Scootering around with black widows


Thanks to Sriwilai and Lit, just a couple of Niramin and Rohith's many amazing family members here in Huay Malai, as well as a couple of our saviors since we've been here in Thailand, we now have wheels! Lit and Sriwilai brought the bike to us before we left for Vientiane, but until this past weekend we hadn't ventured more than 10 minutes down the road. So after rounds and clinic on Saturday, we decided to venture to the big city of Sangkhla Buri for our first solo trip out of Huay Malai. Luckily, the road between Huay Malai and Sangkhla really is amazing--better than a lot of the roads I grew up driving on in western Maine. But, new for us is driving on the left hand side of the road, wild dogs everywhere, hilly and windy jungle roads, and, for Chris, manually shifting up and down all those turns and hills. He did an amazing job though and we made it town, albeit somewhat slowly, but safely. (We thought we were bad ass going 45 mph the whole way, but we later realized we were going 45 KILOMETERS or more like 25 mph..such daredevils.)

Our day in Sangkhla was lovely. We got pizza, stocked up on supplies ie yogurt, bread, crackers aka carbs, and we also found this guy on the left pedal of our bike:
YES. That is a black widow spider. Sorry for killing you spider, you scared me. 

Just as we were getting back into town, a 16 year old patient who had been involved in a motorcycle accident while drinking whiskey arrived in the ER. He unfortunately did not make it out unscathed: 
I think that's a femur fracture. oops. 

  Complete right great toe amputation, before (top) and after nerve block and local anesthesia/debridement. 

 The magician, Dr. Jen, at work. 
 The end product. Voila!

Jen has since taken him to the OR today for ORIF with screws and plating of his femur fracture. 

Needless to say, Saturday was an eventful day. And since then there has been quite a bit of excitement here as well. A group of Singaporean plastic surgeons are visiting us for one week, donating their time and money to pay to perform plastic surgeries for Burmese refugees who would not be able to have these done elsewhere. They've performed numerous cleft palate repairs, soft tissue excisions, extremity contracture repairs, etc.  It's been amazing to see how much can get done in such a short amount of time. 

In the background of all this, there have been a lot of changes at KRCH, that I won't go into great detail about, but what I will say is that many of the physician staff have decided to stop working here due to financial issues, thus bringing our staffing down from 8 doctors to 4, as of yesterday. In addition to this, Jen, Chang Noi, and Thew (so the three other doctors besides myself) are gone tomorrow, so while the plastic surgeons are running the show in the OR, I'll be the hospitalist, family physician in the outpatient clinic, and the ER doctor if any emergencies come in during the day (or night). Graciously, one of the doctors who is still here but will be ending her contract shortly has offered to work tomorrow to help out, so at least one of us will be able to communicate in Thai... fingers crossed!

My last patient of the day after I pulled out his two left front teeth. I should have gotten a before shot of those beauties!



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