Tuesday March 15

Tuesday March 15

Today is a national holiday celebrating the birth of the first President of Liberia, Mr Roberts, so we did a short schedule. We biopsied a groin node on Joseph N, a 20 year old who looks like he has a Burkitt's lymphoma despite being so,what older than usual for it. I will bring the nodal tissue back to Waterbury, where our pathologists have become quite interested in looking at Liberian tissue samples for us. As fate would have it, just the other day I was talking with some of the pediatric residents and attendings at dinner, and they told me about a protocol they have been using with success for Burkitts using methotrexate, cyclophosphamide, and prednisone. I asked them today if they would be willing to try it on Mr Nah if his pathology shows Burkitts, and they said absolutely, so we shall see what happens.

After Mr Nah we did Hans B, a 30s aged economist with the Ministry of Finance, who has a located pleural effusion from TB. He has one chest tube in place, but apparently still has an effusion, so Dr Mike asked if we would do a typewriting and decortication. Santiago and I discussed it several times, and in e end we decided that it just wouldnt be the right thing for us to do for all sorts of reasons, including anesthesia, post-op pain control and breathing, the fact that we are leaving tomorrow, and the fact that neither of us are boracic surgeons. So we put another chest tube in, and didn't get much drainage despite significant manipulation, but we decided to leave well enough alone.

This afternoon we had a fascinating trip to Toode Mission School, about an hour away, and we were accompanied by Adamah's Aunt Ophelia ( she is married to Varney, the Presidents brother). Ophelia is a fascinating woman who has her Masters in geology or something, and has taken on this school as her project. In fact, the school was started by the President's mother, and was pretty much destroyed during the war. Ophelia now has it up and running with 106 students, about 30 being day students and the rest boarders. Boarding costs about $550 a year, but no one is turned away for lack of ability to pay, and in fact none of the students are paying full fees. The age/grades go from kindergarten to 10th grade. The students we met were great: healthy, happy, friendly, and outgoing ! A group of the girls sang for us, and everyone smiled for the many cameras. The current principal is a retired school administrator from Bridgeport, CT who volunteered in the ED at Bridgeport Hospital where he met Adamah and became interested in Liberia. He was looking for an opportuntity to use his skills where they were really needed, and this came along, so he is spending 4 months helping in Liberia. It was quite an inspiring visit, and I particularly enjoyed the opportunity to chat with Ophelia about how this project came to happen for her.

On the way back we stopped at the graves of Adamah's father, and of his uncle Dr. Varsay Sirleaf, which are quite close to the school. Then we drove back to Monrovia and stopped the family compound where two of his brothers live, and we discovered that there was a big celebration going on, perhaps because of the holiday, and President Sirleaf was there. There were a lot of people sitting at tables outside, and she came out to say hello. Then we had dinner, and after dinner when she was leaving she came to where we were to take pictures. Protocol does not allow her to have photos taken with people in shorts, so Santiago and I were out. But she told Adamah that she would meet us in the morning for pictures, so that works out better as Jenn and Eric did not make the trip; her Tubman's revenge continues to be a problem.