Full Bladder, Empty Pocket

Screenshot

Available on Amazon!

In this riveting and deeply personal compendium of autobiographical and fictionalized medical memoirs, Dr. Surafel K Gebreselassie takes readers on an epic journey through the intricate intersections of illness, culture, and human experience. From the under-resourced healthcare settings of rural Ethiopia to the technologically advanced hospitals of the United States, his stories offer a fascinating glimpse into the struggles, uncertainties, triumphs and profoundly human encounters that define the practice of medicine. It is with candor, warmth, and occasional humor that he reminds us that medicine is never simply about diagnosing diseases and prescribing treatments. It is equally about understanding fears and hopes of  patients and appreciating the cultural and social circumstances that shape their experiences. Through the anecdotes he beautifully relates, he makes us realize the humanity that connects caregivers and those entrusted with their care.

Gubae Beyene, Ph.D., Assistant Professor, School of Communication, Florida International University

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ሳሏ

ሳሏ

ሸራዋን ወጥራ፣
ቀለሟን መጥና፣
እየተፍለቀለቀች ፣
ትስላለች።

ልጠጋት ስል

አፍዋን ከፍታ ታስላለች።

እራቅ ስል አጎንብሳ፣
ትስላለች እንደገና።

መጠት ስል መልሳ ፣
ታስላለች ሀክ ብላ ፣
እየተፋች።

ለውቢት ሳሏ
ማስፈራሪያዋ።

( የኮቪድ ዘመን ማስታወሻ)
Jan 2021

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የደሟ ጨው

ደወለችልኝ አከታትላ ቢጨንቃት፣

ፋታ ላትሰጠኝ በለሊት።

አንድ ጊዜ ያዝልኝ ፣

ሌላ ጥሪ መጣብኝ ፣

አልኩና የድንገተኛ ክፍል ሀኪሙን፣

አነሳሁላት ስልኩን።

“ዶክተር ነኘ፣ ከፅኑ ህሙማን፣

የደሟ ጨው በጣም ዝቅ ያለ ታማሚ አለችን፣

ያንተን እርዳታ እንፈልጋለን ።”

አለች …ቶሎ ቶሎ እየተነፈሰች።

ለመሆኑ ስንት ቢሆን ነው ?

የጨው ማነስ ክፋት አለው።

“ዘጠና ዘጠኝ “

በሊትር?

ነው ያልሽው  ዶክተር?

እንደዚህም  ያነሰ አላየሁ።

“ምኑንም አታዉቀው

ያመጣት ባሏ ነው”

በእኩለ ሌሊት፣

በዌስተን ከተማ ፣ፍሎሪዳ ግዛት፣

ነጩን የሆስፒታል ጋዉን፣

ከመኪናዬ ዃላወንበር ፣

አንገቴላይ ጣል አርጌ፣

የልብ ማዳመጫውን፣

የደሟን ጨው ላስተካክል፣

እየተማፀንኩ ወላዲትን፣

ደረስኩ…እየከነፍኩ!

ማሪያ ፣ ማሪያ

ማሪያ ፎልች?

አይኗን እንደከደነች  ፣

እጆቿን አንቀሳቀሰች።

የተከማቸ ጨው ፣

የያዘውን የፈሳሽ ቀመር፣

በልክ በልኩ፣

ሰጠናት በደምስር ።

ጠጥታ ኖሯል ፣ብዙ ፈሳሽ

ከውሀው፣ ከጭማቂው

ከሻይና ከቡናው።

አዋቂ ነኝ ባይ ልጅት፣

መጥታ ከሌላ ግዛት፣

ለኩላሊት ጥሩ ነው መጠጣት፣

ብላ… ፈሳሹን ሁሉ ብታግታት

የደሟ ጨው ከመቶ አርባ ፤

አሽቆለቆለ እያዋዛት።

መጀመሪያ ድንግዝግዝ ፣

ማቅለሽለሽ ማስመለስ፣

ከዛ ማ ምኑን አውቃው።

በልክ በልኩ በቀስታ፣

እንዳይነፍር ጭንቅላቷ፣

ገድበን በቀን ከስምንት ፣

ከዘጠናዘጠኝ …መቶ ሰባት፣

ከዛም መቶ አስራ አራት ፣

አስተካከልነው የጨው መጠኗን፣

አምስት ቀን ፈጅቶብን፣

አማላጅ ይዘን ወላዲትን።

ዉሀም ይወስዳል ፣ በልኩ ካልሆነ፣

እያንገዛገዘ ፣ እያጥወለወለ።

ሱራፌል

( severe hyponatremia, ከሆስፒታል ገጠመኞቼ)

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A letter to Miku

This is my second letter to you.

Michael, I want to remind you how much you enjoyed the bouncy house.  You had fun. Your sister had fun. The invited children all had fun. You were at your best in the new suite. So that is how we celebrated your 5th birthday. 

Mama cooked plenty of food to feed the whole neighborhood. She had all the spices ( berbere, kibe, mitmita) imported from Ethiopia. She was cooking the whole week; beef stew, lamb chops, chicken sauce (dorowot), minced raw beef marinated in spices (kitfo), some vegetable dishes. I helped cutting the meat in small pieces. I was busy renting and putting together the bouncy house so you don’t strip on the wires. We had a special birthday cake from the local French bakery. Your sister was busy helping mama. You kept running in the house, jumping on the couch, pushing the door handle trying to get out to the backyard. All you cared was the bouncy house. It was a hot summer day. It really was hot, so we didn’t let you until it started to cool down some. It is a September in Florida after all.

It was a special birthday for all of us. We also wanted to make you happy. You still didn’t have words to express your feelings but everything else told us you were happy too.   I remember you pulling me to give you sweets before the guests arrived. I had spoiled you so of course I did.  I remember how mama gave me that look of hers. You held my shirt and pulled me again to give you more sweets.  I wasn’t surprised when you started crying when I said it was enough.  Too much sweet was not good for your teeth; I really meant it.   Then I felt bad and asked you what you wanted?  I wish I had extra senses to know for sure.

Miku, what do you want?

Please point to what you want.

Can you say give me?

Please say it. Please try.

You ignored me and went to you sister. She started playing the piano for you the new songs that she had been practicing for your birth day.

Mary had a little lamb…

Row, Row, Row Your Boat…

Happy Birth Day to you…

 Which put a smile on your face. You got excited and started to bite your hand. How many times have we tried to stop you biting your hand just for you to do it again and again when you got excited.

 At around 3 pm all the invited families and their children came one by one bringing you some gifts.  You didn’t care to greet any one or even make eye contact but jumped on the gift.

It seems as if everyone knew that all what you cared for is a car. Indeed, many cars! For an hour you were lost in the new toy cars turning them on and off, playing with them. You never cared to acknowledge the visitors.

Miku, that was just how you were then.  You only wanted to do what pleased you to do. You never cared about pretend play or baby dolls. That was sort of a waste of time for you.  You wanted to figure out how everything worked from the cars toys to the TV, to the  cabinet doors swinging them wide open and pausing as they close again.

Your mind learns differently. I wish that is how my mind worked so I didn’t care about trivial things.

Everything went well except that you made a mess of the birthday suite.  After the guests went home and after you and your sister went to sleep, mama sat down with me to reflect about you and your sister and the years ahead.

A handsome little boy lost in your world. We tried to join you in that world.

 We are still trying.

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The Gummy

Poem by Bethel Surafel

I have a gummy,

That looks so yummy,

But it is an eraser,

That you erase with on paper,

But kids think it is a real gummy,

So when you eat it,

It tastes yummy.

Bethel is 7. She is currently at second grade.

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A LETTER TO MIKU

Miku,

I slowed down as if something hit me. Fortunately there were no cars behind and I was able to make a safe U-turn just before the entrance to the freeway. The flight was a little over 2 hours away which would have been the first since the pandemic started.

My siblings and their families were eagerly awaiting to join them for the baptism of my nephew and the birth-day celebration of my niece. I had already packed gifts for all the children so that was not an easy decision but boy I love you so much I felt something was not right…that I couldn’t leave you and your sister the way you reacted…crying and hanging to me ignoring your mom’s outstretched hands to take you back to the house.

That was also the first time you said “Ba-baa” looking at me and refusing to leave me which was special.

Miku, you were running in the house when I explained to your sister about the trip. You were a little over 3 but you were not using words to express in a way your sister would have. Your eye contact had improved and you were making vocalizations but your communication was limited to hand gestures such as pulling me or your mom to the kitchen table to lift you to reach the grapes or to the garage door to get out of the house. Of course your amazing fascination with numbers…I don’t know how many 3 years olds can count up or down from 50 or a 100 as you did then.

Zero one, zero two, zero three

I would like to remind you that by 3 you had stopped some of the repetitive things that you did such as rolling a water bottle or spinning yourself. You enjoyed jumping trampoline, running in the park, climbing in the playground but never cared about dolls or other children except your sister who was your therapist. She wouldn’t give you anything unless you looked her in the eye. You enjoyed her singing often touching her mouth to sing the same song over and over again.

The wheels on the bus go round and round, round and round, round and round.

You are a handsome little boy with a gift for numbers who one day can can become anything you would want to be but we had lots of anxiety mainly driven by our eagerness to do what we could for you to catch up in some of the communication delays while keeping up on your strength in numbers. There were also days you would surprise us by using both hands on a little Piano that your mother’s friend gave you during your birth day.

Your mom was shocked when I called her that I was on my way back to the house. She knew how that departure was emotional but I didn’t tell her my concerns about separation anxiety which can be severe in children like you who can’t express themselves throwing kids sometimes in to tantrums.

When I reached home you didn’t even care to look at me or turn when I called your name but a moment later you held my hand pointing to the cheerios. You stuffed a handful in your mouth. I knew that my return had comforted you and alleviated your anxiety in those days when you were not able to express yourself verbally.

The next day we walked together in the local YMCA before heading to Key Largo to eat lunch in your mom’s favorite seafood restaurant. You sat on a high chair and ate all the French fries ignoring the chicken fingers that came with it while clapping, on occasions, to the sound of reggae that was playing loudly, or so we thought, while your sister ate Mac and Cheese.

On the way back we stopped by a pumpkin store to take a picture and buy a pumpkin that your sister picked for the up coming halloween.

Miku, we love you boy!

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The ETHIOPIAN CULTURAL GARDEN, CLEVELAND, OHIO—A MONUMENT for the AGES

CLEVELAND’S INTERNATIONAL CULTURAL GARDEN PARK
This beautiful riverine park, given to Cleveland by Rockefeller in 1898, stretching from Lake Erie to University Circle, evolved into a large multi-cultural peace garden. First was the Shakespeare Garden in 1916. Since then, plots have been granted to many cultural communities to develop gardens. This is the world’s only multi-national, multi-cultural peace garden park.

Following petition of the Ethiopian community in Cleveland, on November 12th 2013 at 6:30 pm  at Judson Manor  ( 107 and Chester avenue in Cleveland)  ,Dr Carl Robson, Mr Aklilu Demessie, Mr Scott Embacher and Dr Surafel K Gebreselassie successfully argued Ethiopia’s unique historical and cultural role to the executive board of the Cleveland Cultural Garden Federation. Ethiopia ,the first from Africa, was awarded a site.

FROM CONCEPTUALIZATION TO REALIZATION: DEDICATION OF A GRAND MOSAIC FROM THE ‘LAND OF ORIGINS’
Phase 1 of our garden project, a ‘Grand Mosaic’ on both sides of a wall 12 x 18 ft., was envisioned, developed and completed by our Design Committee after six years of discussion, community planning and fund-raising, and in spite of  financial shortages.  The cost was higher than anticipated. But on August 24th, 2019, we had a wonderful Unveiling Ceremony. Among those present were Ethiopian Ambassador Fitsum Arega, Mayor Frank Jackson of Cleveland, and other dignitaries. Our guest of honor was Artist Professor Zerihun Yetmgeta of Addis Ababa University, who designed the Grand Mosaic and conceptualized the Stele Arch (to be Phase 2). Our Mosaicist, Ernesto Spinelli originally from Kulubi, Ethiopia, who fabricated the Mosaic from Zerihun’s paintings was present, and also Art Historian Dr. Ray Silverman from the University of Michigan, to introduce Artist Zerihun, his long-time friend, having introduced his art to America in the 1990’s. Interestingly, from that time, we already had Zerihun’s painting ‘Tarik’ (‘History’) – copy below – and had been referring to it for ideas, not realizing we would find him. Then, 25 years later, unexpectedly we found Professor Zerihun himself in Addis Ababa, happy to help with the project! In a traditional style, this Mosaic depicts six million years of the history of Ethiopia – ‘The Land of Origins’— from the dawn of humanity to globalization. It is the world’s only monument to Ethiopia’s remarkable history, unity, and diversity. Among the Cultural Gardens, it is a unique work of art.

MOSAIC CONTENT: 5 PANELS OF ETHIOPIA’S UNIQUE HISTORY and CONTRIBUTION TO INDEPENDENCE OF NATIONS

1. Cradle of humankind: Lucy (Dinknesh), 3.2 million years old, was the first significant hominid fossil find, in 1974 by paleoanthropologists from the Cleveland Museum of Natural History, which is adjacent to the Cultural Garden Park. However, older, even more astounding fossils, dating back six million years, have been found by teams under the Museum’s present Curator of Anatomy, Dr. Yohannes Haile Selassie.

Also depicted in this panel are ancient rock paintings from 4,000 year ago near Dire Dawe.

2. Diversification within Ethiopia of 86 ethnic groups and almost as many languages is exemplified by the Konso People as one representative of the many – a group from the South of Ethiopia who first initiated terraced farming several thousand years ago.

3. Ancient Civilizations, Religions of Ethiopia: Foremost is the Axumite Empire – 200 BC to 1000 AD—with builders of uniquely carved, monolithic stelae 79 feet tall. They became icons of Ethiopia with an enduring impact on art and architecture. Queen of Sheba’s son by King Solomon is said to have brought Judaism (known later as Be’te Israel) along with the Ark of the Covenant, per ‘Kibre Negest’ narrative, now said to be ensconced in a chapel in Axum. Christianity was proclaimed by Emperor Ezana in 330 A.D. In 615 A.D., early followers of Mohammad from Mecca were given asylum by the Axum Emperor, and Islam has become a major religion in Ethiopia. About 1200 A.D. Emperor Lalibela, in a town that now bears his name, carved 11 amazing monolithic Orthodox churches based on Axum Stelae designs. Then, also about 1200 AD, Harar, now in Ethiopia, became (and remains) one of the world’s most influential centers of Islam, at that time building 99 mosques, one for every name of Allah in the Koran. Most Be’te Israel emigrated to Israel in recent times. Christianity and Islam are the two main religions of Ethiopia today, being very compatible when outside influences are not factors.

4. Nation-Building, King of Kings, Independence – Rule by Emperors from Menelik I, legendary son of King Solomon and Queen of Sheba, to Haile Selassie. The Emperors, known as ‘King of Kings’, unified the nation and resisted European Imperialism, climaxing with the defeat of a large Italian army at the Battle of Adwa on March 1st, 1896, by Emperor Menelik II, Empress Taytu, and a remarkable coalition of patriotic regional rulers who put aside their differences and joined forces, surprising the Italians and defeating them, thus maintaining Ethiopian independence. This was a stunning defeat and a rallying cry for subjugated peoples around the globe, boosting morale, ethnic pride, and independence determinism. The empty throne in the mosaic indicates the interruption in 1974 of the ancient Solomonic Line of Emperors.

5. Globalization, depicted with a prominent ‘T’beb’ (Eye of Wisdom); also the proverb “Today’s flowers, tomorrow’s fruit”. The second eye is the ‘globe’ of globalization, with an encircling moon of technology. Finally is a message from Professor Zerihun on behalf of the imperative of Art, in the form of a symbolic doorway: the implied message: “We must keep knocking on the Door of the Visual Arts.”

MOSAIC SIDE 2: LOSS OF HABITAT, GLOBAL ENVIRONMENTAL CHANGE – THE UNTHINKABLE POSSIBILITY

The other side of the Mosaic Wall displays Professor Zerihun’s painting from 1987, “When the Sun Gets the Moon”, indicating destruction of forests (e.g. Ethiopian forest coverage once 60% is now less than 1%), and large polluted cities. We have made the Sun a destructive force in spite of technology that enabled travel to the Moon. Environmental decay, habitat loss, fossil fuels, other pollutants, yielding climate change, crop failures, extinctions, zoonotic diseases (SARS, Covid 19), population movements, hostilities, reactive leaderships, destructive military responses– all are intertwined. We have come to the unthinkable possibility of the collapse of civilization as we know it. Yet contrary to the connection of these events, logic fails and destructive policies continue. This painting is a plea, from the land where human life began, to redirect efforts, work together in peace, restore the environment. This was elegantly stated by Michael Higgins, President of Ireland, on his visit to Addis Ababa November 5, 2014, commemorated in a plaque on the mosaic:

“In the very long term, in the multi-secular temporal horizon which is that of Lucy, we are but immigrants in time and space – transient travelers who must do our best to pass on to the next generation a hospitable ground on which they can flourish.”

AMPLIFYING  GLOBAL  IMPACT: PHASES 2 AND 3

The Unveiling received good publicity here and in Ethiopia. Ambassador Fitsum Arega was impressed that this project was conceived and accomplished by our small Ethiopian community. The Mosaic is impressive, yet we need project completion for global impact: 1) historical pride, 2) support for national unity – democracy with diversity – and 3) a plea for worldwide cohesion & environmental restoration. It is desirable to build the next 2 Phases together: Phase 2, a 35 ft. tall stone arch, an   Axum Stele in Silhouette, and Phase 3, a stone replica of a Lalibela church doorway and patio in the shape of a map of Ethiopia. We have hopes for this Garden – a ‘Monument for the Ages’ – attracting worldwide attention and functioning as a unique gathering place. We are determined to complete Phases 2 and 3 as soon as possible.

For more including recent updates and to consider donating to complete phase II and III , visit the GoFundMe page created by Scott

http://www.gofundme.com/f/ethiopian-cultural-garden

 

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“I want to come with you to the hospital,”

“I want to come with you to the hospital, see my stethoscope and mask, mommy got it for me”

That was the sweet sound of my soon to be 4 year old daughter waiting for me after a busy hospital call.
She was dressed in a doll white coat, a stethoscope on her neck and a matching face mask that mom got her on amazon.

She was seeing people with masks every time the TV was on. These days before she goes to sleep she prays “for daddy, mammy, and Mikel”, her younger brother.

This pandemic has caused so much worry, fear, anxiety, pressure , stress, the trauma of being isolated, inability to sleep well, concern about access to basic things like food, financial wellbeing and on and on ,irrespective of who we are , where we live, whatever is our status professionally or financially. Everyone is affected including the little ones. It is even more challenging for a health care provider as we juggle with the fear of being sick, infecting your loved ones or not be able to care for them.

Schools closed and many working remotely from home, many parents would struggle to protect and nurture kids through this pandemic.
Being creative and having a schedule to stick to would be helpful. Mom is using this time of home stay to teach the kids some Amharic.

We decided not to turn on the TV and avoid discussing about the pandemic in front of our children.

This past Sunday while celebrating Coptic Easter, we dressed them up with Ethiopian traditional dress and spend the time together eating Ethiopian food.

It paid off.

All day what she talked about was going to see her nephews and nieces in Ethiopia. It must have brought some memories from our last visit during the Ethiopian New year.

During this time of crisis we all have to step up and turn off the noise, try to relate and be concerned, and while doing all the appropriate things that public health practices recommend, we as parents and health care providers need to project a sense of pragmatic optimism be it at work in the front lines or when we get home paying special attention to the little ones who may not appreciate the facts but may feel unsettled when they see us anxious or worried.

Stay safe.

Posted in Memoir | 1 Comment

COVID-19 in Africa

The impact of COVID-19 in Africa is frightening. Africa already carries 23% of the global disease burden such as malaria, HIV, tuberculosis but only accounts for 1% of the global health expenditure. There are over 4300 confirmed infections with COVID-19 in Africa along with 117 recorded deaths but this may not reflect the true picture due to the wide spread lack of testing in Africa. There are over 650,000 cases globally including over 30,000 deaths and it is increasing rapidly.

The impact in Africa will be devastating unless something is done urgently which is acknowledged by many global leaders including UN Secretary General Antonio Guterres,

“Africa is in urgent need of tests kits, masks, and ventilators, protective suits for health workers…we can still prevent the worst in Africa but without a massive mobilization we will have millions and millions of people contaminated which means millions of deaths”, as reported by RFI.

Some facts about COVID-19
There is currently no vaccine or proven treatment for COVID-19 although there are ongoing trials and encouraging results driven from small clinical data sets prompting use of some medications for compassionate use.

PREVENTION, PREVENTION, PREVENTION
Wash your hands with soap and water for at least 20 seconds or use a hand sanitizer that contains at least 60% alcohol.
Avoid touching your eyes, nose and mouth with unwashed hands
Avoid close contact with people who are sick
Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow; trash used tissue in trash; then wash your hands or use hand sanitizer as stated above.

Symptoms of COVID 19 that may appear 2-14 days after exposure:
FEVER
COUGH
SHORTNESS OF BREATH

Emergency warning signs to get medical attention immediately
TROUBLE BREATHING
PERSISTENT PAIN OR PRESSURE IN THE CHEST
NEW CONFUSION OR INABILITY TO AROUSE
BLUISH LIPS OR FACE
And consult your medical provider for any other symptoms that are severe or concerning.

The 2019 Nobel Peace Prize laureate Ethiopian PM Abiy Ahmed has stressed that only global victory can bring the COVID-19 pandemic to an end on an op-ed published on Financial Times on March 25. He called for a global leadership,
“Without that, Africa may suffer the worst, yet it will not be the last. We are all in this together, and we must work together to the end.”

We all have a moral responsibility to contribute in any way we can to defeat COVID-19.

Source
CDC.gov
Radio France International
FT.com

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