Chirugie

Got to see a C-section performed today in Hopital Cardinal Leger. The patient had prematurely ruptured her membranes a week ago, but began having contractions sometime yesterday. She was just short of 28 weeks, and as the baby was breech, a C-section was considered the best option. No anesthesiologists are on hand in Leogane, thus we had to wait for the arrival of one from Port-au-Prince before we could even begin.

I was rather excited to get to see a surgical procedure here in Haiti. I went in without any concrete expectations, though with a considerable certainty that things were likely different. This was not entirely true, however. The OR appeared slightly antiquated: minimal equipment (no ventilator, for one) and one large, OR lamp on a fixed track. The generator was specifically turned on to provide electricity for the procedure, and to conserve this precious power, suction was only turned on once the uterus had been opened (and subsequently turned off when it was no longer needed). The suction machine, itself, was quite noisy, but when not in use, the OR was noticeably devoid of any beeps, buzzes or whirring. Blood pressure was taken at sporadic intervals manually . And while I am used to being somewhat overheated in the OR, I was downright hot, as the majority of the operation occurred in the absence of any air-conditioning. As a med student I relish the few times I get to feel useful in the OR (or anywhere, really), but it was clear our patient would not likely benefit from the immediate procurement of warm blankets at the conclusion of her surgery. And to think I was not even in full garb: a gown placed over my board shorts and t-shirt, together with mask, bonnet and booties and I was ready to go.

Otherwise, however, the C-section was like any other I had seen in the States. Though I did not actually scrub in, I was able to see the entirety of the procedure easily. Our patient delivered a very tiny baby boy, her second child. Interestingly, I don’t recall the time of birth being recorded (though I may have been too engrossed in his arrival to take note of this event, which likely occurred in Kreyol, anyway). He was quickly whisked away by the waiting pediatrician. I could hear him crying from inside the OR, which was obviously a good sign, though his prematurity (and the lack of a ventilator or any previous administration of steroids, which can help mature the lungs) leaves him in a somewhat precarious condition. At last glance, he was working hard to breathe, but managing to cry, nonetheless... so only time will tell!