Final day of surgery at JFK for this trip. A couple of hernias, an esophageal dilation in a baby who swallowed some caustic substance a few months ago, an ileostomy decommissioning, and a huge groin lipoma. The decommissioning was in a young woman who had a typhoid perforation and severe peritonitis several months ago, so Moses did a loop ileostomy. For the decommissioning we took down the ileostomy, did the reanastomosis, and dropped it back in through the ostomy site. It worked well, and I was pleased that Moses felt comfortable avoiding a laparotomy.
Jennifer had come to the OR and was taking pictures, and after the lipoma we were taken for lunch at the home of George Saff, the Lebanese patient who had the hernia repair 9 days ago. He lives with his brother, who is a big deal in Monrovia. He has been here for most of his life, even during the war years, and has extensive investments in real estate, hotels, and the Lebanese restaurant where we ate last night, and which is next door to their house. He is President of the Chamber of Commerce, and appears to be very well connected in government circles. They put on a very nice lunch for us and Aunt Jennie, whom I saw as we arrived and she was leaving. George is thankfully doing well, walking upright, and just dealing with the scars of a painful first night after surgery !
Tonight we will have dinner at the house, and then go out to some clubs apparently. We might go up to Robertsport tomorrow if the weather is nice. And then we will leave on Sunday afternoon, arriving back in the USA on Monday morning.
It has been a good trip, but I have seen enough pathology and I am ready to return to a place where the diseases are not as obvious, the care can be given without concern for financial issues being in the forefront, and where the patients seek care soon enough so that the likelihood of a successful outcome is substantial. Jennifer and I had an interesting discussion this afternoon about attitudes to work by medical personnel in a setting such as this. I have mentioned before that the result of a high mortality rate for illness, combined with the horrors of living through civil wars(which really were not at all civil), results in people having a more detached attitude toward life than we are used to. It is only natural that they cannot invest a lot personally in the life of a patient because there is a significant likelihood that that patient, if severely ill, will not survive. But what we and others would like to accomplish is to develop a sense of professionalism among health care workers, such that they recognize the special bond of trust that exists between patients and caregivers. It will take a long time to move from here to there.
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