Baby Cow and Pearl

Tuesday, February 9 2016

Today was my second day at the main teaching hospital in Kigali.  Academic day is on Monday and is filled with lectures, case presentations, and simulation sessions luckily broken up by an hour and a half lunch at the nearby buffet.  This year is really remarkable because rather than giving most of the lectures, our role has transitioned to supervising the senior residents’ teaching. This was the goal of the program when it began in 2006 and it is rewarding to see it come to fruition after years of investment by many volunteers and organizers.  Teaching the teachers and training qualified anesthesiologist are much more sustainable endeavors than flying in to provide “mission”-type services.  I always feel a twinge of guilt for possessing the severe dislike for the expression “mission trip” when applied to my work realizing people’s good intentions.  But, it really is much more than providing temporary services.  It is changing the healthcare system’s human resources to eliminate its dependence on foreign volunteers.  Teaching a man to fish is always better than giving fish or importing fish from remote locations.  Fish go bad easily.

The residents did a great job preparing, but there was plenty of feedback, primarily the gross misuse of PowerPoint and the easy mistake of boring your audience to sleep. I am hoping to pull them far away from reading their text filled slides and push them towards becoming dynamic, engaging, and interactive presenters. It is exciting to help them develop into effective teachers and leaders.

Lauren, the anesthesia resident from Stanford arrived last night after safe and uneventful travels.  It is always fun to share this place with someone new and observe their experience of this amazing place and these amazing people.  A stunning redhead with perfectly ivory skin, Lauren, not surprisingly, gets countless intrigued looks from the people walking on the street.

It is also fun that the Rwandese (yep, not “Rwandans”) have such amazing memories. I am always surprised by how many people remember me from my previous visits.  From the doorman at the Serena hotel, to the young guys working in the gym, to the hospital staff and nurses, everyone is so welcoming to a familiar face.  Some of them even greet me by name.  

After work we, of course, return to our oasis at the Serena hotel utilizing the Wi-Fi connection to work on teaching materials and catch up on emails before grabbing a workout and dinner.  There is always the buzz of hotel guests wandering around the hotel or congregating in little groups in the lounge areas.  I imagine they are all business people investing in developing opportunities in Rwanda.  Lauren and I fall silent and into our work at our table by the window in the upstairs lounge area overlooking the pool and waterfall.  

Another beautiful thing about Rwanda is the afternoon storms.  The pale grey sky grows black and threatening, lightening begins to flash, the air turns thick and cool, and the inevitable downpour begins.  Being from the south, thunderstorms are something I definitely miss in Northern California.  After the gym I order my usual nicoise salad washed down with a glass of sauvignon blanc and a bottle of water before we grab a taxi back to Nyamirambo.  I turn on the fan on my room, one to cool the room down, but also to drown out the noise from the bars outside.  I take down the mosquito net and crawl into bed, my eyelids heavy with jet lag, excitement, and wine.

 Wednesday and Thursday, February 10^th and 11^th, 2016

Wednesday we had a driver pick us up at the apartment and spent the day at the military hospital.  We taught “modes of mechanical ventilation” and “pulmonary embolus” to one of the first year residents, Brigette.  She is in her first year of training and is doing well and catching on quickly.  She was formally a pediatrician and switched to anesthesia when she realized that anesthesiologists are the ones everyone else calls for help when patients are very sick.

I was also able to see and catch up with Dr. Jeanne who is someone I admire greatly. The first female anesthesiologist in the country and one of only five anesthesiologists in country before 1994, she was the only one left after the genocide.  She has years of experience, an unyieldingly positive attitude, is incredibly skilled, and I learn from her every time I am around her.  She also has the most contagious laugh and smile that you can’t help but love.  I guess it doesn’t hurt that she envelops me in a giant bear-hug every time I see her.

We skipped our workout at Serena and opted for Khana Kazana, an amazing Indian restaurant in a fancy neighborhood near the presidential palace.  Sleep came easily but unfortunately was abruptly over at 12:38am.  I think my California clock came back to haunt me.

Thursday

We got to commute in a rideshare bus this morning provided by the hospital with several others making their way into work.  It was fun and almost gave a feeling of what it would be like to live and work here.  Today was spent in King Faisal hospital, which is the major private hospital in Kigali.  Private means well resourced and well funded. We attended grand rounds in the ICU before heading to the ORs to work with another first year resident, Eugene.   

Eugene was phenomenal.  Not only does he possess an amazing fund of knowledge, but he is also research oriented, empathetic, and loyal to serve the people of his country.  This last point has turned out to be a huge issue as we watch several of the residents we’ve trained to become faculty leave the country for greener pastures.  It is called “brain-drain,” and I am hoping that by developing people like Eugene, it will decrease as the situation in Rwanda continues to improve.

It amazes me how the personality of a surgeon transcends cultures and ethnicities.  The surgeons in Rwanda are just as cheeky and overconfident as in the United States.  Today Lauren and I received Kinyarwandan nicknames assigned to us by a surgeon.  Lauren’s name is interpreted as “little gem” or “pearl” and mine means “baby cow.”  Apparently both are complimentary.   According to some, baby cows are known for being very cute and another person even says it is a sexy nickname.  I’m not sure I’m going to understand this anytime soon…baby cow?....sexy?..., so I just said “thank you.”

So, Baby Cow and Pearl had a nice workout at Serena before we went to a restaurant called Heaven to meet up with Gaston, a previous student who is now faculty, and a guy named Ryan who Lauren knows through Stanford.  It was a fun dinner with lots of great conversation and laughter.

Lauren and Emmy