Day 6: Tuesday March 23rd

Today was a happy celebratory day on the Op Walk ward of the Hospital General Plaza de la Salud ("La Plaza" as it's called here in Santo Domingo). With all the surgeries completed, we spent the morning rounding on patients, continuing the physical therapy sessions, and in general wrapping things up before our departure.

Routine postoperative follow-up is crucial following joint replacement surgery, and we are fortunate to have our talented Dominican colleague Dr Luis Alcantara (pictured at right) as a partner in this project. He was the surgeon who carefully selected the patients for surgery, and he will be the one to see the patients back in clinic to ensure that their recovery goes as planned. We're certainly grateful to have Dr Alcantara as a partner in this mission.

The high point of the morning was the photograph, in which everyone involved with Operation Walk got together for a large group picture. Between the American volunteers (including surgeons, nurses, physical therapists, OR staff, pharmacists and others), our Dominican colleagues (including surgeons, medical students, nurses, and representatives from hospital admin) and of course the patients, it was a very large group that took quite a while to assemble! The end result was well worth it, however, as you can see below:

It doesn't come through here but, shortly after this picture was taken, the entire group of patients broke out into joyful song! It's a memory that will stick with me for a long time.

Tomorrow we'll be getting on a plane back to Boston, and Operation Walk 2010 will officially come to a close. Looking back on the week, it's clear that it was a great experience for everyone.

From my perspective -- as an orthopaedic resident -- I can say that it was truly an incredible opportunity. Most obviously, we were able to assist on procedures featuring complex pathology resulting from years of non-treatment that we rarely see in the U.S., which certainly contributes immensely to our education as surgeons. There are a number of other benefits, however, which are somewhat less obvious. In Boston interdisciplinary cooperation is prized but, in practice, teams are defined primarily along the lines of role and specialty, with most of the time spent on strategizing and planning occurring with orthopaedic residents and attendings. Here, in contrast, our rounding teams include not only surgeons but also medical docs, anesthesiologists, nurses, therapists, pharmacists and others (see picture at right). Everyone takes turns changing dressings, pulling drains, writing notes and, in general, doing whatever needs to be done. I can honestly say that I've learnt more about the practical day-to-day activities of nurses and physical therapists over the past week than I did over the last 8 years as a student and resident in Boston hospitals!

As a result of an agreement between Operation Walk and the Harvard Orthopaedic Surgery Residency Program, we are happy to report that there will be three residents going on the mission each year (a PGY3, a PGY4 and a PGY5). This year's group consisted of Jeremy Smith -- who served as Chief Medical Officer -- as well as Courtney Dawson and Kanu Okike (see picture below).

All in all it was a great trip. We reached our goal of performing 60 joint replacements in 45 patients, all of whom were extremely grateful. The logistics of the trip were exceptional, due in large part to the very careful planning that began last fall. Our team was hard-working, talented and enthusiastic: when unanticipated tasks popped up, there were always more than enough offers of help to get things done. We grew quite close as a group, and I know I'll always crack a smile when I run into an Op Walk team member once we're back at our regular jobs in Boston. We did a lot of good work, and had a great time doing it. Most importantly we were able to provide a service to a number of disadvantaged patients, a service which has the potential to dramatically improve their quality of life for a long time to come.

Soon it will be time to start planning for our 2011 trip, but for now we're looking forward to spending some time celebrating the successful trip (and also sleeping -- we're exhausted!). We'll finish up the blog entries for this year's trip with a few more pictures of our team members, happy to be celebrating a job well done!