Finally, surgical scrubs that double as a St. Paddy's outfit.

Day 2: No snakebites, no mosquito bites, and no enforced shaving. I’m thriving!

I joined in the morning rounds with the surgeons, and just as I was warned, the questions started firing. The head surgeon didn’t see me at first, so I escaped the few rounds as my new German and Australian friends fielded. But now he was pointing intently at a nasty looking wound on a man’s leg and expecting an elective student answer, and I could tell I wasn’t going to be able to dodge these much longer.

“So, someone tell me, tell me about the healing of this wound.”

It wasn’t a difficult question, just oblique. I suddenly realised what he was getting at.

“Secondary intention. It’ll heal by secondary intention with scar tissue because the wound lines can’t be totally aligned.”

“Good, yes. Who are you?”

A great start to the day – surely legal tender for at least two mangled attempts to read an x-ray or an ultrasound later on.

The incredible bariatric list blew me away. Taken with permission outside sterile zone.

I was keen to check on the patient with the NET from yesterday, but first I wanted to check out the surgical theatre, so I found my way to the changing rooms and pulled together the standard suit. They had surgical gumboots for anyone to wear, and I confess to feeling a bit of a rush putting them on (which in my experience are usually reserved for dyed in the wool surgeons and not the off-brand ones!) The theatre list today was all bariatric surgery, including some complex revision cases. The lead surgeon was quick to rattle off different operations for stomach reductions, and a registrar took us into another room to explain further once we finished up. Bariatrics has become increasingly important as Sri Lanka faces rising rates of obesity (like perhaps most of the world). Compared to New Zealand, which aggressively rations these complex cases that require extensive follow-up, Sri Lanka seems to do a lot more of them. The surgeons here are truly globally trained, and references fly to British, American, and Indian surgical guidelines, societies, and colleges.CSTH seems to see a very heavy caseload, and I can understand how the surgeons here likely become so proficient through sheer exposure, too. Surgery is always demanding, but it seems particularly that way here. The resources might be limited and hospital in need of a refit, but anyone expecting impoverished substandard medicine wouldn’t be further from the truth. Should I ever end up under the knife, I’d feel safe in their hands.

After watching stomachs get chopped up, I’m ready a break from the cream sodas. I’m now going through a few litres of water a day though, lugged home in large containers after work. I’m still yet to find a laundromat to wash my clothes, and at this rate it will be a white coat with nothing under if I don’t find a solution, fast.