After over a year of my literary ennui in blog writing, I had to resume.
My beloved cousin Professor Somnath Sen, the economist, has been chiding and chastising me for my laziness. I had no idea that someone would enjoy reading about my idle ventures.
Last year was an eventful year for me punctuated by multiple physical ailments that I would rather not discuss and forget about. But now I have slowly regained my strength and my schedule. Because, honestly, I feel that to survive, I must serve.
“The woods are lovely, dark and deep but I have promises to keep and miles to go before I sleep” – Robert Frost
For nearly twenty years I have joined my friends in Liga International to work at our medical clinic in San Blas, Mexico. This unique medical venture involves many pilot–owners of small airplanes who co-ordinate to fly down medical and paramedical personnel from the US to Mexico on the first weekend every month.
I came to know about Liga from a pilot friend who used to take me to Baja where we worked as the Flying Samaritans. In my first trip to San Blas our plane made a noisy landing at a small rough strip adjacent to the clinic in San Blas.
This air strip was closed for a couple of years due to concerns around drug trafficking by small aircraft. Sineloa is notorious as a major center of operations for the Mexican drug cartels, but somehow I had missed such eventful encounters all these years.
I met the nurse co-ordinator Jacki Hansen who established and has been running the clinic, enhancing the infrastructure, fundraising and numerous other chores for 31 years. Lately, Jacki has had her encounter with cancer and chemotherapy. This amazing, and seemingly frail, lady remains undaunted and has been coming to run our clinic even during her bouts of chemotherapy working from 6 am to past midnight through the week end. I feel so fortunate to walk in her shadow.
Last month I returned after a gap of over a year because of my open heart surgery. My pilot friend, Skip, flew down from Ukiah to Concord to pick me up. We then flew to Bracket near Los Angeles where Renee, Whiney and Angelo joined us. After stopping at Obregon for immigration clearance we landed at the El Fuerte air strip at about 3pm. Jacki had arrived a few minutes earlier in another plane. Jacki and I hailed our taxi and headed for San Blas while my other co-travellers headed for their clinic in El Fuerte.
We reached San Blas after an hour and were welcomed with cheers and hugs from the local villager volunteers.
There were about 9-10 patients already waiting for us in a side room. The clinic has a large central waiting hall for the patients, surrounded by exam rooms and one wing for surgeries. Upstairs we have two halls with cots for sleeping and a cooking area with an adjacent long dining table and benches.
Over the years the village ladies have developed a warm relationship, cooking and feeding us. They even know our tastes and our idiosyncrasies. My friend Eduarda made me sit down and fed me fried fish, rice alongside a salad with avocado.
I then hurried down to see my waiting patients. Most of them brought their folders with X-rays and lab reports that I perused with the help of a local interpreter. I tried to practice my Spanish but it was grossly inadequate. On this trip we were handicapped by the absence of anesthesiologists. I saw a 15 year old boy with an inguinal hernia.
There was another middle aged gentleman who was miserable with his pain in the bladder area. His CT scan showed an avocado size large bladder stone. But more worrisome was the fact that he also had a large tumor in his right kidney which was certainly a malignancy. I told him that we are not equipped to deal with the kidney tumor and he will need to go to the local city hospital and probably will have to pay for his treatment. He said that he has been aware of the tumor for four years and was not concerned about it. It is the bladder stone that is making him miserable. I could imagine his anguish. I said that unfortunately we didn’t have an anesthesiologist this time, so he could come back next month or I could do the surgery under local anesthesia though there may be some amount of pain involved. Both the gentleman and the boy with the hernia insisted on having their surgery. I told them to come next morning with an empty stomach for their surgery.
I saw the other patients that evening, advised them and went upstairs for a shower and prepared for bed. As I was rubbing myself with Deet to avoid painful mosquito bites, I told my friend in the next bed that because there is no malaria in Mexico, I don’t feel as worried as I was in Africa, Haiti, Bangladesh or India. He said recently there had been cases of the Chikungunya virus in Mexico and central America. Now I was really worried because that virus causes bone breaking pain and fever and has limited treatment available. So I vigorously doused myself with Deet, and kept wishing that I believed in prayers, or had someone to pray to. It must have worked, as I slept well amongst the 10 other volunteers in our hall.
Next morning, after a sumptuous breakfast of papaya, huevos fritos, tortillas and coffee I went down to the operating room. I found Jake, a paramedic who agreed to watch my patient with some sedation and his wife, Ashley, a pathology tech to assist me with another local nurse. Shawn the dialysis technician acted as the circulating nurse. We started our surgery with the hernia repair for the young boy. It went surprisingly well.
Our next patient was the one with the large bladder stone. I gave him a lot of local anesthetic in the wound and Jake gave him sedatives, but we were limited by the available narcotics. I slowly proceeded with my incision to the skin and underlying fascia, liberally injecting lidocaine in each layer. But, as I approached the bladder, my patient started thrashing about as the stone rubbed inside his bladder causing a lot of pain. Jake was looking for Morphine and Versed, but neither were available. I felt something wet and warm on my left foot and noticed that the patient has pulled out his IV needle and had been dripping blood on my shoe for a while.
Jake gave him more Propofol, which calmed him down a bit. I used more lidocaine on the bladder wall, made a quick opening in the bladder and removed the huge stone with some difficulty. The patient became much comfortable after that. I inserted a catheter in his bladder, which would remain for a week, and closed up the bladder and other tissue layers. With a great sigh of relief our whole team went for lunch.
Afterwards, in between seeing other patients I came to check on my signature patient, with the bladder stone. He was all smiles, drinking Coca Cola while his wife thanked me profusely. I advised them about post-operative care and they will contact me through the local physician in case of need.
It was time for us to return to El Fuerte where we would spent the night with my co-travellers before our flight early next morning. I said goodbye to the locals, gave my parting hug to Jacki – promising to return – and took a taxi ride to the motel La Chosa.
I sat at the dining area sipping my well deserved Margarita grande en las rocas. Soon Jake, Ashley and Shawn joined me for dinner. We exchanged stories of our interesting encounters in the past and wrote down our contact numbers and emails.
It was a wonderful feeling making new friends with similar passions and missions in life.
I knew their journies had just began, as mine had started two decades earlier… a joyous–blissful journey that I would cherish to continue.
As Rabindranath Tagore said:
“I have been invited to the world’s festival of joy. Blessed, Oh blessed is my human life.”