Zac and the "Kabul Kid"

(In Zac's words)

Interesting day today-mostly good, some not so good.

First off, because of the "kabul kid" I didn't have to see clinic today-hurray! They called John Green (the medical service corp med operations guy that's been helping me) about 0800, so we went over the Egyptians and had to wait a while. The guard didn't understand any English, and asked us several times if we were American, which we responded "yes, we're still American." I don't think he got it.

There was a guy there from Jordan who was just visiting who does some kind of training work with the Afghanis-he's usually in Kandahar or Ghazni, but was down for the week, so he was able to translate to the Egyptians. We had to wait about an hour before they finally got through the gate.

We had borrowed the DCO's car (deputy commander), and drove them over to the American hospital. While waiting, we walked into the male ward of the Egyptian "hospital"-it was basically a dark bare room with cots on either side of a walk space filled with people, a few with bags of fluids, mostly just laying there. If it had been warmer there would have been a swarm of flies all over them. It was like something out of a WWII movie where they have all those guys just lying around.

The adult cardiologist down at the hospital, who's in the Army but was also flabbergasted that I "got" to do troop clinic, was super accomodating and let us use his room and machine. He came in toward the end, and it was fun to chat about this case along with others he's seen. I asked him tongue-in-cheek if he wanted to switch me places for a week since he sees a lot of adolescents and young adults with congenital heart problems. It's mostly things you only read about in books, but nobody's seen in 50-100 years. it's incredible how primitive this country is.

When I started the study, the first step is to fill in some demographic info, like name, birthday, weight, height, etc. When I asked for his birthday, the parents didn't know. The dad is  a translator and speaks pretty good English-the mom accompanied him. I asked what month he was born in, and they weren't sure. I asked how old he was, and they said "about 10 months, I think." Earlier they said they thought he had been born in January of last year maybe. ????? How can you not know when your child was born?????

So I've given him a birthday (if he goes to the states for an operation, they'll probably use mine since his real one no one knows) of March 15, 2011 since that would make him "about 10 months old." Happy birthday.

They had confiscated their milk at the security gate (I guess like the TSA or something), so he cried through most of the study, which made it extra fun. We gave him little pieces of cheese nips and he settled down enough for me to at least see his basic problems.

He has a huge hole in his heart, between the ventricles, but then I found severe narrowing superior to the pulmonary valve, which I wasn't expecting to see. I had asked the parents in the car ride over what the French hospital had done-they said he had an echo, that was all. I asked if he had a cath or any procedures, and they said no.

Turns out, after I finished the study and explained the anatomy, the dad says "oh yes, they told us when they did surgery they placed a band on his pulmonary artery and clipped his PDA" ?????? you didn't tell me he surgery??????  It was off-pump, lateral thoracotomy, so he didn't have a midline chest scar, but still. Anyway, that explains the supravalvar pulmonary stenosis. I thought he might have had a small residual PDA, although he was screaming at that point and I couldn't be sure.

So after the study, we took them back to the Egyptian compound (they have a gate where the people come in and out) and dropped them off. But the gate didn't open for an hour and a half, so we went over to the chow hall and brought some lunch back for them. When we walked in to give them the food (in to-go containers), there were probably 40 kids running around in there. As soon as we walked in, they literally mobbed us, stuck their hands in our pockets, tried to grab the food, it was crazy. One of the Egyptian folks almost had to beat them back. John unfortunately handed one kid a juice box or something and got mobbed. They were almost like wild animals. We got the food to the couple and the baby, and left, but I hope they didn't get mobbed or something.

Anyway, interesting experience. Hopefully I can get the DVD off to the NGO and they can take it from there.

I found out I was approved to teach biology (maybe I already mentioned that), so I filled out the paperwork. The coordinator asked if there were any classrooms i knew of where I could teach it, so I've been looking around a bit and found one, so I think it's all in place.

I also had lean six sigma last night, and started collecting data for my study yesterday, so that's underway. 

Evidently there's also a weekly meeting for church leadership, and some responsibilities I need to sort out there, so I'm trying to keep busy. I didn't get to study today, but will tomorrow.

Wow, that was a long email but a fascinating experience. Oh, we had one of the PR guys come over, and he took a bunch of pictures and will probably sit down with me in the next couple days to write up a story about this kid. If he does go to the US for surgery, we'll probably send along the photos and it may make the paper somewhere, so I'll watch out for it.

ZAC