Triage Day for the Huebner Team!

Posted on: 05/12/2019

Author: Sally Kolenda

Our patients on triage day

Triage day is one of the busiest days of the trip. For an interpreter, you’re busy from start to finish. This is my 11th trip, and I always support the gynecology team – my dad, Dr. Gene Huebner, and adopted grandfather, Dr. Harold Daily. It’s a well-oiled machine and truly one of my favorite parts of the mission trip. We meet women from all walks of life and evaluate them to determine if they are good candidates for surgery this week.

I jump out of bed to quickly get ready for devotional, where Caitlin McClanahan, a circulator, and I lead praise and worship.

“Did you sleep well?” I ask Mikki Wilson, a circulator and my roommate for the trip.

“I feel so much better,” she responds and then asks, “What are you doing?”

“Nothing in my luggage makes any sense. What was I thinking when I packed?” Fortunately, Mikki has known me since high school and is prepared. She helps me put together a coherent outfit. Thank God for a friend like Mikki.

We arrive on time for devotional. I see Caitlin seated in her usual spot and see Joel’s spot open. Joel Bacon is my dear friend and has been the photojournalist on our last two trips. Caitlin and I had already commiserated the night before when we practiced a song for this morning.

“It’s not the same with just two parts,” Caitlin declared after we struggled through Step by Step, a song we used to sing for our call to worship. In our exhausted state, we opted to sing Trading My Sorrows and sleep. “We can figure out something else tomorrow,” she offered before heading back to her casita.

I take my place next to Caitlin, and remember that, in Joel’s absence, my parents decided I could also be the photojournalist. Yikes! How does that change triage day?

Caitlin and I sing. We know most of the lyrics, but the team collectively agrees that we can improve on today’s effort. That’s what happens when you’re singing for your parents and friends – they tell you the truth.

Evan Huegel is our chaplain this week. It’s his first time on our team, and I’m excited to hear him preach. His plan is to walk through the biblical narrative and show how applicable it is to our lives today. He starts in Genesis and talks about the nature of God. “From chaos and wasteful situations, He brings good – because that’s who He is,” he explains. “The same is true for doctors and nurses – you bring good into the lives of people and the world around us, which magnifies God’s goodness.” Powerful!

Devotional wraps up, and I see my dad. “I can’t triage with you today,” I say slowly.

“Why not?” he quips.

“Because I’ve got to take photos and write a blog – remember?”

I see a panicked look come across his face as he realizes the fatal flaw in his plan. “You can use last year’s blog,” he replies, only half-kidding.

“I can’t. Everyone would recognize Joel’s writing. I have to take photos, and I can’t be in two places at once.”

“You can use last year’s photos,” he offers. I’m starting to think he’s serious.

“I can’t,” I say as my mom approaches. “Mom will have to translate for you.”

“I have to unpack instruments and prepare the ORs,” she says. “We can find another translator.”

“But we have a system. You can take a couple pics in the morning and then come translate.” Gene is really grasping at straws now.

We begin our walk to the Obras, the hospital where Faith In Practice teams operate in Antigua. The patients are waiting for us. We start the morning by praying together – doctors and nurses alongside patients and families. Evan leads a beautiful prayer in English and Spanish. We put the entire mission in God’s hands. I always admire our patients’ faith. They know that God is their source, and they trust Him to act on their behalf. Although we come to provide medical care to the Guatemalans most in need, when it comes to faith, we are often the ones lacking.

I carry this thought with me as we listen to hospital orientation and head to the triage rooms. I see my dad and Dr. Daily in the hall. Dr. Daily is 93-years-old, and my dad has been working with him since he graduated from medical school. He still assists my dad with cases at home.

This year, Dr. Camille Boon, another gynecologist, has joined our team and will be triaging with my dad and granddad. Terry Beckham, first time interpreter, meets us at our room. She’s available to help the GYN team. We enter the room together – the perfect chaotic storm.

Our nurse calls the first patient. I tell Gene my plan is to show Terry the ropes for the first couple of patients. Dr. Boon says she speaks “gynecological Spanish,” which is music to my ears. Terry is a native speaker, and Dr. Boon knows medicine. This just might work!

I explain to Terry that there are two rules to surviving the day with Gene.

  1. Focus the conversation on the patient’s medical history.
  2. Make sure he gets his champurradas, the Guatemalan cookies passed out to patients and volunteers during triage.

The patient enters, and we get right to it. After 10 years triaging GYN patients, I’ve gotten pretty good and fancy myself a pseudo-gynecologist. I ask her why she’s come in today, and she says because someone called to tell her she had an appointment. Strike one, Sally.

Dr. Boon asks about her medical history. After the patient responds, she translates back to Drs. Huebner and Daily in English. But instead of translating exactly what patient says, she uses her doctor brain and shares the relevant pieces of information to a gynecologist and uses the correct procedural terms, too. Strike two, Sally. I watch my pseudo-gynecologist status fly away.

Terry chimes in, picking up context that only a native speaker would catch. Excellent. It’s time to examine the patient.

Drs. Huebner and Boon immediately start brainstorming solutions. They ask Dr. Daily for a report on the physical exam. I tell Terry that while the doctors determine the diagnosis and recommend treatment, I see our role as non-medical volunteers as comforting the patient and showing her the love of Christ. We can hold her hand and pray, or simply be by her side.

The exam ends, and we share the recommended path forward with the patient. Before she leaves, I lead a prayer and give her a hug. I remember Evan’s words from devotional. “From chaos…He brings good.” I thank God for Dr. Boon and Terry. They’re the perfect pair. I wish them well and am on my way to capture photos of the team.

I stop by urology first. Dr. John Boon, Dr. Camille Boon’s husband, and Karina Contreras, interpreter, are chatting with Felipe, who’s just been added to the surgical schedule for a transurethral prostate (TURP) with a possible cystolithotomy. Felipe has many questions about the procedure (as do I because I have no idea what it is). He apologizes for being so inquisitive but says he’s just a curious person. Dr. Boon reassures Felipe in his Southern draw with a smile, “Está bien, está bien,” which means “it’s all good.” I chuckle. We snap a photo, and I’m onto anesthesia.

The anesthesiologists must screen every patient programmed for surgery. I see Vivian MacDonnell, our Argentinian ward doctor, with the biggest smile on her face. She has been interpreting for anesthesia and just finished screen Jandell, a beautiful six-year-old girl with a smile as big as Vivian’s. Dr. Manish Wani, ENT, will perform a mastoidectomy on her this week. I make a note to ask him what that is before snapping a pic of this adorable pair.

In the general surgery room, Dr. Manny Ayyar, is triaging patients with Toni Laas. Their favorite patient of the day is Petrona, an 83-year-old woman with a left femoral hernia that is so painful it’s affecting her ability to walk. She’s on the schedule as well, so I pray that healing is on the way.

By the end of the day, the doctors triage nearly 150 patients, filling their urology, gynecology, ENT, and general surgery schedules. And since I wasn’t with my dad, I experience a different side of triage.

Marilyn Ewing and Cassie McClanahan, Casa de Fe care coordinators, pass out champurradas. (I made sure they went by the GYN room.)

Laura Cousar, team administrator, handles data entry for every patient evaluated! She is smiling when I see her, despite the long line of people waiting to be served. I admire her patience and tell her I’ll try to recruit some assistance.

Scrub techs, circulators, PACU nurses and our pharmacist unpack trunks and set up the operating rooms. Evan prays with patients and their families.

I even get to see Armando, one of the nearly 1,000 in-country Faith In Practice volunteers, who has brought a group of patients from his village to see our team. Armando always inspires me. Without the incredible Guatemalan volunteers, the work we do would not be possible.

There are a few patients who truly touch my heart. The first is Maria Guadalupe, who is suffering from intense pain as she waits to see the GYN team. We pray over her pain, and the Holy Spirit heals it in that moment. All glory to God! I am delighted to find out my dad has her on the GYN surgical schedule for an abdominal hysterectomy. (He tells me this at lunch when he also told me “you’re fired,” a sign that the triage day has gone very well). I thank God for moving even in the intimate details of our lives.

The other patient is Jeremy, the sweetest six-year-old boy, who is scheduled for surgery with Dr. Wani. Jeremy has papilloma blocking his airway leaving him unable to speak louder than a whisper. This little boy is so full of life and excited to be at the Obras. He tells me that his parents have taken him on vacation. His mom laughs and says, “It only feels like a vacation to him!” They are faithful that this operation will give Jeremy a voice. We hold hands and pray, giving thanks to God, and ask for total healing. I see his mom crying silently as we pray, and I assure her that I'll be present on surgery day, too.

I have one last stop before heading to the hotel. Team Huebner always hosts a piñata party at Casa de Fe. Established in 2003, Casa de Fe is the Faith In Practice patient guest house that serves families traveling long distances to receive care. Without this haven, many patients would be left in the streets while recovering from surgery.

This year, Toni Laas’ sorority, Beta Sigma Phi – Preceptor Nu, has donated the piñata and the goodies inside. Although there are only a few children at Casa de Fe, they all have a chance to take a swing at the giant star. Bob Ewing, logistics support, and Toni give the children pointers. The final hit comes from a sweet little girl. As soon as it bursts open, it’s chaos! Children and adults run to see what they can grab. Their joyful laughter and giant smiles tell us it’s good. God’s goodness is magnified through the actions of this team, and we are grateful for the opportunity.