Week Three
The bonus of being universal Monday I was sent into PACU. Not so much to work in PACU but to be a number and help out in holding bay as they lost the PACU nurses over the weekend and the new ones had orientation so they were a bit short. The first patient wasn’t supposed to be there until 0830 after the morning meeting however when the head of PACU arrived the patient was already down there. I think there was a new nurse who didn’t know the times as she was told that the patient needed to be down in the holding bay at 0800 but not sure who told them that. So because she was there Paula checked the patient in which was a bit of a pain as she was going to go through the checklist with me before I needed to do it.
The first patient was a young girl with extra toes. Her grandma was her support person was so pleased that she was getting the surgery that when she was brought back down after surgery she was so happy and grateful that she did a little dance in her chair and the patient while still sleepy smiled when she saw her bandaged feet. The second patient was super nervous he was shaking, this is so different for them and they have never been on a ship before. While they know they are getting surgery to make things better we were told that there are stories that go around saying the people are stealing their organs while asleep, which is a horrible thought but for people who know little of the world and a giant ship with people from all over the world come and say they will do your surgery for free you can understand them thinking there might be a horrible catch with it. The last patient was another young girl who was returned to the theatre for a washout. She was so smiley and happy even though she was coming back to the theatre. She seemed to know the process and even with her limited English was able to answer my questions. She held my hand and tried chatting with me while we waited for her to go through. I really enjoyed the patient interaction that I got for being in there for the day between the holding bay and PACU, though the overall pace was painful with hours between the patients and only 5 patients for the entire day.
Tuesday I was back to my hernias. Its always nice going back to what I know and being busy just makes the day go so much quicker. The first one didn’t look to bad I did kinda wonder how they ended up on the list but once the patient went to sleep and relaxed it just ballooned up out of no where so much so the patient actually went into asystole for a few seconds the anesthetist said he nearly called for compressions. He suspects it was due to peritoneal stretching which he said he has seen changes in observations with that before but never asystole.
They weren’t the most impressive ones today but i’m sure the patients were super pleased to have them done and to feel so much relief. We had a surgical resident from the local hospital working with us this week and he said that for someone to get their surgery here in Sierra Leone they have to go to the bank to get the money out/loan and have a receipt to take back to the bank to prove they can get the money. They are then given a sort of pick list of equipment they will need and the cost of things. It sounded like they had to provide their own equipment therefore very few people can actually get surgery.
Steig and I had arranged to go for a walk after work so I rushed to change and eat dinner as we were supposed to go at 1730 but I didn’t finish till after 1700. He found me in the dining room rushing my food he tried to get me to not rush but I was determined to not miss the chance to get off the ship and go for a walk before curfew.
We walked upto the round about where Kate and I had walked but carried on further around the road and found ourselves at the beginning of a market we later found out was called the ‘Lettice market’ which from what we could tell was the fruit and veg market. There were fish also being sold here as other items but the general feel was fruit and veg. It was crazy; the crowds of people all trying to sell and trade was really intresting to observe. The markets had a very strong oder to them and the ground was quite muddy and I really didn’t want to know the contents of said mud, I just tried to avoid it if I could. The people were so lovely. Some of the ladys were calling out to Steig and said they wanted him and to marry him while Steig was trying to say he was already married. They were trying to explain to me what they were selling which looked slightly like flour but apparently wasn’t. I still don’t know what it was. Then when we turned around there was a massive crowd around us introducing themselves to us and asking if we were Mercy ships. There was one lady telling me about her granddaughter that had a growth above her eye. She said she had been seen by Mercy ships but hadn’t heard anything. I couldn’t really say anything except that if she has been seen by them I’m sure they will hear something soon hopefully which is not great but that the best you can do. We have a sign on the gate saying that all the spaces for the 10months they are here are all full. I do wonder sometimes as I feel like theatres are not always utlizied the way they could be but i’m sure there is reasons for the way it is done. There were a few of these sort of stories being told to us as we continued to walk, but thats just the norm. I loved just wandering around and seeing how their lives go and how they make their money to survive at the markets. I like how the kids are always the first to come up to you as they are so curious and carefree, and the adults are more cautious and stare…but how could you not we kinda stood out amongst the locals lol.
After I got back I tried to find everyone but couldn’t so I went to my room to hang out. One of our friends had been put in temporary isolation as she hadn’t been well but was due to come out of isolation so I messaged her to see how she was and if she needed anything dropped off. She messaged back if I wanted to sneak in so I figured seeing she was due to come out in the morning why not. She replied with a message of crawl which had me totally confused, but i did. I worked out it was because there were people in the lounge opposite and didn’t want to get in trouble. She opened the door and i crawled in only to find everyone else from our group already in there. After a nice girls night we then had to get back out, so again we opened the door slowly and dropped to our knees and crawled out. As it turns out the people in the other room saw everything and were cracking up and the slight of 4 people on their hands and knees crawling around the corridors.
Thursday was my birthday. Happy birthday me.
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Had a bad night's sleep as was woken at 0130. I wasn’t sure what a birthday on the ship would be like so didn’t have any plans, but mentioned that perhaps we could go out off the ship for dinner. Well, I woke up to head to breakfast and got hit in the face by a bunch of balloons that my friends had stuck to the door with a happy birthday sign they were making the night before. They wished me happy birthday at breakfast, and then I headed down to work. I ducked into the theatre without people seeing me start out the list. I left to get an instrument then walked into everyone singing. Brian the anaethetist decided my birthday powers would make the list go like a normal list at home as I had plans at 1700. We were actually on our second to last by 1400. They also put up a banner and a little card which was nice.
At lunch Heather, Mia, and Steig came up for lunch I begged them not to ring the bell but Steig just wouldn’t listen and rang the bell and made the entire galley sing to me. We had planned to go out for dinner though didn’t actually have any idea where but place Steig knew of a place, so we caught two keke and headed off. It was quite an adventure, going in the wrong direction, then one of them not knowing the way, a policeman hitching a ride, then our driver pulling over and leaving us on the side of the road using a screwdriver as a break to stop us rolling down the hill. This was fine until a bus pulled in behind us and kept beeping at us to move but we couldn’t. Some locals then started to push the keke down the road with us still in it and no sign of our driver. Eventually, we made it, looking forward to our Italian food, only to find you can get fresh Italian-made pizza soon found out you need to ring them at least three hours in advance so settled for a burger and chips alongside a simple vodka and lemonade and a really good berry cider.
Got back, and the ride home was not nearly as dramatic. We got back to the ship and I got directed to the cafe which made me think something was up. We sat down and Shekina and Heather came out with a brownie/cake they made for me and sang Happy Birthday. They even got me a present they had negotiated at the markets. I thought it was a tombstone saying happy birthday… apparently its not supposed to be but I like it more that it looks like a tomb. Overall it ended up being a great birthday.
I finally made it into a Maxfax list on Friday. It was a bit bittersweet, as I was so excited to get in there but after two weeks of working with the same general surgeons, I wasn’t there with them on their last day working on the ship. There wasn’t a lot on the list, I watched the first case so got a bit of an idea of how things work as I heard the team leader can be quite particular so wanted to try and get it all right. Jenny was going to scrub for the second originally but then when it came to it they asked if perhaps I wanted to which of course I wanted to. It was only a partial mandibulectomy but still, it was one. The tumor was small compared to some of the others I’ve seen but still decent. The pace was a lot faster than the hernias which was good but again getting used to the different names that people call instruments and using a set I hadn’t used before was a bit challenging but I think I did pretty well for my first attempt. They sent off some of the tumor for specimen, it wasn’t what I thought it would be and had a very soft inside once the surgeon was able to break into the tumor, a bit like clay which was odd to see. That piece was sent to the labs on the ship and then shipped out to London which is where all the pathology goes and they will get the results back in a few months. Quite a different process to what I’m used to with the labs just being down the road, but at least they can do that much.
Friday night was the usual board games and chill-out sessions with the group up at the cafe, where a puzzle was started which still isn’t finished and is driving I think everyone on the ship slightly mad. I had an early night as had big plans for the weekend…. Sorta.
