up for in purposeful content. One presentation was on Abdominal Aortic Aneurysms and the other was on a new-ish surgical technique used to approach the nasopharynx to remove cancer the "maxillary swing". It had started raining during our presentations and flooded the area around the clinic (see video). Sorry about no photos of the presentation but I was using Brent as an example so he forgot to take pictures :(

Dancing and Kickboxing

Sorry again, the weekends here are quite slow. Though this weekend had some highlights. My goal was to get as much sleep as possible so both days I didn't leave my bed till at least 8am. Saturday was a bit boring as we spent most of the time at our hostel reading and lounging around the pool. I had new roommates that all seemed very fun and I invited them to go watch kickboxing with Brent and I. Unfortunately, we were given the wrong time and we showed up 5mins before the end of the last fight. Bummed about missing the fight we returned to the hostel and they invited me to go out dancing with them. So we drank and got to know each other at the hostel then ventured out and bar hopped all night. I had a blast and gained some great intel on where/where not to go in SE Asia. Finishing the night at 3am everyone slept in the next morning until nearly noon. My only plan for the day was to go watch kickboxing. Brent and Lori rented a scooter and tried to find the zoo but returned bloody and scraped up from a moto accident near a construction site. Don worry, Lori (and baby) are ok, apparently she landed/surfed on Brent and sustained minor scrapes. After laughing with them about it Brent and I took off for kickboxing. There were a ton of people and everyone was shouting bets in a pure chaotic manner. I liked the opening ceremonies for each match. The boxers would go through a preyer routine and then thank the crowd, ref, and each other before going at it. There was much more grappling than I originally thought but it was amateur night. It was quite fun and being a whole head taller than everyone here helped us get a great view.
We only have a few more days left at the clinic and then we head off to Thailand. I can't wait! I don't know why the comments section is not working for some of you.. I tried it and it worked just fine. Stay tuned!

Surgeries

Well today was another fun day at the office. Most of the surgeons are really opening up to me and I am learning a ton! I am terrified of needles and yet the Anesthesiologist is having me start every IV, Dr. Vutah and Dr. Money the orthopedic/general surgeons are asking me if I would like to scrub in on most of their interesting cases. I think the Chinese students are growing envious because they keep asking me when I will be leaving. The patients here also are getting a kick out of me trying my Kamer and giving everyone I see the thumbs up. I can now introduce myself and ask for their names. I have also be having some repeat customers, the Buddhist monk who I put a traction pin through his leg was back on my table again to see if we could fix his broken hip. Unfortunately we weren't able to slip the prosthetic femoral head back into his acetabulum so we re-sutured him and ordered more traction. I also assisted in repairing someone's broken tibia, now they will be able to walk! In total I was in surgery for 6 hours today (4 surgeries)! I am loving this, although when I am not at the clinic there is NOTHING to do. Brent and Lori are nice but not the going out type so we are a bit limited as to what we can do. Hope you all are enjoying this blog!

My first intubations!!!

What a day! We had 13 surgeries today and everyone was moving. I decided to give the Chinese students some space and surgeries so I followed the supervising anesthesiologist. He has a sort of scowl on his face so I thought the day would be dull but I was dead wrong. He turned out to be a great teacher! First he explained the finner points of intubation and told me that I would get to try one soon, then he let me push medication into an infant's IV to reverse the paralyzing effects of a minor over dose of anesthesia medication. The baby started to breath better right away, it felt like I saved his life. Then we went back into the OR and he started explaining how the very young and the elderly are the most challenging to intubate and as he did this he had me holding a mask over an 11-year-old boy's mouth slowly putting him to sleep. Next thing I new he handed me the laryngescope and told me to go for it. Of course everyone (the med students) heard him say this and came over to watch me. I fumbled a bit and he helped me find the right position to hold the mouth open and then I saw what looked like vocal cords and I inserted the tube. Then I listened for breath sounds... I didn't hit the stomach! After that I assisted in removing the boy's extra thumbs and got to close on one of his hands all by myself! Next I was asked to intubate an adult. He was a large man and I could see all the way to the bottom of his lungs so getting the tube in was a little easier this time. He was an ORIF (Open Reduction Internal Fracture) case. We tore into his forearm like a bull in a china shop with blood squirting left and right, his hand twitching with ever little tug and cauterizing shock, we crushed, cut, and manipulated bones, the we hammered and drilled in pins and screws...OH! It was so fun. I am now leaning towards orthopedics! I think the docs like working with me because I keep getting picked to assist in the elaborate cases. I will try to post pics soon!

Ups and Downs

This trip feels a bit like a roller-coaster ride; first, this morning my iTouch was destroyed. It fell out of my pocket while we were tuk tuking to work. That really sucked. I nearly fainted in surgery today too. I don't know why, but I think if may have something to do with my rough night of mal de caca. I was helping hold a factured patella together when I became suddenly flushed and dizzy. I have only ever fainted once before so now I recognize the warning signs. I sat down at first and when that didn't help I scrubbed out and re-hydrated. It was embarrassing but not nearly as bad as if I actually fainted. We are having a blast with the local staff here. All of us are joking and teasing one another. It feels great! I also got to drill through another man's knee today and I am still pursuing how to intubate. We got home at the height of the day's heat so I took a siesta in my A/Ced room. When I awoke I went for dinner at the diner adjacent to our hostel and there was a crowd of Cambodians there all shouting at two small TVs showing some Thai kick-boxing. One of the guys at my table was our tuk tuk driver and he filled me in on the fight and the ever changing bet/gambling odds that were being shouted back and forth across the diner. It was fun and I bet $1 a blue fighter and lost; immediately after, many of the "guys" came over to enlighten me as to the finer points of picking the better fighter. I bought them some beers and called it a night. We are pulling our plans together for Thailand and I can't wait!

Frolicking in Wat?

We slept in today which will never get old. It was about midday before we headed out which was our first mistake. Siem Reap in the middle of the day is ridiculously hot. We ended up wasting time till the afternoon when our favorite tuk tuk guy came to pick us up for our final venture into the park. Today we started in the afternoon because we wanted it to gradually cool off rather than heat up. We returned to Angkor Wat and this time we were able to go all the way up to the top! According to the books the top level of Angkor Wat is heaven, which means I went to heaven and back! It was beautiful. Next we went off to Ta Pron temple (otherwise known as the Tomb Raider temple) close to closing so we were the last to get in and had the WHOLE temple to ourselves. It was amazing! We went picture crazy and climbed all over everything ran from collapsing walls (see photos), and just had the time of our lives. I am definitely putting this place in my top 10 most beautiful places I have ever seen. Tonight we had designated for souvenir shopping so we when to the night market and bought art. I'll admit, I bought too much but the prices were so cheap! I bought seven paintings for $70. I hope everyone likes them and I hope to put them up in my house or sell them when I get back. Tomorrow we go back to Phnom Phen and though I am excited for the clinic I dread returning to the Phen.

Angkor What?

So last night was fun we ended up walking through the mini-night market and getting a fish massage. That is when you put your bare feet into a giant fish tank and have all the fish eat the dead skin off of your feet. It is impossible to imagine how bad it tickles the first few minutes that your feet are in the water. But after a while things settle down. Today we went back to the park and viewed the rest of the temples. They are simply mind-blowing (enough so, as to keep us out in sweltering weather). We returned for a quick siesta then out to the real night market where we had some blind Cambodians give us massages, super cheap! All in all it was a great day.