Overnight I thought a lot about how I should do the surgery on the 17 year old girl with the phylloides tumor. The suggestions I received from my US colleagues were excellent, but none of them have ever experienced doing surgery in Liberia. By morning I had figured out the approach I would take if she still refused a mastectomy; when we arrived in the surgical suite and I spoke with her, she remained adamant that she did not want a mastectomy. So we did the operation as I had planned it out overnight, and it worked out well, and I think she was happy with the result. Truth be told, she didn't need a mastectomy and I'm glad she pushed me to figure out an alternative!
We had quite a busy day doing hernias and other surgeries. I spent much of the day thinking that I'm too old to work this hard, but I enjoy it so much. Its personally rewarding to cure people's problems with an operation, but it is equally satisfying to provide surgical residents with this opportunity to work and learn in a very different setting from what they are used to working in. There is also great satisfaction and joy in working with my Liberian colleagues, trading "war" stories, and learning from each other. I have no desire to stop, and will continue doing this as long as I am able.
Today was another busy day for us. The first case that Mickey and I did this morning was a 16 year old girl with a giant juvenile fibroadenoma. These benign tumors grow rapidly, and are always a source of concern for the young patients who have them. Using the same thought processes we used yesterday, I decided on an incision and strategy which again worked out well.
So far in 4 days on this trip we have done 41 cases, which is considerably more that I expected we would do. Ama Taplah, the nurse manager in the OR, has been a big part of making this possible because she is a hands-on hard worker who keep things moving. Dr. Mabenza and Dr. Kukolo have been superb in organizing our work, and in coordinating the whole process.
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