Trip Three: Week Nine! August 17-23

Nine weeks down, four to go! 

This week felt like an emotional rollercoaster, honestly... and it was the quickest (and also longest) week yet. 

On Monday, we had the first patient screening day for the start of the thyroid surgical block! The team saw around 30 patients, many of whom have had these large goiters for 10+ years. While we are technically still doing general surgery, it is quite different than the processes for hernia/hydrocele general surgery. It was interesting getting to learn about thyroidectomy surgeries and the steps these patients have taken before even getting to the ship. The thyroid patients need to have regular blood tests done and medication prescribed to ensure their levels are within a certain range before they can have surgery. Many of them have been receiving care from Mercy Ships for weeks/months before ever being seen by an actual surgeon. Starting this four week thyroid surgical block brought quite a bit of nerves for me. I haven't really done a thyroidectomy and was now expected to be the team leader. I am beyond grateful that the surgeons are lovely and one has been serving with Mercy Ships for many years and knows the flow. 

Tuesday, our first day of thyroid surgeries, felt like a whirlwind of a day. I felt all the feelings... overwhelm, anxiety, worry, stress, anger, excitement, relief, joy, etc... I am thankful for the other two nurses who worked in my OR this week. Both of them were brand new to the Mercy Ships world, but immediately jumped in and caught onto the Mercy Ships ways. By the end of the first day, we had a great and efficient OR flow started. There were moments that I psyched myself out a little more than needed, but everything turned out fine and our patients were cared for well. By the end of the week, our team had a great surgical rhythm and could anticipate each others' needs very well. 

One bit of joy in the chaos of Tuesday was celebrating our dear friend Natalie's birthday! She was the full-time OR educator in 2024-2025 and has been filling in as educator and supervisor a few different points this year. She is a joy to work alongside and I'm thankful for the support and encouragement she gives me. It was special to be able to give her all the birthday wishes! 

On Wednesday, I went for a morning run. It was drizzling a little bit, but we were surprised with a huge rainbow as the sun started to come out! 

I was on-call on Wednesday and Thursday and needed to work late, leaving the OR after 8pm both days. There have been many sick bugs going through the ship community, causing us to lose key members of the OR team due to isolation precautions. The OR was down 3-4 members of the team throughout the week, including two anesthesia providers. Unfortunately, this affected the surgical schedule and forced cases to be cancelled or postponed. 

To safely run an operating room, there should ideally be one anesthesiologist staffed in each room and an anesthetic supervisor available if anything is needed. Because two anesthesia providers were sick this week, leadership decided we could only safely run one OR at a time. In order to try and still care for as many patients as possible, the leadership team decided to trial a "split-shift" approach to the surgical schedule on Friday. In the morning, there were two cleft repairs, then two plastics cases, and then our two general thyroid surgeries. 

When I was first told I was going to be the "evening shift," I was honestly pretty bummed that I'd be working late in the OR for a third day in a row and needing to cancel my Friday night plans. It was almost like the "light at the end of the tunnel" of a very crazy week was taken away. Thankfully, I was actually given the morning off on Friday, along with the other two nurses in my OR, Tara and Freiya. We went for a coffee, a quick massage, and lunch before heading back to the ship to start our afternoon/evening cases. In hindsight, I feel like I was a little bit dramatic with how disappointed I was at first, but I'm human and felt so exhausted by the end of the week. Even through the exhaustion and disappointment, God continued to show me his kindness and provided small moments of joy. I am very grateful for the two other nurses working with me this week and the friendships we are starting to form. I am thankful that I was given the morning off on Friday and for a restful few hours off the ship. I am also very thankful that the two surgeries went smoothly, and we finished at a reasonable time (9pm). 

Saturday and Sunday were spent exploring Tamatave, running errands, and finding time to rest. On Saturday morning, Fabrice and I went to a roadside Malagasy coffee & bread stand. Malagasy bread or "mofo gasy" are like little fried dough-balls. They can be either salty or sweet, and we tried both. I also had a small mug of Malagasy coffee. It was quite strong, but I liked it! The girl running the stand was probably 10-11 years old and her mom/sister was just observing in the background. She would take all the orders, prepare the food/drinks, and take the money. I tried speaking Malagasy with her, but she got so so shy and quiet, the complete opposite of how she had just been running the stand. It was a sweet (and kind of sad) reminder that she really is still just a kid. After coffee, I went and got a haircut at a salon in town. They cut, shampooed, and styled my hair for 60,000 Ariary, or $13.90 USD. While that is more on the expensive side here in Madagascar, that's nothing compared to the $100+ that would have cost in the States... so I was happy! We also did a little shopping and then got lunch. I was so excited to have found cherry Coke zero at the supermarket! On Sunday, I enjoyed a coffee at a local cafe before exploring more of Tamatave on a beautiful, sunny day! 

OR Recap

This week, the OR operated on 27 patients across reconstructive plastics (final week), general surgery (thyroids), and cleft repairs. Of the 27 patients, 11 were general surgery patients.

Overall, it was kind of a chaotic week, but I'm thankful for the patients we were able to care for and the surgeries we completed! With the many sicknesses, we were going to need to cancel/postpone 30 patients because of unavailable crew. The flexibility and endurance of the team allowed us to only cancel/postpone 12 patients, instead of the 30 who were originally going to need to be cancelled/postponed. While having 12 patients cancelled/postponed is still sad, it could have been much worse. 

Please pray that I will stay healthy, physically and mentally, and that those who are unwell will return to health soon! Please pray for those in leadership positions and for the decisions they are making. It is a lot to coordinate and think through and things are always changing!