Vital Times 2019 - 65

The year before, CA-3 resident Timothy Kwiecien,
MD, reported that he especially enjoyed his work with
the Multidisciplinary Pain Medicine team, evaluating
complex pain syndromes and participating in myofascial
pain procedures, minimally invasive herniated disc repairs,
and radiofrequency nerve ablations. He commented,
"Differences do exist between our healthcare models;
however, there are powerful similarities that we share as
human beings, physicians, and anesthesiologists. We work
extremely hard and make personal sacrifices in order to
deliver exemplary medical care to our patients, to ensure
their health and well-being, and provide them with a
better quality of life."

Mbarara, Uganda
Last year for the first time, two of our then-CA-3
residents, Sam Hong, MD, and Sophia Poorsattar, MD,
traveled to Uganda under the auspices of Medicine for
Humanity (MFH), a nonprofit medical care and teaching
organization dedicated to improving the health of women
in underserved communities and training local physicians
so that women can have access to specialty care yearround. Its work represents an educational partnership
between UCLA Health and Mbarara University of
Science and Technology (MUST).
"The cases we did were predominantly urogynecological
surgeries, with the majority being various types of fistula
repairs," said Dr. Poorsattar. With little obstetric help
available in most African villages, many women who
experience obstructed labor suffer from obstetric fistula
afterward, a vaginal tear between the bladder and/or
rectum that results in constant leakage of urine, stool, or
both, and often turns sufferers into outcasts. (Nicholas
Kristof of the New York Times has written memorably
about the thousands of women who endure obstetric
fistula, calling them "the world's modern-day lepers".)

The residents learned to cope under challenging
conditions. There was no EKG or end-tidal CO2
monitoring capability in the operating rooms, and
most operations were performed under spinal anesthesia.
Most patients were very stoic and didn't expect or
need sedation.
Dr. Hong recalled his most memorable case. "We had a
case of a failed spinal anesthetic that we had to convert to
general anesthesia," he said. "We used a Benson anesthesia
machine with no ventilator, no ventilation monitoring
parameters, and no end-tidal gas measurements. To top
it off, the only available volatile agent was halothane."
Dr. Poorsattar said that the rotation was "one of the
most significant moments of growth I have had during
my anesthesia training." Thinking back to all the patients,
trainees, physicians, and staff they worked with in
Mbarara, she said, "I am so grateful for my experience
and hopeful for the lasting positive impact on their lives."

International Research Program
Our department attracts many international physicians
to study and visit here, either as researchers or observers.
Often, the visitors are interested in the work of our busy
liver transplant service. The UCLA Anesthesiology
Visiting International Scholars Program aims to foster
global collaborations through the horizontal sharing of
understanding and experience. Visiting international
scholars have the opportunity to observe in the operating
room or research, attend our Grand Rounds and Resident
Didactic Lectures, and tour the UCLA Simulation Center.
We regularly host international scholars for visits lasting
up to four weeks. International doctors who wish to
perform research must apply for an Exchange Visitor
Program J-1 visa. The minimal period of study is six

Annual Publication 2019 | 65

Vital Times 2019

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