Osteomyelitis- A common scourge of children here in Rwanda.
One of the most frequent problems that children face here is infection of the bones. They usually come when the infection has become well advanced, with pus draining from the skin. Originally the infection comes from a minor infection elsewhere, travels through the bloodstream and lodges in the bone. The bone dies when the blood supply is lost due to the pus which forms; new bone then begins to form around the dying bone.When the child comes to us they have pus draining from the skin often from many places and the bone is enlarged and misshaped. This young boy I met this past week had actually two places which were affected- his upper arm and upper leg. If you look at the X-rays you can see that there is a piece of dead bone within the new bone that has formed; this is the original bone that has died and must be removed much like a splinter which will cause an infection to persist if left inside.
As an American Surgeon, Osteomyelitis was virtually unknown to me before coming to Rwanda, but yet now I have become very familiar with treating it over these last couple of years, thanks to the tutelage of more experienced surgeons and simply having to care for so many patients with this problem.
Surgically speaking, it is difficult to make the incisions to remove the dead bone in such a way that you don’t injure the important nerves and blood vessels which are often are very close to the path which you take to get to the diseased bone. The tissue is thickened and scarred so that the normal anatomy is unrecognizable.
Outside My Comfort Zone
Here in Rwanda I am quite often faced with a necessary but unfamiliar operation like this one. I am acutely aware that in my efforts to help, I can also hurt my patient very seriously- such as cutting a nerve with resulting paralysis. Out of my comfort zone of familiarity and experience, I realize more acutely that I need to ask for help. Guess what? Here’s a surprise: doctors and especially surgeons don’t like to do that. I mean, aren’t I supposed to know what I am doing?
Competence from Dependence
Competence is an essential aspect, the sine qua non, of being a surgeon, right? But where can we really find the competence to do what we need to do? Increasingly, I realize that my competence is not found within myself or what I can mentally or physically accomplish on my own. I’m not saying that I don’t prepare for my operations, but more quickly now I am looking for my competence through prayer and guidance from others. How often I lack faith! But how amazingly the answers come anyway and how specifically God provides! One of my favorite verses captures this wonderful truth -Phillipians 4:19.