Never a dull moment

Today I will go chronologically backward since I have been so busy I am not sure I will remember everything.

It is Thursday and a very active day.  As I was awaiting the start of our first surgical case, a spine fusion in a man struck in the back resulting in an L3 spine fracture, one of the attendings said there is a visiting neurosurgeon who wants to see me.  Turns out there is a brother team of orthopodic surgeon/neurosurgeon who have a spine surgery practice at Cedars-Sinai in Los Angeles.  They have visited several countries in Africa (including their native Gabon) as they wish to set up a first class, western standard spine operating room to do scoliosis and other complex spine surgery.  They have their own charitable spine foundation and claim to have access to sufficient money to do this as well as set up a residency exchange program between Cedars-Sinai and their chosen site.

I spent considerable time with them to suggest that they have found the ideal place.  Our teaching hospital in a large peaceful African country with 18 neurosurgery residents and appropriate desire.  Icing on the cake is Dr. Rick with his huge reservoir of scoliosis patients needing surgery.  Currently he pays $18,000 per child to send them to Ghana for surgery.  Wouldn’t it be wonderful if they could be done at the university hospital in Addis for free!

I phoned Rick immediately and we are trying to locate them (all we know is they are staying at the Sheraton + their email addresses) to try to arrange a meeting of them with Rick.

Second case today turned out to be a tuberculoma in the brain.  Resident who did the case says that is his 7th case; I had none in 38 years of practice.  

In the center of this brain exposure is the tuberculoma

A disappointing episode this morning.  The neurosurgeons told me that they have a new Stryker drill, that lacks a handset.  Also have an ultrasonic aspirator that lacks a foot pedal.  I decided to investigate.  I got in touch with the neurosurgeon in Norway who donated (and paid for) what is probably $80K or more in equipment.  He claims that all of the parts were there when the equipment arrived.  The doctors/nurses here were supposed to contact the supplier who, as part of the sales price, agreed to come to Addis to properly install the equipment and instruct in its use.  Unfortunately none of this was done and now the indispensable parts are missing.  I am hoping I can obtain the missing drill parts once I return to the U.S.  We are going to try and contact the European reps for the ultrasound and see if they are still willing to come here.  This is a tragedy, caused by negligence and disinterest and unfortunately is typical of what often happens here.  These two pieces of equipment would dramatically enhance their capabilities if we can finally get them working (and maintained) properly.

Yesterday, Omar Jiminez, the neurosurgeon with an Ethiopian wife from Scotts Bluff, Nebraska, wanted to spend the day with me at the Black Lion Hospital.  He is a wonderful fellow, smart and motivated, who immediately got the picture and actively participated in our teaching process as well as at surgery.  He did a spine fracture with one of the 5th year residents and was very instructive with some finer points of the surgery that are often discounted and/or overlooked by the residents.

Two of Rick's assistants, Menachem (applying to medical school) and Rebecca (daughter of a neurosurgeon in NYC) wanted to see some surgery.  They came to the hospital yesterday and while they were here one of the nurse anesthetists approached me with her problem of facial pain.  Turns out she has trigeminal neuralgia and presented a wonderful teaching opportunity with the students as well as the residents.

Day before yesterday brought an unexpected opportunity.  I had a call from my orthopedic friend, Guetahoun.  Two weeks ago he was operating for a week in a small town 150 miles from here with a medical mission (Global Medical Foundation) of surgeons/nurses from several countries combined with some Ethiopians.  They did nearly 80 cases in one week. Horrendous cases of burns, congenital anomalies, untreated deforming injuries and much more in  a marginal surgical setting.  Guetahoun said they were having a final “reception” and Today I will go chronologically backward since I have been so busy I am not sure I will remember everything.

It is Thursday and a very active day.  As I was awaiting the start of our first surgical case, a spine fusion in a man struck in the back resulting in an L3 spine fracture, one of the attending said there is a visiting neurosurgeon who wants to see me.  Turns out there is a brother team of orthopodic surgeon/neurosurgeon who have a spine surgery practice at Cedars-Sinai in Los Angeles.  They have visited several countries in Africa (including their native Gabon) as they wish to set up a first class, western standard spine operating room to do scoliosis and other complex spine surgery.  They have their own charitable spine foundation and claim to have access to sufficient money to do this as well as set up a residency exchange program between Cedars-Sinai and their chosen site.

I spent considerable time with them to suggest that they have found the ideal place.  Our teaching hospital in a large peaceful African country with 18 neurosurgery residents and appropriate desire.  Icing on the cake is Dr. Rick with his huge reservoir of scoliosis patients needing surgery.  Currently he pays $18,000 per child to send them to Ghana for surgery.  Wouldn’t it be wonderful if they could be done at the university hospital in Addis for free!

I phoned Rick immediately and we are trying to locate them (all we know is they are staying at the Sheraton + their email addresses) to try to arrange a meeting of them with Rick.

Second case today turned out to be a tuberculoma in the brain.  Resident who did the case says that is his 7th case; I had none in 38 years of practice.

A disappointing episode this morning.  The neurosurgeons told me that they have a new Stryker drill, that lacks a handset.  Also have an ultrasonic aspirator that lacks a foot pedal.  I decided to investigate.  I got in touch with the neurosurgeon in Norway who donated (and paid for) what is probably $80K or more in equipment.  He claims that all of the parts were there when the equipment arrived.  The doctors/nurses here were supposed to contact the supplier who, as part of the sales price, agreed to come to Addis to properly install the equipment and instruct in its use.  Unfortunately none of this is done and now the indispensable parts are missing.  I am hoping I can obtain the missing drill parts once I return to the U.S.  We are going to try and contact the European reps for the ultrasound and see if they are still willing to come here.  This is a tragedy, caused by negligence and disinterest and unfortunately is typical of what often happens here.  These two pieces of equipment would dramatically enhance their capabilities if we can finally get them working (and maintained) properly.

Yesterday, Omar Jiminez, the neurosurgeon with an Ethiopian wife from Scotts Bluff, Nebraska, wanted to spend the day with me at the Black Lion Hospital.  He is a wonderful fellow, smart and motivated, who immediately got the picture and actively participated in our teaching process as well as at surgery.  He did a spine fracture with one of the 5th year residents and was very instructive with some finer points of the surgery that are often discounted and/or overlooked by the residents.

Two of Ricks assistants, Menachem (applying to medical school) and Rebecca (daughter of a neurosurgeon in NYC) wanted to see some surgery.  They came to the hospital yesterday and while they were here one of the nurse anesthetists approached me with her problem of facial pain.  Turns out she has trigeminal neuralgia and presented a wonderful teaching opportunity with the students as well as the residents.

Cooking the lamb

The movie above shows part of the garden before the guests arrived.  Man in the center is my friend Dr. Guetahoun

Day before yesterday brought an unexpected opportunity.  I had a call from my orthopedic friend, Guetahoun.  Two weeks ago he was operating for a week in a small town 150 miles from here with a medical mission (Global Medical Foundation) of surgeons/nurses from several countries combined with some Ethiopians.  They did nearly 80 cases in one week of horrendous problems in a marginal surgical setting.  Guetahoun said they were have a final “reception” and asked if I would like to join him.  We drove quite a way west of town, then onto a cobblestone road, then a rutted dirt road, then a road with stones and even boulders to finally arrive at a home with a 10’ concrete wall.  We entered through the gate into a tropical paradise.  Hundreds of flower bushes and trees, palm trees, eucalyptus and many others.  It was rather cool but our host started a wonderful bonfire.  Turns out the host, Tseguy, is the brother of Dr. Amati from Chicago who put the group together.  Tseguy is a former diplomat and judge and now a lawyer.  There were more than 40 people in the garden, around the bonfire, with bountiful liquor, wine and brandy accompanying an Ethiopian feast;  best food I have ever had here.  Prepared by two lovely cooks, probably no more than 20 years old.  The climax was a freshly sacrificed lamb.  Fortunately I was not invited to watch.  They put a huge (36” wide) metal plate on a rack over the bonfire and proceeded to grill the lamb throwing on many different spices and bottles of wine.  It was unique and wonderful.

I ended up talking most of the evening with a lawyer friend of the host.  We talked for two hours and I learned much about the legal and judicial system here, as well as about taxes, the real estate boom, methods of financing, etc.

Tonite I am trying to arrange dinner with the group of neurosurgeons from South Florida that I met several nights ago.  I believe their potential plan, if they have one, could conflict with our development plans here at the university, so I would like to learn more about their intentions.

Today would have been my father’s 110th birthday!  That’s all for now. if I would like to join him.  We drove quite a way west of town, then onto a cobblestone road, then a rutted dirt road, then a road with stones and even boulders to finally arrive at a home with a 10’ concrete wall.  We entered through the gate into a tropical paradise.  Hundreds of flower bushes and trees, palm trees, eucalyptus and many others.  It was rather cool but our host started a wonderful bonfire.  Turns out the host, Tseguy, is the brother of Dr. Amati from Chicago who put the group together.  Tseguy is a former diplomat and judge and now a lawyer.  There were more than 40 people in the garden, around the bonfire, with bountiful liquor, wine and brandy accompanying an Ethiopian feast;  best food I have ever had here.  Prepared by two lovely cooks, probably no more than 20 years old.  The climax was a freshly sacrificed lamb.  Fortunately I was not invited to watch.  They put a huge (36” wide) metal plate on a rack over the bonfire and proceeded to grill the lamb throwing on many different spices and bottles of wine.  It was unique and wonderful.

I ended up talking most of the evening with a lawyer friend of the host.  We talked for two hours and I learned much about the legal and judicial system here, as well as about taxes, the real estate boom, methods of financing, etc.

Tonite I am trying to arrange dinner with the group of neurosurgeons from South Florida that I met several nights ago.  I believe their potential plan, if they have one, could conflict with our development plans here at the university, so I would like to learn more about their intentions.

Today would have been my father’s 110th birthday!  That’s all for now.