Greetings from the "theatre" where I am using the computer today. Today, I get the computer because the family, except Sarah, is in Bamenda visiting and shopping. Please pray for Sarah as she has had some ongoing GI distress that is manageable but distressing. In the OR, we have now switched from Urology to ENT with Dr Wayne Koch arriving. He has come with his wife for two weeks as another Cameroonian doctor, Dr Acha, has arrived back from ENT residency in Kenya. Another ENT surgeon will come in two weeks as they hope to help Dr Acha establish himself well. They have already seen some "African" pathology which will be operated on in the coming weeks. (side note-Dr Koch was the president of the head and neck society in USA last year. along with the crew from MD Anderson, I chuckle at the "big boys and girls" that I get to learn from here in the corner of Cameroon.)
The girls are doing well as homeschool has begun full-time. I've asked Rebecca to help in the surgical clinic on Thursdays as the residents are to be spending time in lecture and what not on that day. She does well and has enjoyed this. The only problem is the "fire-hose" style of outpatient and surgical pathology. "Fire-hose" relates to the poorly manipulated schedule as people just keep showing up every day except Sunday. Therefore, one can't carve out much flexibility as the patients are scheduled in time-slots or specific days. They just keep coming and coming. So it's nice to have Rebecca to help the flow so the residents don't have to come back after lectures and see all the backed up patients.
We are now running on a skeleton crew of residents, but the positive point is that I like small groups. The negative point is that means I have to work harder as do the residents. Work hasn't killed too many people. I read a chapter in Dr Hale's book "On Being a Missionary" last night that I enjoyed. It was titled, "Nepal 1: Visitor 0." It is about the grind some call culture shock. If any of you have that book, I highly recommend it as I think his perspective is good. The concept is to bond early in the culture and don't be too critical of others (ex-pat or national). I sat and thought of the bond issue (language acquisition and national friends) and wondered how we were doing. Rebecca's weekly meeting with the residents' wives going over the book, The Power of a Praying Wife is going great with good relationships being formed. I think that I'm doing well with getting to know the residents. (I mean, I've already fired one so I must be doing great right?) The administrative thing is not necessarily my forte, but someone has to do it. I've learned that if no one does it, things just don't go so well. I appreciate what another couple here for Switzerland express. He, Christoph, hasn't had "culture shock," he is having bouts of "culture fatigue." I think we all go through this aspect, but in the USA, we'd just call it weariness. The reality is that the normal ways that we have learned to deal with that weariness and fatigue in the USA have to be changed as there isn't the same escape mechanisms in place here. In the house here, there are lots of books and videos that the Sparks have collected which is nice. There are beautiful hills to climb, also. It is just hard to go out and get pizza. I really enjoy the "fo fo and njama njama," but my family has not joined me in that enjoyment. I was the designated supplier of the food this week for the OR "party" on Monday. One person signs up each week and pays 15,000 CFU which supplies the "fo fo - cornmeal glob, njama njama-cooked greens, bitter herbs-bitter greens, and fish-dried and fried fish cut (one piece is the head and some of the body and the other piece is some body and the tail) for the OR staff. I didn't get to eat it until mid afternoon on Monday because I was trying to accomplish my first modified Duhamel procedure on a Hirshprung kid. I hope he does well. I now have a normal cautery unit to work with. I still wish I could have a Thompson retractor or Bookwalter as my pyloroplasty and vagotomy yesterday was so much harder with a little lamp and my intern cranking intermittently on the chest so as to see. We make do. We had to postpone the Heller Myotomy today because the young man had a heart rate in the 40s and anesthesia wasn't comfortable. We'll let medicine have a look, but they can't do too much anyways except an EKG. His esophagus is big and has what is called achalasia so that when he swallows the food gets caught up at the junction of the esophagus and the stomach. I'll try to send some nasty pictures along now and then for all of you who like nasty pictures of pathology. I have a good picture of pus coming from a pericardial effusion on this poor young boy. He probably has TB and so to see what the effusion was we inserted a central line catheter into the effusion blindly. I thought this was a neat way to use the central line catheters as I don't need to use my skill to place them into veins. He now has a good drain and hopefully he can breathe well enough to get his septic hip operated on now.
Anyway, I hope all of you are hanging in there, wherever you are. May God bless. dasen