Odd Happenings at the Clinic

I'm not sure if you'll find the same things to be odd that I find to be odd, but here are some of my recently odd experiences at the eye clinic, and some nice ones too....

1. This patient below has leprosy. I took these photos today as we were preparing to take out the cataract of his left eye (in the background is the eye clinic OR). It's not everyday in the US you see a patient with leprosy (it's not often here either, but more than in the states). I need to look up the systemic treatment for leprosy and make sure what he has already received is adequate....I doubt that will be on my oral boards in November though! This patient has also been bilaterally blind for 5 years from cataracts.

Patients with leprosy lose sensation in their extremities, so because of the lack of pain, they hurt themselves without meaning to, and don't pay attention to their wounds. As a result, after years of injury, they lose digits from their fingers and toes....By the way, "The Gift of Pain," by Dr. Paul Brand, was an influential book in my life if you're interested in learning more about leprosy and how God knows that sometimes we need pain in our lives for our good.
2. The following gentleman ("Dave") had some really bad news the first day he came to the eye clinic - his blind right eye had an invasive cancer, almost certainly squamous cell carcinoma, and had to be removed, which we did. On top of that, this cancer often happens to people with HIV, so we did an HIV test and it was positive...we had to give him that news too. So the day after we did his second surgery, removing the light-perception level cataract of his left eye, the third piece of news was quite a surprise to him - he could see! He looked around him with joyful incredulity written all over his face, gesticulating with both hands as he saw for the first time in years; actually coincidentally it was also 5 years for him that he hadn't seen, just like the first man above.

It's not often that you take out one eye from someone (potentially saving his life) and also restore the vision from dark to light in the other. It's a humbling experience to have that much influence over the course of someone else's life.

At the end of this visit, he said that he had heard of Jesus before, but now just in that moment, he was realizing that Jesus healed him and that he may want Him to be more a part of his life in the future.

3. Ok, so this next event is not so odd. But maybe it's odd that it's so normal to me now. This is part of the line-up of surgical patients on a normal surgery day here. I've been doing 8 surgeries a day, 3 days a week, with my Gabonese team of nurses, nurses' aide, and resident, but have just this week cut down some to 4-5 cases a day so I can have some more time to study for my board exam....This was a normal morning.
4. There have been a lot of little things that have struck me lately....
- I finished a cataract surgery by flashlight the other day because the electricity went off toward the end of the case
- a chemical we were using to resterilize some instruments was causing some adverse effects (chlorhexidine doesn't rinse out of plastic cannulas well!), so we started boiling some of our instruments to sterilize them. At first I started doing this at home....
-but then but as that wasn't very convenient, one of my nurses, Jean Paul, bought a camp stove in town and now we have open flame in our OR daily - that's a little weird! (But don't worry, there are no smoke detectors to worry about...)

-other things that struck me about operating in the jungle: I have had to learn what to do with flies crawling on my sterile field during an operation. I have tried blowing on them (doesn't work because I'm wearing a mask and it just makes me hyperventilate :) ), drowning them in iodine (works better but doesn't immobilize them right away), and finally having my nurse fumigate the OR with insecticide in the middle of a case (not ideal!). I'm also the main person who finds army ants and something the Gabonese call a "scorpion" (but looks more like a strange worm) in the bathroom and kills them with insecticide (maybe no one else is bothered by them??).

5. I have some odd joys too....This baby one year old boy had bilateral opaque white cataracts, and I took them both out in the same day; the parents were glad, and in the following days and weeks were delighted to watch him start walking. -This baby is too cute not to put in here, and she's active as all get-out, but despite that she has congenital glaucoma and the bilateral surgery to lower her eye pressure was only minimally successful. It's tragic that there is no better treatment available to her here in Gabon.

6. Finally, on the lighthearted and non-eye-clinic side....it's odd and wonderful that God has given me a horse to ride here in Gabon. Here is the Malian fellow who takes care of this pony. He's currently out of town so it's been awhile since I've been able to ride, but another missionary found a bunch of Black Stallion books for me and that's kept me pretty happy :) .