Chili Lemon Potato Chips

It is Saturday lunchtime. The African sun is spectacularly bright, the sky a calming blue, and the temperature a perfect 70. I've just returned from a walk in downtown Eldoret. I've got my weeks supply of "Chili Lemon" potato chips and cookies. I'll know in an hour or two if I'll pay the price for not putting on sunscreen.

While the IU House is quiet right now, it has been a hectic week with a visit from the Dean of the IU Medical School, the head of the IU Simon Cancer Center, and the chairs of Medicine and Surgery. This week also heralded the return of the IU medical students! Everyone here is excited to have them back.

I'm here working with the Palliative Care team and we had the opportunity to attend the Multi-disciplinary Cancer Management Course sponsored by AMPATH and the American Society of Clinical Oncology. The three-day course focused on proper management of various cancers. I was excited to see the inclusion of palliative care in the curriculum and encouraged when the majority of attendees signed up for a breakout session on the topic. In fact they had to add a second session to accommodate everyone! I was honored to co-chair the session with Dr. Esther Muinga from the Kenyan Hospice and Palliative Care Association. There was a fascinating discussion on the challenges of communicating recommendations for supportive care and hospice. There are clearly distinct cultural differences around end of life, many of which I am just now starting to understand. Nevertheless, there are many shared challenges as we in medicine try to assure patients that our focus is always about them and not just the disease. We may not always be able to offer chemotherapy, but we can always provide care to the person.

Every time I visit Eldoret my perspective matures, and it aged significantly this week. Earlier in the week the team met to discuss a potential research project aimed at providing hospice support to cancer patients. Later in the week we met to see if their work manning a 24-hour hotline for cancer patients should be published in the medical literature. They wanted others to learn from their experience. The next evening I had dinner with one of the young hematologists. He was explaining some of the progress he has had with acute leukemia patients, patients they were not even offered therapy a year ago. He was clearly excited about his results, but most amazingly he was thinking about how he could develop a research protocol to improve care. As I began processing these discussions, I realized how truly impactful AMPATH has been. They have developed a unique environment where the Kenyan partners are not just delivering care. They are embracing the academic model to develop clinical excellence and promote advances. The challenges here are daunting but the chance to work with my Kenyan colleagues who are so dedicated to improving the lives of their countrymen is truly inspiring. I am humbled by their dedication and honored to contribute what I can.

Ken Cornetta, MD
Director, Inpatient Palliative Care
IU Health Bloomington Hospital
Professor of Medical and Molecular Genetics
IU School of Medicine