Wednesday March 11

Wednesday March 13 Today was Decoration Day in Liberia, so we operated on a holiday schedule in the OR. The first case was Santiago and John resection a transverse colon cancer; Santiago had seen him in the clinic along with his barium enema, which showed a classic apple core. That went smoothly, but with it being a holiday, nothing moved fast today. I did announce to everyone that I was over my frustration from yesterday; I have now entered the final phase, which is acceptance, or perhaps resignation. The next patient was a woman I saw in the clinic with a huge spleen; since I did a huge spleen yesterday, it seemed only fair to let Santiago and Nathan do it. It wasn't as big as the one John and I did yesterday, but it was still a challenge ! The final case was supposed to be a liver abscess next to a sick gallbladder, but when we looked we found a pretty normal looking GB and no evidence externally of anything in his liver. He did have some momentum stuck down to the pre-pyloric region of his stomach suggesting a possible recent perforated ulcer, and I think that might be the reason for his pain. We will treat him for that and hope or the best. We made afternoon rounds, and we were particularly happy to see Victor smiling again now that his Foley and NG tube came out. He showed us some of his drawings, and he is quite an artist. We went to Taaj for dinner with 3 of the HEARTT people. One of the things that Santiago and I talked about was the joy of developing a patient base here. In thinking about the advantages of returning to the same place each time, I had never thought about that aspect, but it really is quite an experience to have patients know that we will be back in 6 months, and they seek us out. We has also decided that seeing former patients, like Harriet and Victor, is important and gratifying and fun, and we will definitely being making a point of doing it on future visits. One of the other wonderful pieces of news today was that Mr Hne, the chief anesthetist who is retiring, told me that he would be happy to come back to work when we visit ! That would be wonderful !