I feel as though I've been a bad blogger. We have now been off the coast of Guinea for one month. Much has happened. Much. And while I've tried to share about ship life and how I'm doing with this transition, so far I have shied away from telling stories from the ward. I'm not entirely sure why that is...part of me is uncertain where to start. Part of me wants to protect their privacy. And part of me is just plain overwhelmed by all that I've seen. I'm a processor, and it can take me awhile to digest what I'm thinking or feeling. And frankly, I shrink from the idea of putting their stories into words, as though that would cheapen it. Because down on the wards, it's not just healthcare: it's personal. It's heart wrenching. And it is altogether beautiful.
But I need to start telling their stories, if only to remind myself that they happened. That for a moment, my life and their lives crossed paths. And though we are credited for changing them, they changed me too.
My ward of the hospital is known as Max-Fax. We generally care for maxillo-facial surgery patients, which generally refers to cleft lip and palates, and tumors of the skull or jaw. The first week on the ward, I had a little old man with a large tumor to the right upper side of his head. I will never forget the smile on this man; gaping with missing teeth and beaming with genuine joy. Though he spoke not a word of English, you could read his delight in even the most minute exchanges. Anything I said to him, he would nod eagerly and try to shake my hand. Translation revealed that he was just overjoyed to be here. He had lived with this tumor (the size of a peach) for about 20 years...that's almost two thirds of my life.
His surgery came and when he returned, his head was bandaged up like you see in those old war movies: big thick gauze wrapped around his head and then under his chin. When he woke up, he gave one of those big toothy grins. It was almost comical. When his dressing was first removed, he held a mirror and watched intently. This was it. The big reveal.
And with that undeniable smile he confirmed with his heart what I knew in my mind: it was good. He studied his new scalp, learning the shape of his head again, touching it ever so lightly. How that must feel, to see your body changed from carrying an ostracizing deformity to wholeness. In a couple days he was gone, returned to the village from which he came. I may likely never see him again, but I will carry him and his smile with me like a little badge of happiness on my heart.
Another of my first patients has turned out to be one of the ward regulars. At over two weeks, she's been here almost as long as the hospital has been up and running! She is a four year old spit-fire: stubborn as all get out, dancer extraordinaire, and ready to command you to play. She is also the victim of a massive candle accident, which burned the right half of her face. Her lower eyelid and cheek had contracted and scarred in such a way that she was unable to close her eye. The plan was to do a facial flap. The surgeons would use thin layers of tissue from her neck and lateral cheek to replace the burned skin to her face and reconstruct her eyelid. I've never worked with plastic surgeons before, but they are akin to miracle workers in my mind.
Her surgery came and went, and tada! She had a new cheek! It was amazing; this beautiful new cheek, all soft and smooth. It remained covered for a few days, as it was extremely delicate. A small drain to the side of her neck allowed any bleeding from the flap site to easily drain to her bandages. After a day of recovery and sleepiness, she was up and running around again. All looked well!
Then about five days later, we began to notice a darkening at the suture lines near her eye, near her nose. By the next day, her new cheek was a patch of leathery black on her little chocolate brown face: the skin was too dark, too taut. Something was not right. Then came the horrible realization. There was no longer vascularization. The flap had failed.
My first thoughts: What now?? This was supposed to work...how could it not work. What will she do now with a dead cheek?? Thankfully, the surgeons don't think this way. They made plans for surgery #2! A few days ago, they performed a full thickness skin graft . This means they literally took a wedge of skin from her right lower abdomen and created another cheek. She took this second surgery like a champ, even pointing out her new tummy battle wound from time to time. Four days later, and it's still holding. Her first dressing change is tomorrow, and only time will tell...
There are so many more but I want to take time. I want to get them right. They deserve to be thought over. And I'm a processor, you know :)
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