March 4

Friday March 4


After a restful sleep, we had a busy day in the OR. The first case was a 4 year old boy with a hernia/hydrocele. Jenn and I did the operation in about 25 minutes, but then it took about 90 minutes for him to wake up. Jenn stayed with him as they bagged him in the PACU, feeling not unreasonably that if she left they would stop, and the outcome would be a disaster. Eventually he did wake up, but the experience brought up some of the issues and problems with anesthesia in this setting. There is no anesthesiologist since Dr. Gouma went back to Nigeria, and the nurse anesthetists are of varying quality. Some are quite good, but others are less competent, and they seem to be the ones who don't provide much supervision or feedback to the nurse anesthetist students. Jenn wondered about bringing our own anesthesia team over when we come but there are major issues with that approach. It will be worth some discussion.

After that case we did some more hernias, and Konneh and Jenn did a gastrostomy on a 14 year old boy who swallowed lye. Konneh was unable to dilate his esophagus either antegrade or retrograde. When I asked him what the future held for the boy, Konneh said "hopefully he will be lucky and be able to go to another country where he could be cared for."

We finished our last case around 5 PM, and then made rounds on our post-op patients. All of them, including the 4 year old boy, were doing very well. One of the hernia patients, who had a huge African incarcerated hernia, smiled when I said "How are you doing?" and then replied "I'm doing fine...how are you doing?" it was really quite gratifying to see all of then doing well after so many worries in the morning. We went back to the Guest House to shower and change, and the we all went out to Senator Edmonde Snow's house for drinks and dinner. He has a lovely and rather palatial house on the ocean, and he was a wonderful host with his girlfriend Peggy. We were joined there by Lydia, and a group of Liberian nurses from Rhode Island who have come over to help in whatever way they can. There were some toasts and thanks from a variety of people for the work we are doing through HEARTT. After that, we went to Lydia's house for some wine and chat; The Honorable (aka Senator Snow) personally drove some of us over in his Nissan SUV. At Lydia's, we were also entertained by a trumpet recital by Eric...it was awesome !

After Lydia's, we went to Groovie's for some dancing till 1:30 AM.