In all the traveling I have done since the beginning of 1998, I am not sure I have ever been truly homesick, but I must admit that I am certainly ready to go home next weekend. Still, it has been a real blessing to be here. Each day is warmer than the one before as we begin to enter the hot season. Still, it is pleasant in the evenings and early mornings and the heat and humidity is not yet unbearable even at its peak. Certainly not as bad as Fayetteville in the summer – at least not yet!
The cases here this week have been the usual variety in a tropical hospital with nothing too remarkable. Tuesday evening, one man came in DOA from an elephant stomp to the body which occurred just a few kilometers from here. Obviously, there was nothing anyone could do for him. The houses here are often made of mud but must be carefully maintained annually. If not, disaster can happen. A mud wall in one home fell on one old woman and fractured her ribs and her pelvis. We placed a chest tube and put her to bed. In another case of mud wall collapse, a teen-aged girl suffered an open fracture of her lower leg as the heavy weight pinned her. Another broken pelvis, this time from an auto accident, came in, too. Others came in with neglected disease of all sorts. We did breast biopsies; a procedure for an undescended testicle; a colostomy for another anorectal malformation (cloacal) in a girl who had been stooling through her vagina for the three years since birth; a tonsillectomy in an adult with a possible lymphoma of the tonsil; a cystoscopy with retrograde contrast studies; two lap cholecystectomies (one of which was among the hardest I have ever done – I was proud of John Tripura’s performance on that and mine the next day when we had to go back and suture a small leak in the bile duct where the clip had come off); removal of a vaginal cyst; a C-section; excision of multiple hemangiomas (blood vessel tumors) of the hand, fingers and arm; a few skin grafts; rotational flaps and Z-plasty for bedsores on a paraplegic 15 year old girl; tendon release for deQuervain’s; removal of a huge spleen in a 2 year old with thalessemia major; bilateral inguinal hernias and a recurrent hydrocele in an old man; a hernia in a young boy; debridement of necrotic muscle after a compartment syndrome in a young child with a bad lower leg fracture; a below the knee amputation for carcinoma of the foot (Marjolin’s ulcer for those of you in medicine); a procedure for an anal fissure; reduction of a dislocated hip (auto accident); removal of orthopedic rods and a few things I have forgotten. In short, an average sort of week except that my training had actually prepared me for a higher percentage of them than is usual. So many times I flounder with cases I haven’t seen before nor had previously thought through. The fact that general surgery is truly care of “the skin and its contents” in this setting is one of the reasons why training general surgeons in this developing world setting is so challenging.
In a hospital which after 40 years of existence still has a majority of workers from the other two main religions in Bangladesh, it is only a few who follow Christ. Monday morning, Steve led a Bible study in which half are followers of the way and half are seekers from the H’s and M’s. Friday, I went with the Kelleys to worship at a small rural church at Hidernashi. They had a bench in the back for us old folks, but the rest sat on mats on the floor. Afterward, four young believers were baptized in a local pond and received for their own a Bible from their church. That afternoon was one of rest and the expatriate church service was Friday night. Sunday evening is the prayer meeting for the missionaries. There will be a picnic meal after the prayer meeting this weekend.
Praise and Prayer Requests:
- Pray for safety in travel as I begin my long trip home next Saturday afternoon.
- Pray for me as I recover from this trip, catch up on all the backed-up work and begin to prepare for the spring business meetings for both the Continuing Medical and Dental Education and the PAACS commission to be held in Chicago hotels two adjacent weekends in April.
Weary, but with the end in sight,
Bruce for Micky and Sean