1/13:my new Chinese friends in addis

After morning rounds dr. Zenebe picked me up as I was planning to do surgery with him at the newest and largest private hospital in addis. Hospital is owned by a very entrepreneurial gynecologist. It is in a beautiful spot high in the hills in the outskirts of addis. I am told that they would not allow him to buy land in the city because he refused to pay bribes to the officials. Now there is an entirely new suburb spawned by what was previously a remote hospital. We are operating on a fellow who fell off scaffolding on a building site, broke his neck and is quadriplegic. Very efficient operating room personnel in contrast to The Black Lion.

Obligatory tea after surgery and they then serve us lunch in the o.r. Lounge, such as it is. Everyone is devouring their injera, but they were very kind to ask me if I would prefer a European meal. They bring me a huge plate of spaghetti.

After lunch I go with Tadios, the first and for a long time the only neurosurgeon in Ethiopia. He is giving a lecture at the Army Hospital on the history of neurosurgery in Ethioipia. In 2008 their three, there are now 6, and in 5 years, if all current residents finish, there will be 22.

Late in the afternoon I return to my apartment to see a very interesting patient.

I am picked up at 7:00 by Alex, a delightful Chinese fellow,age32, who with his Chinese friend, dr. Wong, owns one of the three MRI scans in addis. They also own the only MRI in Djibouti. They have a Chinese MRI machine which is 1/5 the power of the most common machine in the U.S., but I can tell you that the images are excellent. They charge $90 for a brain MRI that is a minimum of $1200 at home, and usually more. Admittedtly our scans are more complete, but they will supply equivalent scans on request.

After touring their facility we all go to their favorite Chinese restaurant in Addis for a 10 course Chinese feast that is by far the best meal I have had in addis. Not a single dish even remotely resembles anything in a Chinese restaurant at home, but each dish was different and amazing. They selected (and treated us to) the entire meal.

After dinner, it is now 10:00 , Wong wants to take us to his house to meet his lovely wife who is a radiologist. We have tea and some Chinese snacks. A marvelous and unexpected conclusion to my last night in addis.

1/11

After rounds this a.m. , one oftheradiologists who aspires to be a neuroradiologist gave a superb lecture on origin, techniques and interpretation of CT scans. After lecture chief of radiology wanted me to look at an MRI of a friend. Very large midline suprasellar tumor possibly extending into pituitary fossa and with possible minimal duralumin attachment to planum sphenoidal.

Then saw 20 or more patients in clinic. Never thought it would stop. A few routine minimal complaints but admitted four for urgent surgery (that means they will be operated in 2 weeks if we are lucky). Preparations take forever and anesthesiologists don' like to work after 1:00, so we are lucky if we can do 2 cases in a day. There is at least a six month waiting list for even huge benign tumors and other conditions that would be urgent at home.

Met Minalu, one of my guides from the South Omo 3 yrs ago, for tea along with Naomi.


Minalu called his cousin Andualem, my main guide in the Omo, so that I could say hello. I have referred a number of clients to him in the past two years.

Had my daily shoe shine with my favorite shoe shine boy.
Walked to dinner at the Ethiopia hotel, a recently discovered very nice dining room with impossibly huge portions. Walked home to end the day.

1/12:different yet again, and wonderful

I was supposed to operate at Zedetu hospital today on a child with a huge hydatid cyst (a kind of worm that can migrate thru the bloodstream to the brain), virtually unknown in the U.S. As often occurs that was cancelled and they asked me to start a case I have been dreading for two weeks. Anyway i was greeted enthusiastically in the O.R. By two American anesthesiologists. Maroj is an American born indian who is a third year resident at Beth Israel in Boston; Laura is from Virginia and the mother of 5 who been here for 2 1/2 years. Both were thrilled I was involved in the case and taught me a lot about neuroanesthesia. Some other stories from them that will await my return.

I left after 5 hours (this will be at least a 10 HR case) as I made a commitment to see some patients this afternoon at one of the private hospitals. One was an ophthalmologist and one a nurse. All were very lovely people.

At obligatory tea afterwards on Bole rd. I went to the bathroom. Came back to find a 3rd person seated at out table who I thought must be a friend of the doctor I was with. Turns out he just wanted to speak English. A former physics teacher who speaks excellent English as well as Amharic, French and German.

I'm waiting for a patient who is coming to my apartment with one of Rick's assistants and then off to dinner.