I’m sitting somewhere over Europe at the moment at just over 41,000 feet. My onboard flight information says I’m somewhere above Paris, but other than lights in the far off distance it feels no different than being over the Atlantic. Having only flown KLM in the past, this is a new experience for me as I’m traveling on Qatar Airways and on my way to Doha. I’ve had my reservations before about flying through the Middle East, but I’m over that now as it’s clearly unpredictable where and when you might run into violence these days. The news media reminds us of that every day. I was recently asked about the safety of Nairobi these days and several of those I queried had the same response. Probably safer than Chicago. Being gone this October, I will miss all of the campaign rhetoric other than what I can glean from the Internet as we have no television at FAME, though you can be assured that I will be back in November to vote. This may be the most important referendum in our lifetimes.

I am so looking forward to seeing my good friends (i.e. family) in Arusha. Lenox and Lee will be away in Nairobi at school, but I will see Pendo, Leonard, Gabrielle and a whole host of immediate family members who usually manage to come by and visit while I’m in town. It is like a homecoming for me, only to equaled to that which I receive at FAME each time I visit. On my way home, I hope to visit the boys in Nairobi for the day since I haven’t seen them in some time and miss them a great deal.

Laura and Kelley will be leaving tomorrow (Monday) from Philadelphia and meeting me at FAME. They are both PGY-3s and both grew up in Puerto Rico. They knew each other only peripherally there, studied in the US at different universities and medical schools (Wash U and Harvard, respectively, I believe) and somehow both decided to go into neurology. Even more miraculously, they both interviewed and matched at Penn, all of which was unplanned. They are the best of friends now and having had the privilege of working with them at home, I am incredibly excited not only to introduce them both to FAME and the wonders that exist there, but also to work with them in the global health setting. They are both incredible teachers and I know that they will have much to give there.

And now for the Raynes House. Through the generosity of Stephen and Liz Raynes and their family, there is now a fourth volunteer house at FAME that will not only serve as our center of operations when we’re there, but also house other volunteers when we’re not. I had posted photos of our ground breaking last March and following the rains of the wet season, the construction is now well under way. It won’t be finished for our visit this time, but it has continued to move along such that the roof will be going on shortly and work will begin on the interior. I will, of course, post plenty of photos while we’re there for the month, but I am including several photos here that I have been receiving from Nancy Allard each week to keep me up to date. Nancy is a nurse/architect extraordinaire who continues to provide her services to FAME and now lives full-time in Tanzania. It was only several years ago that I met with her in Boston and she told me of her desire to spend an extended period of time there, but who knew it would become her permanent residence. With a formal education in architecture from Switzerland and a nursing degree in the US, she has become an essential part of FAME during this time of expansion.

And lastly, a bit of my news. Since returning home last April, I’ve had several minor health issues pop up that may have slowed me down momentarily, but haven’t managed to temper my enthusiasm for the work at FAME or my love of travel. In April, while cutting up a tree limb with my chainsaw, I managed to herniated a massive fragment of disk material that eventually left me requiring emergency back surgery a week later. Unfortunately, the fragment sat on the nerve root long enough to leave me with a completely numb left thigh from my hip to my knee that has remained. Feels strange, but I can live with it. Then, on July 20, while seeing patients at CHOP, I had the sudden onset of vertigo and vomiting along with complete loss of hearing in my left ear. Totally out of the blue and requiring that I go to the emergency room, they first brought me to the little people’s ER at CHOP (per protocol) where the ER attending took one look at me – drenched, vomiting and looking like death warmed over – and sent me to the big person ER back at HUP. They ruled out a stroke and determined I had labrynthitis, either from a virus or a small blood clot having gone to the nerve complex in the left inner ear. I spent the next five days lying on my couch as I couldn’t sit up without vomiting and even though the I wasn’t back to normal, I managed to go back to work a week out from the episode. Unfortunately, I noticed that I had some pain in my left calf and the following day noticed some swelling. Being in total denial, it took me several days to go to the emergency room. Though she won’t admit it, Kathy more than insisted that I go being worried about the obvious. Well, I had an extensive deep vein thrombosis involving my entire left leg and requiring that I take blood thinners for six months. At least it was likely a provoked DVT so I don’t have to remain on them for life. So, I am now traveling to Africa on blood thinners (no worries, I have the antidote for them with me), no return of hearing in my left ear and a numb left thigh. It has been a very humbling six months for me, needless to say, but I feel totally up to the challenge and am looking forward to this visit as much as I ever had, and perhaps even more so……