Thursday, June 11, 2009


Hello All,


Well, I had hoped to have enthralling accounts of my visit to the Cheetah refuge to share today, having signed up last Sunday for the trip.  Alas, it was not in the cards.  About halfway through the afternoon, our internist cum emergency medicine “specialist” Mark found me to say that we had admitted a Japanese patient with epiglottitis.  

For those of you who aren’t of a medical bent, the epiglottis is the little flap that covers up your windpipe when you swallow.  I don’t know if it is actually used in yodeling, but that probably wasn’t an issue in this case.  In any event, the big concern for anesthesiologists in the epiglottitis sufferer is the prospect that the inflamed little booger may swell up and occlude the trachea – with the obvious bad result that your only available organ of respiration is now your skin.  Not particularly effective – “Goldfinger” myths notwithstanding.  The solution in such a setting is to intubate the trachea with one of those tubes you’ve doubtless seen on ER or House.  Such intubations are famously fraught with peril, and are usually turfed to the most experienced chap available (with a surgeon at hand to rapidly do a tracheotomy if things go south).  Well, both Herman the nurse anesthetist and I were signed up for the trip, and as it turns out I trained him.  Sigh. Anyway, although this fellow didn’t look very sick – he could lay flat for instance – it seemed imprudent to leave base.  I couldn’t imagine the level of international incident that would be engendered by having a Japanese airman die on our ward while I was petting Duma the cheetah.  I guess I’ll go next month - Herman said it was worth the trip. Our patient survived the night with no worse suffering than that associated with having to watch movies with the rest of the ward patients in a language that he didn’t speak.


Needless to say I was vexed with life in general.  I consoled myself with an extra slice of pizza at dinner, along with a scoop of ice cream, and later in the exclusive confines of the White House, had a nice glass of a lovely, dry French rose.  As I say, I’ll try again next month.  In the meantime, I’m hoping to go on the upcoming Moucha Island trip – beaches and snorkeling, and a trip to the market.  I shall be more careful though not to count on going.  Else, we’ll have a Romanian diplomat who needs a double lumen tube for lung surgery…

Oh, and the picture above is of Herman and I at the trash incinerator.  No cheetahs, but I'm pretty sure I saw pigeons.  Is there any place they don't live?


A visit today by the French physicians from the base across the runway.  These are the folks who work in the French equivalent of our little clinic.  They don’t have the surgical capability we do – they can refer their patients to CHA Bouffard in town – but they do function as primary care for the French active duty folks as well as spouses and children.  It turns out that for our Gallic colleagues Djibouti is a 2 year tour during which they may be accompanied by their families.  There is housing both on their base and out in town, and the boulangeries, patisseries, charcuteries are by report abundant enough to make life in the French style acceptable.  Myself, I wonder how I would explain to Donna that we’ll be moving to Djibouti for a couple of years. 

Honey?  You know how you’re always wanting to get away to some place warm?  And how much you like French food?  Have I got some good news!  

Best check that any firearms in the house are unloaded first.  In fact the scenario is not too unlikely (not for me, imshallah), as plans are to build a little hospital here on Camp Lemonnier as the base moves from an expeditionary to a permanent establishment.  That done, the standard orders will shift indeed to a year or two, and accompanied tours may be the norm.  I suppose it wouldn’t be so bad.  The kids could attend the French school and come home speaking French, Arabic and Somali.  Not sure how effective a selling point that would be.

Not much else of note to, um, note.  Spotted a fair sized skink ducking under the block of CLUs as I was returning home last night - a thick bodied lizard about a foot long, yellowish in color and with a large diamond shaped head.  I’ll keep an eye out for him in the future.  Beyond that and the house geckos not too much wildlife to report.  I did see a small group of finches in a tree nearby, and I get the occasional glimpse of fast-moving flocks of robin sized birds, but with curved beaks and odd looking wings.  Nowhere near enough to get a useful look however.


Tonight’s ward room movie is Kung Fu Panda...I guess there'll be beer.

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