Photo: James Kirkpatrick
Inside the Clinic. The portable echocardiography unit checks the heart of a Vietnamese child.
Kirkpatrick plans to return to Vietnam, and he speaks animatedly about the long list of initiatives in clinical care, teaching, and research he would like to see become a reality: refurbishing used devices such as pacemakers for re-use overseas, a concept about which he has written several papers; further academic interchange with the staff of Hue General Hospital, who on this trip responded with great interest to lectures such as his wife’s on pediatric Kawasaki disease; expanding the trip to include other specialists, such as Kirkpatrick’s brother-in-law, an interventional cardiologist who could help treat the many cases of rheumatic mitral disease; helping to integrate the concept of palliative and end-of-life care into Vietnamese society; and partnering with experts in resuscitation science about Sudden Unexpected Death Syndrome, which strikes many young Vietnamese men, often in their sleep. “Now that they’re not having wars over there, it’s the number-one killer,” says Kirkpatrick. “It’s most likely a variant of something worldwide: the electricity of
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the heart gets messed up. So we’re thinking of doing a study of training the Vietnamese people in CPR, which they really don’t have there. It’s possible with these arrhythmias that if they could be resuscitated quickly, they might do OK, even if they can’t get to an ambulance or a hospital right away. . . . Most people won’t, but saving even one life is worth it.”
Aboard a Hospital Ship: Joli Chou in Africa Spending two weeks on a cruise ship seems like the perfect escape from winter, but for Joli Chou, D.M.D., M.D. ’04, G.M.E. ’07, it was a “working” vacation. She spent most of her time performing surgical procedures on African patients who couldn’t otherwise get them. Chou is an assistant professor of oral and maxillofacial surgery who practices at the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, the Children’s Hospital of Philadelphia, Penn’s Center for Human Appearance, and Penn’s School of Dental Medicine. For the past two years, she has volunteered her
time – and skills – aboard the Africa Mercy, said to be the world’s largest floating hospital. Operated by the Mercy Ships organization, the ship stays docked at an African port for 10 months, providing an array of medical services. During Chou’s stay, the ship was docked at Conakry, Guinea. Volunteers customarily pay their own way for the flight to the nearest airport, as well as room and board. Chou was in part supported by a scholarship awarded by the American Association of Oral and Maxillofacial Surgeons. During her stint on Africa Mercy, Chou performed three, four, or five cases each weekday, depending on their complexity. “I’m usually operating on my own but, if it’s a big case, I’ll work with another surgeon,” she said. Chou also teaches local surgeons who assist in the surgeries. In addition, she shows the local nurses how to use the medical equipment that’s donated to Mercy Ships. Many of Chou’s more complex cases stem from a lack of access to treatment. For example, last year an 18-year-old showed up with a huge benign tumor on his jaw. “It weighed five pounds!” reports Chou. Because it had been left to grow untreated, the young man had to undergo multiple surgeries to remove and reconstruct his jaw. In the United States, Chou pointed out, “we’d diagnose it much earlier and try to shrink it with injections. But he did very well – he actually smiled.” Several patients suffered from ankylosis (fused jaw joints). In one memorable case, the patient had not been able to open his mouth for more than 10 years. The condition results from infection or trauma that was not treated properly, explained Chou. “I did many of these procedures while I was there, and it was so rewarding. Patients can now eat real food.” Although Chou did take some excursions to land on weekends, the floating hospital was really like a small town, with a bank, shops for necessities – even a