Goood Morning Vietnam…

Glenn M. Weinraub, DPM, FACFAS
ACFAS President

Okay, after many bowls of pho, multiple bun cha’s, untold numbers of banh mi’s and enough cafe sua da (Vietnamese coffee) to wake the dead I am back in San Francisco where it can start all over again!
 
Those of you who know me also know what a “foodie” I am. When Meagan M. Jennings, DPM, and I were honored last month to join a surgical mission to Vietnam, I was certain of the interesting and varied foods we would encounter, yet I was keeping a wait and see approach to what the nuts and bolts of the mission would hold. Wow, what an eye opener! What I encountered in the operating room really changed my perspective on the usual daily concerns.

Did you complain yesterday in the O.R. that your favorite sagittal saw was replaced by a loaner? Is it frustrating that you can’t use name brand suture and are instead forced to use the generic stuff? Did you hit the roof when the circulator handed you a needle driver without a tungsten smooth jawed grip, despite the fact you have made the staff aware of your preference countless times? Did they actually make you use stainless steel when your surgical diet calls for titanium?

 
_{Do Van Thanh, MD, and Glenn M. Weinraub, DPM, FACFAS, working on a compound pediatric deformity.}

You think you have it bad sometimes in the O.R.? Well, welcome to Vietnam. Where saws are replaced by osteotomes that could double for the same chisels used by Michelangelo; where screws are replaced by homemade staples from donated K-wires; where intra-operative imaging is replaced by the picture in your head and where post-op pain meds are limited to acetaminophen and ibuprofen … on a good day. This is a place where you would rather have a MacGyver assisting over a DeBakey!
 
Despite all that, this was perhaps the most rewarding days of my surgical career thus far. Granted, going off to an exotic, underserved location to donate medical services is becoming commonplace, but what is not common are the incredible people you meet along the way.
 
ACFAS member Thomas J. Kaschak, DPM, from Kaiser Permanente in Fresno, Calif., has been organizing this mission to the Da Nang Orthopaedic and Rehabilitation Hospital for almost 10 years now. He has done this without fanfare and at his own cost. Tom is truly a foot and ankle surgical hero.
 

_{The first morning of the triage clinic. From left: Glenn M. Weinraub, DPM, FACFAS; Heather Bristol, PA; Thomas J. Kaschak, DPM, FACFAS; Do Van Thanh, MD; far right: Meagan M. Jennings, DPM, FACFAS.}
 
His main contact in Vietnam is Dr. Do Van Tranh, an orthopaedist who is not lacking in skills and knowledge, but who does lack funding and technology. Then there are the patients, a group of hard-working, poor, but incredibly optimistic people. The circumstances by which these patients find their way to the clinic are often heartbreaking. There is simply no greater gratification than taking what the patient or parent perceives to be an insurmountable situation and converting it in the O.R. into a positive life-altering result.
 
So, what is the take-home message here? Clearly it is that we are all fortunate to be trained in the Western world where we have access to the best products, instrumentation, facilities and professional staffs. The next time an inconvenience occurs in your operating room, just remember how much different it could be!
 
The second message is that we are in a position to help, so I would ask that in the future you think about donations to any of the well-known and well-administered foreign medical missions. This could include outdated equipment, suture, blades, dressing supplies, and especially any retained hardware that you might remove which is still in good condition. Most organizers of these missions will be happy to accept your donation.
 
Remember, the more you give, the more you get.

Questions for Dr. Weinraub? Write him at president@acfas.org.