The night before I left, I was up late packing and thinking about the last time I was in the sticky warmth of the Dominican air. It was during the spring of 2002 and I remember coming home a changed man, full of idealism and eyes opened to a broader view of the world. Now, more mature and pragmatic, I feel that spirit of service that was ignited nine years ago in the Dominican Republic (DR) is still alive. My study abroad experience was a major reason why I chose to attend Creighton for undergrad and it had a profound effect on my life thereafter. I couldn’t wait to see what this experience would bring.
When I got to the airport, I remember thinking I don’t really know anyone except Dr. Manion, and I barely know him. Fortunately, I was immediately included in the team and treated like an old friend. The team of 40-50 people – over half from Omaha – included physicians, nurses, technicians, and me, the lone medical student. The team was full of life and laughter as we waited to board our plane to the DR. People were swapping stories, giving hugs, reminiscing about years past. I could tell we were going to have a great week.
On the bus ride from the Dominican airport to the ILAC Center, I started talking with an anesthesiologist from Kansas City named Guy Giroux. He was the only resident to graduate from Creighton’s Anesthesia program and was taught by Dr. Manion many years ago. He had a great energy about him that was contagious and we became good friends by the end of the ride.
When we arrived at the ILAC Center late Saturday night, fond memories came flooding back into my consciousness. The ILAC Center looked exactly the same as it did nine years ago, very clean and well maintained. We were briefed on what to expect and what the game plan was for Sunday. Then I snuggled into my mosquito netted bunk bed and slept like a rock. However, I awoke to the ever-familiar cry of a rooster crowing at 6am. How could I forget!
After breakfast we started the long process of unpacking the suitcases of supplies we hauled down. We also had to go through the multiple shelves of supplies stored in the adjacent warehouse. I had no idea the amount of materials and drugs we had to sort through and set up for the week. It was amazing to see how much is needed to run three operating rooms, a pre-op area, and a recovery room for 5 days. I always took for granted all the supplies that are readily available in the U.S. operating rooms. In the DR, we needed to make everything count and not waste anything.
I loved how everyone just chipped in and helped where they could. It didn’t matter if you were a physician, nurse, CRNA, or high school student. There was enough work to go around and I liked how there wasn’t the traditional hierarchy in the U.S. I just kind of floated around mainly, helping to set up the operating rooms and sorted through the disarray of donated medications.
In the afternoon, I got the opportunity to travel to a campo about 45 minutes outside the city of Santiago. We got a personal tour by the mayor of the little town. He was very proud to show us all the different foliage, the coffee and banana trees, the school, the church, and the variety of houses. As traditional Dominican custom, we were invited into a house and asked to sit and drink freshly brewed coffee. It was delicious! The Dominican people are so warm and friendly and offer so much even though they have so little. Their hospitality is unsurpassed.
After we got back to the ILAC Center, I decided to take a run around the track instead of going downtown to the mall. The figure eight shaped track is one of my favorite things about the ILAC Center. Banana trees and beautiful flowers surround the sand covered track. They even put in solar paneled lights that outline the track at night. It gives the ILAC Center a magical quality and provides a great area for reflection. I remember thinking how fortunate I am to be able to come down here as a medical student and how fun it will be to be able to come back as a practicing physician.
Over the next five days, we performed over 120 hernia surgeries and I was involved in almost every single one. I started most of the IVs in the pre-op area and helped consent the Dominican patients in Spanish for the surgery. I would help the anesthesia provider bring the patient back and help start the case by hooking up all the monitors. I got the chance to intubate a few patients and put in a few LMAs. Since our ventilator machines were sometimes unreliable, I ventilated a couple of patients for the entire surgery. I would draw up the induction drugs and helped get the patients off to sleep or feeling comfortable. I also scrubbed in on quite a few surgeries, especially helping the pediatric surgeon Dr. Cusick with more complex surgeries, such as un-descended testes. It was a very proud moment for the whole team when we completed our 1,000th hernia surgery on a 7-year-old Dominican girl. It was a great photo op!
At the end of each day, Dr. Manion would make sure the local Dominican Presidente beers were ice cold and we all talked about the highlights of the day. It was cool to see how much we all bonded after the five intense days. Everyone worked extremely hard and did their small part to make this mission trip a success. And what made it all worthwhile was how grateful the Dominican and Haitian patients were. Sometimes in the U.S., we get jaded with patients who are not very grateful or who consistently abuse the healthcare system. But in the DR, everyone was so appreciative and happy. It was very refreshing.
On the night of the last day, we packed up everything and took an inventory of all the supplies we had so we knew what we would need to bring for next year. At the end of the five days, I was amazed by how many supplies we didn’t actually use. It made me realize that we could provide very safe and effective care without needing all the bells and whistles that we have in the U.S. We need to decrease the medical waste that we create in the U.S. If we do this it will help decrease health care costs so more people can have access to health care.
In all, this week long service trip was a complete success and a fantastic experience for me. I know that I will be back some day soon as a physician and hopefully I will be able to bring my wife down to provide some physical therapy. Since I have been interviewing for residency positions, I have been more drawn to the programs that offer international experience and service trips during residency. The spirit of service that was embedded in me by the Dominican Republic and the Jesuits is still very much alive!
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