Ho Chi Minh City: Monday, October 14,1996: Dr. Randy, Bill LeTourneau, one of the team members, and I hurriedly left the health-center hospital as soon as the patients were all checked. We were scheduled to meet with Professor Lam Ngoc An, the head of the institute hospital. With Dr. An, we discussed at length the work of Project C.U.R.E. and the possibility of working together in the future. Joining us in the meeting was Dr. Huynh Daltai, the hospital administrator. I told them that I thought I could help meet their requests to send additional medical supplies to them in the future. They requested goods for their own hospital as well as the hospitals in the other twenty-seven regions of the southern part of Vietnam. The population in that southern part of Vietnam is well over thirty-five million. There are tremendous needs.
I explained the procedures and policies of Project C.U.R.E., and then I pulled out a Needs Assessment Study form and began asking all the necessary questions for our records. The doctors explained exactly how their health-care system worked and were eager to sign our Request for Assistance form.
By that time the patients and operating rooms were ready for the afternoon schedule. I followed Randy into the first operating room after washing, and donning my scrubs, cap, and mask.
The anesthesiologist was just putting to sleep a twenty-year-old Vietnamese woman who had the disease commonly known as “the elephant man disease.” When I saw her, I remembered the movie of the real-life story of the elephant man, who because of his grotesque skin and tissue growth, became a curious attraction to circus goers.
The Vietnamese girl’s face was already sadly ugly, especially on her left side. Additionally, she had it starting on her lower-left rib-cage area and on her back. The doctors made the decision to work on the face and to also remove the growth area from her front, but not to do anything about the growths on her back.
As the team began, I wondered how in the wide world they would ever go about correcting such an awful situation. Indeed, where would they even start? They told me that it was a situation where her condition was not going to be healed, but the surgery would remove the massive growths and the leathery folds of excess skin and give her a presentable and recognizable face. They then proceeded to do just that.
They started by cutting a line in the scalp above the hairline. Then they virtually peeled her face skin forward. When they reached the eye area, cuts were made just below the eyebrows in order to leave all of that area intact. Once the skull and upper jaw areas were exposed, the growths were cut free and removed. The same sequence was followed as they moved down toward the lower jaw area. Eventually the excess skin and tissue were trimmed, and the suturing process began.
By the time the procedure was completed, about the most I could see was a very finely stitched line running from up in the hair straight down to the lower jaw, just in front of the left ear. The stitches in the eyebrow were hidden, and the cut in the scalp up in the hairline will never be seen. I was impressed!
The few little sentences describing a four- or five-hour surgical procedure certainly bear witness to my medical ineptitude. You will simply have to excuse my lack of medical correctness in the area of descriptive surgery. I would recommend two things for you to do for additional and more medically correct details: First, request access to all my gory and bloody photos. Second, go with me next time. But for now, please grant pardon.
The next cranio-maxillofacial procedure undertaken by our team at the Saigon hospital attested to the tragedies of crime and violence. A young Vietnamese man had gotten engaged in a conflict with some pretty hard-core evil people. In an act of retaliation, the perpetrator did not have a gun but managed to find a container of acid. They took the acid and threw it in the face of the young man. His skin literally melted and ran down his face. He had managed to keep his mouth from sealing shut, but everything else on the front of his head was a slick, shiny covering of plastic-looking tissue. The acid had even softened the bone structure of his forehead and cheekbones so almost all the structural features of his face were lost.
But the young man was alive and had claimed, subsequent to the mishap, that he could detect light from behind the solid screen of tissue in the area of his right eye. So, there was hope that if they cut through the scar-tissue covering, a functional eye might be discovered that will once again enable the young man to see.
While the doctors were at it, they decided to transplant some hair-growing skin over the top of the eye sockets and fashion for him two eyebrows. There was a lot of hope floating around the operating theater as they brought the patient in and the anesthetist put him to sleep.
About an hour and a half into the procedure, the surgeon looked up at us and shrugged his shoulders. Behind that cruel mask, there was no eyeball. The acid that had been thrown in his face had also melted the eyeballs. Apparently, the detection of light must have been an apparition. As the inevitable became apparent and the hope passed, everyone in the room seemed to exhale in kind of a disappointed sigh. The team then went to work opening both eye sockets and preparing them for a prosthesis in each. With some recreated facial features, the young man can be encouraged that he is not such a spectacle of gruesome horror walking around.
Besides the intensity and concentration demanded throughout the operations, the roller-coaster ride of emotions stemming from the triumphs and disappointments of the actual procedures exacted a price from all involved. Several of the days, the teams returned to the surgical rooms after dinner and performed their pro-bono acts of mercy far into the night.
As I watched the two teams function in the four different operating rooms, I was proud of the Face the Challenge group. Project C.U.R.E. supplies everywhere, and I watched as the attendant nurses tore into boxes and packs of medical goods that had come from our warehouse. I thanked God for Ruth and Rich and the Quinns and all the people who so faithfully picked up and delivered and sorted, inventoried, and prepared the loads of equipment and supplies for all the containers that were sent from our humble donated warehouse in Denver. Somehow all the efforts seemed very worthwhile. Somehow the grueling travel, the strange food, the lumpy beds with smelly covers, and not being able to snuggle with Anna Marie or play with my grandkids took on a proportional value in light of eternity.
Tonight, a group of us ventured out and found a small restaurant that serves Thai food. It was pretty hot, and caused this Irishman to sweat a whole lot; but it was good for the variety.
In cases like that, I try to play it safe and stick with some chicken or fish item, but then I walk down the streets and see the hanging chickens in the open market and the fish for sale in the hot metal tubs, and I wince knowing full well where the restaurants buy their meat. Oh well!
Tuesday, October 15
I was up early this morning, still grinning over the recent miracles taking place in the surgery rooms. I’ve been having a great opportunity to get acquainted with the individual team members at meals and riding back and forth to the hospitals.
This morning I had the privilege of watching Dr. Jerry Popham in action. Dr. Jerry Popham is an orthodontist and also a plastic surgeon. He serves on the board of Face the Challenge and is a Harvard graduate. He is an excellent cranio-maxillofacial surgeon and is married to a Japanese American lady who is also a doctor.
What he did in the procedure I never imagined could be done. The young woman, about twenty years old, had suffered from some kind of facial paralysis on the left side. The condition had lasted long enough so that gravity’s pull had taken over where there had once been facial muscle tension. So the result was the sliding down of the entire left side of her face. At the time of the operation, it hung down a full four inches below her left jawbone. The objective was to remove the excess muscle tissue and skin, reshape the left side of her face, and create some kind of a muscle network that will keep the face held up and maybe even let her smile once again.
Dr. Jerry started out with the process of going from ear to ear over the top of the head with an incision that would release the face from the forehead. Then another incision went from the first line down to the jaw … just in front of the left ear. The doctors had to work so carefully and tediously so they wouldn’t inadvertently cut a nerve. Of course, they had to continuously utilize the electric cauterizing tool to sear shut the blood vessels that were severed during the procedure.
After Dr. Jerry had worked carefully around the eye area and loosened the face from the skull and cheek area, he ran a probe all the way down to the left corner of the mouth and exited where the upper and lower lips met. He then went up on the skull and began cutting a strip of muscle about a quarter of an inch wide. He swung that muscle downward through the articulated pathway he had prepared, pulled the muscle through the hole he had designed at the left corner of the mouth, and secured it there with stitches. Everything was reshaped, tightened up, and sewn back together. I don’t know how many times during those procedures I told the surgeons how much I marveled at their skill and creativity, but more than that, I marveled at their dedication and willingness to go all the way to Vietnam and donate these talents in an endeavor to share Christ’s love and help some hurting person experience a better life.
Next Week: How do you Make a Jaw Bone?