Today was grand! We finally got the flow right in the mornings, starting with the post-op review of yesterday's patients and going on to the prep and surgeries for today's. Seven patients went home, seven more received cataract surgery (we always plan for 10 surgeries each day, and often book a few more, but there are always some who forget and others who are afraid to have surgery done on their eyes).
I suited up in scrubs to watch a couple of surgeries today - one by Dr. Bob Rea, one by Dr. Tony Pisacano. Tony is using the hospital's operating microscope, which has a teaching microscope attached - this means that I got to share Tony's view, up close, of the patient's eyeball. I had thought of these surgeries as fairly simple - I suppose because they are common surgeries - but it was astonishing to watch the intricate steps and careful process required to extract the clouded lens. Down here, we don't use the sophisticated Phacoemulsifier which uses ultrasonic vibrations to break up the cataract; PazSalud and See, Intl use an older, slower and less expensive direct method. It requires great focus and complete attention to detail: it was an honor to watch two excellent surgeons giving that focus and attention to people who couldn't imagine being able to pay for cataract surgery.
The other surgery today was performed on the Slit Lamp, an essential piece of equipment that had suffered an internal short circuit. After I watched the two surgeries, I saw the completely disassembled Slit Lamp, which looked to be ready for the junk pile. But Hernan Merino, who owns and drives the bus we travel in, got a list of needed tools and equipment, took it to the hardware store, and came back with the necessary bits. Then all the four men on our team, Mitch, Bob, Tony and Barry, collaborated on putting the machine back together. And the women, I have to confess, laughed at this great example of male bonding. But the slit lamp works again!
One more note from today: remember the fuss we had getting our anesthetics through customs? The customs agent was particularly exercised by the fact that we were bringing in Lidocaine. Lidocaine! he said, and showed us a packet of lidocaine that had been confiscated. Today we realized that we were running short on lidocaine and set Hernan out to buy more. With no prescription and no difficulty, he was able to buy a nice big bottle of injectable lidocaine at a local pharmacy. Surely a good thing that those customs folk were on their toes!