International Medicine

I loved every moment of the medical mission. Most of it, though, was a little bit self-serving. There is a question in philosophy whether an act can be truly altruistic. An act that may seem altruistic - donating to a non-profit, for example - gives the donor a sense of satisfaction or pleasure, and hence is not a purely altruistic act. In any case, instead of spending the week anesthetizing patients at the VA, I had the true privilege and opportunity to help kids in Guatemala who needed it. We made a difference in the lives of our 30-some patients. I loved it; it was so satisfying and fulfilling. We do a lot of volunteering and public service as high school students, medical students, undergraduates. But since residency, I haven't had the time or energy for something like this, and I missed it. It feels good, satiates some internal desire to give to someone who needs it. And now, I realize, I have a knowledge base and skill set that's truly useful, necessary, and uncommon.

But did we make a dramatic difference in the community? No, not at all. Communities need infrastructure, resources, physicians who will stay for the long haul. An international group that comes in for a week and then returns to our charmed lives changes things for individuals, but not communities. The people I admire most are those with the vision, resolve, and self-sacrifice to try to make the real lasting changes. One mentor I've worked with helped build a hospital in Rwanda; other anesthesiologists in the department have taught and trained anesthesiologists in other countries. Those are the foundations of real international medicine. What I did - no matter how great it was - was dabbling.

Nevertheless, I learned a lot and I grew a lot. In terms of medical knowledge, I broadened my experience of pediatric anesthesia, especially seeing pathology that would normally be treated much earlier on. I learned how to cope with older equipment, limited medications, a different environment. I began to learn about systems-issues when infrastructure, nursing, floor care, and pain management are limited. My Spanish improved. I cared for patients with medico-psycho-social problems, became aware of how culture affects care, gained an appreciation for the nonmedical issues - education, physical therapy, support systems, ethics - at play. My abilities, techniques, comfort, and confidence improved over the four days we operated. Our operating room teams worked smoother and more coherently with each case.

I am so grateful for this opportunity and would not hesitate to go on future medical missions if I am able. Although I wish I were the kind of mover and shaker that could really elicit change in a setting that needed it, I am content with being one of the players who changes lives of individuals, one at a time.