Something good always comes from a bad thing. After fifty thousand operations without any mortality at all, the one case that died taught us a lesson worth fifty thousand lessons. The record 1:50,000 is a superior record compared to certified United States and developed world hospitals. In December 19, 1983, a child Pablo Ramirez age 6 awoke from anesthesia after a beautiful bilateral cleft lip repair. Strangely in 90 minutes he underwent a series of grand mal seizures from hypoglycemia and died despite all measure of resuscitation. The diagnosis was a mystery because we did not have lab work on the spot. The diagnosis and treatment of hypoglycemia similar to the name Ramirez, was instituted as soon as we returned to our home base on Wednesday.It would have been simple: 50cc of 10% glucose we missed a big problem which it had a cure. I lectured to Stanford clinical laboratory asking the 35 lab techs to keep the next 50 thousand cases. Gloria Guadalupe purchased “lab in a box” with a single drop of blood we performed 21 lab tests on each of the next group of 50 thousand one by one personally. The lab technicians as a group volunteered to support the Interplast trips, not only with a complete lab in a suit case, but with the expertise of their super empathetic group.
Bob Bell and I came up with the idea of purchasing an airplane, a DC3 as a means to augment the effectiveness and efficiency of the team. It was a good idea. We had a few close calls with the company we’d been using. I’d sent one of my pupils, David Fogarty, to set up a program in Navojoa, Sonora, to use Flying Doctors for transportation. Bob Bell was our chief pilot and he accompanied Fogarty to oversee the safety rules of the Flying Doctors (a group of Doctors who were pilots and enjoy flying too remote places to apply their medical and dental skills to “have nots”). I instructive young Fogarty DDSND to take as much responsibility as was requiter however the obsessive compulsive side of the Fogarty personality discover that some safety rule were imperfect and to take as much responsibility as he dared. On their first trip, the pilot ran out of gas just before landing in San Jose Airport. On the second trip, the pilot got lost over the Tehachapi Mountains before Bakersfield. On the third trip, he noted that they flew overweight for that aircraft. Doctor Laub decided to disengage ourselves from the Flying Doctors and start our own Interplast Air Force. A key reason for it being a good idea from Bob Bell. Laub and Fogarty were very concerned about the safety of the team and we needed the OCD Bob Bell to rely on for safety.
The Air Force became very successful. Bob Bell, who had experience as a pilot for the Flying Tigers in China and Indonesia, could not be denied position of Chief of the air Force. Saint George Chippendale became co-pilot and Chief of the Stevedores.
We purchased a DC3, the safest airplane ever flown except for the 747. It seemed that it would never go down even flying on one engine at only 50mph. Bob put full effort into setting up and managing a maintenance program for the airplane. Sure, failures will occur and they did. But Bob had the responsibility of keeping the maintenance program up to snuff. An example of the effects of poor maintenance would be the failure of an engine and then the propeller wouldn’t feather because of corrosion. A safe airplane has big problems with double failures.
His flying skills came from discipline training and experience with Flying Tigers. He stuck to high high discipline and focus through thick and thin. He used a weight scale to measure everything loaded onto the plane. Bob always had the numbers right. He flew by the numbers. But things are a little easier with the DC3 when the shit hits the fan.
The selection of the DC3 for the mission was perfect from the standpoint of the mission. The weight capability made it safe for the weight required. The big wing (low wing loading of 25 lbs per sq. ft._ gave the pilot more of a feel of what’s going on aerodynamically and at the slower speed things don’t happen as fast. A high wing loading airplane relies on being flown by the numbers and distractions with emergencies are more likely to cause problems.
Another example of airplane malfunction is the twisting of the Convair. That will occur when one engine fails and the other engine twists the airplane in yaw and roll. The DC3 and the other hand has very big vertical fin and rudder with plenty of control capability to keep it straight. Although the pilot does need strong legs. During the war, when women ferry pilots were flying DC3’s, jealous men pilots soon learned that women had very good leg strength. As long as it wasn’t overloaded and had enough runway, the DC3 was as safe as was available with piston powered aircraft, at the time we were putting together this concept. And its price was very reasonable. Turbine aircraft were better as far as safety, but the price was out of this world.
We made it into a cargo plane for our 40 boxes of equipment and we recruited flight attendants from the residents’ wives. Carol Commons, Roseann Bell, and other beautiful women, provided sandwiches, coffee, and most of all espirit des corps. Fogarty was there to insure that all were laughing at all times. Who said you couldn’t have fun being a missionary?
At one time, I commissioned three hundred and fifty cazuela bowls in order to have parties with the right equipment for cazuelas voladoras. The previous cargo planes, the light cessnas of the Flying Doctors were unable “to get off the ground” with the clay bowl cargo, and Fogarty had to jettison bowls to make altitude over the mountains. Another reason to quit the Flying Doctors, lack of power.
All in all the DC3 was a very good concept for the mission. There was no question about the way that concept could augment the relationships and camaraderie of the team. We certainly didn’t mind the time it took to Honduras. It was enjoyable. Its use for flights to smaller airports would be restricted because of concern about being real safe in continuing to fly or being able to stop on the runway if an engine fails on takeoff. Bob paid full attention to the realty of the dangers associated with flying and the key element that made it safe was the discipline and hard work he put into it.
One further advantage of the DC3 was that each of the 12 cylinders arrange a circle pattern could be changed simply by unscrewing and inserting another in it place saving lengthy engine overhaul. Such unscheduled landing was a recurrent problem on one occasion over Veracruz one piston failed; we landed, and change the piston-a one hour only delay another hand we landed in Coatzacoalcos near Minatitlan Veracruz another cylinder had gummed up. George Chippendale was not to be denied the trip to San Pedro Sula he took the bus over night to mexico city to buy a spare cylinder. George was denied heroism because it did not fit correctly againsts Bob Bell fearsome warning the engine was retarded without the require braking time the engine locked in and a penalty of 5 thousand dollars for a proper aftercare another instance was in Marfa Texas. The one air field available was used by the narco traficantes industries there was no airport staff available in the airport. In a half hour the INS sheriff arrived delighted to find our four Mexican patients calling them undocumented however upon hearing our sad story about bringing them for surgery he personality turned 180 degrees; he did not arrest or jail any of them but he drove them to the hotel already closed for the night; opened to used for all of us. WOW the power of compassion overcomes the bad habits of a narcos and the uninformed.
In the little story we find that Lucifer had taken the day off and George Chippendale exercised his special connection with that almighty.