See one. Do one. Teach one.

There is an old surgeons’ motto that goes, “See one. Do one. Teach one.” I’m finding it very applicable here in Papua New Guinea. Although, sometimes the first time I see a procedure is the first time I’m doing it! For example, the first tubal ligation I witnessed was when Dr. Pringle, a visiting OB/GYN, walked me through the procedure during my first month at Kudjip. The following month, after Dr. Pringle had returned to the States, I performed many tubals, while showing our trainee, Dr. Cindy. 

Cindy is a Papua New Guinean doctor in the Rural Registrar program. She is the only doctor at her 40-bed rural hospital in the Central Province of PNG. In the program, she gains training in the many specialties that one must know to be a solo practioner: OB/GYN, Pediatrics, Anesthesia, General Medicine, Public Health, and, of course, Surgery. In addition, she gets training in the administrative side of running a rural hospital with courses in budgeting, finance, administration, community relations, communications technology, and maintenance (i.e., how to set up solar power and maintain radio services).  It has truly been a blessing to be a part of her training and to pass on the skills that I have learned. The next time we had a tubal, she did it while I assisted. See one. Do one. Teach one. I’m always amazed how much more I learn when teaching someone else a skill.

The motto doesn’t always hold completly true. For example, the first prostatectomy I saw was one I was doing under the tutelage of Dr. Ben, one of my partners and mentors. Ben grew up here at Kudjip, the son of our senior surgeon, Dr. Jim. After finishing his surgical training in the U.S., Ben returned to PNG to work with his father. He is currently finishing his 2-year term with Samaritan’s Purse Post Residency Program, the same program that brought me to PNG.  Only a few years my senior, I’m amazed at all that Ben has learned in his time here. In addition to learning the orthopedic, gynecologic, and urologic cases we didn’t learn in residency, he has also brought many innovations to the Highlands of PNG, such as laparoscopic surgery, which we take for granted in the States.  Hopefully in two years time, I will feel as comfortable and confident as he is treating the myriad surgical pathologies we encounter here. Even though I’ve seen or done some of these more complex procedures, I’m definitely not ready to fly solo or teach them yet.

Some times the motto is more like “seen a lot, done a lot, and trying to pass it on”.  Dr. Jim has been practicing surgery at Kudjip Nazarene Hospital for 32 years. Most of that time he was the only surgeon here; on-call 24/7. From all those years of experience, he has a wealth of knowledge. Beyond surgical technique, he is also teaching me the intangibles of practicing surgery in a rural, resource-limited setting: When to say no to one patient who has the ability to get services elsewhere in order to help the five patients who have nowhere else to go.  When to say no to an operation because the patient won’t survive post-operatively without a ventilator and ICU level care. When to say no in order to avoid burnout and preserve one’s ability to continue serving here long-term. Sometimes the circumstances seem overwhelming, but Dr. Jim has shown me the most important thing I can learn here: Always say yes when there is an opportunity to share the hope found in Jesus. Countless times, I have witnessed him praying with his patients in the clinic, on the wards, and before surgery in the operating theatre. That is one thing I hope to see and do and teach for many years to come.

(Last two photos courtesy of Katherine Radcliffe)