In Our Context

Mark J. Harris, MD MPH

Anesthesia

PGY 3

June 10, 2018

In Our Context

I recently finished reading the book The Power of Meaning, which was written by a college classmate of mine, Emily Esfahani Smith. The book addresses the question of deriving meaning and finding fulfillment in life. This isn’t your run-of-the-mill self-help book. Part journal and part thesis, it is a compilation of hundreds of hours of research, travel, and interviews with people who have been able to find meaning in their lives and what factors distinguished them from those who struggle to find it. She references the literary and philosophical greats throughout history, as well as the modern science and data that further support these ideas. She distills her observations into four different Pillars of Meaning: Belonging, Purpose, Storytelling, and Transcendence.

Items in the education building’s simulation center at CHUK which include models and equipment for anesthesia, emergency medicine, surgery, and obstetrics simulations. 

As my time in Rwanda ends, I have been reflecting on the ways in which I have found meaning. The staff and residents here have been extremely open and welcoming throughout our stay; we started as strangers and mere acquaintances but easily became colleagues and friends. Our goals, as I mentioned in a previous blog post, were the same: to inch towards that goal of safer and higher quality anesthesia care. We traded stories, experiences, and observations. When discussing differences in practice, the residents would explain how they provided care “in [their] context.” An excellent phrase that honored and expressed differences in setting without judgment or prejudice. Several of the more senior residents had spent 6-8 weeks in the US or Canada to observe anesthetic care those settings, and they would often reference those experiences and the lessons learned that they tried to apply in the Rwandan context. My own observations in Rwanda have helped me understand what components of anesthesia transcend context: what forms the core essential of anesthetic care, regardless of context.

Anesthesia machine in use at King Faisal Hospital. The main volatile anesthetic agents available are isoflurane (pictured) and halothane (not pictured). 

I would like to thank all of the people and organizations that supported me in this endeavor. Thank you to CASIEF and the ASAGHO for their many years of dedication and investment in Rwanda. Thank you to the BWH Department of Anesthesia and the ACGME for allowing me the opportunity to volunteer in Rwanda during residency. Thank you to Dr. Chritton for his dedication to teaching and mentoring, and for allowing me to join him on this trip. Thank you to the Centers of Expertise for the funding and support to make this experience possible on a resident budget. Finally, thank you to all the anesthesia residents and staff in Rwanda who welcomed us and made this experience meaningful. Murakoze cyane.

Reusable masks, blades, and other equipment cleaned and drying in preparation for next use.