When We Come To It

Week two is upon us as we shift from new arrival to a more comfortable daily routine. Dr. Ani and Josef certainly have begun to recognize the recurrent patterns in the healthcare system here and point out the often self-induced inefficiencies. We all remain enthusiastic for teaching opportunities and interesting discussions.

Week two has been a light week in the operating room. It is joint camp, a week devoted to total joint replacement. Unfortunately, this also means that trauma care comes to a virtual halt.  It is difficult as an outside observer to see elective cases be performed when more urgent cases are present in the hospital. I do, however, understand the reasoning behind the choices made. By creating devoted time to a total joint sessions, the hospital and surgeons hope to streamline the process and provide as much predictability as possible for the elective cases in hopes to avoid complications.

From a traveling volunteer standpoint, this puts us in a conundrum. Traveling surgeons have taken time out of their schedule to come visit and teach, but are restricted from the Operating Room, which limits education time. We have voiced these concerns and are met with appropriate empathy. The orthopedic chair had attempted to find some OR time for us. We have been able to get into alternative OR rooms for a few cases, but the situation is less than ideal.  Intraoperative radiology is not available in the other rooms, which limits the care we can safely provide. 

      I’m highlighting these particular conditions to demonstrate how the many layers of volunteerism, healthcare economics, resident education, patient needs, local and international doctor priorities can become intertwined into a complicated mesh of targets and goals. At dinner conversation many of us can become frustrated with the situation. As a returning visitors, Jennifer and I often serve the role of reassurance and reminders that if the system was perfect, our presence would not be needed.  Little steps toward big goals!

Fortunately, the team has remained very enthusiastic.  We have had multiple teaching opportunities on rounds in the wards debating very complex problems and daily classroom lectures in the afternoon.  It is so exciting to see both the local residents and chief residents from North Carolina becoming involved in an animated conversation of orthopedic treatment.

Joint camp ends today, and we will have two days this week of hopeful solid time in the operating room. Dr. Patt will finish up his visit here, which has been has been very warmly received. Dr. Halvorson, a trauma specialist from Wake Forest, will arrive Saturday and we hope to have the OR schedule set for him to hit the ground running. We are excited to see how this trip continues to evolve.