​Day 2: Let's Get Started!


One thing about working as or working with a doctor is the early mornings; there's no such thing as sleeping in when there's stuff to do. So, 5:00 AM rolled up, and some of us got up to head to a pilates class held by Dr. Lieberman, while some of us could barely muster the strength to get out from under the covers of the bed.
6:30 AM came up, and those of us who couldn't get up finally had; everyone was showering, changing into scrubs, and heading towards breakfast before we made our way towards the hospital to begin the work we came here for. The food was warm, and the tea sweet; the most perfect thing to wake up to. Thus, we all regrouped, ate, and left towards the hospital.

We arrived, and immediately got to work. While half of us split to prep the operating room, the doctors and I went to view a few patients in the private ward. Of the four patients seen here, two had surgery proposed, and one accepted; a man by the name of Denis, who had Tuberculosis that had developed into Pott's Disease, which is when the TB is seen outside the lungs and present in the vertebrae (bones of the spine) However, due to inflammation or swelling from this, he is unable to walk and completely bedridden, but we expect him to quickly recover, and with a few days time, once again walk.

With these patients seen, we split into two teams; Dr. Lieberman, Dr. Gorlick, and I all headed to clinic to meet all the patients, while the rest traveled to the operating room for the case.
Clinic was quite an experience, seeing so many patients, each with their own, unique story and situation. Maybe patient A had scoliosis from birth, while patient B had scoliosis from old age, but each were in a situation to avoid surgery through exercise. Some were young, others old. No one was the same. The three of us quickly figured out a routine within clinic; I acted as the scribe, recording vital information, Dr. Lieberman examined, and Dr. Gorlick assisted with filling in the information I was unable to get, as well as handing out suckers to our younger patients.
After a few hours of clinic, we briefly stepped out to check on the others in surgery, and as a reason to stretch our legs on our way to a short call. The three of us arrived to see the case in progress, halfway completed, with not a single problem. The TB was being cleaned out, and the fusion was all moving smoothly along. We chatted shortly about a few things; the case in progress, cases we hoped to do in the next few days, dinner, and headed back to resume our work.
Clinic continued on, with us doing our best to provide care and options to each patient; men and women, boys and girls, we saw everyone. Notes were taken on each patient; One girl has macrodactyly, or really big toes, in addition to back problems. Another girl has a mass on the back that needs removed and analyzed. And with every patient that wanted one, a lollypop was handed out. And, with every lollypop came the same smile. Once the surgery on Denis was completed, a second room to examine patients in clinic was opened with Dr. Perry and Dr. Huang running it, and we continued on.

At the end of the day, a grand total of 79 patients were seen in clinic, with additional 4 in the private ward, and another 9 seen in the neurological ward, for a grand total of 92. Three of those cases were chosen for surgery the following day.

We packed up, and returned to the hotel to discuss more surgical plans over dinner. Who needed what and when? Could it wait for a year? Did we also have all the equipment necessary? Cases were thought upon, and names set up over a warm dinner of chicken, fish, pasta, and rice. At the end of the night, happy with the food in our stomachs and the decisions made, sleep called back to us.

​Day 1 and 1/2: Arrival in Uganda

Whenever you travel, there's always the concern about baggage; Did it all make it on the right flight? Did it arrive? Was it searched? Can I retrieve it? It's a little different on a mission trip such as this, in the sense that these questions make you a little more worried; Are the sterile items in the bins open and contaminated? Did my bags with my supplies make it? Did they remove something?
We arrived in Entebbe in the evening, and after retrieving visas, making sure we were all together, the crew headed to retrieve our bags and bins of supplies. The crew, this year, consists of two teams over two weeks. Week 1 consists of Dr. Isador Lieberman from Texas Back Institute in Texas, Dr. Steve Gorlick, from Toronto, Canada, Dr. Tiffany Grace Perry from Los Angeles, California, and Dr. Meng Huang, a 5th year neurosurgery resident at Houston Methodist. In addition, we have Kari Zagar, the neuromonitor, Sherri LaCivita, the scrub technician, Brian Failla, hardware rep from Globus Medical and myself, Adam Woodward, a premed student.
We slowly see personal bags come out, and the bins all set to the side. While two remain to guard the bags we had on us, some went to retrieve the bins, and others the personal belongings. Once all were grabbed and counted, we realized we were missing 3 bags; one of extra medical supplies Dr. Huang brought, and Dr. Perry's bags, containing all of her clothes, scrubs, and some other personal belongings. After some inquiries and searching, it was determined that their bags never made it in the plane, but we could easily adjust to the situation.
With that in mind, we found the van taking us to Mbarara, packed our bags inside, filed in and began the long trek from Entebbe to Mbarara. 

The following morning, after some much needed sleep due to an early morning arrival, we left from the Lake Side Hotel to the hospital, with the intent of unpacking what seemed like countless boxes of medical, both newly brought and remaining from previous years. The arrival was nice; old friends were met once again, and new friends made. We met and spoke with (Normun?), head of the operating room, who then kindly showed us where we'd be storing all the supplies. After discussing a few rules (you must change shoes when entering the OR to prevent contamination, hats must be worn in the rooms), we went to work on the few hour task of unloading and sorting supplies, in addition to setting up trays of with tools to be sterilized. But, as the saying goes, "work hard, play hard", we found ways to laugh during the work. While wrapping tools to be sterilized, Dr. Gorlick was called over to help wrap, to which he chucked, "Don't worry guys, I'm the bondage king!". It was hard to continue through the laughter for a few minutes.
We finished up the necessary work, and went to the town to get some waters, and get Dr. Perry some fresh clothes. Mbarara is filled with life; people bustling through the busy town, the shops filled with people, all buying and selling goods. We found some of what we were searching for, went to another shop, and returned to relax.
And after a long day, what's better than a game of Jenga with a bunch of friends? Sure, tensions were high and no one touched the table during the games, but it was extremely enjoyable for all parties involved; especially when Dr. Meng was struggling to find a good block to pull, so he jokingly said "I'm going to need my loops for this..." The laughing was so bad, he almost lost the game then and there.

Dinner rolled around, and as per tradition, the fried fish was ordered, and was absolutely amazing. Warm and flaky on the inside, but crunchy and flavor on the outside.
At the end of dinner, we all recounted what we learned through the day, and the thing that stuck out to me the most was that nothing goes to waste here. Tying the tools to be sterilized, gauze was tied together and used, and will be reused to tie more together when necessary. It was very different than in the US, when most things are disposable in a hospital.

Thus, ended our first day and a half.