Rounding third....

…and heading home soon.

As I write this, there are six days left in our whirlwind African adventure. Three of those days are a three day weekend, thanks to the Kenyan version of Labor Day this Monday. I’m telling you, one of the biggest incentives to moving here is the prospect of only working one full week a month, maybe two. Apparently, in October there are so many holidays that you work about two weeks TOTAL from what I’ve heard. This weekend is dedicated to exploring the town of Karen and seeing the home and the grounds that inspired Out of Africa. We’re also making a return trip to the Rusty Nail, the restaurant from my Week 1 post that I never got around to reviewing. This time, I’ll try to write a few words about it.

Our trip to Mombasa last week was exactly the relaxing break I was looking for. It was basically air conditioning, bad movies on TV, the pool, the bar in the pool, the bar by the ocean, the bar at the restaurant, and a day of hustle and bustle in Mombasa proper. The city definitely had a different feel to it than Nairobi. Like most port cities, you could find influences from numerous different cultures in the architecture, commerce, and way of life; specifically to Mombasa, the influx of immigrants from India and the Middle East combined with the European conquests throughout the centuries created a environment I had never experienced before in my life. Honestly, it was both comforting, since it was closest to what I’m used to having now lived in major port cities for the past 10 years, and discomforting given the heightened tensions these days between these prevailing cultures and ours. It’s hard not to think of the 2002 bombing of the Paradise Hotel when you’re actually staying in a similar type of establishment designed specifically for Westerners and well-off Middle Easterners. Then again, you can’t let that get in the way of interacting and facing matters face to face; and more importantly, you can’t let that in the way of enjoying a once-in-a-lifetime experience. At no times did I really feel in danger, and looking back I probably could have loosened up a bit more towards the end of the day in Mombasa when we were being shuttled around by a group of parking attendants who not only manned the parking spots and picked who could park there (i.e. vans full of muzungos with money) but also became personal escorts to the fabric shops we wanted to go to. If you know me, you know how much I love being pushed and pulled around. Ultimately, though, everyone got what they wanted out of the trip.

The overnight train ride to and from Mombasa was an experience I think everyone should do at least once in their life; but only one way, to be honest. The trains and the train stations were straight out of 1955. In some respects, they were pretty well-maintained; let me stress some. We reserved First Class accommodations, which gave us a bunk bed for two in a private cabin with a sink, closet, and bedding. We also were provided dinner and breakfast in the restaurant car. To me, this was one of the highlights. It was a scene straight out of a Humphrey Bogart film, with dinner served in courses and strangers having to sit with one another and make conversation. All that was missing was a murder mystery and chase scene on the top of the train. Probably the most unsettling part was passing through some of the most desolate areas in the middle of the night, then coming to a stop and hearing kids in the dark asking for a shilling. Otherwise, I slept pretty well (all things considered) and saw the most stars in the sky than I have ever seen in my life.

This past work week (if you can call it a week) I spent at the Eye Unit. I’ll admit, it was probably lowest on my list desired rotations since I just never really had any interest in ophthalmology. The half-Wednesday I started I was in the clinic, which, much like the ortho clinic last week, is just a non-stop solid barrage of patients from 9am-5pm, with a one hour break for lunch. Unlike the ortho clinic, this goes on 5 days a week in the Eye Unit. The volume is unreal, though the pathology wasn’t shockingly different from what we’d see in the states. It was pretty much a cataract-removing-glaucoma-fixing factory, which is desparately needed anywhere.

Thursday was spent in theater all day. I had never seen ophthamologic surgery to this point in my med school career, so at minimum it was fascinating for most of the day. The saddest case I saw was a two year old boy who had to have his left eye removed completely because of a retinoblastoma. I had never seen a human eye extracted before (well, intentionally anyways...trauma surgery saw its share of dangling eye balls) and it was pretty gruesome. It was replaced with a small orb that basically looked like a child's marble and then the muscles and fat were used to sew up the gaping hole. The next step is having pathology examine the optic nerve to see if the tumor had spread any further than the eye ball. If so, it means chemotherapy and/or radiation at Kenyatta Hospital, aka The Kings County Hospital of Kenya. Otherwise, I saw so many cataract lens replacements that I'm fairly sure that if given the chance, I could perform one myself on some poor, unsuspecting soul.

Friday was a blend of clinic and theater as I spent the day with the attending who was on-call. The most interesting thing I saw was a corneal repair. I don't know how those guys work with such small, nearly-invisible stitches under a microscope. At least the abdomen after a c-section gives me a bit of a target to work with....

In the evening we visited the home of the minister who presides over the Presbyterian Church. For the first time since coming here, we felt as if we finally got a glimpse into the homelife of a Kenyan. Thus far, it's been hostels and hotels the whole time. It was really nice to feel at home...

Speaking of which, it's only 6 short days left. If you have any souvenir requests, get them to me ASAP. So far, I am bringing back so much coffee that I will most likely have to declare myself a business and pay an import tax.

I've edited my Week 4 pictures and added captions! I'll be adding more Pictures tomorrow!!

See you all soon!