The Calm Before The Storm

Once again, Peter is on call this weekend so we're having a peaceful, AKA boring weekend on the ship.  Fortunately it's been punctuated by a few fun activities.  Friday night he was NOT on call so we managed to go out to the best pizza restaurant in Lome' with some friends.  We've heard of this place for months but since it's on the other side of this large town we've not been there before.  Fortunately, the ambiance and the food lived up to the hype.  Wonderful pizza, mine was a loaded veggie on a thin crust that I managed to stretch out for two more meals.  Now that we know where it is we'll definitely be willing to pay for a cab to take us there. 

Then last night we were invited to a dockside celebration for the 30th birthday of one of our favorite nurses on board.  Crazy Scandinavian Lina - who can dance all night -was surprised with a bar-b-que dinner for about 20 people thanks to the fabulous Josh and his culinary skills as well as the baking ministrations of Doctor Finona and her bestie- radiology tech extraordinaire, Bridgett from Australia.  They made the most amazing ginger laced cake I've ever eaten.  Not all of my "Mercy Hips" are the fault of the galley's Oompa Loompa diet, is all I'm sayin....

Advanced Team trickling into Guinea

Before we get into the meat of this week's blog post I must first thank all you prayer warriors for a few glorious answers to prayers. 

Here is a picture of our intrepid Advanced Team.  Three of them left for Guinea two weeks ago.  They have had some great success with multiple high level meetings to prepare for the next mission starting in August and they've secured living quarters that they moved into yesterday in anticipation of the rest of the team joining them in the very near future. 

The second miraculous praise is in regards to my sadness about the many, many goiter patients we saw.  Peter has been seeing many of them back prior to their surgeries and not only have some of them actually been cured medically so that they don't need surgery but the surgeon that we currently have on board has made room to do some of these surgeries so it actually looks like all the patients that we worried that they possibly had cancer will be able to get surgery during this outreach!  Thank you God and thank you for all your prayers in this regard! 

So - we've had a pretty boring week but are expecting things to get a bit more interesting starting tomorrow - at least for me since our famous eye surgeon will be arriving and apparently there will be at least a few media sorts hanging around documenting his skills.  We'll be seeing all - ALL the kids back that we've screened over the past four months in the next two days so that he can pick who to operate on to train our Togolese eye surgeon.  We're are really hoping and praying that he will be able to operate on most of these kids since no one wants to see little kids doomed to a life of blindness if there's any hope for an operation. 


Eye Team at end of last field screening day

The other storm we're waiting for is the RAINY SEASON!!!  This past week we had our very last eye team screening day and wouldn't you know it poured!  Everyone's heard of the rainy season in the tropics but I'm sure it's one of those things that you can't imagine it until you've lived through it.  It started to rain on the way to the screening site but by the time we got there about 30 minutes later the rain was coming down in buckets and buckets!  The site is a metal roofed building with open windows and a dirt floor in places so the din of the rain on the metal roof was quite deafening.  Each time we thought maybe it was slowing down it started to rain harder!  This went on for a couple of hours but fortunately it slowed down to a light rain by the time we were done and the rest of the week has been dry.  So - we know its just a matter of time before we get hit with the real McCoy. 

OK - so for weeks and weeks I've figured I'd give you all a riveting view of "A Day In The Life of the Doctors Secord/Linz".  Of course it's a whirlwind and I'm sure you'll be breathless by the end but after sitting around snoozing on the deck with our kindles all weekend I think we're ready for some excitement. 

Peter digging into a snack.  See hot pot at the right

For Peter most days are pretty similar from one day to the next.  He gets up about 6 am and wanders over to our little kitchen-y place to make himself some coffee.  God bless those folks at Starbucks who dreamed up their little Via envelopes of instant coffee!  For the first several weeks he would mozy up to the galley and grab a cup of their coffee which we'd try to doctor up with various additives and chemicals to make palatable but alas!  Our efforts were always in vain.  Most days one sip of this hideous variation on the worst that Army Field rations could only approximate and the swill would go down the drain.  So - we gave up and now make ourselves our am instant and save whatever disillusionment might befall us for something later in the day.  Here's a picture of Peter getting a snack where we make our am coffee.  Since coffee time is usually in his undies I'll spare you all that visage.  Not everyone has a refrigerator in their room so we are very, very grateful that we do as we've been able to hoard things like tuna to make sandwiches when we cannot face the cuisine du jour.  This happens not infrequently. 

Following his coffee Peter then heads off to the wards to meet up with the nurses and other docs to hear about the patients over night and what the plans for the day may be. 
I've posted pictures of Peter on rounds before but this one was taken before we started admitting patients so you can see the actual ward.  Yes, the beds are this close together and amazingly most will later have risers placed underneath with a mattress for their care giver to sleep under the bed.  Sometimes these caregivers bring nursing brothers and sisters with them so you can almost imagine how noisy it is during the day and often well into the night! 

Admissions sm near tent on left. Eye tent far, large tent on right

After rounds Peter and Dr. Fiona divide up their work so one of them will usually go to the admissions tent out on the dock next to the eye tent to do all the admissions work ups.  The other doc will usually take care of whatever needs attending to on the ward.  One of them is typically the doc on call and at night they divide the call three ways with Dr. Kevin, the crew physician who is a family practitioner. 


X-ray machine

The Only CT scanner in Togo!

One place that gets alot of use is the radiology suite since most patients need some evaluation prior to surgery - especially all the maxillo-facial cases that we do since these tumors are often very extensive.   The equipment is pretty modern.  Our CT scanner is the only one in the country and even if we can't help a patient we do give them a DVD of their films so they can show it to whatever other doctors they end up seeing.



tissue processor

On occasion Peter will get called to the lab to look at some weird sort of worm or egg they've found as a parasite in one of his patients. They've even asked me to look at some of the slides at times so that I've gotten to do some microscopic pathology.  Here I am sitting at the microscope in the main lab.    On the left is a picture of the CoolScope that I've described before.  It is an internet based microscope that the cytopathologist in England can manipulate remotely via computer and look at slides we've made and render a diagnosis.  This has been very helpful to our surgeons and a relief to me since I've not done any cytopath in many, many years!  At one point they may have had some histotechnologists and anatomic pathologists on board since they have all the equipment for an entire path lab.  Here on the right is the cutest, little tissue processor I've ever seen!  Each canister is a station in the processing cycle to fix tissue prior to making them into slides.  Now they just take the tissue and submit a few sections to a volunteer pathologist in Michigan.  I have helped with some of the larger gross pathology specimens to describe and submit sections to facilitate getting a good diagnosis but that's about all the pathology I've done here. 

Peter at the "doctor's" computer

The other place Peter and I spend a fair amount of time is the Hospital Clinical Staff office where there is jockeying for computers most of the day as people try to get their work done. There are multiple computers there for team leaders and team members from all over the hospital and most of the day it seems like musical chairs as people look for an open computer to do whatever they need to get done.  Since I've been working on my Operating Procedures project I am sort of camped out here most of the day.  Concentrating can be difficult since it's such a circus most of the time.  The other challenge is this room is easily 20 degrees hotter than the rest of the hospital on this deck of the ship.  The hospital is probably 10 degrees warmer than the rest of the ship.  Thankfully, all I have to do is go upstairs to our room to get more comfortable and usually find some peace and quiet. 

This is another one of our blessings in that - although we can hear just about everything our married couple neighbors do and say on either side of us we do have a private space to call our own.  The single folks - those here less than two years do not have that luxury!  These people - especially the many, many nurses are stuffed into six and eight berth rooms with zero privacy during their stay here.  I really admire how much they sacrifice to serve the patients they take care of. 

Well - this is getting pretty long.  I've already told alot about my days - screening out in Lome' on Tuesday and Wednesday mornings - so I get up at 5am.  I also get up at 5 on Friday's now since we've been doing our marathon laser surgeries for the 30 - 90 patients done six weeks previously to ensure their cataracts don't come back.  The screenings are all finished now and surgery ends on the 17th of May.  Soon thereafter we'll be packing up the tent so the ship can sail away. 





Here's one view of the top of the ship at sunset

Most nights Peter and I take walks up on the top of the ship. It's a nice place to stretch our legs, talk about our day and enjoy the cool sea breezes. It's hard to take a picture of it but it is so interesting to see 50 - 70 container ships anchored off the coast either waiting to come into port or taking advantage of the protection of the Togolese Navy to ward any pirate attacks that are increasingly more common in this part of Africa.


Here is a panorama shot off the back of the ship. 



Here we see 50% of the entire Togolese Navy protecting us and everyone else off the shores of Togo. Just about everything is different here.  In a later blog I think I'll tally up what I'll miss when we're gone and of course, the stuff we'll be glad to say good bye to.  Hope our day in and day out adventures haven't been too much of a snooze fest.  Only a couple more week-ends of call before we leave so we'll hopefully have more to write about in the future.  Have a terrific week.