Saturday September 8, 2012

At the hospital this morning our first stop was the ward, where we found good news and bad news. Most of our patients were doing well, including ileostomy man who looked better than expected, but the woman with the small bowel perforation looked worse. She was tachypneic (breathing rapidly) and diaphoretic, and didn't look like she would last too long. One of the difficult aspects of medicine for us here is the sense of helplessness in the face of serious illness. We couldn't put her on a ventilator, or move her to a real ICU, or put her on pressors, or anything else. We were doing all we could by supplying IV hydration and oxygen by mask. We then went to the OR to do an African hernia ( huge, sliding type) in an older man, and then bilateral scapular masses in an older woman. I think these will prove to be fibroelastomas, but they were worrisomely hard, and removal required a lot of work. Oh, yes, we seemed to be waiting a long time between cases. We soon learned that the pharmacist,stationed in the OR to control the flow of drugs and supplies, had to go downstairs to do something, and there was no one in the OR pharmacy for about an hour, so we waited, and I did a little fuming before resigning myself to the situation. Yesterday we had the idea of going to the Liberia-Nigeria football match being held today, so I called Dewalt to see if he could get us tickets. He said he would look into it this morning, and when we were done in the OR he was at JFK with our tickets. We were standing outside the Administration Building when Dr. McDonald came by; we told her about our plans, and she suggested we could go one better by sitting in the VIP section with the President. It turns out that the President is a big football fan; she was out of the country today, but planned to return in time to come to the stadium at halftime. So around 4 pm, with Albert driving and Dewalt, me, Jonathan, and Weltee in the car we left for the game. The traffic was horrendous, and the Liberians have an interesting way of dealing with it: create more lanes going in the direction you want by taking lanes from the opposite direction. We were stuck in a logjam until an official Presidential convoy came by. We joined them (Dewalt arranged it) and that got us to the Samuel K. Doe stadium a whole lot faster. Getting through the crowds into the stadium was interesting,and required a modest amount of pushing and jamming, but again Dewalt made it happen. We ended up sitting in the middle of the second row of the VIP section, right behind the seats for Madame President and the Vice President.The game was a good match, ending in a 2-2 tie, and the President arrived just after halftime as expected. I was surprised at the hooliganism-- throwing water bottles from the stands onto the field, etc --but i guess that is a part of soccer most everywhere these days. Leaving the stadium with the other 35,000 fans was even more interesting than arriving: we got outside to head for the car, but Dewalt and Jonathan got ahead of me, and I eventually lost them in the crowd although Jonathan kept holding his hand up to try to signal me. We were going against the crowd flow, and I admit that I was more concerned for my safety than I ever have been before in Liberia. When I couldn't see them anymore, I was next to a UN ambulance, and there was a UN soldier standing there, so I just stood next to him and started to call Dewalt on my cell phone. But before I could complete it, Dewalt was back to pick me up and take me the short remaining distance to our vehicle. It then took us about an hour and a half to get home with all the departing crowd traffic etc. For me,it was an experience not unlike skydiving: I'm glad I did it, it was interesting and fun and a bit frightening, and I have no desire to do it again. After we were back here at the apartments, Dr.Mcdonald called to make sure we got home safely. She said that she thought a baby had been admitted who might need surgery, but she thinks it can wait till Monday. We aren't planning to go in to JFK tomorrow, but this is one of the problems of being a distance from the hospital and having to depend on others for transportation. I guess it will all work out somehow.