Posted on January 5, 2012
Honduras Day 6: Terrible and Wonderful Things
Last night I went to bed early enough to catch the last half of an Anthony Bourdain episode. He was following a river deep into the jungles of Malaysia, and the further he got, the more primal his experiences became. Much like Marlon Brando in the Heart of Darkness. It was one of Bourdain’s trippier documentaries. At the very end, the camera pans from above to show him standing alone in a tropical grass clearing, waiting for the chopper to pick him up and take him back to civilization. He’s narrating the scene, and says that this particular experience has changed him–he is somehow different, and is not sure if he belongs back in New York City anymore. If you too are a fan of Anthony Bourdain, you know that his documentaries aren’t always fluffy and upbeat. They have a bit of a biting edge to them, and dig a little deeper into the travel experience than the shows that are centered around pretty resorts with white sandy beaches. I’m not sure exactly how many shows he’s done, but I am certain that just by sheer volume of travel experiences, he has most certainly encountered both the terrible and the wonderful along the way.
Just like here in Honduras.
It’s impossible to experience one and not the other.
For the first three days of the medical mission, the crowd waiting for us outside was calm and unhurried. They were given little pieces of paper with a handwritten number on it, telling them when it was their turn. Around a hundred numbers were passed out each day. Those with numbers would be screened that day, and if they were a viable candidate, would be scheduled for surgery the following day. We had supplies for about twenty recipients per day. Yesterday I had started to notice slightly a different feel to the crowd, as if they were sensing that things would begin to be rationed out soon. As I would walk towards the door of the clinic, one or two people would tug on my arm and ask me how much longer the wait would be. Sometimes, the ones who had been denied surgery (because it wouldn’t solve their particular eye problem) would ask me what could be done to cure their blindness. And although the doctors had told me about their own experiences of what it’s like to have to say “no, I’m sorry, we can’t help you” to someone, this is the first time I’d had to look someone in the face and echo those words to them myself–knowing that they would probably never receive help for their condition. None of the people made it difficult for me to do that; they didn’t burst into tears, they didn’t get angry, they didn’t stand there and stare at me waiting to hear something different. They simply accepted what I had to say, said thank you, and would walk away.
Today, the crowd was noticeably more antsy. I could no longer make it to and from the door without being surrounded by worried people, asking me when they would be given numbers to be seen. I began to limit the number of times I had to come and go, since I had become the big gringa target for people desperate to know if they had any chance at being cured or not. I saw a small older woman and two other family members approaching me, and I knew what she was going to ask. I had already made eye contact, so there was no way for me to duck out. “Is this the medical clinic? Can you help me? I have shooting pain up my neck, and the top of my scalp is burning.” The doctors had told me about this as well. Hondurans often carry heavy baskets and other weighty things by balancing them on top of their heads. Later in life, it catches up to them in the form of neck pain and the excruciating sensation of their scalp burning or being peeled back. My spanish is too rudimentary to explain the cause-and-effect to her, or to address the paralysis on the side of her face she’s asking about (which appears to have come from a stroke), so I am limited to “I am sorry, this clinic is only for eye problems and cataracts.” She too says thank you, and then her daughter takes my hand and says thank you, and they walk away. I’m beginning to feel the first waves of emotional drain.
I am so close to getting back in the door. Just a few more feet. “Perdoneme, perdoneme, con permisso, gracias.” And then another hand touches my arm. I tell him to please wait, let me get a nurse to talk to you. Safely inside the clinic, I keep my promise to the man and plead with one of the nurses to come out. Wearing her bright white medical uniform, she makes it down off the steps before being swarmed too tightly to move. She holds her hand straight up in the air. “We have five numbers left. There are only spaces for five more cataract surgeries.” The crowd is wriggling in anticipation of what will be said next. I can reach out and touch their need to know. I part the ocean of shoulders, arms and bellies as I work my way back towards the clinic again. “Only people who are blind in both eyes will be screened for cataract surgery.” Just then the door opens, and two of the Doctors come out. They stand up on a bench to be elevated above the crowd and make an announcement. Dr. Brian, the peoples’ favorite, is speaking. “Yes, we only have five more places available. But we will still screen everyone here, and diagnose your problems. If you came here, we’re going to do what we can to help you.” He goes on to say something funny that I can’t hear, and the crowd laughs. Then they break into applause, and disperse back to the benches and the shade of trees.
I asked Eusebio if he wants to go in the Operating Room to watch Dr. Carlos Martinez and Dr. Jim Wheatley perform surgery. We gowned up, put the gauzy blue nets over our feet and hair, and put our masks on. Upside down. Which neither one of us knew until we were already in the OR and saw everyone else’s. I choose to think that nobody noticed ours. Right outside the OR, a nurse was “blocking” the next patient in line. That means, instead of being anesthetized for surgery, they receive a big needle into their eye to numb it. Other than that, they’re wide awake and conscious. The man on the stretcher looks skinny, frail and brown against the teal and dark blue hospital sheets. I can see the loose, wrinkled skin and the veins of his withered brown forearms crossed over his hips. He is laying perfectly still as she pushes the needle through the skin of his bottom eyelid and all the way in. I should’ve been shocked at that moment, but I’ve grown accustomed to the way Hondurans quietly and stoicly accept instruction and pain.
Inside the Operating Room, Eusebio stands near Dr. Martinez to watch him finishing up the lady being operated on. I move to the edge of the bed of the patient that Dr. Wheatley is in the middle of. The lone eyeball he’s working on (that’s the only way to describe it, the patient’s entire face is covered by a hospital-blue paper sheet with only the eyeball exposed through a plastic window) is lit up brightly by the lamp. It is a big, round and wet orb sitting in a bright-red pocket, as the lids are pulled far open by calipers. I see the blade of something flat and sharp working, working, digging, sliding around under the clear bubble of the lens. It’s fascinating. He is finishing up and I move out of the way for the scrub nurse. Dr. Wheatley stands up and walks around a little to take a break. Then the patient from the hallway is walked into the room by the nurse who did his block, and instructed to lay down on the table with his head near the surgeon. I move into position to be directly over Dr. Wheatley’s shoulder. The scrub nurse pats the man’s hand, says something to him, and then takes the paper face-sheet and unceremoniously sticks the little plastic window in the middle directly onto his eyeball. Literally, she puts a big plastic sticker right onto his eyeball. He is now just “an eyeball.” I cringe as she takes scissors and matter-of-factly cuts a slit across the plastic, exposing the eyeball. Then come the calipers to pull back the lids. Now, the eyeball is big and round and wet, paralysed in place by the numbing of the block, the iris a colorless glow from the blinding light of the operating lamp. Dr. Wheatley begins, and explains the procedure to me as he goes.
There is an incision, and some cauterization, and irrigation, and the making of a “channel” as he presses down on the firm white part of the eyeball. It looks like that firm white part of the eyeball is pretty solid, from the way he’s pressing so hard. Maybe it feels like pressing a small spatula onto the surface of a plum. It begins to make a visible dent into the solid fleshiness. The room was frigid when I came in, but now it feels just as hot as the air outside and I wonder how the doctors work in such unregulated temperatures. Dr. Wheatley explains to me that he’s making the channel as a receiving port and way of entry for the old and new lenses. Eusebio seems to have gotten bored with not being able to see the other surgery very well and is standing over by the door, so I crowd in a little closer and motion for him to come over. Why should I get the only cool vantage point here? Eusebio just waves. I go back to watching Dr. Wheatley. There is a little blood beginning to pool in the pockets of the stretched-back lids, and he irrigates it. It clears up and the beautiful clean white of the eyeball appears again. My mask feels crooked so I reach to adjust it, and I discover that my face is sweating. I notice that, actually, I feel kind of off. I go back to watching the surgery. I want the funky feeling to go away, because the procedure is so interesting and how many times will I get the chance to see one? Dr. Wheatley explains that the liquid dye he’s going to put in will turn the cataract blue, and allow him to see it much better so he can pull it out. It is a primitive form of surgery compared to the modern techniques used in America, but it’s the best they can do in the makeshift conditions of the Honudran clinic. The dye floods in a blue river underneath the lens, and the cataract immediately turns royal blue. I begin wishing that my liver and kidneys would leave me alone and stop melting. Dr. Wheatley sticks the blade thing in, or maybe some sort of tweezer-y thing, I can’t really remember, and starts digging and tugging. I see the patient clench his fist, but other than that he makes no movement or sound. Dr. Wheatley pulls out a large gummy chunk of yellow jelly and explains that the giant cataract has broken in half. He still has to scrape around and get the other half. Aware that something is very, very wrong with me, I am angry at myself because we’re just getting to the cool part. I want to see the old lens delivered, and the new rolled-up lens put in. But the tile on the walls look funny. I look at Eusebio in the corner and he’s looking at me. We have a moment of telepathic understanding. I leave Dr. Wheatley’s shoulder before I do something horrible like crash and take the operating lamp to the floor. I see that Eusebio’s face is sweaty too. He asks if I want to get some air, and both of us push the OR doors open, strip off our gowns, and walk as fast as we can towards the fresh air and sunshine.
Happy to be out of the OR and back to my normal interviewing assignment, my big smile is brought back to a frown when Adam motions me over. I can tell it’s not going to be good. “Here, you have to watch this. I filmed it while you were gone.” On the tape is a middle-aged man wearing sunglasses, and the voice of one of our translators. The man tells us that a group of thieves has been targeting his village, and that he formed vigilante group to protect the women and children against them. The thieves found out about this, and one night they got him alone. They began to slice at him with machetes and he put his arms up in front of his face. But he didn’t know there was someone behind him, and the thief brought the machete around and purposely sliced out both of his eyes. I am listening intently to him tell his story completely matter-of-factly, and admiring this man for his selfless bravery. He says that one of the attackers was a woman. I can feel that first shaky sensation in my chest of wanting to cry for him. Then he lifts up his sunglasses and the translator reaches up to pull apart his eyelids. I can see that there’s something in there, but I don’t know what it is. It’s not eyeballs. It’s all red. It is obvious there is no restoring his vision. I see the cut marks that go from his eyes, up both sides of his head. Then the man unbuttons his shirt and pulls up his undershirt. There are miles of scars where the machetes have slashed at him. On his ribs, on his back. “They meant to kill me. But I will protect my village.”
These three things have happened back-to-back and it’s not even 10AM. I am completely drained at this point. Emotionally exhausted. These Hondurans… they accept these horrible things as their fate. I walk alongside Dr. Martinez and he tells me about his first year here. “About the third day in, I realized what a small drop in the bucket we were, and I began to feel hopeless. But I try to focus on what I can do while I’m here, and that helps. [The Hondurans] are such gracious people, and they accept everything that happens to them. Sometimes I envy this, and sometimes I wonder if it’s part of the problem.”