Embarrassing myself in the O.R.

I met a brave and special young lady yesterday.

She was quietly sitting in the Child Life Room although she’s not a child. That’s the room where patients wait just before going into surgery.


Operation Smile Mission Dhaka


She’s shy. It seems like all the patients we’ve gotten in Bangladesh are shy. Or maybe because I tend to be specifically drawn to the shy ones because they make me want to do something to make them happy and comfortable, so those are the only ones I’ve been interacting with.

Khadiza had travelled 30 km by bus to Dhaka to receive a cleft lip revision treatment by the Operation Smile team.

30 km is no walk in the park in Bangladesh. Sometimes it takes us an hour to travel 7 km between the hotel and the hospital by minivan.

And then the buses are another evil altogether. They are, in a word, terrifying.


Operation Smile Mission Dhaka


For starters, they all look like they want fall apart at the slightest excuse. And if you see how people drive around here, you’d be afraid to get on the bus. There is only one traffic rule here and that is that there are no traffic rules. It’s a free-for-all buffet on the roads.

Secondly, the buses are all, and I do mean ALL, packed to the brim with passengers so that you will always see at least one person standing on the front steps hanging out the door.

The buses here have no doors.

Thirdly, men make up 95% to 100% of the population in buses.



Operation Smile Mission Dhaka


21-year-old Khadiza, whose mother is a housewife and father a labourer, came to the hospital by bus with her sister. I forgot to ask her how her ride was but I’m sure it mustn’t have been pretty.

Khadiza was born with a cleft lip. When she was seven, her family took her to a dermatologist to get it fixed (it seems like quite many people do that here). At first, it seemed like her lips were fixed but, over the years, the cleft came back and started to widen gradually because the lips had simply been stitched together without joining the muscles inside.

When Operation Smile came to town, she sought us for help and was scheduled for a revision treatment. Because it’s a milder case than a full cleft, she was assigned to receive only local anesthesia for the surgery.

I accompanied her into the operating room and thought maybe I should stick around during the surgery to give her moral support, even if she couldn’t see me, because they cover the patient’s entire face and only cut a hole in the sheet to reveal the mouth.


Operation Smile Mission Dhaka


I thought I would be able to handle watching another surgery easy peasy because I had survived one without fainting just two days ago.

But Khadiza’s surgery affected me really strongly.

For starters, the knowledge that she was awake (even though I knew she was sedated and anesthetised so wouldn’t have felt any pain, but she would have felt her lips being tugged around), already made me feel queasy.

I was worried for her, wondering if she was feeling frightened or lonely, since her eyes were covered.

I imagined lying there myself receiving the treatment and seeing what was being done to me. Not exactly the smartest thing in the world to imagine.

Khadiza’s surgery looked more intense to me than the first surgery I had witnessed. One whole piece of lip measuring about 1cm x 1cm x 2mm had to be cut away. I was told that’s the scar tissue and it had to be removed.

I had a lot of trouble watching the incisions. After that, there was like a cm square of raw flesh into which the surgeon had to poke around and under to isolate the muscles or whatever.

I forced myself to watch but the lightheadedness wouldn’t go away. Worse, I started feeling a bit nauseous. I would watch a few seconds, look away a few seconds, watch a few seconds, and back and forth. Did some writing in my notebook to distract myself.


Operation Smile Mission Dhaka


After 10 minutes or so, I decided that I’d better go outside for a breather before I did something embarrassing like faint.

I walked into the break room.

Devin was in there, well, taking a break. Devin is the operation’s Patient Imaging Technician. He takes photos of the deformities for documentation.


Operation Smile Mission Dhaka


Maybe he could see that I was looking a bit green around the edges because he asked me, “Are you okay?”

I kinda nodded and shook my head at once. I said, “Khadiza’s surgery is intense. I had to take a break.”

Devin has been to seven missions, including this one, so he knew what I was talking about. He told me it’s all for the better because they get well after this and they have new smiles, etc. I nodded silently in agreement.

And then, without warning, I started to cry. Even I didn’t see it coming.

Poor Devin, stuck in the break room with some crying girl. He got up to search around for some tissues, then came back and said comforting, encouraging words about how it’s all necessary and they don’t feel any pain during the surgery and they will heal nicely in time to come and they will have better lives.

Devin’s a nice guy. He drew the evil smiley face on my name sticker.


Operation Smile Mission Dhaka


I managed to pull myself together by admonishing myself for being useless. Then I went back into the operating room, by which time the surgeon was done with the insides and was stitching Khadiza’s lip up.

It was all very nicely done. I saw how he had pulled two sides of the lip surface together to cover the raw flesh after he was done stitching up the muscles inside. By the time it was over, she had a perfectly shaped lip.

The surgery was completed in half an hour, after which Khadiza had to sit on a chair for a few minutes before they allowed me to walk her to the ward for recovery.


Operation Smile Mission Dhaka


Because she only had local anesthesia, she was allowed to go home after two hours.

Anyway, her plaster came off and I took a photo. Her lips still look very swollen in the picture because of the anesthesia. And she has ointment on the wound. This is, like, maybe 30 or 45 minutes after surgery.


Operation Smile Mission Dhaka


I suppose it was a good thing she was discharged so soon; I didn’t have enough time to grow too attached to her. I’d had enough to cry about for the day.

Today will be the last day of our mission in Dhaka. It will be a half day of surgeries, following which the rest of the day would be spent packing up all the stuff in the hospital in preparation of our going home.

The photos of me in the O.R. were taken by Justyn. Thanks!

It’s a hazard having him as my photographer, though. One of his hobbies is taking ugly photos of me for future blackmail purposes.

Other than that, he’s a nice person. He gives a lot of personal time to Operation Smile, starting up then overseeing the Student Chapter in Singapore.


Operation Smile Mission Dhaka


Go say hi to him in the Student Chapter Facebook page and tell him to stop being a tyrant to me!

8 thoughts on “Embarrassing myself in the O.R.

  1. Avatar

    @Sheylara: That was hardly embarassing, its perfectly normal for a person to empathise with another human being (especially a child)’s trials:) And you’re definitely not useless, except maybe when it comes to keeping new year’s resolutions, hehe:P

  2. Avatar

    Hi, thanks for the write-up. I was wondering why cleft lip and cleft palate cases are seen to be more prevalent in South Asia and China. All my life, I have come across just one friend who has that in Singapore. On the street and common places in Singapore and Malaysia, there don’t seem to be many having such deformity. Could the doctors there care to comment?

  3. Avatar

    @RN1209: Thanks for your kind words. :P

    @Jimmy: I’m not a doctor, but I believe you hardly see any cleft cases in Singapore because most parents are able to fix their children the moment they’re born. And we have skilled surgeons in Singapore so when the patient grows up, you might not be able to tell he or she was born with a cleft.

    In undeveloped countries, they either can’t afford to go for surgery or they don’t have skilled surgeons in many parts of the country.

  4. Avatar

    Ohh Sheylara, that’s not too embarrassing! I cried myself reading this post!
    These past few posts have been so touching! I especially love the before & after shots. Its incredible what these surgeons are doing for these people! I stumbled upon your blog sometime back in December, and I love reading it! Just wanted to thank you for putting your own time into this blog:) Its great!

  5. Avatar

    @Sheylara: Nothing to be embarrassed about. Operation Smile missions are quite emotional events and we are all affected in one way or another. Getting to know the children and their parents just makes it feel deeper.

    @Jimmy: The worldwide average is that 1/500 children get born with a cleft. In Singapore we are about on that average. There are plenty of clefts around if you look for them (as I do, occupational hazard) but as Sheylara noted the plastic surgeons are very skilled and it is getting harder and harder to see the scars, particularly as the children grow up and the scars heal.

  6. Avatar


    You are admirable for facing your fears in the OR.

    The work being done to help these children I am sure makes your discomfort bearable.

    Great post, lovely children!

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