Monday March 5

March 5

    After a good nights sleep, we went to JFK around 8 am. We learned that Ainhoa, the Global Surgery follow from Children's Hospital (Boston) had organized a full day of surgery for us. We saw Dr. Johnson and Dr. Moses outside, and they greeted us warmly. As we walked in the ED entrance, Santiago called me to stop and say hello to Joseph Nah: he is the 20 year old in whom we diagnosed Burkitts lymphoma last March and who underwent successful chemotherapy ! What a way to start the day! He looks great, and was very pleased and excited to see us! We also saw Emilie, who will be here for a few more days, and then we met up with Ainhoa. We rounded with her, and saw that there are a lot of patients awaiting surgery, so we will be busy!
   Then we went to the OR, and we were greeted warmly by lots of old friends. Diego and I did a baby with an inguinal and umbilical hernia, and then John and I did the same in a toddler. Then Santiago and Diego did a 9 year old with a solitary typhoid perforation of his mid small bowel while John and I did a 60 yr old female with an inguinal hernia. We had more cases scheduled, but it was 4 pm so those cases were put off till tomorrow. Delays are a part of life here, due to many reasons; lack of anesthetists was a big one today. And there was no one to staff the PACU, so the patients were all recovered in the OR and that delayed things significantly.
    After we finished in the OR we went to see a few more patients, including a young girl ( 4 yrs old I think) with a massively distended abdomen. She looks healthy otherwise; she is not malnourished, and has no other health issues. Her abdomen looks like she has ascites, but it is quite soft and compressible. My gut tells me that this isn't ascites, but rather some sort of cystic structure, perhaps mutinous, perhaps a duplication. She will have an ultrasound, and I think we will end up exploring her. Stay tuned !
     At one point in the morning Dr Jallah came to find Santiago because she has a challenging case for him: a young woman who was given a lye enema, and developed a recto-vaginal fistula. She had a low anterior resection and diverting colostomy elsewhere, but now has a low rectal stricture. Santiago wants to try to fix her with a redo low anterior, so I guess we will try on Wednesday.
      Tonight we had all of the HEARTT people over here at the Bungalow for dinner. As usual, we discovered all sorts of connections. Ann Marie is a 4th year Ob-Gyn resident at NYU who is at Redemption Hospital; it turns out that she was a year ahead of Diego in med school at UConn, and they knew each other. 
      It was most heartening and gratifying today for me to be greeted so warmly by so many here, some of whom I remembered, others I didn't. Clearly we are having a positive impact on the people at JFK; not only the patients that we care for, but also the staff. They sincerely appreciate us making repeat visits, and it feels good to be part of the JFK family .