Things come to a head on Wednesday. It is our designated operating room day, but because I am operating by myself, it becomes a challenge. Between the language issues and the limited equipment, negotiating the OR becomes a nightmare. They have scheduled me several small cases anticipating difficulty. They underestimated the problem. The first child arrives without any blood crossmatched. Given the size of the procedure and the age of the child significant blood loss is likely.

The frustration has set in. That’s how I know I am feeling better. Last week between the jet lag, the cold and some mild but constant GI symptoms I was quite relieved just to get through the day. This week, I want to work. That’s why I am here, afterall. But it is a constant struggle. Monday it takes the anesthetist 3 hours to get our patient ready so that we can start our case. It is a 15 month-old boy with a bad brain tumor. We operate for 7 hours straight.

It is wedding season in Addis. I guess this makes sense since the wet season is coming to a close and the weather warming up a bit. Today, one of my oldest friends in Addis – Abdissa is getting married and I am invited to join in the celebration. I met Abdissa on my first trip here. At the time he was the director of a small Christian orphanage; he and his 22 children were my surrogate family. No doubt I will write about the amazing kids in a future entry, today is about Abdissa.

It has been a bad 24 hours. Yesterday we had to discharge home several of our spine injury patients - without treatment. After sorting through the bits and pieces instrumentation that has been brought over over the years, there simply wasn’t enough of the same parts to allow us to stablize even a single thoracic or lumbar spine.

I awoke this morning to powerful chanting. That is not unusual. As my hotel is next to a mosque, 3am chanting has become routine for me. This morning was different however. By the time I got down to the hotel lobby the street was full – quite literally – of people praying.

Less than 12 hours on the ground and I am rounding at the hospital with the residents. They are excited. With my subspecialization in spinal surgery they have been saving the toughest cases for me in hopes of learning a few tricks while I am in town. While I am thrilled by their enthusiasm I am secretly scared as they start introducing me to the patients and the enormity of the task at hand.

I arrived late last night. After almost 2 hours waiting in line for my visa I was greeted by some warm friendly faces. Dr. Abat and his wife Betty. They were some of the first people I came to know when I started making these trips here four years ago. He was a first year resident in neurosurgery then. He is now an attending neurosurgeon at the Black Lion Hospital...

We all enter medicine to make a difference, to help people when they cannot help themselves. It is easy during medical training to lose sight of this. It is not surprising, really. It is not that you stop wanting to help people or do the right thing, it is just that during residency you spend whatever spare energy and time you have focusing on yourself.

Congratulations to the Division of Cardiothoracic Surgery at Cooper who has once again received a “3 star” rating, the highest possible quality ranking, from the Society of Thoracic Surgeons (STS). Developed to provide a comprehensive nationwide system of cardiac surgery performance, only 12% of hospitals in the United States receive the highest category of quality rating, a “ 3 star” designation. This latest ranking marks the third consecutive year Cooper has received top honors as one of the best adult cardiac surgery programs in the United States.

This week, Pharmacy Choice published an announcement that patient enrollment has begun in the RECITAL (A Patient Registry Evaluating Closure Following Access with the Arstasis One Access System) Study. The non-randomized, prospective, post-approval study anticipates enrolling up to 500 patients in at least seven U.S. hospitals including Cooper.