It's around noon of a Sunday here in the Horn of Africa, a time when only mad dogs and Englishmen are supposed to be out. We do have both here - I've met a very nice colonel from London, and our veterinarian quoted me an alarming 60% rabies rate for dogs here in HOA - but neither are in evidence today.
I've been out for a morning run, a triple macchiato at the Green Bean, Sunday brunch, and am settling in for an afternoon of reading and writing. As to the latter, I thought that with your indulgence I might flip through my little red pocket notebook and share some of my observations in their unpolished state, just so as to clear out last week's slate and start the new one afresh.
First though, a little narrative is in order. The picture above is from the Internal Medicine wing of Pelletier hospital, the Djiboutian facility here in town. We had quite a long visit yesterday morning, and like most of Djibouti it was full of startling contrasts that play off on another in fascinating and appaling ways. The photo above will give the viewer the impression of the dignified decay of a post-colonial nation, groping its way carefully to modernity. The setting indeed is superb - the facility sits oceanside, looking westward to the more modern part of the city, with the bath-water warm Red Sea lapping at the rocky shore at its feet. Was I to turn the camera right or left by 45 degrees however you would see a mud and rock strewn "plaza", sprinkled liberally with the garbage, construction debris, and the occasional bit of medical waste that would make a Joint Commission inspector weak at the knees. The interiors of the 15 or so buildings that make up the rest of the walled compound are similarly dichotomous - there are areas of well kept, if quite antiquated, wards, units and medical equipment, a couple of absolutely state of the art modules (a new CT scanner for instance), adjoined to rooms with trash strewn floors and broken furniture that look like the set of some post apocalyptic science fiction movie.
Through this moves the staff - a wonderfully diverse, uniformly polite and solicitous group of caregivers of whom I hope to have much more to report later. We spent a good deal of the morning with Dr. Said - a Djiboutian born, French trained cardiologist - doing some transthoracic echocardiography. We also met Dr. Yussuf, the radiologist who has been an invaluable aid to us here with CT scans and ultrasounds; Dr. Elias, the general surgeon with whom a lot of the previous EMF surgeons and Anesthesia folk have worked; the two Cuban ICU physicians who could not have been more welcoming, and and a group of French surgeons from Troyes here on a two week mission. All were charming and enthusiastic about the possibility of our spending a bit of time helping out. To some extent our ability to do so will depend on the operational tempo here, as well as our new CO's take on what he would like us to do. I am hopeful though that we'll get over there on a weekly or biweekly basis.
I must mention in passing that Dr. Said's full name is "Dr. Said Abdillahi A. God", which is followed on his office sign by "Chef de Service de Cardiologie". The whole looks something like this:
Dr. Said Abdillahi
Chef de Service
"Hmmm", I thought, " I guess cardiologists are the same wherever you go"!
(Just kidding, Tommy!)
Last night the Captains and Colonels up here in the O-6 housing area, fondly called the White House, got together to watch a movie and share some pizza. The move "Taking Chance" was supplied by the Joint Task Force Chief of Staff, and the pizza was supplied by...me. A day or two before, one of my eagle wearing colleagues had e-mailed, in response to to the initial queries about setting up "movie night" that he thought pizza would be a good accompaniment, and that maybe we should get "the Doc" to arrange it. This was roundly affirmed by all on the string, save one whose identity I bet you can guess. I gritted my teeth, pursed my lips, fumed and muttered imprecations - why, of all the presumptuous ...if they had any idea what ...idiotic self-absorbed line officers...too damn lazy to get their own...anyway, I went on like this for a while - all to myself of course. Then I bethought me of a passage from one of the many perfect jewel chapters of Moby Dick. Ishmael is reflecting on the occasional indignities of going to sea, as he prefers to do, as an ordinary before the mast sailor, and he says:
"What of it, if some old hunks of a sea captain orders me to get a broom and sweep down the the decks? What does that indignity amount to, weighed , I mean , in the scales of the New Testamant? Do you think the archangel Gabriel thinks anything the less of me because I promptly and respectfully obey that old hunks in that particular instance? Who aint a slave? Tell me that. Well, then, however the old sea-captain may order me about - however they may thump and punch me about, I have the satisfaction of knowing that it is all right; that everybody is one way or other served in much the same way - either in a physical or metaphysical point of view, that is; and so the universal thump is passed round, and all hands should rub each other's shoulder-blades, and be content."
My friends, I ordered the pizza, grabbed the chaplain and headed out the gates to Allo Pizza to pick it up, oversaw the serving out and collected the funds with the greatest of pleasure, and was sincere when I said it had been no trouble and I'd be happy to set it up again. And if I silently added "old hunks", well I don't think anyone was the worse for it. Such is the virtue of literature!
Hmmm, well here I have gotten all this way and not mentioned a thing from the notebook! I reckon I'll save that for next time. Many thanks to all of you who have e-mailed. Special Thanks to Clarissa and Eric for the music recommendations.
A la prochaine