Emergency surgeries happen at any time during the week, but as I mentioned previously, Tuesdays and Thursdays are the main OR days for elective surgeries. My first day in the OR was quite interesting. When I went to the sinks to scrub, I looked all around for scrub brushes like I am used to. Then, the doctor passed me a bar of soap. I did the best I could to clean all surfaces of my fingers and hands. Then, the doctor used his elbow to get a small amount of pink soap (which I later realized was chlorhexidate) from a pump bottle mounted to the wall. I followed suit and scrubbed my hands a second time, then headed into the OR. I think I was a bit nervous on that first day. When the doctor handed me my cloth surgical gown for me to put on myself, I reverted back to how I put on gowns when doing “sterile” procedures in the ICU. I began to snap the neck of my own gown. With a concerned look, Dr. Faile corrected me, and the anesthesiologist snapped it together for me. (By snapping it myself, I would have contaminated myself, and had to scrub again.)
The patient was already prepped and draped with a sterilized bed sheet (in which a hole had been cut out of the middle). She was anesthetized, but her eyes were still open and there was no ventilator to be seen. The anesthesiologist explained that the patient had been given a spinal block, (a needle is inserted into the spinal canal and the spinal cord is bathed with local anesthetic). She was awake, but unable to feel the surgery being done. Before each surgery, we take time out to pray for each patient. The actual surgery was fairly similar to the ones I have observed in the States, with the exception of minor differences in technique. They do have a bovie for electrocautery. The music selection “High Life,” a popular type of Ghanaian reggae music was different from the 70’s – 80’s rock that I am used to in the States.
On our last shopping trip before packing, I bought some lime green garden clogs on clearance at Target to use in the OR (I have not yet succumbed to the Crocs craze). In contrast, I was quite amazed to see that the British medical student was operating in sandals, but I guess after 2 months, he had become used to wearing sandals everywhere – even in the OR. Now with all this said, sterile fields are still upheld and much is done to keep the operating room as sterile as possible (like not letting nervous medical students screw things up).
On that first day, I scrubbed for 3 cases and got to suture, cut, and cauterize. I have not been in the OR again since Dr. Faile left. Today, however, Dr. Fort – the visiting doctor – walked me through a couple small procedures. I did an incision and drainage (I&D) of an inguinal abscess. I also excised a small cyst from a woman’s shoulder and stitched the skin back together. Although, I am very slow at stitching, I think that the end result looked pretty good. I guess I will find out when she returns to clinic next week.