kasi mingi

it has been really nice to have carlynne here living with us for a few weeks. it is always fun to have new people around to get excited about things that have grown mundane to us, thus renewing our own enthusiasm. in addition to the obvious cultural phenomenon and reappreciation of our beautiful surroundings, kylie is quite excited that carlynne is getting into the first season of veronica mars.

carlynne being around also means that we suddenly have a plethora of pictures around the hospital. until my family came, i dont think we had any pictures of me at work or wearing a clinical jacket, or of kylie in her secretary's office. thanks to carlynne, this newly available memorable medical mosaic has inspired me to write another post about our work in the hospital.

carlynne has been looking after a very nice lady in the female ward who took a "harmless" little antiobiotic called septrim (septra in canada) which gets given out like candy in the rural dispensaries in kenya (and some walk in clinics back home). basically she had a cold, was given this unnecessary medication and her immune system flew out of control attacking her own skin and mucous membranes. i hope this makes you parents out there thing twice about demanding antibiotics from your family doctor for your kids' ear infections and coughs. she is now doing much better and was discharged home today.

i am including this picture mainly b/c i really like this lady. she had an internal fixation of a femoral (upper thigh bone) fracture and has been sitting in bed for over 3 weeks in traction. when i was on call last week i asked the nurses to move her bed outside but they said it was impossible b/c the bed didnt have wheels. being crazy busy i didnt push the issue, so i was quite happy to see her this week outside in the sunshine (perhaps we recently hired stronger nurses). apparently, so was she.

on saturday i was called to the hospital to see a lady with intestinal prolapse. she came to the hospital with a large portion of her small intestine hanging out of her anus. fortunately i do not have any pictures of this. unfortunately it was my job to bring her to the OR and slowly and steadily stuff them all back in where they belonged. unfortunately i just got a call from paul asking for advice b/c they have fallen out again (i fashioned a sumo like g-string support sling out of gauze which held for 2 days at least). i told him it was like juggling a bag of worms. as mentioned previously, our surgeon is currently out of town, so we are trying to help her though until she can receive definitive surgical management.

here are some pictures carlynne took of me in the course of a working day. both involve holding an xray into the sun and both involve consultations, each of which happen a lot in any given day. the first picture is a classic window consult.
as i am walking by the window of the female ward on my way to the OR or outpatients i am often stopped... "hey, can you look at this xray for me and tell me what you think?" this one was a barium followthrough, which are notoriously difficult to read, so i pretty much just made some stuff up.

this picture is of me consulting our medical director steve while my friend daniel, a sudanese intern, looks on. i am showing him a picture of a broken arm (supracondylar fracture) in a 5 year old after i had partially reduced it (read me hanging off the poor kid's elbow and squeezing the forearm while 2 strong men pulled on his wrist with all their might). i really wanted him to say "yeah, that's probably acceptable" b/c i had just borrowed his ortho textbook which explicitly stated "supracondylar fractures are extremely prone to neurovascular complications and thus must always be handled by an experienced orthopedic surgeon". unfortunately he agreed with my gut feeling that it just wasnt good enough and thus i am going to torture this kid again tomorrow morning.

in carlynne's peter parker tour of the hospital she managed to capture the elusive hospital secretary in her native environment, so i have included this picture for the enlightenment of all occupational ethologists engrossed with ethnic organizational environments (note the neat stacks, thoroughly amazing to passing kenyans and anyone who knew kylie growing up).

finally i will include a picture of our culinary adventures sans electricity. when i arrived home from work this week i encountered carlynne mixing up a big batch of granola. being unsure of carlynne's granola making skills (and being addicted to kylie's grand version of the same) i discretely enquired as to kylie's involvement in the granola making process. it was difficult for me to hide my dismay when i was informed that she was not involved at all (granola ingredients being quite scarce in kapsowar and granola being so close to my heart (separated by the diaphragm, pleura and a touch of lung to be precise)) and i am afraid that carlynne was a tad hurt by my lack of confidence in her granolabilities. fortunately it turns out that as a team (with carlynne doing most of the work) carlynne and i can also make an excellent batch of granola.