Excerpts from a Mongolian Mission Journal - Part 1

October 12th, 2010 | Comments POSTED BY: Ivan Shulman, MD, FACS FILED UNDER:

Sometimes-locum-tenens surgeon shares his first-hand impressions during surgical teaching mission to Ulaan Baator

Friday, Sept. 10, 2010

…in the few minutes before my plane takes off from Beijing, I’ll try to give you a quick overview of what I will be doing for the next few weeks.

As you know, I had been doing locum tenens work, covering general surgeons in rather rural and remote parts of the US (Ft. Kent and Houlton, Maine, Dansville, NY, Rock Springs, WY).  Last March, I got a call to cover the hospital in Los Alamos, New Mexico, and as you may know, that is very close to everything I have always enjoyed about Santa Fe.  Long story is that after a few visits, I was offered a job at the hospital in Los Alamos, and since November, I have been working there steadily, commuting to and from Los Angeles weekly as needed so that I can also continue my conducting at the Los Angeles Doctors Symphony Orchestra (www.ladso.org). 

During the summer, I got word of a surgical project that caught my interest.  Out of that, comes this email from Beijing.

I am on my way to join with three other surgeons to teach laparoscopic cholecystectomies (removal of the gall bladder through four little holes, rather than the older traditional long incision.)  We are part of a small team of surgeons, nurses, scrub techs and bio-technicians organized by the WC Swanson Foundation of Ogden, Utah, and are headed for Ulaan Baator, Mongolia.  Actually, once we get to UB, as it is more colloquially called, we will spend tonight in orientation with those who have been there before, and in the morning, I am heading with my team of one other surgeon and half the support staff to a town called Khovd, way in western Mongolia, near where Russia, Kazakhstan, China and Mongolia all meet – for me it is a different version of ‘the Four Corners area.”  If you go to Google maps or Google earth, and paste in these coordinates, you will see the hospital where I will be working.  

48.00385, 91.633288

The “kh” sound in Mongolian is pronounced very much like the Yiddish “ch” sound, so saying at least those things in Mongolian may not be so difficult for me.

The team was in Khovd last year, and we are told that over that time, they went from doing five gall bladder operations to 100.  Part of our job will be not only to continue the teaching process, but also to review what they did, and how they might be able to avoid some of the pitfalls of the learning curve which we all have experienced.  There is apparently a little hotel near the hospital where we will stay, and beyond that, I know almost nothing.  Here is a link to a recent TV item in Salt Lake City about the trip: 

http://www.ksl.com/?nid=148&sid=12129702

I am told that after the 3 ½ hour propeller driven plane flight from UB to Khovd, it looks like the moon when you arrive.  So be it.  Over the weekend, I hear tell that the local staff wants to take us on a four-day visit to the hinterlands, and so I suspect that we will go, forsaking two more days of teaching.  It all looks very remote, and I am looking forward to it, of course.  I am reading a wonderful book called “The Wolf Totem” by a Chinese writer Jiang Rong, who was sent to Inner Mongolia (a part of northeast China) during the Cultural Revolution.  He writes beautifully, and if his tales are anything like reality, I am in for something special.

I’m going to be in Mongolia for about two weeks, returning via Beijing for two nights, and then back to Los Angeles for a few days, and will be back in Los Alamos/Santa Fe after that, to begin my weekly commute again.

I had a good breakfast this morning at a Beijing version of quick food, and instead of burgers and other junk, I had congee with chicken, glutinous rice in tea leaves, and some actually not bad Shanghai pork dumplings (not anywhere as good as Hong Kong or Taipei but, hey for the price of one dollar, I was not at all unhappy!)  My tummy is full, and I am looking forward to taking off in less than an hour.

I like the idea of sustainability in medical missions, leaving something more tangible when we depart, rather than just scars and other short term benefits.  I hope this gets fulfilled for me.

73*,

Ivan

 * “Best Regards,” per The National Telegraphic Review and Operators’ Guide, first published in April 1857.