Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

Head And Neck Cancer Surgeon Steps Out Of His Comfort Zone And Into Kenya

Traveling makes one modest – you see what a tiny place you occupy in the world.
-Gustave Flaubert

Tumor ImageWe have come to Kenya, expecting to work outside of our “comfort zones.”

Our patient has arrived from miles away, riding on the back of her husband’s bicycle. She has an enlarging, bleeding mass growing off of the side of her neck. There are no pathologists available, so we are uncertain what kind of tumor it is, although it appears to be a cancer. She has been wearing a scarf to hide the mass for the past year; her head covering is speckled with blood.

We are anxious. Unexpected things can happen in an operating room this far from home. We expect the local power will fail several times each day. The OR team members come from different hospitals and we barely know each other. The operating room will be sticky and warm despite the air conditioner. None of us has ever worked in an OR that has two operating tables in the same room. Some of our favorite technologies are missing. And like many Kenyans, the patient has had no access to regular medical care, and there are things we do not know about her medical history.

Surgery ImageSurgery is a complicated, dynamic, choreographed variety of chaos, and this unfamiliar environment magnifies the potential for catastrophe. The circumstances here are starkly unfamiliar. Back home, it takes months for team members to learn each other’s routines. We do not have the luxury of time. We introduce ourselves.

Post-Surgery ImageThe patient is moved to the operating bed and is soon asleep. Our surgical team starts slowly but picks up steam. We build up confidence and the case develops a flow. When things become difficult or unfamiliar, our routines are cast aside and we work around the obstacles. The lights flicker off, but the battery powered headlights work just fine, and the anesthetist squeezes the bag until the ventilator again has power. Before long, things feel familiar and safe. The tumor is removed, the stitches are placed, and the patient moves to the recovery room.

Dr. Campbell with Patient ImageLike all of the Kenyans we encountered, she is grateful and gracious. I, too, am grateful for the team that is here. Our surgeons, anesthetists, and nurses perform 25 operations and see 1000 clinic patients over three days. This place has turned out to be a comfort zone after all.


You may also like these posts

Read comments »


Comments are closed.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »