don't forget the M.D.

finally, the surgeon arrived.

This past week an American plastic surgeon arrived from Texas along with an anesthetist. We had several patients waiting to see if he could operate on them. On Monday, he spent the day meeting with all the patients and telling them what they could expect from surgery. He arranged 6 surgeries. 3 cleft palates and 3 burn traumas. Us students sat down at lunch and divvied up the surgeries so we would all have a chance to scrub in on something we wanted to see. The surgeon said 2 students could scrub in per burn trauma, and 1 student could scrub in per cleft palate, and as many people were invited to watch as could fit in the theater. My scrub in surgery was this morning, however I've been in the theater everyday watching. Its absolutely incredible to watch plastic surgery. The first surgery on Tuesday took 8 hours from start to finish (she was a burn trauma patient with the most work to be done of anyone). Her entire left arm had been incinerated to the point where her elbow was in a locked bent position and her hand was locked in a vertical position. The incident had happened 2 years prior. She had no movement besides at her elbow, and her face was also badly burned. The surgeon took skin grafts from her thigh to graft the back of her hand and her elbow, and a full thickness graft from her stomach to graft her lip. Its incredible, the intricacy involved with reconstructing anatomy after fire took it away. He said he could have done more for her, cosmetically if he had been in the U.S. but he made due with what was available to him in our hospital. Either way, the girl walked out with her hand and her elbow back to an extended position, thus allowing her to hold her arm straight down at her side, instead of it permanently being in a cocked position. And with the full thickness graft on her lip, she had more movement at the mouth.

Because the first surgery took so long (our doctor was used to working with residents who would normally take up the task of suturing up the grafts after they had been put into place, but since none of us are actual residents yet he had to do everything on his own) he pushed all the surgeries back. So the second day, he performed two cleft palate surgeries and fixed a harelip on one of the patients as well. Again, amazing. I feel like being a plastic surgeon is one of the hardest fields in medicine because you have to be familiar with the entire anatomy of the human body! Unless, of course, you specialize in a certain area of the body. But this surgeon moved from hand to arm to lip to mouth to eye with such ease, I can't imagine how much time he spent memorizing everything everywhere.

Then this morning, it was my turn to scrub in. I chose a burn trauma. The woman's whole left side of her face had been burned. She had no ear (just a hole) and, originally I thought her eye had been burned out, but it was actually still there, and the pupil had been spared (the bottom half of her cornea was burned) thus leaving her with the ability to see somewhat out of it. But her eye lids had been burned so she couldn't fully shut her eye. I got to stand right over the body, hold the hooks that kept the skin apart as he was cutting away from the tissue underneath, so he could see where he was cutting. I got to suction up blood that spilled into the eye socket, and cut the stitches as he made them, and some other little stuff too. It was fascinating. The whole time I got to ask him questions, and learn about the when to use certain tools and how to fix certain things. I got to look through the layers of tissue and at the facial muscles. I've seen all of this stuff in my anatomy text book, but seeing it in real life, in front of your face is so much better and cooler. Ocular muscles and facial muscle names started coming back to me (even though I took my anatomy final a mere 3 months ago). I can't describe how cool this experience was.

Yet still, I know I could never be a surgeon. The patience, concentration and dedication to your work (you can't leave the theater until you're job is done!) is too much for me. I'll stick with the babies :) I'm happy though, that I've been able to see so much medicine here. I don't think I mentioned it before, but last week I got to sit in on 2 cesarean sections. Two different doctors performed the operations, so it was neat to compare techniques and styles. I just like the work of delivering babies into the world. Something about the fact that the fate of a brand new human life is in the mercy of my hands is special to me. Plus, as a midwife you work with the mother-to-be prenatally until the baby arrives. You develop a relationship. I like that better.


My time here is quickly winding down. This weekend we're heading back to Arusha to stay in a Masai village for the weekend. They slaughter a goat for us and dance around in their traditional ceremonious way. Part of Masai tradition surrounding slaughtering a goat is the milk, the blood and the meat. So we will be presented with each from the chief. yep. I'll be drinking goat's blood this weekend. Then the women take the skin of the animal and create bracelets from the fur. Every part of the goat is used. We'll also have an opportunity to learn the beading that they do. I will take many pictures and post them as soon as I get back to the U.S. for those of you who have asked, sorry, I forgot to bring my camera cord so I can't upload any photos. That, and the internet, although readily available to me now, is still incredibly slow.

Then, next Friday I'll be on my way to Zanzibar which is where I'll stay until my flight back home leaves on August 7th! I can't believe I'll be on a plane for the U.S. in exactly 2 weeks! I can't believe its the end of July already. I hope I get a little bit of summer in the states before fall comes around. I can definitely use some sun and warmth right now. It has been raining in Machame for almost 6 days straight. bah! I'm supposed to be in Africa, nice, warm, Africa. The Texans thought the same thing. They're dying right now. At least I'm used to cold weather! Ohh Africa. Yesterday in surgery, the power went out. It was classic. I'm so used to it now, it doesn't even phase me.

I'll write more next week after the Masai village.