Gideon is a 17 year old boy whose parents brought him to Tenwek in a coma. I did a double take at his head CT when the resident came to tell me about him...it showed the largest brain tumor I think I've ever seen!
The tumor looked to be outside the brain, so while Gideon was unresponsive, I thought if we could remove it and take the pressure off his brain, perhaps he'd have a chance at some improvement. We took him to the OR urgently that night and, as I feared, the tumor had developed an extensive vascular supply so that even as we made the incision and peeled down his scalp his skull was bleeding in countless places. The hospital's only electric craniotomy drill had broken just a few days prior so we had the tedious task of removing his skull using a hand twist drill and manual saw. I had planned to open the covering of the brain over the center of the tumor and begin removing pieces of it, but quickly realized the tumor was way too bloody for that tactic. So instead I opened along the margins of the tumor in hopes of perhaps coming around it. The neurosurgeons reading this know what happened next though. The tumor was putting so much pressure on the brain, the minute the brain was exposed it began herniating toward us, begging to get away from the tumor. I knew between the brain trying to squeeze out of the head and the tumor bleeding, we needed to move fast. I've never done what I did next, and my mentors at Mayo would cringe had they been watching. The plane between the tumor and the brain was actually pretty favorable so I literally ran my hand between the brain and the tumor all around its margins until I was able to remove the thing in one chunk.
Even later that night in the ICU Gideon began to open his eyes and over the course of the next week he made a remarkably full recovery. Thankfully, and somewhat surprisingly, his tumor was a benign tumor called a meningioma, so I'm hopeful he's cured.
Gideon really endeared himself to me and the day he came back to clinic a month after surgery was a special day. I believe God spared Gideon's life and I shared with him the following scripture from the book of Jeremiah.
"For I know the plans I have for you," declares the Lord,
"plans to prosper you and not harm you, plans to give you a hope and a future."
I believe that's true for Gideon and I believe it's true for my family here in Kenya.
It’s hard to believe I'm finishing my seventh week of work here at Tenwek. Certainly it has had its challenges and many days we still feel unsettled, but there has been something entirely fulfilling about serving the people here and being where we’re confident God has led us.
Work at the hospital has been plenty busy. Just yesterday I gave a lecture to the residents, performed three operations while bouncing back and forth to clinic to see 31 patients, and had a ruptured aneurysm come to casualty (what we call the ER here), which I added to the already two cases scheduled for today. I have good help though. The surgical residents here are great and interacting with them has been one of the most enjoyable aspects of my work.
Operating is almost always an adventure. More days than not I feel out of my element. Either I’m doing cases I’ve rarely (or never) done, or even in those cases I would otherwise be comfortable, I often don’t have some piece of equipment and am left needing to improvise. I’ve found myself in the middle of many cases feeling way in over my head, being keenly aware of my own limitations as a surgeon, and asking God to intervene. That is a humbling situation to be in and it’s teaching me a reliance on Him I’ve not previously allowed.
Thank you so much to the many of you who have supported us in various ways. Please know your support makes a real difference for us and is so encouraging as we continue to settle in to our new home here in Kenya.