(warm piano and strings music)
(dark, enchanting music)
- [Announcer] We have Dr. Ryan F. Osborne
and the surgeons of Osborne Head & Neck Institution.
(panelists clapping)
Dr. Ryan is a key ENT surgeon and head of surgical team
who has come all the way from USA for this camp.
- We will be doing our best to take care of anyone
and everyone who is interested in the services we provide.
Our plan was simple.
We'll go anywhere where there are people who need help.
We heard there might be some people here in India.
My name is Ryan Osborne.
I trained as a head and neck surgeon
in South Central Los Angeles, managing the most complex
cancer and trauma patients in the country.
I've operated across the globe
in first and third world countries.
My experiences have taught me the value of flexible
and innovative thinking,
but I realized that our healthcare system
doesn't always allow for that.
So I started Osborne Head & Neck Institute
and made it my mission to find the best,
most creative surgeons around
and I gave them the space to excel.
Together we create a new standard in medicine.
These are our stories.
(nostalgic orchestral music)
- If you must go on your own, let somebody know.
- As we embark upon our mission to India,
we find ourselves congregating again in the airport.
This time, we're flying from Los Angeles to Canada,
from Canada to Delhi.
It took us only, meh, a mere 28 hours.
When we arrived, the team was surprisingly
in pretty good shape.
I guess after Africa, we're pretty much ready for anything.
(tense orchestral music)
So we just traveled literally around the world.
We're in Delhi and what happens?
Of course, the luggage is not all here.
Part of the luggage is here,
but not the part that has our clothes in it.
So we've gotta keep moving,
we've got a connecting flight.
Once we arrived in Delhi,
we assembled the final members of our team.
Dr. Nazarian left his family trip early
in Morocco to meet us,
Dr. Nemanja arrived from Serbia,
and Dr. Swarn Gupta, Dr. Reena Gupta's dad,
he met us from New York.
Dr. Gupta's dad offered to escort the equipment
to make sure it actually got there
and which would allow the team
to catch a small commuter plane
from Delhi to Amritsar Airport
and cut that seven-hour drive down to one hour.
It's an ambulance.
Can you believe that?
Our luggage is going to be transported via an ambulance
from Delhi to Jalandhar.
This is only gonna happen in India.
(man speaking faintly)
- [Ryan] This is how we do it.
(frantic orchestral music)
(warm, reflective piano music)
(somber piano music)
- [Ryan] After a short one-hour flight,
we made it from Delhi to Amritsar.
There was a bus waiting outside the airport
to transport us to the city of Jalandhar,
which is roughly about a two-hour drive.
There we would set up for our mission.
- Ten. - Eleven.
- Twelve.
- We're almost there.
(birds chirping)
- [Ryan] When we arrived to Jalandhar,
I sent the majority of the team to get some rest
and a small group of us stayed awake,
waiting for the equipment to arrive with Dr. Gupta's dad.
Once it arrived in the middle of the night,
we headed to the hospital and began to unload.
We wanted to make sure we were ready first thing,
bright and early in the morning
so we could get right to work.
(powerful, dramatic orchestral music)
After a few hours' sleep,
I got everybody up bright and early in the morning.
We assembled in the lobby to go over logistics
and to strategize how we would triage the day's patients.
(enchanting, rhythmic music)
- [Announcer] We have Dr. Ryan F. Osborne
and the surgeons of Osborne Head & Neck Institution.
(panelists clapping)
Dr. Ryan is a key ENT surgeon and head of surgical team
who has come all the way from USA for this camp.
- We are a group of medical professionals
that believe that medicine is
most uniting profession in the world.
It transcends race, religion,
gender, economics, politics.
It's human, it's humanity.
I know we have a lot of cultural differences,
but just know that during the time that we are here,
we are here to show respect,
to show the quality of our medical care,
and the content of our character to you.
We are here to make friends, to help, and to build bridges.
We will be doing our best to take care of
anyone and everyone who is interested
in the services we provide.
Our plan was simple.
We'll go anywhere where there are people who need help.
We heard there might be some people here in India.
- India is a developing country
and it has developed in the last 50, 60 years
since independence.
People are so much illiterate,
our villages, city is improving.
- We had translators there, but it was still kinda difficult
performing patient examinations.
I found myself repeating myself a lot to the translator.
- There are no male nurses where we were at.
To be a male nurse in India is just unheard of.
- Every patient saw me as their own personal resource.
They were coming to me with all of their problems
because they understood that I was the one
who spoke their language and I could help them.
But I only had so much energy.
- There was about 200 patients waiting to be seen.
- It was a free-for-all.
People would just bombard you and throw you out of the way.
- Every single doctor is busy trying to screen patients
and seeing which one is surgical and which one is not.
- People still believe in the old style medicine.
They still think the allopathic medicine is not that good,
they still believe in the homeopathic, Ayurvedic tricks
and all that stuff.
- Oh, my gosh.
There were, there were some real challenges on this trip.
- Everything that we're accustomed to here in the US,
it kinda goes out the window.
(people chattering)
- [Ryan] Day one of any mission is the same.
It's long.
We have to get through tons of patients,
trying to triage and figure out who needs surgery,
who needs medical care.
Actually, who's even safe for surgery.
- It looks like in India, a lot of people had ear problems
and it was nonstop.
I never had a moment to myself.
Oh, my god.
Ear infection.
(tense, dramatic orchestral music)
- [Ryan] I'm amazed at how despite the language barriers
and the cultural differences,
my team always seems to find a way to bond with the patients
as well as the local medical staff.
(mesmerizing, nostalgic music)
- Crayons.
- I had a memorable patient that had a mass on his nose
called a rhinophyma.
It's a growth of the skin.
It's not cancer, it's not life-threatening,
but it is life-altering.
And one of the reasons this patient wanted to get this fixed
was because he wanted to just be able to present himself
normally to the world.
(dramatic orchestral music)
The surgery for him went very well
and he looked great, I saw him in clinic a few days later.
He looked amazing, he was entirely appreciative
and he felt like we were giving him his life back.
(car honking) (people chattering)
- [Ryan] India is universally known for its beauty.
However, it's also well-known
for its extreme areas of poverty.
(haunting exotic music)
The hospital staff tried to keep us safe
and within the confines of the building, but seriously?
I trained in South Central LA.
I'm no stranger to poverty or dangerous neighborhoods.
So in between cases,
I would sneak out and meet the community.
I wanted a deeper connection
with the people that I was actually here to help.
(vehicles honking)
(enchanting, exotic music)
(tender orchestral music)
- A memorable patient that I had in this day
was a older gentleman who had a lesion
of the inside of his cheek.
And this had been growing for a while.
And it was obviously cancer.
It looked like cancer, it was behaving like cancer.
The game plan for him is to have Dr. Osborne go in,
remove the tumor, and then I'll go in afterwards
and reconstruct the defect that's left.
(tense, expectant orchestral music)
His lip looked great and I think he's gonna do well.
We got the pathology.
It was cancer, but it was entirely removed.
It was great news for him.
I think we cured his cancer
and he's gonna have a longer, healthier life
from this point, so that was great.
(speaking in foreign language)
(people chattering)
(uplifting piano music)
- One of the patients that really stood out to me
was a young woman.
She was probably around 20 or 21 years old
and she had neck masses on both sides.
They had tried to take out this first one
and actually she ended up with a vocal cord paralysis,
and so they couldn't figure out what was going on.
They left most of the mass there because they recognized
that there was something more going on,
but they sort of just left it at that.
They didn't know really what to do next.
So I reviewed the case with Dr. Osborne,
we talked about what we could do for this young woman
with two tumors in her neck, a vocal cord paralysis,
no diagnosis established, and her whole life ahead of her.
- Going into the surgery, yes, I knew I could remove it,
but the real goal was to figure out what exactly is this.
- You gotta live inside that. (speaking faintly)
(swelling, emotive orchestral music)
- I am.
- So we took her to surgery
and the surgical plan was very much to be determined.
(tense, dramatic orchestral music)
- Throughout the surgery, it became very apparent
that there was definitely something strange going on here.
This wasn't a straightforward neck mass.
- I don't think I've ever seen a case like that.
It was absolutely incredible.
And within about an hour, we realized that her entire neck
was full of these little nodular growths.
- I could see the peripheral nerves,
meaning the nerves that are close to the skin,
had undergone some sort of neoplastic change
and I began to think immediately,
this is probably neurofibroma.
Because there are different types of neurofibromatosis,
the goal is to figure out which one the patient has.
- We sent tissue for diagnosis and it came back
as likely to be something called neurofibromatosis.
- Neurofibromatosis is a poorly understood disease,
but one that is not easily managed surgically.
- And I remember we were talking to her father afterwards.
And actually, this was a case I pulled my dad in for
'cause I said I really need him to understand
the full extent of this.
And we were talking, and as the father took my hand
to thank me, I noticed he had neurofibromas on his hand.
We got into this whole story about,
okay, this is a genetic condition
and this is how this might affect other family members.
And he looked up and he said,
"Yeah, my sister had this too."
And it was just one of those things
where you realize you're having an impact beyond that moment
and that one patient,
you're helping this whole family understand something
and seek treatment
that they might not have otherwise known to seek
and it will change their outcomes.
There's no cure, but there's management.
I was glad that my dad could help them understand it
and that we could help her
get on the path towards treatment.
(tranquil music)
(rhythmic, energetic music)
- [Jason] The case that stuck with me the most
was this small girl.
- She was only seven year old.
She was from Nepal, actually living in India.
More interestingly, when you listen to the child,
she was saying she wants to be a doctor
and she wants to do all these missions out
so when she grows up.
- She had fibrous dysplasia,
which is lesion involving the bone
where it starts to change the bone into sort of a cartilage
so it gets soft and deformed,
and it starts growing like a big mass.
And she unfortunately had it right here
on the front of her head
and it was so large that it was pushing her hair out
and it looked like she had just a small little mass of tumor
protruding from the front of her skull.
(melancholic music)
- I remember I was a little nervous to bring this girl
into the operating room, but we had to do it.
- [Woman] Your mommy is gonna be with you.
- And then just at the last minute,
I saw him in the corner of my eye, I said,
"Dad, just come in and just help this girl feel comfortable,
"if you don't mind."
He came in and he took her hand,
and he just soothed her until the anesthesia took effect
and she fell asleep.
(dramatic orchestral music)
- The case involved shaving and carving down that bone
so that her skull underneath looks completely normal.
At three separate times, the power went out.
(instrument rasping)
We're using a drill, we're operating on a child,
and all of a sudden, everything goes black.
I really wanted her to have a great outcome,
but at the same time, I was really worried about being safe
because we were having problems with the electricity.
And I think we did a really good job.
I feel like we made her life potentially a little better.
- After surgery, what she said is,
"I'm glad everything went well
"because I wanna be a doctor like him when I grow up."
I mean, I know how she feels.
I grew up feeling that way.
I grew up feeling like I wanna be like him when I grow up.
- So there was this lady with this large parotid tumor
and I feel very at home with that.
That's something I do absolutely every single day.
(gentle, melancholic music)
(moves into tense orchestral music)
The difference here is we're gonna do this
with no nerve monitor,
none of the typical things that we use
to keep ourselves out of trouble.
(machinery rasping)
(machinery rasping)
Despite not having our normal monitors
and safety measures and safeguards,
the reality is, the surgery went beautiful.
Tumor was removed, facial nerve was totally intact,
she had no facial nerve paralysis or even weakness,
for that matter, and she's gonna do beautiful.
And I'm really happy I had an opportunity to help her.
When we perform a mission,
we try to stay focused on spending every possible moment
just engaged in patient care.
But often, we have to spend time
in sort of ceremonious activities.
You have to acknowledge the hard work
that goes into organizing
and making the necessary preparations
for an international mission to proceed successfully.
(wistful, exotic music)
- My name is Paras, Paras Sareen.
I am from Punjab then Jalandhar.
I was seven or eight years
when I found that I have a sinus problem.
I consulted many doctors,
but didn't get any good response.
- And they basically examined his sinuses
and told him that nothing's wrong,
and they're actually right.
His primary problem is that
he has a really bad deviated septum
and he has collapse of his upper nasal vault,
and that's causing him to be obstructed.
He's unable to breathe through his nose
and that's causing a lot of pressure on the sinuses.
So in this case, we're gonna have to do something called
an open septoplasty.
- I'm quite nervous and excited.
It's my first surgery ever.
- So the game plan for the surgery is, number one,
straighten the inside of the septum
that's causing blockage of his right nasal passage.
Number two, correct the deviation on the bridge of the nose
that's causing his upper airway to be collapsed
and support it with some cartilage
that we borrow from the septoplasty
and then number three,
support the tip of this nose
so that it doesn't continue to droop
and cause him problems in the future.
Paras is asleep and under general anesthesia,
but we're still gonna anesthetize the nose
so he doesn't feel anything when the surgery is over.
The second thing we're gonna do
is work on straightening the inside portion of the septum
by repositioning the cartilage
and removing any excess that's blocking the nasal passage.
We're now gonna open up the skin envelope
that's covering up the structure of the nose.
We're gonna use some cartilage from the septum
and we'll carve that into grafts
that will support and bolster the upper part of the nose
to give him support.
Lastly, we'll close everything up
with a little bit support on the tip of the nose
so that he has a functional nose that looks normal
and will last him his whole life.
I think he's gonna have a excellent result
and this is gonna last him for his whole lifetime,
and I'm glad that we had the opportunity
to take care of him on this trip.
(gentle, nostalgic piano music)
(people chattering and laughing)
(enchanting exotic music)
(vehicle honking)
- Once we left the hotel and got to the hospital,
it was just all systems go.
(restless, dramatic music)
Two separate teams, an operative team, a clinic team.
Patients would be waiting.
They would've slept in that hospital lobby overnight,
waiting for us to arrive.
They knew we were gonna be there
and that we were gonna hit the ground running
the second we got there.
- We're always fighting against time
until ultimately, we ran out.
- One of the cases that I did
was of an older gentleman who had a growth in his larynx.
We took him to the operating room and I biopsied it
so that we could establish diagnosis.
The case went really well.
We found the mass, took a good biopsy,
and now we're just waiting for pathology
to see what the diagnosis is.
So we have to do a trach.
My dad is an incredible person.
He's pretty much,
I think the most amazing person I've ever met.
He always raised us to think of
being a doctor as a privilege,
not as something to be egotistical about.
But he would always say that you're so blessed
to be able to be educated
and the gift is given to you
so that you can help other people.
It's your privilege, it's not...
It's your calling.
- You feel so much good, you know,
when you are next to your children
and you see them doing these things.
That gives you the happiness in the heart
that whatever objectives we had in our life,
we were able to achieve those objectives
and our children are doing it.
- It's one of those things you know
you can never really achieve that.
I don't think I could ever be the doctor he is
because he does it with every fiber of his being.
It's who he is.
- Pleasure.
Standing next to your own child, you know,
and you see them, they grow up
and they are doing these operations.
Sometimes you wonder, you know,
how the children will grow up,
so it was very much giving me lot of happiness inside
to see the child doing all this.
- [James] This is Tanya.
Tanya?
(gentle orchestral music)
- [Ryan] One of the most impactful aspects of the mission
is when we get an opportunity
to work with the local doctors.
They come into the operating room and work with us
and gives us an opportunity to share and exchange
both knowledge and techniques.
- There was this one patient
that came on the second or third day of our clinic.
And he had a very serious ear problem.
He had something called a cholesteatoma inside his ear.
The problem was that he came a little bit too late.
He didn't come up and see us till the second day.
By that point, we had surgeries for every single day,
so the only thing I could tell him was we're totally full,
but if you really wanna have this surgery done,
we can help you, but you just have to come
and show up every morning
and see if anything gets canceled.
He came every single day
and he would wait there all day long
to see if any surgeries canceled.
And finally on the last day that we were there,
we decided to take on his case
because we had a cancellation.
- I'm gonna get out. (speaking faintly)
(tense, dramatic orchestral music)
- The surgery was very challenging
because he had a pretty big tumor,
but we were able to eradicate the growth inside his ear,
clean everything up, and actually restore his hearing.
I was very proud of that surgery.
(melancholic music)
- So this was our last case of the mission.
It was a thyroid, big goiter,
tons of opportunity for blood loss.
And to be honest with you,
I was completely wiped out, fatigued.
In fact, I actually took a nap before the surgery
while Dr. Nazarian was finishing the case before.
And I knew this was gonna be a bloody case.
This lady had hyperthyroidism.
She essentially, what we thought, had Graves disease,
which is a disease in which the thyroid
has gotten really, really large,
it's got tons of blood vessels going to it,
and the treatment really is either
to ablate the thyroid surgically by removing it,
or to use radioactive iodine,
which was not available to her.
(tense, dramatic music)
I really had no energy left in me
and I just knew I needed to pace myself
to get through this surgery.
(machinery beeping)
It was like a sigh of relief.
I mean, in a lot of ways,
we had finally completed a few things.
The mission was actually over,
this surgery was over, I could stop pretending
and I could actually allow myself to feel
as sick as I actually was.
Just a lot of things kinda, kinda came to this one point
at the same time and it was just like, (heavily exhales)
we're done.
So as our mission has come to an end,
we made so many friends.
We've been forever changed
by these once-in-a-lifetime human interactions.
We'll never forget the flavor of India.
The smiles, the spirit, and the vastness of this country.
We've worked as hard as we could to help as many as we could
and we leave knowing one thing,
that when you have a population of over 1.3 billion,
the number of people we helped,
it's a drop in the bucket compared to the number
that probably need help.
From a public health standpoint,
one might say, what's the point?
And really, all this effort, why even do it?
I would just say, ask one person who received assistance
if they feel like it was a waste of effort.
We may not be able to change the world,
but we can change someone's world.
(warm, uplifting orchestral music)
(rhythmic, dramatic music)
(gentle, swelling orchestral music)
- There is no question that this mission changed my life.
- I really feel like I'll never be the same.
- This was a great blessing for me.
- They just really cemented my desire to go into medicine
and go to be a doctor.
- All the experiences in that one week that I was there,
it made me look a lot at the bigger picture.
- I think one thing that people in America
do take for granted and kind of just expect it now
is convenience, like, convenience is a privilege
and we've kind of just expected it from everything.
- We overindulge in everything in the US.
It's so over the top compared to these places we go
where people literally have nothing.
- We have freedoms to express ourselves
and be whoever we wanna be in whatever situation.
- We have education here.
- You have the freedom to study what you wanna study.
- We have the opportunity to work.
- Have the freedom to be who you wanna be.
- We can speak up as females.
- We have the freedom to interact
with who you wanna interact.
- Cars are available, comfortable transportation,
clean water, clean food that we're able to eat
and not really even have to think about.
- We don't realize that a lot of the world is struggling
and that some of the things that we take for granted
are just not available, so it's easy to judge.
- We shouldn't take that for granted.
We should really be blessed and thankful
that we have the opportunities we have here.
- During the mission, we just hit the ground running
and everybody just did the best that they possibly could
with whatever came their way, whatever it was.
- Through all the adversity that we faced,
the crew just did wonderfully and did amicably,
and it just was an amazing feat to see and witness,
and I'm really, really happy that I was part of that.
- My mom was asking me about my experiences from the trip,
and I told her, Mom, this is honestly what I wanna do
with the rest of my life.
- It's really cool being exposed
to all these different surgeries.
It's very, very interesting.
- Helping out during the surgeries
has been absolutely life-changing experience
that I would not trade for anything in the world.
- I hoping that this is not my last mission,
that will be more missions like that all around the world.
And that I will bring something to my home,
to my people, and to my colleagues.
- I felt like I had gone home
and that I was actually able to give back to people
who made me who I am.
- So happy to notice that the whole mission was successful.
- That's a reward for a lifetime,
and I don't think I'll ever forget the people of India.
- Think bigger, think bigger than yourself,
think bigger than your state,
think bigger than your country.
Being in India just kind of opened the doors
and helped me think, I'm a nurse, but at this point,
I'm a global nurse.
I can be more and everyone can be more,
and we don't have to stay in these little boxes.
We actually can make a difference.
- This was the best thing that has ever happened to me,
meeting these people at OHNI, they really changed my life.
Sorry.
Just thank you.
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