Wednesday

After morning conference I elected to make rounds with the residents on all the neurosurgery patients.  I like to do this at least once a week.  We saw probably 30 or more adults and another 15 children.  A neurosurgical museum all in one morning.  Conditions I never saw in 40 years of practice and other more mundane problems but taken to the extreme.

Surgery today was a giant acoustic neuroma and a thus far undiagnosed huge tumor in a 40 year old woman (insert photos)

Waited for a minibus, but in the fashion of the Shanghai subway, locals kept edging us out so we took a taxi back to our guest house.  There is a new cafe practically on our door step, “Step Up” that turned out to be our best lunch yet.   A huge tray of Lasagna and drink for $3.50,

Had been talking for the last few days with Camilla, an academic from Sweden who comes to Ethiopia once or twice a year and is doing research at ASU (Addis Ababa University) having something to do with the “greening” of Ethiopia; i.e. efforts at environmental improvement. We invited her to join us for dinner and we decided to try a different restaurant.

Turns out that a 5 minute walk from our hotel are three outstanding spots: 1) Le Grand Reve; a Belgian restaurant where we actually had an excellent dinner.

Dinner at Le Grand Reve

2) Immediately next door to it is a new modern casual place, Savoy, where we had some gelato after dinner. 3) Just around the corner is perhaps the fanciest restaurant I have seen in Addis (not including the many new westernized hotels), Attica. An Italian restaurant that gets outstanding reviews. In the course of findings these I have also learned about “Five Loaves” that i am going to try next week.  In summary, a lot of my previously favorite restaurants have been closed, but some new wonderful restaurants have opened.

Addis has been undergoing enormous change in the past five years.  You cannot go anywhere, look around you, without seeing at least 3 new skyscrapers under construction.  There are at least 30 new hotels just in the last few years.

Tuesday

Usual morning report reviewing 5 emergency cases from last night.  I then announced that I would like to have 2 of the junior residents with me for my clinic.  Very junior, indeed.  They began their residency yesterday (January 1 — not New Year’s Day in Ethiopia).

A good opportunity for me to recall basic neurosurgical interviewing and examination skills.  A number of very interesting patients, a few rather mundane.

After clinic we walked one mile uphill to the Piazza for lunch.  Mediocre.  Took minibus a long way back to our area of town, then 1/2 mile walk to our hotel.

Went exploring with Daniel (one of the students) looking for a favorite French restaurant from years past.  Walked and walked some more and never found it.  On returning to our guest house, Google maps found it right away.  Will try it in the next day or two.

In the meantime went to a Yemeni restaurant that I like, though it was clear the students were unfamiliar with Mediterranean type food (much less Yemeni),  I was not very hungry so had just  Tabouli with a lot of the wonderful Yemeni bread.  Daniel made friends with the owner and he brought us some hummus “on the house”.

Monday

Off to morning report.  The residents present all the emergency cases over the weekend, about 15 in all.  A whole huge batch of residents (42!) and I know hardly any of them.  All the fellows I trained are now attending, and I am very impressed with them.

Took the students to see their first surgery . . . an enormous sphenoid wing meaningoma.  

The residents assisting, and doing the entire opening exposure were both women.  They have a new state of the art Leica $250,000 microscope recently donated by the Norwegians (The neurosurgery department at the University of Bergen has for many years aided the residency program).  However, in typical Ethiopian fashion they are unable to obtain funds to buy drapes for the microscope so as to preserve a sterile field during surgery.

Leave it to these clever guys.  They did extensive research and came up with a protocol for  exposing the scope to formaldehyde gas for 24 hours.  They then operate directly using all of the controls of this very sophisticated scope without an occasionally cumbersome vinyl drape.

Surgery began at 10am and concluded at 10pm with near total removal of this enormous tumor (we were not there for the entire operation!).

Did not eat lunch until 3pm and had a very late dinner after a very interesting day.