First Day in Peru

Well after my first full day in Peru I am tierd but very excited for what the next 10 days will bring. I left Salt Lake International airport at 8:30am on March 19th. I sat on my buns for 5000 miles until I arrived in Peru just after 11pm. We did not get into our hotel until after 2:30am. Customs and all that jazz hung us up. This morning I had to be up at 6 so that we could be to the hospital by 7. We arrived at the hospital and as we began unloading our stuff it became very evident that we were no longer in Kansas or any where near there. The patient that we were going to be seeing were all lined up outside sitting on something like bleachers. Many had traveled for days to get here from their remote Andean villages. It was clear from looking into their faces that they were so excited to see us and that their needs for facial reconstruction were severe. We are traveling with three maxillofacial surgeons that have been coming down here for ten years. Some of their old patients were waiting with the other patients to once again lay eyes on these men who had so eased their burdens and improved the quality of their lives. The entire group stood up and clapped as we entered the building with our equipment. We spent the entire day seeing each one of the patients that had been brought in especially for us. Our group consists of 17 people, 3 surgeons, 2 residents, 4 medcial students, me, another CRNA, a scrub tech, and three support people. We all crammed into a small exam room and brought them in one by one. It cannot have been a comfortable feeling for these simple humble people to have so much attention. The first picture is one that I took of all of us in a room interviewing a patient.Never mind, it will not let me upload any pictures so I will just have to insert them after I get back. The crazy thing about Peru is that some things are so third world and primitive but others are absolutely state of the art. The imaging that the patient's received was absolutely amazing. The Idaho Condor group that I am with pays for everything for each of the patients that we treat. The imaging that they get cost $40 US dollars. The hospitalization, medication, surgery, imaging, lab work and everything else involved in the first three cases we did totaled $300 US dollars. Certainly seems like there is room to cut back on our outrageous medical expenses don't you think? Anyway, no political stuff right now. We interviewed about 39 people in about 6 hours and picked 18 that would be good cases for the equipment we had. We had to send the other 19 people home which was extremely sad. Many of those people, as I stated earlier, had travelled long distances just to be told that they needed to wait until next year. Those who were selected were immediately placed in the hospital for preoperative workups and to be monitored. They placed all of our patients in the same ward, not the church kind of ward but the hospital kind. Each morning we would walk past the ward and all of our patients would be hanging out of the windows waiting to see us and tell us how excited they were for their turn to have surgery. We made up a tentative schedule so each one knew when they were suppose to get to go to the OR but sometimes they had to be postponed because their lab work wasn't done or for some other concern and they always cried and were hard to be consoled. For those of you who have been to South America you know that the people can be brutally honest and pretty mean to each other. If you are fat everyone calls you Fatty, if you are skinny that is what you are called. So these kids and young adults, in most cases have been ridiculed and defined by their deformities so surgery is their only chance to feel like everyone else. I was told an incredible story that illustrates this point perfectly. A couple of years ago a 19 yeat old kid came to be seen by the group. He had been playing soccer and had fallen and been kicked in the face. His nose had been severely fractured and lay completely sideways on his face. The bones healed that way and he had been living with that and the shame that came with it for years. The years of teasing had taken their toll and the young man wore a hat all of the time and did not ever look anyone in the face. His eyes were always down cast and it was evident that he truly felt like he was worthless. He arrived with his mom and was examined by our doctors. He hung his head as his case was discussed and did not make a sound. The surgeons told him that they could easily fix his nose and could make it look just like it used to, one doctor went as far as to say "we will make you look beautiful". Upon hearing those words the young man looked up and with tears in his eyes said "you can?" That same day his nose was rebroken and set correctly and a splint was used to hold his nose in its proper orientation. When the young man looked at himself in the mirror he burst into tears as did his entire family. Every morning after his surgery the young man was waiting at the gates of the hospital and followed the team around asking what he could do to help. He would not leave. He carried bags and  washed instruments and the floors, he would not leave until the expidition was over. It reminded me of the story of the savior and the healing of the ten lepers.
   After we had met with all of the patients that we would be seeing we had some time to go and see a little bit of Lima. As a group we went to an very nice restaurant near so Incan ruins. Apparently lots of famous people go there. We ate to our hearts content and I even tried guinea pig. That pretty much sums up the first day. I am going to try to post this but I want you all to know that I have not yet proofread anything and the spell checker has not been working so  . . . be kind.

A Trip to St. George and Zion

My oldest brother, Jeff called me midweek last week and said, "Do you know what the weather is suppose to be like in St. George this weekend?" He said that is was going to be in the mid-50s and asked if I would be interested in going down there to do a bit of mountain biking. We planned to go down after I finished my day on Friday and bike all day Saturday. We got a cheap room at the old Motel 6 and prepared to head down. When Friday arrived to my surprise and delight there were no cases at the hospital so we were able to leave early in the morning. By noon we were preparing for our first run

of the day. The weather was beautiful and warm. The first few miles of the 7 mile loop we were doing were dry and fun. However, we did not know that just the previous week St. George had had a years worth of rain in two weeks creating some huge floods and turning everything that was not rock into mud. We quickly figured this fact out as we ended up pushing and sometimes carrying our bikes about 2.5 miles. We wised up and called a local bike shop and asked which rides would be the best to take considering all the rain. The guy told us that the Church Rocks ride was pretty much the only ride the was worth doing.

On Saturday we went out to the Church Rocks which starts out with a huge drainage pipe that goes all the way under I-15. It was dry and mostly slick rock and pretty fun. Our legs were pretty shot after the previous days trudging and so about 1pm we were done. We decided to go and hike Angel's Landing in Zion National Park which was not too far away. We arrived at the park to the happy news that entrance into the park was free that day. We drove in the the nearly empty park and started to 2.5 mile rigorous hike to the top of Angel's Landing. Any of you who

have never heard of this hike need to know that it is incredible and crazy scary. Once you get to the top of the switchbacks you still have to climb a snow covered narrow trail with 1000 foot drop offs on each side of the trail. There are chain handrails along the most treacherous portions of the hike but even while hanging on it is pretty scary. We were slipping and sliding on the way up and much worse on the way down. There are many parallels that can be drawn from this hike and life and all of them pass before your mind while you hang on to a cold chain and stare 1000 feet down below your feet. It was a great hike and it was fun to hang with my brother as well.

A Journey to the Land Southward

I received an email from our program director along with the rest of our class for an opportunity to apply for a scholarship to go and perform anesthesia in Peru. The scholarship was being offered by an anesthetist that belonged to a humanitarian service organization called Idaho Condor. If we were interested in going we were to submit a one page essay on why we should be chosen to go. I submitted my essay with little hope that I would be selected. The submission date came and went without any indication as to who had been selected. I was on a break at the hospital in Payson and happened to check my email. I had been selected. I could not believe it. The email was short and succinct. He congratulated me on being selected and told me that more information was forthcoming.  He said that I should plan on working ten hours a day but promised me that the experience would change my life. I know little more now than I did then. You can look up the website for the organization at idahocondor.org. There are pictures from the 2010 trip and I think that it works the same way. There is one day that they spend in Machu Picchu and then go to Cusco and set up for surgery. I will post more information as soon as I get it.

New Clinical Schedule

Those of you that have been following my rotation schedule will assume that I am in Texas right now. Well, about the middle of last month my rotation schedule was changed. I will still be going to Texas but not until April. I am currently at Mountain View Hospital in Payson, Utah which is only 45 minutes from my house. I will be at this clinical site for three months after which I will be in Texas for four months and then finish with a final four months in Evanston, Wyoming. I just completed my first week in Payson and I am excited about being there. It is smaller than American Fork was but it is busy and will give me a good variety of cases. I am looking forward to being home for the next couple of months. I hope to be better at keeping things updated on this blog but you have heard that from me before.

A Little R&R

Just after Thanksgiving Cami's brother and his wife (Mark and Kim) asked us if we would be interested in spending a week in California/Disneyland with them. They had found a Marriott timeshare slot for sale in Newport Beach and told us that there was enough room for us to stay there with them. They told us that we would only need to come up with money for our food and our Disneyland park passes. Those of you that have been to Disneyland know that a park pass can exceed the gross national product of many a small country.

Cami, my bargain shopper extraordinaire, discovered that we could get military passes at a substantial discount. So I got permission from the hospital to take the time off and we headed to California. The weather for that substantial drive was pretty good. Saturday we drove to Mesquite and stayed with Kim's grandmother. In the morning we went to church and planned on getting back on the road afterward. As we were loading up to hit the road I noticed that our driver-side rear wheel was flat and a huge nail fragment was visible in the sidewall.

We drove on the tire to a nearby gas station and put some air in it and then went to Walmart to see if it could be fixed.  After $85 for a new tire and locking the keys in the car we were back in business. We made good time to Vegas but quickly realized that we were not going anywhere fast when it took us 3 hours to get from Vegas to Primm. The 20 miles from Jean to Prime alone took an hour. The drive to Barstow was pretty much the same type of stop and go traffic the entire way. I think that the total time from Vegas to Newport was about 10 hours.


Our plan was to go to Disneyland every other day starting on Monday and to recuperate at the beach on the days in between. Monday and Wednesday were awesome. The lines were reasonable and we were able to get everything done that we wanted to. The kids had an absolute blast and it was not too bad for the adults either. We spent Tuesday swimming in the incredible pool at the hotel and just generally loafed around. The weather was mid-70s and absolutely gorgeous the entire time. We spent Thursday at the beach in Dana Point. Despite the coldness of the water I just had to get in and be at one with the sea.     

While we were there eight or nine dolphins kept circling the little bay we were in. They came very close to the shore and it became evident that there were several babies with the group. It was really cool until some kids paddled to within touching distance of the pod and then they left.
   You may have noticed that I have not yet described our Friday in the park. Well many of you may understand that Friday at Disneyland can be quite busy and lines extremely long. The fastpasses can help but you really don't get to do as much and after a week of late nights patience begins to run quite thin.

Connor trying to be a good sport during my pity-party

   There must be some unwritten rule of fatherhood that you have to become mean and ornery on family vacations. Not wanting to dissapoint, I held true to this less than pleasnt fatherly tradition and became the wet blanket of the group. My incredible wife with the patience of Job put up with my crabbiness and gave me the space I needed. Luckily, I was able to leave early that day and go back to the hotel with Mark and Kim and one of their boys so that the rest of the group could enjoy their final day at Disneyland and I could get some sleep and prepare for the long trek home the next day. 
   All in all the trip was fantastic and everyone had an incredible time. Many thanks to Mark and Kim for their generosity and willingness to let us tag along.

Absence Makes the Heart Grow . . . Fonder?

Well it has been over a month since I last posted anything and I have been chastised from several sources so I am attempting to rectify my slothfulness. Since last I posted I have made the transition to yet another clinical site but this time I am able to live at home while working there. The new location is called American Fork Hospital and it is only about 8 miles from home. It is considerably larger and busier that either Soda Springs or Montpelier. In the two months that I was in Idaho I participated in 63 cases. In my first two weeks in American Fork I did 67. Needless to say I am having to pick up my game a bit. I feel quite overwhelmed but I am grateful for this chance to work on speed and to really hone my anesthesia skills.

How Great Thou Art

I spent the weekend in Logan with my brother and his family and was driving through Logan Canyon at about 10pm. It was a moonless night and the canyon was extremely dark. It was difficult to see even with my high beams on. After my near miss with the deer in Soda Springs I was moving very cautiously. The trees and rocks cast eerie shadows and made me feel uneasy. I felt foolish for being scared but the darkness was so palpable that it made everything seem ominous. I began to feel depressed about the fact that it was to be another week before I would get to see my wife and kids. I started to feel overwhelmed with my chosen career, feeling like understanding anesthesia was just too difficult and beyond my capacity. After a while I recognized that I had allowed the darkness of the night to give place in my heart for another power of darkness and I was allowing that power to take control. I found a safe place to pull of the road and I turned off my car and got out. I looked up to heaven and cried to God for relief from the burden of the darkness in my heart. My eyes then took notice for the first time of the night sky. It seemed that the heavens were aflame with celestial white light. The expanse of space before me was filled with innumerable points of light. The thick carpet of the Milky Way had never been clearer to my naked eyes. The darkness within me melted away and gave place to a burning gratitude for the Creator. Those trillions of stars and planets and galaxies, rather than making me feel small and insignificant, made me realize how incredibly real God is and how much he loves his children. I was filled with light and a sense of my own worth. I felt a renewed vigor for life and all the challenges it holds to us in this our mortal probation. After a few minutes I got back in my car. As I finished my drive to Montpelier I thanked God for the darkness of the night that allowed me to see and to feel of his goodness.