Letters From Ecuador: Comfort Zones … [8]

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Editor’s Note:

I want to thank Margaret R. Harrington, who was a perfusion student close to graduation, and volunteered her time to work with The International Children’s Heart Foundation (ICHF) and Brian Forsberg, MPH, CCP, on a pediatric mission to Ecuador.  The following is her narrative and insight- as well as her photography of the events and the great story that transpired.

Ms. Harrington is now a CCP and working as a perfusionist. 

Comfort Zones …

Despite my initial feelings of discomfort, I soon realized that being out of my comfort zone was good for me. I discovered that there are many different methods of accomplishing the same task and that to be an excellent perfusionist, one must be flexible and innovative as well as knowledgeable.

Brian demonstrated time and time again that with some keen skills and deft creativity, it was fairly easy to overcome even the most challenging of obstacles that we encountered.

And I discovered that, in many regards, perfusion is much simpler in a developing country. For example, the MUF system we constructed was much more straight-forward than the one we use at Iowa.

Sensors & Alarms…  Not !

The same held true for safety features. At first it felt strange to be working without many of the alarms and safety devices we rely on in the states, such as a bubble detector, level sensor, and cardioplegia line pressure-monitoring device, but I gradually adjusted to working without them, and eventually (after becoming more vigilant of those components) it almost felt less restrictive knowing there weren’t additional “bells and whistles” to contend with, and that we were relying on ourselves to monitor those aspects. In essence, the trip was instrumental in teaching me that it is possible to run a perfusion case quite smoothly and successfully, even with just the basics.

During our two weeks in Guayaquil, our team performed twenty-five pediatric surgeries– eighteen of them on-pump. (I was able to pump twelve of those cases.) The majority of our cases consisted of ASDs, VSDs and TOFs, along with several complex cases which were performed with the help of Dr. Novick during the first week of our mission. Due to the fact that, prior to the trip, I had no experience in pumping pediatric cases, I learned a great deal, especially in terms of getting a feel for the subtleties of the flows and pressures related to pediatric patients.

All Good Things …

My two weeks with the ICHF team in Guayaquil may have been the most beneficial of my entire clinical experience as a perfusion student. I would recommend participation with a mission trip to any student who might be interested. Not only does it provide innumerable learning opportunities related to the practice of perfusion, but it also presents a unique avenue of contributing to a very worthy and important cause.

I am not only certain that my time in Guayaquil with ICHF has helped me to be a better perfusionist, but I also know it will forever be an experience that I keep close to my own heart. I commend the noble and awe-inspiring work of ICHF and hope to continue working with them throughout my career.


I would like to extend my sincere gratitude to Brian Forsberg, for imparting his invaluable (and immensely appreciated) expertise and encouragement, both during the trip and since.

I would also like to thank the International Children’s Heart Foundation, in particular to Dr. Bill Novick and Frank Molloy, for welcoming me to participate in this mission.

And thank you to the other members of our ICHF December 2011 Guayaquil team for their admirable work and for helping to make this experience so very extraordinary and memorable.

I am also very grateful to AmSECT and to the Ely-Gateway Rotary for their generous scholarship contributions.

And last but not least, thank you to Frank Aprile for providing me with this wonderful opportunity in which to share my Ecuador experience.

Finis ‘