There are a few patients here that are on my heart to share.  One is a young man who came in this past week, 22 years old, already carrying a diagnosis of colon cancer.  He apparently had a surgery a year ago, and currently has a colostomy bag.  He presented to us with bowel obstruction, which is painful and often requires surgery to fix.  He didn’t have any records regarding his cancer, no biopsy reports or surgical history.  One hopes they exist, somewhere, but they may not.  At any rate, our surgical team took him to the OR only to find that his belly was full of cancer, metastatic.  Their only recourse was to close him back up.  There is nothing we can do for him except offer him prayer, comfort, loving care…   Please pray for Wilmer.

I had another little guy that I saw 2 weeks ago.  He was a ‘sin cita,’ which means no appointment made.  He and his family drove over 3 hours to see us.  It was the end of the day, and he was the last chart on the rack.  I’m not sure why they came so far without an appointment, but maybe they had heard that we had an orthopedic team visiting us for the week.  In any event, we didn’t even make it to the exam room before I was getting excited for this bright-eyed 8 year old boy.  His parents were helping him with some shoes, and as you can see below (photo), he was in need of some orthopedic help.  His condition was actually caused by burns he sustained when he was 3 months old.  I was excited, because I knew that our surgeons could really help this fella.  Dr. Jeff took a look at him, and was very optimistic.  He is in for about 6 surgeries over the course of much time, but his quality of life will dramatically improve. More importantly, he and his family will be loved on by all us Jesus followers. Pray for him please.  I have forgotten his name.  I’m sure it was Gary or Bruce.

Another is a young man that I saw last night, while on call.  It was one of those situations that I am always dreading, because I was out of my comfort zone of knowledge.  This happens a lot lately…

I got the call from the nurse at around 10:00 pm, and I really couldn’t understand what she was trying to say.  I had her rephrase it, but nope, just flat couldn’t make it out.  However, at the end of her report I did catch that she was “putting a tourniquet on the limb, and it was changing color…”  That last bit got my attention, so I threw on my scrubs and zipped our little fan-belt-screamin’ Suzuki down the hill in the hot humid night to see what was in store.  I was expecting some massively bleeding appendage (machete wound), but what I found was more interesting and potentially more dangerous.

The 16 year old boy had been bitten by a Barba Amarilla an hour previously.  For those of you who have been following this blog, this is the snake that we named the ‘Pit viper ravine of death,’ after.  This is a nasty type of viper.  It’s like our diamondback rattlesnake on steroids, and it’s got a chip on it’s shoulder.  The locals say this snake will actually chase you, and is easily perturbed.

He had 2 puncture wounds on his right shin, with warmth and swelling.  I had ironically, several days ago, just looked in the pharmacy formulary to see if we had the anti-venom for this snake. (This was prompted by a conversation I had with my son Owen.  I was trying to warn him about this snake, since he is always running around playing in the brush.  I told him:  “Owen, watch out for the Barba, because if it bites you, you are going to die.”  Was I too subtle?  Did I get the point across, you think?  Well, he then let me know that he was never going to go outside again.  I had to reassure him to look on the bright side, at least we have the antidote here at the hospital.  I couldn’t let him live out the rest of his days just living in our small apartment, never to see the light of the natural sun again.  Please feel free, Owen, to go outside and play in the brush, and don’t worry about getting bit by the nasty ‘yellow beard’ pit viper because I’m pretty sure we can save you.  It was right after this that I decided to check our formulary to see if we actually had the antidote, and yes, we do).

So, knowing that time was essential here, I decided this warranted a ‘Phone a friend’ lifeline, and I called my buddy Peter.  ‘Hey man, I have a Viper bite, how do I give this antidote stuff?  –Well, there’s a protocol down there somewhere that tells how to do it, I think in the second drawer of my office.  Maybe on the Hospital doctor’s shared resources page too.  But off the top of my head?  …no clue.   ‘Ok, right, thanks man.’  I tried 2 more docs, same response.   The computer files, and Peter’s drawers were dead ends.  I was on my own with this one.  Luckily, we live in the age of high speed wireless internet.  After a bit of a struggle, I found what I was looking for, and the nurse and I were popping the tops of Anti-venom ampules in no time.  We started his treatment, and waited to see how he would do.

This brings us to today.  The young man’s leg is quite swollen and painful, but thus far it doesn’t appear at risk of loss.  However, we are not out of the woods, and these snake bites are notorious for taking people’s limbs, or sometimes lives. His family was considering taking him out of the hospital today because they didn’t think he was getting better.   So, I ask that you pray for him, and for our treatment.

Addendum:  As of this morning, his leg was doing better, he was feeling better, and I am sending him home this afternoon.  Yay!

Last weekend Peter and I drove to La Ceiba together to pick up 2 teams that are joining us for a bit.  It’s very cool how various medical teams come down for short stints to share their talents in different ways.  We compile lists of patients for months, who are patiently waiting to see a specialist for their problem.  This week we have a Urologist, a General Surgeon, and a family Doc who does OB.  Excellent additions…  Anyway, P and I saw something along the road that was so cool:  You know how every year around Christmas your church solicits your help putting together shoeboxes for little boys and girls?  The children are from all across the ‘third world’, and they ask that you put together a box full of small gifts.  One of the organizations that does this is actually our Missionary sending agency, Samaritan’s Purse.  Well, there was a horde of children walking along outside one of the small dirt-road villages on our journey, and guess what they were all toting?  No, not machetes (well, okay yeah, some of them were).  They were each carrying their own Samaritan’s Purse shoebox!  I saw some of them opening them, and pulling out the treasures:  Stuffed animals, balls, little toys…  They seemed very excited.  It was crazy to see children actually receiving those gestures of love that my own wife and children have put together many times.  So I am here to attest that, yes, those boxes are gonna make it to real children, in places of real need, and they are going to be so thrilled.

Movie review:  ‘About Time.’  With Rachel Mcadams, Bill Nighy, and random red-headed british dude.  I’m not gonna lie, this movie twice now has made me shed a tear.  I really think you should watch it.  Don’t look at the cover (as if you were going to Blockbuster to pick out a movie–remember that?)  as it just looks pretty lame.  But give it a try.  Wives, trick your husbands into watching it, sell them with this:  it’s technically a sci-fi movie/involves time travel, and Rachel Mcadams is pretty darn cute.  Husbands, invite your wives to watch a chick flick.  ’nuff said.

I remember watching this movie a couple yrs ago, and it got me to thinking about time.  Specifically, how I want to spend my time.  Isn’t time the ultimate measure of what we worship?  where do we spend our best, most important, most concentrated time?  Is it with the Lord?  is it with our spouses and children?  Is it serving others?  Is it being outside, in the wonder of Creation?  Bravo!  Is it with our phones?  On the computer?  Stressing about our job?  In our cars?  Pursuing diversions to distract us from the difficulties of life? — Crap! You might have missed the boat.  Totally losing out on the best times of your life.  So watch the movie, and chew on that a bit.

I was at the hospital on the weekend, rounding on a couple patients. My buddy Peter—ER doctor, spear-fishing sensei, father of 4 daughters, and big-ol’ teddy bear hug-giving dude—was trying to find me. He used the hospital intercom system: He went into the center courtyard of the hospital and yelled, ‘RYAN!’ It worked…

Last thought. You would think in a hot, humid jungle environment one would up their game, in regards to personal hygiene. After all, this weather instigates profuse sweating, and augments the production of bacteria. Not to be too graphic (ok, yeah, to be too graphic) but the rate at which your axillary/inguinal/taint sweat and odor proliferates is exponentially higher than in the semi-arid regions of Central Washington. At any rate, nope. It ain’t happening. I’m really struggling just to remember to shower. And after 6 weeks, I’ve barely had to turn the dial on my Ladies powderfresh scent deodorant (seriously, fellas, don’t knock it till’ you try it.) I don’t know, maybe it’s because, I mean, what’s the point? In about 17 minutes after my shower I’m hot and sweaty again.

Some pics…