June 4th, 2009

CJ - I spent our last day today hanging with the kids in the burn clinic one more time. When we got there this morning, the kids were waking up. I went back and saw that a bunch of the kids that we'd been following while we've been here went home. Little Bianca, Martha, and a few others have went home. Juan is in rehabilitation now spending time at the Alberge between. He's doing great. Mark got him on the little eliptical today and he was just trucking along. Seeing his burns are on his legs and knees, it's important for him to keep moving. I'm glad to see him doing so well. Kevin, a little boy who has pretty severe scars from burns all over his body, got a graft last week. He seems to be doing great too. It also seems that Daniela's grafts have taken so far, so she's doing well. Lizbeth (pictured), a little girl who had been spending time at the Alberge, had surgery on Tuesday. She got an exander put into her neck so that eventually some of her scar tissue can be removed. Today, she got the news that she could go home. It was fantastic news for her and I'm glad that she's getting to head out for a while. She's a little trooper. I'm going to miss all these kids.

Markey - Today was a very relaxing last day in the burn center. I had the chance to spend the entire morning with all of the kids. I spent about an hour playing with Jhonny, the boy that came into the pediatric emergency room when I was working there last week with burns all over his backside. He has to spend all day laying in his bed on his stomach with his legs spread apart and nothing covering his burnt rear-end. Although this position looked really uncomfortable, everytime I walked into the room he had a smile on his face and started laughing as we played with his cars. It looked like he has been making really good progress from last week when he was in the ER in tremendous pain. While we played it seemed as if he didnt even notice his burns. We were also invited to lunch at the burn center and had a great time eating and talking with all of the staff and Dr. Romero.

Craig - I started the morning playing with the kids in the burn center. It was great as usual, the kids were happy and thrilled to have someone to interact with. I got to spend a lot of time with Lizbeth, the little girl mentioned in Cory's section. She was a lot of fun and even drew a picture of the two of us. At around 10:30 I was invited back into the OR with Dr. Romero. The first two surgeries were burn debridments in which the doctor removes the dead skin surrounding and on top of the previously burned areas. This was my first chance to see in person the cheese graters used to clean out the wounds. Even though it looks and sounds awful, it is a necessary step to allow proper healing of severe burns. First a little boy and then a little girl had their damaged skin removed and then were rebandaged. The third surgery was a little boy who had just arrived the day before. He had terrible burns on his left arm and leg that were horribly blistered. He also had a few minor ones on his face. Dr. Romero allowed me to scrub in on this surgery. He made a cut on the boy's left leg in an attempt to insert a I.V catheter for the administration of medications and fluid. He was unable to use the left leg so he made another cut, this time on the right side. He then motioned for me to suture the boys left leg. It was an amazing opportunity and something I had been hoping to do at some point during our time here. It took 5 five stitches to close the wound and when it was done it passed Dr. Romero's inspection which was a huge relief. The blisters were then removed using the graters and the boy was bandaged up.

After surgery we had lunch with the staff and played a while more with the children. Today was our last day working and we will only be going by tomorrow to buy the staff lunch and say our goodbyes. The time has flown by but the experience has been one we will never forget. It has reminded us all why we entered medical school and reinvigorated us to study harder when we return.

Pete- Well, I got yelled at for my blood draw, but Victor stood up to the chief resident and told her I did a good job. So I guess I came out on top, but as my penance I had to calculate which of my two patients were producing too much urine or not enough urine. It seemed only fair. It was a great last day that reinforced my entire experience that I had in the PICU/NICU. We had a long set of rounds because each patient it seemed had a new set of tests ran that were vital to their discharge. The young lady with cellulitis had a procedure to help her abcess in her leg heal a cleanly. It was something I'd imagine seeing on a documentary not up close. It was gruesome as he pulled infected tissue out of a hole the size of a dime in her leg. An intern and resident did their best to make sure she remained calm, but the fear could clearly be seen in her eyes. After the procedure she fell asleep, and the entire staff monitored her well being. I did my last set of vitals on my patients, and said good-bye to the staff. It was pretty unreal that 2 weeks in the PICU/NICU had gone by that fast. I went to lunch with the rest of the guys and played with the kids for awhile. I think the children will be the best memory of the trip, just observing their resilience and despite it all watching them heal and thrive.