The Excitement of the Peds Ward!

The last several weeks have flown by. We are down to our last week here at Karanda. I can't believe 5 months have actually gone this fast. We've had our moments here, and there's been times I thought the end would never arrive. But as I sit here with a week left to go Shea and I both feel so lucky to have had this experience, and the thought of leaving is bittersweet. Many of our local friendships have blossomed, although saying goodbye won't be quite as difficult since we've decided to return in January. We are excited about the ministry opportunities here, and glad we can be a part of the ministry here in the near future. Its been great having Rhonda around, and we have all benefited from her marvelous cooking (especially our waist lines).

The last several weeks have been great for Shea and I as we have been in charge of the Pediatric ward. Its been quite an experience. We have really enjoyed working with the children. It has been both heartbreaking and heartwarming. Its painful to see these innocent little kids stricken with such devastating diseases, yet encouraging to see kids at the brink of death return to life with proper medical and/or surgical treatment. The ward has also been a wonderful place for evangelism as many of the families are eager to hear about the gospel, and have been very receptive to His calling!

The Pediatric ward has been so busy that it is often quite stressful trying to make rounds and keep all of the patients straight. The other day we had 32 patients in the ward. The capacity is actually 24.....but here in Zimbabwe we really don't have to worry about petty things like “fire marshals” and “regulations”. I've been told by several nurses that the previous high was 30 patients, so you can imagine it was quite a zoo. The actual room the ward is located in is about the size of an average 2 car garage. So you can imagine trying to fit 32 sick gets, there moms/family, IV poles, oxygen tanks, and what little staff we have was quite a challenge. We still have sick kids sleeping under the beds of other sick kids trying to make enough room for everyone.

We've had an incredible array of pathology the last several weeks. We've been stumped on many patients, but we have enjoyed the challenge of figuring out the correct diagnosis, and delivering the best medical and surgical treatment possible. We've seen patients with diagnosis ranging from measles, tetanus, meningitis, cerebral malaria, a necrotic thigh and tuberculosis to pneumonia, neonatal fever, burns, traumatic amputation (her dad was chopping wood and slipped), femur fractures and clubbed feet.

We've had at least 5-7 patients with hydrocephalus some who have received new VP shunts and others that have had VP shunt malfunctions and/or infections. We had one young boy who was evidently playing with a hand grenade and it went off. It took off a good portion of his right hand. (Don't ask me how he got a hold of a hand grenade....I've asked several family members and no one seems to know). We had another young boy who had 2 large tumor growing out of his back and buttock. We removed them both and are waiting for pathology results as well as his skin graft to take.

We had another young boy who was presumed to be bitten by a cobra (never a good thing). He was starting to improve and his family wanted him discharged even though we felt he would be better suited to stay another day or two. We obliged, but unfortunately the boy and about 18 or 19 others were involved in a mass trauma when a large flat bed truck carrying 12-15 people collided with another small truck about one half mile down the road from Karanda. The irony of the situation was that most of the people in the truck had just been discharged from the hospital and were leaving to go home. The trucks hit head on, as they came around a tight corner probably only going about 30-40 km/hr. The impact was still great enough that it sent most of the passengers through the air, and some ended up with significant fractures. All that to say the boy with the snakebite did fine, aside from a couple of lacerations and bruises. We did get our wish and got to keep him in the hospital another night.(I guess they should have listened to us in the first place). Also, Shea got quite the surprise when 20 injured people from that wreck showed up at the OPD right before her lunch break. That's a whole other story, I'll save that one for later.

Anyway back to the Peds ward. We've also had 5-6 patients with severe malnutrition and all are currently on our high protein feeding program. One such patient also had something called a Noma. A Noma is an ulcer on your face that usually eats through your skin and tissue until your teeth and gums are exposed from the outside. This typically occurs in severe malnutrition. This particular patient is a 9 year old boy named David who came in weighing 10 kgs (22 lbs). David was completely emaciated when he arrived. He was also unable to walk and HIV positive. Both of his parents have passed away from HIV and he is now being raised by his grandpa. His grandpa is very attentive and never leaves his side (I think David is his only family). David initially couldn't even turn to look at me during rounds. Now with several weeks of proper nutrition (aside from the occasional lolli-pop I sneak him) and treatment he actually smiles during rounds and has become quite interactive. He goes outside with his grandpa and its just wonderful to see him happy. According to our scales he now weights 15 kgs (its quite a jump, not sure I always trust our scales here, but I'm just encouraged he continues to improve). So with the Lords help David will continue to improve, and with proper HIV treatment and education he may still have many good years of life ahead of him.

So as you can see the Peds ward has been very challenging, but also quite rewarding. The rest of our time has been spent in the maternity ward doing C sections (Shea and I actually got to do a twin C section together...it was great), in OPD seeing patients, in the theater operating on an array of pathology, and at home chasing kids, and changing diapers (although a few less since Beau is starting to use the toilet alot more). Overall things are great, and were excited for one more good week of work here at Karanda. We really look forward to see all of our friends and families real soon. God Bless!

The Perfect Mothers Day Get-Away!

Happy Mothers day to my beautiful wife Shea, my wonderful mom Fran, and my arizona mom Rhonda. I'm a lucky man to have those wonderful women in my life! Yesterday Shea and I tackled “pulpit rock”. Climbing as always been one of Shea's favorite things to do. So for a pre-mothers day celebration what better then a good climb. After Paul and I finished rounding on the hospital, seeing patients in the outpatient clinic, and doing a quick C-section Shea and I headed to climb the massive rock formation.(Its so nice to have a Grammy here for babysitting, and a little break from the kids is always appreciated). It sits about 15-20 kilometer's from Karanda, but most of it is bush roads so it takes about 30-40 minutes to get to the spot where we will begin our approach hike. Legend has it that hundreds of years ago pulpit rock was inhabited by the Zulu tribe. After conquering territories in what is now Southern Zimbabwe and South Africa they left there massive rock for a time. According to the legend they returned some years later with hundreds or thousands (depends on whose telling the story) of Zulu warriors to move the rock to there new territory in the south. Now if you were to see this massive 640 meter high rock structure up close you would find it hard to believe, but you know me.....I'm always up for a good legend! (Elvis still lives...right?)

Anyway, today we were charged with getting to the top of the great rock, and enjoying one of eastern Zimbabwe's finest views. Shea and I along with Dr Stephens (who lead the climb), and our friends Nicci and Anna decided today was the day for the ascent to the top. Luckily, I can tell you there were no thrilling/death defying stories comparable to my climbing mishap in 2004. No major falls or seizures or helicopter rides to trauma centers (not that there are life flights or trauma centers anywhere within hundreds of kilometers). The outcome of this climb was much better. Although there were several moments when I wondered why we were doing this without better equipment the climb went relatively smooth.

It was interesting this was the first time Shea and I climbed together since before we had kids. In the past we have climbed some pretty “hairy” things, and probably taken some unnecessary chances. But now with kids back home waiting for us to return, the idea of taking needless risk, for risk sake seemed a bit less appealing. With those reservations in mind, we still were excited to have a couple of “kid free” hours outdoors, and looked forward to climbing again.

This climb was a bit unconventional. Shea and I are used to climbing shoes, a good rope, a harnesses, and some solid carabiners. (Not to mention a good belay device). Today we just had our tennis shoes, and Dan's old rope that he says he brought "only if the women need it" (Hey what about me, its not like I have the best Life insurance policy here). So that being said he planned that we would free climb the face of this pulpit rock. Well I guess we'd have to see about that.

So we drove our car as far as we could through the windy and rocky dirt roads. We stopped about 1 mile from the base of the rock. We hiked the last mile and enjoyed the scenery as we saw several villages scattered about between the road and pulpit rock. We got to the base of the rock and began our ascent to the top. The majority of the climb was steep, but didn't require any climbing. We just leaned up hill and maneuvered between stones, boulders, trees, and loose dirt, and used all 4's as needed. The last several hundred feet was a 4 sided cliff face without any significant switch backs. This was where it got a bit tricky. Dr Stephens, had done this climb multiple times in the past, and he was used to taking climbers of all skill level up to the top. There were two very difficult spots in the climb, the first at the very beginning and the last at the end. We all went up about half-way on the first part of the climb without any rope. But as the winds picked up and began to howl, we felt a little more comfortable at least having a rope in our hands in case a slippage were to occur. (Wasn't going to be a gentle fall to the bottom). Dan reluctantly agreed, and climbed up ahead and attached his unconventional rope to the base of a tree at the top of the first pitch. We all used this to aid in our climb to the top of the first part of the climb. As I said before it was awesome to be climbing with my wife again, and the risk of death is always a bit of a thrill, but the thought of Beau and Gracie without parents was a bit sobering. So we kept that in mind with every firm grip of a hand-hold, and securely placed foot-hold.

After finishing the first part, we gently maneuvered around a narrow switch-back and came to the base of the last part of the climb. Unfortunately, Dr Stephens left our only rope anchored back at the tree at the other part of the climb. So to enjoy our conquest at the top and the breath-taking views we had to free climb the rest. This last part was bit shorter then the first, and fortunately the rock formation formed a bit of a crack and we were able to snake/wedge ourselves against it. We would have much preferred to have a rope at this point, but aside from a loose rock encountered by Shea's right foot (took away our breath for a second), we all got to the top quite safely.

The view at the top of pulpit rock was magnificent! There were breath-taking views from all 4-sides and the beauty of Zimbabwe was so evident on the summit. What a powerful God we serve! The top of the rock was probably big enough to fit two moderate sized homes, and it even overlooked onto the Mozambique valley which lay about 20 kilometers to the east. We stayed at the top for about 30-45 minutes, but then envisioned Rhonda at home with a hungry Gracie (she still doesn't like to take milk from a bottle), and decided to head back down.

Going down brought a few hair-raising moments, but we made it down with all limbs intact and no major injuries. It was another wonderful adventure for Shea and I, and we were so lucky to have Rhonda here so we could share it together. I can't imagine raising kids with anyone other than my wonderful wife.The patience and love she displays on a daily basis to our kids never ceases to amaze me. Raising these first two kids has been so much fun, and really pretty easy I'm already looking forward to another. Although, I think  we may still have to talk more about that one. :) Happy Mothers Day Shea and Mom! 

A Day in the Life of Mr Mom!

Well today, I thought I would write about something a little unique to medicine, but none the less important. I've written about a surgery day, and an OPD day, but today I think I'm going to change gears a bit. Today I'm going to write about my “stay at home with the kids” day. I currently stay with the kids on Tuesdays and Thursdays while Shea goes to work. I've found these days the most rewarding, but also the most challenging. Here in Zimbabwe the challenges are unique. There is no car, no familiar kid distractions(YMCA/Zoo), hundreds of kilometers to the nearest shopping center, and power outages that make planning meals and doing laundry a bit of a challenge. I think I have gotten used to all the little curve balls (well at least they don't surprise me so much now.......in fact sometime there even fun) and I really love being a stay at home dad. So today there will be no stories of life and death struggle (well maybe for the ants and bugs that cross Beau's path), no blood, guts and bodily fluid (well there is the frequent diaper surprises produced by the little ones), and no life threatening infectious disease (well we did have that really bad stomach bug going around.....Oh well). So today I'll keep it simple, I'm just going to recount for you the details of my day at home with the kids here in Zimbabwe. I know, I know, I know....many of you are thinking how boring, and you know I'm inclined to agree with you. But house wives everywhere need a champion, and now with my vast 4 months of experience I think I can be that champion. So here's the story on April 29th of 2 crazy little kids, and their Dad who is just trying to keep up.

So the day for me started when Gracie woke up at 6am. Usually Shea and I just lay in bed and hang out with her, since there is very little Gracie time the rest of the day (once her big brother wakes up). At 7am I went to the hospital devotional with Paul. Today the Shona singing was beautiful as usual and Paul gave some wonderful words on the basics of salvation. After that the marathon begins. I arrive back home and both kids are up. Shea is getting them ready to eat, but leaves the rest of the job to me since she needs to finish getting ready for work. This morning's breakfast routine went pretty smooth. Usually I sit between the kids with my own bowl of oatmeal. I feed Gracie her rice cereal, and make sure Beau is hitting his mouth with the spoon more then the other parts of his face. And occasionally I'll steal a bite myself. We all finish eating, and Beau is already begging to get down and play. So I rush to the kitchen to get a clean rag, and do my best attempt at cleaning the oatmeal out of various spots on his clothes and skin. He passes the dad test and now he's off to the living room to play for a few seconds. By now its 8am and Rhonda and Shea are leaving for the hospital for the day. Luckily, we'll see them back at tea time. I finish getting Gracie cleaned up. She really wants to be held right now, but I have to put her in a spot that is safe and she will half-way enjoy as try and get Beau cleaned, changed and dressed for the day. From here I'm just going to give a little timed play by play with a little side commentary as needed:

8:15 Beau sits on the toilet (his first day in big boys....he's pretty excited we'll see how long it lasts!!)

8:20 Entertain the kids while cleaning up the bedroom (Not as easy as it sounds)

8:30 Beau is back to the toilet (he actually told me he had to go...that's a first!...he goes and get the M&M (a great reward)

8:40 We all wrestle on the bed (Gracie and I versus Beau....we always win!)

8:50 Gracie goes down for a nap (not without a fight though...she is really screaming)

9:00 Beau is on the toilet again (Are you noticing a recurring theme here!)

9:05 We've got power back on ( this has been a long week without much power, so seeing the fans spin is a welcome surprise)

9:08 I go to put the eggs on the stove for tea time( Tea time is usually from 10-1030, and we have all become accustom to hard boiled eggs at tea (its quick and its a great source of protein that the kids like)

9:10 I go outside to play with Beau and also do some Physical therapy with him (oh and by the way Gracie finally stops crying) We catch lizards, bug, and various insects. Also climb some stairs to strengthen his right leg

9:25 Beau and I run to the hospital to check on Shea and Rhonda's rounds (He likes seeing his mama at work)

9:30 More PT with Beau (we climb some stairs and hang from bars at the play ground.....yes there actually is a playground here, not with US standard regulations, but still there is some stuff to play on)

9:40 Went back inside to check on Gracie (still sleeping), and put on some hot water for tea

9:45 Beau is back on the toilet....the big boys are still dry and he gets 2 M&M's for this one( 1 for being dry and one for going......I know to much detail)

9:45 Gracie starts crying again...I give her a second and she is back to sleep(thank-goodness!)

10:00 Beau and I are back outside catching some more bugs before Shea and Rhonda come home for tea

10:10 Gracie wakes up again...this time for good

10:15 Shea is back so we have some tea, eggs, and peanut butter and bread (Beau loves the egg whites, but can't stand the yolk) This is definitely one of may favorite Zimbabwean traditions.

10:30 I get called from the hospital to put in an Intraosseous line for a man that is very dehydrated. I gladly take a small break from the kids, and go with Paul to the hospital to put in the line. We have a nice drill for these IO lines...it works pretty slick (anyway enough medicine...back to the kids)

10:50 Shea finds Beau is wet while he is sitting in his chair eating( We made it almost 3 hours...not bad for a first time in the “big boys”)

11:00 Shea and Rhonda leave back for work

11:05 I finish feeding Beau and while feeding Gracie he tells me he has to “poop” I pick him up to run to the toilet, and he says “poop in the pants”........man, we were so close....that was kind of a mess to change

11:10 So I guess were back to the cloth diaper diaper...so I changed Beau into the cloth diaper for now (Gracie is crying now(squeaky wheel always gets the grease)

11:20 I change Gracie

11:25 Played with Beau and Gracie on the floor for a while

11:45 Read them both several books (At this time April is warming up some left-overs for our 1pm lunch...thank-goodness for leftovers) April does a great job organizing our meals for the day. My job usually consists of peeling fruits and veggies, cleaning dishes and putting together some of the simpler side dishes. I'm definitely the least skilled cook in the house (even Paul is quite skilled in the kitchen). But I am learning a lot, and occasionally get to throw together a little something myself. Its been a good learning experience for me.

11:55 Took Beau to the toilet....again (another M&M is earned)

12:00 Put Beau down for a nap

12:10 Time for 1 on 1 with Gracie (as I said earlier with her big brother always around, she rarely gets much 1 on 1 attention. So I enjoy getting the chance just to play with her even if it is for a short while. She starts getting fussy pretty soon....She's tired and needs her nap!

12:30 Changed Gracie's diaper

12:35 Gracie goes down for a nap (but once again she's not happy about it and is letting out quite a scream

12:55 Gracie finally stops crying

13:15 Everyone's home for lunch

13:20 Beau wakes up

13:30 I feed Beau some of our left-over delight (he kind of picks at, not to hungry right now)

13:45 Gracie wakes up

13:50 I get cereal ready for Gracie to start eating

14:15 After meals are finished and diapers are changed/bathroom breaks taken(another M&M earned by the way)The three of us head to the shops for a nice afternoon outing. This is always a nice break in the day for me. I put Gracie in Paul and Aprils Stroller, and put Beau on my neck and we walked quite conspicuously to the shops. Its quite an interesting strip of tiny rundown buildings. There are often a few shady people walking around, with women pumping water out of a well, and barnyard animals roaming free. A white guy with 2 kids sticks out like a neon sign. I have gotten used to it, and for me its just a good chance to get out of the house, and pick up some stuff we need as well as whatever “junk food” I can find. Beau always enjoys seeing the people and all the animals that wander around down there. We got a few things, and headed back to the guest house.

15:00 We return from the shops

15:15 A visitor from the Netherlands arrives. She brought several hydrocephalus kids to be looked at, but is confused about where she is supposed to be staying. So April and I tried to sort out those issues while the kids were beginning to melt down, and dinner was in the midst of preparation

15:30 Change both kids diapers

15:45 Help with dinner preparation (stir fry tonight)

16:20 I take the kids outside to keep them distracted and avoid any big 4:00 pm meltdown. My sister Mary Beth coined 4pm as the “witching hour” with the little ones, and I've found that the phrase is very accurate. Gracie doesn't want to be put down anymore. So trying to play with Beau while holding Gracie is always challenging. And Beau always gets a little more needy at this time as well. He's also a little more rough with Abbi at this time...so I really have to watch him close. That's why I usually just go outside so the temptation to tackle her is not as strong.

17:00 Start feeding the kids as they begin there meltdown (Shea is not home yet....I think it was a busy day at the theater)

17:15 Gracie has a nice surprise for me....so I take her to change her diaper

17:30 Beau is still eating well, Gracie on the other hand is melting down. She doesn't want this cereal anymore. She just wants some breast milk.

18:00 Shea comes home and I can gladly pass off Gracie and finish getting Beau fed and ready for bed

18:20 For the next 30-40 minutes I go through Beau's bedtime routine which consists of chasing him around the house, brushing his teeth, chasing him around the house, changing his diaper, chasing him around the house(OK so you get the point), getting his “night night” shirt on, doing some stretching, reading a couple of books, and saying our prayers. He always calls me back in to let me know a few things I forget, but now at 19:10 he's in bed, Shea has Gracie in bed, and at least for now we have some peace and quiet. Another wonderful, yet exhausting day! Not a lot of “me” time today. But as I've found stay at home parenting is a full time job, with something always going on. My hats off to mom's and dad's everywhere that make it look easy. Hope you enjoyed looking into the life of a stay at home dad on the mission field!

Zimbabwe Vacation #7&8

Day 7

We were awaken early this morning April 21st by a screaming Gracie! I was still half asleep, and frustrated at the prospect of being up at 1am with a crying baby. I quickly went to hand her to Shea so she could began what I hoped would be a soothing feed that would put her right back to sleep. Right as I was about to hand her to Shea I looked down and her face was covered with at least a dozen ants. I felt horrible! Our poor little 7 month old was being eaten in her sleep by those pesky little ants. I quickly brushed her off, and we changed her clothes. I went to her bed and found a nice trail of ants going into her bed and making a circle around her crib mattress. We killed and cleaned out many ants from her crib and repositioned the crib in our own mosquito net hoping this would discourage any future “attacks”. We tucked her back in bed for the rest of our short night.

We awoke early for the morning as we had a long drive ahead. We quickly packed everything in the van, and hit the road for our long 8 hour journey back to Antelope Park. It was a long, but fairly uneventful drive. Gracie serenaded our van with her screams for at least the first 2-3 hours of the trip. She eventually calmed down, and with the help of some PB&J and some brother bear Beau traveled well almost the whole ride. We have really been lucky to have 3 very good young travelers on our journey across Zimbabwe.

I did have some time in our long drive today to read a bit of CS Lewis's book “Weight of Glory, which is a compilation of essays and some talks that he gave over the span of several years. There was a quote that I found quite profound. It says “We are half-hearted creatures, fooling about with drink and sex and ambition when infinite joy is offered us, like an ignorant child who wants to go on making mud pies in a slum because he cannot imagine what is meant by the offer of a holiday at the sea. We are far to easily pleased.” I thought this was a very practical quote. I know too often I dabble around in the shallow end of the pool, as it pertains to the depth of my spiritual walk. Its much easier to give God just enough, rather then everything. By doing this I have come to realize we only experience a fraction of the joy God intended. (And I don't mean physical health and wealth here!) The spiritual and eternal Joy is absolutely endless and unbelievable if we can just give God all of us! I'm tired of being satisfied with just the scraps from our Lords table, when he intends for me to feast on His limitless banquet.

Anyway, just one of many powerful and thought provoking quotes from CS Lewis.(Although I will admit trying to digest Lewis's words in a hot, bumpy car with noisy kids is the easiest of tasks!)

Well, We pulled into Antelope at half past two, and enjoyed some beautiful scenery, cold beverages and a dip in the nice pool. It was great to end our trip here at Antelope. The scenery was gorgeous the river tents were elegant, and the food was perfect (especially the Gnu steak we had for dinner). We really enjoyed the wonderful sunset from the deck of our river tent. What a great trip this has been!Tonight we can “sleep in”(not sure what that means with the kiddos, but we'll try!), and we'll hit the road late morning for the last 4 hours of our trip into Harare. I can't believe our trip is already drawing to an end.

Day 8

Well today, April 22nd we left Antelope Park and headed back to Harare. We enjoyed another great breakfast at Antelope and a nice morning walk before loading the car up, and piling all the kids back in for one last drive. The end of our trip came way to fast. The drive today to Harare was only 4 hours, and all the kids did great. We ate some chips and cookies in the car to keep everyone at peace since we drove through lunch. We arrived safely at Harare around 2pm. Fortunately for all of us there are no dramatic or exciting stories to tell about today. We finished the day by doing some grocery shopping as we prepare for our last month at Karanda, and had a great dinner at the Everswicks house. Tomorrow we pick up Shea's mom Rhonda at the airport, and our excited to have her with us for our last month at Karanda. Then on Saturday we'll head back into the bush for 1 more month. Thanks for following along on our little Zimbabwe vacation. I'm sure we'll have some more good stories in our last month at Karanda, and we'll be sure to pass them along.

Zimbabwe Vacation #6 (Victoria Falls here we come!)

Day 6

This morning April 20th we woke up to a beautiful view on the our 2nd floor loft. As I mentioned earlier with the large open window, and trees all around, it almost feels like living in a tree house. We did realize the one downside to having a window that wouldn't close properly was an infestation of small critters. I went to put my shirt and shorts on that had been casually thrown across a chair by the window and felt a multitude of small pinches. I looked down and my clothes were covered in dozens and dozens of tiny, little ants. I quickly took them off, and threw them and the rest of our covered clothes out the window to attempt to rid the loft all the ants. Fortunately they spared Beau and his bed which were adjacent to all the clothes.

The rest of the morning was un-eventful, but wonderful. We had been traveling pretty hard all week, so it was nice to just sit by the pool and relax a bit with the kids. The pool was a gorgeous, and had a 3 layer design with waterfalls and stones creatively placed all around. We were also excited to see a large trampoline close to the pool. Shea showed Beau and I some of her old trampoline moves, and Beau enjoyed being bounced up and down as well. After our morning of relaxing we headed to our final destination.......The Victoria Falls. We were all pumped since this was really the moment we had been waiting for. Neither of us really new what to expect, but I can tell you that what we saw greatly surpassed any expectations that any of us had. I can honestly say that I have never seen anything more powerful in all my life then “The Falls”. Amazing, spectacular, unbelievable, sensational.........none of these adjectives really do it justice. There just isn't enough adjectives in the dictionary to adequately describe it. The moment I looked across and saw the power of “The Falls” I felt so small, yet so blessed to be in the presence of such a Mighty God who actually wanted to have a relationship with me. It brought me nearly to tears, and I was just thankful to have the opportunity to see such a magnificent site. It was a very spiritual experience for me and really for all of us. We all feel honored to get a chance to serve the Creator of this spectacular universe, and being in his obvious presence gave us all a great deal of momentum heading into our last month.

So after I picked my jaw off the ground, and thanked God for allowing me to be here we began our 2 kilometer hike around the falls. The rainy season has just come to an end so “The Falls” were bigger and faster then usual. This also meant reverse precipitation was at an all-season high. Reverse precipitation is just when you have so much water falling a large amount will essentially ricochet back up. As you can imagine this gets you, the viewer, soaked from all angles. Before the hike we had decided we were just going to get wet, and thought we would forgo the ponchos. But I don't think any of us had any idea of how wet we actually got. It was amazing. The trail goes in an arc around the falls, but every 20-40 feet there are overlooks that give you the best views. This is also where you get the most soaked. When you stand at the edge of these lookouts you just get pounded with water from all directions. It hits you in gusts, and it is an absolutely amazing experience. Beau, Paul, Stephen, and I loved to get right up to the edge and feel the full blast of the water. It was great seeing Beau with “the guys” in our group. As the girls hung back just a bit. Beau was always ready to go charging into where the action was. We all just had an amazing experience and our so glad we pushed through with the trip to get here. All the driving, sleepless night, and crying kids were well worth the chance to see Victoria Falls, and experience our Creator at a whole new level.

After we dried off and got back in the car we had to race to make it to our next scheduled event of the day. We left the park at 4:15, and were actually supposed to meet the people to pick us up for our Vic Falls sunset cruise at 4:15. Somehow we managed to dry everyone off, change clothes, diapers, and get the diaper bags reloaded just in time before our cruise took off.(Thank goodness for African time) The cruise was a lot of fun. It was just great to be on the water. We saw several Hippos, and stayed up stream from the falls. At one point the captain said if you go any farther forward the current is to strong, and we'd be in trouble. He reiterated that only jet boats are strong enough to go any closer to the falls without getting sucked over to the edge.(You didn't have to tell us twice). At one point Paul joked about how often those great big hippos get too far down stream. They may be powerful, but definitely no stronger then jet boats. I think we both got a good chuckle with that morbidly funny picture of seeing a big hippo getting sucked over the falls(what a site that would be).

After the cruise we headed back to the lodge for another marvelous feast that Stephen had prepared. The trip was now coming to an end. We got the kids to be as early as we could, knowing that we had a 8-9 hour drive ahead of us tomorrow. We head back to antelope park tomorrow for one more nights on the river tent, then back to Harare the next for the trips conclusion. We just pray for safety tonight with 2 days of driving ahead.

Zimbabwe Vacation #5

Day 5

This morning April 19th, at Miombo lodge we were woken up bright and early as usual by Gracie. She's quite the morning girl, usually by 6am she is up and ready for the day. Its amazing how God changes your mindset and perspective as life brings changes. Several years ago I couldn't imagine getting up at 6am on vacation. If I had to I would be quite irritable, and a little unpleasant to be around for at least a couple of hours. Now, even as we laid in our small thatched roof cottage we both enjoyed being up before sunrise. And as Beau awoke and decided to join us just before 7am it was wonderful just to lay there and see the 2 of them interact as they each took turns making the other laugh. Shea and I can't think of much else we'd would rather do then lay in bed and play with the kids, tell stories, and watch them laugh. I guess the old saying is quite true: “The best things in life our free”.

After enjoying a nice breakfast of eggs, sausage, tomatoes, beans and toast, we had a nice leisurely time by the pool. Beau loves to swim, but over the last couple of months he has started to realize why we adults don't love cold water. He used to love sitting in cold baths and showers, but has recently decided that being cold isn't as much fun as he once thought. But after some coaxing he gladly jumped in and enjoyed being thrown in the air as usual.

After swimming we had wonderful sandwiches for lunch, and jumped in our van and headed to Victoria Falls. Beau and Abbi did great on the drive, but Gracie is really starting to turn into a bad passenger. I think we have finally realized that she has spent so little time in a car seat over the last 4 months, that now she won't tolerated being strapped in for more then an hour. Poor Shea was trying everything, but finally the one thing that gave her some peace was a partially chewed ginger snap cookie (we have great pictures). Gracie loved them and finally calmed down....to the thrill of the rest of the vehicle. After our short 2 hour drive we made it to Victoria falls city, and to our lovely Lokuthula lodge. Its funny every time we arrive in a new place Beau rather loudly exclaims “We're home!”. I can't imagine what life must be like for the 2 toddlers, as they have lived in so many places over the last 1 year. I think wherever we lay our head for the night is home to them. So we're all just glad that they have been such excellent travelers.

Anyway, we made it just in time for check in and were greeting by several odd guests. We found about 10 wart hogs grazing right outside are door, as well as tons of little monkeys swings in trees right out back. The lodge we stayed at was huge. It was a very unique 2 story structure that was completely covered with a thatched roof. The back of the lodge was covered in canvas and the whole rear wall could be completely unzipped so you could see all the wildlife walking around behind us. Paul and April are always gracious enough to give us first choice on the room, since we have an extra crib to fit next to us. So we were lucky enough to get the top loft which also had a large canvas window that also opened up for an excellent view of all the wildlife and trees. It feels very much like staying in a tree house.

As I mentioned earlier when we first arrived there were wart hogs all around our lodge. We all spent a lot of time watching them eat, and interacting with one another, and came to the conclusion that they were quite docile animals. Well initial assumptions about wildlife are often slightly misguided as we found out. Shortly after our arrival Beau and I were walking by a group of trees watching all the monkeys swing from branch to branch with a nice sized family of wart hogs munching on grass near us. By then we had become quite used to having them close by, so I was much less vigilant about watching there every move. I'm not quite sure what happened, but Beau must have made eye contact that they didn't appreciate. In a blink of an eye I heard a large squealing sort of grunt and the male of the group made a quick charge at Beau. Fortunately I was right there so I quickly swept him into my arms, and any serious injury was avoided. So the moral of the story is never trust wildlife and don't tick off wart hogs.

The rest of the day we just relaxed in our nice lodge, and that evening we had a once in a lifetime experience at the Boma. The Boma is a world famous wild game restaurant that just happened to be 2 blocks from our lodge. The food and atmosphere were amazing! We ate animals ranging from eland, ostrich, impala, kudu, wart hog and even crocodile. The wart hog was by far the tastiest meat, and Beau and I made sure we ate a little extra to symbolically teach our little friends a lesson for there attack earlier. During the meal we had African dancers, face painters and drummers. We had a fantastic array of deserts (I think I tried at least 7-8 different kinds). The finale of the night occurred when the drummers actually gave us a little drum and dance lesson. Beau especially loved the drums and hes actually got some pretty good rhythm for a 2 year old. Beau and I were also were one of several called to the front to attempt a little African dance for everyone's viewing pleasure (I think everyone enjoyed watching his facial expressions more then my rhythm-less moves). Overall it was a great day and wonderful evening, and I look forward to melting into my bed with a nice full belly.

Zimbabwe Vacation #4

Day 4

Well today April 18th, we hit the road again! We left Antelope park around 7am this morning, and headed to Hwange national park. Our stay the last 2 days had been wonderful. So wonderful in fact, that we actually considering staying in Antelope Park the next 4 days, and forgoing the hundreds of kilometers of driving that is awaiting us on our eventual arrival at our final destination of Victoria Falls. Our desire to see one of the 7 wonders of the world won out and we decided to press on. The drive today was quite long...about 6-7 hours. We all did pretty well, although Gracie had quite a melt down at one point. The nice thing about no seat belt laws here, is you can just take your kid out of their seat at anytime for feedings. Although Shea naturally would prefer to leave her in the confines of her safety seat, her good judgment was finally worn down by the screams. Gracie got a nice meal, and sat in “Mommas” lap for a while, much to the appreciation of the rest of the vehicle.  

We arrived at Miombo lodge shortly after 1pm. It was nestled right in the middle of the largest game park in Zimbabwe.......Hwange National Park. The lodge here was much more “wild”. It was quite secluded, and no lush green river beds any where to be seen. Its rugged beauty, and feel of untamed wilderness with the possibility of seeing wild game at any time was quite appealing.(Paul and Abbi actually "stumbled" onto a large elephant during one of their walks). Our accommodations were a bit smaller, but also beautiful in there own way. They were small lodges (probably about half the size of an average US bedroom), with shower and toilet partially connected by a common thatched roof, and several smaller thatched walls(by all practical purposes outside). These lodges gave us a feeling of an actual Shona house, and I think we appreciated the difficulties of squeezing in 2 cribs next to our bed, and finding small “nooks and crannies” to place our bags and things. Overall we really enjoyed the location and accommodations of Miombo lodge.

Later in the afternoon we were taken on a game drive right in the middle of Hwange. It was a wonderful night as we all spread across 3 rows of ascending benches precariously strapped on top of a small truck. It was excellent for viewing game. We saw a great variety of animals including: Elephants, Giraffes, Zebra, Hippos, and Crocodiles just to name a few. The best find of the night was a large herd of Elephants, probably 40-50 in number that walked right next to the dirt road as we slowly drove by. It was amazing site to see, and according to the locals was quite unusual to see such a large herd in that particular area. The only animal we didn't see were the lion, but fortunately Shea and I had plenty of close encounters with the lions the night before. We drove back after dark going about 20-40 km/hr on the back of the truck. We were all bundled together enjoying the nice crisp cool evening. It felt much like flying across a lake in a boat after dark, and I think we all enjoyed the sensation of being cold, since it has been so long since our skin receptors had perceived such a sensation.

Tonight ended with a fabulous meal prepared for us by our young guide. He prepared steamed broccoli, pasta, sausage meatballs, and a tremendous mushroom white sauce that filled our hungry stomachs. We continue to be amazed by the talents, and maturity of our young guide as he leads us on this trip across Zimbabwe. Praise the Lord for another safe and wonderful day!

Zimbabwe Vacation #3

Day 3

Today, April 17th was another great day. We woke up early as we usually do with Gracie. But is was great to be in a nice cool tent with sounds of nature all around us. We took our time this morning as we decided not to plan any activities until after our wonderful 8:30am breakfast. Before breakfast we explored the beautiful scenery, and watched as scores of birds and mist gently lifted off the top of the river. Here at Antelope Park there is a long list of activities to choose from. Anything from a safari drive, carriage rides, walking with lions, riding elephants, feeding lions, and so on and so forth. Unfortunately, with our kids being so small there were only several things that they were aloud to do, or that they would enjoy. The one thing that we all agreed the kids would love was the carriage ride through the bush. So after breakfast our group decided to do a horse drawn carriage ride through the game park. The carriage ride was great. Beau and Abbi just loved being pulled by horses, not to mention all the big game animals that we were able to see. We saw one herd of giraffes (at least 5-10) that walked right in front of our carriage. This was tremendously exciting for me, but you can imagine the look on Abbi and Beau's face as the giant beasts crossed our path. In the middle of the 2 hour carriage ride we stopped for snacks at an unusually large tree where a large tree house awaited us. Paul and I took turns carrying Beau and Abbi up the multitude of precariously placed, yet sturdy tree steps for an excellent view of the vast African wilderness. We thoroughly enjoyed our carriage adventure, and had another great meal waiting for us afterward.

Probably the highlight of our short trip so far, has been Shea and I's lion walk. Today we were fortunate to have two of our friends from Karanda, Anna and Nicci meet us for part of our trip. Thankfully for us, they graciously asked the 4 of us if they could watch our kids why we enjoyed one of the more adult adventures here at the park. Shea and I always hate being away from the kids(Oh...who am I kidding...any chance for a small break and trustworthy babysitting is always a welcome chance to spend some time together). So we quickly and gladly accepted and decided that we would partake in Antelope Parks famous “lion walk”. According to the park they were the first safari outfit to ever provide such and opportunity with the un-tamable “king of the jungle”, and still one of the few places in the world where you can actually walk with lions. We've heard wonderful things about this experience, and I immediately jumped at the chance. Shea took a little more coaxing(I wonder why....she has actually taken car of 2 lion attack victims in the hospital both of which were supposedly pet lions), but eventually she agreed.....so we signed up. The walk was an amazing experience. Antelope Park has one of Africa's largest lion conservation programs. The steps of the program our actually quite involved, and I don't want to bore you with the details. But the goal is simple. They want young lions to grow up self sufficient to where they can eventually be released into the wild and survive on there own. The lion walk usually takes place with lions between the ages of 15 to 18 months. The primary purpose is for the guides to see how these younger lions react to other animals and situations in the wild, and to see if they are ready to progress in the program. Today we were with 3 lions. Two males and one female. They were probably 75% of the size of a full grown lion, but still very intimidating creatures. And as we learned lions can never be tamed. No matter how used to humans they are, they can turn on people within seconds for no apparent reason. Supposedly the owner learned that lesson the hard way, when one of his female lions attacked him and took his arm.(a fine thank-you for giving the lion such a nice habitat). So needless to say, we were excited but cautious about the whole experience. The walk started at the edge of the bush where these 3 lions awaited us in a large cage. They were released from the cage right in front of us, and the walk began. We had 3 guides and one other couple with us. The lions were in charge of were we went, we were just lucky to be so close, and able to watch there every move. They started the walk by spotting several zebra about ¼ of a mile away. They all 3 worked together to stalk there potential pray as we walked anxiously right behind them. Unfortunately for us, the zebras caught wind of the situation and quickly retreated, but it was still awesome watching them as they worked together to try and take down some food. We also watched them play, climb trees, and roll around in front of us. We have some great pictures to prove it. The walk lasted about 1-2 hours, and was and great experience. Even by the end Shea kind of warmed up to the idea of the lions. Although she has one encounter when one of the male lions approached her and made strong eye contact (they call it the lions “natty eyes”). So she quickly slammed her stick(as we were told to do), and said “no” and the lion slowly turned and went the other direction. The goal is to always make them feel like you are the dominant animal whenever they get closed to acting up (like my little wife is really dominant over a 200-300 lb male lion). But thankfully it worked very well. The trainers did a great job, and I don't think we had any other “near death” experiences. Overall it was a wonderful time, and something Shea nor I will ever forget. The rest of the night was great. We had another wonderful dinner, got the kids to bed, and crashed ourselves slowly thereafter. Praise God for another great Day!

Zimbabwe Vacation #2

Day 2

Today, April 16th we were met by our long haired, younger then expected white African tour guide at 7:45 am. (He was actually only 20 years old, but very capable and experienced for his age). His name is Stephen. He came with a nice big van, so there was plenty of room for all of our stuff, especially since we had already packed so light. Also there was seat belts in the middle seats, so we could actually use are car seats the conventional way and not just for a high chair at mealtime. Our guide was charged with taking our 2 families hundreds of miles(1950 kilometers round trip to be exact) through Zimbabwe, guiding us through various game parks, cooking and cleaning most of our meals, and handling police roadblocks, and any vehicle malfunctions that could occur. Seemed like a huge challenge for most, especially at 20. Fortunately, he had already guided many mission trips into the majority of countries in Africa. So he was very experienced. Both of his parents passed away by the time he was 9. So he and his sister who was 9 older became quite self-sufficient at very young ages. Needless to say, he seemed to be up for the task, and we were all just excited for a change of scenery and a chance to “hit the open road”. Today we only had to drive 4 hours from Harare to Antelope Park.

The drive went rather smooth....thankfully. The kids did well, aside from a few small outbursts. But nothing that Elmo and Brother Bear and a laptop with a DVD player couldn't fix (Not to mention some nice “biscuits” or as I like to call them cookies).

We arrived at our 1st destination shortly after lunch was served.......and what a feast it was! The view was phenomenal as we had green manicured grass all around, that crawled right up to the edge of lush river, teaming with wildlife. It was the paradise we had hoped for, and we were all thrilled. We stayed in river tents. They were actually large canvas structures with an enclosed brick bathroom attached, overlooking a small marsh that was adjacent to the river. We each had large balconies that overlooked the water, and was perfect for viewing birds, fish, and other wildlife that wondered around behind us. It is really very luxurious, and peaceful. A wonderful place for all of us to recharge our batteries.

All the meals here are provided by the cooks here at Antelope Park. The meals today were simply amazing! We had a large selection of meats and sides with cool crisp ice cream for desert. The best part of the meal was that we were not responsible for any dishes. Paul and I joked about the dishes as we went back for seconds and thirds and casually left our used plates behind. Overall it was a wonderful 2nd day. We praise God that we made it safely, and are already enjoying the rest!

Zimbabwe Vacation

We just made it back to Harare from our weeklong excursion through Zimbabwe. Were all doing well.  I've tried to keep a daily journal of all our notable experiences. I decided to just send out one of the entries every day for each of the 7 days of traveling that we had. Hopefully you find it interesting.......if not than stop reading:):)! Alright, well enjoy.

Day 1

Let the adventure begin! Today, April 15th we set out on the first leg of our trip. We began by driving ourselves from Karanda to Harare. I think we are very excited to have a break from the bush. We have been in Karanda 6 weeks straight, and are anxious to get in a car and head to an actual city. We are traveling with a group called ACTS. They are a group that specializes in leading short term mission trips into remote places in Africa, and they also plan and lead vacations for long and short term missionaries. We were informed by them that we should pack light, probably backpacks and small bags, so as to fit everything in the vehicle for the long trip. Its a tall task to pack “light” when you have 2 kids and your traveling through Africa for 7 days. We did our best to comply, and we'll just have to see how this “backpacking trip” really goes.

We didn't get far from Karanda when our first obstacle presented itself. You see, there are 2 ways to get from Karanda to the paved road that will take us to Harare. One way is 25 Km of bumpy, rocky, winding roads that takes adds about 40-45 minutes to the trip. The other-way just recently became a possibility as the river waters are just beginning to recede (200-300 feet wide at the crossing point, and probably mid thigh to waist deep at some points). This way is only 4-5 Km on dirt road and is a straight shot to the highway. Now we are driving a Land Rover with 4 wheel-drive....so that is to our advantage. We also just talked to several missionaries who recently braved the waters. Two of them said it was difficult, but thought we could make it, the other said she made it but she would not advise trying to cross it at this time. So naturally, that's 2 to 1 in favor of giving it a shot. So......as we approached the river we could see that it was quite high. There were Shona people walking across, but the water was above their knees, probably close to there waist in some areas. I turned to everyone for one last bit of encouragement, made sure the kids were all buckled in, said a quick prayer.........oh yeah and made sure Paul got his video camera out(sink or swim we had to make sure we got this on camera). Then......I decided to go for it. I had two people in the front seat with me. I had Dr Smith (a visiting neurologist from the US), and Shea both eagerly awaiting and pondering every move. It was nice having 2 opinions as I began my plunge into the waters, but unfortunately they both shouted opposite commands as I began driving in the water. Shea shouted “faster”, Dr Smith shouted “slow down”, and April and Paul (in the very back) were shouting other commands as well. As we approached the deepest area of the river I could see that water was approaching the hood of the truck. I could also see that we were making quite a wake (and for a brief second thought: “this could be fun to ski behind.....then I went back to reality), the tires were covered with water, and I knew we were very close to stalling out. I really started to doubt why we were doing this, and wished we had just taken the extra 45 minutes of driving. Unfortunately the middle of the river was no place to turn around. I kept driving, as I continued to get conflicting orders from my 4 backseat drivers: “More the the left!”, “no more to the right!”, “stay in the middle!” “Were not going to make it!!!” But thankfully, after a bit of stress, some shouting, and a few prayers.......we made it to the other side. It was a great feeling! We got through the first major obstacle of the trip, and shaved 45 minutes off the trip as well (always nice with 3 kids in the back).

We made it to Harare with no other issues. We enjoyed a nice big pizza dinner, as we always do in town. Paul and April went to the store and loaded us up with some excellent drinks and snacks for the road. We bunked down for the night, and awaited pick-up from our ACTS tour guide in the morning. I'm sure more good stories are sure to follow!

A Day at the OPD!

Well I hope this doesn't bore everyone to tears, but I decided to write a blog about a typical busy day at the OPD(outpatient department) here at Karanda Hospital(by the way it was April 12). If nothing else its just a good way for me to look back and see what kind of things we see on a usual OPD day. This will probably be more interesting to those of you in medicine or just those of you who find medicine interesting. To the rest of you read on at your own risk. I'll be just listing the majority of the patients I saw, but for your reading pleasure I might just throw in some interesting side commentary.


Anyway, as always the day starts out for Shea, Paul and I rounding on the wards. This month Shea and I have been in the Female Ward. Female ward is generally the busiest. Usually we have anywhere from 25-30 patients that need to be seen. Luckily for me on this particular day we only had 18 patients....so as you can imagine it made rounds quite a bit faster. On this day the female ward had 9 post-operative patients(ranging from hysterectomies(5), ovarian tumor removal, scalp tumor removal, thyroidectomy, and vesico-vaginal fistula repair). We had 9 other patients with diagnosis's ranging from: HIV, TB, pneumonia, vaginal bleeding with severe anemia, heart failure, and intractable Headache. After rounds is when the fun began!

Now to give you some background OPD is not just a normal outpatient clinic. We don't have an ER here at Karanda so from 9-5 everyone goes straight to the OPD....so there is always an interesting mix of the worried well, and critically ill. Basically, the clinic takes place in a fairly small room surrounded by benches. We are all quite packed together in a poorly circulated, warm room. I will sit at a table with a translator next to me, and a long line of people sit crowed around us on benches waiting for there turn to be seen(Its actually a bit unnerving because they just sit and stare why you talk to and examine the other patients). The nurses triage the patients and actually 25-40% of the patients are actually seen by nurses. Its the lucky ones who actually get to see a doctor (Well I guess that depends which doctor it is :)) Many of these people live within a 5-10 KM area, but the majority live quite far away, and many had to get up as early as 4 am to wait to be seen.

On this particular day I saw 68 patients (which is probably quite typical). Now to put this into perspective most family medicine clinics see about 20-30 patients a day(and this doesn't account for all the other patients that the nurses saw). So its quite different than what we are used to back home, and I can tell you I'm learning a lot. OK,OK,OK, now for the list you have all been waiting for. Many of them are fairly routine things, but many were quite interesting. I will just list them in the chronological order I saw them.

I saw crytococcal meningitis(brain infection in HIV patient), drug reaction to HIV medicine(quite common since the HIV meds have many side effects), HIV wasting syndrome(this is usually the last stage before death for these patients), olecranon fracture(fracture of the elbow), foot fracture, fracture of the tibia/fibula(the fracture was a bit old and probably difficult to fix), ascaris infection in a toddler (worms that crawl around your bowels.....think about that tonight when you eat some pasta), Tertiary syphilis,( This was actually quite interesting. This man came in with paralysis from the waste down for 5 days. He had large painless ulcer on his privates (gotta put that for the kids).....usually diagnostic for syphilis. Of course he was HIV positive..so this always complicates everything.....I started him on antibiotics, and when our X-ray machine is working again we'll take a picture of his spine, but for now we'll see how he does), Conjunctivitis (infection of the eye), Kaposi Sarcoma (tumor caused by HIV), Benign prostatic hypertrophy (we see a lot of these around here, since we are one of the only hospitals in the country that removes prostates), new diagnosis of tuberculosis, tension headache, hypertension/backache (fairly typical US stuff), radial/ulnar fracture in a kid, hydrocephalus, osteoarthritis in both knees in an older lady, large ear keloid (enlarged scar), otitis media, tuberculosis, pneumonia in pregnant lady, child with multiple skin abscesses (probably HIV positive), heart failure, abscess of left foot, hepatitis, DVT (blood clot in your leg) , tuberculosis, pneumonia (this was a very sick older man), HIV diarrhea, gastroenteritis, conjunctivitis, impetigo (skin infection in a child), a mother that couldn't lactate, phimosis (a good reason circumcised), 3rd trimester pregnancy with complications, ruptured otitis media, CVA(stroke), malunion of radius and ulnar fracture( 3 month old fracture that wasn't set properly).................OK, OK I'll take a break and put a period. Next I saw post herpatic neuralgia (bad headache and someone who has had a herpes infection), malnutrition, tuberculosis(there seems to be a bit of a TB pattern here), cellulitis(another type of skin infection), conjunctivitis vs glaucoma(sent that one to theater for a proper eye exam), DVT, large lipoma (benign fatty tumor), TB (x2 more), infected VP shunt(shunt for kids with hydrocephalus), pregnancy with poor dating, fungal infection of the scalp, severe eczema, parotid gland abscess, femur fracture, urinary tract infection, pneumonia, atopic dermatitis (allergic rash), cataracts in both eyes (one is totally blind so to late for surgery), hemorrhoids, severe ascites (lots of fluid in the abdomen that shouldn't be there probably from liver failure or heart failure), osteomyelitis of the tibia(infection in the bone), severe vaginal bleeding(had a hemoglobin of 3(should be 12-14 in a normal women), hematuria x 2 years(probably bladder cancer), miscarriage, prostatitis, sinusitis with large reactive lympadenitis(large swollen lymph nodes), tuberculosis(what kind of day would it be without at least one more TB patient...this was on death's doorstep by the way), severe heart failure, and to finish it off one large fibroid uterus (a uterus with large benign tumors).

So that was a mouthful! I think my fingers are beginning to cramp a bit. It was a long, but very fun day for me. I would still prefer to be in the operating room, but the OPD has really grown on me over the last couple of months. I hope you enjoyed the tour through a day at the OPD here at Karanda Hospital. Many, many interesting patients for one day, and there is always more where that came from. I'll be back there to do it again tomorrow.