The mud Cake Wrist or the Wester Doctor?

The wrist was caked in mud and dried blood, the hand drooping forward. I wanted to get a look at the cut, but I knew that once I removed the mud it would start bleeding again. As we stood there, surrounded by a crowd of adults and children of all ages, I spotted what looked like a clean rag in the sand and walked over to pick it up. All eyes followed my every step. The audience was far more intrigued by the western doctor than by the injury he was treating, Cuts they've seen before. I started wiping the wound. The boy watched carefully, still without expression, even when the plug of mud fell away in one lump and a pulse of blood spurted out. By the second pulse I could see that the cut was very deep, running straight into the wrist from the thumb side. I sued the rag for compression, placing it where the mud had been. From the liveliness of the bleeding and the dropped position of the wrist and thumb, I knew an artery and some tendons were cut. It was likely that the nerve running between them had been cut as well.
The passage above from Surviving the Extremes shows various thoughts going through Dr. Kamler's brain as he performers an everyday "mini" surgery in a new environment. Although Dr. Kamler adapts to the new location well and has a positive attitude through the surgery I feel as if he is finding the new environment a bit different, weird as well as stressful. Throughout the first few chapters Dr. Kamler shares his experiences and also his attitude and thoughts pertaining to the new environments that surround him.