week 3 shenanigans

Update: our attempt to rescue our young female patient with end-stage renal disease with pulses of high-dose steroids was unsuccessful. With no other potentially therapeutic strategies remaining, the team faced our last challenge: preventing painful, and undoubtedly unsuccessful, attempts to resuscitate this patient when she ultimately succumbed. It’s quite difficult to introduce the idea of palliation here; it reminds me of some of the orthodox Jewish patients at NYU who find the concept of palliation foreign. I think when it seems like the deck has been historically stacked against you, its hard not to see palliation as accepting defeat. But in this case, we convinced the team that attempts to bring this patient back would be categorically fruitless and likely painful (broken ribs from chest compressions, electrical shocks to restart the heart, etc.) She passed away yesterday.

Now, onto other, happier news.

Yoga

We go en masse every Monday and Thursday to Tunza beach, which is about a 15 minute drive from where we stay. I’m not exactly Mr. Yoga (I’m inflexible in both personality and general body habitus), but its difficult not to be relaxed doing yoga on the beach at sunset with Coldplay on in the background. Plus, the guy who leads yoga, Moosa, is an awesome guy who a) plays ultimate Frisbee and b) takes fabric we buy and can make it into bags, dresses, even a surgical cap for one of our friends!

Tanzanian kids are the shiz

First of all, they are all adorable. Second of all, the young kids get very excited when they see us, yell “Mzungu!” (which means ‘white person’ but which they use for pretty much anyone foreign) about 463 times, and once we respond, carefully say, “Good afternoon.” Either that, or they respond delightedly when we try to speak to them with the four Swahili words that we know. Also, a few times a week, they do calisthenics where they run by in big groups, chanting Swahili songs together. It’s amazing. There is a group of about ten young kids behind the house we were staying at who are about to get uber-spoiled with candy, courtesy of yours truly.

I'm (hopefully) on a boat!

Mwanza is on the shores of Lake Victoria, a gorgeous freshwater lake that, unfortunately, is colonized by a certain worm that causes portal vein fibrosis and massive vomiting of blood in a lot of chronically exposed residents (for example, fishermen). But, apparently it also has an unparalleled view of the sunset. We have been trying to find a sunny afternoon when we can go out on a large boat (don’t worry parents, its driven by a captain and we won’t be entering the water, we are equally terrified of schistosomiasis) and see the sunset. The problem is that the weather is erratic here; it rains for about 1-2h every day, which is perfect because it cools the temperature down about ten degrees and is gorgeous the rest of the day, but bad because it is impossible to predict in the morning whether it will be sunny in the afternoon. But we have a plan to go today; fingers crossed!

Family dinners

We all gather in the Serengeti house to eat dinner together. This often consists of a) some form of pasta (spaghetti, pizza), b) a limited range of vegetables (we’ve now seen carrots and cabbage in every conformation from slaw to pizza toppings), and c) fruit (pineapple and mango, to all of our delight). It’s pretty nice to all gather every evening and share stories between medicine, surgery, OB/GYN, and pediatrics. Due to our neurotic obsession with planning, Annie and I are the de facto parents/camp counselors of the group (which we prefer).

Books

So far, I’ve read Atonement, Virgin Suicides, The Wanting Seed, and Rabbit, Run. All quite good, Atonement and Rabbit, Run are standouts (although I’ve rarely been more infuriated by a main character than by Rabbit). I’m starting on Albert Camus’ The Plague today.

Till next time, quaheri!