Hmmmmm

Busy setting up Final Cut Pro and learning how to use it. Camera gear still being assembled. Will try to post more on the Op Smile trip soon.

Couldn't resist linking this article about witch hunting in Guwahati.

Opportunity Knocks

I met Tinat Masood (through Miss News Anchor Lady) in Guwahati, who has a documentary production company.  She is willing to take me on as an intern on my next trip.  She has these really cool light colored eyes that can see auras.  I'm going to take aura detecting lessons from her as well.  I will try to be in town during the May mission, and be available to Op Smile if the need arises.

Bought the Sennheiser 416  for the EX1 at the recommendation of Cindy McCain's crew.  Will need wireless lap mics also.  

Just found out about the Convergent Design's Flash XDR.  Amazing device.  It takes the SDI output from the camcorder straight from the sensor at 1485 Mbps, and compresses it down to 100 Mbps at 1080p (vs 35 Mbps natively in camera), with the image quality being almost identical to uncompressed.  It also records in the sensor resolution, which is 1980 x 1080 at 4.2.2, compared to 1440 x 1080 at 4.2.0 stored in the Sony.  This makes it comparable to 35 mm theater quality.          Wow.        Not only that, it stores the files in quicktime format, onto compact flash cards, which are only $80 per 32 gigs, vs $900 for the SxS 16 Gig cards from Sony for the EX1, with the added advantage that you can edit the video STRAIGHT off of the cards!  Although this is going to be expensive, the quantum increase in quality, and the savings in memory costs makes it a less painful upgrade.

Also got this AntonBauer Harness to carry everything.  The battery with the XDR would be heavy enough on the back to balance the camera in front.

 

Team Doctor? Moi???

I was told that it was the peds intensivist's job to be the team doctor.  Well, how hard could that be, I sez to myself.  Treating adults would be kind of like treating kids, just bigger doses.  

Below is a picture of Barathi Gourkanti, an anesthesiologist from India.  Note the shaved scalp where I attempted an IV start.  Needed 4 people to hold her down for the procedure.  She was very strong.  Snapped the "no-no's", which were elbow restraints we made from tongue depressors.  Gave her a Shrek sticker which made her very happy.

Betsy Walker is a Postop nurse from Jersey.  I was able to place her IV on the 3rd try, 95 seconds, thank goodness.  Had the intraosseus needle out of the sterile wrap ready to go.  Didn't have any more Shrek stickers, and she didn't want the Spiderman bandaid or the Duct Tape Bandaid.  Here she is, so sad.

Kathleen Putman, OR nurse from Halifax, was hit pretty hard.  Although she asked for a Shrek sticker, she loved the "Where's Waldo" shirt we found.   Tracey Ryersee, OR nurse from Flagstaff, popped a liter of Lactated Ringers Solution for Kathleen, then a liter of cabernet sauvignon for us adults.  A good time was had by all.  Good memories.

Palates

Palatal clefts are more serious.  Since there is an opening between the mouth and nasal cavity, children often have difficulties with speech, swallowing, and infections.   They often will have milk coming out of their nose, even when they're not laughing.   Chronic ear infections are very common, and drainage tubes are frequently placed prophylactically.

This baby is severely malnourished, possibly because of difficulty swallowing.  He is 15 months old, I think, and cannot tolerate surgery because the repair would break down from his weakened ability to heal. We have referred him to a feeding clinic in the hopes that he would put on some growth so we can repair him in the future.  The black spot protects him from evil influences.  Double blind studies have not been done to determine if the spot actually works or not.

Nandita Grover is a dentist from India who worked nonstop making palatal obturators.  This appliance temporarily closes the hole until the palate surgery is done at a later date, preventing food from entering the nasal cavity.   Not having access to her UV oven to cure the polymer material, she simply placed the plastic in the window ledge for the sunlight to cure, which was much slower.  Sun dried obturators, how Californian.   This is the western equivalent of a talisman that protects the child from evil influences.

Eusebia Khyriem (pronounced "U-C-B-A")  is a speech therapist from India.  Children with clefts have difficulties with speech, even after surgery.  They require intensive speech therapy, but all we could do was to get them started.  In our overstretched metaphor, she would be the oracle who tells us that certain behaviors have a repellent effect, and teaches the correct way to act that would be more acceptable. 

Destiny

The upper lip is formed by the fusion of different tissues during the 6th week of gestation. The force that guides two parts together across space and time to fuse as one is sometimes referred to as karma.  When the fusion process is interrupted, a cleft results.  The cause of clefts is felt to be related to a mixture of inherited factors and exposure to toxins. Identical twins have a 35% chance of sharing this defect.  Drugs, alcohol, smoking, pesticides, and many more environmental agents have been linked to clefts.  What is commonly referred to as bad karma is actually a form of spiritual cleft lip surgery, with this universe being the operating room.  The movie was ripped off of Dr. Mark Hill,  from the University of New South Wales web site.  Uh oh.  Karma time.

  

Hanuman's reincarnation

This is one of the patients that we did not operate on.  He has an unusual bilateral horizontal cleft, a "Tessier 7" defect, that would require a larger team than we came with.  Arrangements are being made to have him done in Singapore.  The parents are ambivalent about having the surgery done, because some of the villagers think he looks like Hanuman, an Indian deity, and bring the family offerings.  Hanuman, as a child, tried to eat the sun, thinking it was a mango.  Indra, the god of Weather and War, shot him in the face with a thunderbolt, which left the facial deformity.  Nowadays, we know that Hanuman's defect was merely the consequence of genetic predisposition coupled with in utero exposure to toxic substances during the 6th to 10th week of gestation.  But a thunderbolt is a way cooler explanation.  This picture was actually hanging in the postop ward with incense burning under it.

I think I'm on to something with the rhino mystery.  Miss News Anchor Lady's "pet name" is Rhina.   Rhina, rhino, pet.  Coincidence?  I think not.  Certainly, that would explain how she got past the small elevator, by shifting into human form.  Also explains why she insists on carrying around a large tube of hand lotion, because rhino skin is very dry.  I'm talking LARGE tube.   Mystery solved.

Double click on video to play fullscreen.

Goodbye

Can't believe we're leaving India.  It has been an unforgettable week, intense joy at the transformation of the faces, and sadness for those we didn't have time to do.  Out of 424 patients screened, we were only able to do 157.  This family is being told that their child has to go home without the surgery.  The tears were abundant from families as well as from staff.  Fortunately, another mission is planned for May, and they will get top priority.

Miss News Anchor Lady did a documentary on this Operation Smile mission.  I will try to link that on this blog when she is done.  Her name is Sreemoyee Sharma, told me to call her by her "pet name", Raina, which is pronounced "Rhina", not "Rain ah"

Raina, Rhina, why does that name sound so familiar?  Hmmm, maybe we knew each other in a previous life.

No rhino sightings for days.  It turns out that the rhino victims, Shayrah Kharna and Shelmaylee Kharna, were listed next to each other in the phone book, which was why the investigators suspected that these were non random acts of violence.  

Picasa album will be up soon.

Love yall

Busy busy busy

First time back at hotel in 2 days.  Operated on over 100 clefts so far, couple of kids developed complications with bleeding, pulmonary edema secondary to equipment failure.  Stayed at hospital, only slept 2 hours, so I'm tired.  This has been a very magical week, seems like I'm in a dream.  Too tired to set up Picasa album, so I'll just post these guys.  

Unable to get anything solid about the rhino problem, but my brief snooping around has taken a weird turn.  The RIS (Rhino Investigation Squad) has tantalizing clues that the rhino killings are not random, that they are after one specific target.  More detail when I get them.

Oh yeah, Miss News Anchor took me to dinner tonight at a fancy restaurant.

O.

M.

G.

Naan was sooooooo good.  

Preop screening

Screened about 400 kids for surgery in the hospital that the government renovated for our mission.  There is massive support for this project from every direction, and we are surrounded by superstars, both local and foreign.  I can't even start to describe the talent we have here.  My interpreter is this drop dead gorgeous goddéss who humbly introduces herself as a clinical psychologist.  I found out later that she is the weekend news anchor on television who has worked on several documentaries.  Pictures to follow as soon as I get some good ones.  (She made me delete the ones I took of her because "I can do better than that".)  The Operation Smile India team is turning out to be world class, I don't know how to even begin to describe them, but, wow, just wow.  Took 3000+ pictures, deleted 2500, and we haven't even started surgery yet.  I'll work on a slideshow for here from picasa as soon as i find out how to work it.

Cindy McCain had to cancel at the last minute, but her film crew came.  These guys are going to Cambodia next to film a segment on land mines.  They travel all over the world filming humanitarian subjects.  Between trips, they are professional stunt men for hundreds of movies.  I have started the application process to be their groupie. 

The security guards around the hospital pretend to look surprised when I inquire into the rhino problem.  I catch them exchanging glances when they thought I wasn't looking.  Will go undercover when I finish preparing mock code scenerios.

Itching to get started

Landed at Guwahati as the sun is close to setting. Hour bus ride to hotel, dodging cows, cars, and bicycles. Checked into hotel, the Pragati Manor greeted by several cauldrons of water with fresh rose petals floating, a koi pool, and marble and brass everywhere.

Rode up to room in a small glass elevator, which seems to be too narrow for a rhino to get in. Even if he manages to squeeze past the door, his butt will stick out, resulting in a separation of his fore and aft. Internet intermittent so will need to keep posts short, or risk getting booted off. Hi to everyone who emailed. I'm good, sorry I don't have much free time to respond to emails, so check here. Love you.

Delhi

Wonderful to finally arrive in India.  First leg from Spokane on Alaska had me next to this 300 pound guy who wanted to chat the entire trip, second leg was next to a cute year old baby who sprayed milk all over my new jacket.  The final leg was a grueling 15 hour trip from New Jersey to New Delhi.  Sat next to a very charming medical student returning home after interviews for her pediatric residency in the U.S.   She assures me that rhino attacks are not really a common problem.  Marauding elephant gangs are more dangerous.  Something to do with their discovery that the enormous nasal passage in their trunk served as an impromptu "bong" as they inhaled the smoke from the burning hemp fields being destroyed by the counter-narcotic units.  Unknown is how they went beyond this gateway drug to sniffing cocaine, and she was very vague on where they get the large mirrors and razor blades.  Met a ton of people from Operation Smile.  Norm and Kathy and Kathy and Betsy and Janine and Ashley and Alexis and Madison and Tracy and Dan and Marion and Stam and Pauline and Nolan and Paula and Mary and Rachel and Kristin and Donna and Lucy.  I'm told more is coming, some from India.  And that we will play something called "The Name Game".  Why did they laugh?  The coordinator here in India is Abhisek Sengupt (gonna go with Abby).  This is a picture of him and his staff, I'll get names later.

Countdown

Taking off tomorrow morning.   Temperature is 26 degrees here, dropping to 16 tonight.   In Guwahati, it's 61.  I will try to stay in touch via email, but not sure what the internet situation is over there.  I've been informed that Cindy McCain is on this trip.  Emergency contact person at Operation Smile:

Kristen Edwards

757 321 3229

kedwards@operationsmile.org

You're not going to believe this, but the rhino killed another lady!!!  Unconfirmed sources reported that this time, the rhino has been placed in time out, and his cell phone privileges suspended for a month.

More Killings

Geez, what the heck am I getting myself into?  More mayhem from Guwahati.com:   

                    "Rhino Killed One"

The rhino killed this woman AT HER HOUSE, but was merely reprimanded and returned to the park.   According to the article, he may have been cruising for chicks.

Since we are making up the on call schedule for the summer, I browsed through Operation Smile's Mission Schedule to see what's coming up so I could block off the time.  I'd love to go to Kenya, but that's too soon.  Madagascar would be perfect, but no dates have been set.  Likewise Ethiopia.  China... hmmm... yeah, it's been too long since my last good meal.  Maybe China.

Uh Oh

Found these articles online from today, at Guwahati.com:

"Bomb recovered near Guwahati hospital"

"Arms and Ammo recovered in Karbi Anglong"

Need to go back to REI to see if they sell Kevlar t shirts.

Now for some good news.... India visa got approved for 10 years, woot!

Checklist

Things moved pretty quickly.  Visa is done, they are overnighting it back tonight.  The credentials are all faxed in.  Ticket is booked.

Yay.  Looks like a go.

I have my bags mostly packed.  Went crazy at REI with travel clothing.  Bought lightweight fast drying underwear/tshirts, (can you just see me in Spandex??!!) which if I washed them every night, should get by with 3 sets for the 2 weeks.  I would be wearing scrubs for the most part, so shouldn't need much else, just buy something there if I run out.  There was a pair of pants with "Insect Shield", excited to see if it really works.

So far, I've been able to fit the Canon 1D MkIII with 3 lens, and 17" MacBookPro into the carry ons, and keep them under 10 kg each.   (Drat, my portable injet will have to stay home.)  I may have to bring my 5D instead if I go over the weight limit.  Hmm, wonder if I should get the MacBook Air, since I'm going to be doing this a lot.  Just found out they make 32 Gigabyte cards for the camera, ordered 2 from Costco.

Guwahati

Looks like it's India this time, cool.  Going with Operation Smile from Jan 26 to Feb 6, doing cleft lips and palates, filling in for someone who dropped out at the last minute, or something.  Let's see, that's less than 2 weeks, gulp.  Guwahati is in Assam, which is a province in northeast India (away from the Pakistani border).  

Weather sounds very pleasant this time of year, currently 69 degrees, but lows are in the 50's, gonna need sweaters.  I am planning to take only carry on luggage, which may be a challenge since I will bring tons of camera gear and computer.  Who needs clothes anyway?

Trip coordinator for OpSmile is Brandon Ringler, who seems to be a great guy, sez peds intensivists are in short supply, so I should be okay for this trip.  It's going to take a lot of work to pull this off with such short notice.  Need visa and credentials post haste.