Friday, January 15, 2010

Second case in Kigali

I am in the Anesthesia Team Lounge at King Faisal Hospital in Kigali.
Its the partly private hospital which has the best equipment in Kigali and does the big cases.
Its a beautiful building, with a large central area open to the breeze.
I am working with two residents - a third year from Kigali and a second year Canadian who joined me from Winnipeg.
The Rwandan resident wants to do the big cases with me. After declining to do the 3 day old baby yesterday I decided I should do the neuro case with him today. We are draining a chronic subdural haematoma on a blind 15 year old kid who weighs 20 kg, has a VP shunt and will have surgery for a craniopharyngioma next month. The kid seems very pleasant and cooperative despite all her problems, She only speaks Kinyarwanda but seems to have no neurological deficit apart from the blindness.
The surgeon only booked the case last night so we were delayed three hours waiting for bloodwork. So far everything seems to be going well, but we are doing the case without monitoring temperature, urine output, neuromuscular blockade, or end-tidal CO2, and the ECG is very temperamental. I hope the kid wakes up well when the operation is over. We are flying by the seat of our pants here.

Looking forward to the weekend off - it is stressful working so far out of my comfort zone! Saturday we are going to lie in then I have arranged a car and driver to take us to the genocide memorial at Myamata inthe afternoon. Perhaps not everyone's idea of a relaxing day, but our guide has promised to take us to a restaurant with good food, beer, music and dancing on the way back!

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