Dr. Sawyer in Papua New Guinea.

Dr. Sawyer in Papua New Guinea.

Tuesday, May 8, 2018

A Cup of Water...or a Night of Air Conditioning...

Last month (April 2018) I visited the home of two American nurses in Togo, West Africa.  April is one of the four hot months in northern Togo, located on the southern edge of the Sahara Desert.  Temperatures were over 100 degrees every day, with 40% humidity, making it feel like 120 degrees every day. 

At their home, they only had ceiling fans to cool them down and no air conditioner. There is a nurses sleep room nearby with air conditioning, however, it was not being used because it cost $1 an hour to run the air conditioner, and it was complicated to figure out who owed what, so the sleep room wasn't getting used. 

I posted a plea on my Facebook page asking for donations to help pay the cost of air conditioning, and in two weeks, over $8,000 came in so that these nurses could sleep in air conditioning.  Effective immediately, the AC will run 16 hours a day (8 hours during the day for the night shift nurses; and 8 hours at night for the day shift nurses) during the four hot months of the year.  Also, the hospital administrator thinks they may be able to reduce the electricity cost to 50 cents per hour, which means that the $8,000 that was donated is enough to pay for 8 years of air conditioning.  Below are some of the nurses who will benefit from the generosity of so many people. 

As I thought about this gift to these nurses, I thought about how in two of the Gospels is an account of Jesus talking about people giving even a cup of water to someone who is a follower of Jesus, and that the giver of the cup of water will receive their reward.  In much the same way as a cup of water, a night of air conditioning is even better!  Thank you.

I will be returning to Cameroon in June, to teach and serve at Mbingo Baptist Hospital.  My wife and daughters, along with two others, will be joining me for the last three weeks that I am there.

For those interested in financially supporting this work, you can go to the website below and then scroll down to the box that says, "FIND DOCTOR/MEDICAL PROFESSIONAL" and type "SAWYER, ALLAN" in the box.  If you see a picture of me holding a little girl, then you are on the right page.  Thank you!  Here is the link.

My favorite benediction reads as follows:

May the peace of the Lord Christ go with you wherever he may send you.
May he guide you through the wilderness and protect you through the storm.
May he bring you home rejoicing at the wonders he has shown you.
May he bring you home rejoicing once again through these doors.

Saturday, April 14, 2018

When doctors cry..

After a long labor, I watched the first-time mother give one last push fully expelling her first-born child. The labor had been so long and difficult that the patient was joined by the labor nurse and the doctor in the throngs of exhaustion. But as I wiped the baby and lay this precious new life on the mother’s belly, I heard not just the cry of a baby, but also the muted cry of someone standing behind me.
Earlier in my career I had hosted medical students from a nearby osteopathic medical school. This particular month I had a delightful female student shadow me. She, too, was exhausted from the long labor, and when she witnessed the birth of this baby, the first birth she had ever witnessed, it proved overwhelming for her and she began to cry. Our eyes met as I turned to see who was crying behind me, and she tried even harder to hide her tears. When we walked outside into the hallway, she apologized to me for crying. I put my arm around her and told her that I never wanted her to hide the tears and emotions of compassion and empathy from her patients; that these traits are what would make her a genuinely great physician. Over the years, she has never forgotten this encounter; nor have I.
It doesn’t take much for me to cry. Ask our daughters. It seems I cannot even watch Nemo’s father at the end of the movie allow Nemo to leave the sea anemone alone; or in the movie Wonder, when Augie’s father removes Augie’s space helmet and says to his son, “You are my son, and you are beautiful, and I want to look at my son.” (This was just one of many moments that made me cry watching Wonder.) But these examples are the tears of a father, and not as a doctor.
Looking back at a career in medicine, specifically obstetrics and gynecology, there have been a few moments that come immediately to the forefront of my memory. There were many times of what I would refer to as “doing heart surgery” where my staff and office full of patients would wait patiently for me to finish an appointment where I was speaking more to a patient’s heart than addressing her diagnosis. One such appointment was when I was meeting with a young patient who was at the end of her fight with a horrible and painful cancer. As a Christian she continued to pray for healing, but had reached a point of realization that without an incredible miracle, that this cancer was going to take her life. But like in the story of Daniel in the Old Testament, she would walk through this praising God for being God, and for being a good and loving God. Hearing her say this, I pulled open my laptop in the examination room and asked her to watch a video made by Shane & Shane. Here is the link so you can watch: https://youtu.be/qyUPz6_TciY.
Fortunately, she was the last patient of the day, and after she left the office, I went into my private office and sobbed. I cried because of the apparent injustice of such a beautiful young woman dying of cancer; a woman of incredible courage; a mother; a wife. I cried because there was nothing I could do as a doctor; as a healer; to heal her. And then I cried again as I sat at her funeral, listening to her friends and relatives eulogize her beautiful life.
But this example, like most, was a time when I cried in private. My office staff probably heard me in my office crying, but they left me alone in my grief. Looking back over my career, however, there have been some memorable and moving times where my crying did not occur behind closed doors, but rather quite publicly.
Nine years ago today, on April 13, 2009, a baby boy was born who was given a middle name that was one of my middle names. This little life would not be long in this world, as his lifespan was measured in minutes rather than decades. His story is what prompted me to write this blog today. His parents asked for me to eulogize their son, and so I set out to write a eulogy about the meaning of each of his three given names. A week later, in a church filled to capacity, I looked out over the sea of people who had come to support this baby boy’s family. As he was the son of a police officer, half of the room was filled with police officers and their spouses. I began to weave my way through the eulogy, tying together the names this couple had given their son, and bringing to light the significance of his names. But nearly halfway through the eulogy, my throat swelled, and tears flowed freely down my face. My eyes connected with the eyes of the pastor who was sitting several rows behind the parents. His lips moved and I recognized what he was saying, “Would you like for me to finish?” These seven words were gladly received, and we traded positions; he at the pulpit, and me seated behind the parents. This brilliant pastor had seen where I was going, and as if planned this way, he skillfully wove the eulogy to completion in a manner that was far better than I could have done. As a doctor, I couldn’t save the life of this baby boy, and because of my grief, I could not even finish his eulogy.
The last time that I cried for a patient was yesterday.
After having spoken to the family of a sudden and very unexpected loss, I sat alone in the counselling room and finished drafting the medical report. As I finished the last line of the report, another doctor who had helped me walked back into the room and sat silently across from me. I closed the chart and set down my pen and walked across the room and sat next to her. Seeing her tears caused the tears rimming my eyes to flow freely down my face. We sat together, prayed together, and she shared some insight into her own grieving for patients that is not for me to share. But here in this tiny room in this corner of the world sat two doctors reeling from the events of the day. It was a solemn moment; a beautiful moment; a moment that would be conducive to the healing of two healers’ hearts.
My brain wants to spiritualize this message; or to have some profound conclusion to it, but my heart says to just come quickly to a period at the end of the sentence and be finished. You can draw you own conclusion, and perhaps that is best.
Has a doctor ever cried with you?
Have you ever seen a doctor in a professional setting weep openly?
Were they tears of joy?
Were they tears of sorrow?
Please share your thoughts with me, either publicly or privately. I would love to hear from you.

Friday, December 15, 2017

The Longest Commute

My twelve-year-old Toyota pickup truck only has 63,000 miles on it, mostly because my commute for the past 12 years has been a half-mile from my house to my office.  Then it was a mile from my office to the hospital. Then a half-mile back home from the hospital. Typically I would drive about 2 miles a day. I filled the gas tank of my truck once a month, and generally lived my life inside a one-mile radius.

Then, last January, after selling my ob/gyn practice, my commute changed from a half-mile to thousands of miles.  This coming January I will once more commute to West Africa, to teach African surgeons how to do the surgeries that I do, and to help them use their medical and surgical skills as their ministry to their patients.

If you are reading this, then you have likely helped to support me with these endeavors, and I am extremely grateful to you. This year I am scheduled to make at least three, and possibly four extended trips to three (or four) different hospitals in West and Central Africa. Inside my luggage for the first trip are three complete surgical trays, two for doing cesarean sections, and one for doing abdominal and pelvic surgery. These are brand new German stainless steel surgical instruments, of the highest quality, that will be used for decades. 

I'm extremely grateful to each of you who have helped me to go and to serve and to teach. Know that you are making a difference in the world, one patient at a time. The education that I will provide to these doctors, and the surgical instruments that I will bring, will continue to serve these communities long after I have left. 

If you would like to be a part of my team, you can follow the directions on the left side of this blog. I would welcome you to vicariously be a part of my work in developing countries. 

Thank you, and blessings to each of you, and Merry Christmas!

Thursday, June 15, 2017

Mango Trees & Motorcycles

Mango Tree with Ripe Mangos
Mango Trees and motorcycles just don't seem to belong in the same sentence, unless you are reading an article about things that motorcycles crash into, in which case mango trees would likely be on the list, at least here in Cameroon.

As you might imagine, if you were at a mission hospital joining the surgical team on morning rounds, you would expect to hear about what the on-call team had done the night before.  And so it is here at Mbingo Baptist Hospital.

But after a month here of listening each morning to surgical rounds, and also enjoying the incredibly delicious ripe mangos that are grown here, there seemed to be a connection between the ubiquitous presence of motorcycles and the tasty mangos that were being devoured at mealtimes.

Nearly every day surgical rounds go something like this.  The intern would show a series of  PowerPoint slides and discuss each admission:

Case #1: 12 year old boy with broken arm after falling from mango tree
Case #2: 42 year old male with spinal cord injury after motorcycle accident
Case #3: 14 year old girl with broken leg after falling from mango tree
Case #4: 49 year old woman with diabetic ulcer
Case #5: 24 year old male with depressed skull fraction after motorcycle accident
Case #6: 27 year old male with broken leg after motorcycle accident (hit Case #5)
Case #7: 8 year old boy with laceration after falling from mango tree.

This list is fictional, but still representative of the types of admissions that come in every night at Mbingo Baptist Hospital in Cameroon.

So, finally I raised my hand and asked the surgical team, "Are mango tree injuries seasonal?"  The room erupted in chuckles as everyone agreed that, yes, indeed, when mangos are in season, mango tree injuries increase in frequency.

I knew that motorcycles were dangerous, but I never imagined that morbidity from mango trees could occur with as much frequency and regularity as motorcycle accidents, at least during mango season.

And now you know how mango tress and motorocycles are related!  

Wednesday, May 31, 2017

Saving Lives One Image at a Time

Doctors need good information in a timely fashion to make decisions.  In obstetrics, general surgery, and critical care, even minutes can make a difference in determining whether a life is saved or not.  The availability of bedside ultrasound for rapid assessment in critical areas such as the ICU, emergency departments and labor & delivery units has become more of the norm now than the exception.  Obstetricians certainly rely more on ultrasound than on a stethoscope!

Over the past year over 150 people contributed toward this beautiful, brand new, Sonosite M-Turbo ultrasound machine with two probes.  One probe is for doing obstetric and abdominal ultrasounds, and the other probe is a critical care cardiac probe which allows bedside cardiac, arterial and venous assessments.

Finally, after the efforts and generosity of so many people, this ultrasound has found a home in the ICU at Mbingo Baptist Hospital in Cameroon, West Africa.  Here is has easy rapid access to the doctors working in the ICU, surgery and obstetric wards and is available 24 hours a day!

As of a few weeks ago, the ultrasound was 88% funded, and I will receive an update on June 1st to find out if it is fully funded.  [Based on the initial response of so many donors, we proceeded with the purchase even though all of the funding had not come in.]  The ultrasound itself is the size of a laptop computer, and I brought it on the plane to Cameroon as my carry-on.

Truly this ultrasound will aid physicians here to make better and quicker decisions, and it is appropriate to claim that lives will be saved "one image at a time."

Thank you to everyone who helped to make this happen.  You have made a difference in the world!

If anyone would like to still make a contribution toward this project, or towards the work that I do with Samaritan's Purse in developing countries, you can do so at the link below this paragraph (you may need to copy and paste it) and then scroll down to FIND DR./MEDICAL PROFESSIONAL and type my name "SAWYER, ALLAN" in the box.  All funds are placed in my ministry account and will be used for supporting my work in mission hospitals around the world through Samaritan's Purse.  Thank you.  Bless you! You have made a difference in the world!


Wednesday, May 24, 2017

Thank You is the only Payment Accepted

Who would have thought that a computer network engineer, a wound care nurse practitioner, an infectious disease physician, a cardiac anesthesiologist, and a obstetrician/gynecologist could be such a great combination to bring to a mission hospital?!

Last year I invited (or challenged) these friends to come with me to Mbingo Baptist Hospital to experience Africa from a new vantage point and to give freely of their time and talents to the work at the hospital.  Their respective skills were all very important at the hospital.

We were very grateful to have a cardiac anesthesiologist here to teach the nurse anesthetists how to care for their patients.  In this particular case, his involvement and expertise were especially appreciated by everyone.
Each team member not only utilized their skills and knowledge, but also took the time to teach others.  Here the internal medicine residents are listening to our infectious disease physician giving a lecture; however, she also attended their conferences and attended patient ward rounds to discuss the infections that they saw.

Mbingo Baptist Hospital is also the referral center for the entire country of Cameroon for care of chronic wounds, leprosy wound care, and rehabilitation from amputations.  The wound care department is extremely busy, and our wound care nurse practitioner helped to educate on new techniques, and also helped to relieve the workload.

The hospital is also nearly ready to open a new building which will hold the entire outpatient department.  It is also nearly ready to implement a computerized medical record system.  With these two tasks on their agenda, the timing of bringing a computer network expert was incredibly helpful.  Fortunately, thanks to the Internet, he will be able to continue to assist remotely as the hospital moves forward.

Personally it has been great to have these friends with me here on this trip.  Not only have they been great to have here from a professional standpoint, they have been a lot of fun as we have explored the mountains around the hospital and have spent many hours together at meals and in the evenings.

[Their names have been purposefully omitted out of a security concern.]

Sunday, February 19, 2017

Finishing well in Togo.

The Hospital of Hope is the Mayo Clinic of the northern part of Togo, serving people throughout this region, including Togo, Burkino Faso, Ghana, Niger, Nigera and beyond.  As many as 28 languages are spoken daily at the hospital, requiring an entire department of translators.  The translators seem at times to be in bigger demand than the doctors, nurse practitioners and nurses.

The challenges of communicating can sometimes be more demanding than the art of medicine.  As my nurse and physician colleages can see on this vital sign temperature graph, the diagnosis could be a bacterial infection, or a viral infection, or perhaps a parasitic infection.  Well, in this case it is all three.  Post op infection plus malaria plus chicken pox.  And yet, because of language barriers, I am completely dependent on the nursing staff to communicate with this patient, because the only gestures she understands from me is the smile on my face, perhaps a nod, and a gentle touch.  

Although lately it seems as if the diagnosis is always either just malaria or malaria plus pregnancy or malaria plus pneumonia.  Even though we are in the dry season and malaria is "less" common now than during the rainy season, it seems that we are treating malaria on nearly every patient.  I actually thought I was getting pretty good at diagnosing malaria until one of my surgeon colleagues here laughed out loud and remarked, "that's because everyone has malaria." My ego was quickly deflated with the realization that he was absolutely correct.

As for wait times to be seen at the hospital, could you imagine going to a hospital that is a long way from home and then camping out in front of the hospital to hold your place in line?  If you leave your place in line then you have to go to the back of the line.  And then, depending on how serious your problem is, if it is not so serious, having to wait for several days camped out in front of the hospital?

This reality reminded me of when a Chick-fil-a restaurant recently was opening near our home at 59th Avenue and Thunderbird Road in Glendale, Arizona, and they announced that the first 100 people through the door on opening day would receive free Chick-fil-a for a year.  People started camping out for two or three days before the restaurant opened.  But that is a restaurant and not a hospital.  But as word of the excellence of this hospital spreads across the region, people are coming to the hospital in buses and vans and bring dropped off in front of the hospital in hopes that they can be seen by a doctor here.  The needs are overwhelming.

We just continue to see patients; caring for the patient that is in front of us at the moment; loving them and serving them.  We strive to bring not only physical, but also emotional and spiritual healing as well.  We treat the whole patient and not just their physical needs.  Often these appointments end in tears, not only for the patient and their family or friends, but often also for our own team members.  No tears were held back recently when a young child had lost it's mother due to an acute viral syndrome, leaving this child without a source of breast milk, and the challenges that such a problem creates in a society such as this.  This was a difficult situation to fathom, and struck a blow to the hearts of the health care team members caring for this young mother and her baby.

Behind me in this last picture is the "waiting area" by the front gate of the hospital where people camp out for days waiting for their chance to be seen.

This is the front entrance of the hospital.  The patient waiting area is behind me to the right.  This is a dry and dusty place during the dry season, and then green and muddy during the rainy season.  It has been my pleasure to serve here and to try to bring health and healing to these people and to serve my colleagues who work here full time.

In just a few short weeks I will be returning home to my family. It has been difficult being away from them for the past month, and I still have a few more weeks to go.  However, I have cherished the opportunity to serve here for this season, and pray that I have served here well.