Update from Tenwek
In this installment of International for AANS Neurosurgeon, we revisit a prior story. Dr. William Copeland previously wrote about his experience as a resident working at Tenwek Hospital in Kenya. He has since returned to Tenwek as part of the two-year post-residency program through Samaritan’s Purse, responding to a higher calling to help people. Here is a unique story as told by Dr. Copeland demonstrating his practice in Kenya. If you are so compelled to assist in the work at Tenwek, he is accepting equipment, supplies and monetary donations. Alternatively, there is an opportunity to give of your time and effort as well.
“G. is a 17-year-old boy whose parents brought him to Tenwek in a coma. I did a double take at his head CT when the resident came to tell me about him…it showed the largest brain tumor I think I have ever seen!”
The tumor looked to be outside the brain, so while G. was unresponsive, I thought if we could remove it and take the pressure off his brain, perhaps he would have a chance at some improvement. We took him to the OR urgently that night and, as I feared, the tumor had developed an extensive vascular supply so that even as we made the incision and peeled down his scalp his skull was bleeding in countless places. The hospital’s only electric craniotomy drill had broken just a few days prior so we had the tedious task of removing his skull using a hand twist drill and manual saw. I had planned to open the covering of the brain over the center of the tumor and begin removing pieces of it but quickly realized the tumor was way too bloody for that tactic. So instead, I opened along the margins of the tumor in hopes of perhaps coming around it. The neurosurgeons reading this know what happened next, though. The tumor was putting so much pressure on the brain, the minute the brain was exposed, it began herniating toward us, begging to get away from the tumor. I knew between the brain trying to squeeze out of the head and the tumor bleeding, we needed to move fast. I had never done what I did next, and my mentors at Mayo would cringe were they watching. The plane between the tumor and the brain was actually pretty favorable, so I literally ran my hand between the brain and the tumor all around its margins until I was able to remove the thing in one chunk.
Even later that night in the ICU, G. began to open his eyes, and over the course of the next week, he made a remarkably full recovery. Thankfully, and somewhat surprisingly, his tumor was a benign meningioma, so I am hopeful he is now cured. G. really endeared himself to me, and the day he came back to clinic a month after surgery was a special day. I believe God spared G.’s life, and I shared with him the following scripture from Jeremiah.
“For I know the plans I have for you,” declares the Lord, “plans to prosper you and not harm you, plans to give you a hope and a future.”
I believe that is true for G., and I believe it is true for my family here in Kenya.
It is hard to believe I am finishing my seventh week of work here at Tenwek. Certainly it has had its challenges and many days we still feel unsettled, but there has been something entirely fulfilling about serving the people here and being where we are confident God has led us.
Work at the hospital has been plenty busy. Just yesterday, I gave a lecture to the residents, performed three operations while bouncing back and forth to the clinic to see 31 patients and had a ruptured aneurysm come to casualty (what we call the ER here), which I added to the two cases that were already scheduled for the day. I have good help though. The surgical residents here are great and interacting with them has been one of the most enjoyable aspects of my work.
Operating is almost always an adventure. More days than not, I feel out of my element. Either I am doing cases I have rarely (or never) done, or even in those cases I would otherwise be comfortable, I often do not have some piece of equipment and am left needing to improvise. I have found myself in the middle of many cases feeling way in over my head, being keenly aware of my own limitations as a surgeon and asking God to intervene. That is a humbling situation to be in, and it is teaching me a reliance on Him I have not previously allowed.
Thank you so much to the many of you who have supported us in various ways. Please know your support makes a real difference for us and is so encouraging as we continue to settle in to our new home here in Kenya.
If you’re interested in assisting in the work at Tenwek, feel free to email Dr. Copeland at email@example.com. For details on how to financially support each month or to give a one-time gift, visit www.samaritanspurse.org/wmmgiving.
Kranzler Chicago Review Course in Neurosurgery
Jan. 24-31, 2020; Chicago
46th Annual Richard Lende Winter Neurosurgery Conference
Jan. 31-Feb. 3, 2020; Snowbird, Utah
Third Annual Cedars Sinai Intracranial Hypotension Symposium
Feb. 8, 2020; Los Angeles
2020 Managing Coding and Reimbursement Challenges
Feb. 14-16, 2020; Las Vegas
13th Annual International Symposium on Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery
Feb. 21-23, 2020; Lake Buena Vista, Fla.
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