Shabbat . . . Special Edition

As many times as I have been to Rick’s house for Shabbat, tonight was yet one more unique experience.

I brought with me one of our neurosurgery residents from The Black Lion. Tsegue is very modest and reserved, but one of our best residents. He is currently doing a rotation to the Korean Hospital. This means he works all night at the Black Lion, gives report there in the morning. goes to the Korean Hospital to make rounds and operate all day, and then returns to the Black Lion at night. There is an American orthopedic surgeon who he has become friendly with at the Korean who is a good friend of Rick’s. Tsegue has heard much about Rick and so I offered to introduce him tonight.

Fifteen Swedish Jews who just arrived in Ethiopia this morning came to Rick’s for Shabbat this evening. One and all, they had heard such wonderful things from 30 Swedes who visited at this same time last year, that they wanted the experience. The organizer, Misha, is a wonderful fellow who speaks Amharic. One of the men in the group, Andualem (ne Andy) was here last year and immediately recognized me as his namesake from last year. He is an Ethiopian Jew (Beit Israel) who emigrated to Sweden from Israel shortly after Operation Solomon. He speaks superb Amharic, Hebrew, English, Swedish. We had a long talk about his experiences.

A number of the Swedes were Holocaust survivors from Poland,. In every case their parents had escaped from Poland only to return to Poland after the war. It was then in the late sixties that most of them eventually emigrated to Sweden, when unable to reconstruct any semblance of their previous lives in Poland. One woman told me the story of her mother who escaped from the Warsaw ghetto after she thought her husband had died there. Several years later, while living in Russia and having again married, she met her first husband who was alive. She lived out her life as an authentic bigamist!

Jennifer Kraft was also here this evening (www.jenkraft.blogspot.com). She works for the JDC in Denver, but has been in Addis for the past three months adopting an Ethiopian girl, who is precious. She thinks the process will take at least another few weeks, but has had the child with her for nearly two months and is loving motherhood. We met her when Rick was giving a talk last March in Vail and both she and Rick stayed with us.

After the brief but emotionally poignant “service” and introductions of the many people present there were the Shabbat prayers, an amazing vegetarian buffet with 12 unique dishes served in a kitchen smaller than your bedroom closet, and all prepared by a cook in this tiny kitchen. The Swedes began singing Hebrew melodies and all were very moved by the experience.

My suspicions have been verified. Turns out the Ethiopian government is in the habit of blocking the blog sites in an attempt to prevent circulation of any adverse political ideology.

New Year's Eve

Saturday, December 31 . . . . Happy New Year

Weekends can sometimes be a little tedious, but not today. Rick said to be at his house at 9:30 this morning. When I arrived, Joann and Sam Silverstein were there. After a while Rick arrived from the gym.

A bit later we set out for Mother Theresa’s mission with Rick’s staff of 3 assistants in a separate cab. Road was closed near the Mission, so we parked and walked more than 1/2 mile to get there.

In a small waiting room were at least 60 people as we passed into the exam room, an 8x10 ft. cubicle. During the next 6 hours we saw 30 or 40 patients, nearly all under the age of 25 and most under 15. Remarkable pathology; a dozen with heart disease including two in serious congestive failure; at least two dozen kids with profound scoliosis. In my field, was a post-op with acromegaly (operated by a neurosurgeon from Norway who left the day I arrived), a new pituitary tumor that I will likely be operating in the next week or two, a patient with serious paraparesis that we are working up, and several other neurosurgical problems.

We were all fascinated by both the interesting cases, and Rick’s very uncommon manner, particularly with the youth. Our only break was at 2:00 for tea. Rick’s lunch is a cup of tea and a cup of coffee. Fortunately one of his aides brought us a banana. Actually he bought several dozen bananas and gave them to everyone still left in the waiting room.

In the course of the day, Rick’s instructions for several of the cardiac patients was to get a passport and return next week. He hands them 300 birr (about $18) to pay for the passport and will be paying about $9,000 for each to fly to India for their heart surgery.

I told him that I could only do the pituitary tumor at the Korean Hospital as we will need special microsurgical instruments for a trans-sphenoidal operation. This is a private for profit hospital (in contrast to the Black Lion where all care is free). He said no problem, he will pay for it (about $7,500).

Quite a remarkable day.

First day in Addis Ababa: 12/28

Arrived yesterday after an uneventful 13 1/2 hr. non-stop trip from
Washington Dulles. The iInitial part of the trip to European mainland
was a chip shot; after that it got a little tedious.

Things often don't go smoothly here and sure enough there was no one
ostensibly waiting for me at the airport. After looking unsuccessfully
thru the throngs for a sign that might have my name, a woman was nice
enough to offer her cell phone. Called Akeza Teame who was supposed
to have a driver waiting for me and got a wrong number. Called his
hospital and no answer. Taking a taxi would have been no problem, but
I did not know the location of the apartment where i was to be
staying. Finally called Rick (Hodes) and he said he could come for
me. He told me to go to parking lot to wait for him and guess who was
at bottom of walkway . . Akeza! He has a new phone number since last
year.

He drove me to the apartment he was going to let me use; no more than
5 minutes from the airport. A large 3 bedroom apartment, 3rd floor
walk up. Fortunately the guard/doorman lifted my 60 lb. instrument
laden duffel onto his shoulders and carried it up for me.

Today I was awakened by the rooster in my neighbor's yard. I paused
for a moment of reflection to thank Akeza for the pleasure of hot
water. If I were in the apartment I was supposed to be in on the
hospital grounds, I would not have had this amenity.

Once outside, it was like morning in Vail; cool, a bright sun, soon to
warm up to 70 degrees. I took a taxi to the hospital. The driver
thought for a moment after giving me a good look up and down and said
the fare would be 100 birr (an obvious farengi, Amharic for foreigner,
fee). After walking away twice we settled on 50 birr, still more than
a local would pay.

I immediately felt at home in the gray, dark, unlighted passageway
leading to the four flights of stairs up to our conference room. I
was delighted to recognize the residents from last year. After a
report of the usual overnight two depressed skull fractures, fall from
scaffolding, etc., I elected to spend the day at the Korean Hospital
(also known as MCM Hospital -- you can google it). This is a private,
very profitable hospital on a large tract of land donated to the
Korean Christian Missionaries who founded it.

I was wonderfully at home in the O.R., today quizzing both the
attending and resident in Socractic fashion regarding the planned two
cases. My training under the tutelage of Bill Collins at Yale was
today passed on to yet another generation. At first gently, and then a
little more forcefully I led them to re-think their surgical plan in
both cases, the first a meningomyelocele (i.e. spina bifida) in a
three month old, and the second a large herniated disk.

After surgery we made rounds on a virtual neurosurgical museum of
post-operative cases. Most of the patients had huge tumors, that
would never have attained that size in the U.S. as the patient's long
ago would have presented to their doctor with symptoms. All patients
seemed to be doing very well. We then went to see three patients who
had been admitted while we were in surgery. Two had huge hypertensive
hemorrhages that were inoperable; the third had a small hemorrhage in
a vital area. I don't expect any of them to survive.

We finally had lunch at 3:00, at a pizza place on the way back to the
Black Lion Hospital. My host ordered a "fasting" pizza. Fasting
occurs twice every week (Wed and Fri) for Ethiopian Christian
Orthodox, in addition to 40 days of "fasting" prior to Easter.
Fasting, however, is not what it means to us. To them it means no
meat or dairy products for the day. Our vegetarian pizza with tuna
was excellent.

Rick is getting some people together for dinner tonite and I will be
joining them. A very memorable day for me, in which I was energized
by the opportunity for some meaningful teaching moments.

Story of the day

I was supposed to be picked up by one of the residents this morning at my apartment. When he did not show, I called him. Turns out he did not have my phone number and was still at the hospital after operating all night.

I decided to take a minibus to hospital. There are hundreds if not thousands of these on the streets. One comes by nearly every minute. For the minuscule cost (15 cents for wherever they go) you get the privilege of riding with 15 others crammed into 12 seats.

I had no idea where the minibus was going so asked "anyone speak English". Fellow in front of me answered "I know where you are going". "What". Turns out he was a medical student in my class two years ago and is now an M.D. and was on his way to his hospital where he is interning.

He told me where to get off and change for a minibus to Black Lion Hospital. That's another story not worth telling.

Bye for now.