Gore in Guatemala

High in the mountains, a brief procedure turns to bloody excavation.

Published April 5, 1999 9:14AM (EDT)

In 1980 I was working in the Guatemalan highlands with a rural development
organization. What had first appeared as a sore pimple on my upper back had
gradually become a large, tender lump that was not only bothersome but
worrisome. Although we had our own medical laboratory people in our group
to help us deal with the ubiquitous parasites that made their way into our
intestines, we did not have a doctor qualified to diagnose my problem. So
we went to see Dr. Cobar.

In the years between the great earthquake that had struck central Guatemala
in 1976 and my arrival there in 1978, our organization had been involved in
some emergency medical work. Through those activities they had gotten to
know Dr. Cobar, a kind man whose interests lay more in healing than in
making money. He ran a clinic in a medium-sized agricultural town about two
hours by car from our encampment. I dropped in for a visit one day on my
way home from Guatemala City. He looked at my lump and felt around it for a
few minutes before pronouncing that it was a sebaceous cyst. "No problema,"
he assured me. I could come in next week and he would take care of it with
a 20-minute procedure.

Looking forward to the relief of having the cyst gone and full use of my
left arm restored, I drove into Dr. Cobar's clinic the next week
accompanied by Annie, one of our team members who was a trained RN. It was
our policy to bring along a "witness" whenever we had to have medical
procedures done in Guatemala, and Annie would do the driving on our return to
home base.

Dr. Cobar greeted us with his usual broad grin and led us into a small room
behind the reception area. A stainless steel gurney with drainage gutters
built into its surface sat in the center of the room.

"Just take off your shirt and lie down. This won't take long," he said,
rolling up his sleeves. He asked his assistant to bring him his tools and
to load up a syringe with a local anesthetic. I lay face-down on the cold
steel thinking that it looked an awful lot like an autopsy table. Dr. Cobar
began pumping xylocaine into my flesh all around the lump. My cheek lay
pressed into the steel as he began to open me up.

He mumbled something to his assistant in Spanish, almost as though he
didn't mean for me to hear it. Unfortunately, what I heard was, "Don't we
have a sharper scalpel than this?" His assistant told him, "These are the
best tools I could find."

My eye rolled up to meet Annie's but I could see that she didn't understand
what had been said. A few minutes later my hands reflexively grabbed at the
legs of the gurney as the dull scalpel passed beyond the anesthetized zone
and I experienced the feeling of being stabbed in the back.

"Urrrrggggh!" I said, and the good doctor thanked me for telling him that
it was time to inject some more xylocaine. I noticed that his voice was not
quite as carefree as before. After the injections he resumed his carving
and excavating, saying something about the unexpected adhesions that my
cyst seemed to have into the surrounding tissue. Oh, wonderful. He asked
for scissors.

By now my face was pressed into a pool of my own blood, which was
accumulating on the steel table in a red slick. The doctor was making
frustrated grunts as he dug deeper into my back. Again, he outran the
anesthetic and I stifled a scream. Now I was getting worried. In fact, I
could feel myself going into the early stages of shock.

"Annie," I told my companion, "I think things are a little worse than he
expected. Can you make sure he keeps numbing me out." It was hard to talk
with my face smooshed into the bloody steel. Annie used her meager Spanish
and some finger pointing to ask that another hypodermic be made ready. My
fear was that he would cut into me one time and I would jump, thus causing
him to sever the nerve that controlled my left arm and God knows what else.

Now Dr. Cobar was sweating, too. This had become an epic of minor surgery.
What was projected to be a simple no problema 20-minute procedure had drawn
out into a 90-minute feat of endurance.

Finally, at the point where I was close to fainting, he announced that the
stubborn cyst had been freed from my back. "My God," he exclaimed as if
he'd just reeled in a humongous battling fish. He asked for a jar with
formaldehyde in which to save the trophy and then began trying to stitch
together the crater that was left in my back.

After close to 2 hours on the gurney, I was allowed to sit up and wipe the
congealed blood from my face and chest. It remained matted in my hair as
Annie and I made our unsteady way to the beat-up little Datsun pickup that
was our ride home. Dr. Cobar caught us just as we were about to leave.

"I'm worried about those adhesions," he said. "They shouldn't have been
there. I'm sending your cyst to the lab in Guatemala City."

Yeah, yeah. Whatever. I just wanted to be out of there and back in my bed.

I only wish that this were the end of the story, but not only did the healing
take months, I had to deal with the concerns of our doctors back in the
United States that the cyst might be a cancerous tumor. The specimen was
sent to the States for analysis but was found to have deteriorated due to
the diluted formaldehyde in which it had been preserved. I wondered if, in
fact, I was going to die and leave my family of five kids with no Pa.

Evidently, it was not what we feared it might have been, for here I am to
tell the story of my hours in surgery under the dull knife of the man we
came to call "Dr. Crobar."

By Cliff Figallo

Cliff Figallo is director of community development for Salon Table Talk.

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