Wednesday, February 29, 2012

Intensive scare

The wireless here at the hotel is quite a piece of work. It comes and goes, gives us five options that may or may not take us to a connection, and when we call the desk to complain there is a fire drill of hustling clerks playing musical chairs, calling someone on the phone, smiling and explaining in Vietnamese, and suddenly there it is. Sometimes I see 4 out of 5 bars, but most of the time it is 1 or 2 and my computer is not happy. So the blog limps along...

Also at odds with the blog are some long days - Thursday night went until 10pm with a sick child, but more on that later...

I love our walk into the hospital, because we can peruse the city and see how the people function from day to day. We are getting pretty good at dodging motor bikes, which unlike some cities I know, do their best to gracefully dance their way around us without hopes of carnage. Sometimes we see signs that look funny to us, but I'm sure they sound and mean something totally different than we think.
















Our Vietnamese surgeon, Dr. Tuong, is our barefoot doctor. He slips off his blue plastic slippers and keeps his feet cool on the OR floor. Also shows a level of confidence that he won't get too much bleeding. His assistant had cute socks with on spot for the great toe and the rest of the sock for the four little toes. So many cute details when you look closely.


















One little two year old patient had a very gnarly cleft which involved both sides and left a central island of gum, lip, and bone. These are so strange to look at and condemn a child to a lifetime of inability to eat or speak correctly, as well as the cruelty that comes with being different. You can see the transformation here, and the look on the mother's face as she sees her child's repair for the first time. It is a moment we all treasure.

































Thursday was cataract day at the hospital, and I enjoyed seeing these two men sharing their post-operative bed. They were laughing and talking and having a good ol' time, and after I caught this photo, they gave me a big chuckle and a wave.













Our very capable Vietnamese anesthesiologist, Dr. Thinh, sitting on his sandals to have his lunch. What a great idea!





















We had one child keep bleeding after a palate, and he even had to come back to the operating room for a touch up. He kept oozing later, and just looked like he was working too hard to breath. We worked with him for awhile, and finally decided that going up to the dark ward with very little attention was not going to be safe. We had him transferred to the intensive care unit, and there he stayed for the night. But I have never seen anything like it in my life.

Twenty-eight or so patients, five nurses, and one doctor. The doctor was kind enough to give us a bit of a tour of his patients, which included enough critical and complicated medical problems to scare even the most seasoned of us. Many of them had a breathing tube in, but not to a ventilator. Only a lonely thread of plastic with oxygen made its way to hang into the end of the tube and give that vital boost to what looked like an otherwise dire situation. The bed with a lady's feet you see in the foreground, perpendicular to the others, was an older woman who was ashen and barely breathing. She had a can of Ensure at the head of the bed next to her, and was intubated with an endotracheal tube going to room air. I'm not sure if this is Hospice care, if she is waiting for a bed space, or being transferred to a room. Probably not, with an endotracheal tube, but no one is watching her, so why not?













Our dear intensivist to the rescue. Our little guy did very well under his care, and was fine by morning.