Day 2
Technically day 1 of my elective. Had a really good rest in motel room 6, the same room I stayed in 2.5 years ago. Certainly does bring back a lot of memories. Good cold bucket shower o start of the day, followed by amazing bubur ayam for breakfast and “spiritual breakfast”. Pak ayub, who was visiting the hospital and teaching about management gave us a talk on the fuel of leadership, burning out and keeping love for god first, using Elijah and peter’s recomission as examples. Very apt for the start of electives.

Morning report next. Some interesting cases. Late presentations are the norm here. Followed dr tatie and dr vivy around to see patients. Very wide range. Few babies. 35 weeks is so fragile out here. Pre-eclampsia. Saw a baby with skin looking exactly like scalded skin syndrome- the only thing was he’s newborn. Other pts- stroke, hernia (had huge hernia for many years but only presented recently when it was painful. Thank God it was not strangulated.) pneumonia w ?lung ca (?breaking bad news in rural setting with indoesian’s quite different) mennorhagia  and pcos an anemia with prolonged pt (underlying diagnosis not known-lacking resources-cannot do tests for clotting factors) bleeding post-prostatectomy (no TURP here, open prostatectomy comes with many complications in the elderly).

Went to theatre in he afternoon to see  the most dramatic surgery I’ve ever seen. As I sai, late presentation is common. With much work to do and staying so far from the hospital, many patients put off presenting until things get unbearable. Lady in her 30s came with basal cell carcinoma which brought a whole new meaning to “locally invasive”. Superficially, the upper border affected was the lower eyelid, lateral border just medial to left ear and jawline, inferior border chin, medial border nasal septum. Ulcerated so badly that you could see the conchae, the maxillary sinus, bits of bones, tongue, and her teeth were maligned because of the tumour. In non medic term, about half the face was affected. 3.5 hours for a WLE of BCC which had to include enucleation. Her eye appeared fine but tumour invaded posteriorly. She could not open her eye prior to surgery due to the bulk of the tumour. To ge plastic surgery some time post-op but I really wonder how much can they reconstruct. 

In short, today really hit home the reality of a rural hospital esp late presentaions and the lack of resources. Bmh is relatively well equipped compared to many. But there’s just so much more that can be done.

Non medical things wise, ppl have been really nice. Was very nice to meet up with all the ppl I met last time, and refreshing to see the new ones. They are all so enthusiastic and so willing to serve despite many of them being far from home, leaving many comforts there. Cheerful smiles and big hearts everywhere. 

Prayer points:
Pray for a blessed, productive elective, for me to learn about medicine, missions, life, and most importantly God

Pray for the good work done here to be blessed and to continue to touch many lives

Pray for the hospital. It’s undergoing accreditation by he government. If this goes through, foreign missionaries can apply for work permits

Pray for building of relationships. I’m what they call a passive Indonesian speaker and a lot of them call themsleves passive English speakers: meaning I understand them but can’t speak their language well and vice versa, so conversations have been a bit “constipated”. Despite that, they are real nice so I’ve got to know quite a few of them.

Pray for protection. It’s banjir season so saw lots of stagnant water on the way here. Mosquito transmitted illness alert!