We love Madrid

Still walking and eating, pictures of our last day in Madrid. 

The Royal Palace. Which we view from our apartment. 

Royal Gardens. 

Lunch

Royal Garden

Walk home after great dinner at Vietnam Restaurant. 

Calle Lepanto, 4

 Views around our apartment;

Cafe in front of our building. 

Our living room balcony. 

Evening view from window. 

Transition to Madrid

  I left the Commador hotel in Jerusalem at 2:30 AM on Sunday morning. 12 hours later I arrive in Madrid via Warsaw. Remind me to check a map before I make a plane reservation through Warsaw again. 

  I take the metro to Chueca and walk to the Odessa hotel. The room is small, cheap and clean. I'm am exhausted again. After I got food and water I laid down and sleep for five hours. Get up drink more water and sleep another six hours. 

  Feeling pretty good the next morning, I take the metro again to the Opera station. Our apartment is a few blocks away. It is a beautiful neighborhood. 

  Danielle and Frank arrived a few hours later. We have spent the last two days mainly walking and eating.  Also, seeing an amazing Flamenco show at Casa Patas, and a Cezanne exhibit at the Thyssen-Bornemisza Museum. 

Plaza Mayor walking home after Flamenco show

One of many cool buildings. 

Frank and Tia T

Desert after lunch at La Sanabresa. Great 3 course meal for 10€. 

D and I showing our best Flamemco moves in Plaza Mayor. 

Ansam

 I met Ansam last year through a woman I was introduced to in Portland. It's kind of a crazy story but we ended up doing surgery on her nephew Talal, another crazy story, and we have kept in touch. She is a wonderful, bright and strong woman. 

  Most of the team had left and it is Dr. Jo and I now. We will spend the day with Ansam. 

  Enjoy the pictures and video. 

First a walk through Sebastia, where John the Baptist was beheaded. 

  Olive groves 

Picking wild zatar, oregano

Classic Palestinian country BBQ 

Then we go to her house and watch her make bread with the fresh zatar. She says there is no name for it. I name it sheema. 

It is the most wonderful relaxing day!

Thank you Ansam and family!

Touring Hebron and Bethlehem

After AM rounds ( all kids look better including the baby girl with the trach), we have the traditional tea and kanafee with the hospital administrators. They gives us  plaques, certificates, and Palestinian scarves. 

  It is 1pm when we start our tour day. Off to Hebron. One of the oldest cities in the world. Glass and ceramic factories. Abraham's tomb in a building that is divided into a mosque and a synagogue. 

  There is a lot of conflict in Hebron due to very close contact with the settlers. 

 

Phoenician glass

Ceramics

View of Hebron 

Tomb of Abraham 

The mosque

  Then we dash to Bethlehem, making it into the church as doors close. I am hypoglycemic and can only handle the tour for 10 minutes before I bail to get some food. 

Church of the Nativity

Zealot carrying cross to Jesus manger site

View across the street

It is another long day. 2 hour drive back to hotel and dinner. 

Big Tuesday

1 day old Mylomeningocele

Replacing skull flap on 10 year old. 

Big ruckus on the floor after I brought our last patient to his bed. Angry father decided to take it out on a local physician. Not one of our patients. 

  He went after him at the crowded nursing station. A huge crowd came out of nowhere. I found myself blocked in by curious Arab mothers.

  There was a lot and yelling and screaming pushing and I decided it was time for the little white American to get out of there. Palestinian authorities showed up and arrested the man. 

  Unfortunately, our other nurse was caught in the middle and was very shaken by it. 

  No body was injured. 

  We have two or three cases today. Then leave to Ramallah her group PCRF dinner. Then we are going to Pres. Abbas compound to meet him. 

Down and ups in a day

Wednesday was our last day of surgery. Ending with a very difficult case. We had a three month old that needed a VP shunt. Unfortunately, she had several congenital anomalies that made her very tough to intubate. Unsuccessful after several attempts, her heart rate dropped and needed chest compressions. She came back but never had spontaneous respirations.  She was bagged but still had low O2 sats and the decision was made to place a tracheostomy. 

Not how you want to end the last case of a mission. 

She is doing well in ICU but will need several procedures due to her underlying syndrome. Trach should be temporary. 

 I had time to waste waiting for a taxi so I went to the salon across the street for hair wash and blow dry. We have a big night ahead. 

 

We dress in our finest, ok, cleanest clothes and get in the van for a ride to the president's compound. Pass through a lot of security, sit in a couple rooms, and finally meet Palestinian president Mahmoud Abbas. 

We drink tea, chat. Doctors ask for a surgical microscope and laparoscopy. He says OK. 

Inshallah

Thirty minutes later we are off to dinner. 

Is it Monday?

Drive to Rafidia hospital. 

Nablus street. Our group waiting for taxi. 

Hotel al Yasmeen

8am to hospital, 10 pm to hotel

Out first full day. Three cases. But every complication in the book today.  

Complicated positioning, complicated airway, complicated skulls, difficulty obtaining blood from lab, and difficulty waking patients from anesthesia. 

  A very long day. 

Large frontal craniosynostosis on a two-year-old from Gaza

Dinner

Meza and mixed meat platter at Al Rausheh. 

Clinic day

  Today was the best clinic day I have had since coming to Palestine. We screened 30 patients and scheduled 12 for surgery.

  No body yelled or screamed at us and we were finished by 2pm. 

  We are in the OR. Dr. Samar and Jo are doing a laminecty on a 12 year old boy with osteogenesis imperfecta. Positioning him prone with his fragile contractured body was a challenge. 

  This is Hanna, PCRF social worker and I. 

Another Feburary in Nablus

Round 3!!
I leave in the morning, retuning to Nablus with the pediatric neurologist to Rafidia Hospital.  Then taking 4 days to explore Madrid on the way home, ahhhhhhhhhh, siesta.