Today was a day full of surprises. Some good, some unexpected and....well nearly bad. We started as usual with Chapel and morning report. There was one interesting story overnight with three words that should probably never go together: "Bike. Drunk. Scrotum." I'll let you use your imagination beyond that...but I guess I can aide you. Basically the guy came in with his scrotum torn from his bike that he was riding while inebriated. Bad idea. If you're considering it, probably avoid it. I've heard of enough scrotal tears to know it's not probably safe. If you're lacking a scrotum, then I guess go for it. Or at least wear pants. I'm not quite sure. Anyway, the testicle was dangling outside of the skin, so obviously the guy was slightly concerned. From what I hear the Congolese nurse or doctor, not sure who, put it back and sewed it, and then the guy just took off without paying. I'm not sure why they didn't call me, but I guess I would have done the same thing, and the guy would have absconded regardless. It gave us a good laugh to start the day. Though really, scrotal tears are no laughing matter. Now that maybe you're thoroughly grossed out, I'll tell you about some other things.
From there we saw a couple clinic patients, then Kara, Stephanie and I met up with Anna Wegner (Dr. Wegner's wife) and she took us to the market. Thankfully they fixed a few of the bikes, so we were able to all ride to the market. It's not really that far, a mile maybe. So we could have walked, but why walk when you can bike (unless you're drunk and not wearing pants of course). Jason stayed behind to continue rounding on the patients, but I think that was mostly because he didn't have a lot of overwhelming interest in looking at fabric to make clothes. I consider the market to be part of my public health experience. Looking at how they prepare and sell food, their clothing, how they work, what their conditions are, etc. it's all public health and my wheels were turning during the entire experience. Pictures will be worth a thousand words in this case for sure, and I wish I could post them now, but alas I cannot so you will have to wait. But I will say that they have the market broken up into segments: fruits and vegetables, fish, other meat like crocodile, and then the clothing and shoes and such. Most things are fairly cheap, and the fruits and veggies are great. The fish is smoked, though I'm not sure how much I trust that. Some of the meat too, I might want to take it still alive, which is what they say about the crocodile to make sure it's not rotting. If I want crocodile I have to buy the whole thing.....still alive. Amanda said I should keep it in the bath tub. I thought she was kidding, and I'm not completely sure still, but everyone has said that oh yeah you have to get it alive. I was pretty sure they were just messing with the Mondele (white person), but they were selling whole, live crocodiles at the market. I'm not quite sure what I would even do with it once I had it, so I probably won't buy a crocodile and slay it for my eating pleasure. Hopefully someone else cooks with it while I'm here. We had the ground crocodile in the spaghetti the first day, but other than that not so much. They had some gigantic catfish, which looked like I would want to eat it, but not sure how fresh it is or how long it's been sitting out. I guess they've fed us fish here so it must be somewhat okay to eat. Like I said, public health thinking anyway. One guy stopped us and gave us a platter of meat, onions and spices. It was goat meat - which I must say was quite delicious. I think he gave it to us hoping we would like it and buy some. I would go back and buy a slab for dinner sometime. Kara didn't seem to enjoy it much, though Stephanie did. I ate most of it, but I'll eat pretty much any meat, and this was well cooked so figured it was probably safe.
We left our bikes with a woman selling vegetables, I guess she knows Anna and is willing to watch the bikes when we go to the market, so we were able to just walk around and look. There's a bunch of stores selling different fabrics and such, and basically you buy your fabric and then take it to this other guy who can make just about anything you want out of it. I think he comes by the complex later actually, not sure. We need to figure that out. But he makes shirts, pants, skirts, dresses, purses/handbags, scarves, headbands, etc. I found some fabrics that some family members might like and I'll have him make some stuff for me to bring back. I looked to see if there was anything that caught my eye for a shirt or anything, but didn't see anything that popped. I'm more interested in buying some stuff to bring home for my apartment, and at the Harvey's house they have some stuff made by the Aca people (the pygmy population here in the Congo) out of wood. Very cool and definitely some stuff I liked, so I'll look to buy that later. But I think the bags and stuff they make are supposed to be nice, so we'll see what he can make out the fabric I bought. I'm tempted to by a machete as well from the market....because who doesn't want a machete in their life. You can never have too many machetes is probably a motto in life. We'll see how much they are, but I think Anna said they're pretty cheap, and they'll sharpen it for you if you want....which would be awesome, but really I should probably keep it dull.
They also have a bunch of stores selling the things that you might enjoy: Coke Zero, Pringles, cookies, etc. You can even buy head and shoulders shampoo in the one store. Pretty crazy, but I guess if you're willing to pay in life in general, things are available to you. This is also a bartering system, which I love, but you have to speak the language. Super glad we had Anna because I had zero clue what anything was supposed to cost in general. Some of the fabric the girls bought seemed nice, but the guy tried to charge about twice what it was worth and Anna was like, um no. So she argued in French and got us a good deal. I'm starting to pick up on some basics of the language, but I never took French so it's like Greek to me....or like French I guess, but you get the point. Anyway, Anna helped a lot and I'll definitely make sure I just go whenever she's going. It was really cool and fun anyway to see everyone interacting. It's a very relational experience it seems. Anna shops at the places where she knows people, which she started going there because they are more fair or whatnot. Seems everyone has their little connections and goes back to those places to shop again and again. We probably do the same thing, just maybe not as consciously back in America. But maybe if we haggled more we would do that.
We got back from the market and joined Dr. Wegner for some clinic patients for a bit and then headed off to lunch. Spaghetti (no crocodile, sad face) with an avocado salad, pineapple from Sarah (delicious again as always), and garlic bread. After lunch we headed back to see some patients. We were planning to join Amanda to teach a CPR class of sorts to the nurses, but there ended up being a giant thunderstorm, so it didn't seem like many people were going to show up. Also, we had an emergency case (which I'll tell you about momentarily), so we ran off to surgery and she had it under control with a reduced crowd. Okay, the case. Basically, this guy came in with abdominal pain. Pretty much what we got. So we grabbed the ultrasound and it was my turn to scan the guy. So I did a FAST exam to start and didn't see much other than some free fluid in his abdomen. Heart, kidneys, spleen all looked good. Small bowel looked dilated, but was hard to tell much else. His abdomen was really really tender though and you could tell he was in pain. It wasn't exactly rigid, so not like a hard core surgical abdomen definition, so we were debating whether to sit on him or take him to the OR immediately. If we waited, there was the possibility that it could worsen and he would have dead bowel and we would have to do a resection and anastomosis. So, ok Dr. Wegner said just lets prep the OR and take him to make it easier. Boy were we wrong. In the United States it would have been a much easier diagnosis, because you know we have this handy dandy thing called a CT scanner with contrast. In the Congo our radiologist happened to be me on that case, and we had just the ultrasound, so it's limiting (and Dr. Wegner obviously looked at it too). We opened the guy up and I saw this blob of dark red, which I immediately assumed was the liver......nope, not liver. It was dead bowel. A whole lot of dead bowel. Dead, distended small bowel that looked just awful (I have pictures). We were like, oh wow, didn't expect that. So resection and anastomosis time. It looked like he had an internal hernia that was probably just there, and the bowel cut stuck and twisted around itself, cutting off the blood supply and dying. We tried to untwist and such, but it was too distended. We tried to decompress it to no avail. So, Dr. Wegner started resecting with Jason first assisting on this case. I circulated. Ended up taking out 1.6 meters of dead small bowel -- so yeah, really good thing we took him right away. We probably would have either gotten a call later that he was tanking and tried to rush him into surgery, or he would have died. So, relief for sure. Took about an hour and 40 minutes from start to close, so it really went quite smoothly in the end. Thank God for guiding us to do the operation, because we probably saved the guys life.
There was a point where we were getting ready for surgery and I see this guy sprinting across the field holding a baby in his hands, so naturally we thought something was terribly wrong and I went running to the Salles de Urgences (ER). Thankfully, the baby wasn't as sick as it looked with him frantically running. Still not sure, but maybe he was trying to outrun the drizzling rain thinking it might start up again. The baby was sick, but not like about to die sick. She had a fever of 38.6, but glucose was stable, she was responding and moving, and she wasn't seizing. They took a blood sample for malaria and when I finally got to ask through our French student what was up, they dad said she had malaria. So not sure if they already knew or if they just assumed, but it's what it looked like. Thankfully it wasn't like a real emergency though. Trying to minimize babies dying on me at this point.
After the operation Jason and I walked a bit to grab some bread and other dinner supplies. We found some quanga (which is like some mashed root that they eat here all the time, that has zero nutritional value. It's kind of like potato I guess) and some "gato," which at first we were like, hmmm Spanish for cat, probably no. But it was a pastry of sorts, like a donut. So we grabbed that and headed back. We had some leftover rice, corned beef and beans from that last few meals so we mixed it all up and finished off the cheese that the Kitchens had left behind as well. More nutritious than yesterdays meal by a smidgeon I guess.
I walked over to Joyce and Henri's house afterwards to borrow the guitar. I'm trying to prep some songs for Easter Sunday, and debating at the moment on what I want to play. Thinking I'll do kind of a mixture of songs they know and some they don't, because it's a great opportunity to teach them songs. It's also Easter and there are some cool Phil Wickham songs that I love doing for Easter as well, so I'll probably teach those as well. We'll see. They've given me some freedom with it, so I want to own it and really bless them with some music, but I also want them to be able to sing along and learn the songs, so we'll see. Anyway, I started jamming on the guitar and then Jason came in and said "Oh, Dr. Kiong was sleeping." Well, sleeping no more as I'm strumming away. Whoops. He was cool about it though and said no worries. Then I started getting eat alive in the house by mosquitos, so he said I'm like the piper for mosquitos, which is probably true.
One thing from yesterday I forgot to tell you. We were rounding on our patients and Dr. Kiong calls me over into a separate room with two patients. I walk in and am like, yeah what's up. He says, "These two patients have tuberculosis." To which I responded with smiling and backing out of the room immediately. The Congolese medical staff all started laughing and wanted to know why I left so quickly. I was like, um I don't want tuberculosis. They responded with, "but you're a healthy guy. Didn't you get the vaccine too?" I explained to them that yes I'm healthy, but even health people get tuberculosis. And no, we don't get the vaccine in America. They seemed a bit dumbfounded. Then I pulled out my TB N95 mask and they were all laughing saying how no one ever wears one. Really, who knows who all has TB at this point with the patients we are seeing. I realized that one of the little girls in the ER has been receiving treatment for TB and she's been coughing a lot. So I guess we'll see when we get back! Pretty much nobody wears a mask or seems concerned, but it's probably largely because it's so hard to isolate anyone....there aren't exactly reverse airflow isolation rooms in the Congo.
That's about it for the day. Trying to rest up for tomorrow, which I think there will probably be a couple surgeries since the Congolese guy is back to help out on Fridays. They probably have a couple things scheduled. I need to talk to Sarah too about visiting some of the pygmy population with leprosy on her home visits and we were also told we could organize a jungle hike with her and the pygmy group. I guess I should start referring to them as the Aca people, which is more "politically correct," I think. They say pygmy and Aca here, so I'm not entirely sure. They call me Mondele, but it's meant to be a mean term by any means. Anyway, we'll see. Probably try to set that up in the next week or so. Would be great and I hear we might see some monkeys when we do that, so here's to hoping. No elephants or gorillas directly near where we are, so I won't be taking pictures of those. One guy today was telling us how he killed a cheetah once. He was flipping through a dictionary and there was a picture of a cheetah. He says, "oh do you know what this is?" I said a cheetah. He says, "Oh, I killed one once." At first we thought he was joking....but he wasn't. I guess he killed a cheetah. Stud. I won't be killing cheetahs, and I'd probably rather not run into one, but a jungle walk sounds great just the same. Thanks again for reading, hope you enjoyed the events of the day and you should really look forward to today's pictures -- there's some great ones. Blessings to you and be sure to check out the website for other blogs that have been written by people in different countries, and Kyla will be in the Philippines soon as well: www.makeachangeinternational.org/blogs
Thanks!
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