The final day of this trip started with us seeing the thyroidectomy patient from yesterday who had the post-op bleed and re-exploration following cardiac arrest and resuscitation. She spent the night in the “ICU”; she remains intubated but breathing on her own. Her pupils are reactive, and she showed occasional glimmers of waking up, but I think she may have suffered permanent damage. Time will tell. Then we saw Francis and changed his dressing. We encouraged him to get up and move around; he will need further encouragement to exercise the arm and regain full function. He will see Dr. Gbozee for immediate follow-up, and I asked him to come see me when I return in March. We said our goodbyes to the surgical faculty at morning report, and then went upstairs to the OT. Jonathan did 2 upper endoscopies with dilation on children with esophageal strictures from lye ingestion. This is a continuing public health problem which really needs to be addressed.
We said our goodbyes to the Operating Theater staff, and bought them pizza for lunch. Led by Ama, they worked incredibly hard and well during this visit, When we come, they are always asked to perform at a more intense level than they are used to in their day-to-day routine, but this volume of surgery on this trip was way beyond any previous time. I think all of us felt that we were doing something especially good for the people of Liberia but providing surgery that was free for almost all of the patients. It was my sense that a substantial percentage of the patients we operated on this time would not have been able to have their surgery if they had to pay for it. We then went to the Administration Building to say our goodbyes; Dr Brown was away, but we saw Dama Yekeson-Koffa, the Deputy Administrator, and expressed our sincere thanks for their part in making this a very successful trip.
Back to the hotel around 12:30; I decided to take a nap while the others went mask and cloth shopping with Teresa Cummings. After a shower and packing up, I went down to the lobby and checked out. Fortunately this time there was no issue about the bill going to HEARTT as Masmina had arranged !! I then made a significant error by have 2 deliciously cold Club beers before the driver came to pick us up to go to the airport: big mistake to drink beer before the 75 minute ride to the airport! I made it, but it wasn’t pleasant !
We had an uneventful flight from Monrovia to Brussels, and now we are in flight to NY(JFK). I was surprised at the gate to be upgraded to Business Class, since I had the same pleasure back in March…but I’m not complaining !!
As I have written in many posts about this trip, it was very productive, and not just because the five of us worked hard putting in long hours. I felt strongly that there were so many people at JFK who were behind this effort, in large part because they liked the fact that they were part of a team providing free care for a lot of people who needed it. In the past we have had many productive visits, but we have never before come close to 107 cases. We leave with a good feeling about what we (meaning us and HEARTT and JFK and everyone involved) accomplished, but some trepidation that we have raised the bar quite high for our visit next March and beyond.
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