At first, I couldn’t tell what I was looking at. (Warning: Graphic medical images below.)
I was standing next to The Surgeon on the left side of the patient, as he was checking the surgical site. When I walked over to the right side of the patient to get a better view, I couldn’t help myself when I exclaimed,
“Whoa! I’ve never seen anything like this!,” in English.
The Surgeon was the only one who understood what I had said.
Hovering over the patient, I was asking eager questions and I really, really wanted to take a picture. I wouldn’t have the guts to ask permission, though, until evening rounds eight hours later.
The Surgeon, whose specialty is hand and reconstructive surgery, had tried a new technique that he learned in the US last summer (I think…I was too excited to get details on timing). Basically, by using existing skin from other parts of the body, you can create a flap that is used as a makeshift skin graft for another area. By suturing the two parts of the body together, the skin grows naturally over the affected area and after about a month, you separate the two appendages.
Here, the patients thumb has been sewn into his groin, while the skin grows over it. (SO COOL.) If the patient’s recovery is successful (which it will be, because The Surgeon is kind of a big deal), he will be the first to have had this type of surgery in the country.
(Labels! Because I know it's hard to get your bearings on some random medical image on the internet! And yes, I did have this patient's and The Surgeon's permission to take this picture.)
For the rest of the day yesterday, I followed The Surgeon around on his consultations at the largest private hospital in the city.
My numbers have been slow for my study and I was getting bored at the public hospital that I've been working at. Who knew that I’d be acting like a baby medical student again, instead of a “doctora,” pestering The Surgeon with questions and making him stop mid-stride, so that I could take pictures in the hallway? (Obviously, this is something you do with surgeons who are family friends and not, say, actual professors!)
I saw several more patients who had had skin flap surgeries, including this one:
(Second and third digits are sewn together. The black skin is because the patient's hand is dirty--The Surgeon cleaned this up--not because it's infected or gangrenous. And yes, this patient also me gave permission for the photo.)
I also saw another patient in recovery after The Surgeon reconstructed 80% of his nose, using his forehead skin. (Not pictured, sorry).
When The Surgeon was done with consultations around 7 p.m., we were literally standing in front of his car in the parking lot, when he was called back to do a consult in the ER.
Oh, medicine. Your tether to the hospital is ubiquitous.
This time, the other medical student who had been with The Surgeon for the day slowly and articulately explained the rationale for the surgery that this patient would have (Thank you, kind medical student…whomever you are!), while we waited for The Surgeon to look at x-rays.
Then, The Surgeon decided that the ER patient didn’t need imminent surgery, so we left and he drove the other medical student and I home.
When I got home, I found out that one of the patients that The Surgeon had operated on last week had died. Before going to the private hospital, we had stopped at a different semi-private hospital to do a consultation in the ICU. On our way out, we had run into that patient’s daughter.
When we talked to her at noon, the daughter had said that her 91 year old mother had had a thombus and edema, but it sounded like she was stable. By the time I got home at 8 p.m., my aunt and uncle were getting ready to go to the funeral home.
Apparently, the mother died right after The Surgeon and I left the hospital. Within a matter of hours, the body had been prepared and by 9 p.m. last night, the first funeral service (led my uncle, the pastor) happened at the funeral home. The burial at the cemetery will happen this afternoon.
Obviously, I didn’t take pictures at the funeral home last night and I didn’t mean to be somber. I just wanted to comment on how quickly funeral arrangements are made in this country. The death of this patient happened very quickly, but the family is relieved that their mother didn't suffer for very long before passing.
Con mucho amor,