Today started with a fair amount of uncertainty. The government had said that the announcement regarding the results of the election would be made yesterday. That didn’t happen but there was unrest in the streets anyway. Apparently a couple of policemen were killed and others injured. The CBM therapists didn’t come in and that usually means that there is too much potential for disorder in the streets. There was a 26 week old newborn in the nursery that the anesthesia crew were trying to intubate so our surgery lineup was a bit delayed. Charlie was hot to do a shoulder scope so he proceeded with that. It went well and he got great visualization with Mark’s help. It may have been the first ever to be done here. Aldo sacrificed himself to do the clinic while I did the other leg of the big girl with the bilateral (bilateral meanign both sides/legs) Blounts. Mike did the worst side 3 days ago. Jean Joel (JJ--Haitian man training as an Orthopedic assistant) scrubbed and passed instruments. It helped him a lot to get better acquainted with the procedure.
|Connie reorganizing the nonorthopedic OR supplies|
Aldo finally got to do his case this afternoon with Mark. It was another earthquake case. The guy had an ununited fracture of the base of the femoral neck. He had initially been treated with pinning with several “old school” Knowles pins. Two of the pins had already been removed. Mark and Aldo found the fracture quite displaced. After cleaning out the scar tissue and reducing the fracture, they fixed it
|The 3 Vitales Michael, Mark, & Aldo|
Charlie and I finished up the day in the OR with bilateral clubfoot corrections in a severe arthrogrypotic. Charlie assisted me on the first foot then I assisted him on the other side. He did a very nice job. He is a confident skilled surgeon. The surgery is a bit controversial because it is largely cosmetic. These kids have virtually only fibrous scar tissue in their legs and are commonly unable to stand or walk. Their feet are very rigidly deformed and the mothers are unable to get shoes on the kids feet. Should we be spending valuable time and resources doing procedures on kids that won’t help them to walk or even stand? Scott and I agree that doing the correction gives the mother of the child a much better image of her child and that makes it worth it.
During the day we got the word that the government had announced that the top two vote getters in the first round were the two who everyone thought had honestly won. These were the same two that the OAS had determined to be the winners. The current president’s hand-picked candidate is out. There seemed to be virtually no street unrest that followed the announcement. Now there will be the final election sometime in the next few weeks. No one seems to think that there will be any violence from now on.
This was our last work day with the Vitale team. Mark and I did an exchange SIGN nailing of a femoral nonunion. The case went well. Extracting the rod took a while. The distal end was covered with a fair amount of scar tissue and bone. Once the rod was out, the reaming and reinsertion of a larger diameter nail proceeded uneventfully. It has been great for both of these orthopedic residents to be able to do these cases and become acquainted with the SIGN nail. It is being used so extensively throughout the world that all orthopedists should have a working knowledge of it. Lew Zirkle has made a tremendous contribution to orthopedics and mankind with this device. There is a worldwide epidemic of femoral fractures especially in developing countries.
|Preparing the SIGN nail for implant|
Aldo again took care of the clinic while Charlie
|Kame, Connie, and Nitin- anesthesia providers|
|Brittany, Lab Technician giving hope of a strong lab soon|
|Tom doing a very tough case on an earthquake patient.|
While we were occupied, Aldo and Mark did a couple of cases including a diagnostic knee arthroscopy/MRI. This has been an incredible two weeks for all of us. The new friendships forged, new things learned and new opportunities explored have helped all of us become better human beings. Sharing this time together in service to people who have so much less than us has given us a much deeper appreciation for how privileged we really are. I want to hold this Vitale team up as the prototype for future teams. Mark was the driving force that put things together.
|Mark, Terry, Charlie, Micheal, & Aldo|
|Bidding Aldo goodbye|
|Tom camping out at HAH in the volunteer quarters|