and the beat goes on

Resident presenting on neural tube defects

Today was going to be an easy day.  Friday morning is just for teaching . . . morning review, two presentations by residents and rounds.  Planned to be out of there by 11:00, and as I was getting ready to leave they tell me there are 9 patients with trigeminal neuralgia (also known as tic douloureux) waiting to see me.

A few of the tic patients

As some of you know this has been a specialty of mine for many years.  For the past five years I have been lecturing on the subject in Nairobi and here, and trying to teach them a simple, sustainable, percutaneous technique requiring very little equipment and seemingly ideal for this environment.

One of the 4th year residents, Abenezer, was assigned as my aide and translator.  I think I may have identified the future of tic in this country.  He was great.  After the first or second patient he took a thorough history by himself and was intelligently and thoroughly discussing the patients with me.  He would then meticulous explain to each patient their therapeutic options.  All were reaching near the end of their rope and chose to proceed to have this surgery next week.

Zenebe with his daughter in 10th grade who is going to
school in Lexington, KY next year

The full menu at Zenebe's 10 bed hospital

As I was finishing this, Zenebe (the only privately practicing neurosurgeon in the country with his own 10 bed hospital and "ICU", called to tell me that he had a patient with tic who he wanted me to operate on this afternoon.  So much for my free afternoon.  He sent a driver for me, we had a light lunch together and successfully treated his patient.

Finally I was free to spend the weekend at a hotel in a more active part of town.  Over the past several days I have been speaking to a general surgeon friend from Gondar who helped me during my first trip here six years ago.  At the time he was a first year resident.  Shibikom is now one year out of his residency and a general surgeon at the medical school in Gondar.  If he can get a group of my friends together, I will fly to Gondar Sunday morning to have dinner with all of them Sunday evening and then return to Addis on Monday.

Tonite I went to the very moving and inspirational shabbat at Rick's house.  There were 30 students from the University of Maryland and elsewhere, many pre-med.  A number of them were anxious to speak with me during dinner and I had some wonderful conversations with some delightful young men and women.  They are all flying to Gondar Sunday morning, and I will likely fly with them if I go.

Large grey/white mass in the center is the large pituitary tumor

Tomorrow (Saturday) was supposed to be another free day.  However, Hagos, one of the attendings called and asked if I would help him do a large pituitary tumor tomorrow.  Goodbye to my free Saturday morning.