Home again, home again....

I arrived safely home Friday night after a long, but uneventful trans-Atlantic trek. No big mushroom cloud of ash was going to stop us....we just skirted the burping volcano adding a mere hour to the 24 hours of total travel from Tenwek to Denver. The best part of the whole two month adventure was Tim's open arms and big smile at the end of the international terminal runway when I got through customs--it is great to be home!

Things I have learned....

--Kenya (and its people) is a beautiful, rugged, tenacious place
--The medical and surgical need is huge and often overwhelming at times
--The staff at Tenwek are gracious, hard-working, and patient with the visiting staff as we bumble through learning a new system in very foreign surroundings
--Caterpillars are truly evil creatures that bite, sting, and attack hands and feet and cause significant loss of limb all over Kenya
--Mt Kenya is a very high, cold, beautiful mountain
--You don't need half the 'stuff' you think you do including more than two outfits for two months, CT scans, or ice cream (well, maybe I did die a little inside after seven weeks without ice cream)
--Almost anything can be accomplished in the OR with a 3-0 vicryl
--With just a little 'decontamination' and Cydex, practically everything can be reused including pleuravacs, bovies, bowel staplers, tru-cut biopsy needles, and ventilator circuits
--An African safari is a must do, once-in-a-lifetime event for every human being on the planet
--There is no place like home

Thank you for all of your support and prayers over the last two months. I am truly blessed to have such an infallible and steadfast group of family and friends--you all made this wonderful adventure possible.

One day in the life...

Here is one day in the life of an American ‘muzungu’ (white-girl) surgeon in Kenya…

Up at 5:30am to make some tea and eat a piece of fresh daily banana bread.

Walk up to the hospital for 6am devotions with the surgery team before making rounds on male and female surgical wards, ICU, and pediatric ward. This is similar to home and includes addressing diet, pain, management, and changing dressings on woundcare patients.

Make rounds with the consultants (attendings, bosses, big cheeses) at 7am. We have the interns and first year residents present overnight events, vital signs, exam, and plan for the day. Xrays are reviewed and teaching points are made.

Conference at 8am which includes Grand Rounds, Morbidity & Mortality, Morning Report, Chapter Club, or physician devotions depending on the day. These conferences cross specialties so the pediatric team is there with the OBGYNs and the surgeons, etc. It allows for some multidisciplinary teaching and learning experiences.

Theater (OR) cases start around 830-9ish depending on the day and the case. My busy OR day last week included:
--A palliative below Knee amputation for a large skin cancer
--A keloid scar excision for a 2 yo boy
--An exploratory abdominal surgery in a man who had had a colon resection a week earlier but was not progressing--we found an anastomotic leak and he needed a diverting ostomy
--Biopsy of a soft tissue muscle tumor in a 14 yo boy who will likely need additional procedures based on the pathology results--these take three weeks to get back from nearby Kijabe Mission hospital
--Incision and drainage of an abscess for a patient with Ludwig’s Angina, an infection in the neck originating from a rotten tooth
--Removal of a 15cm benign fatty tumor from a 40 yo lady’s shoulder
--Appendectomy

Evening rounds at 6pm with the intern on call to check on the patients and make sure tasks were completed for the day.

Home to the guesthouse for dinner at 730 with local Kenyan food of Chipati (fried flatbread), sumkumuwiki (shredded cooked kale with spices), rice, and roasted vegetables with beef.

Back to the hospital to make sure patients admitted for surgery the next day are appropriately prepared, blood is ready if needed, and labs are drawn.

Bed by 10pm after some email, Skype, or blogging.