Thursday September 12

    No bad news this morning when we arrived at the hospital, so that was good. We spoke at length with the woman who appears to have recurrent rectal cancer; after thinking about it, she doesn't like the idea of us operating on her and then leaving. Not surprisingly, she is concerned about who will care for her after we leave tomorrow, and as a result she has decided to take her chances and wait till we come back in March. She understands the risks involved, like the cancer spreading. She has agreed to come to the clinic in February to see Dr Moses, who will order a CT scan for her at Tapita, so we will have the results when we arrive on March 3.
     In the OR, our first case was an 11 month old baby with bilateral hernias, who is somehow related to one of the OR nurses, so that added a little more pressure !  John and I repaired the hernias after I experienced the usual coronary spasm inducing process of intubation and anesthetic stabilization. Anesthesia for these babies can be difficult under the best of circumstances; in Liberia it can be frightening. In any case, it went fine.
     Coming out of that case I found Jonathan and Diego in the lounge talking to a crew from Power TV who were there to interview us and film our work. I imagine that after the film appears on Liberian TV it will be picked up by 60 Minutes lol ! Anyway, our next case was Ahmad, a 10 or 13 year old boy with a painful growth on his left knee. He is an orphan living in an orphanage supported by an American charity called Orphan Relief and Rescue; the President of that group had contacted Wilfred, the HEARTT coordinator at JFK, to ask for help, and Wilfred asked me if I would see him. Obviously I don't do orthopedics, and an x-ray of his knee showed that this mass was calcified like bone, but we saw him and thought it could be removed. With the availability of modern communications, I was able to send the X-ray to my friend Dr Michael Kaplan, an orthopedic surgeon at Waterbury Hospital; he thought it looked benign and should be removed. So today we removed it, even more easily than I had expected; I suspect it was ectopic bone growing in an area of trauma, and it is unlikely to recur. I like the idea that so many different people worked together to improve life for this orphan.
     We then did a couple more hernias: Diego and I did an easy one, while John and Jonathan did a hernia in which the appendix was part of the sac, so they did an appendectomy as part of the repair. Following those we did a couple of minor surgeries under just local anesthesia.
      All total, we did 48 cases during this trip, which is more than we have done on any trip in the past. And we have a couple of cases we might do tomorrow morning to hit 50.
      We went to the Administration Building to get our empty supply duffles, and I had the chance to speak with Dr Mcdonald about a few matters. She is going to come to the bungalow tonight to talk to all of us and get suggestions about the impending postgraduate training program.