"No-See-Ums"

Overall, thanks to two cats in the house, I don't notice the bugs too much. The bugs mostly stay outside except for the occasional ant or little cockroach or this bug in the picture that keeps trying to get in the house. I've thrown him out twice so far. It's at night that you realize how much the cats help--the rain forest all around comes alive with sounds--chirps and whistles and buzzes and rustles. Or after a rain when you can watch the bugs pour out of the ground almost like turning on a spigot.

Then there are the bugs you don't ever see--the "No-See-Ums". The ones that leave a million bites on your arms without you ever knowing they'd been there. I've actually made it a month without any bites so I didn't really believe in the stories about the "No-See-Ums". Then I spent an hour at a church in a small village. At the end of the service, I looked down at my arms and it looked like I'd developed leprosy or a bad case of the measles. I never saw a single bug or felt a single bite.

Hand Trauma Week--Surgical Cases

Sorry to the nonmedical folk reading this, there's a little bit of blood--no guts though. So this week has been hand trauma week. One case was a machete wound to the wrist. The other was a close range shotgun wound to the hand. I'm still working to try to save the index finger and part of the thumb for the patient who accidentally shot his hand. I don't think he'll have any sensation left in his index finger, but he really wants to keep it. I'm going to have to do a tendon graft to reconnect the tendons in that finger. The patient with the machete wound severed both arteries, both nerves and all the tendons on the palm side of his wrist. The photo shows my repair of the arteries. Tomorrow he'll be back in the operating room for repair of the nerves and then tendons.