When our dermatome let out its first dry, metal-on-metal complaint, we knew we were in trouble. In the controlled, fluorescent-lit world of our home operating rooms, lubrication is an unremarkable certainty—something that simply exists, like gloves or gravity. In Cochabamba, Bolivia, on an exploratory surgical mission fueled by good intentions and multiple unknowns, it became the object of an epic quest. We had been advised to not bring mineral oil in our supplies because of customs concerns. Not to worry, the hospital would surely have some… or not.
The diagnosis was clear: our dermatome needed mineral oil.
The prognosis: uncertain.
The treatment plan: La Cancha.
“La Cancha”, for the uninitiated, is not a market so much as a parallel universe. It sprawls. It multiplies. It laughs quietly at maps. Stalls bloom into streets, streets dissolve into alleys, and every conceivable object—boots, live chickens, car parts, quinceañera dresses, mysterious powders—is offered simultaneously. If something exists in the physical world, there is a decent chance La Cancha has it, often in bulk, sometimes alive. The team, armed with the surgeon’s trademark confidence and decisiveness, plunged in.
We asked vendors. Many vendors. Some nodded enthusiastically and sold us cooking oil. Others offered motor oil. One man produced something fluorescent and alarming that smelled faintly of citrus and optimism. We rejected all politely, growing increasingly aware that “mineral oil for surgical instruments” was not a common phrase in the marketplace lexicon. Then I had an idea…
Up ahead stood a cluster of heavily armed military police with immaculate uniforms, large weapons, and an air of unambiguous authority. Surely, they would know. After all, what is a dermatome if not a precision cutting instrument? What is mineral oil if not lubricant? And what are weapons if not…well, precisely oiled cutting instruments?
The logic was flawless. The execution… less so.
The team followed as I approached confidently, gesturing the international sign for “important question incoming!” In earnest Spanish, I asked where one might find lubricating oil suitable for a dermatome… “the same type of oil used for weapons,” I helpfully clarified.
The atmosphere changed instantly. Smiles vanished. Hands adjusted grips. The entire group of officers went from mildly curious to keenly alert in under a second. We had, it seemed, gone from benign foreign tourists to suspicious individuals seeking weapon maintenance supplies in the largest open-air market in the country.
I backpedaled furiously, as Sam forcefully tugged my arm and looked at me with wide open eyes that practically screamed “are you out of your mind?”
“No, no—cirugía! Hospital! Dermatome!” I explained, describing the instrument like a panicked magician revealing a rabbit. I mimed surgery. I mimed skin grafting. I mimed healing. I may have mimed saving lives in an exaggerated performance, despite Sam’s intent to calm the situation.
For a long moment, we stood there—doctors, soldiers, dermatome—locked in mutual assessment. Finally, one officer’s expression softened. Then another. A senior officer stepped forward with professional curiosity, nodding while examining the group: Anne, red and shushing me; Sam, still shaking me; Jack, laughing his socks off; and me, still miming. “Ah,” the officer’s face seemed to say, “This is unconventional, but earnest.”
Directions were given. Detailed directions. Accompanied by vigorous pointing, dramatic arm sweeps, and what might have been a warning or a blessing… it was hard to tell. We thanked them profusely, promising once more that we were lubricating patients’ futures, not firearms.
And just like that, the crisis was over and we were already eating the most sweet and later stomach upsetting street pomegranates. La Cancha, as it turns out, truly has everything—including stories that will be lubricating mission trip dinners for years to come.
Back at the hospital, as the dermatome hummed contentedly once more, we reflected on the day’s lesson: in global surgery, technical skill is essential, cultural humility is critical, phrasing your questions carefully around people with automatic weapons is advisable, but most importantly, having friends around to stop you from digging yourself further into a hole (or jail cell)… that is priceless.
