A full day to start our second and final week of this trip. We started with breakfast at Madam President’s house and fascinating conversation as usual. Santiago asked her if she missed being President; she responded that while overall she was happy doing what she wanted without harping from adversaries, she missed having the power to fix things immediately. After that we went to JFK and did a variety of operations. The last case was a 38 year old man with a large right inguinal hernia which had been present for years. In the past week it was causing him worsening pain, but he didn’t want to come to the hospital, maybe because of fear of hospitals or fear of the cost. In any case, he finally came in early yesterday morning. He was in the ED most of the day getting IV fluids and making arrangements for his hospital bill. He was carried up the 4 flights to the Operating Suite because none of the elevators are working yet. At surgery he was found to have a perforated colon with extensive fecal contamination; during the operation he had a cardiac arrest and could not be resuscitated. It was a very sad ending to the day, and a reminder that health issues are often complicated by social and economic factors that are out of our control.
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