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Uganda Spine Surgery Mission – Day 6

UGANDA DAY 6

Dr. Lieberman was up bright and early this morning, well actually not so bright as he was up and out the door before sunrise. As he embarked on his daily morning run, he was joined again by 17 year old local, Joshua, Dr. Lieberman’s new running partner. The two ran 8 miles, and Dr. Lieberman took great pride in outpacing the much younger Ugandan, only to have his hubris shattered after Joshua revealed that his shoes had no soles, and that the local was practically running barefoot over dirt, gravel and broken glass the entire time.

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Dr. Lieberman graciously provided young Joshua with the resources to purchase new shoes… so tomorrow morning Lieberman is screwed.

The team gathered on the bus and waited an extra 15 minutes for Dr. Gorlick who was fashionably and predictably late. He had just enough time to pop into the hotel restaurant and grab a handful of pre-made mini omelets. One of the hotel attendants ran out after him with a take-out box as Zvi, in a hurry, had grabbed the runny omelets with his bare hands.

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Despite leaving late, we arrived right on time to the hospital, so no egg on our face (although there was some on our hands). The team, led by Nurse Sherri and equipment manager Brian Failla, prepped the patient and room for Dr. Lieberman’s morning case. Having a few surgeries under their belt, the team breezed through set up and broke skin (made the first incision) at 9:00 am sharp.

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The patient was a 17 year old Ugandan teen named Deus, who had an unfortunate accident falling out of a tree. Technically the case was a real doozey, the boy’s spine was essentially split completely in half, having been fractured with the T5 vertebrae dislocated in front of the T6 vertebrate.

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With steady hands and help from Drs. Silverstein and Kisitu (the local orthopedic surgeon), the team placed 12 screws in 45 minutes. After a few X-rays and a few additional tweaks, the spine was sitting completely intact again, realigned to offer the patient much improved upper body support and strength.

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After Dr. Lieberman’s successful case Dr. Hisey and Mike operated on a gentleman for cervical spine degeneration affecting his working ability on the farm. The case was full of challenges including a lack of all necessary instruments, but that didn’t hinder the operation in the slightest. They were able to “Macgyver” through the surgery, finding creative solutions with a great outcome.

Dr. Lieberman had a quick check in with Deus, the teen from today’s first case. He was awake and stable, however in quite a bit of pain understandably so. Dr. Lieberman is convinced however that within 48 hours he’ll be sitting upright comfortably in a wheel chair. After the patient check in, it was time once again for Dr. Lieberman’s favorite part of the day, clinic, or as he so affectionately refers to it “the penalty box.” We only had one patient to check in with, a very young girl named Ester who suffers from neurofibromatosis, a tumor of nerve cell origin which can engulf the spine and put pressure on the spinal cord and nerves. Updated MRI scans revealed extensive tumors on both sides of her young spine. They had developed to a level that made surgery impossible, and there are no alternative medical options available in Uganda to battle the disease. This was a devastating diagnosis for the team and Ester’s mother, however young Ester seemed unfazed, continuing to goof around and play with Dr. Lieberman’s rolling stool. Ester is an amazing young girl and we hope that her positive attitude will help carry her to a fun-filled childhood despite the complications that may arise. In fact Dr. Lieberman’s son Josh left Ester with some paper and pens so she could continue to draw for fun and hopefully take her mind off the pain.

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Dinner was a blast tonight as we were joined by two of the hospital staffers, our main man Uganda Stan, and anesthesiologist Andrew, as well as an eager young UK medical student named Silas, who is currently getting some hands on training in the Mbarara ER department. It was great to have these new members discuss their lessons of the day, especially Stan and Andrew as they recounted what they’ve learned from us as a team, witnessing first-hand the camaraderie and support that allows us to “achieve the impossible” as Andrew stated in regards to the day’s first case, a spine that was split in half. Andrew remarked that when he had first seen the x-rays, he did not believe it could ever be possible to fix the spine, and he was completely blown away by the commitment and hard work of the team, all coming together to achieve the impossible.

Along the same vein, today’s quote of the day:

When pressed about his thoughts on the “impossible” case and observing Dr. Lieberman strategically rebuild a shattered spine, resident Dr. Silverstein remarked

“That was the sweetest spine surgery I’ve ever seen”

Runner up quote of the day:

From an exchange at the hotel restaurant. The team favors the whole fish dish at the hotel restaurant, offered as a medium or large size, yet there seems to be quite a bit of controversy and confusion regarding the price and size discrepancy between the two menu items. The following is the conversation with our waiter:

Dr. Lieberman: What is the difference between the medium and the large fish?

Waiter: the price…(long pause)… sometimes

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To support the Uganda Spine Surgery Mission visit: http://www.ugandaspinesurgerymission.com

Texas Back Institute