Friday, June 4, 2010

Doctors of Carpentry

May 31st, 2010
As winter progresses here in South Africa, so does my inability to wake up in the morning. It is pitch dark whenever I wake up and it doesn’t get light until I get to work. Also, for those who think Africa is just one big giant sun-fried continent, that is so far from the truth. The African sun is not what kicked my ass (well maybe in Durban, but this is like comparing Costa Rica to Finland), it was the African cold! There is no central heating in any of the houses and as a result, the houses are generally freezing. My house is full of tile and hardwood, and my room feels the coldest. For the past week or two, I wear socks, BOTH pairs of pajamas, a thermal shirt, my black sweatshirt with my hood on, and a beanie to bed. Yet, I’m still cold. Also, my family’s hot water isn’t the greatest so I have learned to take cold showers…a lot. Additionally, as the days get shorter, the calls for prayer start later. Now I didn’t think these existed, and then I went to Dubai. Then I thought it only exists in the extremely Muslim countries. But these occur throughout South Africa as well. Muslims pray five times a day for twenty minute each session, and they like the whole world to be aware of it. There are speakers at the mosque about a mile and a half way in a town called Gatesville (same town as the Gatsby). So every morning at around 6:15 I am “gently” wakened up to some man screaming to Allah. I can only imagine how loud they are at the mosque. In the summer, they start around 5:20AM. I didn’t realize how strong of a Muslim community I lived in. Our driver, Uncle, is Muslim as well. The mall across the street is strictly Halaal, which means no pig products are sold. At Mugg and Bean, bacon is called macon…and to be honest I have no idea what macon is, so I don’t order it.
We got picked up at the usual time without Lauren. It was strange not having that third person in the car. We got to Jooste and went about our business. I feel so ready to come home so it becomes difficult to keep my head in the game here. The motivation is beginning to fall and the daydreaming continues to increase. For our final week, Hailey and I decided to challenge the surgery department. After our disastrous beginning in Durban, we had been apprehensive to go back to the surgery department. We put on our scrubs and had a choice to go into the orthopaedic theatre or into the general theatre. I’ve always wanted to see how barbaric carpentry works, so I went into the orthopaedic theatre. When I walked in, I saw the surgeon at work doing a tendon repair on a hand. She had been stabbed seventeen times by her ex boyfriend because he didn’t want to let go of her. It was sad because I could tell which wounds were defensive and which ones were inflicted unknowingly (yay for watching years of crime shows). Thankfully, I didn’t get nauseous at all. I wasn’t expecting it though because I really have an interest in it and anything beats perianal abscess drainages (there was three of those happening back to back in the other room). He introduced himself as Ernest and he was wrapping up the surgery. He took off his scrub gown and WOW what was underneath was insane. This man was built like a train. He had huge arms, shoulders, back, chest…everything. I guess you really need that build for this occupation. We watched another surgery after the tendon repair and I was really enjoying what I was seeing. After he wrapped the next one up, he turned to me and asked, “are you keen on scrubbing in on the next surgery?” Hell yes!! But then I retracted and asked what that consists of and he says just holding things and helping out.
So I was hustled into the scrub room and was taught how to properly scrub in. I walked into the operating room, hands in the air in order to keep sterile and was dressed by a nurse into a scrub gown. She asked what size gloves I am and I had no idea. I compared with Ernest and I actually dwarfed his hands. Turns out I’m the biggest size of gloves you can get, sad. After I was all gowned up, I approached the table careful not to touch anything non sterile. My first operation would be a complete ankle reconstruction filled with plates and screws. The lady fractured her foot 10 weeks ago and is just now coming in (nothing out of the ordinary). Her ankle had essentially fallen apart and had shifted to the left. Also since it’s an old fracture, tons of new bone grew erratically. We had to take away all of the new bone and then reposition the fibula in an attempt to shift the ankle back into place. We opened her up and it was quite a rush. It was so amazing because I looked around and it was just Ernest and I on the table and a couple scrub nurses helping us when we needed it. I was told to hold the retractor and put a couple clamps down. Things were running somewhat smoothly (it had been difficult to remove all of the improperly grown new bone) and we began to get the plate ready. Ernest put the plate against the fibula and asked for the drill gun. The nurse pulled out this giant drill gun hooked to an air compressor. With help from the X-rays being taken every minute or so, he began drilling into the ladies fibula. He did the first and last screws with ease. After he drilled, he inserts a depth gauge to see what size screw needs to be inserted manually with a screwdriver. Right as he finished his second screw, he looks at me and says, “your turn” and hands me the drill gun. I don’t exactly remember what went through my head; I think it went a little like “no way. YES. No I can’t. Oh my God it’s a human leg. Now is my time” so I said yea, sure. He put the drill guide into place for me and said to drill away. I put the bone-residue covered drill bit into the guide until it clicked against the bone. Then I realized this city boy has never really used a drill gun before. I put some elbow grease into it and drilled into the damn thing. Midway into the drill I realized he didn’t tell me when to stop, but I remember hearing how it went. I pierced the fibula, which took some force, and the drill went straight through the marrow like butter and then hit the other side. When I felt the drill exit the other side I stopped immediately. I put the depth gauge in, took the X ray and it was in the right spot. The proper measurement for the screw was between 14-16mm. My measurement: 14mm : ) and I repeated this procedure three times and got 14 each time. After each drill I was given the screwdriver and screwed the screw in. Under all those blaring surgery lights, I broke a sweat putting those screws in. It takes a lot more effort than I thought! I guess when you’re trying to bore a screw through some bone; it does take some intense effort. Now I know how Ernest got his massive arms.
This truly felt like a pinnacle moment in my experience here in South Africa. I couldn’t believe I scrubbed in as a first assist for an ankle reconstruction and was able to drill holes into some ladies leg. It felt so good to do it (not in a sadistic way) but I thoroughly enjoyed the entire surgery and think orthopaedics is an awesome field. Here is the craziest part of it all; the entire time this operation happened she was AWAKE and alert! She was given an epidural before the surgery began so she couldn’t really feel anything. But I’m pretty sure she can hear a drill going into her leg. Oh well, welcome to Jooste.

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