In a typical week at home in the SOS office, it's likely that we will see one or two people with some really profound orthopedic pathology. A really crooked knee, or a really deformed hip. It's not exactly rare, but it's unusual... mostly because in the US, really bad pathology gets fixed early on.
Not so in Guatemala (or Ghana, or Nepal...). In underserved countries such as these, profound orthopedic pathology just gets lived with, sometimes to an astounding degree.
The take-home: a high percentage of patients we see here present with really impressive pathology. Their knees and hips are truly awful. Crooked, painful, and profoundly dysfunctional. And they are truly disabled.
Today - our first full day in Antigua Guatemala - was Screening Day. By 7 am, the hospital filled to overflowing with potential patients, the hallways a jumble of crutches and canes and walkers. Then, one by one, each patient was interviewed and examined by our Med/Surg teams, and their potential to have a safe and effective surgery was assessed.
This all sounds simple enough... until one considers that each team consists of two surgeons, an anesthesia provider, a medical doc, a nurse, and an interpreter. X-rays are reviewed, patients are examined, the medical chart and history are reviewed, any necessary additional tests are ordered, surgical risks are reviewed, and consent forms are signed. And all the while, every piece of related information is being translated from Spanish to English, and then translated back again. And this process is repeated over 100 times. This is then followed by a conference where each case is discussed and the details of each surgery are considered.
So... it's a busy day.
The single most impressive feature of this patient population is simply this: the patients and their families are so nice. So appreciative. So thoughtful and patient. They are, without exception, a pleasure to care for. And this sentiment is repeated among our staff over and over again.
At one point, we apologized to a woman who had waited over three hours to be screened. She smiled and said "It's okay. I have already waited 10 years to have this operation."
Inevitably, there are patients who are turned away. Either their pathology is too complex, or their medical status is too compromised, and they are simply sub-optimal surgical candidates. We do what we can for them - new crutches, a brace - but we have to send them away without the operation that may improve their lives. And even those patients smile, and shake hands, and express profound appreciation. This is perhaps the most moving demonstration of this culture's perspective on Operation Walk.
Screening day is over. The surgical schedule for the next four days is being finalized. Tomorrow morning, we begin our surgical interventions in earnest. But already, the trip feels like a tremendous success - mostly because of the nature of the Guatemalan people.
Tomorrow: surgery day numero uno. Respiré profunda, Señor!