Day 5, Thursday July 31: ' Seasoned pros'

8 am start at the hospital and we found patients already lined up outside the hospital, awaiting their consults for the day. We got to the OR theaters and the three teams separated, each beginning their prep routines...

We once again ran into unanticipated setbacks throughout the day, but it's day four, and we're all used to it by now. Nothing is a surprise any more- I was quickly driven into town for a little adventure in search for some new extension chords to replace those that we had blown out in the O.R. I got back a little while later, and it was back to business as usual.

Early afternoon, in between cases, Dr. Lieberman and I grabbed some T-shirts and soccer balls to hand out to some of the orphaned children that he has been taking care of for the past couple of years. The kids lined up and we presented them each with the shirts then coaxed them to smile and pose for the camera. I did so with the sparse Luganda I know and am thrilled as I realize that one of the kids speak Swahili, with which I ask him to smile for the camera. He looks at me, surprised and confused that I spoke his language, but then obliges, grinning cheekily into the camera.

A little while later, I was back observing Dr. Kerner as she finished up with her case. Her patient was maybe 4 years old, and Dr. Kerner had just removed some scar tissue from the little boys cheek, releasing the contracture. As they finish suturing the patient, he vomited and we realized that he hadn’t actually been fasted before the surgery, but we were also relieved that he had not yet been extubated so there was minimal risk of aspiration.

A little later, I walked by Skylar, our neuromonitor and c-arm (x-ray machine) operator extraordinaire impatiently talking to the manufacturers of the machine after a power outage causes it to shut down intra-operatively and it refuses to boot back up. The machine was done for the day (and hopefully not for the whole trip) but the teams manage the rest of the day without it.

I switched back and forth between Dr. Lieberman's last case and that next door, where Dr. Fisk was performing the BKA (below the knee amputation) that had been scheduled from their last day. The amputation was as gruesome as it was intriguing and Dr. Fisk took charge as Lance and Marvin assisted.

Watching Dr. Lieberman and Owusu's thoracotomy and anterior release, I marveled at the beauty of the human anatomy as I watched the patient's right lung maximally inflate after being pumped. I also doubled as videographer for both surgeries (this one and the BKA next door) as we record some video to document the surgeries. 

We once again conclude Dr. Lieberman's operating day with another bout of 'Sweet Caroline,' hollering as a local nurse walks into the room and gives us some concerned looks. All in all, we ended the day having done three ortho/trauma cases, three plastics cases, and two spine cases. As we tried to leave for dinner, we found a few more patients in the hallway, who had been waiting all day to see us.

8 o’clock finish time, we headed over for dinner, this time at the Agip Motel where they had run out of all African food (I guess it’s that popular). We were joined by Dr. Kerner’s son Alex and his friend Afan, who also readily joined us in our daily reflection ritual…
 
Quote of the Day:
‘So what are you gonna do without your balls?’ - Dr. Kerner in reference to the ortho/trauma team missing the femoral heads of the hip prostheses

“I will make new ones,” Scharschmidt’s response to Kerner

Runner up quote of the day:

‘Your comfort is our total interest’- Dennis, the Vice President of hospital operations as he and dr. Lieberman discuss our transportation schedule. 

Dr. Bitariho, Lieberman and Dennis, VP of hospital operations.

I am No longer a spine fellow – Dr Owusu

Hallway Clinic

‘After all you’ve done to me, all you’re giving me is a T-Shirt?’

“I guess I’ll grow into it”

T-Shirts and soccer balls donated by Dallas Football club

Dr. Lubis at her finest

2014 Spine team

Lieberman and Owusu reviewing the evening consults

“Everytime I come in here, it looks different