Day 6:
Starting with a workout and breakfast, we prepared for the full day ahead. Hannah gave a lecture on neuromonitoring emphasized its role in reducing post-op complications. Hannah spoke of the value of real-time feedback on the functionality of the nervous system mid-operation. Hannah also took a playful jab at Dr. Lieberman by reminding him just how cold (freezing) he likes to keep his OR! Unfortunately for Dr. Lieberman, this is almost impossible to achieve in Uganda where sometimes the OR gets so hot that it could double as a sauna!
We reunited with a previous patient who showed significant improvement, reminding us of our mission’s impact. Today, we faced 42 patients, mostly children, with severe conditions. Despite the emotional toll, their resilience and gratitude were humbling.
While we were making our way through the clinic we met up with Dr. Hisey who had been vigilantly working on 20 year young male who was shot by poachers leaving a 7.62 round lodged in his cervical spine. The team was able to remove the bullet with no complications in a quick and clean operation.
Dr. Fisher and Dr. Kenneth were completing a T5-8 decompression and biopsy on a patient who was suffering a multitude of problems. Dr. Lieberman stepped in to help finish this case when we finished working through the clinic. Each team had one more surgery planned for the day while the new X-ray scans from the morning clinic patients were continuing to come in. We made time to review the new information and make final determinations on how we would proceed.
Dr. Hisey was operating on a C6/7 ACDF (anterior cervical decompression and fusion) on a 54 year young male who was hit by a falling tree branch that dislocated his facet joint. Amazingly, this patient walked himself to the hospital! A C5-T4 laminotomy and fusion were underway in the other OR with Dr. Fisher as the lead.
Back in the presentation room Dr Lieberman looked over the updated X-rays from the morning’s patients and began formulating the best course of action. He identified 3 patients who were the best candidates for surgery. The remaining candidates who were not fit for surgery were assigned differing amounts of time for follow-ups.
The big takeaway from today which continued to be a consistent theme throughout the whole week, was that no matter how much it seemed the odds were stacked against us, we were always able to overcome and get the job done! We could not be stopped by unexpected complications, increasingly dwindling supplies or ruthless pathology. These patients were counting on us!
Day 7:
The morning lecture engaged the staff and set a positive tone. Dr. Hisey spoke about degenerative conditions of the Lumbar Spine.
Morning rounds were post-op oriented. We were thrilled to report that each patient demonstrated significant neurological improvements. As we were completing rounds, we noticed a woman who we had not previously seen sitting in a wheelchair. Apparently, she had gotten word that Dr. Lieberman was in Kampala and showed up with her scans in hopes of getting to meet with the team. She was 50 years young suffering from severe L4/5 stenosis and disc space collapse. Upon examination, Dr. Lieberman determined that our best course of action would be to perform an L4/5 ALIF. Thankfully, we were able to get her on the schedule for the next morning.
We handled four surgeries, with each team adapting to the local conditions and limited supplies. Dr. Hisey’s patient with an L2 burst fracture and Dr. Lieberman’s case of spinal decompression highlighted our team’s growing efficiency. Both cases went according to plan, the rooms were flipped, and the second case for each room was underway.
Dr. Hisey closed out his day with an L2-5 decompression followed by a posterior spinal fusion at those levels. Dr. Lieberman headed back to the orthopedic department and left Dr. Fisher to perform a T5-7 decompression and biopsy.
A surprise visit from large group of monkeys outside the building added levity to the day. Despite delays and complications, our team’s adaptability and perseverance ensured successful outcomes.
The main takeaway was the strength gained from stepping out of our comfort zones. Our team’s resilience and determination to overcome obstacles reaffirmed our commitment to providing quality care under challenging conditions.