King Faisal Day #4 - On a roll

This morning for breakfast I had a new treat, Nutella. It's made from hazel nuts and it tastes like a creamy mixture of peanut butter and chocolate (heavy on the chocolate). I had it on a roll and it was pretty tasty. With a glass of the "Full Cream" milk it seemed quite fattening. Shaloy has commented that I should be losing weight but my clothes don't feel any looser.

Everything else is as it should be; Warm water for a shower, driver was on time, my daily Skype visit with Shaloy. All is well in who-ville. At King Faisal, I have Betty and Deogene assigned to be with me and Said comes in on his Day Off!! That's what I'm talking about!! someone who wants to learn badly enough to go an extra bit. It's quite encouraging. Dr. E also seems quite satisfied to have us bring some images and a report. He's hopping to keep up with CT & plain films much less scanning the patients who need sonograms.

Today's cases included a focal fatty infiltrate within the liver that had a mass like appearance. Another was an in-patient whose right kidney had gotten so big that we could not identify any internal structures, It was hypoechoic and the patient was febrile with a lot of pain in the area of the kidney. It looked inflammatory but the Radiologist thought more likely malignant, I'll follow-up on tomorrow's CT scan.

I went to lunch with Deogene and Said to a local restaurant just about 1/4th mile from the hospital. There were tables and a young lady brought us drinks. The food was buffet of the typical Rwandan lunch, cabbage salad, chips (thick French Fries), cooked bananas (not sweet), cassava, rice, greens (with some sort of bitter seedy green tomato that today I decided might be some variety of eggplant), thin gravy which is appropriately called "soup" and one cube of meat. As much as you can get on a plate (except the meat which is limited to one cube) for $800 FRw ($1.40 U.S.). I've never seen anybody go back for seconds. They get enough the first time. We do a lot of visiting about culture variations and they are surprised to find out that you don't get any money when you marry off your daughters.

I asked Said about a scar on his forehead. He shows me another on his arm and I come to understand he is a survivor. Deogene explains that there was a lot of "cutting". We talk about the reconciliation process and the "Men in Pink". (I'll try to get a picture soon). Their prisoners wear pink pants and shirts that look sort of like scrub suits. And most that I've seen have an interesting knitted cap/hat as well.

We did about a dozen studies and had plenty of time for theory sessions between patients. All three of these people can learn sonography if they get a bit of encouragement, are aggressive in getting their hands on the transducers and go over cases with the radiologists. Our day ends with a renal transplant patient for possible early rejection. The resistive index in all of the poles is less than 0.6, kidney is 10 cm with a tiny bit of collecting system dilatation and otherwise unremarkable 2d findings. The arterial anastamosis has some turbulence, but the angle corrected velocities are around 70 cm/sec.

I catch a moto into Mumenge to go to the forex and exchange dollars for francs. I decide to wander a bit and find that there are quite a few stores selling African and especially Rwandan arts/crafts/pottery/baskets/carvings etc. I look but won't buy until I've looked multiple places, on multiple days, compared prices and see who is consistently friendly and not trying to gouge because I'm white. After looking in a half dozen stores I see that this place also has people wandering the streets asking for money and selling some of the stuff I've seen in the stores. I put on my stone face and walk past but one woman is persistent and when I hear that she is offering me two small african drums for $500 FRw (1$ U.S.) I decide to buy, , , but I've only got a $2,000 bill and she quickly wants to just have me buy something else that she has and not give me any change. Others realize that the muzungu has slowed down and might part with some money and there is soon a small crowd of women thrusting their crafts at me, competing to be heard along with a couple of women who have nothing to sell but keep asking for money. I try to focus on the woman I'm buying from and she finally gives in and asks someone for change. I make my exit as quickly as possible without running and within a block the last one gives up. I do not enjoy that type of shopping!

I remember that I saw another restaurant nearby that advertised Indian cuisine & I'm up for more of what I had last night. I'm there in ten minutes but on closer inspection, , they advertise Indian, Chinese and American food. I walk in scope out the restaurant's menu and don't see anything resembling Indian. They've got a market though & I find a treasure. . roasted peanuts. . . I plunk down my money and get the nuts and two packets of Koolaid stuff (I'm getting tired of drinking boiled water or Fanta). On the walk back, I'm on a tree lined street and the pavement is pretty much painted white with bird droppings. The birds are circling overhead and in the trees and I wonder if I should cover my head. These are big crow like birds with the markings similar to a magpie. It reminded me of that old Hitchock movie "The Birds". There were literally thousands.

Home by city bus. During our lunch time cultural exchange we had discussed "personal space" and the lack of that concept with the Rwandans. It was re-inforced on the bus ride where there were four adults in three seats. It was impossible not to touch the entire side of the person on each side of you. One real absurdity is the driver's insistence that whoever is in the front passenger seat wear a seatbelt. The drivers frequently just drape theirs over them so that it appears they are wearing but they aren't clicked. Additionally there is always someone sitting between the driver and that front window seat (riding the hump), and it's fine that they don't have a seatbelt nor any of the other passengers. The last of my tilapia filets and cabbage salad for supper. The koolaid - "pineapple with ginger" tastes like medicine.

CVTC News: All the boxes that MaryAnne shipped have arrived without damage. Thanks! I've gotten many very positive comments about my name tag. I wear my CVTC name tag every day and they are uniformly impressed with the appeareance. I've had multiple comments: I guess kudos to the marketing folks who picked or designed the name tag. I do check my CVTC e-mail daily.