My nice teammates

Yesterday was Valentine's Day. I met a few nice people here, whom I want to introduce to you. The first is Chris, an anaesthetist from the US. He is leaving today after six weeks at the mission. As you may recall, I was called to see patients in the ER the night before. There were two patients requiring surgery. The man with incarcerated hernia needed an earlier operation but the child might wait till next morning. It was already midnight. I felt that if I could complete two cases in one goal, I might finish by three in the morning. I didn't know whether the anaesthetist would be happy on not. So I asked Chris after he arrived. He just gave me a simple answer "Go ahead". Fortunately, the operations went smoothly, and we were home by 2:15. I was quite excited and I wrote in my diary immediately after our return. I met Chris again at breakfast. I heard him discussing with Mike, the anaesthetist nurse, about our work last night I'm happy that he admired my work. I think most anaesthetists would appreciate an efficient surgeon, and equally, a surgeon would appreciate the anaesthetist helping to finish most of the cases for the benefit of the patients. The second person I wish to introduce is Charlotte. She is a young gynaecology trainee from France where she is in her last year of training and suspended this to come to Monrovia for six months. Charlotte said she has learned a lot here. Training in gynaecology now emphasizes more laparoscopic surgeries. She can have much more cutting edge experience here. Charlotte is also leaving us today. She was just back from her end of mission holiday on Monday and there were a few cases already waiting for her. As we have only two OT rooms, all OT cases have to mix together and take turns to be operated on. After I finished a debridement case, I found Charlotte struggling with her hysterectomy for a woman with a large fibroid. I went in and asked her whether she needed my assistance. She happily accepted my offer. The third I have to introduce is Mike, an anaesthetist nurse from Switzerland. There was no case in the afternoon as I was not on call, I might have chosen to stay in the compound or go shopping and prepare for the evening farewell party. I chose to go back to the hospital. I met Mike at the entrance. He was so excited when he saw me because he wanted to find someone to review a child for him. This was a boy born eighteen months ago with an imperforated anus. He was referred to our hospital with a colostomy done. There was quite a bad prolapse of the colostomy. The parents were very keen to have a repair done and they had been seeking help everywhere. Somehow Mike and Michael, an outgoing American surgeon, found a surgeon in the US who would like to offer help but needed more information about the child. So they called back the child. Now the child was here but Michael had gone out shopping. Mike did not know what to do. He met me and asked me to see the boy immediately. I examined the child in the ER. It seemed probable to me a case of low imperforated anus without fistula. It would be better if we had imaging to confirm the diagnosis but should not be too difficult an operation if we have appropriate instruments. But we are not authorized to operate on these kinds of elective procedures. So I met with the Medical Director and asked him to refer the child to the Mercy Ship. Last one I am introducing to you is John. He is my very good partner. John is a private surgeon from Chicago. He is father of five children. It is his first visit to Africa and he has the same excitement as I had last time. Although he is already fifty, he is very energetic. We like to discuss the case management together. As he says, only one surgeon working in the hospital would be very busy but manageable for a short period, but two might have more fun and time to think and learn. I met him in the ER when I went in to see that boy. John was reviewing a one-year-old girl with suspected intussusception. He asked me to have a look. He took Charlotte's ultrasound machine and performed a US for her. There was a quite typical concentric and sausage-like lesion in her upper abdomen. We then took the patient for an abdominal X-ray. After operating on two very surprising cases of intussusception in last few days, we were puzzled by the classical presentation of pathology. It was after six before we were ready to operate. Everybody had gone to the party except those on call. I stayed behind and assisted Mike in the anaesthesia, as the child was young. It was indeed a case of intussusception. We were right! We were more excited than before. It was fun! This is teamwork. I like these people. They do not calculate. They offer help whenever it is necessary. Au Yiu Kai