A two-hour drive. A subway ride. Two flights. Land at 1 a.m. Crash for a few hours. Another flight. A death-defying hour-long taxi ride winding through the mountains at alarming speed, passing trucks on blind curves, traversing fault lines that made the road shift and heave. All this to make it to a small town in southern Ecuador for a marathon week of humanitarian surgery with early mornings and late nights, four or five cases a day, and power outages with a patient on the table.
This is not a complaint at all. It’s a fond memory. It’s the stuff that makes all the years of medical training and sacrifice worth it. For so many of us, a career in medicine is a chance to help others and make a difference in the world. The reality of the day to day of medical practice is at best less glamorous and at worst disheartening, when paperwork is endless and unpleasant patient encounters are all too frequent. There is a lot of gloom and doom awaiting young physicians with rising debt and the tightening belt of insurance. But there is still joy to be found.
I haven been lucky enough to travel to South America twice this year for humanitarian mission trips focused on care for children with cleft lip and palate. It had long been a goal of mine, though the pandemic temporarily disrupted so much of this work. It is grueling work, hot and uncomfortable, but I’ve never felt so fulfilled. The teams are full of people who donate their time, resources, and expertise and who share a common goal. They step up when challenges arise, and time and time again put the needs of our patients before their own. It’s so inspiring to be a part of.
And the patients. I am so lucky to be a part of their care. Crowded waiting rooms full of children. Chubby babies whose smiles melt the heart of an entire room. Families who traveled hours or even days across international borders to try to access the care their child needs. You can’t help but squeeze in one more case for someone who really needs surgery, lest they have to wait another year or potentially live the rest of their life with a problem that can be fixed. It is a situation so disparate from my normal that it makes the minor inconveniences of my typical work day seem somewhat silly.
One patient in particular who sticks out in my mind was a 6-year-old girl who arrived unannounced on the hospital doorstep midway through the week, having missed the screening day during which we filled the week’s surgery schedule. She and her mother had traveled hours and hours on a bus looking for help. She had had a cleft lip repaired in the past, but part of the repair had failed, resulting in a large hole in her lip at the base of her nose. With our strict limitation of resources, we typically reserved most of the OR time for patients in need of their first surgery who were younger and struggled with speech or eating. But we couldn’t turn this patient away, couldn’t send her back home to face the teasing of school peers, which had already made a young child solemn and fearful that yet another repair would fail. So we added her on to the schedule, stayed late, pushed thoughts of fatigue and blinding neck pain to the background, because it was simply the right thing to do.
The perspective is an incredible gift, and in many ways, has buoyed my faith in my career choices. To be able to offer patients hope is the meaning of this job. If you ever have the chance to be a part of this kind of work, I guarantee you’ll get more than you give.
Have you provided humanitarian medical care? Share your experiences below.
Heather is the inaugural Facial Plastic and Reconstructive Surgery fellow at Penn State. Her clinical interests include patient communication, medical education, facial reanimation, and complex reconstructive surgery. Heather was a Doximity Op-Med Fellow in the 2021–2022 cycle as well as the 2022–2023 cycle, and continues as a 2023–2024 Doximity Op-Med Fellow.
Image by 1981 Rustic Studio kan / Shutterstock
