Our team arrived to Guatemala City armed with medications and OR supplies, with the determination to bring surgical healthcare to a region that might otherwise not see it.
The Sisters of “Clínica Corpus Christi” picked us up in a mini bus and drove 2.5 hours to Patzún. We unloaded our equipment and set up our two operating rooms- one with CO2 for laparoscopic cases. My family and I, including my father Dr. Peter Rojas, a general surgeon from Victoria, Texas stayed in Patzún Plaza – or the “Patzún Hilton” as we called it. There was hot water (an upgrade from previous years where we had stayed at the Convent without it) but no heat in the rooms, which became very evident in the middle of the night.
The first morning our team headed back to the Clínica to see a large group of potential patients and their families: men, women, and children of all ages. The women were dressed in detailed handmaid dresses with embroidered belts, many of them carrying children (not just babies) on their backs, some with long braids with colorful ribbons. My father and I, speaking Spanish, screened more than 40 patients to determine who we would be able to help in the next three days. We came with Dr. Derrick Garrett, an anesthesiologist from my parents’ hometown of Victoria Texas. We were told that two anesthesiologists and one surgeon from Guatemala City would join us the following day.
That day we started operating around 9am, moving back and forth between rooms until about 8pm at night. Everything ran smoothly thanks to key members of the team- my little sister Hilary Rojas Davis, RN BSN who started IV’s and prepared patients for the OR, my mother Julie Rojas, RN BSN who received patients after surgery with my husband Jorge Madden who helped with translating, waking them up and reassuring their families. My brother-in-law Dr. Craig Davis, an emergency room physician from Pensacola, Florida, “ran the board” and organized surgical case flow throughout the day. The rest of the team of nurses and OR support consisted of scrub nurses, circulating nurses, equipment managers and the sterilization team, vital to the entire endeavor that helped perform laparoscopic cholecystectomies, hernia repairs, lumpectomies and axillary excisions all day.
We finished the first day exhausted, walked back to our Patzún “Hilton” and promptly all fell asleep. Little did I know that the ear plugs I had brought from New York City would come in handy when the wild dog “symphony” started around midnight.
The next morning, we arrived back to the Hospital to find crowds of people waiting outside. Some had previously been told they had surgery today and arrived fasting in preparation. Others arrived fasting just in case they could have surgery, too. There were also several very pregnant women who had heard there was a gynecologist in the team and were hoping to be examined. I rounded on all of our patients from the day before with Sister/Dr. Virginia, who explained that all of the patients had done well overnight and would go home with ibuprofen alone. In countries other than the United States, most patients do not go home with narcotics (even though some of our patients had bilateral hernia repairs). I reviewed breast self-exams with the female patients and their families since these women would probably never see a mammogram machine, and I spoke to the Sister/Dr. Virginia about possible postoperative complications.
Later that morning, I watched the patients from the day before leaving with their families, walking slowly but with big smiles and shaking everyone’s hand on their way out. One of the hernia repair patients had a bumpy four-hour bus ride back home that day, so I asked Sister/Dr. Virginia to give him some intramuscular pain medication for the long journey to his “pueblito”.
My father and I operated upon 11 patients that second day after we heard that the third surgeon would not be arriving. We did have additional anesthesia staff and therefore were able to continue to run two OR rooms at once. During a lumpectomy, I felt my patient moving and I asked the anesthesiologist if she was waking up. We then realized the entire ground was shaking. I grabbed the patient and our instruments and waited until the 5.8 magnitude earthquake was over about 15 seconds later. I heard my little sister yelling in the hallway, but everyone ended up being okay (including the patients).
For lunch that day the Convent Chef made delicious tamales. Jorge and my brother-in-law Craig were able to spend time with the children of the Convent’s orphanage, bringing toys and applying temporary tattoos that Tattly(Brooklyn) had donated. They decorated their arms with tattoos that looked like jewelry, emojis, flowers and animals, and were very excited about showing them off.
On the third day the entire team woke up very exhausted. I realized that morning that we were 2,230 meters above sea level and this might be a symptom of altitude sickness. Our 11 patients from the previous day recovered well and I watched the same discharge procession later that morning, with one of the younger patients letting us know that he would be visiting us in “Nueva York” since my husband told him that’s where the NBA games were played. He explained that he had tried to visit before but that his “papeles” had not been accepted.
We were able to treat five more patients the last day, who have since recovered very well. Sister/Dr. Virginia sends me emails on their progress and will help follow up the pathology results of my breast surgery patients. They cannot afford to pay for their surgical specimens to be analyzed in Guatemala City so Jorge and I put the required 200 quetzales (about 30$) in the specimen bag to pay for the processing. I hope the tissue makes it to the pathologist.
We left later that afternoon for Antigua, Guatemala. We were unable to travel on the roads after dark so Jorge and I left for Guatemala City the next day. Although I wish we could have stayed longer and helped even more patients, I returned to work Monday morning with my Guatemalan handmade treasures I had bought at the market, and a heart full of gratitude to be part of a project that made a small but meaningful impact to the lives of 26 grateful patients of Patzún.