Dr. Michael S. Murphy has developed an unusual way to ensure proper postoperative care for patients he won't see for several months. The orthopedic surgeon, who travels twice a year to the Dominican Republican to treat its neediest people for free, writes his follow-up instructions with indelible ink in Spanish on their casts.
He keeps in touch by phone and e-mail with the Dominican hospital staff. Those patients who need attention before he returns "just show their casts to the local doctors," Murphy said.
"There is a tremendous sense of community in [the] country," said Murphy, who lives in Lutherville and is a surgeon with Greater Chesapeake Hand Specialists in the same neighborhood. "We know they will look out for each other."
Murphy, 52, left Saturday for La Romana, a city of about 250,000 on the southern coast of the Caribbean country. The surgeon, who has visited the nation twice a year since 2002, arrived just after Hurricane Tomas, which drenched the Haitian side of the island over the weekend.
He is also facing a daunting schedule: He will organize two clinics, perform about 40 complex surgeries and conduct dozens of postoperative visits before he flies home at the end of the week.
Every November, Murphy — who learned Spanish so he could communicate with patients — and a team of nurses and surgical residents from area hospitals run clinics and work long hours in operating rooms with the staff at Centro Medico-Central Romana hospital. He and the team return in the spring for follow-up treatment.
The hospital in La Romana screens as many as 400 patients before the U.S. doctors arrive and decides which cases require the most immediate attention. The local doctors will have completed the surgical preparation, tests and X-rays so that the patients are ready for surgery.
Patients know when the American doctors are coming. The children usually arrive at the clinic in their best dress — often clothes given to them by the team on a previous visit. Communication is via word of mouth: If Murphy wants to see a former patient, he just lets that be known, and within hours, the patient shows up, he says.
Many cases involve children suffering from congenital problems, as well as fractures, lacerations or severe burns incurred while cooking over open fires.
"These kids are not crying when they come into the OR," said Linda McCoy, a nurse accompanying Murphy for a second time.
Murphy said even his youngest patients are "tough, impressive, stoic."
"We don't have pain meds for them, and most don't have even an ice bag at home," he said.
He will be doing yet another surgery on a 12-year-old burn victim, a tissue transplant that may help restore movement in her hands and arms.
"We see patients with the most devastating injuries," McCoy said. "The work is so rewarding, and the people are so thankful."
A deaf and mute teenager suffered a deep machete cut to his forearm. He was originally treated at a remote clinic, where a botched operation resulted in a nerve being wrongly connected to a tendon.
"Every time he moved his arm, he would scream in pain, only there was no scream," Murphy said, describing the boy's agonized gasps. "We were able to repair the damage. When I saw him in the recovery area, he was lifting his arm and smiling."
The teen's mother named a duck Miguelito and insisted the doctor accept it as a thank-you gift. Murphy donated the fowl to a local farmer.
A local hotel provides accommodations, and the Dorothy Scott Fund at Union Memorial Hospital pays the team's airfare. Team members take all the supplies their suitcases can hold, and some equipment stays in storage in La Romana until their next visit.
In Lutherville, Murphy's office staff has collected gifts — candy, toys, clothing — that the surgeon will distribute to patients and their families, as well as to children at an orphanage in the Dominican Republic.
The Lutherville surgical center, which recently replaced some equipment, also donated the old — but still useful — material to the Dominican hospital.
Working with older equipment is beneficial to the young doctors who accompany Murphy to La Romana, he said.
Said Murphy: "They learn to work with limited resources and are much less wasteful when they get back here."
And, experience tells him, many of those same doctors will ask to return to La Romana with him in the spring.
mary.gail.hare@baltsun.com
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