My last week in Durban (27 October - 2 November)

After all the hype of the weekend- going out dancing and getting crazy- we had to return to King Edwards for one last week of work before we went down to the Western Cape and all it had to offer. Although we had been in Durban for so long this week proved to be the best one so far, and, I think the best one I had in South Africa.

So somehow I wrangled my way into going out with the paramedics on Monday. Awesome!! I got there and met a guy named Marcus, the supervisor of the hub that I showed up to. He taught me quite a lot of interesting things about the history of SA as well as the various names for the emergency codes. Apparently the South African version of an MCI (mass casualty incident) is called an 'Echo-Delta'- he worded it as 'the sky is falling'. I'm totally going to have to put together a SA glossary for all the random phrases and abbreviations I learned. Anyways, I digress. After hanging with Marcus, I immediately got placed with an ALS paramedic named Maihen and we went out on a call for a inter-hospital transport. We sat there for like 2 hours before the guy was stable enough to be moved, but thank goodness it was blue sky sunny or I might have went crazy. After that we went to the Airport and visited the crew of Air Mercy, the SA equivalent of Life Flight. I got to see the helicptor and the plane as well as play some ping pong with the crews! Such excellent guys, it was a shame I was only able to go one day. Other than that, the day was slow. Check out the photos!

Tuesday was probably my favorite day in the whole South African trip. Tuesday morning we returned to IAL and met up with Dr. Rajaruthnam in cardiothoracics. Leanna and I immediately got taken to the operating theaters and dressed down to go into a Coronary Artery Bypass Graf (CABG)- pretty much a double bypass open heart surgery. We arrived in after the sternum had been sawed and the chest cavity was exposed. All I can say was that in the four and a half hours we were there watching, my head was spinning for three and three quarters of it, and then 45 minutes of me starting to figure out what was going on. It was incredible! They hooked the patient up to bypass and drained the heart, it was like a balloon deflating, then another doctor starts cutting the leg! I was like uhh, but then the surgeons explain that they use the saphinous vein from the leg for the bypass as there has not been a suitable artificial one created yet. Crazy huh? Apparently veins are there in sufficient number to just take one and tie it off. But anyways, it was just amazing to see the intricate suturing of a vein to the heart, using these near-microscopic needle and thread. When he got the vein sutured to the heart, they would re-inflate the heart to check the seal, then rapidly deflate it to continue. Just amazing. After what felt like 20 mins but was actually an eternity, they successfully restarted the heart then began the closing sequence. While the second surgeon was finalizing the suturing of the chest, the main one showed us an angiogram of where the blockage had occurred. As he did so he kept looking over at a panel of stats on the patient and all of a sudden he froze and stared- the patients arterial pressure had suddenly dropped to 55. He immediately started walking over to the patient holding up his hands and sharply ordering the other surgeon to 'Re-open!'. By this time he had already taken off his gloves and gown and was waiting for the sisters to re-prep him. In literally less than two minutes the patient went from fully re-sutured and bandaged to completely open, heart exposed and all. There was nothing quite like it; in that two minute window the intensity level of the OR skyrocketed and we really got to see what it took to be a professional heart surgeon. Cool, controlled, and with no hesitation whatsoever, the head surgeon took over and placed a stint in the patients femoral artery to stabilize the pressure. I have to say that seeing this procedure and the control and management of the problem after was the high point of my trip. It can get repetitive and stressful going to class everyday and studying for hours and hours every week, but moments like this one make you remember what exactly it is you are working for.

The rest of the week we spent at a TB and HIV class for the sisters at St. Marys. It was quite slow-paced but I did get some interesting statistics on SA and Swaziland HIV prevalance.

Friday: TO CAPE TOWN!!