Dr. Ormsby Trains Resident Plastic Surgeons in Egypt
Rarely in a lifetime, an opportunity arises that has one throw caution to the wind and do something that may be really fruitful, but entirely terrifying. Last year I was asked to train two surgeons from Egypt in my office with my patients and my practice. It is a delight for me to teach that which I truly love, and I was more than overjoyed to have a talented, bright student on my heels, to encourage and to motivate. Imagine having an interested young man who would read the chapters marked as important, and return the next day with written questions. Any professional would jump at this opportunity. The sense of volunteerism as well as the potential to improve the skills of someone trying as hard as possible was irresistible to me.
So there passed a half year of language challenges, cultural and professional differences, as well as another gender perspective. It appeared to me that the value to them was enhanced by all the textbook and journal article readings and assignments that I made available to them and discussed with them with notes and drawings. I eventually learned that these two surgeons were overwhelmed and extremely appreciative for what I had made available to them. They were so grateful that they returned to their homes with rave reviews, glowing reports and requests that the military hospital system bring me to Egypt to teach them and provide training to their plastic surgery residents. The process of traveling to Egypt began with multiple documents submitted, assuring them that my certification for plastic surgery was in order.
Furthermore, the tensions in the Middle East had escalated, sometimes resulting in violence, which greatly disturbed any reasonable decision to travel to Egypt. A military escort was to be provided at all times, and a traveling companion, who would easily translate from Arabic to English, was available and would be accompanying me with all expenses paid. Of course I was the uncomfortable party, unaccustomed to not only overseas travel but teaching on this level, as well as the conditions that I would face once in Cairo.
When the time came for me to leave, I was recommended to take my specialized instruments – those probably not available outside my specialty. Little did I know that almost all my instruments would be needed as the ones provided were mostly inadequate for the surgeries I was expected to perform.
Three weeks before my departure, I was notified that I was expected to lecture to the attending physicians, administrators and residents on three occasions. Preparing these talks vastly impacted my preparations for travel, but I worked diligently bringing my packed thumb drive and lecture attire.
Upon my arrival, following a day of sightseeing, I had a day of clinic, examining some 50 patients requiring write-ups of diagnoses, prognoses and treatment plans. The next day some of the patients appeared for surgery, and the residents watched, listened and learned. I had several patients for surgery including:
The next few days included clinic and surgery on patients who were selected from the clinic day; they were prepared for surgery through hospital admission the night before, had surgery the following day, and were discharged home about a week after surgery. The two weeks in Cairo passed very quickly with this kind of intense schedule. Other surgeries that were performed included: otoplasty (ear prominence reconstruction) on a 10-year-old girl and the same surgery on her father the next day, rhinoplasty on a young woman, and breast lift on another 40-year-old slightly overweight woman.
During clinic hours, the most prominent problems noted were overly large noses, obesity, scar deformities from burns or trauma and associated problems. It was important to carefully explain all diagnoses to the residents and to outline a plan of treatment for every patient. The patients from clinic were, without exception, very courteous and respectful with every effort made to speak English or obtain a translator from Arabic. The residents were fluent in English, making the teaching much easier for me. Of course the physician attendings spoke excellent English, but the nurses and hospital helpers spoke no English. So language barriers were challenging but with patience, surmountable.
The hospital system ran efficiently but lacked many of the instruments to which I was accustomed. The anesthesia department was attentive and delivered general anesthesia almost without exception. The residents were interested, worked hard and seemed diligent. I was asked to work much harder in Egypt than I am asked to at home, but the patients are much more numerous, seemingly unending and eager to be seen by the “expert U.S. doctor”. As a result, the demand for my attention to care for patients as well as to teach residents far exceeded my energy and expectation; but everyone was so appreciative that it made up for my exhaustion. The one lecture I was asked to deliver was not so well attended, but I do think that the time to advertise was limited by the many delays in my departure from home. I very much enjoyed the teaching that I was able to deliver, as well as the care that was so vastly needed.
I must say that I have never met a harder working group of people than those from Egypt, and just keeping up with them was a huge effort. I learned that there are no more hospitable, gracious, respectful and courteous people in the world, and the generosity offered far exceeded my expectations. Although there was a constant military presence in my transportation and at the hospital, and there were frequent searches and surveillance, I never noticed any unrest or violence. Upon returning, I would offer the limitation of an 8-hour day, more frequent breaks and more specific, specialized instrumentation. I am so grateful for the opportunity to visit this wonderful country and for the shared information in my specialty.
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