I started the year as I had done the previous 8 years on a Medical Mission to Ecuador accompanied by my wife who works as a nurse. I was fortunate this time to have two colleagues from my department accompany me. I have always recruited from other cities, other departments; this time it hit me, I work in the best department in the world why not invite some of them. So I solicited the 4 or so people who I thought might be able to go and who could get along the surgeons and nurses, 2 of them said yes and so off we went.
Our mission is to do total joints for hip dysplasia as well for Rheumatoid Arthritis and some osteoarthritis. Before I first went, I had questioned the utility of doing such major and expensive surgery in a developing country as opposed to say spending the money on public health or something. Thing is, most of these people are hugely disabled in country without much of a social safety net and there really isn't much short of a total joint replacement that is going to help them. Of course there are more patients needing the surgery than we can do in a week so there is always the prioritizing and rationing aspect.
What I like most is the team aspect. Many of the team go down every year and it is always great to work with them again. Somebody asked once why I come back every year and I said because of the team. Wrong answer? I guess I was supposed to say because I wanted to help people which is supposed to be why I went into medicine.
I think that coming on these missions has made me a better anaesthesiologist and physician. One thing you learn in the developing world is how to do the best you can with what you have. This is a very transferable skill to the developed world. The other thing in a mission like this is that you see the planning and teamwork that goes into surgery, something we don't always appreciate in Canada.
Cuenca where we work has become like a second home to me and I told my wife that if the mission ever stopped, I just might keeping on coming.
We often take a post mission vacation in South American but didn't do it this year and returned with most of the team following the mission.
I once again rode in the MS Bike Tour with a team of my colleagues including this year a couple of OR nurses. My wife and I had ridden this on our own and it was gratifying a couple of years ago when people approached me about forming a team which has increased in size. We all ride a our own pace but we always meet a the rest stops and this year we rode as a team from the last rest stop to the finish on the second day, letting our slowest rider a 60 something lady who rode a mountain bike cross the line first. I really recommend riding in the MS Bike tour in your area or sponsoring a rider or just donating, it is a first class event and the people who organize it are great, without the attitude we see so often associated with charities and volunteers.
I was also able to go on a group ride from Mt Robson to Clearwater in July. This is a nice ride with a net elevation drop and only a few large hills. We had a really nice group which is nice because group dynamics can make or break a ride. This was organized through Mountain Madness which I cannot say enough good things about.
I have to reflect on how 10 years or so ago I started riding longer distances and how I have become what some people consider a serious cyclist and MAMIL even if my wife usually has to wait for me. Some of the rides I have been on I could not have ever seen myself doing. I was talking a year or so ago to one of my now team members who was concerned about the distance at MS Bike Tour. "90 km," I told him, "is not a long distance." Okay yes it is.
I had a little mini-sabbatical. I felt sorry for one of the residents who had finished and didn't have a job so I gave him all my weeks in July and August and just did the pain clinic weeks. On top of this I had a cycling vacation already planned in Slovakia followed by a 4 week educational mission to Rwanda. Taking the extra weeks in the summer was just the tonic I needed; I typically take 3 sometimes 4 weeks but in a city with 7 months of winter, you really want to take advantage of our summer such as it is. This also enabled me to take the above bike trip. Most of the extra weeks I just spent at the dacha.
Our Slovakian bike ride was everything we had hoped for. Technically we started in Budapest and finished in Kraków. Budapest we had visited in 1999, when it was still quite shabby without a lot of restaurants and tourist infra structure. It now has all of that and is a beautiful city to visit.
Our in-laws joined us on the trip. We had some adverse weather, climbed some huge hills, ate some great meals and stayed in some really nice places. I strongly recommend this guided trip which can be booked through Freewheeling, a Canadian company or Greenways a Czech company. We had a couple of days in Kraków after the end. Kraków was a city I have always wanted to visit and it was everything I had hoped for.
After Kraków my wife and I flew to Amsterdam, a city I now regret waiting 58 years to visit. We had 2 fantastic days exploring Amsterdam before we went to the airport, I turned left and my wife went straight.
It was my second trip to Rwanda. This is a teaching mission through the Canadian Anaesthesiologists Society International Education fund and is aimed at teaching Rwandan residents in anaesthesia. I had done this in 2011 and had left frankly a little disappointed and frustrated. This was in a sense unfinished business for me.
The educational aspect of the trip unfortunately proved to be another disappointment. Part of the reason was the success of the program, there are more Rwandan staff anaesthesiologists (very gratifying since I trained some of them) than before so there is less for the Canadian doctors to do. Another factor was that there are now American Volunteers through HRH who tend to be better funded plus HRH has donated equipment which tended to marginalize the Canadian volunteers. In addition the teaching program had expanded to two other hospitals in Kigali which spread us very thin. There were of course all the frustrations of trying to practice medicine or rather to teach others to practice medicine in the developing world and while there are issues of equipment and training there is still an issue of attitude which is a barrier. I do sound negative however I did notice a lot of positive improvements in surgery and anaesthesia since 2011.
There were also distractions of not having water in our apartment most of the time and a major case of traveller's diarrhea which laid me low for a couple of days. African toilets are pretty disgusting and the most disgusting ones are unfortunately located in hospitals.
I did take advantage of the tourist opportunities and visited Akagera National Park on the Tanzanian border which is Savannah land, the gorillas on the Congo border and Ngungwe National Forest which is the last untouched rain forest in the country and where I finally got to see a chimp up close.
I was quite happy to leave after 4 weeks which I told my wife were the longest 4 weeks in my life. I did arrive home somewhat rested, refocused and was prepared to get on with things after 3 months mostly away from work.
Then as I already blogged I got fired as department head. I should get over this but it has overshadowed the fall for me.
Soon after returning it was back to the airport and off to Las Vegas to see Jimmy Buffett in concert. I had been a big fan in the late 70s early 80s but had sort of lost touch until a few years ago I bought his box set. I was pleased to see he was still playing concerts, got tickets for this concert and my wife agreed to come. We went to the pool party in the afternoon. It was my first experience with his fans the Parrotheads. The concert of course was fantastic.
Vegas on the other hand is a bizarre artificial place whose sole purpose seems to be to extract as much money from you as possible.
In November we flew to Winnipeg for the Grey Cup which is Canada's football championship game. Our home team was playing which was bonus although we had booked the trip and bought the tickets months ago. Winnipeg is a way better city than its reputation and they put on a pretty good party. Of course our team winning topped off the whole weekend.
In December I went to New York ostensibly for the PGA meeting. This was a popular meeting when I trained and worked in Eastern Canada but I had never gone to it. I was able to fly on points in business class which is a bonus and my wife and I got to look around, walk the High Line, go to some decent restaurants and saw two musicals (Lion King and The Book of Mormon) before my wife flew home and I stayed for the rest of the meeting.
I got back from NY on December 15 worked a couple of days and then it was Christmas break and done to the dacha.
The real highlight of 2015 was getting rid of two Conservative governments as in a shocker the NDP dumped the Conservatives in Alberta after 40+ years and then in the fall the Liberals dumped the federal Cons. Okay I would rather have had the NDP beat the Cons and I hope the Liberals live up to their promises, something they haven't really done in the past but I would have voted for the Montreal Canadians against Harpo and it is great to feel good about being a Canadian again.
Overall a pretty nice year all told. I think I will take it easier in 2016.
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