Friday September 6

    After our experience with Jacob, I was anxious walking into the hospital this morning as I wondered what happened overnight with our choledochoduodenostomy, and I was thrilled to see that she is doing well. She complained of the expected amount of pain, but overall I am pleased.
     In the OR, it was a somewhat disorganized day but we were able to get a number of cases done. Jonathan and John decommissioned another ostomy while Diego and I repaired an incisional hernia on a woman who works in the Presidents house. I had seen her in July, and through some miracle we actually got her a bed in the hospital and got her hernia fixed when we said we would ! Yes, today I reached that final stage in the process i go through on each visit: that of resignation.  We are here, prepared to do whatever work needs to be done; if the system with its many inefficiencies cannot make full use of what we bring, so it goes. I'm not going to get angry or frustrated about it; I have passed beyond that stage for this trip.
      Another patient had a large keloid on his scalp from a traumatic injury; J and J excised that and then created some flaps to close the defect. Then Diego operated on an unfortunate man with a very bad infection in his private parts. I won't go into detail, but it was not pleasant at all. Finally we cleaned up the leg of a young man who had some sort of infection in his posterior calf. He was first treated by a local healer with burning herbs and the like, and then came to JFK for antibiotics. There was a skin wound, but each time they cleaned it, it would bleed significantly. So they wanted us to clean it in the OR. We found a lot of clot, but could not identify a bleeding source. We cleaned it and packed it, and hopefully he will start healing.
      John is doing an excellent job of keeping our records on his iPhone: We did 23 cases this week, which is right on target for our expected 40-45 overall. We will do a couple of cases tomorrow ( Saturday) morning, and then have a 1 1/2 day rest.
      Tonight we went to dinner at the apartment of Jonathan's aunt Augustina;  she is here working for the UN Peacekeeping Force. She cooked a delicious meal which we all enjoyed before coming back to the bungalow.