What a week! These last seven days have been brimming with excitement and fun.
Nasal Sidewall Basal Cell excision
All hands on deck for hernia repair
Monday began with an excision of a basal cell carcinoma from the nasal sidewall. Tyler, the PA student, and I scrubbed in and it was one of the strangest cases I have witnessed in my short career as a plastic surgery intern. What was crazy about the case was the fact that the patient was awake and fully conscious throughout the whole thing. Dr. Moorman injected a local anesthetic, we covered part of her face with drapes and she closed her eyes, but she was alert and vocal through the whole procedure. The reason for this was twofold: intubation wasn’t necessary for the brief operation, and, this was the hospital’s form of Moh’s surgery, in which the suspicious lesion was run downstairs to the pathology lab, scanned for cancer, checked for clear margins, all while the patient and surgeon are in the OR. This patient’s scans came back as basal cell which is cancerous, but not malignant, and the margins were clear so we did not have to take off any more. The second patient of the day had an inguinal hernia that we were able to remove. Inguinal hernias are in the groin region and occur when the hernia falls through the inguinal canal, the “holes” that the testes drop through during development. The major risk associated with the procedure is the cutting of the spermatic cord which can lead to infertility or loss of a testicle. Luckily there were no accidents and the hernia was removed successfully, the mesh put in place to prevent further growth, and the skin stitched back up. We were then supposed to have two more cases, a lipoma and melanoma excision but the hospital had some failure in their water system and all the faucets were pouring brown water, which is not exactly hospital standard sterility. With the OR closed to non-emergent cases we headed home to make dumplings with the kids.
Tuesday and Wednesday we were back in the office and it went significantly smoother than the previous week. Lexi, the PA students, and I mastered the trade, switch, and swap of pairing up to meet patients and we each got to see a fascinating menagerie of clients. On Tuesday, we met with breast reduction and hernia consults, skin checks, a man with a strange sac of fluid in his elbow, and even a lady who threatened the life of one of the PA’s. Wednesday was very similar to last week’s with many skin lesion excisions and a few follow-ups. We did remove a giant cyst from the back, and stitched up a father who had sliced his leg with a machete that morning while chopping coconuts.
Baths at Virgin Gorda
Snorkeling at The Dogs
Thursday we were up and out of the house early in the morning, not headed to the hospital or the office, but to the marina where we were to meet Captain Rob and set out on a four-day excursion to the British Virgin Islands. The five-hour crossing from St. Croix on the forty-three-foot catamaran was seasickness-inducing, yet pleasant. We arrived in the bustling tourist hub of Tortola in the early afternoon, cleared customs, and headed for The Indians snorkeling site just off of Norman island. The colors and sheer abundance of fish were nothing like I’ve ever seen before. We sailed to Cooper Island from there, where we moored for the night after Stand-Up-Paddle boarding to shore for dessert. Friday morning Lexi and I awoke to the splashing of water against the port holes and the welcoming voices of Ava and Stefán through the roof hatch informing us we had arrived at the Baths. The Baths at Virgin Gorda are the most visited site in the B.V.I.’s and have been the location of many Victoria’s Secret photo shoots. The rock formations coupled with the crystal blue water was utterly stunning and the snorkeling off-land was on the same caliber. We saw a two to three foot long lobster which was unlike any Maine lobster I have ever been exposed to, as well as a stingray. From the Baths we headed to the Kraken, a sunken ship intentionally wrecked by Sir Richard Branson that is fitted with an art installation of sorts–a giant metal Kraken with tentacles surrounding the entire boat. The burning-man-esque dive was incredibly cool, but slightly eerie. Our next stop was The Dogs, a snorkeling site less remarkable for its fish, but more for its coral and marine flora, where we saw a school of sixteen squid. The busy day closed on Scrub Island where we relaxed in the pool and took our host family and captain out to dinner.
Saturday was, not surprisingly, another wonderful day that we began at Fallen Jerusalem, yet another spectacular snorkeling spot. Here we saw school upon school of fish, as well as a flounder, and an octopus (a rare find). Next we took an unanticipated stop at Cooper Island to wait out inclement weather and walk on stable land. Everything happens for a reason and it was here at this unplanned excursion that we saw at least five turtles, including one that came right up to the side of our boat. Once the storm had passed, we made our way to our final snorkel spot, not to the pristine waters of a reef but to the slightly murky depths above the R.M.S. Rhone, a 300 passenger steam-sail ship that sank in 1867 in a hurricane. The wreck is now colonized by coral and other marine life and gives off quite a spooky feel as you think of the twenty-two crew and one passenger that survived out of the 300 people on board. That night we docked at Peter Island, ate as much as possible to avoid baggage the next day, and went to bed after a few games of cards. This morning, which feels like an eternity ago, we pulled into St. John, cleared customs as we were technically back in the U.S., said our goodbye’s to Captain Rob, and boarded the ferry for St. Thomas. From the port we jumped in a taxi headed to the other side of the island where we boarded a seaplane. I’ve done planes, I’ve done ferries, I’ve done catamarans, but never had I done a seaplane and it was very exciting to see a new method of transportation. After a long day of travelling we finally made it to our third and final U.S. Virgin Island, St. Croix, the one we have become most fond of. I’d like to extend my gratitude to the Moorman family for giving us these four incredible days in the B.V.I.’s and for taking us into their family to the extent we felt as if we were going home after the adventure. Despite the disorienting rocking sensation I feel right now because of the boat, the trip was still hands-down well worth it. Let’s see what the OR brings this week.
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