COTW: Duct tape fixes everything

(New perspectives on our life and team being almost invariably a good thing, both for you our readers as well as for ourselves, we are happy to welcome Greg, our visiting anesthesiologist, and his reflections.  He and his wife Stephanie host a family blog, and you can find the link on the right sidebar.  -Eric)

Last night, my wife heard a knock at our kitchen door.  It was one of the medical students.  “Duct tape! Greg said you have duct tape!” she told him that she had returned the duct tape to the other visiting missionaries who had the foresight to bring such an essential tool.  And off the med student ran to find the duct tape. Now, we are relatively new to life among the Mcropders, so this would fall within the category of “new experiences” for us.  I have never before had to send a medical student to my house to get duct tape to make my anesthesia machine work.  

My name is Greg, and my wife, three children and I are serving along side the Mcropders in Kibuye for 9 months.  Yesterday evening, I was outside searching for an internet signal, when one of the hospital employees found me and handed me a note.  There was a 5 year old girl who had just arrived in the ER with multiple machete wounds to the head, inflicted by a “crazy person” in her village.  She had a skull fracture and was in a coma.  Agneta, our visiting surgeon from Kenya, had evaluated her and decided she needed to go to the operating room immediately for a decompressive craniotomy and exploration.  They called me because I am the visiting anesthesiologist.  

They have been doing surgery at Kibuye for many many years.  However, it was not until after I arrived 2 months ago, that we starting performing surgery under general endotracheal anesthesia.  Before yesterday, we had done a total of 4 general cases.  This very hurt little girl would be the fifth.  So, I went to work preparing the anesthesia machine, connecting it to the air compressor, then connecting it to the oxygen cylinder.  Unfortunately, this time, there was a large leak of oxygen around the connection between the tank and the machine, making it impossible to maintain pressure in the machine.  Sadly, I did not realize this until after the child was intubated on the OR table.  We managed to limp along until the student could return with the duct tape which we used to position the tubing at just the right angle to minimize the leak ... but it was not pretty.  In fact, it looked a lot like a sophisticated medical device ... held together with duct tape.

Back in the US I don’t see many craniotomies on 5 year olds, but I have to say, I was astounded by the work that Agneta did.  The child’s skull looked like a jigsaw puzzle.  Agneta, somehow took it all apart, repaired a dural tear, controlled the bleeding, and then reconstructed the puzzle, using Jason’s Dewalt drill and multiple sutures.  The girl remained stable throughout surgery, and was extubated (breathing tube removed) at the end of the case.  This morning, she remains in a coma but is otherwise stable.  We are praying that as the swelling in her brain subsides over the next few days she will wake up and make a full recovery.  

We are all so grateful to have had Agneta here this month.  She was trained at Tenwek hospital, with Jason as one of her teaching attendings.  She has a brilliant mind, gifted hands and a compassionate heart.  It has been massively encouraging to spend this month with someone who has benefited so much from the desire that God has given the Mcropders to teach and train African physicians.  Sadly, she returns home tomorrow.  And I can’t help but think that if this little girl had come in a few days later, she would have had little to no chance of survival.  We praise God for His gracious provision for our team, for our hospital and for this little girl.

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