Ghana Adventure

months ago i mentioned the unique patient transport system utilized by the anastasis...the operating suite is on B-deck and the ward is on C-deck (one level below, with no elevators). so once a patient has had surgery and is ready to be returned to the ward, the recovery room staff calls up to the ship's reception desk. the receptionist on duty gets on the all-ship overhead intercom and calls the transport team..."transport team to the operating theatre." the transport team is made up of three or four guys, all of whom work other jobs on the ship (deck hand, chaplain, whatever) but who also volunteered to work as part of the transport team. so when paged, these guys leave whatever they're doing and come down to the recovery room, where they put the patient on a very MASH-like stretcher. they carry the patient/stretcher down the hall to the stairway, where they hook up the four corners of the stretcher to a rope-pulley system (see pic below).


after all four corners have been hooked up, one guy stabilizes the "upstairs" end of the stretcher, while another stabilizes the "downstairs" end. a third guy, in this case glen in the picture below (black arrow...glen is the galley manager), slowly lowers the patient using the rope/pulley system


finally, once the patient reaches the bottom, the transport team unhooks the stretcher from the ropes and carries the patient to his/her bed. voila!

right before i left the anastasis i saved a bunch (like 300) of the professional photos that mercy ships took while i was in ghana, with the intention of posting some of them on this site when i got home. however, in my typical somewhat scatterbrained fashion, i forgot to pack the CD...luckily, my astute cabinmate rachel found it and is mailing it back to me. i was really excited about posting some of those photos because many of them are of screening day, where i wasn't allowed to take my camera. so, keep checking in because i'll definitely post them once i receive the CD.

in the meantime, these are the two patients who i got to know the most: peace and vincent. peace had a mandibular myxofibroma (see june/july blog entries) and vincent had a large parotid adenoma. both vincent and peace were amazing people...it was an honor to get to know them and help them during my stay.

some of the crazy anastasis inhabitants who made my trip more...um...colorful:

a cabin 8A brownie and fanice party turned into a weekly event...on left, jessie from connecticut (admissions nurse and hippie chick extraordinaire), in the center is rachel from australia (dental assistant/local M&Ms supplier).

my roomie rachel...proud mother of a newborn molar.

meg, my food soulmate. no, she did not win the ghana national lottery...this was the cost of our dinner that night...the largest bill in ghana is equivalent to $2, so you have to carry around a fat wad of cash.

donna, dental hygenist from sacramento and cohort in long discourses on the virtues of mexican food.

jacinto, from the dominican republic...guardian of medical supplies and
(i think) the only native spanish speaker on the anastasis.

time for a 9pm dip in the pool...sun visor? check. bucket of popcorn? check. group of girls willing to do water aerobics while singing at the top of their lungs? double check.

cairin, OR nurse from south africa/new zealand. she may appear to be a nice, sane girl...

...but we all know better.

dr. thermon imparts some age-old wisdom on us youngins

meg and i having one of our true africa experiences...riding a (unusually empty) trotro while enjoying some fried dough that we bought out of a basket on some woman's head.

seth and rachel whip up some smoothies.

at the top of the gangway, you find yourself at reception (A deck), where you can do fun things like reserve conference rooms, get your ID badge made, print stuff, check the message board for daily activities, etc. the reception staff are terriffic and constantly busy with all of the international and local phone calls that the ship constantly receives.

just down from reception is the pacific dining hall, which is the main dining hall on the anastasis (there is a smaller one, the aft dining hall, which is reserved for families and shift workers). many a good time and questionable meal has been had here.

stairs going up from reception, onto upper deck and promenade deck.

at the top of the stairs (promenade deck), you find the international lounge, which is where all large crew meetings happen. we have devotions here in the mornings, thursday night services and occasional weekend movies, talent/no talent shows, etc.

down the hallway past lots of cabin doors...

also on promenade deck is the mediterranean lounge (medlounge for short), which is sort of the "living room" of the ship. the sala victoria coffee shop is just to the right of this picture. people hang out in the medlounge to read, play cards, check email, etc.

the library (A deck)...meg calls it "jenn's habitat" because i can usually be found here in the evenings...checking my email, updating my blog, reading magazines or checking out books/dvd's.

just above the library is the aft deck, which is the ship's backyard. there's a basketball goal, hockey/soccer goals and a big white screen where they show outdoor movies every saturday night. the aft deck also hosts monday night cricket matches (i still for the life of me can't make any sense of that game) and the occasional irish folk dance.

this is a view from the lido deck (above promenade) which is where the small swimming pool is located...it's not very impressive so i didn't bother taking a picture of it. shown in this pic are the lifeboats. luckily i've never had to use them...

view off of lido deck. that's all i have time to post for now...will add more later. hope you enjoyed the tour!

every week or so the industrious communications department here on board publishes a little "anastasis update" or patient story, which they post on the local network. i just figured out how to link these to my blog. my picture is actually in one of them, and all of these have been published since i've been here. in most cases i have met (or operated on!) the patients that are featured. they're all short (1-2 pages) and i think they're pretty interesting...enjoy!!

[clicking the link will take you to a webpage with a "download file" icon. click on "download file"...in about ten seconds a second "download file" icon will appear (a small globe with green arrow). click again on "download file" and your computer will bring up the file. (when the "file download box pops up, click "open"). it may take a few minutes for your computer to load the document (they are pdf's) so just be patient.]

1) Screening Day
2) Screening Day Through Ghanaian Eyes
3) Anastasis Report July 13
4) Anastasis Report July 31
5) Anastasis Report August 18
6) Anastasis Report August 31
7) Bawa's Story
8) Abibata's Story
9) The Blind Fisherman
10) Fuseina's Story

so i finally took my camera to the OR today...i didn't get a chance to take many pictures because i was in a 6 hour case. but i thought i'd share a few of the shots i did get and give you an update on my work.

after spending two weeks in room 2 with dr. ralph doing general surgery, i was moved to room 3 with dr. thermon, who arrived three weeks ago from arkansas. he is an ENT
(ears, nose, throat) surgeon and we've mainly been removing various large glandular tumors (adenomas) arising from the parotid and submandibular glands. the surgeries can be a bit tricky because some of the nerves of the face run through these areas and you have to make sure not to cut these nerves while removing the tumor or else the patient may not be able to move certain facial muscles. so about 90% of the procedure involves finding and dissecting the nerves, while the other 10% is taking the tumor out.

working with dr. thermon has been great...he's super-nice and highly skilled. he also has a ton of interesting stories, historical facts and
political/ethical issues that we like to talk about during cases. he also has a great sense of humor...for instance, me and my partner (cairin from new zealand) have a great time teasing him about his propensity for putting drains and/or staples in every single case, no matter how small the incision. he takes it all in stride and we've worked out a (fictional) bartering system whereby we allow him to use drains if he smuggles cookies from the galley for us via his wife who works there. =)

anyhow, the 6-hour case i was in today was on a young guy with a large parotid tumor. the case took longer than
usual because of the tumor's large size (the skin over top was stretched so thin that it was starting to break down) and because it was very highly vascular...we lost about 1500 ml of blood during the case. but it went well and when the guy woke up in recovery he kept saying, "God is so great!" over and over again. days like today make me so glad that i'm here.

top pic is of operating room 3 (nice and clean
at the end of the day!). next is the area where we scrub before surgery. third is the patient with the parotid adenoma who we operated on today...after that, dr. thermon and me during the surgery. next is me and the anesthesiologist (from ireland) during the surgery. last is the recovery room.

...
nobody. sorry guys, but not a single one of you chose the correct specialty (although candy store owner does sound tempting), which means that no one can claim the two week, all-expense paid trip to the italian riviera that i had planned to give out as a prize. bummer.

today was a momentous day, as i officially submitted my online residency application for a position in...anesthesiology (yes, anesthesiology). i fully admit that it was a dark horse and i didn't see it coming...had no inclination towards it when i left home in june. so, lest you think that i've finally gone off the deep end, allow me to walk you through the thoughts and experiences that led me to this decision...

1) i arrive on the anastasis and everyone seems to be talking about how we are desperately seeking more anesthesiologists to cover the month of august. will have to cancel surgeries if we don't find someone. hmmm. i ask if there is a general shortage of anesthesia providers in medical mission organizations and find out that yes, there is.

2) i attend peace's surgery, am thoroughly impressed by dr. gary's amazing skills (see july 7 blog entry) but am equally impressed with the resourceful, creative problem-solving abilities of the anesthesiologist. central line, fiberoptic nasal intubation, warming IV fluids in microwave to combat potentially dangerous hypothermia, infusing whole fresh blood...

3) i (very) casually start to look into the field (honestly i was pretty clueless about it as it had never crossed my mind)...what kinds of fellowships are there? what kinds of rotations do you do in residency? residency work hours? do you have to be good at crossword puzzles? do they actually do anything?

4) it occurs to me that anesthesiology has a winning trifecta combination of no clinic, no rounds and no full H+P's. plus you always get a lunch break. nice.

5) but will i get bored? will it drive me crazy to be in the OR and not operate?

6) much thought. more research. find that the beauty of anesthesiology is that, as in ballet dancing and free throw shooting, the great ones always make it look easy. that is, a seemingly uneventful surgical case is often uneventful only because the anesthesiologist has thought through every complication in advance and prepared for/taken preventative measures accordingly.

7) however, when things do get exciting, they are REALLY exciting.

8) i pick the brains of some of the anesthesiologists on board. continue to be impressed. i had never given a second's notice to "the man behind the curtain" before, but actually find it to be pretty darn interesting.

9) i really do love to intubate.

10) but i also love surgery.

11) the more i look into anesthesiology, the more i feel a deep peace about it. i can't describe or explain this phenomenon except to say that it's the kind of peace that only comes from God.

12) good grief, i haven't even done a rotation in this specialty. what am i thinking?

13) my job in the OR is awesome and i come to the conclusion that the OR is the only place in medicine where i really feel at home.

14) but my life outside of the OR is even better and there is no way i am going to give that up, even temporarily. i am working on reading book number ten since arriving in africa...i haven't done that much pleasure reading in four years of medical school combined. i want to have a family some day and spend lots of quality time with that family. i want to be able to regularly get away for weekend ski, kayaking and hiking trips during residency. i want to be able to easily move to another part of the country if a family illness or hypothetical husband's job requires it. finally, i want to be able to help fill the need for anesthesiologists in developing countries and continue to have amazing experiences like i've had here on mercy ships.

15) in short, i know that i love surgery. and i know that i would be good at it. but would i be a happy person outside of my job? probably not. i believe that in anesthesiology i've found a way to be both content with my job and with myself.

so with that, i begin the long wait to find out which of 18 states i'll be moving to next spring...