Notes from a TDY, Part 3: Philippines Recap

Whoa, time flies.  The Philippines mission port is complete and it was pretty intense.  I participated in two SURGCAPS, one SMEECAP and lots of surgeries.  Overall, the surgeries were really satisfying and we had some great cases.
My favorite case was the thyroglossal duct cyst case.  Not only is it a relatively infrequent operation due to the rarity of the condition, it was an awesome story of luck and being able to help a young girl.  I met her and her mother at the second SURGCAP.  She was the second-to-last (penultimate?  too grandiose?) patient of the day.  She was getting an ultrasound and I was waiting around for my last patient.  We had run out of papers and hadn’t even registered anyone for the past hour.  Many of the other providers had already left to go walk the nearby streets for snacks, souvenirs, etc.  The Mom was really distraught when I said that we wouldn’t be able to help.  Not in a histrionic sense but in a tears-welling-in-the eyes/look of defeat that really made me sad.  I decided to take her phone number just in case something opened due to a last minute cancellation. I emphasized that it was extremely unlikely to happen.  
The next day, I was reconciling the patient tracker to the next day surgery schedule when I noticed that a patient wasn’t on board.  I had a LCDR who spoke Tagalog to call the patient and it worked out to have the patient come on board the next day.  I was really worried since she had no i.d. but I had sent a picture of her ashore and the beach det spread the word and it all worked out!  She had surgery that day and was sent home two days later.  The surgery went perfectly and we did an excellent Sistrunk procedure.  The Mom was borderline catatonic- I think because she was so overwhelmed.  Even the last day, when it was clear they were both really happy, their affect was really flat.  I mean, they were appreciative but it was clear that while this was a stroke of fortune, life was really tough for them.  It was a reminder to me that, while the compliments and appreciation that come with the job are nice, the real satisfaction needs to come from within me.  It goes back to childhood when my parents would tell me to “just do your best.”  If I give my best effort in preparing my knowledge base, sharpening my skills and staying engaged in all aspects of patient care, I can be happy knowing that it’s a job well-done.  And I think that’s important given that medicine is imperfect and there will be complications and/or difficult patients and while I’m sure I won’t be in the best mood that day, at least it won’t send my entire self-worth as a physician crumbling down.
Anyway, we also did a few thyroids, parotids and skin lumps and bumps.  We did an awesome lateral neck mass excision which turned out to be a pleomorphic adenoma with carcinoma ex in situ.  So that was life-saving!  Awesome!

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