Thursday March 10

Thursday March 10

My day in the OR today doing a ventral/umbilical hernia, a breast cancer, and an adult inguinal hernia. I'm not sure why it was so hot in the OR, and maybe it was the new Goretex sterile gowns we were wearing, but especially in the first case I was sweating like it was a steam room.

The 56 year old woman with breast cancer was interesting from several points of view. When I met her in the pre-op area, Moses and Santiago were with me, and without actually looking at her breast, Moses said that this type of patient is the kind that he would delay surgery for a long time, hoping that death would come before he was forced to operate, because the outcome is so dismal. I think there is wisdom in his comments; on the other hand her chest X-ray was normal, and so who knows how long it would take for her to die. The second interesting feature was that her breast cancer was unlike anything I have ever seen. It looked like a small tree trunk growing up from her chest, and it was hollowed out in the middle. She had an axillary ode the size of a lemon. In any case we took her to surgery, and managed to close the would after doing a mastectomy. I don't know how long she will survive, but I hope that what we did for her improves her remaining time.

While Jenn and I were doing the mastectomy, Dr. Jallah was operating on a girl with a recto-vaginal fistula. She sent out a request for help, and Santiago went in to work his magic. He did some kind of fancy advancement flap to close the defect; hopefully it will work ! I am very pleased that he is here with us, providing expertise to us and the other doctors !

This team is working out well, and everyone seems quite happy with their experience to date. It is also interesting and fun to be here with so many other HEARTT people; I think the cross-cultural exchange ( between medicine,pediatrics, and surgery) benefits all of us more than we realize.

Tonight we all went to Taaj, an Indian restaurant on Tubbman Boulevard near Golden Beach. We had an excellent meal, and great conversation. One of the pediatrics residents was telling me that they do have some IV chemotherapy for kids with retinoblastoma and for Burkitt's lymphoma. She showed me before and after pictures of one boy with a Burkitt's, and his response to chemotherapy in 5 weeks was astonishing ! This type of story is that kind of information that will hopefully get people to realize that there is always hope, and that things are looking up for Liberia.