Please Move Down The Hall, Nuclear Medicine In Progress

Posted on July 19, 2011

By 7:30am, there is already close to 100 people milling about the outside of the Children’s Surgical Center compound waiting for the facilities to open.  Roza, my project manager, pulls up in our borrowed van with my Safe Haven families in tow.  Von Sao, a serious, quiet 8 year old girl with bilateral club feet has been accompanied by her father.  Veng Von,  a 6 year old boy, is all laughter and curiosity.  His knee is completely backwards.  It looks and hinges normally, it’s just simply pointing in the wrong direction.  He scampers about with an ease that is hard to credit when you look at his leg.  As Pierre, one of my colleagues, and I watch, he gives us a grin and then bends his leg up to his face.  His mother is with him and she gives him a playful swat.

Roza tells us that everyone had trouble sleeping in the guest house we rented for the families last night.  Apparently the parents and kids, so used to sleeping on the floor of an open walled hut could not get comfortable in beds inside an enclosed room.  It was so foreign, they simply could not rest.  Von Sao is also registers her complaint about the amenities: the guest house TV is black and white and she is not impressed.  Even in her hut with no walls in the middle of a village outside Siem Reap, she can at least see cartoons in color.  City life is not living up to her expectations.  I slip her a candy to ease the disappointment.

I suspect part of the exhaustion they are all feeling all stems from the frightening unknowns looming ahead of us.  None of these parents or their kids have ever ventured outside their villages before.  The 7 hour drive in a van was not a pleasant journey with both kids getting car sick.  Now we are sitting outside in the sun waiting for our number to be called to see one of the doctors who will consult on their surgery.  Pierre and I distract the kids with our IPADS and then ruthlessly use our connections to get upstairs into the offices where Eric, one of the western administrators, meets with us.  I have been emailing Eric for months setting up these appointments and try not to feel guilty about using these connections to get our kids bumped to the top of the line.  Within minutes, Eric makes arrangements for us to get X-Rays ahead of our consultation, saving us hours of waiting.

We’ve explained to the children and their parents that X Rays are special pictures allowing the doctors to see the bones inside the body.  The kids are loathe to give up their Ipad games in favor of trudging inside to get the X Rays but another piece of candy solves seals the deal.  Thank God I bought a huge bag of it, because every time I hand one to Von or Sao, I’ve got a half dozen other little kids eyeballing me.  We are bustled down the hall towards the X Ray chamber by the technician.  It looks a lot like a mad scientist’s chamber from a bad 80’s B movie.  They take Sao in first and push the rest of us 15 feet down the hall for “safety”.  The old X Ray machine cranks and groans.  Pierre and I half expect a green light to start glowing out of the top of the chamber.  This thought is further reinforced by the envelope I am handed to hold the X Rays which reads “Nuclear Medicine.”  I move a few more feet down the hall from the chamber and hope Pierre doesn’t want to father children someday.

X-Rays in hand, we are back outside in the searing sun to await our turn with the doctor.  While we wait, Eric pops down and takes me on a tour of the facility, in particular, the large patient wards where the patients recover.  Those who are the worst off have actual beds, while family members sleep on mats on the crowded floor.  It is one of the more advanced hospitals around, saving countless lives, however, it is nothing like any Western hospital.  Having spent many years working in Cambodia, I am used to taking my ‘western mentality’ out of the picture.  But I can’t help but think how a typical western would react to the old, crumbling building with dirt strew hallways.  Controlled, sterile enviorments are not the norm here.   A teenage girl who has been horrifically burned is on one of the beds in the ward.  She smiles at me and I would have handed her a candy, but she has no real hands left.  They are raw stumps, fingers completely burned away.  Her face and upper torso has also sustained 3rd degree burns.   The image is now burned into my memory.  I cannot imagine the pain she must be in.  This ward is a far cry from a burn unit in the USA.  Despite this, the CSC has incredible surgeons on staff doing burn work and their survival and rehabilitation success rate is outstanding.  I mention to Eric about Lers La, our Safe Haven boy with the 3rd degree burns on his legs and he introduces me to one of the trauma burn surgeons who agrees to do a consultation for us.  We haven’t even gotten the two we have with us into surgery yet and already are making plans to bring a 3rd Safe Haven child in for medical treatment.

My two little wards outside have now moved on to watching “Supergirl” on the Ipad and have attracted quite the crowd of kids and adults waiting outside.  Many of the adults are peppering Roza with questions wanting to know about our organization and if we will help their kids too.  They have seen we are getting some preferential treatment and want in on the action.  I can hardly blame them.  Four hours waiting in the sun is frying both my brain and body.  We are taken to see a physical therapist for additional evaluation around 11am and the children’s charts are updated with their notes.  Sao looks bored with the whole procedure and promptly snags Pierre’s Ipad the second they are done poking and prodding her.  Von thinks it is great fun and he shows off how many ways he can bend his leg in absurd directions.   This takes another hour and promptly at noon, everything shuts down for lunch and we are instructed to return at 1:30 to continue waiting for our final consultation.  The families are totally exhausted and we shuttle them back to the guest house for a much needed nap.  I hop a moto back to my hotel to spend some time in the air conditioning and greedily consume several bottles of cold water.

By 1:30 we are all back outside in the waiting area.  Word has spread that the white girl has candy and dozens of sick or injured little kids are finding excuses to walk by me and give me coy smiles.  Von falls asleep on a bench while we are waiting and when our names are finally called, Roza scoops him up in his arms and carries him inside.  Our cranky little 6 year old has had enough adventure for the day.  The head of the hospital is in Thailand, but his 2nd in command, Dr. Moony, reviews the charts and X Rays.  The verdict for Sao is what we expected.  Two surgeries to correct her feet.  They will do only one at a time, followed by corrective braces and physical therapy.  Von is far more complicated.  He will need three major surgeries.  The first to correct his knee, the 2nd for his hip and the 3rd for his ankle to put his leg back together normally.  It will be a long term process.  We are led upstairs to one of the wards to settle the families in.  In fact, we wind up on the same ward as the girl with the burns.  My description of her situation to Pierre was not adequate and he is deeply affected by the sight of her, now sleeping with her ruined hands held up away from her body.

Our little tribe is highly distressed over the thought we are leaving them to sleep here in the ward.  They have just discovered that there are worse options than an enclosed guest house and beds.  The ward is very crowded and the sheer amount of people and pain around them is overwhelming, particularly to Sao’s father who is terrified of staying there and begs to not have to stay, but the rules dictate otherwise.

Roza, Pierre and I go to the market to get toys for the kids and other little snacks and items for care packages.  I buy a large doll all dressed in frilly pink for Sao.  The doll is adorable but has a terrifying, Chucky like voice that loudly recites little cheerleading chants.  It’s highly disturbing and I yank out the batteries thinking the rest of the ward probably doesn’t want a creepy doll chirping out “2,4,6,8 – isn’t life really great?” in the middle of the night.  For Von, a transform robot knock off which I also yank the batteries out of.  The lights and sirens would probably also not be appreciated.  While we are shopping, Eric calls.  Apparently Dr. Moony is hesitant to authorize the surgeries without the head of the hospital there.  Our Western privilege may have gotten us to the front of the line, but now it is keeping us from having the surgery scheduled as Dr. Mooney doesn’t want to make a decision about children who are under “Western” care in case something goes wrong.  Eric is frustrated saying that the doctors there are all very competent and can easily do the surgeries without the head’s input but we are stuck.  Dr. Moony refuses to change his mind.  And Dr. Jim is not back until Wednesday afternoon.

We are disappointed, but such are the setbacks in situations like this.  We ask Eric if we can take our families off the ward and put them back into the guest house until the actual surgeries to lessen their emotional distress.  I think if Sao’s father has to sleep on the ward, he just might change his mind about staying for the surgery. Permission secured, we go collect our families who break into huge grins and won’t stop thanking us for getting them out of the ward.  We tell them they MUST go back once the surgery is scheduled.  Privately, I totally understand.  I am not sure I could sleep in the ward at night either.

It has been a long exhausting day.  I pile everyone back into the van and give the kids their toys.  Sao and Von break into huge smiles.  Such toys are grand things in their world.  Sao hugs the doll closely and smoothed out the dress, which is in stark contrast to her own clothes, black with dirt and worn out.  I shut the van door on their beaming faces and wave goodbye.