Day 8: Saying Goodbye to Our Patients

On Friday, October 26, Niloo Edwards, MD, head of the division of cardiothoracic surgery at UW Hospital and Clinics, joined a Wisconsin delegation that journeyed to the Dominican Republic, there to spend a week providing free cardiac surgery to indigent residents in Santiago.
During his stay, Dr. Edwards and other surgeons operated on 11 patients, survived hurricane conditions and gained a greater perspective on health care in Latin America. The following is Day 8 of Dr. Edwards' blog of his experience. Return to Dr. Edwards' Blog: Day 1
Day 8:  November 2, 2007
Today is the last day and we sleep in for the first time. So far we have been up every morning at 5:30am, and today, since we don't have an operation, we wake up at 8am. The Wausau team has already gone to the hospital to start the last operation of the mission. They are doing the 36-year-old who came in on Wednesday with a heart attack.
We arrive at the hospital at 9am and start to break down the equipment. We return the monitors and heart-lung machine to the "garage." It is hard to suppress laughing at our helpers, who pound on the elevator door and yell "Quatro piso!" (fourth floor). Somehow, the elevator operator hears and stops on our floor.
Packing up
PHOTO (above): Packing up
The mission gets elevator priority over everyone else, including patients. On the second floor, I see a man in a wheelchair waiting for the elevator, but the operator makes him wait for us. As I walk by I notice he is gray and sweating; I think he is having a heart attack. I am not sure how to help, but fortunately the elevator comes back and this time it takes him.
It reminds me of the second day, when a family member stopped Annette and I as we were making rounds in the ICU. Her mother was having a problem. We ran down the hall with her and found her mother trying to climb out of bed and pull out her breathing tube. There were no nurses or doctors to be found on the unit. We didn't know what was wrong with this patient and she had a breathing tube in, so she couldn't tell us, either.
At times like this, our medical training is of little help. Without some idea of the patient's problem or some access to medications or treatment options, we are as useful as the diplomas on our office walls. You feel quite inadequate.
Putting the equipment away takes most of the morning and part of the afternoon. We try to label everything to make it easier for the next team, but we realize it is futile. Before we leave, Annette and I visit all the patients to say goodbye. They are so grateful, and give us small trinkets like key chains and bottle openers - gifts from their need, not from their excess. It is very touching.
We take photos with each of the patients. In one room I am talking to a patient who is ecstatic that she is already feeling better, despite the recent operation. When I turn around, there is a lady crying in the corner: It is the woman whose surgery we had to cancel. Annette and Mary go over to console her. Fritz comes in behind us and reassures her that she will be the first patient selected on the next mission, but she is worried she might not make it until February.
There is no real way for us to guarantee that the next team will consider her operable, but it is unacceptable to take away all hope. As we leave the room, she breaks our hearts by thanking us for helping the others.
Consoling the woman whose surgery we had to cancel
PHOTO (above): Consoling the woman whose surgery we had to cancel
It is with mixed feelings that we take our final leave of the hospital. We are physically and emotionally tired. We have done a lot, but we realize it is nothing compared to the number of patients who still need help. But there is some reassurance in trying. It reminds me of a poem I learned in school: "Little drops of water, little grains of sand, make the mighty oceans and the pleasant land."
That evening, the chief of cardiology throws a big party for us at his home. Before we leave for the party we take a group photo of Heart-to-Heart mission team #16. Great people… all heart.
The Heart-to-Heart mission team
PHOTO (above): The Heart-to-Heart mission team
Go to Dr. Edwards' Blog: Day 9