Surgery!

Every Tuesday, a gynecologist comes to Huarmey Hospital. He's the only one in the area who is able to perform Cesarean sections. Usually, when a woman is having trouble with her labor and needs this procedure, she needs to be ambulanced to Chimbote, a large city two hours away. Many women with at risk pregnancies are told to go straight to Chimbote and avoid Huarmey Hospital altogether, and so we see fewer 'gestantes' than I would like. Supposedly, a full time gynecologist and a surgeon were supposed to start work on February 1st. I've yet to see them.

Huarmey Hospital does have a surgical wing for times like this Tuesday, when Dr. Pinillos comes in for a scheduled Cesarean section. Whenever I ask nurses and passing doctors when the surgery is supposed to take place, they say only 'soon.' I don't want to be forgotten when all the action happens so I loiter around Dr. Pinillos as he chats with the staff. Nurses in another room dress the woman in a green scrub gown and get her cleaned up.

The head enfermero (nurse) in the hospital eventually waves me over the the surgical wing. He gives me green scrubs to wear, plastic bags as booties again, a mask and a hair net, and then takes me into the procedure room. He says a lot of things like, 'This area is sterile, over here isn't. Make sure you never touch this or go here.' I plan on just standing in the corner and touching nothing; this seems like the safest bet. Eventually a few other doctors show up and get dressed with the gown and gloves and everything. Again, I can't believe how hot it is. The room is so bright and without air conditioning or fans, summer near the equator is brutal.

We're soon ready to begin. I am waved over from my silent post in the corner to stand directly across from the gynecologist, right at the body of the gestante. Another obstetrician has taken the post of 'person who hands over surgical instruments when Dr. Pinillos calls for them,' for which I am grateful. I don't know the names of all these scissor-, pincer-, and clamp- like things even in English. I'm content to just watch the procedure from my front row seat.

When Dr. Pinillos makes the first cut, my first thought is, 'wow, that's what fat looks like.' It's so unbelievably cool to see the insides of a living person right in front of me. I should have expected that I would be doing more than just watching, but I'm still surprised when I'm told to dab gauze in the surgical area when blood starts to collect. Easy, but I feel super important. What undergrad in the States is allowed, no, expected to touch things during surgery? I'm also given retractors to hold at various intervals. I'm trying really hard to remember the names of all these instruments in case the doctor yells for them, but so far I've only really mastered 'gasa!' (gauze).

Dr. Pinillos calls me 'doctora' whenever he wants me to hold something or dab at something. I've tried to be very clear when I say I'm a student here and not try to claim that I have any real skills, but I sometimes fear that the hospital workers think I know more than I do. Many of them call me doctora, but for the most part I think that is because Brittany is hard to pronounce in Spanish. At least I hope this is the reason. I'm not ready to fly solo just yet.

Before I know it, Dr. Pinillos has reached the uterus. He instructs me to use this suction thing to suck up all the liquid as soon as the baby comes out. My rudimentary language skills are just enough to recognize a cognate between the name of this instrument (which I now forget) and it's function. The baby emerges, I suction furiously, and no one yells angrily at me like I've done something wrong. Success! The baby even starts to cry within a few seconds, and then is carted off into another room to be cleaned up.

The whole process of retrieving the baby takes about ten minutes. It seems like such a simple operation: cut through skin, fat, muscle, uterus, grab baby + placenta, then sew everything up in reverse order. It takes much longer to do the sewing, obviously, and every few minutes the nurse has to wipe of Dr. Pinillos' forehead so that he doesn't drip sweat into the body cavity. He keeps yelling 'dry!' and I can never tell if he means his forehead, or the body, which intermittently needs to be cleared of blood with some gauze.

Before the Cesarean even started, another doctor who was not participating in the surgery asked me if I had my camera. When he offered to take pictures for me, I thought he meant one photo of me in my surgical getup before anything happened. But no, this guy went to town with my camera. He bopped around the room and snapped over thirty pictures during the 90-minute surgery, even capturing the exact moments when the baby emerged. What's even crazier is that no one else in the room seemed to mind that this guy, who was not wearing a mask or anything sterile, was running around with my camera in their faces. They completely ignored him. And I have documentation of my first experience assisting in a surgical procedure.

I can't wait for next Tuesday, when Dr. Pinillos returns.