Waging war against heart disease.

Yesterday, the first day in the OR, was a day punctuated by moments of fear and doubt.  Have I forgotten anything? Will I have what I need to succeed today?  There was some comfort in being familiar with the heart-lung machines at Tenwek: I had used these machines for 8 years at Maine Medical Center (MMC).  

I can relate to these signs

Heart-Lung Machine at Tenwek with
Oxygenator mounted on the right 

They were like my old ‘97 Avalon, which I had driven for over 200,000 miles.   However, I would be “driving” that pump on the opposite side of the road (with the feeling of uncertainty that US drivers experience when they begin driving in Kenya, which is on the left side of the road- the British system).  Let me explain:  Because of the layout of the operating room at Tenwek Hospital, the oxygenator is mounted on the right of the pump.  Since 1980, I have operated with the oxygenator mounted on the left side of the pump.  My left hand would be controlling the blood flow and my right hand would be called upon for clamping and unclamping lines.  After all these years, my right hand and left hand must switch roles.  Add this difference to the many other differences, like the types of intravenous fluids I would be using, electrical plugs, gas supplies, the shape of the syringes, the packaging of medications, and, in some cases, the concentration of those medications; many things are different here.   At MMC, we outlawed the use of sharp hypodermic needles in the OR more than ten years ago.  We use only blunt needles to draw up medications or to inject blood into test tubes.  No blunt needles at Tenwek- all are razor sharp.  You could hurt yourself here if you were not careful.

All of these things add up to moments of serious doubt.  Should I really be here?  Between these moments, there are moments of affirmation, like seeing the ECHO of Carole’s  perfectly functioning new heart valve after her surgery.  

A big moment of affirmation for me was on Tuesday evening, at about 9pm, when I decided to walk from our apartment up to the recovery room, to check in on Carole. As I walked up to her bed, I immediately noticed that the endotracheal tube had been removed; then she made eye contact with me, and her face broke into a big, toothy smile. She raised her hand from the bed and waved to me.  Thank one smile assured me that I’m where I am supposed to be.

Another moment of affirmation occurred later yesterday evening, while reading a passage from Deuteronomy 20, entitled “Going to War.”  The passage begins by stating, ”When you go to war against your enemies and see horses and chariot and an army greater than yours, do not be afraid of them, for the Lord your God who brought you out of Egypt, will be with you… Do not be faint-hearted or afraid; do not panic or be terrified.”

Several years ago my mother reminded me that I am in a war.  She said something to me like this, “I am glad you are working in heart surgery. There have been a lot of heart problems in our family, and now you are doing something to help people with heart disease.”  This was a new paradigm- There is more to it than the nifty technology.  I am fighting the number one killer of American men and women.  My three uncles were casualties, and so was my father.  It is a privilege to fight back on North American soil and also here in Kenya. 

Be sure to read my next blog.  I will post that photo of the owl that I had promised and share a few photos of Holly and me, “being brought out of Egypt.”   I will also tell you about our celebration of America’s birthday, the Fourth of July, in Kenya.