Giant steps...everything irie...pull my finger!

Sorry for leaving everyone hanging yesterday-I've already heard it from a few of you; "where's your blog from yesterday?!" I'm ok mom!  I got home late Thursday night and couldn't stay up to blog-was too tired.  So now I guess I have to update you on the last 48 hours-here goes...

Me, my little girl Ma-Nowah, and her big sister!

Thursday was a good day; a great day actually!  My little girl took her first few steps!!  She has been such a pleasure to round on everyday and see her progress.  It really is one of the best parts of my day.  Even with the many frustrations that I've encountered, she alone makes this whole thing worth it.  She has won a special place with all the nurses-they love her!  It really is an honor to be able to touch people's lives like that.  It never gets old and each time feels like the first.  Many times back home I find that it's so easy to kinda forget that Hippocratic Oath that we all took upon graduating medical school; out here you're reminded of it on a daily basis..

As usual, the clinic didn't fail to disappoint yesterday.  Having been here now for 3 weeks I'm able to see many of my follow-up patients that I've met in the office (those I've injected, sent to therapy, even the 2 finger amputations!) and they're doing really well.  It's exciting to see.  There's this hallway that is lined with people on my way into the clinic that have been waiting for me to arrive.  It's pretty cool b/c sometimes I feel like bending down and slapping everyone's hands like I'm running out onto the basketball court!  It's fun to greet everyone in the hallway and then see them individually in the office.  I must admit though (man this mouse running around is distracting me...I digress) I do have some patients that frustrate me b/c either I can't do anything for them or am not sure what the best thing to do for them is.  I have this lady who has come in to see me twice now and has this mass growing from her skull.  It has this fluid weeping from it and looks infected.  I sent her for an xray and it seems that her skull is involved and being damaged.  I'd like to send her to Ghana to see a Neurosurgeon, but she can't afford it and I don't want to be in an awkward position if I take her to surgery myself to remove it and then leave her brain exposed.  I hear there's a surgeon here in Liberia at another hospital who may be able to help her.  Tried contacting him today.

Me and Justin our first weekend in Monrovia

My last interesting one I'll share with you is a little boy who had 2 weeks of ankle pain.  He was another one that came hobbling into the office unable to walk.  As soon as I saw his ankle I knew he had a septic joint.  His entire foot and lower leg was swollen and extremely hot and he couldn't move it at all.  I figured it'd be a perfect time to show the medical student how to aspirate an ankle joint...straight pus!!!  I sent the kid directly to the ER to get started on IV antibiotics and get placed into a splint. After clinic I went to the ER to make my rounds again and check on him.  He had gotten his antibiotics and was placed in a splint.  He had signed out AMA by morning.

Some new friends at Robert's Port!!

 Later Thursday evening I decided to go check out reggae night at Club 69!  Justin had told me about it and we planned to go when he was here, but we were so busy with everything else I didn't get a chance to check it out.  So I figured I'd see how Monrovia does it Jamaican style!  It was so much fun!  The music was great.  It was weird being in a club again-feels like I haven't been to a club in a long time.  It was nice too!  Kinda on par, if not better, than some of the NYC spots.  The only thing is-Liberians start partying waaaayy too late.  I got there at like 11pm and almost no one was there.  They don't go out until like 1 or 2am!!  I stayed out for a bit and ended up getting home at almost 2:45am.  It was worth it though!

Thad this one is for you and all the Vegas crew-"put dat PePe down!"

 When I came in today one of the nurses was like "oh, so you went to reggae night last night huh?!!"  Liberia is too small man!!  I only did 2 cases today: a secondary closure of this little baby's thigh wound that had a huge ulcer and then I did an elbow disarticulation for that guy with the infected open forearm fracture.  I'd never done that one before.  It's a pretty cool operation actually.  My other surgeries were cancelled b/c the patients didn't make the full payment, and another was cancelled by anesthesia b/c the patient didn't have any available blood for transfusion-the family had to be called in to donate.  In case you all are wondering, many of the surgeries run around 10,500 LD (Liberian Dollars), which translates into about $150.  That's alot of money here.  Initially I thought the anesthesia team was very conservative about cases and transfusions, but they've seen many patients die on the table b/c they don't have blood products available so they're really big on getting blood from family members and transfusing patients before surgery.  Problem is it's hard to get in touch with family and have them come in and pay to donate their own blood.  I don't argue.

Me and Lydia (one of the volunteer coordinators) at Groovie's.

I was a bit tired after surgery so I made my way back to the dorm to take a nap.  After a short time my phone starts to blow up!  It wasn't a number I recognized so I figured I'd return the call later, but everytime I ignored the call, the phone would ring again!  Long story short, turns out to be this VIP lady who was given my number by someone else and had a finger fracture 2 days ago. She asks if I could come check her finger and make sure it was straight...sure I'll be right there...
When I get to the ER this lady has all the nurses and another one of the doctors tending to her finger.  Mind you this is in the middle of the trauma ER-you already know the type of patients that are in there.  I needed to pull on her finger a bit to straighten it out, but there was this whole fiasco of getting some pain meds before I did it.  As you can imagine, the thing that got me was all these proceedings for such a small thing (relatively small I admit) when others wait for days for care in the ER.  I've noticed that things here can be just as, if not more, political than back in the states.  I'm not going to get on a soapbox right now-it's late already.


Me, Dr. Muvu, and some of the OR staff.

 For lunch today I got a call from one of the friends I met when I arrived to see if I'd like to go get some good Liberian food after my surgeries.  I tried some Liberian collard greens with various meats. Delicious!  Everyone has been sooooo gracious to me.  Looking out for me and making sure that I'm ok.  They are making my stay so pleasant.  Everyone keeps telling me to just relax and that I'm family now.  It really is a good feeling.  I can't get over it.  The drivers take me wherever I need to go and everything.  They're even going to try and arrange for me to get to travel and visit Ghana for a weekend!  I got invited to go to this club called Groovie's tonight.  The woman whose house I went to on Wednesday owns it.  She also sings there.  It's a pretty classy place with a more mature crowd.  When we got there we had reserved seating and my meal and drinks (pineapple juice for those who know me) were paid for.  There was a live band that played good music and many people were dancing.  At a certain point in the evening Ade (the owner) stops the music and gets everyone's attention along with Lydia and another doctor here in Liberia and introduces me in front of all the people in the club!  I wasn't expecting that one!  I didn't know what to say.  Good thing they didn't ask for a speech!  Soon as I sat down I got a message on my cell phone asking if I was at Groovie's!!  Liberia is too small!!

Should be another good weekend. Will keep you posted.  Have a good weekend everyone!

SHOUT OUT TO MY NEPHEW TYLER AND MY BEST FRIEND MARC-HAPPY BIRTHDAY!!! LOVE YOU!!

"Humility is not thinking less of yourself, it's thinking of yourself less."
-Rick Warren