Friday, March 17 – Cute children, a fellowship interview, and Grand Rounds…

Anya examining a young patient

Overall, it was a quiet day for us and, with everyone very excited about leaving for the Serengeti tomorrow morning, it was a welcome break. Preparing for the Serengeti, we all had to pack for three days and two nights that we would be spending in luxury at one of the many tented camps that exist within the park. Getting there is another matter as it usually takes several hours of driving on one of the bumpiest roads anyone could image, so much so that it feels like any dental fillings that you had prior to traveling on it will be long ago fallen out once your journey is complete.

A young patient of ours enjoying my baldness
Usha’s little friend

We had to make sure we had enough supplies to make our lunches for the journey in the morning heading to the park – typically peanut butter and jelly sandwiches, hardboiled eggs, fruit – essentially what we had brought to Ngorongoro Crater for lunch, though this time the eggs would be adequately hard boiled, of that I was certain as Jill had promised. We’d also be providing lunch for Patrick, our driver/guide, who would be coming today to pick up Turtle and get her ready for the journey. Driving to the Serengeti is no small undertaking, and breaking down while there is another matter altogether as services in the park, even if you could get to them, are very limited. Last year, we spent the entire weekend game viewing in the park with a completely shattered windscreen held together with duct tape as there was nowhere to have it repaired and the only other option would have been to return home, which none of us was interested in doing. There is absolutely no option to leave your vehicle and walk anywhere given the amount of deadly wildlife that would like nothing more than to make a meal of you.

Mudy, Sulle, and Usha evaluating a patient

Even though Turtle goes out on only several occasions each year, she has been getting very long in the tooth and has been requiring more and more upkeep over the years making it even that much more important for Patrick to take the vehicle and check it out for our journey. Land Rovers, despite being the absolute best vehicle for driving in Africa, or any other similar terrain, do require more TLC and upkeep than their off-road cousin, the Toyota Land Cruiser, but are tremendously less expensive to operate as the repairs are simpler and parts much more affordable. Land Cruisers operate longer between repairs, but when they break down, it becomes a major hit to the wallet. Most safari companies have turned to using Land Cruisers for these reasons, but having driven both for the last dozen years, I would take a Land Rover Defender over the Land Cruiser any day of the week for a number of reasons. The Land Rover is more comfortable, has a wider stance and better stability, and is far less likely to get stuck in the mud. And then there is the sentimental part of me that would choose an old Defender over anything else, though I’m sure if you put a gorgeously restored 1960s F40 Land Cruiser in front of me, I wouldn’t turn it down.

Clinic today was a bit slow, but there were numerous cute children to be seen making Usha quite happy in particular, but all of us enjoyed seeing them. Prior to coming here, I had been asked to give Grand Rounds for the neurology department at the University of Virginia, my alma mater, and had set this up to be done virtually since it was obviously impossible for to fly back for the day. I hadn’t realized that it was actually the Distinguished Alumni Grand Rounds, and I was incredibly honored to be given the opportunity to speak to a department that I hold in incredibly high regard for the training that I was provided there. They had asked for me to speak about the work we’re doing here at FAME and about the accomplishments that we’ve made over the last decade plus. Giving Grand Rounds virtually, which is how most have been done since the pandemic, would not have been a concern had I still been in the US, though doing so from a country where all the internet access is cellular based, and the power grid is about as stable as a cerebellar ataxia (sorry, neurology joke).

Mark and a special friend

Every time the power goes out here, which is quite often, our router in the house takes about five minutes to recycle, meaning that there is no internet during that time. Being on a Zoom as the presenter can be a bit nerve wracking as you’re waiting for the power to go out after which the router must reset. I thought I had perhaps outsmarted the issue by having my computer use my phone as a hotspot which would avoid the power issue, but I had counted on the cellular service on my phone waxing and waning like the aurora borealis. I signed on early to make sure things were working well which it seemed that they were, but then everything froze as the signal on my phone dipped to below a sustainable level for the presentation. Sitting in my room, halfway through my presentation, there was a bit of despair, but I was able to switch to the WiFi in the house thankfully and finish the presentation.

My title slide for Grand Rounds the the UVA Neurology Department

It was now 8 pm and I was starving, but I discovered that they had planned for me to speak with the residents separately in a question-and-answer format which was on a different platform than zoom. Still needing to pack for the Serengeti, not to mention eat dinner, I linked up to the necessary website to speak with the residents. Unfortunately, the bandwidth necessary for me to actually see the residents wasn’t present, so I was mostly talking to a black screen for much of the talk. At some point, my power went out and I was again at the mercy of clumsily reconnecting the internet and the WiFi once our router had recycled, but everyone was patiently waiting for me to come back on. I finally finished the session with the residents just before 9 pm, starving and still needing to pack for our long weekend trip.

Jill in the new vegetable market

Meanwhile, Mark had scheduled one of his virtual fellowship interviews for today since he knew that we wouldn’t be leaving for the Serengeti until tomorrow. My talk was only an hour plus the question-and-answer session, but Mark’s interview was probably the better part of six hours or so. When we got home from clinic, he was already well into his interview and in between sessions, he came out dressed in his suit and tie wearing flip flops. We were all grateful that he was at least considerate enough to be wearing pants as I’m sure all of us have thought about going bottomless, at one point or another, while on a Zoom call during the pandemic. One highlight, for me at least, during his interviews was that he was meeting with Caitlin Loomis at Yale. Caitlin had been a resident at Penn who spent a month with me in my office prior to my having joined the Penn faculty full-time. She then went on to complete a stroke fellowship at Penn and then to Yale where she has been on faculty there ever since. It was great seeing her and I’m sure Mark enjoyed the short break in his otherwise lengthy interview session.

Earlier in the evening, Jill and I had gone into town to run some errands (mainly to pick up snacks for our trip this weekend) and while there, visited the new vegetable market that had been constructed during the pandemic. The old market was a very large structure that was essentially a dirt floored partially covered mass of vendor’s stalls, mostly all carrying the same produce as the next, but somehow everyone knew which of the vendors they were looking for. There were hundreds of stalls and in addition to the produce, there was a fish section where fish from the various lakes in the region and as far away as Lake Victoria were sold. It was a photographer’s dream, and I had taken a few nice photos there in the past. The new market has a solid floor and cinder block stalls for vendors to display their produce. Jill and I walked around, most looking as we were leaving for the weekend and weren’t in need of anything, but still enjoyed exploring.

Eagles fans everywhere, even in Karatu

Tomorrow, we would be leaving early, but not so early as I had made everyone leave for Ngorongoro the week before. The plan was to first go to Oldupai Gorge and Shifting Sands and then make our way to the Serengeti, having lunch at the Naabi Hill Gate. We had heard that the migration was mostly hanging around Naabi Hill and into the Central Serengeti, so there were plans to see as many of these wildebeest as possible. With this huge number of animals and especially all the wildebeest calves, there would also be a significant number of large cats looking for an easy meal and that was something that we were interested in seeing.

Sunset from our veranda

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