One of my favorite things about being a surgeon in PNG is that my children get to experience what I do in an up-close and personal way. In some ways I think it makes it much easier for them to understand the “why” when I have to leave the dinner table early or head to the ER in the middle of a bedtime story. It’s always a highlight for me when the family joins me on rounds. I think the only people who enjoy their company more than I do are my patients and the surgery ward nursing staff.
Naomi is the least shy of our four and is always there to ask questions, shake or hold a hand and greet the patients in “Tok Pisin.” The patient in this picture is a young girl who had a terrible infection of her right foot that required multiple debridements. Her heel bone ended up exposed and she’s now on wound VAC therapy to help prepare the wound for a skin graft sometime soon.
Matthias was quite fascinated by the wound VAC machine. He and Simeon always want to know how things work. They kill us with questions.
This young guy was speared in the left chest. The weapon narrowly missed the heart and injured one of the veins in his left lung. He lost a lot of blood but his family got him to the ER in time for us to help him. We thank the Lord for a team here at the hospital who can respond quickly when the need arises.
Naomi, ever the inquisitor, wanted to know why he’d been stabbed. This led to a conversation with a 2-year-old and a 6-year-old about what it means to be so drunk you can’t remember what happened. Life is just filled with teachable moments.
Ever the helper, Naomi insisted that she help Daddy with the chart. I found it most helpful for her to hold the medicine reconciliation sheet so I could check the patient’s meds while I wrote orders and notes.
This man had an unfortunate encounter with his brother’s bush knife (machete). It seems that his brother was less than pleased that the patient’s pig had gotten into his garden and damaged his crops. As an old missionary surgeon I know commonly said, “With families like these, who needs enemies.”
This is Chris. He’s been my patient now multiple times. He suffers from a terrible infection in the bone of his upper arm that has required multiple operations to try and get it cleaned and healed. This picture is from the second half of rounds. The other three kids have been otherwise distracted, but not Naomi. I’m pretty sure she thinks she’s already the Chief.
Right now we are in between trainees at Kudjip. This means that on the weekends if I want company on rounds I have to bring my own junior colleagues. That’s a pretty special privilege if you ask me!
Our days at home in the last months have been full of fun celebrations, visitors, and new friends. The kids are growing at lightning speed and I only wish I could share (or remember) all of the hilarious things they’ve done and said that have kept us in stitches. But this photo blog should get you caught up on some of the other highlights on the PNG home-front!
We’ve had some great days, some long days and some challenging days here at Kudjip. It’s been a busy time of learning, stretching, growing, and relying on God, my family and my team at the hospital. We are now doing surgeries that have never been done in the highlands of PNG. Thanks to Samaritan’s Purse/World Medical Mission, Riverside Methodist Hospital, Storz, Dr. Mark Potter and Dr. Mike Pyle we’ve acquired the equipment needed to allow the people of Jiwaka Province to enjoy the benefits of laparoscopic surgery. Here are just a few of the highlights in pictures.
It’s no secret that the kids are my favorite patients.
The other thing I love is my own kids getting to meet and bring joy to my patients
However, I’ve found that toddlers tend to slow down the efficiency of morning rounds
The Hospital celebrated it’s 50th anniversary in March.
It’s not everyday you get to teach a GS (Nazarene pope for you non-nazarenes) how to prepare a mumu.
Getting ready for the 50th Anniversary mumu (traditional PNG feast).
Being a general surgeon in Papua New Guinea means that some days I do orthopedic surgery, others urologic or gynecologic, and on others, trauma, plastic or burn surgery. Variety truly is the spice of a surgeon’s life here. One of the more rewarding “surgeons” that I get to be is a pediatric surgeon.
Little Jim – needed a bowel resection because he had dead small intestine secondary to “pigbel”
Winston – had a large cyst attached to the base of his tongue that needed to be removed
Mr. Joe, one of our anesthesia officers safely putting a child to sleep for surgery
Mr. David, another one of our excellent anesthesia officers here at Kudjip also does pediatric patient transport
Kua was hit by a bus and had an open skull fracture and broke both of his femurs
Each week I have the privilege of getting to take care of children who are sick, hurting, and in need of surgical care. This past month seems to have been filled with more sick kids than usual. I wanted to share the stories of two of those children with you. Getting to take care of these small patients has been an incredible privilege.
Simpson is two-and-a-half-year-old boy who is almost the exact age of our second son, Matthias. Simpson came to the hospital short of breath and very sick. His chest x-ray showed an enlarged heart, several times bigger than normal. Based on the history of tuberculosis in his family, he was started on a course of treatment. However, after a couple of days of this his condition worsened. Dr. Erin, one of our family doctors, realized that something other than tuberculosis must be the cause. In the middle of the night he was having difficulty breathing and his blood pressure began dropping. After scanning his heart with the ultrasound, Dr. Erin drained a significant amount of pus from his pericardium (the lining that surrounds the heart). This temporarily relieved the pressure on his heart and allowed his vital signs to improve. The next morning I took him to surgery and did a procedure called a pericardial window to drain and washout the infection surrounding his heart. When we arrived in the OR we found that Simpson had no intravenous access because of the severe swelling from his infection. In the night, Erin had put in a special IV line directly into the marrow of one of his leg bones. Unfortunately, this was no longer working and we struggled to find alternate access. Simpson’s infection was so severe that it had caused a condition called Disseminated Intravascular Coagulopathy (DIC), which was making the veins all over his body fill up with clots. I tried unsuccessfully to put a large IV in one of the veins in his neck, legs or upper arms.
Dr. Paul Hitchen, a visiting orthopedic surgeon from Australia, was finally able to place another IV in Simpson’s bone and this allowed us to complete the procedure.
Simpson is still in the hospital and has had several setbacks along the way, but we praise God that he will soon be going home. He’s alive today because of the Lord and thanks to the great team of doctors, nurses and volunteers we have here at Kudjip.
Remna is a ten-year-old girl who has been Simpson’s bed neighbor on the surgery ward for the past couple of weeks. Remna was initially admitted to the pediatric ward with fevers and several painful and swollen joints from septic arthritis. Unfortunately, like many of our patients, she had come to the hospital very late and her disease was extensive. Despite being started on multiple antibiotics, her infection spread and she began to have difficulty breathing and, just like Simpson, her blood pressure started to drop.
On chest x-ray, her heart, like Simpson’s, was enlarged. The ultrasound showed that her heart was struggling to beat because of all the pressure from the fluid. As we were getting ready to start the procedure to drain the fluid around her heart, her heart suddenly stopped beating and we had to begin CPR in order to save her life. I quickly placed a large needle under the edge of her breast bone and withdrew some of the fluid around her heart to relieve the pressure. Fortunately, it was thin, watery fluid and not pus. During CPR I was able to place a drain into the space around the heart that allowed the fluid to come out. The drain removed almost a liter of fluid from around her heart. During the next twenty minutes (which felt more like twenty hours) we continued CPR.
In total, Remna was defibrillated four times, but eventually she resumed a normal heart beat and regained a blood pressure. Clearly the hand of the Lord was upon Remna in those moments. The type of drain that we used to remove the fluid from her heart is not something that could be purchased here in Papua New Guinea. However, on the most recent shipment of supplies from Nazarene Hospital Foundation, we received a number of donated pericardial drain kits. This is not coincidence, but rather divine provision!
When the procedure was complete, we eventually drained the infection from her joints and then prayed that she would wake up. When we checked on her later that evening she was awake, talking, and telling her mother that she was hungry! Through her recovery she has shown no signs of any brain injury or damage. Remna still needs a lot of prayer and ongoing care. She now has a deep infection in several of her major bones (called osteomyelitis) that will require months of care, and possibly more operations in the future.
These two children represent the reward and privilege that I feel it is to care for some of the sick children who arrive at Kudjip Nazarene Hospital. They are a testament to how the Lord provides what we need exactly when we need it. Sometimes he sends the right person to do a procedure or sometimes its a medicine or specialized piece of equipment. These kids also represent the many other stories of children that I haven’t shared. Perhaps some of those stories aren’t as hopeful and unfortunately, in some cases, the families of those children continue to feel the loss of their little ones that we couldn’t save. But in the midst of it all, we know that God provides the hope, grace and comfort that each of our patients needs.
“Whatever you did for one of the least of these brothers and sisters of mine, you did for me.” – Jesus
Surgeons can do patient transport too.
Simeon, the junior consult and smile therapy director.