"I could see and hear the commotion of people crying and mourning and I feared I was too late."

One of the greatest blessings of my time in Ethiopia was being able to teach surgery residents. I was privileged to serve as the residency program director for the Pan-African Academy of Christian Surgeons (PAACS) in Soddo, Ethiopia. Though I did my best to teach well, they say some of the best lessons are caught, not taught. That sometimes means you have no idea you are even teaching! Near the end of our time in Ethiopia, I discovered that I delivered one of my best lessons completely unbeknownst to me.

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During much of my time in Ethiopia, I was the only general surgeon at the hospital, so endurance was always a challenge. I tried to keep Sundays quiet so I could recover for the next week, allowing our surgery residents to hold down the fort and call only if needed.

One Sunday, I was at home with my family when the first year resident on call called on my cell phone.

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I immediately knew something was up.

When I answered, I heard a loud commotion and the broken up voice of the resident over the sketchy cell phone reception. Even though I only caught some of the message, I made out the words, "can’t breathe". The gravity of the situation came through loud and clear, but before he could finish his message, the call died completely.

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I knew that we had two patients in our "ICU" that had tracheostomy tubes (breathing tubes placed through an incision in their neck and placed directly into the airway). One had a cancer in the back of her mouth that had required placement of the tracheostomy to prevent suffocation. We had placed the tracheostomy tube in the other patient due to trauma, but I suspected it could probably be removed soon, as he was doing well. But I also knew that tracheostomy tubes were notoriously difficult to manage in our rural setting and tended to get clogged with secretions if not properly cared for.

Time was of the essence, so I raced across the hospital campus from my house to the ICU building. When I neared the building I could see and hear the commotion of people crying and mourning and I feared I was too late.

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Upon entering I was amazed at what I saw.

The resident was standing helplessly between the two patients, both of whom were gasping for air and clearly on death's door. I instructed him to quickly remove the tracheostomy tube altogether from the trauma patient while I began squirting saline down the tracheostomy tube of the cancer patient while suctioning out the tube.

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I wasn't sure what the outcome would be, but it wasn't looking good.

By God's grace, the trauma patient immediately took a huge breath of air once the tube was out! Whew, one down one to go. The second patient's tube was quickly cleared and she started breathing again! With relief on my face but my heart still racing on the inside, I gave instructions to the resident and the nursing staff and headed back to my house.

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God was watching over us that day! I was thankful, but moved on.

Several years later, my family was leaving Ethiopia to move back to the United States and the surgery residents held a beautiful going-away dinner for us. The resident from that Sunday afternoon was now one of the senior guys and he requested to speak to the group.

He pushed his chair back from the table, stood up and retold the story of the two patients in the ICU that Sunday afternoon. But now I heard it from his perspective.

The moment the call had dropped, his heart had dropped with it. From his prior experience as a general practitioner at a few local hospitals, he was confident that he knew how the situation would play out. He was confident that I would simply not come, that he was on his own, and that the patients would both probably die, as was common at the other hospitals where he had worked.

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He was speechless with complete surprise and joy when I showed up to help!

He learned that doing the right thing, even when it is hard, is always the right thing. He shared how PAACS had completely transformed him as a doctor. PAACS had shown him a different way - to love and serve his patients.

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I was floored and humbled at how we often don't know the impact we have on the world around us. Go live better!

- Dr. Paul Gray, MD