Meet the Team

Long-time readers know that the first post of the week is always “meet the team”…

FIRST-TIME or new readers, WELCOME to “meet the team” that invites you to join our journey this week—there are three of us traveling together this time, and I’m super-excited to once again be blessed with two other awesome attending physicians.

First I have to tell you who “I” am, though—briefly, my name is Heidi Bell, and after finishing residency in 2006 my husband Matt and I moved down here to Guatemala to serve as full-time medical missionaries for two years.  It was an amazing privilege then, and it’s been possibly even more of a privilege to be able to keep up a practice of sorts here in Guatemala by coming down for a week every three months on a regular schedule.  God has been super-faithful to provide for this mission through six years on faculty of a very busy medical school, contracted pharmaceutical work, unemployment for nearly a year, and now full-time work with a pharma company.  I mostly left clinical medicine in the US in 2014 for a better work-life balance, so now I live in Cary, NC, with my husband and two crazy-but-fun children- Isaac is 11 and Micah is 7.  Gotta give mad props, always, to my husband and especially my in-laws, who faithfully support this mission by driving down from Michigan nearly every time I come down here to help with the kids!

I’m traveling this time with Kathryn Pool, who some of you will remember from last June!  She and I met in a facebook group that we are both in—and she came down and met me in Guatemala sight unseen from Columbus, Ohio!  I was so impressed that she would do that once in a lifetime, so imagine how excited I was when she said she was coming back!  Mad props to her family, also, for supporting her in it.  Especially with 3 teenage girls!  Let’s be praying for Dad this week, right?!  Dr. Pool is in practice that is fairly heavy in obstetrics and light in gyn surgery, but you would never know it by her skill in the OR.  I can’t say enough about how excited I am to have her back down here!

The third member of our party should “complete us” quite nicely, I think— Dr. Milicent Triche and I graduated from residency together! We’ve been facebook friends for a while, and I have LOVED watching her three kids grow up—Ty is 14, Micah is 12, and Maya is 11.  They are awesome and active, so that’s another Dad to pray for and be thankful for this week!  Oh, if 2006 could see us now… SO cool to get to work again with a friend from residency.  And if anyone that knew us at LBJ’s ears are burning this week, we are definitely why.  Mili opened her own practice (!) in Houston, Full Circle OB/Gyn, in 2008 just two years out of residency, which never ceases to amaze me.  Can’t wait to hang out with her in the OR especially this week.

Our trip got off to a rough start when my flight to Atlanta this morning was delayed and I missed my connection to Guatemala.  These poor ladies have been major troopers all day hanging out in Guatemala City with mostly just medical Spanish skills.  In the market, it’s not really helpful to know how to ask someone about their vaginal bleeding or how well her baby is moving, so you can imagine the stress of waiting nearly eight hours for me!  We are now finally headed up to the mountains and Chichicastenango, but we will likely arrive to our beds after midnight tonight.  Please pray for supernatural rest and strength since we are scheduled for a long day of clinic tomorrow.

Humble Pie

So every now and then, I make the grave mistake of starting to think that I kind of have some stuff together.  I start becoming confident in my surgical skills, or my parenting tactics (ha!), or sometimes even in just my ability to be a “good person”.  Those are the times that God, in his grace, steps in to humble me before I really manage to get out of control!

This week—and especially today—was clearly one of those times.  I’ve been going along nicely for a while now, without really getting in to anything scary or nerve-wracking or starting to feel like something I couldn’t handle in the OR.  I’ve also been going along nicely for a while without encountering any really major surgical complications in my patients.  Do you know where this is going yet?

So this week, I got to take not just one but TWO former patients back to the operating room for repair of a surgical complication—one from earlier this year and one from three years ago!  I’ll spare you the details since you aren’t all gynecologists, but suffice it to say that neither of their conditions was at all pleasant to think about living with.

Dr. Hoak was ready, willing, and ABLE—as always!—to help us repair a fistula, and I thank God that he and I were finally down here at the same time (I haven’t seen him in about a year!) when this lady came in so I didn’t have to put her off until further help could be found.  Her surgery took us several hours yesterday, but she looked great this morning.  She is in for quite a long recovery, but we are hopeful that she will be feeling much better soon.

Today we took another lady back, who had a repeat of “things falling out” after we did a hysterectomy and fixed those things three years ago!  This is a known risk of the surgery, but heartbreaking when it happens.  I’m very hopeful that she will feel much better now after her re-operation today (colpocleiesis for you gyn-curious folks—if you don’t know what that is, suffice it to say you do NOT want to Google it!)

Our second case today was a very sweet and very bright young lady who wanted to wait until today to operate because she has University classes on Saturday.  We knew her case was going to be challenging, but neither Lee Ann nor I has ever encountered the amount of bleeding that we did on starting the case as a vaginal surgery.  Every single clamp we placed after the first few seemed to only make the bleeding worse, when anatomically they “should” have stopped it easily! 

It wasn’t long until I asked the nurses to start asking the family to gather up some blood donors for the patient as it looked like we were headed towards the need for transfusion.  I’ve always felt I had a bit of a safety net since I’m a universal donor in case of emergency, and after a few minutes I asked them to actually send someone in to use my foot to collect a unit of blood from me while I operated with my hands! 

THIS was when I finally learned that today, apparently, there is no one available in the hospital lab who can perform the studies needed for a transfusion.  Umm, this would have been good information to have before we were in the process of losing what turned out to be about two-thirds of her blood volume!  Thank GOD Dr. Iris Gamez, a REALLY good anesthesiologist, was here today and on top of it!

It was clear by now we needed to open up the abdomen emergently to get the bleeding stopped, which we did quickly—but the damage was definitely done.  Dr. Gamez struggled with meds and fluid for several hours before someone arrived at the lab that could make a transfusion happen. Her family members stepped up like I have never seen a family here step up before, and long-story-short, she has now received two of three total bags that she will end up receiving. 

There is nothing quite as humbling, confidence-shaking, and exhausting as realizing how close you came to actually killing a patient by operating on them.  May we never forget to properly respect the privilege granted to us of operating on another human being.  It is indescribable how cool it is to know you can cut things open, fix them, sew them back up, and cure a patient’s problem. But let us not forget that with great privilege comes great responsibility, and let us continue to pray for Ester’s recovery.

The hospital we work at here, the “Good Samaritan” hospital, is truly a place that I believe is blessed by God’s hand.  For all the faults and missing equipment, and for all the grievous errors or breaches of “sterile” technique, we have almost inexplicably good outcomes.  I believe with all my heart, and have for many years, that it is only a result of God’s grace being poured out due to the people working here with true hearts for the patients and in obedience to The Lord. 

So tonight we will go to bed exhausted—physically, mentally, and emotionally—but resting assured in God’s love and provision for us as we bumble along in this world trying to make the most of it. 

Meet the Team!

Good morning from Guatemala!  Hoping that I will have some time to get some internet coverage (it’s pay-as-you-go physical, plug-in modem here mostly—remember those?!)  so I can get this posted today.  Wanted to get everyone up to speed and on the same page… so it’s time to

“MEET THE TEAM”!

Long-time readers will know that is literally the title of the first post of every week here, so let’s go…

I’ll start with introducing myself better to the new folks:  I’m Heidi Bell, an OB/Gyn from North Carolina (currently in the Cary area) with a bit of a winding road of a career history--  It goes like this:

• ·         Studied medicine at ECU (where you’ll see I met most of the others on the trip later)
• ·         OB/Gyn residency in Houston, Texas—where God was clearly preparing me for His work in Guatemala by teaching me Spanish through my patients
• ·         Met my amazing husband Matt while in Houston, and he and I felt called together to move to Guatemala after my residency training
• ·         Spent an unforgettable and life-changing two years living here in Guatemala with the support of a group called Agape in Action from the Houston area—you can read more about them here:  agapeinaction.org
• ·         Returned to the US to take a faculty position at ECU in 2008 where I stayed until 2014
• ·         Have been amazingly blessed and privileged that God has been faithful to provide for and continue to keep going this current mission set-up, which consists of 3-4 times yearly, one week trips down to do a few different things:

o   Perform affordable gynecologic care and surgery for the indigent population

o   Be the hands and feet (and yes, scalpel!) of Christ for these people in any way that I can

o   Strive to encourage the long-term missionaries here in the area with whom I have become very close over the years and been blessed to know—especially the Ficker Family who you can read more about here:  adonaiinternationalministries.org and docsforhope.org

o   Bring different small (2-5 people usually) teams with me each time who hopefully go away with a renewed sense of how “the rest of the world” lives and hearts renewed by The Gospel as well.

And that was way too much about me!  But I should also mention this can only be accomplished with the support and patience of my family (including in-laws, a husband, two kids, and a goofball Boxer dog) at home as well as my church family in Cary.  Life is truly better than I deserve, friends.

I’m joined this time by three ladies who I look forward to getting to know better—I’m continually blown away at how many people “sign up” for this trip sight unseen and with very little detail about what they are getting in to!  Serious cool-cat-easygoing-hero status here, y’all~

So Lee Ann Garner is an OB/Gyn working in the Wilmington, NC, area currently.  I met her at ECU when she was a medical student there, and one of her current partners, Julia Posey, came down with me a few years ago as a resident.  You might recognize the city of Wilmington from recent news, where Hurricane Florence hit.  Her kids (10, 8, and 4 if I remember the ages correctly) are STILL not back in school there!  What an amazing sacrifice to show up for the trip anyway, right?  Let’s pray that she and her family will be truly blessed this week!

Dr. Nikki Parson was an OB/Gyn resident while I was on faculty at ECU, and we’ve been talking about getting her down here for years now.  She works in Charlotte now, and I absolutely LOVE that she brought along her “right-hand (female) man” from her office for the experience.  Crystal Yarborough has worked with Nikki in her office since she started there out of residency, a little over 3 years ago now as a Certified Medical Assistant.  Theirs is clearly a special and close relationship, and it has been awesome meeting her!  Nikki has two beautiful boys in 6^th and 7^th grades at home with another clearly amazing husband of the group.

It is Crystal’s first time leaving the country, so maybe some extra-special prayers for her this week?  She has been an awesome trooper so far, especially since she has two kids (16 and 9!) at home and clearly is very involved and beloved in her community.  Poor thing was up at 5:30 this morning with well-wishers calling to check on her (not quite realizing that we are two hours behind NC here… 😉)

So today will be a bit of time in market and then a LOT of time in clinic seeing patients and hopefully setting up lots of surgeries for the coming days.  Pray for patience, wisdom, and perhaps a bit of efficiency as we dive in to usually 20-30 patients.  But above all, pray that we can truly be a light and just a tiny reflection of God’s love for them—it’s pretty hard to feel in a world that can feel rather bleak at times.

Everyone hug your families hard and appreciate them today!  We are running off of your prayers and love from afar… so thank you for that.

From Skip's Heart (Thanks for the Guest Authorship!)

Our day is winding down after a marathon clinic at Good Samaritan Hospital seeing prospective surgical patients. The Mayan women and their families are very patient. We started at around 8:45 and finished around 8:00 this evening. 32 women were evaluated, treated, and 9 were scheduled for surgery. We have several operations scheduled over the next few days and will be busy but our patients will be much better and back to their daily normal activities soon. We are exhausted but in a satisfying fashion. I am always reminded of mercy, God’s mercy, when I come in contact with these women and their families. Their families, by the way, are so caring, supportive and participate in their care and recovery. They do it with style and with sincere love, appreciation and support. We learned so much today from the interactions with the patients and their loved ones. We learned patience, compassion, out and out honesty with no secrets, faith-faith in our ability as well as in their belief in a mighty power, trust- in us and the blessing of God, the power of a smile or a laugh and the power of a touch, a human touch. We ask for your prayers for us as surgeons for agile, healing, skillful hands and prayers for the quick and full recovery of our patients.

Dr. Heidi has had a most eventful week thus far. I was amused by the fact that she volunteered to check her carry-on in Raleigh through to Guatemala City but failed to pick it up at baggage claim. It has been entertaining watching her make call after call to American Airlines who has now issued a statement informing Dr. Heidi that  they will make a one time exception and deliver her bag to Chichi tomorrow. Tag the bag and your finger Dr. Heidi!!! Don’t forget the bag! Secondly, she arrived in Chichi with a horrendous cough. After clinic this evening, she experienced an ill timed coughing spasm and has pulled a muscle in her lower back. Poor Heidi! We will support her and care for her and pick up the slack. To top it all off, she somehow managed to microwave her tea this morning with a set of keys still in the microwave~  Mind you, she and Tom have used the “leave the keys in the microwave as you come or go” system for the last almost ten years, so that statement is not as weird as it sounds.  Luckily, it seems the vinyl and leather wallet keychain thingy that they were in seems to have saved them from actually combusting.  So there’s that.  Feel better Doctor!  And also, please try not to burn the place down?

More to follow. For those of you reading this blog who are not a part of any missionary work, listen to me! I am very new to this concept and, in fact, I shunned the idea for years! Believe me, I had many opportunities and requests, but felt that I should care for women at home. I finally gave in and accompanied Dr. Heidi to Chichi in 2016. My life changed in 24 hours and I realized that the needs of women in third world countries far exceed the needs of women in the US. So, I ask you to involve yourself in some form of missionary work. Agape in Action is a great choice. Time or cash! Remember, Jesus tells us that what we do for the least of my children, you do for me. Think about it. Double shot. You do for Christ and your fellow man!

Let us know if you want any further information about how to get involved~  sending money, of course, is pretty easy.  Unfortunately, you will find that most missionaries have learned to kind of dread the question, “what do you need?”—because the answer is pretty much always “money” and missionaries HATE asking for money!  So if you ever want to make a missionary’s job easier, that’s how to do it.  But also, please don’t ever, ever, ever forget or underestimate the power of prayer.  Every missionary—definitely including use this week!—covets your prayers and appreciates them more than you will ever know.  Let’s go change the world together, folks!

In Christ~

Meet the Team

Some of the longer-time readers may remember Dr. William “Skip” Johnstone, who first joined me on a trip back in February 2016.  He was an attending physician at ECU (which is where we met) for a bit and is now in Wilmington teaching the residents there and fighting the good fight to keep the art of vaginal surgery alive.  He is an amazingly talented and experienced surgeon, and I love both learning from and working with him.  In 2016 on the trip, it was his first experience with anything outside of the United States that wasn’t a resort location.  I had the amazing and rare privilege of watching his life change before my very eyes on that trip, as they were opened to a whole, bigger world than he had simply ever known before.  Since then, he has LED two surgical mission trips to the Dominican Republic in addition to re-joining me on this trip! And all of this God has done in a man who hates to fly, folks.  Just imagine what he could do with you…

One of the third-year residents in the Wilmington, NC, program, Kimberly Hildner, is also along on this trip.  I’ve been so blessed by a constant flow of residents from this program since back in 2015 when I initially reached out for help with the trips.  All of the residents have been awesome to work with, and I’m sure Kim will be no exception (no pressure, Kim!)  She is originally from Florida and hopes to move to Denver, CO, after graduation next year to practice a full scope of obstetrics and gynecology.  I look forward to getting to know her better during the week, but am already excited about her heart for Guatemala—she has spent some time here as a fourth year medical student, where she is excited to go back and visit after we finish up our surgeries later in the week!  It’s so cool to hear other people’s experiences here in “my second home”, and it’s nice to have someone else along that can function as a tour guide of sorts.

While spending six weeks here as a fourth year medical student, she was able to travel quite a bit while she was here—but the one place on her list they never made it to?  Chichicastenango, of course!  What a great opportunity (that’s where we are now). 

Our morning got off to an early 4 am start at the RDU airport, followed by two flights with a layover in Miami.  Then the drive from Guatemala City to Chichicastenango, where we will lay our heads for the week and work.  Our little hospital, The Good Samaritan Hospital, is ready and waiting for us to start up clinic tomorrow morning, so it will be the first of several long days.

Skip has requested to write the rest of the blog tonight, so I’m nervously handing off to him now…

Heidi speaks the truth and is very passionate about her role in helping the women of the region who need surgical care. As she so eloquently stated, my life changed when I made my first medical mission trip with her in 2016. I always ASSUMED, and probably correctly, that if I took a week from my practice back in NC and operated on women in need of surgical care but who had no way to pay that I’d be extremely busy. However, my first trip with Heidi opened my eyes to the fact that NC poor and third world poor cannot compare. The profound living conditions of the indigenous population in third world countries is almost unimaginable, yet when you offer to help them, their gratitude and appreciation is all I need! The patients are cared for by their families and they go home after major surgery on Tylenol and ibuprofen and are thankful and smile a lot. Selfishly, I get more out of what we do here than the patients I think. I am looking forward to a great week with my colleagues doing what we do best for a population in dire straights. Thank you Heidi and Agape in Action for allowing me to be a part of a great mission!

Pictures!

Okay, a quick update on last night~  Long story short, we had a lady come in to deliver her TENTH baby!  Her lay midwife called around midnight to say they wanted to come in, and they arrived about 45 minutes later... then delivered around 2:00 am.  Mom and baby were doing pretty well (especially considering the amount of meconium that was present!).  Unfortunately, this morning the baby was breathing way too hard for our comfort, and we flew him in to the national hospital in Quiché~  Please pray for this little boy!!  His mom is still doing well, but we've had kind of hit-or-miss care at the national hospital so must just remain hopeful and prayerful.  We are grateful that she was brought in, though, as it would be quite unlikely that this baby would have survived without medical attention.

As promised last night, though, here are a few pics I was finally able to download...

The "obligatory" first-uterus-of-the-trip selfie... Chris, Adele, and me...

Chris and Adele operating!

A bad place to leave the clinic key... (inside the locked clinic!  Oops.)  Note the pathology specimens in background waiting to be taken up to the basket that goes in to The City each week to be read...)

Chris and Adele doing what they do best again!

Adele operating "solo" (OK, with Chris kind of hiding so it looks like she is solo in the picture...  Sometimes we cheat a little for residents and students who would otherwise never have pictures of themselves operating ;-))

Me and Chris with one of our "paychecks" for the week-- two really nice papayas from a sweet infertile couple that I've been trying to help for a while now... wish them luck!  Sweet Eva is the lady's name.

This morning's "return on investment" from yesterday's clinic... Please pray for this little boy (as yet nameless; they usually don't choose a name until sometime between 15 and 40 days of life), as he actually became quite sick after this picture.

Leslie and Katie Ann, taking care of this sweet baby in the middle of the night!  We brought Katie Ann some "honorary Doula (birth support person)" scrubs after Jess's awesome delivery and her amazing help... just didn't know she would be using them so quickly!

Sweet momma totally tuckered out after her delivery...

Mommy giving her first "liquid gold" milk to the baby!

From later this morning, when Shea was helping to support the baby's breathing with a CPAP machine... still praying this will have a sustained effect!

Meet the Team

Ah, the ever-creative title of the week's first blog... as the long-time readers (both of them) yawn.  But let's face it~  not much has happened yet.  We just got here this evening after the several hour ride up through the mountains from Guatemala City.  After a quick run to the grocery store, we now have our beds made and rooms moved in to for the week.  Now it's time to sit back, relax, fix a cup of tea, and light the pilot light for the hot water.

Oh wait~  we also have to spend half an hour trying to get Chris's phone to recognize the Guatemalan network so she can talk to her baby!  It's funny, though-- we were pretty tempted to get irritated about that, and then I remembered that on pretty much every single trip, there is some kind of internet or phone technology that needs troubleshooting-- but every single trip, we have all the phone and internet service we need!  I have called in to plenty of conference calls or over-internet meetings from here, I've stayed up to date on email, and I've caught up on patient charts in the EMR.  All pretty amazing technology making the world smaller and smaller -- and taking away our excuses not to travel it!

Anyway, I promised to introduce you to the team so here goes:  I'm Heidi, the arguably craziest of us as this is somewhere around my 33rd trip back down here for a week after moving back to the US in 2008 (my husband Matt and I lived here in Guatemala from 2006-08).  I'm an OB/GYN, and it's kind of a long story, but this is the only place I actually practice clinical medicine anymore.  I'm starting to miss it more and more, so these trips are an amazing privilege and blessing every. single. time.

Chris (DeLuca) Schwering many of you also know~  she was a resident at ECU when I was an attending there, and this is now at least her 8th trip back since going with me as a resident!  So very cool to now be taught by my former student many surgical skills she has picked up since then... never stop learning, right?  Her husband Tony flew down with us but rode out to Canillá this morning to install some WiFi, security cameras, and other generally tech-y stuff for the new hospital there.  They left their 3 year old sweetie, Caitlyn, and an 11 month old foster baby, nicknamed "Bubbles" for privacy, in very capable hands at home~  but still, it's hard to be away from each other and the tiny ones, so please pray for comfort for them this week!  (I should also mention they have a beautiful 21 year-old daughter also-- but they're pretty used to her being away at college ;-))

Adele Moser is a third-year OB/GYN resident in the Wilmington, NC program.  She is actually the fourth resident to come down from that program in the last couple of years, but the first one that I actually knew before traveling together!  We met when she was a third year student, and I have adored her ever since.  I'm really looking forward to seeing the amazing amounts she has learned in the last four years and hopefully getting her some great operative experience.

It's only about 8:00 here, but a group picture will have to wait until tomorrow-- some of us (i.e., Adele) had been up since before 2 am local time and thus didn't make it far in to the evening!

Tomorrow we will spend just a bit of time in the market, then set up and run clinic all day.  We will have a better idea of what's in store for us once we get through usually 20 patients or so tomorrow, so clearly we will keep you posted and try to get some pictures up.

Thanks for following along with us and praying for health, wisdom, and safety this week for us all.