Day 3 – Monday, 12 May
MORNING DEVOTIONAL:
Our Monday morning started out with some more fabulously strong Guatemalan coffee and another excellent breakfast from the hotel staff.
Chaplain Dennis led us in another devotional or pep-talk. Dennis spoke about the cultural and cosmological differences between us North Americans and the Mayans. And how Guatemala is a kind of mix or collision of those different ways of thinking. This blog isn’t long enough or designed to go into depth about what Dennis was talking about, but his point was to remember that the folks we’re helping here often approach things from a perspective we’re not used to.
Beatta led us in a centering mediation. Dennis then let me read Sonnet 116 by Shakespeare, which talks about love. Because love transcends all backgrounds and all perspectives.
Then: Breakfast and devotion time was interrupted by our neighborhood volcano, Volcan de Fuego! Or Chi Q’aq’ in the local Mayan dialect. Fuego is just 10 miles from where we’re staying, and this morning he acted up. Please see the photo above of the volcano spewing a mushroom cloud. But should we panic? A couple of us recalled what Yvonne, one of our local Guatemalans on the FIP team, told us if see Fuego spewing smoke: It’s a good thing. It means Fuego is percolating away the the pressure underground, which is much better than having all that pressure build up and then erupt in a cataclysm.
Here’s the thing: Ancient Mayans considered volcanoes sacred, as channels or gateways between the earthly realm and the divine. Fuego in particular was seen as the abode of benevolent spirits. So we all decided to take the Mayan perspective this morning (thank you, Dennis) and consider this as an omen of a good first day of surgery.
FIRST, A TRIAGE FOLLOW UP:
A specific story from Triage yesterday came to light last night at our Team Dinner. Pogo, our Ear, Nose and Throat (ENT) surgeon, related the story of a Guatemalan girl, around 13 years old, who has trouble breathing because of a flattened nose. After Dr. Pogo examined her and interviewed the girl’s mother, Dr. Pogo and their team determined that surgical work would help her breathing and offer some cosmetic improvement to her nose.
Then the girl’s story became unexpectedly poignant: The girl’s mother asked to speak to Dr. Pogo and our translator outside of the room, away from the girl. Outside, Dr. Pogo learned the little girl was actually adopted. 13 years ago the girl’s birth-mother found herself in a desperate situation: impoverished, pregnant, single, with no access to knowledgeable advice and no prospects to be able to care for a child. The woman ended up wrapping compression bands around her abdomen in a desperate attempt to abort the child. It didn’t work, and the little girl was born.
A friend of the mother’s ended up adopting the girl and raising her as her own. However, the compression band stunted her nose’s development so that now the girl’s unable to breath through her nostrils. And it’s obviously affected her appearance. The girl’s adoptive mother has never told the child she was adopted and for the time being—with the trauma of having to travel miles and miles to Antigua, and to have surgery—it’s just too much for her. But the mother wanted to fully disclose to the team the reasons behind the girl’s condition.
A story of heartbreak for a woman in a terrible situation; a story of the deep and abiding love an adoptive mother for her child; and now a story of hope.
I will try to follow up with Pogo’s surgical team later this week to see how things turn out.
MONDAY – THE SURGERIES BEGIN
Team Pogo hit the ground running this morning. Our schedules were set, we were well rested and a Guatemalan good omen was behind us. I tried to gather a few of the teams together for group shots, but it wasn’t easy! Our surgical teams were busy. I did manage to corral a couple. Please look through the photos above for the following 3 shots:
*The 3 team members beaming with smiles are the Post Anesthesia Care Unit: Left to Right, Nurse Sherry, Translator Jeff and Nurse Kim. Jeff did a tremendous amount of translating today for patients waking from anesthesia. Not pictured: Beatta also spent a tremendous amount of time today in Post Anesthesia.
*Four fantastic women I managed to catch as they hustled in for a quick lunch are the OBGYN team: Left to Right, Nurse Becky, Dr. Mary, Dr. Kim and Technician Carre. Later on they would invite me to watch them do some of their astonishing work.
*I tried, I really tried, to get the pharmacy team to pause just for an instant and pose for a shot, but they were crazy busy. Look for the shot above of two women from over their shoulders. Left to Right, Dr. Emily and Pharmacist Katie. Katie dispensed surgery medications as well as post op medications patients would take home with them. Emily would run the post op meds out to the patients who were recovering. Emily also speaks Spanish, and would make sure they understood dosages and frequencies.
SURGERIES IN PROGRESS
Obras Sociales Del Santo Hermano Pedro Hospital has eight operating rooms and the FIP team was utilizing four of them today.
In the United States, a non-medical professional such as myself would never be allowed into the OR. But here in Guatemala, for purposes of documentation and as long as I promised to obey the rules, I had the privilege of visiting the ORs while our professionals were in action.
Please see the first 3 shots above of our surgical teams at work.
Next, in the 4th surgical team shot, Dr. Pogo is performing a tonsillectomy. They allowed me in to watch, but there was a catch. Doc Pogo insisted I come on over so he could show me how instruments were applied, how the incisions were cauterized and what a tonsil looks like. Doc Pogo believes bloggers should have full immersion! So in addition to a medical mission, evidently this week is a teaching mission.
The 5th and final surgical team shot is not around the patient’s table, but just after a successful hysterectomy. Here two FIP nurses and one of our Guatemalan colleagues are doing a count of all the items used to perform that surgery—needles, sponges, other things beyond my understanding, and anything that might potentially be left inside a patient. This comes from years of practice and unimpeachable professional discipline. An exact count is taken of everything used during the procedure. And before the patient is sealed up, three people check that the numbers match. Lesson: training, discipline and procedures are followed everywhere, no matter where these professionals are working.
POST SURGERY SUCCESSES
Finally, I was invited to watch some of the patients come out of surgery and their anesthesia. Today I’m highlighting three of them.
(Please note: This week, any photos of patients taken and shared in this blog are done with their permission or the permission of their guardian.)
RANDOLPHO: Please see the photo above of a Guatemalan gentlemen in recovery with three nurses beside him (Kim, Shelly and one of our Guatemalan partners, Marilyn). Randolpho gets the prize as the very first patient out of surgery this week!
Randolpho is a local priest and, amazingly, a boxer. He had surgery to repair to his septum. Jeff translated a delightful conversation I had with Randolpho. He had just come of surgery and yet his sense of humor was fully intact. He asked my name and I responded in Spanish with “Ricardo.” He answered back in English, “Ah, Richard.” He then asked about our faiths. I was not going to tell a priest that I’m a fallen angel, so instead I said, “Everything good in me is because of my mother.” Jeff dutifully translated Randolpho response: “It is mothers who truly hold the theology of God in their hearts.”
LUCRECIA: The next patient out was a little girl who had her tongue repaired. This is going to do wonders for the rest of her childhood, as she’ll now be able to speak without any any impediment. Here’s what amazed me: Lucrecia awoke from surgery with the energy and charm of an angel. Look for the photo above of the the little girl accompanied by Beatta, Kim and Jeff. A bit later Lucrecia’s mother came in. I have to tell you, the glow of her mother’s smile—of relief that her girl had this transformative procedure and simple joy—lit up all of our hearts.
MARIDA: Finally I’d like to share with you Marida, who had surgery to repair her right knee. During one of my visits to the recovery room, Marida was weeping and moaning in fear, and I was dismayed. Nurse Kim told me not to be alarmed, as this sometimes happens with patients rising out of anesthesia. Indeed, I witnessed several times today how Kim, Sherry, Beatta and Jeff cared for and comforted these patients. Many of these folks likely never had surgery before; it can be terrifying. Please look for the photo above of the Guatemalan woman in recovery with Nurse Kim. As you can see, when Marida finally realized she had come out of the worst, and that she’d be facing a new life with a repaired knee, she was beaming.
SHOUT OUTS AND/OR QUOTES:
I have one shout out today. One of Team Pogo’s CRNAs, Aaron T., came to my rescue.
When putting on your scrubs, you need to store your valuables in lockers. I, your hapless blogger, tote my Macbook everywhere. Since I’m not a disciplined medical professional, I didn’t bring a lock for my locker. Aaron took pity on me and let me store my stuff in his locker. Even Dennis helped with this, stowing Aaron’s key in safe keeping when Aaron had to go help patients (while I wandered around the cafeteria looking for a Coke.) Sometimes it takes a village to care for…the village blogger.
(See photo above of Aaron once again opening his locker for me.)
RELATED NOTES AND THOUGHTS: GUATEMALA’S PERILOUS GEOGRAPHY
Guatemala is situated in just the right spot that makes many necessary updates to infrastructure—roadways, bridges, water distribution and sanitation—incredibly challenging. According to the World Bank, Guatemala ranks in the top five of countries most affected by floods, hurricanes and earthquakes. Another reason why Faith in Practice comes here.
HURRICANES: Situated as it is between the Pacific and Caribbean, every summer Guatemala is buffeted by hurricanes and cyclones. For example, just last year in 2024, five major hurricanes hit the country:
Oct 4 – 10: Hurricane Milton
Sep 21 – 28: Hurricane Nine
Jun 26 – Jul 11: Hurricane Beryl
Jun 24 – Jul 1: Hurricane Chris
Jun 16 – 20: Hurricane Alberto
EARTHQUAKES: The Motagua Fault runs through Guatemala. This fault is the dividing line between the Caribbean and North American tectonic faults. As if this wasn’t enough, the Middle America Trench is just off Guatemala’s Pacific coast, creating a major subduction zone, where the Cocos Plate is sinking beneath the Caribbean plate. Some particularly devastating earthquakes in recorded history:
1773: Antigua – the city of Antigua was left in rubble
1902: Guatemala City – thousands perished
1914: Cuilapa – the town was destroyed
1917: Antigua (again) – hundreds perished
1976: Guatemala City – over 23,000 perished
VOLCANOS: Guatemala is home to four active volcanoes, and 33 dormant volcanoes. In the 20th century there were no less than 14 volcanic eruptions in Guatemala resulting in almost 3000 fatalities. Returning full circle for today’s blog, Fuego, near Antigua, coughed a plume this morning. Perhaps it turns out Fuego’s smoke this morning was a sign of good luck for all our patients on this first day.
–Rich, Pogo Team Blogger
Photos for this entire week are by Jeff E. and Rich N. (The really good ones are from Jeff.)
