Holding down the fort.

Both the residents and the long-term surgeons are away from Togo for the month of February. Dena and I are holding down the fort. Thankfully, we are not alone as plans were made for a couple of other surgeons to come out for a couple weeks each to help fill in. The extra hands help, even if it's just to help get through the line up of cases for a day.

When I started in January, and I knew we would be alone for February, I did make a few goals for myself, for example c sections and management of orthopedic trauma. Now that February is here, goals or not, whether I've seen or not, prepared or not, it just has to be done. One of the visiting surgeons illustrated this for me when he saved a mandible fracture for me. The other night a trauma patient, having suffered a mandible fracture, presented to the hospital. The visiting surgeon, evaluated, ordered an xray and tucked the patient in. Then, in the morning, promptly told me he had a mandible fracture for me to take care of.

The patient was not talking in this picture, his lower jaw is just disconnected from the rest of his face. In the past month I had put arch bars on once. So I got to be the one to teach the other three.

Perhaps not perfect, but it's at least in line again and could heal. Hope he likes bouillie, as he'll be sucking that from the corner of a plastic bag for the next 6 weeks.

I have not tried the bouillie myself, but it is the most common diet I see in the hospital for my patient's. It's like a porridge. It can be mixed with milk to make it thin enough to push down nasogastric tubes and is actually used as the base for the tube feedings that we make in house. (Bouillie itself has minimal innate nutrition) For our post op patient's, a liquid diet consists of bouillie. The soft diet.... bouillie again. Down at the corner by the hospital gate the ladies line up at their tables every day selling plastic bags of bouillie. They know what the demand is, and they supply it.

I'm sure the next few weeks are going to force me to learn and move through uncomfortable situations and decisions more quickly than I would like. But as always, we'll take it one patient at a time. One day at a time.

On a lighter note: I got a call the other night. Over the phone it was explained to me that a man had just come, and he had swallowed the morning. Confused I asked for the case to be repeated. He had swallowed the morning. So I tried repeating it instead, "he swallowed the morning?" to which the response was the affirmative. Bewildered and absolutely stumped as to what I was going to do with this information, I managed to ask... "well, is he in pain?" I had no idea how the "morning" was harming the patient, but figured I could at least discern if the patient was in danger or not. By the end of the phone call it was finally successfully communicated that the patient was actually a small child and he had swallowed the money. Needless to say, I was laughing so hard by the end of that phone call. Laughing and greatly relieved. Swallowed money I can deal with.... swallowed morning, not so sure.

Much Love.