Photographer Doug Bruns travelled with Physicians for Peace volunteers on a plastic surgery training mission to Tegucigalpa, Honduras. He sends these updates…
Sunday, September 21
Arrived at Toncontin Airport, Tegucigalpa shortly before noon, amid rain, and caught up with Dr. Brody, or Garry, as he prefers. Today is his birthday. He’s 76! Happy birthday Garry – the airline lost your luggage! Dr. Luis Gonzales is our host and picked us up at the airport. He tells me there there is a strike on at the hospital, that soldiers are filling in for staff. That should be interesting.
Monday, September 22
Into the OR at 7:00 am to repair the thigh of a young man. A month ago in a motorcycle accident he broke an arm, but of more concern was the thigh where the skin had been scraped off. He was back into the OR for a skin graft. Dr. Brody, Garry, is a plastic surgeon. He is here to teach. The goal of this mission is to leave the country with a medical staff, interns specifically, with more education than they had previously. Garry’s method is Socratic. “How would you do this?” “How can you repair that?” The interns and the occasional medical student speak good English. It is a requisite of their program. They respond to Garry’s challenges with good humor, mustering every bit of training and education they can so as to impress and not disappoint.
The day flagged and cases were lacking. Garry observed, “They weren’t ready for me.” He anticipated that cases would be queued up, that he’d have a steady stream of patients and opportunities to teach. The cases did not materialize.
But word got out that Garry was in the hospital and in the hall we were stopped by a man who wanted a nose job, a woman who wanted a face lift and a young man with a cleft palette. His eyes spoke volumes and his mother watched on as Garry and the interns examined him in the hall, our make shift exam room. When I left the hospital late in the day the young man and his mother were standing outside the OR, looking down the hall through the glass. He has been added to the docket and presumably will have a new smile when we leave town.
Sept 23, Wednesday
I am a photographer. I volunteered to come to Honduras to document the work Dr. Brody and Physicians For Peace does here. He and I were sitting at a table yesterday, in between operations, when a young medical student approached us. We were dressed in scrubs. Dr. Brody looked like a physician–and I guess I did too. The medical student shook my hand and asked me what my speciality was. I smiled coyly, “photography,” I said. She laughed good heartedly. “No really,” she insisted, “What’s your speciality.” “Really,” I replied, “photography.” I showed her my card and pointed to Dr. Brody who was watching with a grin. I pointed. “He’s the talent at the table.” The point of the story for me was her eagerness. She wanted to learn, a desire I see in abundance.
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I mentioned earlier that Dr. Brody’s method is Socratic. Here are a few of his questions to the staff here at the hospital:
“If that were your girlfriend, how would you treat that injury?” (To a young, male, intern.)
“How are you going to feed him?” (About a patient who had a major face reconstruction yesterday, including lips.)
“Do you notice what he’s doing?”
“Once this heals, what’s the problem going to be?”
“How are you going to deal with this?”
And what I gather to be his two favorite questions:
“What’s your plan?”
“What are you going to do?”
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We visited the burn unit this morning during rounds. It was difficult. An adolescent sat in the hall, his legs burned, completely despondent, tearing up, staring at his legs. A woman burned in a club lay still on a bed, struggling to live. Two members of her party have already died. A man doused in gasoline by a gang and set afire seems resigned to his pain. I struggle to compose a photograph that will not be something other than reflective of utter hopelessness. Then I see Dr. Brody talking to a patient. He reaches over and touches the man’s hand. Therein lay hope, compassion and the human connection.
Thursday, September 25
I mentioned earlier in the week the strike. The problem is, I think, a conflict between health care workers (i.e. nurses and technicians) who are on the public payroll, and those in the private sector.The government decided to allow private sector practitioners to come to public facilities, like our hospital, to train and study. The hospital is a limited resource and those now working in it see this as an invasion of their turf.
When we arrived at the hospital on Monday, there were, say, two dozen nurses and technicians milling about at the front doors. Today, four days later, I’d guess at least twice that. Further, they had a look of steely resolve in their eyes. And of course there was media. And we all know that when media shows up and people get on television, well, that changes everything. And it did.
We had no patients this morning. The OR was empty. The halls were empty. There were doctors aplenty, however. But how much coffee can a doctor drink, really? By the afternoon there was a slight break-through and our interns had found enough sympathetic ears to come to our aid, ever so limited, but help out nonetheless with a patient. Tomorrow looks dicey at best. So, I have bailed and will be heading home a day early. Doctor Brody, like the professional he is, is staying the course, one more day in the hope that he can help the interns, patients and doctors at the hospital. I suspect he will find some way of imparting his experience, strike or no strike, one more day.
