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6/22/04 (Tuesday)

It’s 6:30 AM and I am up and showered.  I wanted to think and pray about our surgeries today.  Our first case is the lady with cervical cancer.  She has a resectable lesion and could be treated with a radical hysterectomy and node dissection followed by radiation therapy.  But we are all she has.  I don’t feel secure doing radical surgery anyway and especially here.  Yet, I feel we must do something to help her, at least control her bleeding.  She has had some heavy bleeding at times and with no ability for blood transfusion, she could bleed to death.  I pray, Dear Lord, please hold her in Your hand and protect her, heal her.  Please equip Jane and me with the right knowledge and wisdom to do the right thing for this lady.  She is placing so much hope in us, Lord.  Please help us reach out to her and transfer that hope to You.

Yesterday morning this 65 year old Indian lady and her son came for a gyn consult.  She had heard a gynecologist was here.  She lives in an Indian village and had to spend a lot of money to travel by canoe several hours and then catch a bus to come to San Lorenzo.  She lives in a remote village on the river.  They showed up at 8 AM to see me.  She didn’t have a problem although she came prepared to have surgery.  I told her she didn’t need surgery or any pills.  She was happy and by 8:15 they were on their way back to their village on the river.

8:00 AM.  After breakfast we saw our post-op patients and eventually began our first surgery about 10 AM.  Our first case was the poor lady with cervical cancer.  We were able to get the uterus and cervix out, which should stop her bleeding.  She had no palpable nodes in the pelvis or abdomen.  I prayed for a miracle and I believe God delivered.  Our afternoon was taken up by the lady with a very bad rectal prolapse.  Jane and I did a bowel resection and it went well.

Paul, the anesthesiologist, cleaning the OR table

Paul, the anesthesiologist, cleaning the OR table

I commented to Jane about how helpful Paul, our anesthesiologist, is.  He is truly a team player and pitches in to help throughout the cases, not like at home where the anesthesiologist sits and reads. 

Jane writing the operative note

Jane writing the operative note

Jane and Sheila closing the skin.  Maria Luisa circulating.

Jane and Sheila closing the skin. Maria Luisa circulating.

When we were done at 8 PM I changed clothes and found my legs and ankles very swollen.  I was surprised to see the edema which was probably secondary to the shoe covers that extend up the leg and are held by an elastic band. 

When we were seeing patients in the clinic there was this one lady who had 4 miscarriages in a row.  She had one previous successful pregnancy by her previous husband.  This current husband is blaming her for not having any children.  He denies he may have a part to play in this.  The culture here is very much mail dominated.  The man wants his woman for sex and babies.  Painful intercourse is of no concern to him unless he is the one hurting.  Jane expressed frustration with this cultural attitude.  Yet, the husband of the lady with cancer broke down and cried when we told him the diagnosis.  He was there today tenderly caring for her.  Jane told me that 1 to 2 years ago they had lost their 2 year old who was run over by a truck.  The truck kept on going and no one claimed responsibility.  It is such a hard life here.

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