Dr. Mark Boyko, MD’07, was taking a snooze in the call room when he was awakened by a bang at the door. The ER doctor was needed downstairs immediately. A young boy, brought to the new children’s hospital in Laos by his parents, had a snakebite that needed urgent care.
Before anything could be done, Boyko had to identify the type of snake that had bitten the boy. Understandably, very little time is devoted to venomous snakes in Canadian medical schools, but Boyko, who has worked extensively overseas, has a tropical diseases diploma that he earned along the way.
“I don’t know the snakes of Laos that well, but I got my laptop out and googled pictures with him. He showed me – he pointed right to the one. It was a green pit viper, a neon green deadly snake. Most snakebites don’t actually inject venom, but about 20 per cent of the time they will. He was in the unfortunate 20 per cent.”
How did he know? Without any bloodwork to go on, the test goes like this: Drop some blood into a glass vial and duct tape it to the wall, Boyko said. Give it 20 minutes and then check – the blood should clot normally. If it’s still runny, like water, then the patient is sick and needs anti-venom.
“He was very sick,” Boyko said. “He was vomiting blood, his leg was swollen, and he was bleeding from the leg. We had to try to get some anti-venom right away.”
That proved to be tricky, not just because of the rarity of the malady, but also because of the language barrier. They made their way to the pharmacy, which was closed, and Boyko tried several keys before gaining access. The language on the vials of anti-venom was in Thai, so a local doctor was tracked down to translate. Luckily, the hospital did have green pit viper anti-venom. The correct vial was identified, and Boyko administered the anti-venom to the boy. It helped turned his health around.
“You just have to get creative in those parts of the world,” Boyko said. “But those are feel-good stories. It’s good to reflect and realize how far you’ve come along, in terms of your training, that you can manage stuff like that.”
Boyko, 36, has been managing health crises, not just in southeast Asia, but in various parts of the world since his medical school days at Western. During the summer after his first year, he travelled with a team of medical, dental and nursing students to Tanzania as part of the MedOutreach program. The summer after his second year, he found himself treating an underprivileged population in rural south India as part of the India Health Initiative (IHI).
“I decided from then on I was always going to make it part of my career,” Boyko said. “There are always ups and downs, but the gift you get from overseas work is so tremendous for your own personal life.”
The Sarnia, Ont., native also worked in remote areas in Canada – Nunavut and northern British Columbia – during his training before heading to Vancouver in 2007 to do two years of family practice at the University of British Columbia. And he completed his extra year of emergency specialty training in Calgary, where he currently lives and works.
In 2010, he got his next big taste of international medicine when he travelled to Haiti following the devastating earthquake and subsequent cholera epidemic in January of that year. Volunteering with Haiti Village Health, Boyko worked in a cholera tent for four weeks.
“That was quite eye-opening,” he said. “It was one of the more challenging trips I’ve been on. I remember it was really hot out. You’d get only a few hours of sleep. We did it in shifts, and you’d sleep about 40 yards from the Médecins Sans Frontières tent.”
The locals prepared a little breakfast for the doctors before they washed up with chlorine and were sprayed down so they didn’t bring any cholera into the tent. Inside were cheap, foldable gurneys (“picture MASH-style”). The 40 or so gurneys would always be filled with people, and the doctors would go bed-by-bed assessing the patients and trying to turn their health around.
“It was quite dramatic. People would come from miles and miles, sometimes dragging a relative for days on a mat,” Boyko said. “They were either dead when they arrived, or they were super sick, or they weren’t too bad. If they weren’t too bad, they didn’t need to go in the tent – they could just do oral therapy on a little side clinic we had. But the ones in the tent were getting IVs and were much sicker.”
One might wonder how doctors and other volunteers manage to come away from experiences like these with their psychological health intact. In fact, some don’t. Boyko knows colleagues who have done similar work who now suffer from PTSD.
“You never know the true reality of it until you’re there, and then you deal with it afterwards,” Boyko said. “It does affect some people more than others. I don’t know if I’m just fortunate, but I’ve been pretty lucky. Like anything in life, exposure helps. The more time you spend in developing spots, and the more sickness you see in your career as a doctor, you get more comfortable with it.”
What Boyko has come away with from his experiences in international medicine, which includes work in 10 countries – Papua New Guinea, Peru, the Philippines, Bhutan and Cambodia, to name a few – is a big dose of perspective.
“Your mind is very aware when you come back about what’s important and how you want to structure your life,” he said. “There are gifts in that because you come in with fresh eyes to your own culture. A lot of people structure their lives around money or climbing the ladder. And, hey, I was probably the same 10 years ago. But I view things differently now. Life is not about money. You have to do what you’re passionate about, and you have to fill your life with love.”
Boyko is back in Calgary for now, working as an emergency physician at South Health Campus hospital. He also keeps his toes in family medicine, working one day a week at the refugee clinic doing intake exams for Syrian refugees who have landed in Calgary.
“It’s a really special place,” Boyko said. “There are a lot of good hearts and great work being done there. I think it’s a great thing Canada is doing, and I’m happy and fortunate to be part of it.”
He lives a simple life back home. Only recently did he purchase his first car, and that was only for travel to and from work (and to the mountains in his free time). No big house, no extravagant vacations. For now, he’s simply enjoying spending time with friends and family.
“That’s probably the hardest thing about going away – you don’t want to lose those relationships back home,” Boyko said. “It’s important to take enough time when you’re back to connect. So, I’m here for now. And we’ll see when the next adventure comes.” WAG
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