Sept 12
We had another quite large clinic today. In addition, we had a couple of cases including a hip hemiarthroplasty that I did with ZJ. It turned out to be another fairly long day. Nathan and Amy came back today. He still has the symptoms of dizziness when he stands. I asked about the xray machine getting fixed. The Fuji rep apparently needs to come here to deal with the problem. He is going to try to get that arranged in a timely fashion.

Sept 13
7 cases were scheduled today. We canceled one and did 5. One patient didn’t show

There were some smaller cases. One was the bilateral clubfoot patient that Bill and I did last week. The feet look really good. We recasted them in neutral. The next cast change should let us get to 10 degrees of dorsiflexion or more. The biggest case was the obese lady with the pathological fracture of the femur and many metastatic lesions throughout her femur and pathological humerus fracture. We fixed her femur with a SIGN nail and methylmethacrylate. She bled significantly and since we only had one unit of blood decided to not fix the humerus. The case took quite a long time. I also did another arthroscopy with Francel. The patient is morbidly obese and Francel had difficulty getting visualization. I took over and the case was not easy for me either. It may not have been the best learning experience for Francel. Our last case was an elderly gentleman with an intertrochanteric hip fracture. We set up the fracture table and the case went well. We finished at nearly 2 am. Irma was a real trooper all day long and until we finished. I offered to watch the patient in recovery but she insisted that it was her responsibility.

I talked with Francel earlier in the day and he told me he will be here til end of year and would like to stay on afterward. That is great news for us and the program here. I am sure there will be some financial issues and probably a need for us to be involved in subsidizing his practice in some way. I’ll talk with Scott and others about that.

I had an interesting encounter with an expatriate today also. Anthony Kilbride is a friend of Brooke Beck. He is from England and works here on water project. He has had an ongoing problem with a knee for about a year. He suspected it was a meniscal injury. He had a prior meniscal lesion in the other knee several years previously and had an arthroscopy. I assessed him and his findings are consistent with a torn meniscus. He was very surprised that we do arthroscopy here at HAH. He thought he would have to go home to England to have it taken care of. I talked about HAH, the work being done here and the need for fund raising for this program to have long term stability and success. He must be a fairly important person in his program because he told me he meets with Bill Clinton on October 8. He said he would like to talk to Clinton about our work here. I plan to scope his knee before that. I gave him a book to give to Clinton.

Ernie Schwab from the LLU School of Allied Health was here for a few days. I talked to him about the possibility of getting some type of certificate for JJ as an Orthopedic Technician. He believes it shouldn’t be very hard to do.

Sept 14
Clinic went well. I left for the airport at 2 pm for Santo Domingo. Jeannie and Cameron picked me up and we drove to Cabarete. It is so nice to be back here again. It’s great to be with Jeannie after nearly a week.

Sept 15 -17
Just two days in one of my favorite places is hardly enough. A couple of good windsurfing sessions and a nice round of golf made the short trip worth it. Tim and Summer were there also. Tim got out on the windsurfer and did really well. He is making steady progress.

Sept 18 – 29
Pat Yoon from Minnesota is bringing a team to cover for me in Haiti while I am gone. He has been very involved in the project and his commitment to the work there is remarkable. This is his third or fourth trip there. I cannot thank him enough for what he and his teams have done to keep the work going. He is fellowship trained in foot and ankle and does a lot of trauma in the Twin Cities.

This was our last return trip to Appleton to work during our Year in Haiti. I was again on call for 9 of the 11 days. I once again enjoyed being “home” with Jeannie even though we are staying in our neighbor’s downstairs apartment. This trip back was fairly similar to the others with office hours and several elective cases including total joints and one Oxford. I got several cases in while on call also. We ate out several times and made it to the tennis center several times. I had several meetings in New London to work on getting things ready for my work beginning there in November. Jeannie and I also attended a Foundation banquet in New London and had a good time meeting and talking to several of the people that I will be working with. We took some time to look at houses with a real estate agent and found one that was a really good price that we like a lot. It has been on the market for two years so perhaps we will have time to sell our house and buy it. It has a main floor and basement – NO upstairs which I like. The kitchen is perfectly functional but some changes will need to be made. There is no fireplace in the master bedroom either. There is a three car attached garage and a two car detached one. That will be perfect for a tractor to deal with the acre lot. The landscaping in the front is bad and will need to be redone. It is less than 5 minutes from the hospital and office. I would favor moving to New London mainly because of the winter road conditions.

Something very special occurred also. We were able to meet with Joan Malchowski, the director of publicity for the Packers. Jeannie and I had about an hour with her. I explained the work being done and the amazing opportunity it presented. I gave her a signed copy of the book as well as two others to give to whoever in the Packers organization she wanted. She is very interested and supportive and will try to spread the word to Packers fans.

Sept 29
I got an email from Haiti that we have only one functioning anesthesia machine. The large team coming from Puerto Rico is wondering if they should even come. I am sure we can solve this issue with a good biomedical technician. I have offered several times to bring the head of the biomedical technology department at our sister Adventist hospital in Puerto Rico to help us develop this area at HAH. Now will be a good time to bring him over to solve this “crisis.” It might be the start to developing our own program with their assistance. The young man, Wilfredo Perez, who heads their department is a good friend of ours. When we first moved to Puerto Rico more than 40 years ago, his family lived two houses down from us. His mother did medical transcription for me. He was about 3 years old. A few years later, I taught him to windsurf. He still practices it avidly today. When he decided to study biomedical technology, he came to Walla Walla, Washington where we were living to study. He spent many weekends at our home during the years he was studying there.

Sept 30
Last day of work in Appleton. We leave tomorrow morning to return to Port au Prince. I called Freddy Perez today and told him about our needs. He is very interested in knowing more about the types of anesthesia machines that we have at HAH. He will have to check with administration to see if they will give him the time off to come and check things out.