Alright, so our first real task for the day was to lead the CME lecture for the anesthesia nursing students this morning. I barely snuck in a quick shower under a few drops of water before the water was (once again) absent from our pipes. We came in early to the Theatre and sat in the conference room until everyone arrived. Instead of leading the discussion, we called each student anesthetist to the front of the room individually to teach their pre-assigned topic (from Wednesday) to their peers. I have to say, it was impressive. They all did an amazing job, and I was particularly happy with Esther, who started dishing out questions to the others in true socratic form. Really impressive to see. At the end, they had Joe and I come forward, thanked us for our teaching, and gave both of us a photography book from the Mara/Serengeti as a gift for our time. Each of them then signed the books.
Personality powerhouse Naaman tells 'em how it is.
Esther opening a can of didactics on the class.
Hosea thanking us for breaking down the student anesthetist's egos.
You're welcome, buddy.
This is the book we each got. It's like a preview to the pictures I should be taking next week.
The Kijabe Anesthesiology Department.
After this, we had Dr. Newton walk us around the hospital talking about the VIA program and expected experience for residents. This will be part of a promotional video for residency. I took video, and Joe took some good shots of the process.
The man is like a promotion machine. He needed no prompting.
Who says anesthesia and orthopedic surgery can't get along?
(Mom - you'll appreciate that Dr. Boeve wore Univ. of Michigan scrubs every day)
The main hallway between Casualty and the ICU. AKA - The Intubation Interstate
The radiology suite
This fire alarm sign had 13 steps, but step #2 is my favorite.
Do you have your fire-repellant dishwasher ready?
Dr. Newton talking to a ward patient in Swahili.
The tuberculosis ward. Very sick people here.
Naaman and Boniface pressured into singing our praises.
After I had run out of battery power for the camera, we briefly went back to the OR to check on a few cases and settle our affairs. We ended up giving feedback to the Theatre manager, Mary on our experience and what we thought she could do to improve the ORs. We were, once again, asked to consider staying long-term. Not surprising.
Some of the OR leadership
That's the Theatre Manager, Mary, next to Joe.
We then left the ORs for good, and stopped by the house briefly before walking up to the post office (expect a card, ladies), and from thence on to Mama Chiku's for lunch.
This is right outside our front door.
Looking out of Mama Chiku's
After lunch, we walked further into "town" in order for Joe to (of all things) get a haircut. I stood outside and entertained the local wildlife.
Broadway to Manhattan, Kijabe
My view standing outside the barbershop.
The wildlife. Cute, but I watched her eat a cracker off of the dirt.
We then walked back to the house for a long nap under the hot mid-day African sun.
The school along the road. People carry water jugs everywhere (except to our house)
Towards the Rift Valley
Stop looking at me, swan.
Around 4pm, we woke up and walked up to RVA for a follow-up jazz session as part of Joe's concert series for Africa: Riffs on the Rift Valley.
The cup tree at RVA. Each cup represents ten victims of the Chai Room water bottle.
"Is everyone paying attention? Good, because you still won't be able to keep up."
We even got invited back to the musical director's house for dinner after the session. He has the most amazing bouganvillea vine covering a tree on his property, and we had an americanesque steak dinner before he drove us down to the hospital (we had been getting calls from the ICU with ventilator alarms screaming in the background).
Bring me THAT shrubbery.
The hypoxic patients will have to wait.
Upon our arrival, there was a patient with an oxygen saturation in the 80s with spontaneous, choppy ventilations and oxygen just blowing by the endotracheal tube. I turned the oxygen on the ventilator to 100% and hooked him back up to the ventilator. His sats quickly fell into the 40s despite good minute ventilation. I know what you are thinking: "Hypoxia despite 100% FiO2?! What else are we to do?" Well, this is Africa, so what I did was turn the oxygen level down to room air, and the sats came back up to 100%. Weird, right? I then brought the nurse into the room and made him stand there while I turned the oxygen back to 100%. The sats fell again, and again I turned the level back to room air with return of 100% oxygen saturation. It just goes to show you: Never trust anything here to tell you the truth. Even the machines can lie to you...
...almost got me.
Please put me on more ICU call.
Sincerely, Joe
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