Winner Man

Today is a national holiday in Togo.  Tobasky day.  It is actually a Muslim holiday, but it is celebrating when God provided for Abraham so that he did not have to sacrifice Issac on the altar.  Such an interesting thing to think about on my first day on call.  First, that God provides and is faithful.  Second, He demands faithfulness from us.  Third, how Muslims and Christians actually do have some similar roots though in this modern time it is easy to forget that.  Even though this is a Muslim holiday, because it is celebrated nationally the hospital observed it too.  We still had clinic, but put more of the elective stuff on hold until next week.  I learned today that one clinic visit costs a Togolese person $3 (in US) though this does include a follow up visit.  Since today was a holiday, however, the price increased to $4 a visit.  Sort of puts an interesting spin on the $25 dollar copay that I normally have to pay when visiting the doctor.

Here is a question for my L&D folks out there.  10ml of pit mixed in 1L of NS. How many drops a minute would I need to start dosing/titrating pit correctly? And then how fast can I increase it by (keeping in mind the fluid volume I am giving the pts)?  I have been thinking about this and am not quite sure I am figuring it correctly.  If anyone has any input let me know.

It has been interesting to twist my brain into thinking in Kg, Celsius, and hematocrit instead of hemoglobin.

The Wilm’s tumor baby did well today.  The surgery went better than expected.  Such a blessing.  I had a couple of women come into “maternitiy” (which is what they call L&D here) with sickle cell disease in a sickle cell crisis.  Sickle cell disease is much more common here than in the States.  I have only seen this one other time during my residency.  Sickle cell disease makes pregnancy high risk and can be life threatening to the baby.  Unfortunately, one of these women had lost her baby before she even got to us today.  My heart breaks for her.  Not only is she in severe pain, but she found out that her baby has not survived.  I hope to stabilize her tonight and then we will start the long, hard induction tomorrow.  These are the times when I wish I spoke the language the most. 

French is the most universal language here, however, the tribal language in this particular area is a tongue called Ewe (pronounced ey-vay).  Most of the men and those with education speak French, however, not all women here have been educated and sometimes Ewe is all they know.  There is another group of people here called the Falanies.  These are people probably best described as gypsies.  They look and dress very differently and seem to be a people without a country.  They are found in Gana, here in Togo and also in Benin.  They speak a different language altogether.  There are only a small handful of hospital staff that speak the Falanie language at all.  

Today I had the privilege of being invited to one of the anesthesiologist’s homes for a lunch party.  He is a native to Togo and we were celebrating the end of an internship for some of the OR assistants.  Let me tell you, the Togo people know how to eat! It is rude to not finish everything on your plate that you have been served, but I thought I might literally explode from the inside out by the time the lunch was over.  I don’t know how a single person could consume so much food in one sitting… us Americans that attended were the only ones who couldn’t seem to muster it. The lunch consisted of a 4 course meal.  It started with a type of cole slaw (yes, I am praying hard that I don’t get sick), then a huge heaping pile of rice with a homemade hot sauce on top.  Next was….well, I am not sure how to describe it. The name of the dish is Pot (haha, yes I had to laugh a little at this one too), it is a starch that probably best compares to really bland mashed potatoes that they cover in a sort of spicy gravy and then they put roasted chicken on the side.  The Togolese people eat the chicken bones and all.  In the interest of saving my teeth I only ate the meat.  The fourth course was a sweet bread cake that you ate with your fingers and again dipped in hot sauce.  All of the portions were an entire meal in and of themselves.  I don’t think I am going to eat for another week!  The whole experience was really interesting.  I am so glad that I got to try some of the native food and see a little of life outside of the hospital compound.  These are the moments when you really get to experience what the country is like.  At the end of the lunch we all stood in a circle and sang a song that involved lots of clapping.  The Togo people were really serious about the song and it took a lot to keep an appropriate expression on my face as we sang.  The lyrics were simple and just repeated over and over again.  Imagine the following in a sort of French/Jamaican accent.  “Jesus is a winner man.  Jesus is a winner man.  Winner man, winner man, winner man.  Jesus is a winner man.”  If that doesn’t make you smile, I don’t know what will.