Through a previous medical outreach journey to Nicaragua, Subhjit Sekhon saw first-hand the dire need for health care services in some of the remote and underserved areas of the world.
The UMKC School of Medicine sixth-year medical student recently received a travel fellowship award from the American Society of Tropical Medicine and Hygiene to go back to Latin America to study the risk factors and sociodemographics associated with women suffering from cervical cancer.
“During a medical outreach trip to Nicaragua, I had the privilege of serving more than 900 patients from several remote and under-resourced villages,” Sekhon said. “For many it was their first experience with a health care professional. A majority wanted help for common complaints. By meeting basic health care needs, I developed a passion to help medically underserved areas and create sustainable health care solutions.”
Guatemala suffers one of the highest rates of cervical cancer among women in Latin America with more than 22 in every 100,000 women diagnosed and more than 12 in every 100,000 women who die of the disease each year.
Sekhon will travel with colleagues from Washington University in St. Louis to work at La Liga Nacional Contra el Cancer (INCAN) in Guatemala City, the largest cancer referral center in the country. It is the only comprehensive cancer treatment center in the region for the poor and underserved and provides care for more than one-fourth of all cancer patients in the country.
She said her research study will explore characteristics associated with noncompliance to treatment or follow up among women with a diagnosis of cervical dysplasia or cervical cancer. She will also assess barriers to treatment and analyze outcomes of treatment in patients treated at INCAN.
Sekhon was one of 26 students from 21 medical schools across the country to receive the 2019 Benjamin H. Kean Travel Fellowship in Tropical Medicine. The annual award is the only medical student fellowship dedicated to promoting a career path in tropical medicine.
“My primary interest in tropical medicine is to understand the disease in totality of circumstances,” Sekhon said.
An exact time frame for her travel has yet to be worked out, but Sekhon said wants to learn more about the intersection between infection, biology, the patient and society.
“As a future physician-scientist, tropical medicine appeals to me because it equally weighs social determinants of health with the microbiological basis of disease, which I believe is the true way to treat a patient, conduct meaningful research, and implement health care change,” she said.
Keerthi Gondi, a fifth-year medical student, and Kathryn Kyler, a bioinformatics student, were selected as the School of Medicine’s winners of the 2019 Health Sciences Student Research Summit. This year’s research event on April 17 at the UMKC Student Union drew a record 66 student posters from the medical school.
A panel of faculty judges selected the top three poster presentations among BA/MD students and chose the top two presentations from School of Medicine graduate students.
Gondi presented the winning poster, Symptomatic Versus Asymptomatic Idiopathic Intracranial Hypertension in Children. The second-place award for BA/MD students went to Nikhil Havaldar, fourth-year student, with a poster presentation on Epidemiology of Human Rhinovirus in School-Aged Children and Adolescents with Medically Attended Acute Respiratory Infection. Yicheng Bao, fourth-year student, was the third-place winner with a poster on Visual Field Loss in Patients with Diabetes in the Absence of Clinically-Detectable Vascular Retinopathy.
In the graduate student category, Kyler presented the winning poster, The Association of Weight with Drug Dosing Variation in Children Hospitalized with Asthma. Second place went to Poghni Peri-Okonny, a graduate student in cardiovascular outcomes research, with the poster presentation, Blood Pressure Variability and Cardiovascular Outcomes in Heart Failure with Preserved Ejection Fraction.
This year’s faculty judges included Sarah Nyp, MD; Jessica Markham, MD; Maria Cole, PhD; Jennifer Qayum, MD; Amanda Montalbano, MD; Sean Riordan, PhD; Janelle Noel-Macdonnell; PhD; Jennifer Dilts, MD; Nilofer Qureshi, PhD; Alain Cuna, MD; Peter Koulen, PhD; Bridgette Jones, MD; Jared Bruce, PhD; Dan Heruth, PhD; Rosa Huang, PhD; Kamani Lankachandra, MD; Xiangping Chu, PhD; Wail Hassan, PhD; Jannette Berkley-Patton, PhD; and Mike Wacker, PhD.
The research summit also included students from the health sciences schools of dentistry, pharmacy, nursing and health sciences, as well UMKC’s School of Biological Sciences. This year’s summit drew a record 100 research posters.
The warm weather is here – and the UMKC Health Sciences District has a number of upcoming healthy initiatives for staff, students and faculty. Whether it’s an e-bike rental or a walking group, the District is working to get everyone active and outdoors.
The Health Sciences District Run/Walk club has begun again this year. Each weekday over the lunch hour, you can join fellow students, faculty, staff and friends from throughout the district to run or walk the 2.5-mile route. If you’re interested in participating, the group meets at 24th St. and Charlotte – just look for the Run/Walk sign. New this year: the group is putting together a team to participate in the Hospital Hill Run.
Unlike past year’s, this year’s race will take place on Saturday, June 1. The starting and finishing lines for all three race distances – 5K, 10K, and half marathon – will be set up at Kansas City’s Crown Center. All UMKC running enthusiasts, faculty, staff, students and alumni, may receive a 20 percent discount on registration. To sign up for any of the day’s races, use the code UMKCDISC19. Register at hospitalhillrun.com. If you’re not participating as a runner but would still like to get involved, the event is looking for volunteers. Contact Alison Troutwine at firstname.lastname@example.org for more information.
On April 24, the District will be host to a free pop-up yoga class. Start time is at 5:15 pm. The class will be held outdoors in the green amphitheater space on the NE Corner of 25th St. and Holmes Rd. All registered participants will be entered to win a free yoga mat and a gift card from Ruby Jean’s Juicery. If interested, bring your own mat and register at umkchealthsciencesdistrict.org.
And if you need help getting around to all these fun activities, the District has you covered. RideKC Bike has released a new fleet of smart, electric-assisted bikes housed in the district for bike share users. They are already available just outside the UMKC Health Sciences Bookstore, and you can start or end your trip at any RideKC Bike hub around the city. To. Get started, download the Drop Mobility app to find bikes and hub locations near you. Your first ride is free.
The district is committed to encouraging a healthy lifestyle throughout our District community. It’s a perfect time to enjoy this beautiful weather and take advantage of these great offerings.
Third-year medical student Yicheng Bao has co-authored two recent journal articles related to research on a link between Type 1 diabetes and autoimmune disease.
He was the first author of an article published in the September issue of Wiley Journal of Diabetes, “High prevalence of comorbid autoimmune diseases in adults with type 1 diabetes from the HealthFacts database.” He also is a co-author of an article published in October on the American Diabetes Association web site, “Diabetes Care, titled, Late-Onset T1DM and Older Age Predict Risk of Additional Autoimmune Disease.”
Bao began his research during a summer medical student research program at Washington University in St. Louis. The program was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Bao continued working on the study when he returned to school at UMKC for the fall semester.
The study showing that adults diagnosed with type 1 diabetes are at greater risk of developing additional autoimmune conditions has been reported in a number of health care and diabetes-related media outlets.
Yicheng Bao, a third-year medical student at the UMKC School of Medicine, conducted a research study that shows adults diagnosed with type 1 diabetes are at greater risk of developing additional autoimmune conditions.
Bao received an Endocrine Society Outstanding Abstract Award for his work. He was then invited to give an oral presentation of his results at the March annual meeting of the Endocrine Society in Chicago. This was a special and rare opportunity, as most selected abstracts are designated for poster presentations.
Much of Bao’s research took place during his summer medical student research program at Washington University in St. Louis. The program was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Bao continued working on the study when he returned to school at UMKC.
Following his presentation in Chicago, Bao’s results have been reported in a number of health-care and diabetes-related media outlets.
“I came to work on this particular project because of my interest in diabetes and its complications,” Bao said. “Diabetes is a growing public health concern, and it is very debilitating for patients. It has multifaceted complications that confound their care, and this area in particular requires more research.”
His study found that people with type 1 diabetes can develop multiple autoimmune diseases. And, those diagnosed with type 1 diabetes as an adult run a greater risk of developing them.
Bao’s study collected patient data on 29 autoimmune conditions. He found that the overwhelming majority of additional conditions developed in adults after being diagnosed with type 1 diabetes.
These results of could lead health-care providers to give closer attention to symptoms of autoimmune diseases in diabetes patients diagnosed with the disease as an adult.
Bao said he developed skills from the experience that have lead him to continue his research efforts. He now intends to pursue a career in academic medicine and research.
“I learned to ask scientific questions that have significant clinical implications, and to answer these questions with biostatistics and data analysis,” he said. “Using these skills, I am working on several other studies about diabetes and its complications that will be submitted for publication soon.”
Links to media reports of Yicheng Bao’s research study on type 1 diabetes in adults:
Usman Hasnie knows well the importance of clean and adequate water supplies. As a high school student, he saw it first-hand while serving in Pakistan as a volunteer with SOS Children’s Village, an organization that provides care and resources to abandoned, destitute and orphaned children.
Hasnie is also from Flint, Michigan, and watched as a water crisis has thrown that community into a state of chaos for the past three years.
The images of both have prompted Hasnie to seek ways to make a difference. His latest effort will be as a member of the American Medical Association Medical Student Section Committee on Global and Public Health. He was selected to be part of the committee at the AMA national meeting in June.
“The issue of water sanitation is something that is very personal to me,” Hasnie said. “It’s a global issue that I hope to tackle and the AMA is giving me the opportunity to do that with other students around the country.”
Hasnie joined the AMA’s student section two years ago.
“The American Medical Association was an opportunity to advocate for my patients and to be part of the nation’s largest and most influential physician organization striving to increase access to healthcare for everyone,” he said.
Last year, Hasnie served on the student section’s committee on Long Range Planning. Now, he will serve a one-year term with 13 other medical students from across the country working to educate the AMA on public health topics and to organize public health initiatives.
Some of the agenda items for the year are providing educational programming at the AMA interim and annual conferences, and creating a campaign for National Public Health Week in April 2018.
At the same time, Hasnie hasn’t forgotten the people of Flint or the children in Pakistan. He said he plans to focus some of his committee’s attention on the Flint Water Crisis, firearm violence and water sanitation.
Fifth-year medical student Vaishnavi Vaidyanathan spent nearly two months exploring the histories of stroke patients and the effects of the clot-busting drug tissue plasminogen activator (tPA). The result was a research poster she recently presented at the 2017 American Academy of Neurology conference in Boston.
Her presentation showed that patients treated with tPA within the first 24 hours of a suffering a stroke have significantly fewer early onset seizures.
Vaidyanathan began her study last September while completing a neurology rotation at Saint Luke’s Hospital. Under the guidance of Saint Luke’s neurologist Harold Morris, M.D., and Angela Hawkins, M.S.N., R.N., stroke program manager, Vaidyanathan reviewed the histories of nearly 1,300 stroke patients.
“They allowed me to write it up and go through process with their guidance,” Vaidyanathan said. “I learned so much from that, literature searching, how to write up an abstract, doing bio-statistics. It was a great learning opportunity.”
The annual neurology conference in Boston drew an international audience of nearly 14,000 physicians and scientists.
“This conference was a great experience,” Vaidyanathan said. “I got to meet people who are celebrities in the neurology field. They’re very well-known. I had the opportunity to listen to talks about the latest research that’s going on in neurology and hear all the great innovations that are happening. It was an awesome experience.”
Vaidyanathan said she already has ideas for future studies that look at the effects of tPA and other intra-arterial interventions on the incidence of post-stroke seizures.
“I hope to do further investigation of these patients and get more results that I can write up and present,” she said.
Grant Randall, a fifth-year medical student, has been selected to take part in a student research fellowship program at the National Institutes of Health.
Beginning this June, Randall will take a leave of absence from medical school to devote his full-time focus to NIH’s Medical Research Scholar’s Program. He is the fourth student from the School of Medicine chosen to participate in the program.
“I talked to some of our students, Blake Montgomery and Dean Merrill, who did this NIH program and they had fantastic things to say about it,” Randall said.
The yearlong program offers medical, dental and veterinary students an intensive research fellowship participating in basic, clinical and translational research at the NIH’s campus in Bethesda, Maryland. Randall said he is excited about the prospects of working with and learning from some of the top researchers in the country.
“You get to take part in lectures pretty much every day and do basic science research, often with Nobel Laureates,” he said. “They do leadership classes, classes on statistics, how to conduct clinical research, writing research papers. Basically, a lot of the skills that people typically pick up along the way (in medical school and residency), they teach you there.”
Randall will spend the first couple of weeks of his fellowship meeting many of the NIH researchers and mentors to get an idea of the opportunities available and find a research project that meets his interest. He said he hopes to work in translational research to get a taste of both basic science and clinical research.
He acknowledged School of Medicine mentors Michael Wacker, Ph.D., assistant dean for medical student research, and John Foxworth, Pharm.D., professor of medicine, for encouraging him to explore the NIH program. Randall said he became interested in research while taking part in out-of-town clinical electives and working with scientists at the University of Iowa on immunology projects.
“That was my main exposure to in-depth basic science research, being in a lab every day,” Randall said. “I loved it and decided I wanted to do more.”
Fifth-year medical student Gaurav Anand took part in the student research poster competition at the National American College of Physicians’ Internal Medicine Meeting. The three-day conference took place in San Diego at the end of March.
In addition to presenting his research poster, Anand attended lectures on topics ranging from radiology to ophthalmology, as well as participating in suturing and arthrocentesis workshops.
Anand called the experience both humbling and enlightening.
“Being invited to attend and present my research at this National ACP meeting was an enriching experience, not only by attending the lectures and workshops, but also from learning about the groundbreaking research happening across the country,” he said.
Anand presented his poster, Pharmacological control of oxidative stress-mediated effects on endocannabinoid signaling pathways. He conducted his research at the Vision Research Center with Peter Koulen, Ph.D., director of basic research and Felix and Carmen Sabates Missouri Endowed Chair in Vision Research; and Christa Montgomery, Ph.D., research scientist at the Vision Research Center.
Anand earned a spot in the national poster competition last September when he won the student poster competition at the annual meeting of the Missouri chapter of the American College of Physicians.
After winning the Missouri competition, Anand continued his research prior to the national meeting. He said he is gathering data from the most recent experiments and had not made any major alterations to his poster or abstract.
Anand said he plans to continue his research efforts throughout medical school and his residency training.
“Research is the foundation on which new discoveries are made,” he said.
Kayla Briggs, a sixth-year student at UMKC School of Medicine, is part of an 11-person group that left on March 18 for the Dominican Republic on an eight-day medical mission trip.
The team consists of physicians, nurses, paramedics, an interpreter and Briggs.
“We can all contribute to make the world a better place both near and far.”
– Kayla Briggs
Working from the Good Samaritan Hospital in La Ramona, Dominican Republic, the group plans to spend the first two days in clinics meeting patients and assessing needs before spending the remainder of its time performing surgical procedures.
“We will have two operating rooms, one for general surgery and one for urology,” Briggs said.
The team will be performing elective procedures such as repairing hernias, removing gallbladders and excising masses all in hopes of preventing patients from encountering more serious complications in the future.
Briggs will serve as the first assistant in the operating room once the surgery procedures begin. She has already completed seven months of surgical rotations at UMKC. On March 17, which was Match Day, Briggs learned that she will begin a surgical residency at the University of California-Davis Medical Center in Sacramento, California, this summer.
“I’ve done medical mission trips before but never a surgery trip, so I’m really excited about this trip,” she said.
The mission is a collaborative effort with the Dominican Republic Medical Fellowship.
Other members of the mission team include:
Glenn Talboy, M.D., Chair and Program Director of the UMKC Department of Surgery
Edna Talboy, interpreter
Teisha Shiozaki, M.D., chief resident, UMKC general surgery
Patrick Murphy, M.D., section chief, Children’s Mercy Department of Urology
John Gatti, M.D., director of minimally invasive urology, Children’s Mercy Department of Urology
Louise Davis, CRNA and mission trip coordinator
Reidun Fuemmler, CRNA
Scott Davis, CRNA
Vahe Ender, paramedic
Matt Libby, paramedic
DAY ONE, SATURDAY, MARCH 18
Today was quite the day – we had to be at the KCI airport at 4:30 am. After a relatively short layover in Chicago, we headed to Punta Cana, Dominican Republic.
The Dominican Republic is a hot tourist destination and the airport shows it. The terminals are modeled after tropical huts with straw roofs.
Navigating customs was surprisingly easy. After picking up our five duffels and several rolling bags of surgical supplies, we headed to the exit where our bags were scanned once more. Our surgical instruments looked like weapons in the scanner and we were held for nearly 30 minutes trying to explain who we are and what we’re doing here. After lots of talking (shoutout to Edna Talboy for being an incredible translator), we were released.
We rented our cars (a van and sedan) and were on our way to La Romana – about a two hour drive. The highway system is what you see in the U.S. and was easy to navigate. Once in the city and at our mission, we unloaded our personal belongings.
The mission has separate bunks for women and men with a common room. All our sheets and linens are provided.
After a great dinner of roasted chicken, rice, and beans, we headed off to Jumbo. The only way I can describe it is a mix of Walmart, Target, H.E.B., and a department store … except much shinier. They have EVERYTHING – food, clothes, electronics, appliances, outdoor supplies, you name it. It was fun to browse the aisles and see what brands are similar and what’s different.
After picking up some snacks, we headed back to the mission to meet Matt and Vahe, the two paramedics joining our group from Boston. We then walked to the local restaurant and had ceviche, calamari, and bruschetta. Needless to say, we all slept like rocks after a long day of travel.
DAY TWO, SUNDAY, MARCH 19
Because it’s the weekend, we slept in a bit. Breakfast was served at 8 a.m. and was a hearty offering of pancakes, bacon, sausage, and fresh pineapple and papaya.
After breakfast, we headed off to Hospital el Buen Samaritano. It’s a private hospital that is funded by the Village Presbyterian Church. The operating rooms have the basics – anesthesia machines, overhead lights, and one even has a C-arm for taking X-rays during orthopedic cases.
We spent the morning organizing the plethora of supplies – laparoscopic equipment, suture, instruments, suction tubing, drapes, sterile water, sterile towels, liter boluses, etc. After dividing the two operating rooms (one for adults, one for children), we headed to Jumbo again to shop. Then it was time for lunch.
After a busy morning, garlicky noodles with chili and a short siesta was just what we needed. Our afternoon was spent seeing all the patients that had been identified in the bateys (rural areas where the sugar workers live) by the promotoras (health promoter) as needing surgery.
On the adult side, 21 patients were scheduled for pre-operative evaluation. Patients were asked about their past medical history, any prior surgeries, and if they’d ever had trouble with anesthesia. Twelve were scheduled on the adult side with three more that will be coming tomorrow for evaluation (transportation can be an issue for some).
I was reminded time and time again just how rusty my Spanish is. Without Alex and Edna, our amazing translators, it would be impossible to provide safe and smooth patient care. After refueling with a dinner of roasted pork, potatoes, broccoli, and carrots, we indulged in coconut pie and passion fruit cheesecake from a local bakery. We then fell into our nightly routine: a walk to Jumbo followed by relaxation at the restaurant. Tomorrow, we start operating at 8 a.m.!
DAY THREE, MONDAY, MARCH 20
Breakfast is served at 7 a.m. on the days we’re working. Oatmeal and fresh fruit energized us for the day ahead.
We arrived at the hospital just after 7:30 and patients showed up shortly thereafter. On the agenda for the adult room was a laparoscopic cholecystectomy (removing the gallbladder), lipoma excision, and fibrous adenoma excision. The pediatric room performed three hernia repairs, one case involving the removal of a child’s extra digits (called polydactyly), and a ganglion cyst excision.
It felt great to be back in the OR! After the first two cases, we took a break outside in the courtyard to eat a lunch of ham and cheese sandwiches and rice. There’s nothing like enjoying a real sugar sweetened Fanta underneath the warm Dominican sun.
We finished operating at around 4 p.m. After monitoring our last patients for post-operative complications, we instructed them all to return to clinic on Friday for wound checks.
Lyla Graham, a 12-year old from back home, had family and friends donate gifts for the children in lieu of receiving birthday presents for herself. We toted around a drawing of Lyla that we lovingly named ‘Flat Lyla’ (in the tradition of Flat Stanley) and snapped a few photos of the children with their gifts. These were not only a great tool for distracting purposes, but were also the sweetest parting gift before sending the children home.
Muchas gracias, Lyla!
We experienced our first tropical rainstorm (what seemed like a torrential downpour) of the trip during our evening siesta time. Dinner was fantastic – roasted chicken, rice, beans with lentils, roasted carrots, and fresh cherry lime juice. Dessert was just as good – a massive chocolate layer cake filled with dulce de leche.
Tomorrow is our busy day. Can’t wait to update you all on how it goes!
DAY FOUR, TUESDAY, MARCH 21
WOW – what a day!
Teisha said something the other day that resonated with me. When she’s not busy, she has a tendency to be lazy. When she is busy, she is more energized. I found myself relating to that and I think most surgeons would agree – downtime or a lighter schedule is nice, but being busy makes you feel productive and useful.
Today was our busy (and productive) day.
The pediatric room performed three cases (all inguinal hernias). We did six cases on the adult general surgery side: one laparoscopic cholecystectomy, two lipoma excisions, two inguinal hernia repairs, and one add on hydrocele repair. We did our best to stay on a tight schedule. I got to help a lot with our first lipoma excision (on the back of the patient’s neck) and got to perform a significant portion of the lipoma excision on our next patient’s arm (with the expert assistance of Dr. Talboy, of course!).
The first case – the laparoscopic cholecystectomy – was not without a few hiccups. The power in the Dominican Republic is not as reliable as in the States. Just as we were achieving our critical view the power went off – taking away our “eyes” by cutting power to our camera and light cord. In the room next to us, an OB/GYN was performing a c-section. After three minutes of wondering when the backup generator was going to kick in, the lights flickered back on. We heard a newborn’s cries shortly thereafter, and finished the remaining cases without further incident.
Our meals were fantastic. Breakfast was scrambled eggs and fresh croissants. Lunch was empanadas and rice delivered to the hospital. Dinner was roasted chicken, pasta, potato salad, fried plantains, tres leches cake, and banana pineapple juice. I don’t think any of us will come back from this trip any slimmer.
Today, we broke from tradition and drove to Plaza Lama instead of walking to Jumbo. Different selection, similar massive super store idea.
Our schedule is all downhill from here! We have two lipoma excisions and one inguinal hernia repair tomorrow. I’m excited for the lipomas – they’re satisfying.
DAY FIVE, WEDNESDAY, MARCH 22
Today was an eventful day. We started off with a breakfast of French toast and bacon before heading off to the hospital. Our first case went off without a hitch – an uncomplicated bilateral inguinal hernia repair. Our second case was a slightly more complicated. After a few tense moments, we successfully repaired a patient’s hydrocele and hernia. He was admitted to the hospital and we will check on him tomorrow morning.
We followed with a simple forehead lipoma excision. While in the recovery room, the patient and his mother took a look at our work in the mirror and returned to shake our hands numerous times. They were so thankful to have such a simple but visible problem resolved. It was a great reminder of why we do this.
During our cases, two c-sections were performed in the OR next to us. We had so much fun fawning over the babies; they were so cute.
After a quick lunch of braised chicken and rice, we finished up all the cases (including three inguinal hernia repairs on the pediatric side) by 1 p.m. We all looked at each other knowingly and said, “Beach day? Beach day.”
We returned to Casa Pastoral to grab our swimsuits and sunblock before heading to a public beach in Bayahibe, a 30-minute drive from La Romana. The scene was picturesque. A bright sunny day, sandy beach, beautiful water, happy voices of people from all over the world carrying in the wind, and plenty of Lay’s limón potato chips (our favorite!). The waves were so tranquil, perfect for jumping in without being too rough. I haven’t been on a beach since my fourth year in the program and I had forgotten how much I missed the ocean.
Dinner was (once again) delicious. Braised pork, rice and beans, and carrots with cabbage. Dessert was a super rich, super tasty carrot cake. After dinner, we walked to the central square in La Romana and went to Trigo de Oro, a French bakery and restaurant. At about 8:30 p.m., yawns were circling the table and we decided it was time for bed.
Tomorrow is a quick day – two lipoma excisions. Dinner will be at a pizza parlor on the river. Can’t believe tomorrow is our last day of operating!
DAY SIX, THURSDAY, MARCH 23
¡Hola mis amigos!
The name of the game is to front-load cases at the beginning of the week to make room for any add-ons. Today was a lighter day; we were scheduled for two cases in the adult room and three in the pediatric room.
First, we checked in on the patients we admitted to the hospital yesterday. They were doing well and were discharged later in the day. Our first case was a neck mass excision that we initially thought was a lipoma. After removal, we discovered that it was actually an infected cyst. The second was a foot mass that turned out to be a ganglion cyst.
Our pre-op and post-op room is the same three-bed space. Because the cases are elective procedures on healthy patients, once the patient is alert, can eat and drink, and is able to walk, he or she can go home. For cases like the foot mass, you want to ensure the patient isn’t in pain and won’t move during the case. Our awesome CRNAs came up with the idea to lightly sedate the patient and administer an ankle block in the hopes of numbing up their foot. Not only did this work like a charm (the patient snored as we were cutting out the large mass) but will also provide extended pain relief.
After both rooms had completed their first two cases, we hung around and ate empanadas with a side of rice and beans for lunch. The third child never arrived so we decided to pack up our equipment.
Louise, our mission coordinator, has been on this trip 21 times. Dr. Murphy has been on it many times, too. They’re experts at identifying what leftover supplies can be donated, what we should save for next year, and what we’ll need when we come back. That’s one thing I’ve loved about this trip. It’s a sustainable effort and you don’t leave feeling that without your presence, the patients are abandoned.
After packing up our supplies in the hospital, we headed back to the mission to clean up. We ate at El Chiringuito, a local pizza shop. The food was incredible – chewy pizza crust, plenty of cheese, and lots of fresh ingredients. The company was excellent, too.
Tomorrow, we will see patients back in clinic for post-op wound checks. Our afternoon will be spent at the beach with plenty of sunblock and Lay’s limón chips. Hard to believe this trip is almost over.
DAY SEVEN, FRIDAY, MARCH 24
After a breakfast of pancakes, bacon, and orange juice, we headed to Hospital el Buen Samaritano one last time. Seeing our patients in the post-op clinic was immensely gratifying. Patients and their family members were so grateful for their operations.
I continue to be amazed by this patient population’s tolerance of pain. Even those who had their operations two days ago were walking, talking, smiling, and taking minimal amounts of Tylenol and ibuprofen.
At around 10:30 a.m. we headed back to Casa Pastoral to get ready for the beach. The combination of a hot car, fatigue, and some questionable arugula on our pizza left my stomach feeling questionable. I made the tough decision to sit out of beach day and rest instead.
Folks headed off to the beach at around 11:30 a.m. It was rainy most of the afternoon and when they came back cold and soaking wet, I knew I made the right decision to stay. After an afternoon siesta, we enjoyed one last family dinner of pork steaks with rice and beans and a dessert of tres leches cake and Neapolitan ice cream. Our evening was a little shopping at Jumbo, a walk around town, and packing our bags.
Tomorrow, we will head to the airport at 8 a.m. I can’t believe this adventure is coming to an end.
DAY EIGHT, SATURDAY, MARCH 25
After a breakfast of sweet rolls with coffee, we headed to the airport. The drive through the Dominican countryside was gorgeous, lush green landscape and seemingly endless sugarcane fields.
Customs was busy. All flights out of Punta Cana leave between 11 a.m. and 2 p.m. and lines were especially long because it’s spring break for many.
After a stop at Chicago’s Midway Airport, we finally arrived in Kansas City at 8:30 p.m. We all said our “goodbyes” and “see you laters” before going our separate ways. For those who’ve been on a mission trip, you understand the craving for a hot shower and your own bed near the end of the week. While I don’t want to speak for everyone, I’m positive we all slept like babies.
This has been the adventure of a lifetime and I’m so thankful for the opportunity to share it with you! I hope to return to La Romana in the future as a surgery resident.
If you’re interested in going on a mission trip, I recommend finding one associated with an organization that has a permanent presence in the community you’re traveling to. This ensures that even after you are gone, the patients are still connected to care. And if foreign mission trips don’t fit into your budget, don’t forget about everyone in need in our own community and country. We can all contribute to make the world a better place both near and far.