The Internet Paves Way For Doctor to Help out in Homeland

As we were getting ready to walk out of the clinic for lunch, a scene like one from a movie unfolded. A helpless mother from a neighboring village came in carrying her 27-month-old daughter who was minimally responsive. The child had a critical neck swelling, which was keeping her from breathing normally. After a one-minute evaluation, we immediately took her to the operating room for an incision and drainage of the mass on her neck. Within moments of draining the mass, the child began to breathe easily and was obviously going to make a full recovery. I thought to myself, this was the most rewarding “lunch break” I ever had.

Shortly afterward, we headed to the adult hospital. There we saw a 60-year-old patient with a painful swelling on the floor of his mouth, which he had been tolerating for the past three months. It looked to me like oral cancer. He, also, was going to need surgery.

Over dinner that evening, we reviewed all the patients we had seen that day and mapped out our approach for the rest of the week. Over the next four days, Vahanyan and I operated on 20 patients and averaged 12-14-hour days. We performed multiple cleft palate cases, cleft lip cases, removed several oral and neck tumors from adult and pediatric patients, performed cleft lip revisions, removed one set of wisdom teeth and even did a bone graft from the hip to the oral cavity for a patient with a defect in the upper jaw. There was no air conditioning in the hospital and the temperature would reach the low 90s at noon. The nurses had special sterile instruments to dab our foreheads so we wouldn’t contaminate the field with our sweat. The hospital water occasionally ran out and the operating nurses had to rinse our arms and hands with small buckets of water after we scrubbed. I was operating with instruments I thought didn’t exist anymore. Despite all this, things went as smoothly as they do in our pampered operating rooms in the United States. I learned quickly that as long as you have the skill set and will, everything else falls into place.

My only regret is that I could not stay longer. On my last day, I was proud of our work, but wished we were able to treat more people. There were close to a dozen patients who still needed surgery — a reason to return in the near future. I hope that the surgeries we performed will make life for our patients a bit easier and I hope some of the skills I passed on to the staff will help them treat patients for years to come.

Perhaps most importantly, half way across the globe, I found a good friend and excellent colleague in Stepanakert. The exchange of knowledge and experience between us taught me lessons that no modern day dental or medical school can teach. The only major disagreement between myself and Vahanyan that week was the endless debate over the check after every meal.

(Dr. Armond Kotikian is a Los Angeles-based oral and maxillofacial surgeon.)