The rains were again very heavy overnight, and continued into the morning making the roads a muddy mess and keeping patients from coming in. We had morning report, though, and reported to our neuro clinic space at 8:30 am to an empty “waiting room,” which are the benches sitting immediately adjacent to our outdoor clinic. The rains were so heavy at times that it was nearly impossible to hear when anyone was speaking, and the Tanzanians speak particularly soft on a regular basis, further increasing the difficulty communicating. And me, with hearing out of only one ear (due to a bout of labyrinthitis in 2017 that left me deaf in my left ear), it was virtually impossible for me to hear anyone when the rains were at their greatest.
The roof over our clinic area is fiberglass, greatly amplifying the sound of rain, though most of the roofs here in Tanzania do the same thing regardless as they are either metal or fiberglass and will make even the lightest of rains very audible. Overnight, the rains will awaken you with or without the loud thunder that will often accompany it.
The clinic was very slow today with only a total of 9 patients to be seen, and they were a mix of the typical diagnoses – headache, epilepsy, and numbness and tingling. Dr. Frank, though, did stop by to tell me that a tourist had been horseback riding in the conservation area and had fallen from their horse striking their head. They felt fine apparently, but couldn’t remember the fall specifically, so they were on their way here to FAME to get a CT scan. It would take about three hours for them to arrive and it was already well after noontime, so the question was when they would actually arrive.
We often talk of “mzungu time” (“mzungu” meaning stranger and includes anyone not born here in Tanzania and of any ethnicity) and “Africa time,” that refers to what one should expect. Mzungu time means on time as it would at home in the US or Europe. Africa time refers to the often more laid-back schedule here and could range to within several hours of when someone is supposed to arrive to half a day depending on how far someone is traveling and what encounters they may have on the way – rains, washed out bridges and roads, car trouble, etc. With this patient coming from fairly far in the conservation area, that could prove to be a problem given the heavy rains that we were having, and which were surely occurring there as well.
Sure enough, we expected the patient to have arrived around 3 pm or so, but we were long finished with patients, and they were not here. As we were packing things up for the day the patient, of course, arrived and looked particularly well. We went back to clinic, and I had the residents quickly evaluate the patient, who spoke some spotty English, though wasn’t entirely fluent making the mental state exam a bit difficult. The patient spoke French, which Yombe spoke fluently, though unfortunately wasn’t here any longer. They exam looked very good and there was little worry of anything serious, though we were still going to obtain a CT scan as that had been decided before they even arrived here given the fact that they were a tourist and a safari company was responsible for their health. We walked home as it would take a few minutes to get the scanner up and running, but we would be called when it was finished. As expected, the scan was entirely normal with no signs of any significant injuries or otherwise.
As we walked back to the reception area to speak with the patient’s tour guide as well as the patient, Theandra called Yombe in Philadelphia, who proceeded to speak to the patient in fluent French to give her our recommendations. She had had a mild concussion as she didn’t recall the accident itself but was otherwise entirely fine. She was scheduled for more horseback riding, and I suggested that she take it easy for a few days before returning to any galloping around on a horse, but mostly to rely on how she was feeling to direct her activity level. If she developed any additional symptoms, she should take it easy for a day or two and then resume. She didn’t require any additional treatment or medications.
We had decided to have dinner at home tonight but would then head out to the Lilac Oasis for Karaoke (once again) given just how much fun everyone had there previously. Besides, Annie wanted to hear Jill belt out one her gritty delta blues songs again. It was still raining off and on during the afternoon and evening, and the rain continued to come down during our time there. One side of the bar opens onto a veranda that overlooks thick vegetation leading to a small river and the tree frogs were croaking boisterously as if they were serenading our group. Being inside during the rain while still being able to hear nature outdoors was very special, though once the music got going, the inside action certainly took front and center.
The power went out several times early on, wreaking havoc on the internet, and putting our karaoke night in jeopardy, but things eventually came together, and a list was made of everyone’s preferred songs to perform. There were also other guests who were equally interested in participating in the karaoke, and given the number of open mikes, there were typically multiple people singing each song.
When Jill’s first blues song, Women Be Wise, came up to sing, the lyrics were showing up at all, though the instrumental still played appropriately, so she just sang it from memory which I think blew everyone away, me included. That was just more than anyone expected. As time went on, everyone got into the action as well as some dancing, though I kept my record intact as I only filled in for the missing Yombe on one song, repeating the phrase, “it wasn’t me” whenever it came up in the lyrics. Sure wish I could remember the name of the song. Though it wasn’t entirely “Midnight at the Oasis,” we were there quite late and once again seemed to close the place down. We had clinic in the morning, but only a half day, and no one had really drunk extensively during the night.
We had also ordered a bunch of food (which took an inordinate amount of time to come out in classic Africa style) as the menu here includes most barbecued meat – chicken, beef, goat – as well as chips mayai (French fries and eggs cooked into a frittata). The grilled beef was some of the most tender I have tasted in Africa. We had plans tomorrow for dinner and the pool at the Manor Lodge, though it would really depend on the weather regarding the likelihood that we’d be spending time outdoors. The road to the Manor is a trip as you pass through an easement in the conservation area to reach the lodge.
