Monday march 4

Our first day of work on this trip, and it was a good one !! We went to the 2nd floor surgical ward at 8:30, and were introduced to a man with an acute abdomen who was looking very poor; my initial thought was that he had acutely ischemic or dead bowel. Dr Kiiza and Dr Konneh arrived soon after, and we all soon agreed that he needed an urgent laparotomy. We got that in the works, and then saw a few more patients before heading off to Grand Rounds....only to discover they were not on for today. But when we were there we met Dr. Bobo, one of the senior internists, who told me that he had heard from Adamah last week about the possible endoscopy unit, and he was extremely excited !! So Santiago and I went to the 3rd floor to meet with Dr. Bobo and Dr. Brisbane to discuss this possibility. Dr Brisbane is probably the most senior internist at JFK, and he is a remarkable man; he stayed at JFK during the civil war to keep it running as best he could, and he is a hero in the eyes of many. Interestingly, and perhaps not surprisingly, he is quite reluctant to talk about the war years, and takes little credit for the amazing work he did. In any case, the endoscopy deal is that a GI group in Evansville decided to upgrade their scopes, and so they have about 9 colonoscopes and 4 upper scopes which they would like to donate to JFK. In addition, one of the manufacturers has offered to donate a tower, which contains the video screen, the light source, and all of the electronics for endoscopy. Santiago and I had discussed earlier how we would need a physician champion to get this up and running, and we were extremely excited to have identified them this early in our visit. We will have more meetings about this project during this visit, and hopefully we can get it up and running in 6-9 months. Having it would definitely enhance the desired role of JFK as a referral center. After that we reclaimed Dimple's 3 bags of anesthesia supplies and went off to the OR. To say the reception that we received was joyous would be an understatement !! It was a wonderful,exciting moment that I will never forget ! Santiago and Nathan did a Hartmann's decommissioning as the first case. John and I were going to do the acute abdomen as the second case, but he coded and could not be resuscitated in the preop area; In a way I was glad we didn't subject him to an operation he was unlikely to survive. Then I went to the Admin building to get more of our supplies and met Dr McDonald just outside the ED; she asked me to come with her to see a VIP who had just arrived. He had been to JFK twice in the past week with the same complaint. It sounded to me and others that a leaking cerebral aneurysm was a definite possibility, so they got a UN helicopter to fly him to Ghana. Dewalt went to the airport and was able to get the bag we forgot, and that was another good addition to the day. Dimple went right to work with the anesthetists, and I could see that they were thrilled to have an anesthesiologist with them. She was impressed with what they could do with limited resources, and they were pleased with all the supplies she brought. Mr. Hne was also very happy to receive the pulse Oximeters, which will help make surgery safer at JFK; I also gave one to Mr Moore to use when he accompanied the VIP on the flight to Ghana. Kenna also fit in well, and I could see that she will have no problems working with the scrub techs and nurses. It was a great day in the OR, and that sets a wonderful tone for our visit .