As written by Carol on the Plasticos Blog –
Happy Halloween, From Bhutan
Burn Camp, Day 6, Monghar, Bhutan.
It is Halloween in the USA and here in Bhutan Guru Rinpoche, the mischievous and multi-incarnate spirit credited with bringing Buddhism to Bhutan in the eighth century, seems devilishly busy. Just after one AM we are awakened by a 4.3 earthquake centered twelve kilometers from our hotel. Despite this omen, the first two burn scar surgeries go smoothly, but in the middle of the third (around midnight in California) there is a loud POP and all our electrical equipment—cautery, tourniquet, monitors—spark and go black. After a flurry of pushed switches and flipped fuses we are reconnected, but a moment later the anesthesia machine lets out an ungodly shriek when some gas erupts from a loose hose. The dials are stable and the technicians shrug, so we proceed.
We are more than halfway through our last long day, heading for lunch, when the stand-out case of the whole trip comes in. In the third OR, staffed by a Bhutanese team, a squirming toddler is half anesthetized, surrounded by eight to ten adults, one of whom, an “ENT technician,” has a slender forceps burrowed deep inside one tiny, bloody nostril. Apparently the child was scooping water from a stream when he scooped up a leech, which managed to latch itself inside the baby’s nose. He was raced to the hospital but just as the ENT got the forceps in position, the leech slithered out of sight. .Having lost our appetites we abandoned lunch and intubated the toddler. Then Larry placed a pediatric foley cather then blew up the balloon in the nasopharynx to push the critter out but to no avail. Carol and Sam finally made good use of the pediatric bronchoscope we’d brought along for any difficult intubations. Alas, a thorough search of the nose, palate, trachea and esophagus yielded no black, slimy sucker, so the child was awakened and sent to the ward. Luckily the traditional medicine healer had a proven plan: deprive the baby of all water for twenty four hours. When the leech becomes thirsty, tempt him out of whatever secret body crevice he is hiding in by putting drops of water below the baby’s nose. Have forceps at the ready.