Monthly Archives: May 2011
Getting ready to start the final editing process, so I can get the manuscript off to the printers.
I’ll be back in Bogotá – at Authors Bookstore on Calle 70 No 5 -23 in August (August 18th).
I’d like to have an event here in Virginia but I am still working on the details. I’ll post the dates and times when I have something scheduled.
New article posted on Yahoo! (associated content). Most of you have heard me talk about the topic before – it’s usually one of the first questions I heard when interviewing surgeons down in Bogotá – but I wanted to publish something where the rest of the world could see it.. (Colombia as a destination for American medical tourists – five reasons why..)
Met with my not-so-hidden co-writer to go over our notes, and to start the editing process. Dr. Klein has written all of the drug content (he’s a clinical pharmacist), and much of the Bogotá city chapter. We’ll be getting together again this week to go over the book, in-depth and try to get a little closer to publication. It’s the first time I’ve seen him since leaving Bogotá, so it was great to get together again.. Now it will be a lot coffee (and sushi – our brain food) until the book is finally complete.
One of my new articles on Dr. Borraez has been published to Yahoo! (associated content section) – it’s shared content with the site.. I’ve also written two other articles, one of original content, so I’ll let you know if they get published. I thought it might get a little more exposure this way. I’ve written this trio of articles for Yahoo! as a trial run, so we’ll see how it goes..
My last today here – and I managed not to work my final day – until now.. Spent the day at the market, and spent the afternoon with friends…
Going to do one last post, before I finish packing up and getting ready to leave tomorrow morning.. Hard to believe leaving would be so difficult – but this has been an amazing time.. Writing this book has been a dream come true, even though at times it’s been frustrating, exhausting..
Making new friends here was an added bonus – but it makes it hard to leave..who would have guessed the girl from the itty bitty town in Virginia would enjoy the big city so much?
For everyone wh s daunted by the thought of a big city like Bogotá, in Colombia, no less.. Don’t be afraid – enjoy the vibrant life that is Bogotá.. the sophisticated mix of city, with quaint country traditions like bike riding on Sundays..
Now, it’s time to start editing.. Be back in August to present the book..
I have published several Images of Surgery in Colombia to the web to give outsiders a glimpse into the operating rooms here in Bogota.
So, I was really excited to head out to Hospital San Carlos.. It’s an older hospital – out in the south part of Bogotá, set apart from the city by verge of being in the midst of a park.. It’s where they film “A Corazon Abierto” which is one of my favorite programs here (or was, while I had a tv to watch.. along with RCN news – which is fantastically dramatic..)
But when I got out there, security informed me that no tours on the weekend, and no, I could not come in.. So I peeped in windows, and wandered the grounds. It’s an interesting place, several of the windows I peeked in looked like old storerooms and had equipment that must have dated from the originally opening.. It’s an art deco building, but it definitely has a gothic feel – great place to film one of those B movies about murderous patients in a haunted sanitorium.. (except of course, for all the pretty landscaped flowers, LOL) so much for my active imagination..
Wish I could tell you more – but unlike many of the security guards I’ve encountered – there was no charming this one..
I submitted an article on Colombia as a medical tourism destination to Yahoo! for publication. The article discusses several of the factors I’ve mentioned before, and includes my observations from the last several months. We’ll have to wait and see if they think it’s suitable for publication.. Of course, if they reject it – I’ll be sure to post it here, for all of you and your critiques..
Update: 14 May 2011: I received a comment on the website from a Mr. Gabriel Amorocho (of ProExport) inviting questions – so I have sent him several.. Thank you for contacting me. I will update readers and let them know if I receive a reply..
There’s nothing like a government agency to remind you of your own insignificance. In this case, it’s Colombia’s ProExport.. ProExport is the government tourism division and one of its specific aims is to promote medical tourism to Colombia.. and here I am, writing a guide to medical tourism in Colombia…hmmm.
So as a writer on medical tourism in Colombia – I thought it would be nice to meet with someone over there, just to hear more about ProExport, what they do, what they are doing to further medical tourism, what they thought the future of medical tourism was in Colombia, etc.. It was a pretty important interview for me – because I thought I would be able to get a lot of questions answered for potential medical travelers, from an official source… yeah – it would have been nice.. But..
Nope, Nada, Never. Not even after five months! of calling, emailing and trying to get an appointment with someone, anyone, over at ProExport. Everyone I’ve met here has tried to intercede, even my downstairs neighbor (who knows someone who knows someone etc..) to get me just twenty minutes with someone from ProExport.. I’ve emailed several people at ProExport directly, from the information they provided.. I even managed to navigate the operators, with multiple transfers only to be transferred to an endlessly ringing phone.. and called again, and again, and again.. Never even got a form response to my emails..
It was easier – to get a reply from the President himself, (President Juan Manual Santos), and he was exceeding gracious about it.. (I sent him a copy of my first book – silly, but I was excited – my very first book, and just a week or so later, I received a very nice thank you note..)
So it’s the last weekday, of my last week here in Bogota, so I guess this humble writer, has been humbled again – and I will accept defeat.. There will be no ProExport interview for this unknown writer..
Most of you will never meet Dr. Borraez, a trauma surgeon at hospital San Blas, one of the public hospitals in the poorest neighborhood in Bogota, but now you will have heard about him. In March of 1984, when he was a second year surgical resident Dr. Borraez , training at San Juan de Dios, Dr. Borraez was assisting in a surgical case with a patient that had a serious infection preventing closure of the abdomen.
(In cases of severe abdominal trauma, infection or necrosis closure of the abdomen can lead to the patient’s death due to compression of the abdominal compartment – leading to a sequelae of abdominal compartment syndrome —> internal organ hypoperfusion —-> organ failure —-> respiratory distress —> death. So basically all the swollen abdominal organs crush the blood vessels and other structures..)
During this case, the attending surgeon and the other operating room staff were looking for something to use to close the abdomen*. Sometimes surgeons used sterile operating room towels but that increased infection and allowed for massive fluid losses, and the synthetic films were prohibitively expensive (and not without their own problems.)
So while he was in the OR, Dr. Borraez spies the IV bag, and starts thinking.. He then took the largest bag made (a urology fluid bag – 3 liters) sterilized it, and placed it in the abdomen. And it worked – perfectly, as if it had been designed for that purpose.. It was clear, which allowed surgeons to monitor the wound, it was hypoallergenic, it prevented infection, it’s strong yet flexible and most of all – it was cheap (about 2 dollars) and available in any hospital – world-wide.
Since then, he has been recognized internationally for its use, especially after noted Atlanta trauma surgeon, Dr. David Feliciano came to Bogotá and saw this technique in use. He wrote about it in standard American trauma textbooks used worldwide, gaining some well deserved recognition for this kind Bogotá physician, who continues to work and innovate (for the last 27 years) in this humble hospital serving Bogotá’s neediest patients.
He now speaks at conferences world-wide, talking about the Bogotá bag – and different ways it is now being used. Hundreds of research studies and case reports have confirmed his findings. His contribution was recognized as one of Colombia’s top ten innovations in Medicine, along with the Hakim valve (which we mentioned in another post.)
He has successfully used the Bogotá bag as a permanently implanted internal closure device (placed between the muscle and the intestines) in 55 patients with no problems.
He continues to innovate for more affordable and practical wound closure devices. Currently, he has adapted a colostomy bag, along with a natural sponge and a suction canister as an effective wound-vacuum closure device, which mimics the success of the cost-prohibitive ‘wound vac’ (KCI) but only costs about a dollar to implement. (Wound vacs can be several hundred dollars per day of use.)
Yet, somehow, in between seeing patients, surgery, creating affordable solutions and teaching residents – he found time to sit down, explain all of this to me – and show me several patients with their “Borraez bag” in place.
* a temporary measure until swelling / infection subsides and allows for surgical closure.
In other news, I want to say hello to one of ‘my patients’ – (I know he is reading this) Cristian, a very nice thoracic surgery patient that I met during rounds one day. I tried to take a picture (he was very gracious and granted permission instantly) to show what a great guy he was – I met him as he was walking down the hall, chest tube canister in one hand, and puffing on his incentive spirometer in the other.)
He, too, made time for me, a strange American nurse, speaking bad Spanish – to answer my questions and tell me all about why he was walking the halls and puffing on this little box.. He gave me a tour of the hospital while we walked, and he puffed intermittently, as I thought about how everyone, doctors, nurses and patients have been so welcoming to me here. This kindness has certainly made this project not only possible, but a wonderful experience, that I will greatly miss when I return to the USA in a few days.