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2/13/08 (Wednesday)

6:00 AM.  The noises of the morning awakened me.  The city is coming alive and the workers are heading out to the palm groves.  I finally got to bed a little after midnight and shortly thereafter the generator went off and everything was black and silent.  The power is still off and who knows when it will come on again.  Jane said the transformer for San Lorenzo is in Borbon, a couple hours away.  She said that for the past few years the city has said that transformer is overloaded but nothing has been done about it.  The power is out and now we have no water since our pumps are not working and our generator is on its last leg.  It was not working yesterday afternoon and then it worked last night.  I suspect the generator will fire up in a little while and we will try to go as far as we can on that back up power.  I do not know how we are going to do our surgery if we don’t have power consistently.  That was not pleasant yesterday when the lights went out in the middle of surgery.  We did not even have a flashlight handy.  Jane has the only flashlight for the clinic and she had left the surgery to tend to some emergency issue and did not return to the operating room.  I plan to take my flashlight with me today so we have some back up light in case something happens.  I may even get out the battery powered headlight and wear it so it can be turned on if needed.   

Father, into Your hands I commit this day.  It is starting off uncomfortable.  We have no power, we have no water.  Our surgery schedule is full and we have recovering patients needing attention.  Lord, we have to depend on You as our source.  Yes, You are our source of everything we need but frequently I forget that and focus my concern on other things.  I am doing that now, Lord, and I ask forgiveness for not turning to You now.  Lord, I pray that this day will go as You planned.  I pray also that we all trust You first and allow Your glory to shine.  Lord, thank You for this new day.  May we glorify You in all that we do and say today.  Amen. 

9:00 PM.  We are finished for the day.  Our surgery time started at 7:00 and finished 14 hours later.  Standing all day has produced swollen feet for all of us.  Some of our surgeries were quite difficult taking more than the usual time to complete them.  Then on top of all that we had multiple power outages resulting in a dark operating room each time until the generator could be started.  I got out the headlight and put fresh batteries in it and wore it starting the second surgery.  When the power went out we were able to continue working by the light of my headlight.  Every case except for the last one had at least one power outage during the surgery.   

Our post-op patients are doing well.  Some have gone home already.  Linda and Annette have taken over the post-op care and they are doing a fantastic job.  They have lightened our load by managing these patients for us.  They are having a lot of fun doing this and are living up to the challenge in every way.  I am so proud of them and glad they came along.  Linzy, likewise, is scrubbing for every surgery and is a great instrument tech.  She has made our surgeries run smoother and more efficient.  I have enjoyed the opportunity to work with Dr. Weise.  She is relatively new in practice and is eager to learn from me.  I am enjoying the opportunity to help her fine tune her surgical skills.   

 Our first surgery involved a hysterectomy.  This surgery was moderately difficult and took some time.  The surgery went well and the patient tolerated everything nicely.  The only frustration was the power outage in the middle of the case.  Fortunately, Dr. Weise and I had just ligated a major blood vessel and we are preparing to move to the next step.  When the lights went out at least we didn’t have anything bleeding or needing clamped.  We could pause without putting the patient at any risk.  It is frustrating to have the lights go out unexpectedly and have to wait in total darkness for a few seconds to a minute before the generator is started and we get some power back. 

Our second patient had multiple uterine fibroids and wants to conceive.  She wanted the fibroids removed to facilitate conception.  Barb and I did the surgery.  It was a challenge but it went well and we were able to return her uterus to a more normal state.  We hope this surgery helps her accomplish her goal.  This surgery I wore a battery operated headlight in case the power went out.  And it did almost as predicted.  This time my headlight was on and we could continue working without having total darkness stop us in our tracks.  I wore the headlight for the rest of the day. 

Our third patient was another hysterectomy.  This woman had large fibroids and was anemic from bleeding heavily.  Her surgery was difficult because of the large size of the uterus and difficulty obtaining good exposure.  We had to take it slow and easy and methodically work through the procedure.  Mixed in with this were several power outages. 

Our fourth patient had a fallen bladder and required an anterior repair.  This surgery went quite well with no problems.  Dr. Weise did the surgery with me assisting and answering questions.  She is getting some good experience surgically. 

Our fifth patient was a woman I met last Saturday when Jane, Linzy and I walked to town.  This woman and her husband run a hotel and she invited us in for a visit and gave us a special treat of fresh fruit juice and grilled cheese sandwiches.  She came in on Monday for an exam and we recommended a D&C, which we accomplished this evening. 

We are now getting ready for our dinner and then I hope to be in the bed soon for a longer night’s sleep.  Our surgery day tomorrow is all general surgery with a couple gall bladders and some hernias.  I may be able to get out of the operating room some tomorrow and lay down in the middle of the day.  My feet are swollen from standing all day.  In fact, all of us have swollen feet.  The heat and humidity really sap your energy as well as promote the swelling.  Because of the short night last night I am especially tired today.  As soon as I got back to my room tonight I took a shower since we at least had power and running water now.  I feel so much better just having done that. 

Father, today was a challenge, as You knew it would be.  I gave this day to You and You delivered for me.  You kept me going when I was very tired.  You kept my mind working and allowed me to stay alert in spite of the fatigue and heat.  You wrapped Your hands around my hands and enabled me to do some tough surgery.  Lord, thank You for Your involvement here.  We are here to serve You and You are making it happen.  Our patients are receiving Your miracle of healing as You touch them.  We are receiving Your grace and mercy as we are instruments in Your hands to deliver the care You called us here to do.  Thank You, Lord, for Your unfailing love.  We are privileged to be recipients of that love.  Lord, I praise You tonight!  Amen.

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