goodbye

Leaving. I knew it would be a sad day. I had no idea it would be this sad. The last two years were the most challenging, difficult, and intense years of my life. To leave the ones who were there through all the hard, exciting, and heart-breaking experiences...words cannot describe the loss we feel.

Our month of goodbyes in pictures. We said goodbye to those who we became good friends during our first few months of language learning.  We give these folks credit for keeping us alive when we first arrived.

We said goodbye to the operating room and surgical nursing staff at a lovely farewell dinner.

We said goodbye to M, who is a lovely friend and helped keep us fed by cooking beans and rice, tortillas, and bread for us.

We enjoyed an early Thanksgiving dinner with the entire compound.

we said goodbye in church (Luke spoke in Hausa...which was kindly translated into "better" Hausa that everyone could understand). :)

we (thankfully) said goodbye to Luke's beard :)

The schoolkids had a farewell party for us and gave us lovely custom tie-dyed pillowcases

we will miss you Buddy :(

Finally, a bunch of people (including most of the operating room staff) came to the airstrip to say final goodbyes. Many tears were shed.

As you can see, there were so many goodbyes to so many people we have come to know and love.
And, this isn't everyone. There were many more good byes with many more people, but you get the idea.  It has been one of the saddest months of our lives. But we are also excited to get home and see our families and see our friends that have been praying for us and supporting us these two long years and to tell them of the great adventures that we have had. Mixed emotions, Argh!!!!

we'll miss you, too, Martin

Welcome Fall!

We are getting into the spirit of fall around here. Leaves are falling off trees, the fall sniffles are going around, and we are down to a crisp high of 100F.  So, in honor of fall, we put on some sunscreen and braved the heat of the Wednesday market in search of pumpkins.

We found one "pumpkin patch" in the market

we picked three of the most pumpkiny-looking squashes and bartered him down to a price of $2.50 each

We didn't want to carry the pumpkins all over the market and back home through the 105F heat, so we paid this guy to motorcycle them back to the compound

This weekend it was time for a pumpkin painting party!!!

Before

During. We convinced are most artistic friend, E, to come over and help paint since Luke has the fall sniffles/sore throat and wasn't up to it.

Grumpy cat with bloody fangs... Happy Halloween

the backside

Dreaming of the Cold

We ended the day with delicious tomato soup and grilled cheese sandwiches while trying to pretend it wasn't still 93 degrees inside at 7pm. Welcome Fall!

a few pics from our weekend away

one of my favorite things we saw in the "big city" store

picnic lunch

the yellow tea submarine

would you rather....

There are three ways to travel from our remote hospital to the capital city: plane, bus, or car. We don't have a car, but it is our preferred method of transportation if we can catch a ride with someone else. The plane is convenient, fun, fast, and reliable...but it is expensive (and not always available). The buses are cheap and widely available...but you are taking your chances on reliability and comfort. So, we often choose the bus.

Of our last four bus trips, three of them have involved vomiting:
  

First, a lady vomited in the aisle. Someone put some sand over it. It still slid up and down the aisle the whole rest of the trip..

Second, I (Tab) vomited on Luke's lap. I was feeling sick that morning so I had a ziploc bag with me just in case. At least the vomiting was pretty controlled. Luke still likes to tell everyone that I vomited in his lap.

Third, a Fulani boy vomited sour milk on us. Within the first 20 minutes of an 9 hour bus ride. Luke almost lost his cookies, too, just from the smell. He hates rotten milk (whole other story).

The fourth bus trip involved minor neck injury from banging my head on the ceiling when we hit a huge speed bump (we were in back row of the bus). That was also the bus ride where we waited three hours in 110 degree weather for the bus to pick us up.

Yesterday the "vomit on the bus streak" ended, only to be replaced by something worse: total bus breakdown.

The ride was going well. We had arrived at the bus station at 7:30am as instructed and by 8:30 the bus had arrived and we were on our way. We didn't have a problem finding seats, but by 10:00 the bus was starting to get very warm. I thought, "I wish we were on an air-conditioned bus, because this is going to be very uncomfortable when it is 120F this afternoon."  Then, the air-conditioner came on! I thought, "This isn't so bad" and we settled in for a nice ride. Two hours later we smelled burning rubber. Shortly thereafter, the bus driver turned off the air conditioner and the bus slowed way down...and we pulled over to the side of the road next to a big tree. Uh oh.

by the side of the road

People slowly filed off the bus. The driver set up his cot under the tree. No announcement was made. We all knew something was broken, and out in the middle of the desert it can take a long time to fix anything. So we waited. A bush taxi pulled over and a few men grabbed their bags and ran to catch a ride.

at least there was some shade

people from the nearby village brought mangoes and water to sell 

Eventually, a couple of buses from other companies stopped and the fastest, most prepared 2-3 people ran to catch a ride in their available seats. One hour passed. Then two. Then three. We were still at least three hours from our destination and were starting to wonder how we would get there. We made a back-up plan to have someone from the capital come and get us if it took much longer. Then, after almost four hours of waiting, another bus from our bus company stopped. Everyone grabbed their bags and rushed to the bus door.

boarding the bus (didn't get a good picture of the crowd, but it didn't always look this calm)

We hurried but we were almost the last in line to get on the new bus. But, we eventually got a seat that we shared thanks to the insistence of a lovely Christian pregnant lady that ended up sitting on a cooler in the aisle. The bus had seats for 48 people but now there were an additional 20 people on it. To say the bus was overcrowded would be an understatement.There were eight people between the bus driver and the door and another 8 standing in the aisle.

the front of the bus (see Luke and the right) with 8 people crammed between the driver and the door!

Before long,  the bus started to overheat and the bus driver turned of the air conditioner. Only, this time we didn't mind the heat so much. We were just happy to have a ride!

It is amazing to me how calm and relaxed the bus passengers remained throughout the whole ordeal. There was barely any complaining and the only pushing/yelling happened at the very end when everyone was trying to get on the new bus (a few people still didn't make it).

So, would you rather ride a moving bus with some vomit or have your bus break down for hours in 110 degree weather? I'll take the vomit, thank-you. 

Hearts

In honor of Valentine's Day, I played heart surgeon.  When I was on call last night a young man came in with abdominal pain. My intern evaluated him in the ER, noted his abdominal tenderness and some difficulty breathing. Then he did an ultrasound and reported to me, "His abdomen is tender and. I think he has a pericardial effusion ["fluid around the heart"]...but I can't be sure."  I'm proud of him for doing the ultrasound and looking at the heart- its not something a surgeon always looks at when consulted for abdominal pain!

I took the ultrasound to the ER to evaluate the patient. He couldn't breathe well while lying down, his liver was enlarged and tender...then on ultrasound I saw a HUGE pericardial effusion. Biggest I've ever seen  It was like the heart was a tiny, quivering ball surrounded with fluid.

A picture of a small pericardial effusion from the internet. Probably measuring about a centimeter.  Now imagine the fluid space to be wider than the heart...that's what I saw

I measured the distance from the heart muscle to the sac: over 9 cm! Usually pericardial effusions are graded as small (less than 1cm), moderate (1-2 cm), and large (>2cm). This effusion was off the charts. We also got a chest x-ray:

a normal chest x-ray (thanks Wikipedia)

His chest x-ray...his heart shadow took up half of his chest!

Amazingly, his heart rate was only a little bit fast and his blood pressure was normal. Obviously he had had the fluid for a very long time. Months probably (likely from tuberculosis). His liver had been hurting for three weeks because of the pressure build-up. After seeing an effusion that big, I wanted to rush him straight to the operating room to get the fluid off.   But it was the middle of the night, he was stable, and the effusion had been there a long time. So, we took him this morning. I opened the heart sac, put a drain in it, and got over 1 1/2 liters of fluid out! It was a pretty satisfying operation and I got to literally touch someone's heart on Valentine's Day. :)

Yesterday, we got a package from my mom with some amazing Valentine's treats (just in time!). She included some heart-shaped sprinkles. I happened to have a box of cake mix and some frosting and was inspired to make a last-minute Valentine's cake to bring for the OR staff.

The power went out, so I ended up baking the cake mostly in the dark ...but it still turned out.

When I gave it to the OR supervisor, he was a confused when I said "Happy Valentine's Day." It took a few minutes to explain why I brought a cake because I didn't know the French word for Valentine's Day and its not really celebrated holiday around here. Most of the OR staff didn't even know it was Valentine's Day, but now they do and they were very happy to eat some cake! :)

I also made some Valentine cookies last weekend...

The cookie press was left here by a missionary several decades ago. Still works fine!

Usually I would make Spritz  wreaths for Christmas....but the Christmas red hots came in January this year. So I made the Valentine version of Spritz...What do you think? Perhaps a new Valentine's tradition has been started.

Happy Valentine's Day!!!