Tuesday March 7 and Wednesday March 8

       After a good night’s rest, we all felt recovered from the sad experience of yesterday, and we were ready to take on the new day. When we arrived at JFK it seemed like it was going to be a slow day, but as so often happens, it filled up quickly. Paul did a VP shunt with Dr. Doe on a child with severe hydrocephalus. Gaspar went to the Outpatient clinic and found a lot of patients who need surgery. I had to rein him in a bit by explaining that there was no way we are going to do 4 thyroids in a day!I think it was a valuable experience for him to see the variety of patients who show up to the surgical outpatient clinic. It ended being a busy day with more hernias. The hospital has announced that the usual charges for surgery are waived during our visit except for the cost of drugs; we are already seeing an influx of patients as a result.

    Wednesday is Decoration Day, a national holiday in which people remember their relatives who have passed by cleaning up and decorating their graves. We had a busy day working starting with a young woman in her 20s who had presumed appendicitis which ruptured about 3 weeks ago. I’m not sure why she stayed home, but she was brought in yesterday and we operated on her today. There was a lot of pus, and very difficult adhesions. In the course of dissecting an area of small intestine perforates so we had to repair that. The area of the appendix was encased in scar tissue; we eventually decided that further attempts to get to her appendix would likely cause more harm than good, so we put in drains and finished. It’s difficult to predict how she will do; time will tell. After that Gaspar did 2 appendectomies with Dr Mabanza and Dr Charles while Paul and I did a man with recurrent bilateral hernias. Repairing recurrent hernias is always a challenge because the tissue planes have often been ob.iterated by the previous surgery; additionally, we often don’t know what type of repair was made. This patient told us the his repairs were done years ago in Nimba County.and done at different times by different surgeons. The left side was large, and it was a difficult repair but we got it done. The other side was smaller and easier.

Tomorrow will be another busy day I suspect.