I thought I'd finally let yall see my place. Not bad huh. Ok, this is the Sheraton, Addis. For a paltry $8000USD a night you can stay in one of the villas. It really is a strange sight to see among the stark poverty. My place is actually below. It really is very nice and I think I have finally settled into a routine. Alarm goes off. I go, roach spray in hand, to the kitchen. Blast off a roach or two. Put up a big pot of water to boil for my shower. Make a cup of instant Nescafe. An hour later I am off to the hospital.

This week was a reasonably full week of operating. However, the responsibility with which I have been charged is finally setting in. I am here to teach and lead. We have 4 children on our service who need urgent operations. There is a woman who is paraplegic from a thoracic spine mass who needs an operation. And we currently only have 2 days a week of dedicated operating time.

A significant fraction of our patients come from several hundred kilometers away to receive medical care. There is no insurance for the vast majority of these patients. It is especially hard see families grapple with the harsh economic realities. If neurosurgery (or medicine in general) can only serve to postpone an inevitable death, does a family spend their entire life savings to attain this goal? As I write this, it sounds overly dramatic. But this is a reality faced by many families. Fortunately, for most at our community hospital in Houston this is a nonissue. They receive full medical care regardless of their ability to pay or insurance status.

I am finding that stick injuries are disturbingly common here in Ethiopia. Whereas our community hospital is inundated with gunshots to the head and motorcycle accidents, here people are victims of blows to the head with sticks. Depressed skull fractures like this are a common occurence.

Dr. Mersha gave me a tour of the city on Friday, including a trip the the Addis Museum and his private clinic. The salary of a resident (actually doctors in general) is often times not adequate to provide for a family. As a result, many will work another job at a private clinic to supplement their income. At the museum, we had a chance to explore further into Ethiopian history. The saga is divided by a series of rulers - from the Solomonic Dynasty to Haile Sellassie. I also paid my respects to Lucy. As I find out, this is not in fact Lucy, but a replica. The real Lucy is locked away somewhere in a vault.

Yesterday was Christmas Eve. A friend from the hospital and I visited the children at the orphanage. A whole program has been developed for around 100 children without homes in Addis. The day began with singing and a play by the children, followed by a religious ceremony teaching the meaning of Christmas, ending with feast.

Today I celebrated my second Christmas. As there is a strong Christian population here, this is a very important holiday. Part of the celebration includes the preparation of special meals. Hence the calling of sheep and chickens from within my apartment building all night long prior to the celebration today. I shared Christmas with a friend's family. We enjoyed a traditional Ethiopian meal followed by the traditional coffee ceremony. This is quite a ritual. It begins with the roasting of fresh coffee beans which are then ground and served as three rounds of coffee. The afternoon finished with the beginning of Borat. Will have to rent it when I return.

Tomorrow the week begins. Hopefully we can be granted one more operating day to help relieve some of the backlog of patients. We will start by treating a child with a large brain mass (abscess?) and hydrocephalus followed by the patient with a thoracic spine mass.