First day in the OR

So today I was scheduled to be in the operating room (or as they call it, the operating "theatre" - sounds more ominous indeed). Really I expected a day full of routine cataract surgeries...which is what I got, but in what seems to be a classic Nepali fashion.I walk in the theatre with my clean scrubs on, and a lady starts yelling at me to put on the standard scrubs they have - she hands them to me and there are old blood stains all over the top. This may not seem strange but these are eye surgeries - very little blood involved, and certainly not the squirting kind!

I try and convince her that my scrubs are actually freshly washed and clean! No dice...so I change and start towards the theatre...and she starts yelling at me again. This time I need to take my shoes of and wear a pair of SUPER nasty slippers that the patients were wearing in the waiting room. I figure its OK, I've got socks on to protect me...But no socks are allowed either! I must do it barefoot...

Now many of you know my brother Cem has an irrational fear of oral herpes...he is terrified of it. He might even ask you if you've ever had any type of oral lesion in the past before he would share a glass with you. I have a similar (albeight less paralyzing) fear of foot fungus - they're stubborn and unsightly. So while some of you may think putting on sandals that hundreds of barefoot people walking in trash and feces all day is no big deal...I beg to differ. I also begged this woman to let me keep my socks on but she would not budge.

The "theatre" was equally amusing. It was mostly cataract surgeries but with a few twists. One, each doctor did about 30-35 eyes in the span of 6 hours. In the US, most doc's I've seen do at the most 8-10 a day. This place is a cataract factory, which is a good thing. The doc doesn't speak with the patient, they just get up on the table, surgery is done very fast, and the next patient is getting on the table simultaneously with the last getting off. It was scary at first, there were some very unsterile techniques employed, but it seems like they have it down to a science. The best part was when a particularly grateful patient got on the table, then stood on her knees and started to a say a buddhist prayer for the doctor before starting - problem is she bowed down and placed her hands and hair on the sterile operating instruments...surgeon was flaterred but not happy.

Lastly, I got to see my first nasolacrimal duct obstruction surgery. I only mention this because it was easily the most brutal surgery I've seen in the generally tame realm of ophthalmology. An incision was made between the eye and nose bridge, and the area where one of the inner facial bones (ethmoid bone) was exposed. Just press hard against this area on your face, that is the bone...and behind this is your nasal cavity. This bone needs to be purposely broken for the surgery, so using the equivalent of a "bone hole puncher", the doc makes all these little holes until its big enough to continue - it was pretty nasty, breaking someone's face like that. The one thing that gets to me in medicine is the sound of bone breaking *shudders*.

Interestingly, this bone is particularly think in Turks, thus the procedure is a tough one to do in those of Anatolyan decent...we are hard-headed figuratively and now it seems literally as well.

In the spirit of Keith Olberman's "Countdown" show (or as we affectionately call him, Keffies) , where he declares at the end "it has been X many days since the Bush administration has delared mission accomplished in Iraq...", I shall end my blog posts with -

It has been 3 days since I have arrived in Nepal and haven't had the runs.

Till next time.