By Sarah Woodrow, MD
Cooper Neurological Institute
This is part ten in a series of updates from Dr. Woodrow’s mission to Ethiopia. View additional posts from her on the Inside Cooper blog by clicking here to view all posts tagged “Ethiopia.”
I always leave Addis with mixed feelings. Happiness – having caught up with old friends and made some news ones. Sadness - at all the pain and suffering that never seems to change. Relieved to know that, in less that 24 hours, I will be having my first hot shower in 3 weeks. Physically exhausted from the long hours of operating and the on-call duties combined with preparing and delivering several formal lectures a week. Emotionally exhausted from all the ups and downs. Pride as I look at the developing neurosurgical program here knowing that whatever little difference I may have made in peoples’ lives here these new residents and surgeons will be able to do so much more. Excited to be going to home to my new puppy whom I have left in the care of friends, hopeful that he will still remember me. Twenty-one hours of travel time leaves a lot of alone time to reflect on the last 3 weeks.
It is also a time I spend asking myself whether I am going to return and, if I do, what am I going to do differently.
Unlike the last trip I made, when my trip was tainted with prolonged OR closures and lack of vision in developing the training program, I have been inspired by the changes I have seen. I have no doubt that I will be back. So, I promise myself that on the next trip, some things are going to be different.
I am going to be more persistent. Persistent at finding out ahead of time what equipment they have so that I can build on it. I think my 20-minute rant during one of my lectures highlighting the need for the surgeons there to better understand the different types of spinal instrumentation (so that they can tell visiting surgeons like me exactly what they have and what they need) has gotten through to atleast some of the new residents. Also more persistent at chasing down donations for supplies before I leave, including figuring out a more cost-effective way at getting them delivered – extra baggage charges are not the way to go.
I have also promised myself that I am going to be a bit more of a tourist. With only 2 days off the entire trip – one for the wedding and another to catch up with Dr. Abat and his wife I never saw much of the city – in fact I realize despite three trips to Addis I really have seen very little of my surroundings. Next time that will change.
I think next time too I will see if there is anyone who wants to join me on the trip. Anesthetists are always needed – especially ones comfortable with neonates and neurosurgical cases. A scrub nurse – not so much for me – but to help train the ones over there. A floor nurse – one who has interest and experience taking care of neuro patients -who can help teach the nurses there to better take care of these patients. A physical therapist….. the list goes on as the need is so great. Anyone game?
If I could leave you with one final image and thought it would be this one. It is the story of Selam. She is 10 years old. For almost a year her head has been getting disproportionally larger than the rest of her. She has stopped interacting with her family. She does not speak. She just stays in bed and stares. For months her family had been taking care of her in this state at home, saving for the big trip to the city where she can (hopefully) get treated.
It turns out she has a bad infection in her brain caused by a tapeworm. It has created a giant cyst, growing slowly to the point where is takes up more than a third of the contents of her skull. For us, this is one of the good cases – one of the ones we can potentially save.
We operate and remove the cyst, which looks like one huge ball of yellow jello filled with water and containing multiple stones. The next day, she is speaking for the first time in months. The day after, I insist she gets out of bed and starts to walk. Her mother is petrified – she doesn’t think she can do it, she has been so sick for months. With the help of the father of the child who is her roommate we get her up and she takes her first steps, albeit with a lot of assistance. Her mother is sobbing with tears of joys.
Selam gives me a big smile as I snap a photo. I don’t need anyone to translate for me. It is one of the highlights of my trip. Although I am far from a great surgeon and her procedure was not a particularly challenging, one the image will be etched into my memories for a long time to come. It will be a constant reminder of why I am here and why I need to return.