Historic Day

Today I performed the first transesopahageal echocardiogram ever in Botswana. A patient was sent from up country with an expanded ascending aorta, and I was asked to exclude the likelihood that it was due to an aortic dissection. The GE Vivid S6 machine that was left here by the CT surgeons from Mauritius (they did two valve replacements here at PMH prior to my arrival) had a TEE probe (both adult and pediatric!) waiting to be used, and when I got a call from a doctor up country for this indication, I responded. Once again, it was Little Red Hen syndrome. I had to find a place (the endoscopy "suite"), the meds (for sedation, prevention of excessive salivation, analgesia, and simple things like a tongue blade with topical anesthesia, the care of the probe (cidex cleaning and drying). Everything went fine, and the referring doctor was delighted to have the results (no dissection).
The day was busy and included consultation on a patient with heart failure, who had a spectacular cardiac examination and turned out to have a congenital heart problem called Tetrology of Fallot. I am getting jaded...I am almost expecting incredible pathology every time I am referred a patient for consultation!