NICARAGUA, APRIL 2016 – Tony LoGiudice MD, Class of 2016

A call to service has always distinguished the medical profession as a vocation rather than a job. This is what drove me to enter the field and continues to provide the joy and satisfaction in helping others that has made residency bearable. Much of what I experienced in performing acts of service during medical school and before focused on providing resources, awareness, education, and sometimes a direct service (skillsets being limited as they are).

My experience in Nicaragua revealed the vastly different resources available to the citizens of poor countries. Much can be said about the conditions of the operating rooms, the “sterility” of surgical technique, and the limited technology at hand for diagnostics. These presented challenges in diagnosis and operative treatment, sometimes influencing what treatment could be offered. To say the least, it certainly makes me appreciate the utility of a Cobb.

While the operating experience was a true privilege (and certainly will keep me thankful for the near-infinite resources available back home), more was learned from the patients. The patients were the best sort of people you hope to treat as a physician. They were earnest in their efforts to heal and recover. They were there to improve their life. I was humbled by their gratitude and bravery. This is not just because they only had a Tylenol on the first postoperative evening, but because they submitted themselves to some very strange looking, foreign people for surgery that might totally change their lives. As little as they might understand, they had faith in our intentions to help them! In turn, I found myself, my heart, so quickly tied to their well-being in a profoundly personal manner. And while I have certainly experienced this repeatedly during residency, I really enjoyed the lack of perfunctory distractions (EPIC, ACGME, ACA, HMO, CMS, etc).

So upon returning home, I remember that our patients here deserve the same trust and faith in their physician. Too often perceived as high-maintenance, misinformed, or “crazy”, patients here in the United States have other issues prohibiting their good health care. And they are too quickly dismissed. While I may not be in a place to solve the socioeconomic problems for an individual, I certainly can identify their “idiosyncrasies” as my own lack of understanding of their problem, and look beyond them to provide whatever appropriate care I can offer. And while none of this is new to me in concept or practice, it certainly is easily forgotten in the rush of entering practice, meeting new demands, and discovering the pressures beyond training. Trust must be earned through excellent care.

My love of Orthopaedics lies in its unique ability to restore function, independence, and quality of life to people suffering from injury, disease, and deformity. The opportunity and privilege to treat the underserved in Nicaragua demonstrated some of the extreme disparities in health care that so desperately need attention. With these experiences, I plan to return with greater focus on my own future practice, looking to address the similar disparities that can be found in our own cities and communities. I hope to provide care to patients of any and all socioeconomic backgrounds to help people recover from injuries, return to work, restore function lost and correct deformity.