Photo op

So last night the three of us went bowling. There is only one bowling alley in Asmara (and my guess is only one in the whole country), and we just happened to make our way there yesterday afternoon to play a game. We invited one of the medical students who had never played and had never been to a bowling alley before. The bowling alley itself, I think, had 6 lanes in total. There were numerous big screened TVs with nintendo systems hooked up to them for the kids to play. There were also multiple pool tables, but thankfully none of the smoke that usually comes with a pool-table-containing establishment. The bowling game itself was interesting with all of the pins being manually reset by young boys who were responsible for this chore. There wasn't any sort of automatic pin-resetter. The actual lanes were a little bumpy and the entire establishment was just a little run down in true Eritrean style. It was a lot of fun though. The final scores were: medical student (first time bowling in his life) 150, me 123, Henish 57, Hannah 53. In Hannah's defense, her initial ball choice was the lightest ball I have ever seen--like 3 or 4 lbs and apparently had a twist to it, so somehow it always ended up in the gutter. I don't have an excuse for Henish.

Today was a much better day than yesterday. The little boy I mentioned in my last post is still alive and is now producing urine with the help of lasix. His respiratory status has improved a tiny bit, but I still think he should be dialyzed in the short term. The attending, however, thinks that we should wait. He also thinks we should wait to try a trial of steroids until his 24 hour urine protein returns. I just pray that he makes it another day. In other patient news, I diagnosed a patient today with likely hepatocellular carcinoma. She presented with several months of right upper quadrant (where the liver is) swelling and tenderness. Her liver function tests were very nonspecific and suggested a chronic process. So, despite the fact that the initial ultrasound said cirrhosis, I took her down to the ultrasound tech and had him redo her ultrasound. This time, this guy saw she had multiple discrete masses with no clear liver tissue, which correlates with her history (also included a large weight loss) and severe hepatomegaly. Based on this read, I think she has HCC. I don't have any way to confirm the diagnosis, and getting a CT is too expensive. So, hopefully she will be able to go ohm soon.

Today for lunch we went to Asmara Palace where we confirmed that most of the restaurants here in Asmara will not have a lot of the food that they have on the menu. Hannah and I asked prior to ordering if they had the salmon, crab, or lobster that they put on the menu, and the answer was no. In terms of fish on the menu, the only food they had was red snapper. Luckily that sounded good, so that is what we got, and it turned out to be ok. After lunch we decided to brave a piece of cake from the bar and, as per the cake we had on Easter, it tasted like banana. This cake was supposed to be dark chocolate, but all we could taste was banana, so we opted to not eat it.

After work today we met with Tsige, Melles' wife who showed us around Asmara. She first took us to the "recycling center" which was really more like an organized junk yard with a bunch of people taking scraps and making them into something. At the entrance there was a grain market different from what we had seen at the main market in town. We saw men pounding on giant pieces of metal making flour sifters, containers for brewing Suwa, benches, etc. There were people doing wood work. Everywhere there were piles of old parts, old tires, old doors, and just random trinkets. I was sort of in visual and auditory stimuli overload while I was there. It is definitely a place where a photographer could go crazy taking pictures. Hannah and I both did go a little nuts with pictures.

After the recycling center, Tsige took us to the road that leads to Massawa, the coastal city here. There we were finally able to see just how high up in the mountains we are being in Asmara. The view was absolutely beautiful and finally we were really able to see the landscape here, which is more like what I pictured Africa to be. We also got lucky and saw our first camels, which Hannah and I both took pictures with. Seeing the road to Massawa made us excited about our upcoming trip there this weekend just so we can see the country-side since we haven't been out of Asmara yet.

After our photo-ops, Tsige to us to another market to show us more shopping. Somehow we had missed this market in our initial wanderings. We did find some stuff worth buying. My big purchase of the evening was a hand carved wooden Ostrich. There really isn't a whole lot of bargaining here, and these trinkets are relatively expensive. Our night ended with dinner in the hotel where the three of us (Hannah, Henish, and me) lost track of time and ended up chatting in the restaurant for a good 3 hours.