Operating rooms have a lot in common ' trays of instruments; monitors and other electronic equipment; and when in use, several gowned and gloved doctors and nurses doing surgical procedures that range from the routine to heroic.

However, some operating rooms are different. Most provide healing, but the truly special ones offer hope. Capt. Angela Martinelli, a science officer with the Congressionally Directed Medical Research Programs knows first-hand about those ORs.

Martinelli is a Public Health Service nurse and a volunteer with Operation Smile, an organization that provides safe, effective reconstructive surgery for children and adults born with facial deformities such as cleft lip and cleft palate. A recent mission to Santa Cruz, Bolivia 'Martinelli's 14th since 1993 ' provided another example of just how special an operating room can be when an entire staff works together.

"This was an interesting trip because I was the only operating room nurse from the United States, working with a team of plastic surgeons and anesthesiologist from Bolivia, Italy, Spain, Mexico, and the U.K.," Martinelli said. "There was some chaos and confusion, which is natural for this kind of atmosphere, but after two days of screening, we were ready to get to work."

What followed the screening was four 10-hour days of surgery, consulting, consoling, and reassuring. More than 100 surgeries were performed, and nearly every patient came a story of heartbreak or joy.

"A woman who works at the local orphanage brought an 11-month old boy for screening," Martinelli said. "His cleft lip had interfered with his nutrition so he was small for his age and clearly malnourished. This repair of his lip would not only improve his nutrition but would greatly improve his changes for adoption."

Martinelli said she had long been interested in practicing nursing in remote locations and non-traditional settings, and Operation Smile offered all of those. In addition, she said the opportunity to get to know the people of the community and their culture is invaluable. Seeing where and how people live and witnessing their values and behaviors is always insightful, she added.

During an Operation Smile trip to Bolivia in 2008, Martinelli learned of a local woman born with a cleft lip who was shunned by her family and kept at arm's length by her husband. Knowing her plight, a close relative of the woman helped her sneak out of the house and get to the hospital. Despite the attempts of her enraged husband to prevent the surgery, the woman had a successful procedure. Later, when looking in the mirror, she said, "My life begins today."

Experiences like that are what draw Martinelli to continue serving. Quoting a Latvian proverb ' "The ready back gets all the loads" ' she said the spirit of camaraderie always manifests itself once the team gathers and meets for the first time.

"Professionally, I am amazed every time a group of nurse, doctors, and other volunteer, come together and produce such amazing results, since most of us have never worked together before," Martinelli said. "But like clockwork, within hours, you see professional experts kick into gear and set a plan in motion. It takes a certain type person to enjoy this type of work so only those who are up to the task are the ones who keep on coming back."

She told another story about her recent trip. A young boy who was born and lived in the mountains near La Paz suffered from a cleft lip. The boy's mother was blamed for the deformity, and when she learned of the Operation Smile mission, she took her son on the 30-hour trek to the hospital. The surgery went well, and when the mother saw her son in the recovery room, she said, "My son was born in La Paz and now is born again in Santa Cruz."

"Florence Nightingale said that one's feelings should be distilled into actions which bring results," said Martinelli. "This is such a special opportunity, and I am honored and humbled with every mission."