Last Week at Tenwek

My final week at Tenwek Hospital continued to be an unforgettable experience.  I was exposed to a large spectrum of medical cases that deepened my desire to pursue orthopedics, but also introduced me to other fascinating fields of medicine.  This in itself would have caused me to classify this week as “incredible.”

However, due to the longer period of time my family spent at the hospital this year, I was able to experience so much more.  I worked with orthopedic surgeons throughout my time at Tenwek, and was able to see God work both physical and spiritual miracles in the lives of Kenyans.

One particularly remarkable example involved a pregnant Kenyan woman who had severely fractured her hip.  The femoral head had broken completely through the acetabulum (the socket), incapacitating her and endangering the baby.  All the doctors could do was apply 6 weeks of traction to her femur (pulling the bone) and pray that her acetabulum would align.

I was there for her final week of traction, and upon its removal, the doctors were utterly astonished to see how well the acetabulum had aligned.  It had nearly regained anatomical position, which, considering its initial condition, should have been impossible.  The doctors acknowledged this as true miracle, which greatly bolstered the patient’s dwindling faith.

I also witnessed gun shot wounds that should have lead to amputations, but instead ended in restored ambulation and spiritual regeneration.  Even if the patients were already believers, it was still immensely satisfying to see the genuine gratitude on the patient’s face and to worship the Lord together.

Over the course of the week, I witnessed dozens of different medical cases and assisted in nearly 20 surgeries. Each case had its own unique problem and each provided me with new insights.  I will not describe them all in detail, however, each medical circumstance I observed can be categorized into one of three medical specialties: Orthopedics, Ophthalmology, and General surgery.

(taken from the Tenwek Hospital website, tenwekhospital.org)

I spent the majority of the week with the orthopedic surgeons.  One example that was particularly meaningful to me involved the partial hip arthroplasty (half of a hip replacement) of a man whose femoral head had entirely cracked off from the stem.  The head of the femur had begun to die, and was unsalvageable. This was of particular interest to me due to the orthopedic internship in which I had been embroiled for the first half of the summer.

During this internship, I assisted in research regarding the biomechanics of joints and the effects that certain prostheses have on joint biomechanics.  It was very fascinating to assist in the implantation of one of the very prostheses I had been researching during the early summer.  This particular case required an Austin-Moore prosthesis (AMP), which is a single piece including both ball and stem.  The acetabulum was in good condition, negating the need for a total hip arthroplasty.  I was mesmerized as the surgeon removed the femoral head, rasped the intramedullary canal, adjusted the length of the femoral neck using a bone saw, and implanted the prosthesis itself.

During the procedure, I assisted by retracting the wound, protecting the sciatic nerve, cauterizing certain veins and arteries, and irrigating the wound (cleaning with saline).  Other very exciting orthopedic surgeries that I assisted during the week include a ruptured patellar tendon, an open tibia fracture requiring an intramedullary sign nail, an open ankle fracture of both tibia and fibula requiring three pins, and severe open finger fractures. While I would have been ecstatic to have seen just these cases, I also had the privilege to assist in other fields of medicine.

(taken from the Tenwek Hospital website, tenwekhospital.org)

I spent part of two days of the week working with the ophthalmologists.  During this time I observed several pediatric cataract extractions and assisted my father in many different surgeries.  My father’s specialty deals with strabismus (misalignment of the eyes) and I was able to assist him in several of these types of cases.  One memorable example was a child whose eyes were extremely esotropic (one eye pointing towards the nose).  My father delicately recessed both medial rectus muscles and resected the left lateral rectus muscle while I positioned the eye using locking forceps, held the muscles using muscles hooks, and kept the eyes moist.

The difference in ophthalmic surgery and orthopedic surgery is astounding.  An inadvertent movement of 0.5 mm in ophthalmic surgery could ruin an entire operation, while in orthopedic surgery it is nearly inconsequential. Coming from the orthopedic theater, ophthalmic surgery seemed so clean and sophisticated.  The bloodiest operation I assisted in involved an evisceration (removing all the intraocular contents) for a painful blind eye, and, even then, it paled in comparison to the gore found in orthopedic surgery.

Perhaps the most immaculate surgery was the single general surgery case I observed.  During this procedure, surgeons endoscopically placed a stent in the canal that leads from the pancreas to the duodenum.  It was highly technical, very fascinating, and didn’t require a single incision since the scope was passed though the patient’s mouth, down the esophagus, through the stomach into the duodenum.

My medical experiences at Tenwek this year were so fantastic that I don’t begrudge the inevitable 14 years of further education.  My time at Tenwek, however, was not spent solely “practicing” medicine.  I spent evenings and weekends in fellowship with other missionary families who demonstrated kindness to my family and I and showed themselves to be truly God-fearing people.

(taken from the Tenwek Hospital website, tenwekhospital.org)

Although Tenwek Hospital may be a place of great need, it’s clear that God is blessing those working there, working through them to advance His kingdom.

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