A 5am run with Joshua and then we boarded the shuttle bus by 7:15. We divided and conquered the morning rounds and the preparation for surgery. Promise was brought into the pre-op area of the OR, naked except for the brown blanket shrouding her. She sat on a stool alone in the little room as the anesthesiologist prepared for her case. He started to hum a Bantu lullaby, which seemed to calm her. All motion in the OR stopped as we took note of this simple gesture. As the anesthesiologist left the room to get supplies she became frightened. A hello from members of the team, a smile and then some drawing with Dani Thayer made her smile and put her at ease. It is the simple acts of unexpected compassion that restores faith in humanity and this is often the most powerful medicine. I was once told that “this is not something you learn in a book but it is something your mother teaches you”. Promise was comforted and began her six hours of surgery without complication that included a vertebral column resection and thoracoplasty to correct her spinal deformity.
Following surgery, the lost pallet of supplies to furnish our storeroom had arrived thanks to the unrelenting efforts of Errin Dalzell and the support network back home. While we unpacked the pallet, we continued to care for a friendly young woman, named Sharon, which we met during clinic on our first day. Sharon, a shy-eyed young woman with a beaming smile, visited the clinic with difficulty walking, weakness and loss of sensation in her arms and legs that had started several years ago. At first glance, Sharon's condition had features common to spinal cord damage. Dr. Mimran observed that the cranial nerves that control neck and tongue movement were also abnormal, indicating brainstem compression. The review of the XRAY films revealed an anomaly in the highest cervical segment could account for the neurologic status. Due to the severity of this condition, the surgeons requested a CT films to corroborate their finding definitively and to develop a surgical plan. Sharon and her family did not have the resources to obtain these films, so HVO arranged for the funds and transportation on her behalf. It was also decided that a member of the team 2 should accompany her to ensure that correct films were obtained, expeditiously. J.P. Clark, the neurophysiologist of group 2, escorted Sharon and her sister, Hope, in the team bus, to an offsite private imaging facility in contrast to Mbarara University Hospital where the CT scanner was in a state of disrepair. The CT scan was uneventful but the trip provided the CT scans necessary for Dr. Mimran to confirm that the cervical spine was entering the skull and likely accounted for the brainstem issues. Dr. Burch and Mimran decided that the surgery would require a head and neck surgeon to provide access to the anterior spine through the mouth and would require a transoral approach. Considering the need for this expertise along with the high risk of the spine surgery, they felt that the surgery could not be performed safely in Uganda.
The surgeons met with Hope and Sharon and discussed Sharon's diagnosis.
The news was disappointing for them not only because they could not get the surgical care they had wished for but considering what was required, there was little hope for surgical care in the future. After a moment to digest the news, Sharon beamed again and expressed her gratitude for the diagnosis and the kindness and compassion our group provided.
Following surgery, the lost pallet of supplies to furnish our storeroom had arrived thanks to the unrelenting efforts of Errin Dalzell and the support network back home. While we unpacked the pallet, we continued to care for a friendly young woman, named Sharon, which we met during clinic on our first day. Sharon, a shy-eyed young woman with a beaming smile, visited the clinic with difficulty walking, weakness and loss of sensation in her arms and legs that had started several years ago. At first glance, Sharon's condition had features common to spinal cord damage. Dr. Mimran observed that the cranial nerves that control neck and tongue movement were also abnormal, indicating brainstem compression. The review of the XRAY films revealed an anomaly in the highest cervical segment could account for the neurologic status. Due to the severity of this condition, the surgeons requested a CT films to corroborate their finding definitively and to develop a surgical plan. Sharon and her family did not have the resources to obtain these films, so HVO arranged for the funds and transportation on her behalf. It was also decided that a member of the team 2 should accompany her to ensure that correct films were obtained, expeditiously. J.P. Clark, the neurophysiologist of group 2, escorted Sharon and her sister, Hope, in the team bus, to an offsite private imaging facility in contrast to Mbarara University Hospital where the CT scanner was in a state of disrepair. The CT scan was uneventful but the trip provided the CT scans necessary for Dr. Mimran to confirm that the cervical spine was entering the skull and likely accounted for the brainstem issues. Dr. Burch and Mimran decided that the surgery would require a head and neck surgeon to provide access to the anterior spine through the mouth and would require a transoral approach. Considering the need for this expertise along with the high risk of the spine surgery, they felt that the surgery could not be performed safely in Uganda.
The surgeons met with Hope and Sharon and discussed Sharon's diagnosis.
The news was disappointing for them not only because they could not get the surgical care they had wished for but considering what was required, there was little hope for surgical care in the future. After a moment to digest the news, Sharon beamed again and expressed her gratitude for the diagnosis and the kindness and compassion our group provided.
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