Becoming an Ecuadorian Plastic Surgeon: Palacios Part I

Based on an interview conducted with Dr. Palacios at the restaurant of Anne Oh, a student of Course Surgery 150

Gerardo’s Borrero’s father and my own moved out west to the Manabi province after becoming doctors. Gerardos’s father got rich in Bahia. My father actually met my mother at a party in Bahia which made his friendship wtih Gerardo’s father even stronger.

I became a doctor in Guayaquil. After that I went to Argentina to do plastic surgery. During that time Gerardo had a child with a cleft lip and palate. So he took his son to Fernando Ortiz Monasterio (F.O.M) in Mexico. He was the top guy there and very well known across Latin America. He did a good job, but then the boy needed speech therapy.

Gerardo was studying for Banking Business in Stockton, CA and he had a classmate. This classmate was a very good friend of his and was a pediatrician at Stanford. He consulted and put Gerardo in contact with Donald Laub. After this Gerardo and Donald became involved about how Donald could go to Ecuador, and Gerardo wrote me about the possibility of meeting Dr. Laub.

However, I couldn’t meet Dr. Laub at that time because I was still studying in Argentina and couldn’t make the trip to Guayaquil or Cuenca. So I wrote Dr. Laub and told him I would very much like to meet him, but couldn’t abandon my studies. So we arranged for me to meet with him in Palo Alto at Stanford in 1977. He was the chief of the plastic surgery division at Stanford. Interplast which was very small at the time.

As I mentioned, Gerardo’s son needed speech therapy so he was referred to Conti Seeley in the Linguistic Institute in Berkeley. Seeley knew Ecuador and Spanish but did not know speech therapy. So he referred Gerardo to Dr. Chase, Dr. Laub’s boss. Dr. Laub met Gerardo during consultation. Laub assured Gerardo they would be able to help his son, without knowing they even had a speech therapy unit. Gerardo’s son was treated and Laub got to know him. Laub asked Gerardo if there were other cleft lips in Ecuador, he said, “Yes, there are.” He said there were two people who could help arrange a trip there, Jorge Palacios and Edgar Rodas.

The first Interplast trip to Ecuador happened in 1977, a year after Laub visited in 1976 for the Ibarro Latino-American Society in Quito. Laub met Faisal Misle during that first meeting. Faisal’s daughter had been poisoned with lye by her psychotic babysitter. The woman had fed her Drano, burning her whole mouth from the inside. Laub treated her with skin grafting. That was a very important case. Faisal was always a supporter after that. He had invented a lucrative knitting machine, named after his daughter, and dedicated half the proceeds to those in need.

During the Interplast trip to Quito we had four students with us. They stayed with Gerardo and Laub went with the patient, Fabian, who was now 25. He was a photographer and made a tour book of Ecuador. He had travelled to the Amazon where he met with the cannibals, who nobody had ever visited. They had a 20 ft spear with a long point which was very difficult to touch.

I had spent time with the Indian’s as well. Before graduating as a doctor in Ecuador, you have to do a year of service to the government. So I went to the jungle and brought medicine to the Indians. Many of them came for treatment. I was competing with witch doctors, who killed each other with poison to absorb each other’s power.

After this I decided that I wanted to do cardiovascular surgery. Dr. Christian Bernard had made the first heart transplant. I wanted to become the first Ecuadorian surgeon to do the heart transplant in a human being. I got a scholarship to stay at Stanford three months just observing as a medical student. I was not even an intern, I was just observing and helping. I began at 7:00am with the chief resident and I was the last guy to be done that day in the operating room. I had to clean. It was my fascination and I wanted to learn. They gave me from time to time more responsibility.

Untitled drawing

There was a doctor there named Dr. Orticochea who was an arrogant but important guy in the cummunity. His arrogance had no sypathies for residents. THey would say, “Palacios, go to help Dr. Orticochea.” But I wanted to stay in the last row. He said “Who are you?” Well, I am Jorge Palacios.” “Where are you from?” “Ecuador.” “What are you doing here?” Well, there are things that I want to do, such as vascular surgery.” “Don’t do that! Do plastic surgery. Because you only need an assistant, your secretary, few instruments, and then you can do the work in any place where you want to do it.” His advice went in one ear and out the other. He said to do cardiovascular surgery you need an institution, the complex of an institution. But I still wanted to do cardiovascular surgery. 

The next time I heard, “Palacios, go to help Dr. Orticochea,” it was the same thing.

The second time that I came they gave me the opportunity to work as an intern. I was on duty when in comes an Indian man intoxicated with Valium. He had wanted to commit suicide. We lavaged his stomach and he was sleepy, so I had to get his information from his wife. I asked the name and all the information about him. Then she took her wallet and showed me a picture of a beautiful girl of about seventeen years old, very nice. She told me, “She is the reason why my husband is like he is now.” I didn’t really want to ask more because she might be a lover, or something like that. But she said to come back at 3:00 in the afternoon. I was intrigued by the mystery. I went back at 3:00, and a burn sequelae (injury). It shocked me. The lady told me, “My daughter.” The last shock.

Untitled drawing (1)That night I didn’t sleep one minute because it came to my mind: Horticocher and plastic surgery could change the face of this girl, could change all things, could release the contractures. The magic, the plastic surgery, could work. How could Orticochea fix this? Plastic surgery could help this girl. That night when I could not sleep I thought, Okay, this must be the reason Orticochea was telling me about plastic surgery.

I could see how plastic surgery could fix this thing that is destroyed but still I said to myself, I want to be a cardiovascular surgeon. I didn’t want to change my objective so it was a fight in my mind. It was a sensation about my life and my future, about what I’m doing, just a year before I graduated and go to an intensive program. I wanted to know what to do. I couldn’t just leave.

Two days later I asked for a date with Dr. Orticochea. “Well, Doctor, I came here just to talk about what else there is to plastic surgery. He said he could train me in both plastic surgery and cardiovascular surgery, but I would need a scholarship.”

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