Our days in Rwanda are quickly drawing to a close, and we’re kind of trying not to think of the inevitable, because it will be sad to leave.
Today was spent at King Faisal hospital – one more day in the ICU with Christian, the senior resident. There are several medical students here, from Belgium and Denmark, who have an interest in anesthesiology, and who have become an integral part of the our teaching program. So today two of them came with us to King Faisal.
The morning was relatively light – several of the patients in the 6-bed ICU are actually ready to go, but are waiting for beds in the stepdown unit to be freed up after the departure of a cardiac surgery team that is currently visiting King Faisal. So there really were only one or two critically ill patients. In the afternoon, though, the speed picked up. Just when I had logged on to a teleconference with the US, there were sudden calls for help: one of the cardiac surgery patients in the stepdown unit had suffered a cardiac arrest. Kristi and the students went over to help the team, but despite a long resuscitation, the patient died. It was the only death in an otherwise very succesful cardiac surgery trip.
Meanwhile, one of the patients in the ICU deteriorated, and came very close to being reintubated. We had good discussions with Christian about how to determine the time to intervene, and how to intervene if needed. We finally decided to try CPAP, which apeared to be a good choice.
And meanwhile we still managed to squeeze in a few lectures. I gave Christian the same talk I’d given the residents at Butare: how to use the medical literature. And we also had talks about two topics close to my heart: intravenous lidocaine and the use of respiratory variation in the arterial waveform.
At the end of the day, we said goodbye to Christian, and to King Faisal hospital. We walked over to Shokola Lite, a small, excellent (and expensive…) restaurant near the hospital. Robin Petroze would pick us up there, to go to dinner with Sara Rasmussen, one of the pediatric surgeons from Virginia who arrived today in Rwanda for a one-week visit. Shokola, as might be expected, serves excellent chocolat chaud:
Then we had dinner at an Lalibela, a local ethiopian restaurant. Robin’s time is also almost up – she’ll be departing shortly after we do. We chatted about experiences over some excellent Ethiopian food.
Tomorrow will be out last teaching day. Since the Indian team is still at CHUK, we plan the same program as yesterday: case discussions with the residents in the morning, and then teaching rounds in the ICU.
And then it will be time to say CHUK goodbye. It will be a sad moment.