Monday March 7

Monday March 7

After breakfast we went to the hospital with the expectation of doing 3 cases, but to no ones surprise there were complications : the older man with the left groin enterocutaneous fistula said he didn't want surgery until he saw his son, and his son hadn't visited in 5 days; the parents of the 14 year old boy scheduled for colostomy decommissioning hadn't shown up to sign the consent; and the 16 year old girl scheduled for an ileostomy decommissioning had not yet put money down for the second surgery. So it was looking rather bleak, but then the parents came so Santiago, Konneh, and Yuk were able to go ahead with the boy. They took down his colostomy, resected his sigmoid, and did an EEA anastomosis. I took a pice of his colon for pathology to see if indeed he does have a lack of ganglion cells. I then spoke to Señora, who spoke to Lisa, the social worker, and we were allowed to proceed with the ileostomy decommissioning because the fees were waved for our patient. That is a very nice thing that happens for us here : if there are patients we feel we should operate upon because we have a particular skill set, then Dr McDonald is very generous in making it happen through waving the usual fees, or getting extra OR staff, or whatever.

After finishing we saw some consults in the ED; one in particular was heartbreaking. A 9 year old girl who had surgery at another hospital in November for what was suspected to be an intussusception now comes in with a severely distended abdomen, serious malnutrition, fevers, and weight loss. She has several masses in her abdomen, and looks like she has some malignant process going on, most likely lymphoma. But I'm not sure if we will ever know the exact diagnosis.

Later we went back to the guest house and I took a short nap, and then we joined the dorm people at Cafe Jamal for pizza and beer. After returning to the guest house, Santiago, Eric, and I stayed up talking to Emmanuel and Catherine about Liberia, and the war mostly. It seems like the wounds of the war may have healed on e surface, but there are scars which run deep.