I rolled into Round Rock last Sunday night, already reveling in the sheer immensity of infrastructure evident in the US.  My mom's first few items of business were that my grandma was in the hospital, my brother had surgery, and my apartment fell through.  Well, crud.  It was too late to visit Oma, and Kent was four hours away, so the first thing to check on was the apartment.  We ended up making another trip down to San Antonio to check out the other apartments available, since my place's current tenant had decided he didn't want to move out after all.  Technically the lease was in my name and I had the legal right to kick out the current tenant, but to keep everyone happy, the complex offered me a fantastic deal on a much bigger apartment.  Having taken care of business there, mom and I stopped by New Braunfels on the way home, to do some preliminary house scouting for brother Kyle, who would like to buy a house but only has a few hours a week off with which to househunt.  We ended up going back Wednesday with Dad and adding Kyle to a third trip on Friday.  Housing wise, it's been a busy week. 

From the trip, someone tallied everything up.  The first week (clinic out in the boonies), we saw around 1850 patients, all of whom received medication, and over 200 of them were given shoes, which is more of a ministry than I was prepared to comprehend.  Each and every patient heard the gospel, and there were 177 documented decisions for Christ made that week.   The second week, we saw several hundred more patients, but 87 had operations, and another 144 had dental procedures.  Again, the power of God was moving and many more patients made professions of faith, most of them with a doctor right there in the hospital.  The honey bear was our only patient who did not hear the message of salvation.  The numbers cannot do justice to the integrity of the work God was doing through this team and, as is often the case, God worked in mighty ways in the lives of the mission team members as well.  

          

            

We were cleaning up from breakfast when one of the Honduran hospital staff ran in looking for, at a minimum, a surgeon and an anesthesiologist.  A guy with a gunshot wound had just been dumped on the doorstep, and their services were desperately needed.  Several others of us with some trauma experience hustled along to find a mostly unconscious fellow with a bullet hole in his neck that sucked in air as he struggled to breathe.  That, plus the crackly feeling throughout the skin over his chest and arms, was confirmation that the bullet had ripped a whole through his windpipe and/or lungs.  Neither is a good option.  As it turns out, both were true, and this poor dude ended up with tubes coming out of every orifice we could find, including two new orifices we created, in his neck (to pass a breathing tube straight into his windpipe below the damage) and his chest (to pull air out of his chest and allow his lungs to expand).  If our team, complete with an experienced neck surgeon had not been here, this guy would be dead.  The locals had never seen such a dramatic surgical attempt at constructing an airway, even though similar procedures are done regularly in the US.  My job, in keeping with my assignment as a nurse, was to monitor his pulse and oxygen level, and to keep sharp stuff from poking medical personnel as they scurried about the cramped clinic room.  Amidst all the bustle of lifesaving, blood was quite literally everywhere, and the custodial lady was continually trying to mop the floor around us as we worked.  It took some convincing to keep her out of the room until after we were done.  That is true dedication to the job.

That which is being used as a recovery room and post-op combined was originally designed as a regular patient hospital room.  This set-up has advantages and disadvantages.  Disadvantages include trying to maneuver around 6 beds plus scattered family in a room intended for 1 bed, maybe 2 in a pinch.  Scarcity of outlets is also a problem for needed equipment, like heart monitors and suction pumps.  A distinct advantage of the patient room setup is that we have a bathroom handy, which is where I spent most of the day today.  Honduras has caught up with my digestive tract, which is peculiar because nobody else from our 50-some-odd person team has tummy troubles.  The ladies working recovery with me thought I was just shirking duty with my frequent potty breaks.    Luckily, we brought a working pharmacy with us and the doc in charge handed me the appropriate anti-amoeba/antibiotics with a promise that my food will be passing only one direction and at a normal speed before we travel again. 

Meanwhile, I'm inadvertently subverting my current role as a recovery nurse.  Doctors decide stuff and nurses do it.  The real nurses have no trouble following directions, but apparently I do.  For instance, I might take out an IV, using my clinical judgement to affirm that the patient no longer needs it.  In one of these cases, the patient's chart said she needed to drink a certain amount of fluid before taking it out, and she hadn't yet had that quantity.  But she was drinking well and already needed to use the bathroom, meaning she's better hydrated than I am and is ready to go home.  But the nurses got all over me for defying doctor's orders.  Can a doctor defy doctor's orders?  Nevertheless, in this and several other respects, four years of medical school most certainly did not prepare me for a week as a nurse.  Healthcare's division of labor usually works out well, with each team member playing his part, but not in this circumstance.  I have lots to learn.