From Thighland to Thailand

February 26, 2014-Wednesday

Thailand/Myanmar 5.5

“Yesterday we were swarmed, today is worse” Bill Ho

Lights on at 0500.  The power generator came on and so did the room lights.  Everyone got up in unison still half asleep like robots on a timer.  We get started early because yesterday’s experience with the swarm of beelievers (in the mission team) was a harbinger of things to come.  We don’t lack any less enthusiasm though because we are here to work and do the most that we can. I think doing your best no matter what circumstances is what God asks of us.

We meet in the morning as a team to reflect on our experiences, any concerns, and game plan.  Pastor leads us with some exercise stretching and singing.  We then are asked about our day on a scale of 1-10.  There’s an “8” and then a “9” while Lena says it’s a 10 for her that you can see it in patient’s eyes that someone cares for them.  And it was very emotional for her.  Trevour says it breaks his heart to see so many in need.  Others feel that it is overwhelming.  Some patients realize that we cannot cure their chronic conditions but temporary relief is still of some help.  Asking patients what they want, their response is to just have someone come. 

We have a wonderful breakfast.  In fact the chef was brought in to cook for us.  He was a gourmet chef from some famous meditation center.  We eat very good, but it seems that we are getting fattened up for the kill…

Patients arrive early since many have spent the night somewhere.  If they weren’t seen yesterday then there is nowhere else to go.  The waiting area rapidly fills up with patients. Sayadow’s people are registering patients indiscriminately and although it seems helpful, it later becomes harmful.  Everyone gets assigned somewhere no matter how small or large their health problem is and we endeavor to see them all.  Most of the patients are farm laborers that need to be in good health to be able to work.  Musculoskeletal injuries are common and their pain needs to be in control so that they are able to work.  No work and there is no food on the table.  They need to see and many patients have cataracts or are blind either in one eye or both and the goal is to give them the best vision that they can have.  Many sustained work related injuries.  There is no workers comp here.  Many patients have few teeth and dental caries.  They need to have at least some dentition to eat.  There are no dentures available.  WE are the only doctors that they have seen in their entire lifetime, ever.

We are challenged by the situations we are put in and limited skills that we have.  I routinely perform 6-8 hour surgeries back home, which are actually quite fun, and I look forward in doing them.  Some of these patients that I see here are not so quite clear cut and I am humbled by them because, frankly, I do not see the option to do nothing, and I am not sure what I can do for them.  I get in the “cut to cure” mode or “when in doubt, cut it out” position.  Half the time, I think its one thing and after excising the lesion (sebaceous cyst, abscess, fatty tumor) it’s another, but it’s all the same.  It had to come out.  Huge 2-3 inch masses of the breast, back, and head are routine and common. These patients are tough as the surgery is done under local anesthesia lying in awkward positions.  I am always anxious that I might encounter a situation that I know I have to treat and never have before.  Today was one of them.  A young boy about 9 years old had webbed toes and webbed fingers on his good hand.  His other hand was so deformed from a condition that arose in utero-amniotic band syndrome.  His left arm was deformed and he had no functioning fingers, more like a club hand.  His right hand had good grip but the fourth and fifth fingers were stuck together due to syndactyly or webbed finders and there would be worsening deformity, as he grew older.  His hand worked to some degree but was not optimal, but might be able to perform everyday tasks.  I asked the father why he brought his son in and what was he hoping that I could do for him.  He wanted the boy to be able to eventually work and to help out the family.  To be honest, I have never repaired a syndactyly before.  I remember this or that flap needed when studying for board examinations and this was one of the situations that I usually prepare for before the mission trip “just in case” I encounter it.  I forgot to this time.  It is tricky because skin can die and infections can lead to the loss of the two fingers especially in this situation, which would then be disastrous.  What about aftercare and hand therapy that is typical after an operation such as this?  It would be very easy to stay in my comfort zone and say well, “At least you have some function” and not offer anything for him.  Next? Comforting words do not always equate to hope.  I had to think it over lunch and make my decision.  Go for it.  I have to thank Linh and Andy who were able to help me with the operation since it was extremely difficult to do otherwise.   One flap by one and rearranged the skin slowly separately the fingers while repairing the skin down to the natural web space.  Eureka!  I could see the smile on his face as he could separate his fingers and bend them independently for the very first time. Corinthians 10:13.  That is why were here: to make a difference and to give hope

As the day wore on, it was apparently no stopping to registering patients.  Some of the mission team decided to go back after dinner since there were so many more patients to be seen and the Burmese doctors were still going at it.  We worked until after 9 pm and still they were getting registered despite our objections and frustrations.  Everyone was tired including the translators that we had to bring back.  So we ended clinic and told the patients to come back tomorrow.  In the meantime, Jennifer, who is taking most of the photos for documentation, was doing a photo ministry as she printed out photos for overjoyed patients, families, and staff, some who have never seen a photo of them selves before.  They were excited as they repeatedly asked her to “Print, print, print.”

Now we have to sleep, sleep, sleep