by MICHAEL AKERMAN, M.D.
“To succeed, jump as quickly at opportunities as you do at conclusions.”
– Benjamin Franklin
Many Americans have a preconceived notion about Serbia. The events of the 1990s left an impression and influenced opinions about the country. My recent experience in Serbia differed greatly from my own expectations, and I feel extremely fortunate to have spent time there.
My journey began at a get-together in New York with some of my colleagues and friends. As the night was winding down, I mentioned to my Serbian friend that I would be very interested in visiting her home country and doing some anesthesia work there. Within two weeks, I was put in touch with Serbian native Dr. Ivan Velickovic, director of OB anesthesia at SUNY Downstate Medical Center, and I was booked for travel a few months later to Serbia.
The details of my trip started to come together. The first few days after my arrival, I would attend the “Eighth Annual Scientific Symposium in Anesthesiology and Intensive Care” conference in Niš, Serbia. The meeting organizer, Dr. Radmilo Jankovic, was kind enough to invite me to give a lecture and to co-lead an ultrasound workshop. During the remainder of the week I would then travel to the Serbian city of Leskovac to teach regional anesthesia at the local hospital.
Offering Patients a Better Hospital Experience
I arrived late on a Thursday night in Niš; within a few hours of my arrival I presented a workshop on regional anesthesia with Dr. Jinlei Li from Yale University. With the help of Dr. Nada Pejcic (our host and local expert), everything went smoothly. The workshop was divided into two sessions — morning and afternoon. We focused on upper extremity nerve blocks in the morning and lower extremity nerve blocks in the afternoon. The success of the workshop was evident from the enthusiasm of the participants. The level of interest was so high that we gladly stayed to answer questions. After the workshop I was free to enjoy the many lectures and parties that were organized as part of the conference. The last day of the conference I presented my lecture — “An Update on the TAP Block.” Overall, the conference was an exciting and very educational event, and I am honored to have been a part of it.
In the early morning on Monday, I met up with Dr. Pejcic and we drove to Leskovac Hospital, a beautiful drive south of Niš through fields, farmland and beautiful scenery. We spent the next four days together offering patients our services. In that short time, we performed 27 quadratus lumborum blocks (mostly post-cesarean section under general anesthesia), one combined spinal epidural for labor pain, and one peripheral nerve block for an orthopedic procedure on the lower extremity. Twenty-six of the 27 patients who received the QL block reported adequate post-operative pain control. The patient who received the CSE reported an excellent birthing experience and the patient having the orthopedic procedure reported no pain. It was an amazing feeling to be able to offer these patients a better hospital experience. The patients and the medical staff were very appreciative. The level of interest in and excitement about regional anesthesia was palpable.
I wanted to leave my colleagues in Serbia with something they could continue to do even in my absence. I met Dr. Pejcic at the PGA before I went to Serbia and we talked about my plans to visit for a few weeks prior to my arrival. We discussed regional anesthesia extensively and she was well prepared by the time I arrived. During those four days in Leskovac, I spent a lot of time teaching her the use of ultrasound technique and regional anesthesia concepts. By the fourth day, Dr. Pejcic was not only performing QL blocks independently, she was teaching her colleagues how to perform them as well. Since I returned to New York, we remain in contact and Dr. Pejcic has been continuing to offer regional anesthesia to her patients. She has performed more than 70 blocks (and has expanded her repertoire to include popliteal and adductor blocks) and has presented her work at a local conference. Dr. Pejcic’s love of regional anesthesia, patient care and constant learning is something that I hope to emulate in my own practice.
My week in Serbia went as fast as it came. I met wonderful and hospitable people, people with warm hearts who have a strong connection to their history. They often take the time to sit and “have a drink” (normally coffee or tea) and enjoy each other’s company. Dr. Pejcic and her husband made me feel welcome in a foreign country. Every night they had another trip planned. We drove on roads rarely traveled to get to the top of a mountain for unforgettable views, visited monasteries, tasted fresh spring water, and of course ate a lot. I also learned about the history of this region from the people themselves and visited places of historical significance such as Skull Tower and Crveni Krst, a Holocaust concentration camp in Niš. This was a week I will cherish, and one that gave me much more than I gave in return. I appreciate my hosts inviting me into their home and treating me like family. I hope to plan more trips where I can work with my Serbian colleagues to provide exceptional patient care.
While people in the U.S. may be familiar with medical mission projects in Latin America or Sub-Saharan Africa, very few people know about the opportunities that exist to participate in these projects in Eastern Europe. I decided to go to Serbia because an opportunity presented itself. Ultimately, it was a decision that led to expanding my world view, meeting new people, and sharing what I know about anesthesia and acute pain with a dedicated group of professionals who hope to better serve their patients.
Michael Akerman, M.D., is an assistant professor in the Department of Anesthesiology at Weill Cornell Medicine in New York. He specializes in regional and thoracic anesthesia.
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