Since my first year at Tenwek, where all of my communications were through written emails I've felt I've been able to bring more of Tenwek 'back home' with the addition of my photography. The most impressive aspects of the Tenwek cardiac surgery program to me this year is how much the cardiac program here has grown and is growing... and how do you capture progress in a photograph?
There are several cardiac teams visiting Tenwek each year helping to bring hope to so many of the people in this region of Eastern Kenya who have no where else to turn. We are seeing patients every day in our clinics that we have the ability to help, but not the time or resources during our limited visits. You hear about this sort of thing happening around the world all of the time. The hard thing about being here is that we see those people. They have faces, and families. Like the one-year old baby brought into clinic this morning by her parents with congenital disease so advanced that there is nothing that anyone can do. No matter how compassionate our doctors try to be when informing the family members that there is nothing that can be done for their sweet child, the end result is heart ache and anguish. We've come so far at Tenwek, but we have so much left to do.
5 years ago I had the privilege of pumping the first open heart procedure at Tenwek Hospital. The case took took hours to set up for and most of the day to accomplish. Today, we did 3 cardiac procedures (2 open hearts and one closed cardiac procedure) in 2 different operating rooms simultaneously for the first time, using state-of-the-art heart lung machines that were donated from a hospital in New England and we were done by 4:30 pm.
The heart-lung machines were donated almost 2 years ago and have been held up in the port at Mombasa this whole time. We received word when we arrived at Tenwek last Friday that the crates of equipment had been released and were 'thought to be' on their way to Tenwek. They finally arrived yesterday, after completing 2 valve replacements and finishing our evening cath conference, Bob (the perfusionist who donated the heart-lung machines 2 years ago who happens to be working with us this week), Johnson and I went down to the loading docks to put the second pump together (literally, it was disassembled in many large and small pieces). After assembling it, we pushed it up the ramp into surgery and set up the circuit so it would be ready for surgery in the morning. By the time we finished up and got back to our rooms it was almost midnight, but the pumps were beautiful and today was going to be another centinel event at Tenwek... doing simulataneous open hearts in 2 different cardiac OR's.
One of the changes to our trip this year is the addition of a Chaplain to our team to help not only our team, but the families we interface with while at Tenwek. Pastor Rick is a Samaritan's Purse Chaplain and has been a valued member of our team. He can be seen in the operating rooms praying with our staff and/or our patients. As I was in the pump room (another new addition to the Tenwek cardiac program... but more on that later) this morning charting on our first patient, I could hear Pastor Rick praying with some of our team members outside of my patient's room. Here is a picture of him later today praying by himself quietly outside our second patient's room:
I staffed our first case of the day with the Kenyan physician assistant who is being trained to do perfusion. As usual, during the morning set up I was taking a few pictures (every few seconds)... and our patient asked the Kenyan nurse in the room in Swahili if I would take her picture.
Her surgery went very well and she was in the ICU in the early afternoon.
Our last patient of the day was a gentleman who had suffered from Tuberculosis. A side effect of the TB was scarring on the membrane that surrounds your heart; the pericardial sac. The pericardial sac is typically a very smooth membrane that completely surrounds the anterior portion of your heart. There is a fluid between the heart and the pericardial sack that acts to lubricate the heart as it beats in your chest. This patient's pericardial sack had become calcified as a result of the TB, so that it was as hard as stone. I took the picture below as they were putting in his monitoring lines prior to his procedure.
His surgical procedure consisted of removing the calcified sack surrounding his heart that was compressing his heart and putting him into congestive failure. The calcified tissue was so hard, portions of it had to be removed with orthopedic tools used to chip away bone. His hemodynamic status was very compromised as a result of his pathophysiology, but thanks to our talented team he did very well.
Our whole surgical day was finished by about 4:30 pm, which was a pretty spectacular feat. Having such a late night the evening before and such a busy day today, I was more than ready for a little 'Tom-time" to download photos and get caught up on my blog for all of you at home. After cleaning up in the room before dinner we attended cath conference to review the next days cases and I was hoping for an early night back at the room to relax with my photos...
Before going to dinner, Dr. Mike stopped by my room to ensure I would be attending the cath conference promptly at 7:00 and to let me know about a 'social' at one of the opthomologists homes on the hospital grounds later this evening. Well, since I wasn't feeling too 'social' with our hectic schedule, I thought I would just retire to my room after conference and 'do my own thing'. When my roommate got back to the room and asked if I was going to the gathering, he heard one of our team members was going to give his testimony so I decided to be social after all.
After basically getting lost on the way to where we thought his house was and walking about 25 minutes to what was literally behind the guesthouse where we were staying, we arrived at the gathering on the top level of their living quarters. It was open air with a fire place and was surrounded in Christmas lights so it was a pretty festive little gathering. Still not really knowing what we were walking into, we heard a group of people singing church hymns in Swahili. I recognized the song from a church service I attended last year. After a brief panic about thinking I might have to sing in public, we entered the room. There were various members of our cardiac team present with most of the people being native Kenyans and local medical staff.
After a couple of songs, the group took their seats and Dr. Carol got up and recited a short story about a little girl who had gone to see her doctor for a cardiac issue she was having only to end up having an untreatable issue that would result in her ultimate death, but in the process the physician found the Lord. Dr. Carol then talked about one of her patients that had a profound impact on her. A young girl who had been raped and beaten and presented to Tenwek Casualty (the hospital ER) with an arrow protruding from between her eyes. Dr. Carol spoke with the girl before she operated on her and explained that she was not sure if they could save her eye, but would do the best she could. The surgery was ultimately a success, and her eye was saved, however she lost sight in it completely. Several days after surgery, Dr. Carol sat with the young girl to see how she was doing 'on the inside' due to her recent trauma. The girl barely spoke any English at all, but said over and over 3 times, "I am trusting in Jesus, I am trusing in Jesus, I am trusting in Jesus".
At that point one of our cardiac physicians started to tear up and began to quietly cry in her seat. Obviously from a similar experience of her own or maybe from an experience she's had while at Tenwek. Then another Kenyan physician began to speak about the long hours he has had to work while going through his medical program at Tenwek. He had to stay up many nights to care for sick patients and admitted that he would pray to God that he not have any patients so he could sleep, but the patient's would keep coming. He said what he's learned while at Tenwek is that God gives us all the grace we need, and His grace is sufficient for anything we are going through. More stories about more patients with more devastating medical cases that most of us can even imagine, and more testimonies of God's saving grace.
Another Kenyan physician began speaking about his situation and about a quote from 'The Miracles of Tenwek'. This was a book I read about Tenwek that was given to me by Franklin Graham of World Medical Missions on my first visit to Tenwek 5 years ago. The quote was, 'there is no safer place in the world than in God's saving grace'. He went on to talk about how busy his life had become and how there is never any time for the things he wants to do, because of all of the things that he 'has' to do, but God's grace is really all that he needs. I sat there choking back my emotions as I listened to him because it felt like he was telling my story. The never-ending job responsibilities, the obligations that seem to stand in the way of everything I'd rather be doing.
There were several testimony's by other members of our team that were very heart-felt and emotional as well. A Kenyan resident who was sitting next to me started to speak about how he had not yet started a family or was even married and was trying to find his place in life. He said that after spending the past 9 months at Tenwek and quoting a verse from Deuteronomy, that the Lord blesses those who work with their hands for all they do. That our responsibilities are to work fevereshly with the talents that God has blessed us with in helping others who are less fortunate. I immediately thought of the photo below that I took earlier this morning for no apparent reason. A photo of only the hands of one of our anesthesiologist as he inserted an arterial line into our last patient of the day.
I'm so glad I decided to be 'social' tonight because I had an incredible evening with some individuals that really impacted my life and once again provided me with some much needed perspective on things that I've been struggling with so much lately. Perspective to see what is really important and what I really need to be focusing on right now.
I'll end this post with 3 pictures from Michael Taylor on our team. He shared his photos with me earlier this evening and I was struck by the following 3 photos out of his collection. I thought they were very pertinent to my 8th day at Tenwek and succinctly expresses our teams commitment to using our God-given talents to help those in need.
Thanks Michael.
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