One of our worse nightmares in bringing our children to a foreign country was realized when Grant came down with appendicitis and needed an emergency appendectomy. As far as emergency surgeries go, this was a relatively minor and routine one (in fact, an American intern we met only a week earlier while doing her residency in Ecuador said as much in a random conversation); however, that did not make it any less nerve-wracking, tense, or scary. And whenever there is surgery that involves general anesthesia, minor and routine applies to those performing the surgery – not to those who are undergoing it – or their family. Add to that the foreign element – and you have a recipe for disaster or, fortunately in our case – a good story and happy ending.
We were just barely four weeks into our year long trip, but Grant had already violently vomited twice, and, the appendectomy aside, he undoubtedly suffered the most medical issues of the group: migraines, intestinal issues, fractured arm…we became well versed in the Ecuadorean medical system. Yet, fortuitously we were spared the true Ecuadorean hospital experiences, thanks to Ana, our Ecuadorean Guardian Angel.
Greer and I were able to view the Ecuadorean medical system second hand. On our frequent jogs in Ambato, we would run past the local hospital and observe the lines of literally over a hundred people waiting outside to get in to be seen. While doing research for a work project we learned that one of the reforms of Ecuadorean President Rafael Correa was universal healthcare. Many people praised the president and his resolve, yet one of the criticisms was that while access to healthcare was free, it created a shortage of doctors and available hospital beds. I am still haunted by those images and the thought that we may have been subjected to such conditions, were it not for our friend, and guardian angel, Ana Vera.
We had just spent the previous day with Ana and her daughter, Cindy, at La Parque Familia, a sprawling recreational venue on the outskirts of town, with an awesome view of Ambato. It was a carefree weekend, and it was on the heals of our first jungle adventure in Tena/Mishualli. It was a quiet Sunday and we were getting acclimated with our new environs. Our day started out exploring a local Ambato establishment with fellow foreign colleagues from the university. It was soon after lunch that Grant began to complain of difficulty breathing, taking breaks during our short walk home. It was uncharacteristic of Grant to complain, but he ventured on.
It was a Sunday afternoon and we were all excited for the boys to start school the following day. We were meeting Ana who was going to help us navigate the Byzantine school list of things to purchase. I should have known we were in for an ordeal when Ana, a teacher at the school, and Cindy, a former student, had difficulty figuring out all the supplies that were needed and where they could be purchased. It would span several days, multiple stores, hundreds of dollars, and across several continents before we would be done. Though I cannot verify it scientifically or medically - I think the stress of our school supply shopping contributed to Grant’s appendicitis, I know it contributed to my angst.
Still having trouble breathing, we determined that Grant should see a doctor. Late Sunday night, and haunted by visions of those long hospital lines, we were relieved when Ana informed us that she had a childhood friend who was a doctor and had a clinic in town. Dragged away from his workout at the tennis club, the doctor would meet us at the clinic on a sleepy Sunday eve. As we pulled up to the clinic it appeared to be closed for the night. However, we were met by the staff and informed that the doctor would greet us shortly.
Upon his arrival, the doctor did a standard examination… stethoscope, blood pressure, temperature…some things transcend language, culture and continents. He then began probing and poking around Grant’s chest and stomach. It wasn’t until he stabbed Grant in his right side abdomen area that Grant cringed. My years of medical school training (okay – my rudimentary knowledge of basic medical fact) immediately indicated appendicitis. Yet, when told the diagnosis, we questioned the one who did have many years of medical training, and asked why did Grant have trouble breathing if it was appendicitis? We were informed, through our translator Ana, that in younger patients appendicitis manifests itself that way. I also knew from my medical experience that appendectomies had to be performed relatively quickly. Though fleeting as they may have been, we had thoughts of transporting Grant to Miami, or even Quito – a mere two and a half hours away. And the surgeon, who was highly recommended by the attending physician, was on his way to Quito to send his family off to Paris. Though not quite a high-pressured sales pitch, I had the feeling of one of those time-share promotions where if you didn’t take advantage of the deal today – we’d lose out on the two free weeks in Hawaii, only this time, if we didn’t choose the surgery now, we’d lose our son.
Once that decision was made (is it really a decision if you don’t have a choice?), we ventured into an unknown world of Ecuadorean healthcare. While it was far superior to the standard of care your typical Ecuadorean would receive at a public hospital, it was not what one would expect from a facility in the states. Already diagnosed with a serious illness, there was no elevator to take him to his second floor room, so we traversed the steps. Being a private clinic, Grant had his own room and appeared to be the only patient, a far cry from the crowds Greer and I observed on our daily run, and even better than our occasional visits to emergency rooms at home in the States. It was added comfort for what lay ahead.
At this point, I would be remiss if I did not acknowledge the care and support of our guardian angel. It would not be hyperbole to say that Ana saved Grant’s life. Rather than try to navigate the Ecuadorean healthcare system on a Sunday night, we may have said let’s just see how he feels in the morning; or, and this I couldn’t even imagine, go to the hospital and try to articulate and comprehend in a foreign tongue what was going on with Grant. Ana stayed with us for hours, getting take out, providing translation, but most importantly, being a trusted and dear friend to people she had known for nary a month.
It was tense times for all, but none more than for Grant. The rest of us were able to indulge in take-out while he lay helplessly awaiting going under the knife. It was decided that we would all wait until his surgery – by now scheduled for about 10pm – was completed and then I would stay the night while Greer and Garrett would go home. It was a daunting feeling that I did not relish. What had we put our son into, was this a gargantuan mistake to bring our family to Ecuador? None of that mattered at this point, as his fate was determined and the surgery was imminent. There was no attendant, no wheelchair, only his family to escort him to the operating room.
The actual surgery went rather quickly – he was in and out in less than an hour (was the flight to Paris leaving on time?) But what transpired next seemed like an eternity. I am not sure if we should have been relieved and welcomed by the personal care that Grant received, essentially being the only patient, or should we have been concerned that there were no other patients, like the restaurant that has no customers…There is something to be said for the hustle and bustle of a hospital… paging doctors over the intercom, orderlies pushing gurneys through the corridors, the nurses station that functions as command central and, more importantly as surrogate moms… yet these were my idealized visions of what a hospital was like; then I realized I was in Ecuador, and the vision of the patients lining up for the hospital like teenager girls lining up for Justin Beiber tickets knocked me back into reality. I was thankful for our upgrade to a deluxe suite. When Grant was finally wheeled back to his room, long after the surgeon had left, he was still groggy and knocked out from the anesthesia. Greer and I continued to have second thoughts on whether or not we had done the right thing, bringing our children to this foreign land. But at this point – all doubts and reservations were moot.
He came out of the surgery in quite a stupor – incoherent, bug-eyed, unable to communicate – and the worst thoughts went through my head. Those doubts and reservations were exacerbated when Grant began coughing up blood! Panicked, we ran to get the nurse on call and explained in our broken Spanish what the problem was. What I wanted to do was to call the doctors back and scream my, anger, angst and anxiety at the situation. And when the nurse informed us that Grant was fine – that he was just bleeding from his lips caused by a cut from his braces, I thought … did she think I was some dumb gringo who would accept that response? In a word…yes. There was no yelling or screaming – only prayer and hope that she spoke the truth. There was no more coughing up blood.
As Greer and Garrett departed the hospital for a not so good night’s sleep, I was able to catch intermittent but, unsettled, sleep. Of course I continued second-guessing the medical staff – why wasn’t he hooked up to any monitoring devices, why was blood trickling from his IV, why was he still unconscious? At home, he would have had multiple machines monitoring and measuring every heartbeat, pulse rate, breath, brainwave and blood pressure. All he had was the nurse who occasionally came in to check his vitals. Throughout the night I listened for his breathing – it was soothing and reassuring. To say I was awaken by Grant would imply I was asleep, when he blurted out… “Dad, did I have my surgery yet?” and those were the happiest, best and most welcoming words I had heard from Grant since “happy see you daddy”…his first sentence, ever!
Grant was on the road to recovery, however our own recovery and life of normalcy and routine in Ambato, Ecuador would have to wait. Instead of sending our boys off to school while Greer and I enjoyed some much needed down time, we had the added stress of nursing Grant back to health and getting Garrett acclimated to his new school and its environs. In hindsight, Grant’s surgery had a much greater impact than initially recognized. In one sense, it showed that we could overcome just about any adversity that would face us in our adventure. Yet on the other hand, it was a big setback from which it would take some time to recover. The emotional drain left me physically weaken, spiritually shaken, and psychologically damaged.
Grant made a full and speedy recovery. He left the hospital less than 24 hours after his surgery. His rapid return home was very cathartic and therapeutic for us all. His arrival at school a week later completed the first full month of our adventure, yet we all learned many lessons before he took those first steps into the classroom. Not to be lost in all of this is his younger brother Garrett. Not only was he part of the medical drama as it unfolded, but he was tasked with the unenviable task of starting a new school, in a foreign land, where he did not speak the language, by himself, without his best friend who was recovering from major surgery. Garrett's fortitude in the face uncertainty was a source of strength for us all. And For me, it was just another opportunity to practice PAT - Patience, Acceptance and Tolerance.
We were just barely four weeks into our year long trip, but Grant had already violently vomited twice, and, the appendectomy aside, he undoubtedly suffered the most medical issues of the group: migraines, intestinal issues, fractured arm…we became well versed in the Ecuadorean medical system. Yet, fortuitously we were spared the true Ecuadorean hospital experiences, thanks to Ana, our Ecuadorean Guardian Angel.
Greer and I were able to view the Ecuadorean medical system second hand. On our frequent jogs in Ambato, we would run past the local hospital and observe the lines of literally over a hundred people waiting outside to get in to be seen. While doing research for a work project we learned that one of the reforms of Ecuadorean President Rafael Correa was universal healthcare. Many people praised the president and his resolve, yet one of the criticisms was that while access to healthcare was free, it created a shortage of doctors and available hospital beds. I am still haunted by those images and the thought that we may have been subjected to such conditions, were it not for our friend, and guardian angel, Ana Vera.
We had just spent the previous day with Ana and her daughter, Cindy, at La Parque Familia, a sprawling recreational venue on the outskirts of town, with an awesome view of Ambato. It was a carefree weekend, and it was on the heals of our first jungle adventure in Tena/Mishualli. It was a quiet Sunday and we were getting acclimated with our new environs. Our day started out exploring a local Ambato establishment with fellow foreign colleagues from the university. It was soon after lunch that Grant began to complain of difficulty breathing, taking breaks during our short walk home. It was uncharacteristic of Grant to complain, but he ventured on.
It was a Sunday afternoon and we were all excited for the boys to start school the following day. We were meeting Ana who was going to help us navigate the Byzantine school list of things to purchase. I should have known we were in for an ordeal when Ana, a teacher at the school, and Cindy, a former student, had difficulty figuring out all the supplies that were needed and where they could be purchased. It would span several days, multiple stores, hundreds of dollars, and across several continents before we would be done. Though I cannot verify it scientifically or medically - I think the stress of our school supply shopping contributed to Grant’s appendicitis, I know it contributed to my angst.
Still having trouble breathing, we determined that Grant should see a doctor. Late Sunday night, and haunted by visions of those long hospital lines, we were relieved when Ana informed us that she had a childhood friend who was a doctor and had a clinic in town. Dragged away from his workout at the tennis club, the doctor would meet us at the clinic on a sleepy Sunday eve. As we pulled up to the clinic it appeared to be closed for the night. However, we were met by the staff and informed that the doctor would greet us shortly.
Upon his arrival, the doctor did a standard examination… stethoscope, blood pressure, temperature…some things transcend language, culture and continents. He then began probing and poking around Grant’s chest and stomach. It wasn’t until he stabbed Grant in his right side abdomen area that Grant cringed. My years of medical school training (okay – my rudimentary knowledge of basic medical fact) immediately indicated appendicitis. Yet, when told the diagnosis, we questioned the one who did have many years of medical training, and asked why did Grant have trouble breathing if it was appendicitis? We were informed, through our translator Ana, that in younger patients appendicitis manifests itself that way. I also knew from my medical experience that appendectomies had to be performed relatively quickly. Though fleeting as they may have been, we had thoughts of transporting Grant to Miami, or even Quito – a mere two and a half hours away. And the surgeon, who was highly recommended by the attending physician, was on his way to Quito to send his family off to Paris. Though not quite a high-pressured sales pitch, I had the feeling of one of those time-share promotions where if you didn’t take advantage of the deal today – we’d lose out on the two free weeks in Hawaii, only this time, if we didn’t choose the surgery now, we’d lose our son.
Once that decision was made (is it really a decision if you don’t have a choice?), we ventured into an unknown world of Ecuadorean healthcare. While it was far superior to the standard of care your typical Ecuadorean would receive at a public hospital, it was not what one would expect from a facility in the states. Already diagnosed with a serious illness, there was no elevator to take him to his second floor room, so we traversed the steps. Being a private clinic, Grant had his own room and appeared to be the only patient, a far cry from the crowds Greer and I observed on our daily run, and even better than our occasional visits to emergency rooms at home in the States. It was added comfort for what lay ahead.
At this point, I would be remiss if I did not acknowledge the care and support of our guardian angel. It would not be hyperbole to say that Ana saved Grant’s life. Rather than try to navigate the Ecuadorean healthcare system on a Sunday night, we may have said let’s just see how he feels in the morning; or, and this I couldn’t even imagine, go to the hospital and try to articulate and comprehend in a foreign tongue what was going on with Grant. Ana stayed with us for hours, getting take out, providing translation, but most importantly, being a trusted and dear friend to people she had known for nary a month.
It was tense times for all, but none more than for Grant. The rest of us were able to indulge in take-out while he lay helplessly awaiting going under the knife. It was decided that we would all wait until his surgery – by now scheduled for about 10pm – was completed and then I would stay the night while Greer and Garrett would go home. It was a daunting feeling that I did not relish. What had we put our son into, was this a gargantuan mistake to bring our family to Ecuador? None of that mattered at this point, as his fate was determined and the surgery was imminent. There was no attendant, no wheelchair, only his family to escort him to the operating room.
The actual surgery went rather quickly – he was in and out in less than an hour (was the flight to Paris leaving on time?) But what transpired next seemed like an eternity. I am not sure if we should have been relieved and welcomed by the personal care that Grant received, essentially being the only patient, or should we have been concerned that there were no other patients, like the restaurant that has no customers…There is something to be said for the hustle and bustle of a hospital… paging doctors over the intercom, orderlies pushing gurneys through the corridors, the nurses station that functions as command central and, more importantly as surrogate moms… yet these were my idealized visions of what a hospital was like; then I realized I was in Ecuador, and the vision of the patients lining up for the hospital like teenager girls lining up for Justin Beiber tickets knocked me back into reality. I was thankful for our upgrade to a deluxe suite. When Grant was finally wheeled back to his room, long after the surgeon had left, he was still groggy and knocked out from the anesthesia. Greer and I continued to have second thoughts on whether or not we had done the right thing, bringing our children to this foreign land. But at this point – all doubts and reservations were moot.
He came out of the surgery in quite a stupor – incoherent, bug-eyed, unable to communicate – and the worst thoughts went through my head. Those doubts and reservations were exacerbated when Grant began coughing up blood! Panicked, we ran to get the nurse on call and explained in our broken Spanish what the problem was. What I wanted to do was to call the doctors back and scream my, anger, angst and anxiety at the situation. And when the nurse informed us that Grant was fine – that he was just bleeding from his lips caused by a cut from his braces, I thought … did she think I was some dumb gringo who would accept that response? In a word…yes. There was no yelling or screaming – only prayer and hope that she spoke the truth. There was no more coughing up blood.
As Greer and Garrett departed the hospital for a not so good night’s sleep, I was able to catch intermittent but, unsettled, sleep. Of course I continued second-guessing the medical staff – why wasn’t he hooked up to any monitoring devices, why was blood trickling from his IV, why was he still unconscious? At home, he would have had multiple machines monitoring and measuring every heartbeat, pulse rate, breath, brainwave and blood pressure. All he had was the nurse who occasionally came in to check his vitals. Throughout the night I listened for his breathing – it was soothing and reassuring. To say I was awaken by Grant would imply I was asleep, when he blurted out… “Dad, did I have my surgery yet?” and those were the happiest, best and most welcoming words I had heard from Grant since “happy see you daddy”…his first sentence, ever!
Grant was on the road to recovery, however our own recovery and life of normalcy and routine in Ambato, Ecuador would have to wait. Instead of sending our boys off to school while Greer and I enjoyed some much needed down time, we had the added stress of nursing Grant back to health and getting Garrett acclimated to his new school and its environs. In hindsight, Grant’s surgery had a much greater impact than initially recognized. In one sense, it showed that we could overcome just about any adversity that would face us in our adventure. Yet on the other hand, it was a big setback from which it would take some time to recover. The emotional drain left me physically weaken, spiritually shaken, and psychologically damaged.
Grant made a full and speedy recovery. He left the hospital less than 24 hours after his surgery. His rapid return home was very cathartic and therapeutic for us all. His arrival at school a week later completed the first full month of our adventure, yet we all learned many lessons before he took those first steps into the classroom. Not to be lost in all of this is his younger brother Garrett. Not only was he part of the medical drama as it unfolded, but he was tasked with the unenviable task of starting a new school, in a foreign land, where he did not speak the language, by himself, without his best friend who was recovering from major surgery. Garrett's fortitude in the face uncertainty was a source of strength for us all. And For me, it was just another opportunity to practice PAT - Patience, Acceptance and Tolerance.