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Just Breathe And Remember Nicaragua

By Check C. Kam, MD

All surgeons feel frustrated every once in a while, such as when instruments that are needed are not available, when there are excessive delays in between cases, or any other countless issues that typically arise during the day.  When this happens, I take a breath and I think back to my week spent volunteering in Nicaragua and this completely changes my demeanor. I become much more grateful for my situation and grateful for the resources I do have to help my patient.

During the final month of my hand fellowship at Indiana Hand to Shoulder Center, I volunteered as a hand surgeon with Dr. LaSalle to travel to Managua, Nicaragua.  During that one week in June we saw over 60 patients and performed over a dozen complex surgeries.  We saw all 60 patients during the first full day and then planned out surgeries for the rest of the week. The 60 patients all arrived early in the morning and waited patiently in the hot, muggy waiting room all day but everyone was clearly happy to see us despite hours of wait. The old military hospital lacked many of the medical equipment that we take for granted. It is funny how certain details become permanent memories as I somehow recalled there was only one tourniquet in the entire hospital and it was 42 inches long.  The tourniquet was wrapped around the patient’s arm 4-5 times before being secured. There was no flipping between rooms as this tourniquet was needed for the next case as well.  We had no sterile marking pens, which does not seem like a big deal now, but it did when I was a fellow and you always cut where your attending drew the lines. In another case, which required silicone Hunter rod’s for a two-stage tendon reconstruction, we did not have any rods available but were able to use sterile pediatric silicone urinary catheters instead. Necessity is indeed the mother of inventions.

My one week in Nicaragua has truly shaped me as a surgeon and more importantly as an appreciative human being. No matter what my circumstances may be at the moment, I take a breath and for one whole second truly appreciate all my blessings. I then realize how silly and immature I am to be upset at such trivial issues when I step back from the current situation and look at the big picture. Then, somehow, the current problem doesn’t seem so bad after all.

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