When Neo goes to be tested by the Oracle in ‘the Matrix” he meets a small child who can bend spoons, The real trick here explains the child is that “there is no spoon”
We are in the Matrix.
Imagine being transported with all your friends and coworkers to a strange place where you’re doing your daily job but the world and its rules have changed.Welcome to Cabral Hospital DR.
Dateline Tuesday Oct 13th: Today it was my turn to dodge the bullets.
After a real bad day and noc monday trying to get my little AVR/MVR lady through her surgery. After a good 4.5 hrs of sleep and a hot shower, we hopped on the bus and arrived at the hospital at 7am, Fortunately the resident Doc Bernice was able to wean down alot of the heart medications she was on and we we’re able to get the breathing tube out by mid morning. It looked like the worst was over for her.
She had survived the surgery and re-exploration and our whole team was relieved.
Dr Crouch was schedualled to do 2 cases today, so he got his first one, another Avr/Mvr and all went well.
His anesthesiologist Dr Joe (Jose’) Bodranko was busy keeping it all going but at the same time firing off the most witty retorts since Mark Twain! Those southern gentlemen are so charming…especially to the ladies. 
We got our case started around 10:30 by having the patient walk down from the ward as usual, Will gave him a big “my Casa, Su Casa” welcome hug and he was off placing lines. It is an incredibly friendly country and everyone goes by their first names, patients, nurses and doctors. Also lots of hugs and kisses for everyone. 
Our case today a young 34 yo man had an extremely tight and stenotic mitral valve, his Pulmonary artery pressures were 78/40 pre-op and Will and I we really worried that it would be tough to get him through. (though everyone in general is younger than our patients at home-they all have “sicker overworked hearts and other undiagnosed diseases) 
Fortunately both morning cases went well without mechanical equipment error or surgical incident, hey the day was looking good……
As Dr Crouch started his 2nd case a beating heart coronary artery bypass, I got a tour of the Hospital and ER by Dr Juan and Dr Shayanne the residents.
On our way down from surgery we encountered an bizzare site. As you may recall the elevator is less reliable than a wisconsin weatherman, we saw two men carrying a corpse down the same main stairwell that we had carried those 67 boxes up. I watched as the poor mans body slide back and forth on the liter waiting for him to potentially slide off.
If that wasn’t shocking enough, the ER was filled with patients waiting days for any treatment, If you were not directly bleeding to death then get in line and wait.
Many people were stuck in an ER side ward waiting for surgery like this man who had his leg fracture in water jugtraction for the last 27 days.
It made our complaining about lack of supplies and OR equipment sound like whining babies.
Then we got word that John’s case was having trouble, the patient had extremely tiny coronaries and the cines(xrays of the arteries of the heart) did not show things accurately. The patient had to urgently go on the heart lung machine and was not doing well. This was now about 5pm, after two pump runs and several additional grafts and a herculean effort by Dr Crouch and all 19 team members that man was moving out of the OR to ICU on everything we had and a faulty intra-arotic ballon pump at 10 pm. (Agent Smith is always lurking in the dominican matrix!)
Now the delema……would the bed and the pump fit in the elevator and would the elevator run.
The ‘tower of terror” as we now call the elevator, has intermittent working capability and often no lights.
As we rolled out of surgery past the 20 family members and scrambled onto the small elevator, Will and Joe Butterfield were the only ones who could ride inside. Everyone else including the patient’s family ran up the two flights of stairs to the 6th floor elevator doors while the elevator clanking noisily descended to the first freaking floor!
We could not believe the elevator went down to the first floor , sat there a while then finally meandered back up to the 6th floor, and then we cheered as the door finally opened and we could rush this critically ill patient into the ICU. Thats our rooms where we have 2 ventilators for all the ten cases we are trying to do. that means your getting the breathing tube out the next day ready or not.
With all hands on deck, the patient was moved over to his ICU bed and Dr Crouch, Betsy and Chris took over trying to stablize this guy till 1 am, then finally took a cab back to the hotel for a few hours rest.
Just before the rest of us left at 11pm, I saw our first two heart surgery patients from yesterday, Both young women had Double Valve replacements, They had met before surgery because they shared a big room with the other preop candidates. The two women gave each other hugs and happily posed for this picture for me.
After all the hours of standing, bleeding, re-exploring, broken cable repair, extra pump runs, faulty elevators, carrying boxes, using the same bloody sponge all day, agonizing, whining, lamenting, not having your real instruments, broken IV pumps, second guessing…………it was suddenly crystall clear why we were here!
In this pretty Island community, for 10 days we are all that stands between life and death for a handful of natives. We are their hope. In their Matrix, we are the “one’.
We rode the bus back to the hotel and collapsed. Or prep starts at 7am.
We don’t want to let them down.
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