During her inaugural medical mission this past April, Crystal Aycocke learned first-hand that there’s nothing comfortable, routine, or easy about providing healthcare in austere conditions like those found in the mountainous, jungle terrain of Chiriquí Province, Panama.
She also knew it was one of the most amazing experiences she might ever have as a CRNA.
“My church network has ‘planted’ over 65 churches in Panama, but we hadn’t done a medical mission in over 15 years,” says Crystal, a CRNA since 2014. “The Panamanians asked for medical help, so we were kind of the guinea pigs to get that modality off the ground again. Most of the people we cared for don’t have access to basic healthcare, and we were able to provide that for them.”
Joining Crystal on the medical mission was her pastor and his wife, a nuclear medicine tech, a pediatric intensive care unit nurse, a trauma intensive care unit nurse, and five nonmedical church members. The nonmedical volunteers were taught how to take blood pressures, but mostly they helped keep things flowing, maintained the peace, entertained the kids while their parents were being seen, and provided other types of support so the healthcare professionals could focus on providing patient care. The team was small, but Crystal says they accomplished a lot.
Crystal knew going in she wouldn’t be providing anesthesia, even though she was the only anesthesia professional on the trip. “That’s the great thing about being a CRNA, we can wear a lot of hats,” she explains. “I leaned on my APRN knowledge and filled the primary care role. I actually really enjoyed that role and can’t wait to go back. Taking the time to really talk to the patient and do what is truly in their best interest was extremely fulfilling.”
The majority of the mission was spent in Rió Sereno, a town in Chiriquí Province close to the border of Costa Rica. “We weren’t in hospitals or healthcare facilities,” Crystal recalls. Instead, she says the team set up their clinic at a different site each day, usually in churches but one day at a school.
“There was always a triage area so the team members could take each patient’s blood pressure, heart rate, and blood glucose,” Crystal says, describing the clinics in detail. “We also had a separate area where we used cables and sheets to create ‘curtains’ to provide a little privacy for us to see patients individually.” In a nutshell, they got creative and did the best they could with what they had to preserve the dignity of their patients.
On some days, Dr. Eduardo Perez, a Panamanian physician, worked with the team. “Dr. Perez spoke no English and I speak little Spanish, but we made it through. It was a pleasure working with him!” Crystal says. Prior to the mission team’s arrival, Dr. Perez had ordered meds for them so they could bring a small mobile pharmacy to the different sites.
“On day two of the trip, I was the only advanced care provider and all of the drug labels were in Spanish,” Crystal recalls with a good-natured laugh. “To say that I was a little nervous would be an understatement!” She was able to figure out most of the meds thanks to familiar prefixes and suffixes; others she had to look up their translations in English. “I quickly realized that some drugs do not translate to English and are unavailable in the U.S., so those went into a separate box that I told everyone in our crew was off limits. I figured out who I wanted translating for me and off we went.”
Crystal says she saw 120 patients by herself that day, from infants to the elderly. “No one was turned away,” she says proudly. “It was so hot and I was exhausted, but man was it fulfilling to really help people. The majority of the issues we treated were undiagnosed hypertension and diabetes. The healthy patients wanted things that we Americans take for granted like vitamins and cough syrup. We also did a lot of education!”
Most healthcare professionals who go on a medical mission come back having experienced “a life-changing moment.” Crystal was no exception.
“I had one little elderly lady that had been previously diagnosed with diabetes or hypertension—I can’t remember which—and she was out of medicine. We gave her a month’s worth of medicine. Before she left, I asked her if she needed anything else and she basically responded that she ‘got what she came for.’” Crystal then asked again, this time with emphasis—“But do you NEED anything else?”—and pointed to a table where she had arranged all the over-the-counter medications.
The lady very shyly and hesitantly told Crystal that she could use some Tylenol. “I handed her a box and she immediately started crying and hugging me as if I had given her a million dollars,” Crystal recalls with a smile. “It was a life-changing moment for me, to say the least.”
Other memories remain vivid in Crystal’s mind as well, such as the kindness of the villagers who cooked for the team every night. “We ate a lot of chicken,” she recalls. “They would kill the chickens on the spot, so we didn’t have to worry so much about food precautions! They would make huge batches of whatever they were cooking in these big cast iron cauldrons over an open fire. My favorite dish they made for us was arroz con pollo (rice with chicken).”
Bonding experiences with the team created other memories that will last a lifetime, including a visit to a coffee plantation (“Panamanian coffee is phenomenal!”) and a hike to a mountain lookout to take in the view of the Pacific and Atlantic oceans and a nearby mountain range belonging to Panama’s indigenous people, the Ngäbe. “It was extremely windy up there,” Crystal says. “To the point where I was worried it would literally blow me over the edge of the cliff!”
Crystal says she looks forward to her next trip, and also to one day participating in a true anesthesia medical mission. “I absolutely plan to do another trip. We learned a lot and have a lot of ideas how to make the trips smoother in the future.” She says the plan is to do a medical mission every year, and that she would love to take more healthcare professionals with her. “My dream is to see us grow to the point of having multiple teams hit the ground at one time, set up in different locations, and be able to treat more people each time we visit.”
For the time being, however, Crystal is back to work at Blount Memorial Hospital, a 275-bed Level III trauma center and primary stroke care center located in Maryville, Tennessee. It’s where Crystal has spent her entire anesthesia career to date. “I am from Blount County and love being able to take care of my friends, neighbors, and church members,” she says. “There’s nothing better than being able to tell someone you care about that you promise you’ve got them and you’ll literally be watching every breath they take. To then watch them take a breath and relax, even just a little… That’s my favorite part, being that comfort to people when they are scared.”
When she’s not providing high-quality anesthesia care or planning her next medical mission, Crystal enjoys spending family time with her husband, Justin, who is a police officer, and their 5-year-old daughter, Avery Grace, who starts kindergarten this fall. “We live at the foothills of Great Smoky Mountains National Park, and we love to travel. My current hobby is learning how to ‘travel hack’ with credit card points,” she laughs.
All things considered, it’s a safe bet that there’ll be a lot more travel in Crystal’s future!