Warning: This post contains some graphic surgery photos towards the end of the essay.
“I think it is very interesting when you go inside the brain. It’s like you are diving in the ocean because around it is just water, this CSF [cerebrospinal fluid]. You can see some structure, some anatomy structure. You have to discover everything first. Second, you have to control the scope to go around. I think the brain of the baby is very beautiful, but it’s more risky if you damage it.”
At 27 years old, Dr. Le Quang My traveled to Uganda for eight weeks to learn the ETV/CPC procedure to treat hydrocephalus, which was pioneered at CURE Uganda by Dr. Warf. It is an alternative to placing a shunt in patients. Hydrocephalus, or water on the brain, is the result of excessive cerebrospinal fluid (CSF), which causes pressure on the brain. Left untreated, the pressure will cause damage to the brain. In many untreated cases, the condition leads to death.
The ETV/CPC procedure is a combination of two procedures to treat hydrocephalus. The surgeon performs an ETV (endoscopic third ventriculostomy) by first making a small incision. The surgeon then enters with an endoscope, which is a small tube with a camera. The surgeon locates the floor of the third ventricle and creates an opening by pushing the scope through it. This allows the CSF to flow to a new path. This process is combined with a CPC (choroid plexus cauterization). The surgeon locates the choroid plexus, which produces CSF. He then cauterizes it to reduce the amount of CSF created.
“With hydrocephalus patient[s], we have two options: one is shunt and two is endoscopic. Shunt is very safe and fast and easy, but the prognosis is not as good because the baby will depend on the shunt, which has potential for a lot of complications: infections, obstruction, shunt malfunction. I think it’s not so good. ETV/CPC, I think, it is the best up ’til now. The baby need not depend on the shunt. Plus, ETV/CPC is the best treatment for hydrocephalus. We have some researchers in Dr. Warf at CURE and Boston, and some from India and U.K. We can see the better outcome of ETV for hydrocephalus patients.”
Dr. My was trained by Dr. Peter and Dr. Justin on the ETV/CPC procedure. During the eight-week training, he spent most of his time with Dr. Justin.
“Justin, I call him my master. He is very friendly and kind. He taught me a lot. Even Dr. Peter, the same in my mind. When I do surgery with Dr. Peter, I think I feel a little nervous, a little nervous always, but I think it is helpful for me. A little pressure helps you to improve.”
During his time at CURE Uganda, Dr. My interacted well with the Operating Room staff, and he shared stories of Vietnam while learning about Uganda and joking around. The staff found his accent particularly amusing, and often attempted to mimic him, which he took in good humor. Dr. My’s face had a contagious smile, which shined even more when he was masked up for surgery.
“It’s not only training ETV/CPC, it’s about how to connect with other people. I have some friends from U.K., from Africa, from U.S., from Ireland, and lots of people from Uganda. Everyone is very kind. It’s quite [a difference] in culture between Asia and Africa and U.S. and U.K. We connect very well. Everyone is very happy. We go out for dinner, play sports together, travel together. I love the life here. It’s very peaceful. It’s not stressful like Vietnam. In my city, it’s very crowded; a lot of people, a lot of vehicles. It’s very noisy. Most people don’t have free time. They work and work, try to find a lot of money, and then they don’t have free time for life for their family [or] for their children, even for their friends. Some people in Vietnam have a lot of money, but they don’t have time to do something like travel around the world or see their friends.”
“In my mind, I want to connect with everybody, and I want to do a good thing for everybody. I think even though we were born in different countries, we have the same passion: trying to find a better method for treating hydrocephalus patients. Before I came, many people in Vietnam asked me, ‘Why do you go to Africa? Why not U.S. or U.K.? What do you learn in Africa?’ It’s a very hard question. Most people in my hospital, when they go across go to U.S., U.K., Korea, or Japan, they think those countries are better. But in my mind, you can learn everywhere and from everybody.”