These store fronts are actually home fronts as well - most of the shop owners seem to live upstairs. If you look in the way back of any shop, there is a stairway going up. The balconies over the stores have birds in cages, hanging laundry, potted plants, and sometimes a staring face watching the passer-bys. Some of the buildings even have three stories, but even with this added space, the living area must be small as the buildings are not very deep.
The "gift shop" as we call it is a store at the ground level of the hospital. It is mostly items related to an admission - cots, covers, packaged food items, and a variety of colorful plastic bowls and tubs.
Most of the patients we see are accompanied by the whole family - who clearly participate heavily in the care of their family member - and there are usually 4 beds in a room, spaced about 18 inches apart. The frames at the ends of the beds have hanging laundry, and it appears each family shares the one bed allocated to their patient. There are of course no electronics to entertain but everyone seems quite happy together. The beds have no railings, no matteresses, there is no nurse call button, and no one uses sheets or bedding - just woven mats over the slatted bed frame.
Once a patient hits the operating room, all hands are on deck. Everyone swarms the table and gets the patient immediately to sleep, usually with one provider hugging and reassuring in some way while the rest attach monitors and ready supplies.
I wish I had more personal stories to share about the patient histories, but at 13 cases per day, it is pretty much a dash to get a patient safely tucked into the recovery area and then ready the table for the next patient. One thing that is sometimes a problem is that the area where the patients must wait for us is around a corner and not staffed with a nurse. We have our two support people, Catherine and Phi, who do a great job getting the patients' arm bands on and getting the charts ready to go. Our pediatrician, Alice, does a great job getting the patients screened and putting out medical fires. But it is not a safe place to give pre-medications, so often the younger patients do not like leaving their families with these strange looking aliens. As each patient leaves, the others left behind get more bug-eyed than the last as they listen to the receding wails, and this behavior crescendos throughout the day. We are working on solutions, but it is a difficult scenario of concerns to balance.
Meanwhile, back in the OR, we have our own balancing act. I put up little signs and reminded each person about moving cell phone calls to outside the patient care area. It seemed to work, as our Vietnamese colleagues are so very eager to please and do their share. I hate to be the mom and post the notes, but for once it has seemed to work. Are my sons reading this?!! ;^)
Another issue burst our way - flood! A hose behind the scrub sink outside our room burst and gushed under our surgery door to one side and our supply room to the other. The sinks are large free-standing units that can be moved around, with attachments to a water source not unlike our sinks at home have under the kitchen cabinets. But the water source is about a 1 1/2 inch pipe, so the volume of water that can come out is quite torrential. Within minutes, there was about an inch of water around the sink, and a make-shift levy of towels around the OR. The handy man of the OR, who has helped us periodically with structural, electrical, and technical difficulties, came running to the rescue and turned off the water. Meanwhile, cases continued unabated, and the clean-up and box-moving began.
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Sweet letter from Thao, our first nurse helping with anesthesia. She is going to be a hard act to follow.
Dr. McClure demonstrating one of his techniques for helping add symmetry to these very difficult noses that result from repairing a cleft lip. We are getting many patients who come in for a revision after prior closure of the open lip. That first step of closing a cleft lip gets the teeth covered and makes it possible to later repair the palate, but often flattens one side of the nose. The nose is not very forgiving with its framework of cartilage pieces, and fixing one is a challenge.
Usually both tables finish about the same time at the end of the day, but today one case went a bit longer and the Vietnamese team took over. Dr. Bill worked on the patient's nose, and Dr. Tuong revised the lip. It was fun to be able to step back and see the all-Vietnamese team hard at work, using the Resurge model.
Clever tips are coming my way from my colleagues here. Kwuong shared with me his ingenious way of using the face mask as a funnel to fill the machine's CO2 absorber with granules.
And no trip is complete without a visit from some kind of animal. Frankie got a nice surprise as she was moving bottles around, and when she jumped back, we thought she had gotten an electric shock from the sterilizer and been thrown off her feet. But she stood pointing, like Dicken's ghost of Christmas to Come, and there scurrying around the bottles was a moving clothespin. This was the Cadillac of Cockroaches, the King of Krud, and here he was at our feet, looking for somewhere to hide. I tossed a glass to cover him and just got his legs, so Bill rearranged it and enabled me to get this picture. Our brave OR cleaning lady just grabbed it up in her hand with a paper towel, and as she walked past us all, the people parted to give her a wide berth. All I remember Frankie saying was, "They have a spine!" Made me think of Peter Lorre, "It's alive!" What is it about cockroaches that makes us so squeamie?
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