Spending the day with Dr. Gabriel Ramos, Oncology Surgeon


Spent the day in the operating rooms with one of my favorite Mexican surgeons, Dr. Gabriel Ramos Orozco.  Dr. Ramos is an oncology surgeon with offices in Mexicali (Baja California) and his hometown of San Luis Rio del Colorado in Sonora, Mexico.

Dr. Gabriel Ramos Orozco, Oncology Surgeon

Dr. Gabriel Ramos Orozco, Oncology Surgeon

In the operating room with Dr. Gabriel Ramos

We spent the day in his hometown – first at the Hospital Santa Margarita, where he performed a laparoscopic cholecystectomy, and then in his offices seeing patients.

In the operating room

In the operating room – photos edited to preserve patient privacy

Hospital Santa Marta

The hospital itself was a small intimate clinic.  The operating rooms were small but well-equipped.  We were joined by Dr. Campa, an excellent anesthesiologist and another general surgeon.  While the anesthesia equipment was dated, all of the equipment was functional.  At one point, the sensors for cardiac monitoring and oxymetry readings malfunctioned but within seconds a backup monitor was attached.  (This is a frequent occurrence in most hospitals around the world and the USA because the sensors that connect to the patient with gel are cheap disposable and somewhat fragile.)

There were several monitors dedicated to laparoscopy with good display quality.  The operating rooms had ample light and functioned well. Overall the clinic was very clean.

ramos surgery

The surgery itself proceeded in classic fashion.  The patient was positioned appropriately and safely before being prepped and draped in sterile fashion.  Since the surgery itself was of short duration, anti-embolic / DVT prophylaxis was not required but was still applied.  (Note:  in Mexico, these stockings are of limited utility – and for more lengthy procedures, TEDS or electronic squeezing devices are usually applied.)

The surgery itself was under an hour, with no bleeding or other complications. The patient was then transferred to the post-operative care area for monitored recovery from general anesthesia.

Dr. Ramos performs laparoscopic surgery

Dr. Ramos performs laparoscopic surgery

In the clinic

It was an interesting day – because he sees a diverse mix of patients.  As a general surgeon, he also operates for many of the classic indications, so there were several patients who saw Dr. Ramos for post-operative visits after appendectomies, cholecystomies (gallbladder removal) and the like.  There was also a mix of patients with more serious conditions like colon, testicular and breast cancers.  His patients were a cross section of people, from the United States and Mexico alike.

International patients

Some of these patients came for the lower cost of treatment here in Mexico, but others came due to the dearth of specialty physicians like oncology surgeons in places like Yuma and Las Vegas.  Many of these international patients spoke Spanish, or brought translators with them since Dr. Ramos is primarily Spanish speaking.

Since D. Ramos is not well-known outside of Mexico, many of these patients were referred by word-of-mouth, by former patients, friends and family.

Then it was back to the hospital twice to visit his patient post-operative.  She was resting comfortably and doing well.  It is this level of service that draws patients to his clinic both here and in central Mexicali.

This winter, Dr. Ramos returns to school so to speak – as he will be spending several months in Barcelona, Spain and Colombia learning new techniques such as uni-port laparoscopy.  He will then be able to offer these state-of-the-art treatments to his patients back here at home; whether these patients come from northern Mexico or other parts of the globe.

Highly Recommended:  Excellent surgeon with well-coordinated team.  However, patients requiring more extensive surgery (large tumor surgeries/ cytoreductive surgery) should request Dr. Ramos perform surgery in the larger Mexicali facilities for better access to advanced and specialized support services like hemodialysis etc. for sicker/ higher risk patients. 

However, the level of care was appropriate at this facility for this procedure, which is rated as low-risk.  (i.e. generally healthy patient, with straight-forward procedure)

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How’s the book coming?


I was in the United States most of last week (at my reunion) but I didn’t stop working.  While a reunion may not seem like the most ideal situation for a medical writer – it’s actually a great opportunity to talk to people and get their opinions about health care, medicine and surgery.  After the first few minutes of catching up – talk naturally turns to everyday life, and for many of us – ‘everyday life’ involves worrying about the health of our families.. Also, many of my classmates – and old friends have been some of my biggest supporters of the blog (and my other work) so it was good to get some critical feedback.

Bret Harte class reunion

The book is coming along – almost continuous writing at this point.  While I (always!) want more interviews with more surgeons, I am now at the point where I am filling in some gaps  – talking about the city of Mexicali itself.  So I am visiting museums, archives, and talking to residents about Mexicali so I can provide a more complete picture to readers.  Right now, I would really like some information about 1920’s -30’s Mexicali – I can find a lot of interesting stuff about Tijuana, but Mexicali is proving more elusive.

It’s a bit of a change from my usual research – finding out about decades old scandals (even local haunted houses), visiting restaurants and nightclubs, but it’s been a lot of fun., even if it seems frivolous or silly at times.  I hope readers enjoy this glimpse into Mexicali’s rich history as much as I have.

Finished the cover – which to me, is critical at this point.  (I use the cover to inspire me when it comes to the less than thrilling stage of copy editing) so I am posting an image here.

cover for the new book

Meeting with an architect later this week – to learn about, and write about some of the variety of styles here in Mexicali.  (There is such a surprising array – I thought it would be nice for readers to have a chance to know a bit more.)

Now there’s one house I’ve dubbed “Mexicali’s Graceland.”  I don’t know why Graceland comes to mind every time I go past this home (it looks nothing like Elvis’ home in Memphis) but the term has stuck.  I am hoping to get some of the history on this house because it just looks like a place where even the walls have stories to tell.

The pictures aren’t the most flattering – but I’ll post one so you can tell me what you think.  (It’s actually far more lovely in person – with the contrast between the pink walls and the white scrollwork, as well as some of the more classic design features.) I guess my imagination tends to run away with me – with images of grandeur and elegant ladies sipping champagne in the marbled halls of the past – but then – most of my usual writing is technical in nature, so I have few outlets for my creativity.

Mexicali’s Graceland

Meeting with my co-writer today to go back to the archives..

Wrapping up and saying “Thanks!”


It’s a busy Sunday in Mexicali – presidential elections are today, so I am going to try to get some pictures of the nearest polling station later.. In the meantime, I am spending the day catching up on my writing..

a polling station in Mexicali

Lots to write about – just haven’t had the time..  Friday morning was the intern graduation which marks the end of their intern year – as they advance in their residencies.. Didn’t get a lot of pictures since I was at the back of the room, and frankly, unwilling to butt ahead of proud parents to get good pics.. This was their day, not mine and I was pleased that I was invited.

I did get a couple of good pictures of my ‘hermanito’ Lalo and Gloria after the event.  (I’ve adopted Lalo as my ‘kid’ brother.. Not sure how he feels about – but he’s pretty easy-going so he probably just thinks it’s a silly gringa thing, and probably it is..)

Dr. ‘Lalo” Gutierrez with his parents

Lalo’s parents were sitting in the row ahead of me, so of course, I introduced myself and said hello.. (They were probably a little bewildered by this middle-aged gringa talking about their son in atrocious Spanish) but I figured they might be curious about the same gringa that posts pictures of Lalo on the internet.. I also feel that it’s important to take time and tell people the ‘good things’ in life.  (Like what a great person their son has turned out to be..)

Same thing for Gloria.. She is such a hard-worker, and yet, always willing to help out.. “Gloria can you help me walk this patient?”  It’s not even her patient, (and a lot of people would say – it’s not our jobs to walk patients) but the patient needs to get out of bed – I am here, and I need some help (with IV poles, pleurovacs, etc.)  and Gloria never hesitates.. that to me – is the hallmark of an excellent provider, that the patient comes first .. She still has several years to go, but I have confidence in her.

She throws herself into her rotations.. When she was on thoracics, she wanted to learn.. and she didn’t mind learning from a nurse (which is HUGE here, in my experience.)

Dr. Gloria Ayala (right) and her mother

She wasn’t sure that her mom would be able to be there – (she works long hours as a cook for a baseball team) but luckily she made it!

Met a pediatric cardiologist and his wife, a pediatrician.. Amazing because the first thing they said is, “We want nurse practitioners in our NICU,” so maybe NPs in Mexico will become a reality.. Heard there is an NP from San Francisco over at Hospital Hispano Americano but haven’t had the pleasure of meeting her.  (I’d love to exchange notes with her.)

I spent the remainder of the day in the operating room of Dr. Ernesto Romero Fonseca, an orthopedic surgeon specializing in trauma.  I don’t know what it is about Orthopedics, but the docs are always so “laid back”, and just so darn pleasant to be around.  Dr. Romero and his resident are no exception.

[“Laid back” is probably the wrong term – there is nothing casual about his approach to surgery but I haven’t had my second cup of coffee yet, so my vocabulary is a bit limited.. ]  Once I finish editing ‘patient bits’ I’ll post a photo..

Then it was off to clinic with the Professor.

Saturday, I spent the day in the operating room with Dr. Vasquez at Hospital de la Familia. He teased me about the colors of the surgical drapes,(green at Hospital de la Familia), so I guess he liked my article about the impact of color on medical photography.  (Though, truthfully, I take photos of surgeons, not operations..)

Since the NYT article* came out a few days ago – things have changed here in Mexicali.  People don’t seem to think the book is such a far-fetched idea anymore.  I’m hopeful this means I’ll get more response from some of the doctors.  (Right now, for every 15 I contact – I might get two replies, and one interview..)

Planning for my last day with the Professor  – makes me sad because I’ve had such a great time, (and learned a tremendous amount) but it has been wonderful.  Besides, I will be starting classes soon – and will be moving to my next location (and another great professor.)

Professor Ochoa and Dr. Vasquez

But I do have to say – that he has been a great professor, and I think, a good friend.  He let me steer my education at times (hey – can I learn more about X..) but always kept me studying, reading and writing.  He took time away from his regular life, and his other duties as a professor of other students (residents, interns etc.) to read my assignments, make suggestions and corrections when necessary.    and lastly, he tolerated a lot with good grace and humor.  Atrocious Spanish, (probably) some outlandish ideas and attitudes about patient care (I am a nurse, after all), a lot of chatter (one of my patient care things), endless questions…  especially, “donde estas?” when I was lost – again.

So as I wrap up my studies to spend the last few weeks concentrating on the book, and getting the last interviews, I want to thank Dr. Carlos Ochoa for his endless patience, and for giving me this opportunity.  I also want to thank all the interns (now residents) for welcoming me on rounds, the great doctors at Hospital General..  Thanks to Dr. Ivan for always welcoming me to the ER, and Dr. Joanna for welcoming me to her hospital.  All these people didn’t have to be so nice – but they were, and I appreciate it.

* Not my article [ I wish it were – since I have a lot to say on the topic].