It was before six and only Jeremy, Katharine and I were at the long, golden cloth covered tables in the hotel courtyard. Jolly Joe was already proudly making coffee with his new bright red espresso machine and I was watching the sky lighten and change, the beautiful cool morning offset the urge to catch a few more minutes of sleep.
An hour later the entire team had eaten and most were loaded onto buses heading for clinics and the two hospitals. A short ride later through town and then onto the newly paved Jura road that runs between the port at Kenya and up into South Sudan, we pulled into Lacor. The bright orange and yellow glow was especially striking as we walked onto the hospital grounds, turning right down the long hallway towards the surgical ward, being careful to not slip on the freshly mopped floor as we avoided the impossibly long line of people waiting for an x-ray.
I changed clothes and waited my turn to round with Candace and Sandy, looking at foley bags and deciding which would come out and which would stay. Kay and Julie had spent the night caring for the patients and after giving their report they headed to the guesthouse to rest.
And just like that we were back to work. TURP after TURP. I was careful to send the patients to recovery with clear urine, irrigation dripping in one port and washing out the other. Anne, Jeni, Lou, Donna, Izzy and Hannah got the men in and out with care and good humor and expedience.
Over the years Anne has become a urology expert, despite how far removed running continuous irrigation into the bladders of thin old men is from taking care of tiny intubated cardiac neonatal babies. She and the others have an amazing understanding of how to run saline at the correct rate to prevent clotting and to get the men over the wall to the ward safely and quickly.
That’s something that astounds me every year. The patients are located somewhere on the hospital grounds, which in itself can be a major chore, then brought in to sit under their doctor’s name. An IV is started, their consent is signed and they’re given crayons and a coloring page to work on while they wait for surgery. It’s not unusual to see five grown men and women carefully tracing the outline of a bunny or a unicorn. Floating bubbles, a bright pink flamingo hat and dark happy toddlers running around with toys give a sense of peace to an otherwise chaotic scene.
No one works harder than the PACU nurses. Day after day, year after year. Long hours and constant activity mean they rarely see anything outside the OR, no morning tea with warm greasy chapatti, no greasy cabbage and boiled potatoes and cold Coke for lunch. And when they arrive back to the hotel late at night on the last bus, stethoscopes and lanyards still around their necks, they don’t have time to sit and talk or eat dinner or shop. Living on animal crackers, peanut butter, trail mix and candy they push themselves with grace and smiles and a special language of inside jokes.
Tuesday night we arrived home after ten. I sat with Sophie, Heath, and Nyana as they wrote out schedules and consent forms and organized for the next day. I pitched in where they would let me and then became emotional at the dedication of our team. Of course most people know that everything makes me cry in Uganda, but this was justified. They worked past midnight every night to be sure that the day’s records were complete and that the next day’s were ready to go. Last to stop working and first to begin again they were a well-oiled machine, their skills and personalities complimenting each other as they worked tirelessly.
Under normal circumstances I have a lot of trouble sleeping and these conditions are anything but normal. There is so much to see.
So much to do. So many people to meet and to catch up with. So much to think about. So much love to give and to receive.
My heart fills and then overflows until it releases as tears.
There will eventually be time for sleep, but it won’t be tonight. I rested under my mosquito net content and so completely grateful.