Chapter Four- Bonecrusher

That's what I would call myself if I was an orthopedic surgeon. It's also a possibility for the name of my first son.

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I realize its only been a little while since I last updated, and you're thinking "What could this kid have possibly done in the last week that is worth me reading?" I watched a guy get his knee sawed off, that's what! On Tuesday we got to go to St. Helena, a private hospital in Welkom, to watch orthopaedic surgeries for the day. Brian and Lois proved themselves useful connections yet again and hooked us up with their surgeon friend Dr. Van Sittert. We put on scrubs and masks and got to stand in the operating room at a safe distance (1 meter = outside spray range). The first surgery was a knee replacement which was a real treat. For an hour and a half he sawed, drilled, and hammered on this guy's knee. On a scale of 1 to a water-skiing squirrel, it was pretty neat. I'll spare the more squeamish among you the details, but anyone who wants to hear a good story should ask me when they get a chance. The next two surgeries were arthroscopic, a shoulder repair and meniscus removal. It wasn't as visual but it was sort of like an in vitro sewing and welding lesson put together.

Back at Bongani the last couple of days, we spent more time actually talking to the doctors and asking them questions about diseases and treatments and drugs. If you'll humor me, I'll cover some of the more interesting ones here. One patient suffered from Stephen Johnson's syndrome, a severe skin reaction to either the ARV's or antibiotics she was being given for her HIV and TB. Its a dark, blotchy rash and can progress to their skin falling off which is obviously very serious. The only thing they can do for her is to remove the drugs and hope she recovers. Another thing we have seen several times is patients in their 20's suffering strokes, because the HIV virus attacks their blood vessels and causes them to become inflamed and stop blood flow. There was a case of neurocysticercosis, which is a parasitic tapeworm entering the brain which causes seizures and vomiting from increased pressure inside the skull. These are the more interesting ones, but HIV, TB, pneumonia, and meningitis are still by far the most common. We have learned how to spot TB and pneumonia on x-rays and are learning the drugs they are given. My goal is to be able to know how to diagnose and treat these common conditions on my own by the end of my time here. I have so much information and I'm hoping to be able to make a medical presentation when I'm done. We are also finishing up our lessons with Dr. Makhakhe and will start seeing patients in the ARV clinic next week.

Back at home things are going well. We have had rice for probably 75 percent of our meals which I'm perfectly content with. In addition to the bitter cold (it drops below freezing about half of the nights) it has been raining the last three days which makes me regret leaving summer back home when I remember, this is way cooler! Two new girls, whose names I will not try to butcher, are coming to the Village today which is exciting.