Today was a hard, but great day. I like working, though at 51 years old, the energy doesn’t hold up quite as late into the day. The day started with a 7:30 meeting called by our gifted medical director, Dr. Mardi Steere. The medical director is an important job here, as the liaison between the medical staff and the Kenyan leadership and hospital board. The medical staff itself is remarkable, with about 30 doctors, half Kenyan, half expat, all dedicated to providing health care to the most vulnerable. This morning’s meeting dealt with the big picture, strategic planning, and was really encouraging.
Following the meeting, straight to surgery. We are extremely fortunate to to have Dr. Thomas Higgins working with us. Thomas came out with his wife Meghan, and two children Owen and Corine. Amazingly, they have taken a leave from their comfy life in Salt Lake City to work with us here in Kijabe. They have settled in like pros, the kids jumping right into kindergarten and second grade at RVA, Thomas being the work horse at the hospital, and Meghan going for runs in the hills around Kijabe and shopping “madukani” (at the shops) like she’s lived here for years.
Thomas took the first case in Room 8, pinning a badly fractured elbow in a 7 year old child. Meanwhile down the hall in Room 6, I cleaned out a man’s broken leg which had suffered a bad infection. He’s almost ready for a SIGN nail and bone grafting, maybe in a month or so.
As I was finishing the first case, a friend from Bend showed up in the operating room. David Utley, a professional photographer, and his wife Cindy used to live in Bend, but now work for Samaritan’s purse, based in North Carolina. David was passing through Kijabe on his way back from a photo shoot of Samaritan’s Purse’s work in the Congo. He snapped a few photos in the operating room, and then I walked him to a friend’s house in the pounding rain.
Following this, Shelminth, a talented general surgery resident in her second year, removed some pins from a child who had previously had his elbow pinned. Later in Room 6, we had to amputate the leg of the poor man with the overwhelming infection. Amputation is heart breaking for everyone, and is a last resort when all hope is lost for the limb, or when continued efforts to save the limb would gravely endanger the patients life. Sadly, Kamau fit both these criteria. Though tragic, he can now get on with healing, his chances of survival are much higher, and he will eventually walk with a prosthesis.
Meanwhile in Room 8, we are preparing for a big case, fixation of an acetabular (hip socket) fracture. Dr. Higgins is a trauma specialist from a large trauma center, and acetabular fracture is one of the signature surgeries for a trauma surgeon. I took the opportunity to scrub in with Dr. Higgins to learn from the master. I have done these fractures here, but he makes it look easy and taught me a number of “pearls”. The surgery went extremely well, and both the resident, Dr. Kingori, and I learned a lot.
Back in Room 6, a big upper extremity case. This poor woman had been shot through the arm during a church bombing a couple of years ago. Remarkably, she has essentially the same condition as the young lady, Caroline, we saw yesterday. The problem is that the gunshot wound had removed most of the ulna (forearm bone), one of the bones was dislocated from her elbow, and her hand and wrist were no longer linked to her arm. The injury had been about two years previously, the arm was badly scarred, and the surgery proceeded slowly. In the end, however, she had a nice stable arm, so much so that we didn’t even need to put her in a cast. She’ll be painful for several weeks, but can start using her arm immediately.
Meanwhile back in Room 8, Dr. Higgins repairs a badly broken wrist.
The day went much longer than expected, and as I walked up our driveway in the dark at 7:30 pm, it seemed much steeper than usual. We had had 17 people over for dinner from our team, and they were just leaving as I walked in. Ann had graciously hosted them and had a beautiful dinner of salad grown in our own shamba (garden), and creamy tomato chorizo pasta with fresh home-grown basil and toasted pine nuts. Amazing! I warmed mine up in the microwave, and plopped down in front of the fire with Michael and Jane.
Tomorrow is a national holiday, and I’m not on call, so I plan on sleeping in, going for a bike ride, and preparing for a talk I’m giving tomorrow night. Thanks for walking with us here in Kijabe.