these get longer & longer each time...take in bite-size readings, if you have to...enjoy the last part of the unedited preview of my book...
Assisting
eye-surgery--Obubra, Cross River State, Nigeria, March, 2000
Probably one of the most rewarding experiences of my entire life thus far…I had
the honor of assisting doctor Lanre in the surgical procedure of removing
cataracts from patient’s eyes during what was to be my first "medical
mission" with Family Care Nigeria….I know, it sounds highly impressive…
No, “doctor Whyte” did not administer the anesthetic, nor hold the scalpel or
make an incision of any kind. My job was simple--to hand the doctor his
surgical tools from the table & to water the cornea with serine. The
procedure went as follows:
a)
Patients were screened by a doctor in general consultation & if a cataract
was present & the doctor recommended surgery, the patient was sent to the
eye-surgeon where I was eagerly standing by to assist…J
b) 1
of the nurses would talk the patient through the procedures to take place &
would give them a series of tranquilizers & general anesthetics…it would
typically take about 20 or so minutes for this initial set of anesthetics to
kick in, so this was being done while the previous patient was in the last
stages of surgery…
c)
next the patient was led into the operating room where the surgeon himself
would massage the patient’s eye while the nurse would prepare the materials to
be used during surgery…I asked Dr. Lanre why the massage was being done &
was told that the eye is a series of very complex but also very tightly bound
muscles…if the eye is not fully relaxed when the initial score is made into the
pupil to remove the cataract, the eye’s inner muscles would immediately (as
well as irreparably) spill out on the scalpel’s impactful incision…
d)
after the 10-15 minute eye-spa was complete, the patient would then be given an
intensely localized anesthetic via a serum straight to the eye…this was the
first real shock I noticed in each of the village patients that took to the
surgeon’s table...No amount of doc’s explanation/reassurance can fully prepare
you for a 6-inch needle going straight into your eye.. I’m clearly not a doctor
& clearly the needle doesn’t go into the eyeball itself, but rather to an
adjacent muscle directly next to the eye…the interesting thing is that while
pain has been dulled through the general anesthetic, the patient is still
feeling the needle being inserted, as this is the instrument by which the local
anesthetic to the eye is being given…you can imagine the occurring reaction...
This
only takes a minute or 2 to kick in & within 5 or so minutes of the needle
going in, the doctor is ready to create the incision into the eye…
I can
still remember the bewilderment in expression on each of the village patients
as the clip was put on the eye to hold back the eyelids, as well as when the
bright surgical lamp was placed above the eye…(almost as though your human
instinct would help you blink back & shut out the light, if only you
could)..
What
was curious to me was that while the patient’s entire body was sedated
(partially) & the eyeball itself fully numbed to any pain, the patient,
while avoiding any feeling of the surgical procedure whatsoever, was very much
awake during the whole process & could, of course, see the whole operation
being done from the fullest “upclose” vantage point…fun.. J J
e)
surgeon creates incision into the eyeball
f)
special assistant to doctor Lanre, Brian Whyte, performs vital “assistant
duties” aka “Serine on the Cornea”; If I live to be a 1000 (not likely) &
never see another eye-surgery take place (likely), I’ll never forget the phrase
“Serine on the Cornea”…This was in fact the principal reason for my existence
in that operating room…while the nurse assisted in the surgical procedures, my
job consisted of handing the very sterilized instruments to the doctor with my
very sterilized/gloved right-hand, while my left-hand would (& most
importantly) every 15 seconds spray the cornea with a solution (whose surgical
name I don't remember, but all I remember hearing is "Serine") from
the needle I held…The reason nurse would so implicitly remind me to squirt said
solution on the patient’s eye was because not only was the natural process of
the eye’s hydration through blinking being severely hampered (with a clip
holding your eye open), but the surgical lamp with a wattage of God-knows-what
was beaming down directly onto the naked eyeball…so if I were to not hydrate
the eye with this serine solution, the eye would risk severe burning…I felt
quite valuable to the whole procedure in that case…
“Serine
on the Cornea indeed, nurse!!…remind me as many times as needed!”…
g)
While all this is going on (& this part equally vital to the surgery itself),
Dr. Lanre took the time to speak to each patient individually about their souls
& their relationship with God…He didn’t miss even 1 chance to share with
each one the Good News of God’s Son, Jesus, coming to earth specifically to
show His love for them personally (the person on the operating table) &
give His life for each of them…It was the most awesome experience watching
& listening, as doctor Lanre was removing a lens from their eye, he was
also speaking into their Spirit & giving not only physical-sight remedies,
but “spiritual-sight” remedies as well…many of the patients had already known
Jesus & yet others (in this remote part of Africa) had not yet been granted
the joy of hearing the Gospel…these gladly gave their hearts to God in praying
with Dr. Lanre to receive Jesus Christ as their personal Savior right there on
the operating table…I was impressed with his sense of urgency in this, as we
all realized that he most likely would not be seeing them again anytime
soon….(Obubra was a ways from Lagos)...
h) the
entire lens is popped out & is replaced with a new intraocular lens? At
this time, being that this was 12 years ago, certain details of this surgical
procedure escape me, but in researching details of a typical cataract removal,
it seems the standard procedure is for an intraocular lens or IOL to be
inserted into the eye using a small fuse…again, whether or not this was done on
each patient at this free health camp in the middle of rural Obubra, Cross
River State, is no longer accessible by my mind’s “intraocular lens”…however, I
do remember each patient being given a fat pair of “eye-glass” (pidgin English
for glasses) right then & there in the operating room after we completed
surgery…so I’m guessing they didn’t have a lens put in their now “lensless” eye
after the cataract was removed, but rather were given glasses to perform the
function of focusing for them…
i) The
eye is stitched up with needle & thread…quite literally, accept this thread
is called_____(still looking that one up)
j) Post-operative procedures take place i.e. clip taken off the eye, etc.,
patient is given glasses, surgeon discusses the prescription of painkillers/eye
vitamin’s, etc. & patient is then referred back to the optometrist, who
gives the patient a more specific prescription “eye-glass” so patient’s vision
is as focused as can be made possible without the natural lens (or without
laser-surgery)…patient is also given instruction to return to a local general
hospital where, several weeks from the time surgery was done at our free health
camp, the stiches will be removed...
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