Before and After

OR days 4 and 5. Patients continue to dribble in for evaluation. Today there were two infants. Families carry growth charts or small booklets with information about the babies and their vaccines. One 3 month old infant with a cleft lip hasn’t gained weight in two months. Since babies only have to fast for 4 hours, she had her surgery the same day. The results are very rewarding.

Part of each day is spent figuring out how to make do. Today we made more homemade “no-no’s.” These are tubes that fit around children’s arms to keep them from bending at the elbow to tear at IV lines or stitches. Commercially available no-no’s are made from polyester, plastic, and Velcro. Ours are cardboard from the boxes we shipped our supplies in wrapped in disposable  medical pads (chux) and attatched with bandage tape. Our makeshift IV boards are plain cardboard.

We had a visit from a representative from the American embassy to El Salvador and it was nice to see some US miliary uniforms amidst the Salvadoran force that guards our unit.

About Lisa M. Asta, MD

Lisa M. Asta, M.D. is board-certified by the American Board of Pediatrics and is a Fellow of the American Academy of Pediatrics, for which she is also a Media Representative (she has been interviewed for “Kids Health” on Health Radio, and quoted in Parenting Magazine, USA Today, and the New York Times, among other publications). She is a Clinical Professor of Pediatrics at the University of California at San Francisco and past pediatric chair at John Muir Medical Center in Walnut Creek. She graduated from Temple University School of Medicine and the Johns Hopkins University. Dr. Asta is also a writer whose fiction has appeared in Inkwell, Philadelphia Stories, Schuylkill, and Zeniada. Her essays have appeared in the Journal of the American Medical Association, Hippocrates, the San Jose Mercury News, and The New Physician Magazine. She is an occasional contributor to KQED public radio’s Perspectives series, and has written articles for Bay Area Parent, Valley Parent, Parents’ Press, and Parents Express, as well as online at,, and She wrote a chapter in The Field Guide to the Normal Newborn, ed. Gary Emmet, M.D. currently has two how-to videos for parents in production which feature Dr. Asta. For more on Dr. Asta’s writing, visit
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