6/24/04 (Thursday)

6:40 AM. Up and showered. I must have slept better or at least the roosters and dogs slept better. Last night when I turned out my light a rooster began crowing right outside my window. I heard a half dozen crows and the next thing I heard was the sound of morning – the traffic on the road, people talking, roosters, dogs, you name it.

Our two patients from Tuesday, Beatriz (radical hysterectomy) and Gloria (bowel resection) were having some problems yesterday. Beatriz’s bowel is slow to return, she is nauseated but over all is doing okay. Gloria has a fever. We have been pushing IV antibiotics on her. It could be more pulmonary on her but the big worry is a leak at the bowel anastomosis. We have no means of determining the problem other than laying on the hands, listening, observing. X-ray, lab, pharmacy support is a dream, not a reality. The possibility of having the situation of the operation was a success but the patient died is too close for comfort.

Today, Phyl flies to Florida. I miss her so! I am enjoying the experience here and I wish she could be here experiencing this culture also. I pray for a safe trip for her. Father, I humbly bow before You today in thanksgiving for where I am at and what I am doing. I petition for Your grace to cover Gloria and Beatriz and our other patients and Your protection for those we will operate on today. Please, Father, protect Phyl as she travels. I miss her so much. Thank You, Father, Lord Jesus, for allowing me to walk with You and to reach out to others in Your name. Amen.

10:45 PM. Our day is done! We had another 12 hour day in surgery and then came rounds. We did a thyroidectomy that took 3 to 4 hours. I had also a lady with a draining cyst on her perineum. As I dissected this out I found an old needle from a previous surgery performed on her 1 1/2 years ago. She said she has had painful intercourse but her husband didn’t believe her. She took the specimen and showed it to her husband. Our post-op patients are doing well. We will now sit down to our evening meal.

Large goiter

The thyroid mass fills Jane

The pathology we are seeing here has been incredible. It is amazing what people live with and won’t seek attention. They deal with pain as something that is part of everyday living so don’t complain about it. No one whines or is demanding. They deal with their pain and move one. I wish some of my previous patients could hve the same attitudes. We expect to live without any problems whatsoever. Little problems then seem big and many visits to the doctor result from our intolerance to pain. I think the Ecuadorians could teach the Americans on what is really important in life.

Yesterday in the OR we were trying to attach leg rests to the table. The latch to lock the leg rest worked very hard and Sheila couldn’t get it done. I tried to push it in and had to strain to do it. Well, in the midst of the strain when i was fully concentrating on the latch, I lost self control and ripped off this loud fart. Sheila just doubled over in laughter as did Paul, the anesthesiologist. Jane was talking and didn’t hear it. I was very embarrassed to say the least. Tonight, when we were checking our post-op patients we asked Gloria (bowel resection) if she had passed any gas yet. She said she had just a little one time today. Sheila looked at me and said, “I bet it wasn’t as good as the fart you did yesterday!” I am still laughing!