2-21-08

Internet access has been extremely limited--I appologize, so most of my stories will probably have to wait until I get home...

Today I did my first trauma case. A man was shot three times while trying to defend his cows--once in his leg, once through his chest and once into his abdomen, but without an exit wound. We sat on him for a day and a half until he developed an acute abdomen, hypovolemic shock and acidosis before we decided to take him to the OR. There's no such thing as a CT scan here. Once we decided to take him to the operating room "emergently", we waited around two more hours for a make-shift chest tube to boil. We removed a section of bowel that had been perforated by the bullet and closed him back up.

Surgery here is somewhat different than back home. Ketamine is the standard anesthetic and patients are not intubated. Sterile technique is attempted, but not always carried out well. During the operation, the patient was frequently semi-awake; he even tried to sit up and look at his guts spilling out of his abdomen at one point. He occasionally would spit blood across the room from his hemothorax. He started talking about yams. Near the end of the case, the electricity went out and we had to finish in the dark. It was a miracle he made it off the operating table alive.

The prime minister is coming in two days for the ribbon cutting ceremony at the hospital in Kolofata, 17 years after the hospital actually opened. He was supposed to have come many times before, but for one reason or another, the plans would always fall through. The concern this time is that there may be too much dust in the air for his plane to land in Maroua, where there is no radar at the airport. Everyone is super excited about the event and cleaning the hospital like crazy. All the staff get new white coats to wear. We have been designated official photographers for the day...if he actually shows up.

my first day in africa, alone

I arrived in Douala, the biggest city in Cameroon, one day earlier than Jessie and Chrissy, two family medicine residents also going to Kolofata. I waited for them in Douala so that we could make the journey up north to Kolofata together.

2.9.08
I generally tend to consider myself a strong, independent, courageous person, but I am not. I think I try to be for the sake of others and for the sake of my ego, but when I am stripped of everything I have ever known, my language, my culture, my rules, and I can no longer rely on past experiences to figure things out, I suddenly feel completely raw and alone and the furthest thing from brave.

Today I dared to venture outside the four walls of my seemingly safe, somewhat familiar hotel room, in search of a bank and atm. The hotel clerk warned me not to go too far because, well...she then lost her words and just kind of pointed up and down at me. I just nodded in understanding; yes, I know I don't look like everybody else.

My atm card didn't work, so I came back empty handed, but I was still proud of myself for wandering out into the jungle alone, even if it was only a block up the street.

anxious anticipation

I just bought 180 dollars worth of granola bars, toilet paper and deet, and I'm not even going camping, at least not in the normal sense.

When I signed up to go to Cameroon one year ago, the only thing my brain had room for was an overwhelming sense of excitement. I would not allow even an ounce of fear or doubt to seep inside. I was excited for the adventure, for the unknown, for the different. One month ago, I had a mental break down and decided for at least one day that I was no longer going. I didn't want to be robbed, raped or murdered. My two thousand dollar nonrefundable plane ticket wasn't worth my life. Now three days before I leave, I have entered this strange, calm, almost zen-like state of mind. The embassy still hasn't sent back my passport with my visa and I'm not even freaking out about it. Despite genuine efforts, I still don't speak French. I have no idea how I'm getting from Douala to Kolofata once I arrive. I got home from Montana later than expected after my car died in the middle of Iowa leaving me stranded, and my to-do list is down to my toes, but it's all good. Everything will work itself out; it always does. (kinda sounds like the stages one goes through when facing his or her own mortality...)

I have been told that nothing in Cameroon is predictable, and that being flexible and adventurous are essential survival skills for the unlikely visitor. Hopefully I prove to be adventurous enough to face the uncertainty, the unexpected and the great challenge that lie ahead. I am willing to predict, however, that this experience will likely change my life forever. Ready, set, go.