Shabbat, January 4 and more

Friday,  January 4

Sadly, Janet and Rachel left last night after slightly more than one week of continuously unexpected and unique experiences.  Janet has been using my extra cell phone this week so we could arrange where to meet, etc., and she called me from the airport to tell me check  in was a breeze (that is not always the case) and the plane was departing on time.

Well, the interesting things are starting to happen.  The day started with our usual morning rounds to review 5 trauma cases from last night.  Following this, one of the attendings had asked one of the residents, Hanani, to review the indications for the use of mannitol in brain edema.  I thought he did quite a good job, but the attending who had made the assignment was quite didactically critical.   Naturally I had to put in my two cents which was at variance and this prompted a spirited discussion.

Following the first tea, two of the residents in sequence made excellent powerpoint presentations on the subjects of aneurysms,and transoral resection of cervical tumors and other masses.  The irony is they are equipped to do neither of these procedures, but at least they are now conversant in these subjects.

After a second cup of tea. there was a spirited discussion between Hagos and Mersha (two of the attendings), and the newly 3rd and 4th year residents (they advance to the next year each January 1) regarding a recent written and oral examination that was felt by the residents to be extremely difficult and unfair.  The issue was that there was hardly any neurosurgery on the examination, rather mostly anesthesia, plastic surgery, neurology and radiology and with many questions having little or no clinical relevance to neurosurgery.  The residents had legitimate complaints.  The problem is that the residents are regarded as visitors when they do these rotations (i.e. attachment in their parlance) and are often given instructions and assignments far afield.  My recommendation was that the attendings should draw up a list of objectives for the residents on the various attachments and these should be circulated to the heads of the respective departments as well as to the residents.  This seemed to bring an acrimonious discussion to a conclusion.

There then appeared at my door Omar Jiminez (born in Columbia and named after Omar Sharif) and his very lovely wife who is originally from Addis.  Omar is a neurosurgeon in western Nebraska, and had contacted me a few weeks ago to tell me he was coming to Addis for the first time with his wife, and would like to make arrangements to do in the future what I have been doing here.

We went to Mama’s Kitchen for lunch, recommended by Janet who was taken there yesterday by Atsinef, the guide for Janet and Rachel.  We had a superb lunch. 

one corner of the large circle of guests as we welcome Shabbat

After an afternoon running errands and catching up on the internet at one of the hotels, I went to Rick’s (Rick Hodes . . . rickhodes.org for those who have not heard about him). I invited Omar and his wife Sali to join me.  The turnout was the largest I have ever seen; more than fifty people in Rick’s very small living room, including his brother from Telluride who I have been hearing about for the last few years.  Turns out 10 or more were with a group that is doing cardiac surgery at our hospital’s Children’s Cardiac Center for a week.  We had people from multiple cities in California, Washington, DC, Cleveland, Vancouver, Telluride, New Orleans, Princeton, NJ, NYC + many more.  A very moving evening.  I had a long conversation with a Lynne Friedman from Los Angeles who identified herself as a Burmese Jew.  Turns out her family is originally from Burma.  There is still a synagogue there serving the eight Jewish families remaining in the country, and a Jewish cemetery.  She recently raised money to refurbish the cemetery.

As I was preparing to leave, one of Rick’s older boys approached me and started telling me about his 27 year old brother who has had seizures for the past several years.  I gave him a prescription for an MRI scan and told him his brother must immediately start on an adequate dose of Phenytoin (one year ago he was on an inadequate dose, still having seizures, and stopped it), and I want to see him at my apartment next week.  Two hours later his brother called to make sure I would follow through on his case.

Took a cab back to my “guest house” at the Black Lion Hospital.  

So far on Saturday, my phone has not stopped ringing.  Emergencies at the hospital, calls from old friends, etc.  Also had a call from Rick who is today seeing a seven year old with a mass coming out of her head.  Berhanu (his assistant) is going to bring her to my "house" along with the fellow mentioned above.

I was up several times during the night and must have fallen asleep again, when there was a knock on my door.  It was 9am and my visitor was the woman in charge of the "guest house" who was supposed to come yesterday.  Very lovely and took notes on all of the "needs" for the apartment.  With luck they will be done by next year.

Was taking a shower (some day I'll post a photo of the "shower") when there was a knock on the door.  It was Wubi, my housekeeper who I had not yet seen this year.  When I finally checked into the guest house two days ago I put all of my laundry from the first week in a laundry basket.  When I arrived back at noon on Friday, all of my clothes had been washed and were hanging out to dry.  Wubi shops and cooks food for me, clean the apartment daily, does my wash;  she asks me to pay her every Friday.  It was $6 per week last year, perhaps a little more this yearl.