Just a Perfect Day

Coffee, bananas, cereal, watermelon; breakfast is all good but Tania promises Guatemalan food for tomorrow. We are mooching around pretty much ready to go to clinic. There comes a point in most volunteer trips when the tiredness or heat or complacency can creep in to the team and they are then not ready for the unexpected.It can happen when the first days have gone well. As is human nature we expect it all to be so and sometimes forget our environment. Jair takes exception to Ailish's note of caution and decides to prove it by having A Perfect Day. Out the door in the sunshine and up the bad ass hill with purpose. The patients are arriving by bus and today everyone turns up. Along with the referrals from clinic they have 8 patients for cataract surgery today. Dr Nesly, a local ophthalmologist, will also be in assisting today.

Over in Optometry we find out that the town of El Remate is out of water. Anne, Dominic and Tania organise buckets of water to help keep the adjoining bathroom clean throughout the day. The post-ops from yesterday are first to be seen and its a bit chaotic. Two patients are in the one room getting examined and instructions at the same time with English and Spanish crisscrossing. It is little things like the forms are not ready and the patient packs have no tape because the patients brought a roll of tape with them yesterday. The important thing is that all of the surgeries are really successful but there is room for improvement here. They start off acuity testing in room one ...casa; pato; buta.. The fans are on already as it looks like its going to be a hot one today. We work hard today to keep the flow managed evenly and to keep the patient experience calm and positive.

Emotions are a bit stretched as evident when a young woman and her 9 year old daughter present. It is clear from acuity that this is not a regular sight issue. As a precaution we test her daughter as well who initially looks like she is on the spectrum. Kind words of encouragement and the gradual strengthening of her voice indicate it is mostly shyness. The little girl is wearing a coat with a faux fur collar. In consultation with Cheryl she identifies a genetic problem. The mother explains that her eyesight started to go when she was around 12 years of age. Cheryl gently explains that there is nothing we can do, even were we in the US the condition is rare and has very little options. By way of breaking the bad news that the genetic disorder might pass to the young girl Cheryl instead talks about an examination routine to monitor the young girls eyes. When they have left to consult with Eric he needs little warning that this is a special case and treats it gently.

We get on with the day but these are the patients you carry with you, next week when you are back at the office or sitting on the couch watching a game. The luck of the draw, her and not one of us. A rare condition is interesting from a medical standpoint but its heartbreaking from a personal one. And a fur collared coat when we are all sweltering in the heat and humidity.

Lunch at 12:30 is a chance to here about the perfect day. Surgery is going well, the students talk about being in 'flow' and everyone knows what to do and it is great; the best day of the week so far. Lunch is also delicious and the hot sauce just right.

We reconvene for the second run of the day. It is much hotter today and Londi is tracking numbers. Her family are here and that is a real lift for us all, twin gils and a boy all doing really well. We settle on doing 60 for the full day which means 29 of the NPV staff this afternoon. NPV are an organisation dedicated to preserving the biosphere through sustainable communities and support the provision of health services for their communities as part of their work. Many of them speak some English and it is relaxed. Heading to 4pm and we should be done when more patients are queued up. We take everyone in the queue but no more and those last 5 stretch us. Feet are tired; legs are sore; it is hot and brains are tired from decision making in English but communicating in Spanish. Surgery are bopping with delight at their day, 8 surgeries and all went well. And a full clinic. We are all delightfully tired as we stroll down the hill.

Dinner tonight is in Hotel Gringo Perdido. Alfonso at the hotel is one of the reasons that International Vision Inc is here in El Remate, spotting an opportunity to tell Cheryl about the clinic in the area that would suit our needs. We head back to the Sun Breeze hotel and organise some washing for the launderette. The place is closed when we get there but his mobile number is on the door and he soon arrives on a quad. No problemo, washing will be ready tomorrow and the price is very reasonable. Some take a lift with Dr Nesly and others walk the 3km to the hotel. Enjoying views of the lake enroute and again when we get there. Dinner is a set menu and is delicious. We have fun talking with Dr Nesly and the Perfect Day. But we do talk about the post-op patient experience and how maybe we need to smoothen the process; giving each patient their own time at consultation. Everyone takes that on board.

Tania has organized a mini bus to take us back to our hotel. A clean bed, a cool evening, good food, great company, an excellent day of clinic and surgery. Its hard to beat a perfect day.