Well, I thought it was probably my (Bill) turn to write something of my antics since arriving in Kijabe. Things at the hospital have been somewhat different from what I anticipated since the attending surgeon (or consultant in the local vernacular) that I had arranged to work with here has been ill and unable to work for several weeks and now has returned to the US for further evaluation and treatment.
I have spent most of my time working, instead, with an Australian surgeon, Dr Bird, who is the Chief of Surgery here and has been here for 11 years. The first day, in fact the first case, as I was preparing to assist in a thyroidectomy the OR supervisor pulled me out and said: "You are a general surgeon right?" I told her I was a general surgery resident and she took me to another room where a patient with a HUGE lipoma (fat tumor) was being intubated. The rest of the day I was in that room doing cases with a Kenyan intern. The attending would poke his head in from time to time to see how I was doing but otherwise I was on my own. The cases were mostly minor ones that I was well familiar with. If it was something I hadn't seen before Dr Bird would show me how to do it, but most days for most cases I run my own room.
I do get a chance to scrub in with Dr Bird and the Kenyan upper level resident on the service quite often as well on more sophisticated cases and often he will let us do large portions of those operations without him as long as I am comfortable doing it. This has given me many opportunities to teach and learn from the residents here. Coming here after beginning my senior resident year at home is like coming to college out of high school. I felt reasonably competent to deal with most things I have encountered at home, but here the rules, the patients, the diseases and the resources are so different I feel at times quite lost and not infrequently frustrated. I knew life would be different without ready access to a CT scanner but I never thought how heavily I rely on other things that are unavailable to me here such as Arterial Blood Gases, Arterial Lines, and reliable laparoscopic equipment.
Kijabe hospital is remarkably well equipped with subspecialists for a mission hospital. There are training programs in General Surgery, Pediatric Surgery, Neurosurgery and Orthopedics but still the range of things I see are so much broader than I have ever experienced. I will in one day operate on a breast, a toe nail, a colon, a tongue and an anal sphincter. It is fascinating and humbling to again be made aware of just how much I don't know. God has been good to bring me to this place where I am well-supervised and supported so that I can see that despite my 14 years of preparation for this field I still have a LOT to learn. Continue to pray that I will serve effectively and learn fast.
Things I do not want to forget: praying before every surgery, operating on people who have no where else to go, teaching Kenyan residents, eating breakfast while looking out over the Rift Valley, walking home for lunch with my family, watching my children play with Kenyan children, learning from career medical missionaries, sending people away with advanced disease because they were not caught in time, losing patients to resource limitations, trusting in the plans of a Holy God
-Bill
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