The days run together out here and after a while you forget which day of the week it is. Weekends and weekdays are all treated the same way. There is a certain time of the week though that does stay sacred and that is Sunday and we are all given a chance to give thanks and worship.
Tonight we had a very special guest aboard to lead Catholic Mass- the Bishop of South America’s Northwest Region. About 50 of us gathered in the Wardroom in our Coveralls and Working Uniforms facing a makeshift altar of a card table draped with white tablecloth, Jesus on the Cross, two candles, and a statue of the Virgin Mary. We joined in song as we waited for the Bishop to arrive. As he walked in and we stood, he related to us that he had taken the RHIB boat (fast boat) over to the Ship at night from shore, and was a bit soaked J. We helped him get dried off and luckily the ceremonial garb had been kept dry in a dry bag. I was raised and confirmed Catholic, and even served as an altar boy back in Lancaster, PA, but this was the first Catholic I had been to onboard a ship, and from a distinguished high ranking member of the Church. It felt good to take a break, convene together, and have some time to think about things. Sunday was always a day that my family got together when I was growing up, and here too aboard the USNS COMFORT we were family.
Two weeks into this mission and it feels like I have been out here for a few months. So many experiences happen each day, peaking the senses at all times, making the perceived time seem longer than the actual time. That is my theory anyway. It is the same type of feeling that I had when I was going through the intense experience on TV.
It’s go, go, go, and rarely have a chance to step back and reflect. Tonight was good for that.
The reflection must have been calming because I awoke the following day feeling as bright eyed and bushy tailed as ever. Even without coffee I was raring to go at 5am ready to hit the shore and see patients all day long. We were assigned to the RHIB boat again today, but today the water was glassy and we were able to pick up speed and not get wet.
Amongst our crew was CAPT De La Pena, a 70-year-old Family Practice doctor, who is a bulldog and funny as all get out. For him to be hard charging as a Navy doc at this age is commendable (I think he joined with he was 52 J). Also in the mix was Petty Officer Waters, a fairly new Navy recruit (age 20 I think) who I had noticed working all sorts of thankless jobs such as dishwashing, cleaning the johns, scrubbing the decks, and now she was headed out to the site to help out. I was happy for her. She’s the type of young service minded youth that is good to see. And she wasn’t afraid to speak her mind either, which made for a good laugh most of the time.
Things were a bit disjointed at the site today. We arrived early, and I saw the largest group yet waiting to be seen outside the fence of the school.
In particular I noticed a lot of children (ninos). Supposedly there were several busloads of families from the “campo” (country) that had been bused in overnight to be seen. This was going to be fun I thought. The most interesting patients (and often the most appreciative) are from the rural areas. We waited for about an hour and they still had not let the patients through the gates. There had been some confusion and fighting outside about who would get to see the doctors first, as the government had pushed the “campesinos” (country people) to the front of the line. This was not taken well by some. Eventually they barged through the gates and my translator and “nurse” Maria and I set to work. Much was the same patient in and patient out, and to keep myself sane I would try to have each patient leave with a smile, even if it meant just talking with them about their lifestyle, what they liked to do for exercise, what they liked to eat, and give them some advice on living healthy. I asked them about their families, their love life, their goals, and dreams, and to tell a story about the country or the city or their youth in Colombia. As opposed to many of the patients that I have seen in urgent care settings in the United States who just want to get in, get their medication and get out as soon as possible, their was a different type of appreciation and respect for doctors here in Colombia. These people literally hung on every word a “U.S. Doctor” (me) said to them. The most productive part of these visits was health education, teaching the patients about the importance of exercise, what foods to eat, to not smoke, not drink alcohol, limit sweets, and lose weight. They may have been fooling me, but these patients clearly took what I said to heart and started making lifestyle changes even right there in front of me as they turned over their flasks, cigarettes, chocolates and hard candies. It was this lifestyle education (clearly missing for some) that I found most rewarding, as it is this knowledge that will sustain and make a difference into their futures.
This afternoon my favorite patient of the day came in. A 75 year old gentleman, looking a bit hunched over, with his shirt draped over his shoulders, came in with his daughter. She explained that he had traveled over four days from the country (much of it by boat) to get here to Tumaco. Four days ago he was working on the farm and to avoid colliding with a branch had put his arm out and proceeded to dislocate his shoulder. As I removed his shirt I saw his left shoulder clearly out of socket anteriorly. Wow! Four days ago?? When one dislocates a joint the muscles contract around and unless you pop it back in immediately, it becomes increasingly difficult to get that joint back in articulation the more time that goes by. This 70 year old farmer was extremely strong and this was going to be challenging without any anesthesia to relax the joint. I asked his permission to yank on his arm to try and see if I could force it back in, and he replied, “Yes, whatever it takes. I have traveled long and far in a lot of pain. What is a little bit more?” I used all my strength to try and force the head of the humerus bone back into the normal shoulder socket. It would not budge. Damn! I took off my uniform top, as I was sweating up a storm. “Let’s go over to the physical therapy room where I can put you on a table to get some leverage.” There was a stretcher set up on a stand that had been functioning as a PT table and I put the man up on that in a prone position. I then instructed an assistant to take a sheet and wrap it around his body to provide leverage the opposite direction to which I would be pulling traction on the man’s left arm. I had my friend and Dermatologist Dr. Carrie Hall who was nearby push on the Humeral head as I pulled the man’s arm downward with all of my might. It still was out. The man winced in pain, but said Sigua! Sigua! (Continue! Continue!). We realigned and took our positions and then on the count of three, I pulled again as hard as I could.
As I released the humeral head slid back into normal position! The old man rolled over with the biggest smile on his face that I have ever seen. He shook out his arms and shoulders, looking like a Colombian Michael Phelps shaking out his muscles on the blocks before a race. As we rigged up a shoulder sling for the man, his daughter and he could not stop saying thank you, and I smiled and said you’re welcome. This was a team effort. Yes indeed it was.
Day 6 ashore. 70 patients seen today. 457 patients and smiles this week. Total Colombia patients seen by USNS COMFORT Team- 9,968