African rain...

Cool looking tree during boat ride on Lake Piso.

 I got my first taste of African rain today! There was this bad storm and it was raining hard and thundering all night.  The raindrops were like grapes!  This morning there were a lot of bushes and twigs all over the place.  The current (electricity as the Liberians call it) was all messed up for a little bit over here, but it was back together quickly.

I hope you guys aren't getting tired of my patient encounters during the morning ER rounds, but I find some of them too interesting not share...
So 2 days ago this guy was involved in a bad RTA and sustained a bad femur fracture and a crazy degloving injury of his leg-his skin and soft tissue were just completely ripped off clean down to the muscle!  A very interesting injury pattern.  When I saw him this morning his leg looked nonviable and I explained to him the likelihood of him losing his leg.  He wasn't trying to hear it and was pretty insistent on saving his leg and didn't want to be admitted; I wonder if the herbalist or country doc is keeping a blog like this one!!  I'd love to read it...
                                                                                

Trying to drive through Red Light!!

 We had our weekly grand rounds conference this morning.  The Ob/Gyn Service gave a presentation on gestational diabetes and screening during pregnancy.  I think I mentioned before the heavy emphasis placed on perinatal care here-it is much needed.  There was a very intense discussion that ensued between the visiting physicians and the Liberian doctors here; basically they were going back and forth about modalities for screening and prevention amidst limited resources.  They don't even have a robust supply of glucose strips here to even screen for diabetes, and many visitors come here emphasing how important it is to check glucose levels.  It goes in this repetively frustrating cycle and I think it seemed to come to a head today.  They went on for about 20 minutes talking about what should be done and what needed to done, trying to come up with solutions-by the time I left the conference I wasn't sure if any solution or action plan was even agreed upon...

Cool painting that Justin bought at Mamba Point

 I only did one surgery today.  My other scheduled case was cancelled by anesthesia-more blood issues.  I've become facil at operating within this system.  Working as a surgeon in a developing country like this you really have to be somewhat malleable.  Everyday I'm learning to become a more versatile and adapting surgeon.  Since I had an early operative day I went back to check in on the trauma ER and found some stuff to do.  A young girl had come in with a huge laceration on her leg that needed to be washed out after some acid substance fell onto her leg-sometimes I don't understand how some of these patients get into the stuff they do!  Anyway, I did a debridement of her leg in the procedure room of the ER since no one was around to pay for her to go to the operating room.

I was able to run a few errands today and made it to the grocery store again.  I was wearing my scrubs at the time and this guy stopped me and asked if I was from Mt. Sinai in New York-he was an American!  He had previously seen some of the Sinai team out here and he is here working with the US Embassy.  He was a cool guy too-gave me his card and invited me out to the embassy to hang out!!  You never know who you're gonna meet!

Craftsmen in downtown Monrovia

I went to try this restaurant tonite for dinner called PA's Ribhouse.  They had an upstairs with really nice food for USD (US dollars) and a downstairs with LD food (Liberian dollars)-guess where I ate?!!  Dem' LD ribs be bangin'!!! LOL!!  I had a pleasant dinner watching a little soccer with some of the locals. I'm learning some of the slang-I swear it just sounds like geechi or gullah that I'm used to down south back in the states!

Hope everyone's week has gotten off to a good start.  Nite.

"You can easily judge the character of a man by how he treats those who can do nothing for him."
-James D. Miles

Beautiful beachside at Robert's Port