One lady's accessories

One patient, today, really made me smile. 2 ladies came in, one the "sikman," the other the "wasman." Initially, the sikman had her coat around her head, so I couldn't see her neck. I asked her to sit on the exam table so I could examine her, she took off her coat and sat down. I went to go and listen to her lungs and was struck by her necklace. I looked, and looked again and sure enough it was a phone cord. The kind that goes from the receiver to the handle. I didn't say anything as I looked at her earrings - paper clips. One was white, the other red, the plastic kind. I finished examining her and then asked if I could get her picture. I tried to ask her about her accessories and find out where she got them, but her and her wasman just laughed. I explained that I had never seen anyone wear them before, but that they looked nice, which they did.

Now playing in McCoy Park: Mud Men

Some men from Goroka are working on the new hospital site. They asked Mike if they could do a traditional mudmen show for the Work and Witness teams. So tonight was their first show, their next is Friday night at 5:30pm for any who might be in the area of McCoy park.

Before they started they told us that this is how the people in the Goroka area, the Asaro Valley, traditionally dressed when they would go out to fight. Apparently they were quite scary to their enemies as they seemed like ghosts. They wore only mud, banana leafs, ferns, and a mask made out of clay. They said the mask lasts 4 yrs once it is made. After trying it on, I can verify that they are quite heavy. I also don't know how they see when they have them on, I sure couldn't see a thing.

For the performance, they walked around in their mud costumes while someone made a fire. I wasn't quite sure the significance of the guy making the fire. A few carried bamboo poles, likely weapons in a real fight. After they were done, we got to try on the masks and pose for pictures.

Sam's Mumu

Today was a big day for Sam. Sam just graduated from high school and in 2 weeks leaves to head to Northwest Nazarene University in Nampa, Idaho. He is going to be missed by lots of folks here both nationals and missionaries, so today was a day to bring everyone together at a mumu. Mumus are big events here, and Sam's was no different. He had 4 pigs, 60+ chickens, and over 300 invited guests. Lots of people gave pigs, chickens, or vegetables for the mumu, or gave their time to help put it all together. Some folks were up all night getting things ready for today. Sam was up all night, and this am killed the 4 pigs with a baseball bat and then they got the big pits ready to cook the food.

I am on call this weekend, but was able to make it down for some fellowship and food. As they were getting the food ready, some folks got up and shared a little. Pastor Robert, the pastor of Emmanuel church shared and then prayed for Sam. Sam's PNG dad, Simon (top R), Pastor John, and Andy also talked before Sam thanked everyone for coming and for their part in his life. After that, it was time for the food. They put the food in takeaway bags to make it easy for everyone. Often times at mumus they divide the food up based on who brought what, who helped, or who is family. Today they made no distinction, except for the fat. They conveniently made up special bags for the "white skins" that did not include the fat of the pig that the PNGers love so much (in pile is pic on L). The bags included chicken, some pig meat (I got the psoas muscle with vertebrae and spinal cord attached), kaukau, bananas, taro and asump. I ate the chicken and some of the pork and then tasted the taro (the Myers made me), before sharing it with a student nurse. Often as a result of mumu's people end up with pigbel from undercooked pork. The next 3-4 days should let us know if anyone got sick, hopefully not.

Adventures in Gardening Part 6

Some folks have asked how the garden is coming, so I thought I would let you all know. There are less than 2 weeks before Bill comes back to his garden. I know I haven't been able to grow as much as he does, but hopefully keeping the weeds down will be seen as a good thing.

I have recently gotten some things to grow. 3 watermelon are growing, there use to be more smaller ones, but they seem to have disappeared and just these 3 remain. The farthest one on the left seems to have stopped growing though, as the 2nd one is overtaking it in size. Hopefully they will get bigger, we shall see. New cucumbers and cabbages are also growing. My first cucumber plant produced some very nice cucumbers, and I am hoping for good things from these ones. I also planted some more just a few days ago, so hopefully we will have lots of cucumbers for a while. The cabbages thus far look good, but others looked good too, until the bugs ate them. We shall see if they survive or not.

I also have some unknown plants growing from seeds I found in Bill's shed. They weren't in a package, but were just laying on the table. I decided I would try and plant some of these. So I currently have 2 unknown plants growing (one on the R). I think they are both squash type things, but we will soon find out.

Remembrance Day

Today the hospital was closed in honor of Remembrance Day, which is a day PNG remembers all their soldiers who have fought and lost their lives in military conflict. The real holiday is July 23rd in recognition of the first engagement between PNG troops and Japanese troops on that day in 1942 at Awala near Kokoda, but we did it today so it wasn't in the middle of the week.

After the house fires yesterday, there was talk of the 2 subclans of the lain fighting this am, but thankfully they didn't. A new Work and Witness team is here from Washington, so since the doctors had a day off, we had a softball game. We had a good time playing. We play across from the Primary School, so after school we had a lot of fans who came to watch. They have the best seats in the house, right behind the plate, and along the baselines. At times they help us when the ball gets away from someone. They don't really play softball or baseball here, but some do play cricket. Following softball, some of us played ultimate frisbee, which gave us a good workout.

House Fires

This afternoon I looked out my window and saw a bunch of people by the Riggins house looking out over the valley below. Not knowing what they all were looking at, I decided to go and find out. Once there, I saw in the distance, smoke coming up from a house. When I asked what happened, I got various stories. I heard that 2 lains were fighting over land, that one lain didn't want to fight so they "cooked" their houses, someone else came back and said it was just one tribe that was doing it to themselves. No one really seemed to know, but no one hesitated to share what they thought was happening. As we were watching, more houses went up in flames, and people were seen gathering together at one house, apparently discussing what they should do. At one point we heard the sound of bamboo burning, which sounds somewhat like a gunshot, but unfortunately later we did hear some gun shots. I don't really know why they set the houses on fire, who was involved, or if anyone was hurt. I know none of the missionaries were hurt, and that we need to continue to pray for the people of PNG that violence would not be their answer to everything.

Bush Knife injuries

Bush knives (machetes) are household items here. They are used to cut grass, weeds, sticks, banana trees, fire wood, and much more. Everyone has one and use it often. When I walk to work it isn't uncommon to see kids carrying them as they go to school. At times, pts even have them under their pants in the exam room. Small kids also use knives and bush knives like they are toys. Thankfully, the majority of times, the kids don't get injured when using them, but some times they do. Adults are often injured with them, as they are the weapon of choice in chopchop injuries.

Today I saw 2 kids, almost one right after the other who had eye injuries from a bush knife. The girl (on the left) was cutting wood and somehow managed to hit her eye. I don't really know how that is possible, but that is what they said. Unfortunately, she can't see from her eye now, and I am not sure she will be able to. The first kid I saw was probably 5, and the dad said another girl accidentally hit him in the eye with a bush knife. Thankfully, he was able to see out of his eye, but was going to court to demand compensation. Bush knife safety classes are something the people could consider here, like they do in the States with hunter safety classes, especially considering the number of injuries and accidents that occur with them.

Isaac's Deputation

Pastor Peter and Jenny Isaac and their children are PNG missionaries to the island of Vanuatu. They have finished a 2 year term, and are now back in PNG doing deputation services. At these services, they share of the work that God is doing through them, and raise money for their ministry, much like other missionaries do in their home country.

The Nazarene church of PNG has sent out 4 missionaries, so it was a special time for Emmanuel Church to have them back, last Sunday. They made signs and banners, and had a skit showing the different missionaries in their countries with their flags. The show of support for the Isaacs was quite inspiring. I am not sure that churches back home do the same when missionaries come back to share what God is doing.

The Isaacs shared stories of how God is using them through a radio program, and how they have reached their neighbors. One neighbor, was an elderly man who they adopted and became a grandfather to them. When he passed away, Pastor Peter was asked to speak, and 2 of his sons are becoming Nazarene pastors. Pray that the Isaacs may continue to reach Vanuatu with the truth.

Paulus

Paulus was admitted last weekend by Ravi, a visiting ER doc. His father told us that 2 wks prior he developed an infection of his lower lip, that turned into an abcess. He didn't seek medical treatment, and afterwards started developing a headache, and fever. After this, his started to swell and he had trouble seeing, then he got confused. They brought him to us when he got the confusion.

Ravi, having never seen it, but having read about it, diagnosised him with cavernous sinus thrombosis. We don't have a CT scan or MRI to confirm this, but we are working off it. Although Ravi admitted him, I get to take care of him. Like Ravi, I had never seen of it, but remember being warned about it in residency, especially with infections in the middle third of the face. The cavernous sinus drains the middle part of the face, and directly communicates with the dura, so an infection can lead to meningitis. Occlusion of the venous blood flow can lead to swelling of the eyes and vision loss. This can be a fatal condition, especially when not recognized right away, we pray we were in time.

I have been surprised at how well Paulus is doing. He can't open his eyes or see, but communicates with his parents about his needs. He complained of a lot of pain of his eyes, head, and neck, but this has gone down a big. His confusion seems to have resolved and he is able to follow commands. He has continued to have temps of 102, so, today, I found some Vancomycin to give him, along with all the other antibiotics that we have. Today, he was laying in bed eating a scone and his dad was giving him fanta which he drank from the bottle cap, when I rounded this am. His parents faithfully care for him and always greet me with a smile. I am not sure if he will recover fully from this, but am praying with his parents every morning that he does.

OMM anyone

As an osteopathic physician, one of the things I learned in medical school, at the Philadelphia College of Osteopathic Medicine, was osteopathic manipulative medicine. OMM is just one of the many tools, along with prescribing medicine, physical therapy, performing surgery, etc, that osteopaths have to treat patients. Manipulative medicine allows the body to return to its normal state, thus helping the body to heal itself.

In the first 2 years of medical school, I spent hours each week in lab learning OMM. Once on rotations I used OMM less frequently depending what attending I was with, so my skills declined. In residency, I didn't have an osteopathic attending for much of my time there, so I only used OMM occasionally. I did have the luxury of having other DOs in my program who I could refer pts to, or talk to about pt care. Here in PNG, I am without a referring or consulting DO, thus I am on my own. The other day I sure wished I had someone I could have consulted with.

I saw a lady, 1 month postpartum, who walked into my room using a stick and obviously in pain. My exam didn't produce any obvious hip, knee, or ankle findings that would account for her discomfort, however her Xray showed her problem. Her pubic symphsis is elevated on the R (in the xray), and lower on the L. I stood in front of the viewbox for about 5 minutes trying to come up with some manipulation to try and help her out, but to no avail. I used NSAIDS instead, and prayed that her body would indeed heal itself.

Weekend fun

This weekend we have enjoyed some fun activities. We started with the 4th of July party at the park (see prior blog entry). On Saturday, we enjoyed a kickball game in the field office field. A bunch of us played while the nationals enjoyed watching us and laughing as we missed catches, or missed each other when we would try and get them out. I kicked a lot of balls with my shin instead of my foot, so I have a nice bruise now which is quite sore. There is now barbed-wire on the back of the field, so the ball got a little deflated from folks kicking it for a homerun, or a ground rule double. Scot Riggins's kick was the most impressive as he managed to kick the ball into the fence around the Southern Cross for a home run, but it wasn't enough for his team to pull out the win.

Last night, we had a ladies night at the McCoys house. We watched a movie, painted nails, played a few games, and then sang Happy Birthday to Diane Chapman for her birthday which was on the 4th.

This was our Sunday for English Lotu and Potluck, which we do on the first Sunday of the month. This time we honored Sam for his graduation from high school. Sam will be heading to NNU - Northwest Nazarene University in August, and we will all miss him. Not only did we celebrate and congratulate Sam, but we also took the time to remember our country's (US) independence. The English Lotu is attended by many different missionary groups, including folks from Switzerland, England, and Canada. To remember our independence we sang our national anthem, then the others shared their national anthems (or some sort of national song). It was quite educational. I wasn't aware England has an independence day, but we sang their song anyway. After that, we heard John Alt, one of the Swiss missionaries, share about the One we can trust and His different names.

4th of July in PNG

For some reason PNG doesn't recognize July 4th as a holiday, instead they choose to recognize their own Independence Day, Sept 16th. So, I had to work today like it was any other day, but this evening got to celebrate the 4th. We didn't have fireworks, but made do. I had hot dogs with the Dooleys and Sam over a fire, and then Becky, some of the Radcliffes, Riggins, and Myers, joined us for sparklers and smores, and, the ever popular, flashlight freeze tag. The evening got cut short by the rain, but we had fun, without any major injuries. My most memorable 4th of July was last year when I redislocated my shoulder while participating in the games at the Leiberts, and then got locked in the bathroom. Thankfully, there wasn't a repeat performance this year.