Falling from the Sky Addendum

I'm sure some of you may have had a hard time believing the largest airport in the entire country could be completely blacked out for hours-that's why I shot this movie as I drank my last Tasty tusker before the coolers warmed up. As you may know, I shot hours and hours worth of video while I was in Kenya last October-so you get the complete experience, I will be uploading some of them here for you! Keep checking back!



As a side note, while I was travelling around between Nairobi and Maseno I took Jetlink airways. While I lived, for future travellers, this may not be a good idea. Be sure to check out the video below which inexplicably is dubbed with Sarah Mclachlan techno and matrix references between plane crash footage.



Learning Swahili the Hard Way

"Ok children, if you want to talk in class I need you to raise your hand like this...(SNAP!) OH MY GOD! SOMEBODY HELP ME! DON'T FEED IT TO THE CLASS HAMSTER!!!!!"

"Haha Mwalimu wetu aliaga dunia kwa ukoma!"

Out teacher died of leprosy

Pints of Pus (A guide to become an overnight viral video superstar)

If you have read my posts about Samson and the witch doctor, you know I was dealing with some serious abscesses over in Africa. Nothing compared to the massive incision and drainage of a leg that we performed while over in Kenya. The story was a 12 year old girl was playing field hockey (like ice hockey, but without canadians and the players have more teeth) when she was kicked hard in the side of her leg. Like many of us, she shrugged it off and continued on with her life. Unfortunately, she developed a big pool of blood in the area she was kicked called a hematoma. The hematoma bleed lateral compartment of her right leg and over time, it swelled up, causing pain so severe she was unable to walk. When Dr. Hardison and I saw her she would scream and cry anytime her leg was touched. We knew we were going to have to check it out internally. We brought her to the operating room and gave her ketamine to anesthetize her and opened up the lateral portion of her leg. What followed had to be seen to believed-thankfully I had my camera in the OR and began shooting video right away. Thick blood mixed with pus began pouring out of the wound at such a fast rate it was quickly covering the table and falling to the floor. We grabbed a metal basin nearby and put her foot over it as we explored the hollowed out cavity with our probes and foreceps and pulled out long clots. I didn't think it would ever end as we quickly filled up the metal basin with I would say 3/4 of a liter of blood and pus (if not more) and packed her incision with iodine soaked gauze packing. The next day we removed the packing and cleaned out her wound a little more at the bedside-but after that she didn't have any more drainage and felt well enough to go home!

I think my most memorible incision and drainage was the one I did by myself without Dr. Hardison-and it was definitely the one I would have felt much more comfortable with someone watching over me just in case. This was a small 5-6 year old boy with AIDS and numerous complications. One of his many complications were nearly a dozen abscesses on his neck which Dr. Hardison asked me to individually incise and drain and pack. Once again, the boy was brought to the operating room and given ketamine to anesthesize him. I watched the boy's chest heave in and out-his neck moving up and down with every breath. I took the scalpal blade in my hand and knew I was going to have to make sure I was very careful of any movement and his variations in breathing. One small error and this boy would have a cricothyrotomy or worse. I elected to hold the scalpal blade with my fingertips for better control as I meticulously opened each one and drained them all without incident. Before he left to go home, I was able to finally get a smile out of him.

By now many of you are probably wondering how what I have said will make you a viral video superstar. A few months ago, I was uploading videos of my trip to youtube for later use in this blog. Well, I uploaded the incision and drainage surgery of that child's leg. Yes, I did say in the description that this was a medical procedure done under sedation uploaded for learning purposes, and yes, there are hundreds if not thousands of actual surgery videos to watch on youtube if you are so inclined. Perhaps I should have titled it something other than "EXTREME PUS DRAINAGE" but I figured no one was going to watch it anyway. Well within a few days, my video has 30,000 views! I scratch my head why and then I see on the comments section "congrats, you made the front page of www.popthatzit.com" (not to be confused with pimplepoppers.com or the boilandblackheadblog.com). If there is one thing I have learned in life, it's that there is a fetish for everything-and some people really like to see enormous zits pop. Pimples are just the gateway to bigger pus payoffs-large incision and drainages, sandfly removals, the list goes on and on. Who can say if "pus porn" is addicting, but based on the numbers I was saw on my youtube video-I would say it is. The comments on the video (you can see them here) are hillarious. Some people expressed 2 girls, 1 cup-like nausea and vommiting from the video. In the end, youtube ended my fun by pulling the videos and giving me a warning that if I post anything like that again I will be BANNED FROM YOUTUBE! Thankfully, the more progressive folks at vimeo have not pulled the video, so you can still check it out. I do warn you before watching these videos-it is a very graphic procedure so if you are easily disgusted by blood or pus-do NOT WATCH THIS VIDEO.

Incision and drainage 2 from dan ketterer on Vimeo.

Leg Incision and drainage and exploration from dan ketterer on Vimeo.

More Swahili Translations

Try this rope swing Jimmy, it's super fun and it takes you right over acid crocodile lake! There you go, you got it....AAAGHHHHHHH!

Kamba ilikatika alipokuwa akibembea

The rope cut as he was swinging

Betsy Ross's husband's style of parenting

Alimwumiza mtoto kwa sindano kubwa

He injured the child with a big needle

Sunday Bloody Sunday

How did you ring in the 2010? Was it a champagne toast? Watching the ball drop on TV in a warm toasty home? I was on 30 hour ICU call on New Year's Eve at the Regional Medical Center here in Memphis. The Med does not have nearly as many "Code Blue" emergencies at the other hospitals, but before started my shift I got this strange feeling that there would be one that night...right around midnight.
Sure enough, the only code of the night comes as the skeleton crew (made up of 4 residents-no interns strangely) gets ready to ring in the new year. The person who coded was a very sick individual and his numerous medical problems stacked against his chances of living as we injected him with medications to restart his heart and each of us cycled the CPR roles. I felt that sickening feeling as the bent and cracked as the CPR was done. I ended being the one that got to call his wife right before midnight to say her husband was dead.

As we helped the staff clean the poor man up for his wife, who was on her way-we started the paperwork and I believe we all felt the exact same way. A strange sense of solidarity that came from the fact that we were all upper levels and experiencing a new year like few else would. The moment was not marred by the recent death, we felt connected in that moment though. I tried to get a picture of all of us with my camera phone but the other residents didn't like the idea considering what just occurred. I then thought to myself-I must have taken 1000 or more pictures in Kenya but I have almost no pictures of my fellow residents and I've been here a year and a half already! It may be the reason you take more pictures at Disneyworld than you do of your co-workers-one is exotic and the other mundane and routine-but in moments like the one I experienced at midnight I realized just the opposite was true.

It's amazing how much memory is like a sieve over time when you don't take those pictures to remind you. Of course, I didn't have my camera with me at all times with me nor did I have a 24 hour documentary crew (it wasn't in the budget-they spent the money on something called medicine instead) so I couldn't capture everything that happened. Despite my nimble fingers, there were just some things I couldn't get to that were so important to cover and I kept reminding myself I would have to come back to cover it. One of these things was the Bloody Sunday which already I feel has become a victim to my poor memory. Pieces of it have broken apart from what I thought was an impossible to forget experience. The same thing happens with my comedy-so many amazing jokes and skits lost because of poor memory or thrown away post it notes.

Tonight I am again on 30 hour call and I decided to get some sleep early in case it was going to be another long night. I had the strangest dreams/omens, not really pertaining to Kenya but haunting and none the less would soon be forgotten unless I posted it here. In my dream I am cruising through what I think is Las Vegas and noticing that many of the big hotels are modeled after famous buildings around the world (Luxor, New York, New York, etc) and I sort of laughed that instead of so many people being able to personally see the real amazing sites in person that Las Vegas was their sort of cheap alternative to world travel. As I drive through I am amazed that they have a replica of the Eiffel Tower in Vegas (I actually didn't know that there really was one before this dream-but it turns out there is here). Yes, you can see all the magnificent knock offs of famous world structures in Vegas if you are so inclined. Once I get to my destination, I am somewhat surprised to see many people that were at one time significant were waiting for me-only except I can no longer remember their name. The sky is blood red as the sun goes down and I am struck with an intense pain. My vision gets blurry but I try to keep it together but I can't remember anyone's name of the people around me to ask for help. These are not your trivial acquaintances either-but current and former girlfriends and other really meaningful people I am surrounded by but cannot remember their name. At this time I am in a building with big glass panes for walls and as I look out at the blood red sky I see 2 black clouds in the shapes of claws, one on each side of the building that I am in drawing closer. As my vision blurs and I wake up, I feel the cold black claws of death envelope me in their grasp.

After waking up, I knew before I forgot it as well I had to post about the bloody Sunday I experienced while in Kenya. I remember walking from the guest house to the hospital and rather than being greeted with the calm quiet and maybe the occasional monkey-there was chaos. Ambulances were scattered over the lawn families outside crying and moaning. This was not the quiet hospital I was so used to waking up to. I am able to piece together the pieces of the story-the major one being there was a big car accident on the main road going to the hospital. An entire family was travelling in a private car when they were struck from the side with a packed speeding matatu (van cabs). Cars in Kenya tend to lack many of the safety features that we are so used to, airbags being one of them. A husband was driving and his wife in the passenger seat and the kids in the back. The car was struck as it pulled out-the matatu smashing into the driver's side killing the dad and at least 1 of the kids in the back. The wife was relatively unscathed except for a few cuts wailed in her room in disbelief of what was happening. Her children had to be transported to the provisional government hospital. Several people in the matatu were also injured or killed as well and they were all brought to our sleepy hospital-overwhelming what little staff there was. We ended up transferring them as quickly as we could to better equipped facilities-with no ICU; there was not much we could do.

Another injury I saw that day was one I had never seen before, but considering the risk factors for getting this injury, I was more surprised I had never seen it before. The patient was a college student at Maseno University across the street-pretty and young, receiving blood transfusions. I asked Francis the clinical officer what had happened. Apparently, she was having sex and the man was so well endowed that he actually punctured through the posterior part of her vagina (the posterior fornix for those medicos out there). She was now had an open cavity into her peritoneum and was bleeding into it-not good. We ended up boarded her onto the ambulance with the car accident victims and transporting her to Kisumu.
I am scratching my head now for other things that happened that day to later cause me to label that day as "Sunday Bloody Sunday" but I cannot remember now. Was there another death or injury I am forgetting about? The fragile nature of memory had caused that day to now be fragmented where I once thought it was bulletproof. Thankfully, I have this journal, and thousands of pictures to help me remember Francis, Samson, Lynette, and Dr. Hardison and all those who mean so much to me, that I will not lose them in that red sky.

I will post some more swahili translations once I get home