Barriers

 

One of our solutions, the party
One of our solutions, the party

 

Why do you not participate in an international humanitarian surgery for cleft lip and palate?

The basic barriers which confront any student, resident, or colleague who desires to partake in international service in surgery are: language, contacts, and surgery equipment. When I awoke, Rip Van Winkle-style, from my several hundred CNS intravascular tumors in May 2001, I realized that continuing the life of helping other people with a science and skill – surgery – was not possible. Without medical license, nor driver’s license, without the 11 million dollar power of the foundation Interplast, with need of collateral pathways in parts of the brain, which are affecting by “chemo-brain condition,” and with proved absence of tracking and mapping functions. That being said, and those conditions being collated into the new life plan II, the actual fact of retirement was confirmed.

Dear Doctor, even if you have a spirit which is unquenchable, you have many fewer resources. What to do was the question. Next to nothing was a reasonable option, but the answer to the problem was simply: “Answer the phone calls, Señor.” “See what they want.” I did that and enjoyed each call. I talked to the extent that I could determine what the subject matter of the contact was all about, and then pursued whatever it might be, with research on Google, in encyclopedias, and other conversations with people, and let the thread lead on and on.

RAC called and asked for a lecture in his new class, sophomore seminar, “Medical Experiences in Foreign Lands.” “Why do that, Professor?” “The purpose is to establish personal contact with students.” That purpose had been stated by the wise governance in charge of the Stanford spirit, the Stanford method.

“But I can’t; I have no slides; no dog and pony show.”

“I have nothing, I am not together.”

“Come to class anyway.”

“Okay.”

I sat there. Professor Jim Mark told about his kind and happy experience in Dar Es Salaam, Tanzania. David Werner told about village healthcare in the mountains of Mexico, where they are no doctors; treating person to person, his reference being the Merck manual. The question, “Don, what do you think?” turned the ignition key. My lecture was, “I am one of you,” I said in Damien fashion. “No skill, no science, nothing to offer the peoples in the foreign lands, but let me tell you the joys of that as a career, and how that happened here at Stanford, the strongest and best research institution in the world.” I talked about RAC realizing the priority to forward the field of medicine by following the path, which was posted to be, “Research, my son.” But, he slipped up personally, performing a CL&P repair with assistance from students who were helpers to the fact. They shared in the satisfaction of doing it. That compensation was later given the name, “psychic income,” which is attached to the wonderful experience, not to be found in bio-tech business nor even in research and science discoveries.

I realize now that it was not to be acquired of the path titled, “Research my son.” It was found to be abundant and easily attainable as one of the low-lying fruit, able to be picked at every corner on the path marked, [insert name later]. Here it is; this way makes sense. Here is where all previous training and experience are quietly compelling. This is what I want to do for the rest of my life. Helping persons directly with a magnificent science and skill which can be applied to persons in foreign lands, and which is able to be learned simply with hard, hard, hard work, a desire to reach the nirvana of delivering something done by your own hands, and with the help of your nice comrades. I will show you cases for demo. The barriers and obstacles are significant, but they are not like the dead ends which are contained in a maze. [INSERT PICTURE OF MAZE] The crises that happened are not problems; actually, they are opportunities to meet other sections of society, people with other expertise. These persons will bring the disciplines, which enlarge and contribute to your joy of learning. They are found at the university (of Stanford), and later on, they are found in another bubble: your non-profit 501.c.3, public interest, educational, and the group of like-minded expert friends. The basic needs have the appearance of barriers: language, contacts, equipment, and skills, but these are forthcoming.

Regarding contacts, the initial parachute trips made just 40 years ago have naturally become the sustainability factor, which is now recognized as so important in construction of any international program:

Lemperle, Phil Collins, Jose Barragan, Luis Bueso, Oscar Asensio, Fernando and Luis Monasterio, Namik Baran, Morselli, Hein, Bhumsak Saksiri, Pahn [confirm name], Jose Maria Salido, Loja [find name], the Communist from Cuenca, Cesar Mischaan, the man from Samoa, the Americans: Bill Magee, Eid Mustafa, Charles Horton, Brian Mullaney, Erving Grousbeck, William Lazier, Bob King, Barbara Sonsini, the Congressman from Gilroy, Paul Daines, Chuck Swanson, Susan Hayes, Amy Laden, and the forebearers of Interplast: Jesus of Nazareth, Albert Schweitzer, Tom Dooley, David Werner, Kent Garman, Lauren Eltherington,

This means that the next set of confreres is forthcoming, at this time. They are Jonatan Dunlap, Clayton Crawford, Ariana Afshar, Sonja Sumagh, Evaleen Jones, Arlene Samen, Catherine deVries, William McClure, Dick Ott, Roberto Palma, Richard Siegel, Zimmermann, Jill Helms

The fourth big problem, for students especially, is that students are regarded by any foundation in the United States as “useless,” a “liability,” “I don’t know about teaching,” and “they don’t contribute directly to the bottom line.”

“Barriers” are not things that get in the way. Rather they are opportunities. As you all well know crises in the Chinese cultural connotation is problem and opportunity. With that in mind, barriers are really simply the means to the end, the means by which to develop the full potential of the foreign mission.
Barriers are opportunities. The opportunity to establish new contacts and networks. “Barriers” are apparent; they appear to be things in the way and they may discourage anyone undergraduate or medical student, practicing physician or academic physician educator they are not true barriers; they are opportunities for one to talk and meet with other people and expand one’s networking using solutions of the other players. In barriers the psychological attitude is as important in their management as is the physical, intellectual, and spiritual, and of course social approach. Judy said Don, stop praying for problems and crises; you have enough.

They only open more doors to other personalities and other organizations. Don’t you have enough friends? But on the other hand, we welcome these doors opening.
So in this theory, the law of paradoxes is helpful. We develop two columns, the reality in black color and one the barrier in color.

Stanford medical school

  • Heavenly and muscular center for practice and for the creation of new theory and principles
  • Many resources
  • but lacking the ability for application of the theory and practice

Mexicali

  • human pathology abundant
  • requests for increase knowledge and skills
  • but one of the world’s worst climates and having few resources

Mexicali

  • workers with highest incentive possible
  • tax free exemption in place – Maliquidores allow American manufacturers to establish factories in Mexicali
  • cleft lip and palate abundant; little medical care
  • invitation to begin medical interchanges with Americans
  • turf fences and wars easily startedStanford medical school
  • personnel at all levels teaching and patient care chomping at the bit for good cases: the cleft lip and palate cases
  • barriers are the medium, the agent, the method, the opportunity to put into effect and the impulse to demonstrate the foreign mission program spirit
  • Interplast foundation forming a synergy with the university medical school
  • Each organization has a sense of self-ownership and a proprietary instinct

Interplast is a spirit and an organization

To answer this “request”, a system has been put into place: the Swanson Instrument Loan Program of Laub an offshoot of the student gift program.

$125,000 has been put to work for acquisition of fine plastic surgery instruments by the Swanson family foundation of Ogden, Utah. Affable friend Chuck Swanson is experience in acquisition of instruments from the armed services particularly in trade for larger items such as beds in wheelchairs which are exchanged in and unique system to obtain brand-new instruments without direct purchase. Hospitals have been phased out by owners such as Aurora medical insurance company in a consolidation. Entire hospitals and their capital equipment have been acquired, including portable x-ray units and anesthesia systems. DRL and Swanson developed a plan to loan to any of approved by us, provided the beautiful instruments are returned. Attorneys were employed to develop a legal return agreement. (Footnote see p.m. Notice by US mail was given to every AAS PS member in 1982. (Footnote – Javier Beut Mallorca Spain, CPM of Plastic Surgeons of the World Cirujanos Plasticos Mundi use the instruments on several occasions for actual teaching workshops in India, Kenya, Albania. The system worked but few responded. Therefore in the interest of better use we donated them to this most frequent user of the plan. The concept seems to be good enough to reinstitute under administration by the Craniofacial society which has umbrella capability (able to supervise such a program)

capital equipment can be requested from the same source: anesthesia machines, autoclave, oximeter, monitors, mouth gag, dermatome. Another program is the student instrument gift program (Laub and Lederer*) a set of 24 Brian instruments are available both as a gift to the host surgeon of a form medical mission, an individual or a group. The other 12 instruments being a gift to the student or resident in order to promote their career**these programs are an example of what anyone is able to do.

____________

***Adson Brown forceps, Mosquito forceps, Crile Wood needle holder, amygdala tonsil snap, etc.

 

 

 

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