Today was the day of our lady patient with the cancer of her tongue to have her surgery.
Early this morning Richard and I made a nice walk around the palace compound near our house. It is a good loop but part of the walk is new construction of the brick path, wall repairs, and street work. We found they had done new black top yesterday and the brick walk is nearly finished.
All over Kathmandu are these seemingly feral dogs who feed on what they can find in the street. Many are maimed, some have collars, and most seem either to be intact males or pregnant females. They are territorial to each other, but very friendly to humans. Most of them look like dingos, a kind of average mix of dog breeds. This one had a very cute wookie face but got spooked and began to bark when I pointed my camera at him.
All along the walk we see not only piles of rubble and signs of the recent devastation, but also very organized efforts to sweep, pick up, and clean up. This tidy row of reused sandbags were filled with shards of glass and debris, probably left for pick-up by the road.
Some parts of the palace are taped off to avoid pedestrian traffic next to the crumbling walls. In some places the paint is intact and they still seem standing, but a gentle push shows some movement to the bricks inside the paint layers.
Even some of the road, once laced with nice brick patterns, are roughed up.
Shankar picked us all up after breakfast and we went to the Ministry of Health to register Tom, our new surgeon, and then to the trauma hospital to see our patient for the day. Saturday is the day of rest, the other 6 - including Sunday - are for work.
On arrival to the hospital, the military hospital next door was being razed by a large bulldozer.
We entered the new hospital via the emergency room, which was a room about 75 feet square filled with registering patients, patients on guerneys, and a central desk. It was a large and busy place.
We made our way up to the 2nd floor, changed into our scrubs, and were led by some of the local MDs into the operating room. It was full of people, including the anesthesiologist and his four assistants, who eventually put the patient to sleep. The surgeons were all discussing various plans and flaps for this patient. She has a very large tumor on the side of her tongue that will require removal of 1/2 of her tongue and maybe floor of the mouth. They apparently do not or cannot use frozen sections to guide the surgery. The ENT doctors will start with removal of the lesion and a neck dissection to remove lymph nodes.
There was so much work to be done first on the patient, and so many people in the room, that we all decided to take a cab home and Dr. Tom could return when they needed him. We went up to the roof top lounge to visit and read, and Tom's call finally came a couple of hours later. With some talk of a possible fibula graft and hemimandibulectomy, it appeared that the procedure had become more involved and any possible number of choices for his day could unfold. The rest of us stayed behind, and now at midnight I have heard no word.
The rest of us napped, shopped, had dinner, and worried. We will find out tomorrow what happened.
Early this morning Richard and I made a nice walk around the palace compound near our house. It is a good loop but part of the walk is new construction of the brick path, wall repairs, and street work. We found they had done new black top yesterday and the brick walk is nearly finished.
All over Kathmandu are these seemingly feral dogs who feed on what they can find in the street. Many are maimed, some have collars, and most seem either to be intact males or pregnant females. They are territorial to each other, but very friendly to humans. Most of them look like dingos, a kind of average mix of dog breeds. This one had a very cute wookie face but got spooked and began to bark when I pointed my camera at him.
All along the walk we see not only piles of rubble and signs of the recent devastation, but also very organized efforts to sweep, pick up, and clean up. This tidy row of reused sandbags were filled with shards of glass and debris, probably left for pick-up by the road.
Some parts of the palace are taped off to avoid pedestrian traffic next to the crumbling walls. In some places the paint is intact and they still seem standing, but a gentle push shows some movement to the bricks inside the paint layers.
Even some of the road, once laced with nice brick patterns, are roughed up.
Shankar picked us all up after breakfast and we went to the Ministry of Health to register Tom, our new surgeon, and then to the trauma hospital to see our patient for the day. Saturday is the day of rest, the other 6 - including Sunday - are for work.
On arrival to the hospital, the military hospital next door was being razed by a large bulldozer.
We entered the new hospital via the emergency room, which was a room about 75 feet square filled with registering patients, patients on guerneys, and a central desk. It was a large and busy place.
We made our way up to the 2nd floor, changed into our scrubs, and were led by some of the local MDs into the operating room. It was full of people, including the anesthesiologist and his four assistants, who eventually put the patient to sleep. The surgeons were all discussing various plans and flaps for this patient. She has a very large tumor on the side of her tongue that will require removal of 1/2 of her tongue and maybe floor of the mouth. They apparently do not or cannot use frozen sections to guide the surgery. The ENT doctors will start with removal of the lesion and a neck dissection to remove lymph nodes.
There was so much work to be done first on the patient, and so many people in the room, that we all decided to take a cab home and Dr. Tom could return when they needed him. We went up to the roof top lounge to visit and read, and Tom's call finally came a couple of hours later. With some talk of a possible fibula graft and hemimandibulectomy, it appeared that the procedure had become more involved and any possible number of choices for his day could unfold. The rest of us stayed behind, and now at midnight I have heard no word.
The rest of us napped, shopped, had dinner, and worried. We will find out tomorrow what happened.
