My day began before 6, skyping with my darling boyfriend, who is toiling the entire month of July away, plucking guitar strings by the water on the coast of Maine. Our daily routines are pretty different, so the time difference is just a minor detail in the scheme of things. In any case it's a great way to start the day, being able to see him.
After breakfast at Pinetree, Marc and I caught a ride with Constantine, our regular driver, to the hospital, since it was particularly muddy and rainy this morning. We met Val in the department so that we could take her to the Mother Baby Hospital for tumor board, where we saw more puzzling hematology/ oncology cases. This week, a woman in her 80's with an ulcerating neck mass and associated jugular chain adenopathy that I scanned a couple of weeks ago was presented. The pathologist thought that if there was a thyroid lesion, the biopsy was most likely reflective of metastatic thyroid cancer. I was able to chip in that when I scanned her, the mass was completely separate from the thyroid, which was normal in appearance. This interested the oncologist as the dermal involvement and presentation would have been atypical. Since the biopsy and path were done on the outside, it will be repeated at MTRH. We are thinking it will probably be a squamous cell.
After the conference, the chief oncologist bemoaned the lack of consistent Radiology involvement at tumor board, and how desparate he felt for radiology input, not only in diagnosis, but in image guided biopsy and intervention. Marc and I talked with the residents about this upon our arrival back at the department. They apparently have conflicting didactics. The chief residents plan to speak with the consultant radiologists about changing the schedule so that they are able to attend in the future.
Marc gave an hour and a half talk on ultrasound physics, followed by an ultrasound practicum, for which I served as the patient model. My carotids and thyroid were imaged, as we learned more knobology and other useful skills. The residents practiced on me, and it was interesting to have the patient's perspective, noticing that some people are more heavy- handed than others. The heavy handed folks make really lovely ultrasound images. I sortof knew this already, but was able to experience it first hand.
I went back to IU for lunch to regale my colleagues with stories of glorious Mt. Kenya. Some of the others went rafting in Uganda for the weekend, which turned into a party on the Nile. It sounded like fun, but quite different from our trip!
In the afternoon I learned that our carpenter, Patrick had used inches instead of cm to build our digital photography structure, as I had been afraid of. It's a beautiful piece of work aside from the few things which need to be fixed over the next couple of days. We wasted some wood, and some of Marc's money! Onward...
Val brought me a Tusker, the Kenyan beer taken in these parts, as we sat in the library this afternoon, after I had already decided she must be the most down- to- earth Dept. Chair I'll ever know. We spent some time pooling photos of baby animals we had seen on safari to help Marc, who was trying to cheer up his stressed wife, Lisa, who is home in Indiana, preparing to begin the Bar exam tomorrow. Our efforts resulted in a ridiculously cute powerpoint slideshow, which begins with two small bunnies kissing. Although it was not an original safari photo, it was included for its intense cuteness. I originally found this ridiculous photo on my engaged friends' fridge while visiting them one day. Carolyn and Joe, you know who you are. I explained to Marc and Val how there were arrows pointing at each respective bunny indicating your names, and they had a fit. We marvel at your engaged bliss. But I digress.
I then proceeded to my second Swahili lesson with Wycliffe. Initially, going over lesson one, biffing my conjugations, I was feeling like somewhat of a slow learner. When we finally moved onto lesson two, I learned to count not just to ten, but into the thousands, and was beginning to fancy myself quite the language savant. We laughed through the whole lesson, as Wycliffe has a gift for keeping it light, when concentration is drawing creases across my forehead.
Jane is already leaving tomorrow night, and so she took us out to for an amazing Indian meal in town. Diners included Barbara, who started the diagnostic lab at MTRH, Jane, our favorite TB researcher and pulmonologist, Val, Marc's boss and the Chief of Radiology at IU, Rabia, Jane's research scholar, Marc, my "boss (mdozi, in Swahili)" here, and I. We talked about everything from what we're working on, to the distinction between STI and STD (one of Barbara's specialties) to motherly instincts or lack thereof, and got to know each other well over cheese naan, palak paneer, chicken tika masala, stuffed capsicum, and something delicious termed "mushrooms Eldoret."