The Gift

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Dr. Robert “Bob” Couch
GLMS President

I am writing this from northeastern Peru, sitting on the bank of the Huallaga River. This river will become the Marañón River, flowing into the mighty Amazon as it courses east through Brazil into the Atlantic. I’m in the jungle, and the temperature reached 38 C (about 100 F) today, but because of the humidity, it feels much hotter. The air is heavy, and as a non-acclimated Gringo, I can feel the weight of each breath.

I’ve come back to Peru with Teach to Transform, an organization founded several years ago by a colleague in my Emergency Medicine practice, Dr. Tom McKechnie. He created this faith-based organization to empower indigenous people to provide basic medical care in their own communities. Instead of a “go and do” philosophy, he’s adopted a “go and teach” approach.

Our first trip to Peru last year emphasized basic wound care, health and hygiene, and taught the Helping Babies Breathe program of the American Academy of Pediatrics, a neonatal resuscitation curriculum for resource-limited circumstances. The impact this can have on reducing infant mortality is tremendous, saving upwards of 80 percent of newborns that are not breathing at birth.

This year, we are teaching splinting, suturing, and IM injections. Our students come from near and far, some traveling days by boat on the rivers to receive our training. While the need for these skills is not as great in urban areas, many in the rural regions do not have access to any kind of medical care. Empowering these residents with skills to aid their community can have a huge impact on ensuring that patients are getting the appropriate initial care and referral to a clinic when necessary.

We are working with several local physicians who staff a clinic in the city of Chazuta, our home base while in Peru. These physicians are assigned to the clinic for a year, providing a required year of rural service, between their completion of medical school and the start of their specialty training. They practice in austere conditions, doing the best with what they have. We were able to provide their clinic with basic equipment and supplies supplementing what they had on hand.

As a physician in what I believe is the greatest country in the world, I find myself taking many of our accouterments for granted. We practice in comfortable offices and hospitals, and go home to sleep in comfortable beds. Most of us don’t ford rivers, climb mountains, or risk our lives to get to our patients. We are blessed beyond words, and I think we have a responsibility to share the gif of healing that has been given to us.

There are many opportunities to share our gifts. Here in Louisville, two great examples are clinics run by volunteers and medical students at the Men’s and Women’s campuses of The Healing Place. Dr. Erica Sutton has spearheaded the efforts to bring Surgery on Sunday to Louisville, providing much-needed surgical care to patients who could not otherwise afford to have procedures performed.

Our own GLMS Foundation provides a number of openings for service, including local, state, and international missions. Dr. Denise Puthuff, chair of the Foundation Medical Missions Committee, will once again be organizing their annual Nicaragua trip in January. The Foundation keeps a list of medical mission opportunities on its website.

Some physicians say, “There’s nothing I could do on a mission trip,” or “I could never take the time to do something like that.” I thought the same for a long time, being envious of the surgeons who go and have such an immediate impact on patients. I’ve learned that anyone can have a great influence on the success of an undertaking. Our length of service can be from a few hours to a few days, weeks, or even months. We can all teach, passing on our knowledge, and perhaps igniting a passion for others to do the same. We may not even know what effect our activity may have. Our biggest impact may be through a simple act of human kindness, such as giving another person a drink of clean water.

Serving others outside our usual comfort zone has many other benefits, such as giving us an opportunity for introspection. Am I impatient or rigid? How well can I adapt in unfamiliar territory? How can I get back on the path to self-actualization?

Ultimately, I go not only because of the effect I can have on others, though this is a noble calling; I go because of the effect others have on me. Going and teaching has changed my worldview, and helps restore my faith in our ability to help each other.

These trips are not without their own peril. I will have to transition from teaching basic medical skills to someone who has traveled days through the jungle by boat, to returning to the states and seeing yet another irate patient, Google printout in hand, telling me what they’ve decided is wrong with them, all the while berating me because they had to wait an hour for me to see their “emergency” that has been present for six months. I just have to take a deep breath and smile, knowing that somewhere else, a person I’ve shared my gif with is helping another.

Docendo discimus – By teaching, we learn.

Robert Couch, MD, MBA, is the emergency department medical director at Norton Audubon Hospital and the founder of Southern Emergency Medical Specialists, PSC.

Reprinted by the permission of Greater Louisville Medical Society.

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