Friday, August 3, 2012

Just a Pile of Old Rocks

While I bashed Rick Steves a little bit on the food advice, I can say that he's really been spot-on with seeing the sites.

If we had read more carefully we would have had tickets to the Uffizi and Academia.  It wasn't Rick's fault, he tried to warn us.

Where Rick really shined for us this trip were two thing: Information about the Roma Pass, which at 30 Euros/ea was a real plus, allowing us to skip lines at the Collosseum, Forum, and Borghese Gallery.  We saw all three without additional charges.  If we had felt like traveling on busses, those would have also been included so we highly recommend going with the Roma Pass. 

Also, Rick completely hooked us up with Rick Steves Audio Europe. It's an audio guidebook complete with walking tours for lots and lots of sites, all of which we downloaded ahead of time (no internet connection required in country).  The FREE iPhone app also has maps, and full transcripts of the audio content.

We used them for the forum and for the Colosseum.   Both were just under 1 hour long, and paced very well.  We learned things that wouldn't have been easily apparent: there were 80 elevators underneath the floor of the Colosseum for elevating animals, plants, gladiators, etc. 

Most of the Colloseum was built as a combination of brick and concrete and then finished with Marble exterior.  We also learned about another roman invention - the vomitorium (passageway beneath seats) which is something present in all of our stadiums to this day.

For the forum, the walking tour was necessary.  Without some type of guide, the astounding site would have only appeared to be a pile of old rocks with a few rotting columns. 

There were many people hawking tours with large groups trying to huddle around one tour guide.  We were able to go at our own pace with our personal guide on our iPhones.   It was like a far cheaper (less interactive) version of Elizabeth from Florence.

We learned about the history of Rome, the Roman empire, architectural features, as well as history of many of the emperors.

One of the most beautiful parts of the forum were the grounds of the former palace of the vestal virgins.  The vestal virgins were the keepers of the fire in the temple of Vesta (also in the forum).  It was thought that as long as the fire burned in the temple that Rome would continue.  That this dedicated and important group of women was chosen prior to turning 10 and served a 30 year term.  If they were still virgins at the end of the term they were given a large dowry and were allowed to marry.  If they were found to have lost their virginity they were given a loaf of bread, a candle, and buried alive in a catacomb.

There was also a really neat collection of glassware from ancient times.  It again was nearly impossible to photograph so you'll just have to believe that the range of colors and patters was stunning.  Several pieces were made with the millefiore technique seen in some of the beads from the store in Nairobi.

The history and detail provided by the walking tours were astonishing for something provided free of charge.

You're going to love Italian Food?

Being foodies - Lisa and I had thought that in a country with such strong food traditions we would have little issue trying to find good meals.  Wow, were we wrong.  We've had pasta so dente that you needed to pick it out of your teeth with a toothpick, tons of mediocre pizza, and meh pastries.  Not to mention the "risotto" that one cafe tried to serve that was basically wet jasmine rice with a few mushrooms thrown in for good measure. Most of the gelato has been good, but a few were underwhelming.  Of course there are two sides to every coin so I'll present both here.

Us: We came unprepared to find great food.  Yelp, our usual tool for finding fabulous food is far less functional here than in the states.  Our primary guide book (Rick Steves 2012) was also pretty ineffective when it comes to food/eating.  Turns out next time we travel in Europe we'll be picking up a Michelin or Zagat guide to bring along.

Italy: You really have three kinds of restaurants: Italian dining, wine bars, and cafes.  They basically all serve the same thing: pizza and pasta, coffee, wine.  The price varies, and the quality varies (not as much as the price).

Over the trip we really came to appreciate the vast smorgasbord of variety that's currently provided even in stuffy 'ole Indianapolis (Thai, Japanese, Italian, Chinese, Sandwich, Burrito, etc).

We finally got smart and spent a little more time researching (plus more $$) and had our first really solid meal of the trip last night at Taverna Trilussa.  It's an Italian restaurant that specializes in delicacies of Rome in particular.  They prepare each pasta dish individually serving it in it's pan to emphasize their small-batch thinking.

Lisa had a tasty spinach ravioli in an egg-based cream sauce that was finish with bits of hard boiled egg.  It was what alfredo sauce in the states always wishes to be. I think that she finished it, which means it was really good.

I had a roman specialty called amatriciana which is a hollow pasta tossed with a tomato based sauce and cured pork cheek - guanciale (although the English translation on the menu just said bacon.....).  It was very tasty and the pasta was cooked to perfection.

We also had a tasty dessert that night called Mille-feuille which was lots of tiny sheets of pastry with tall layers of pastry cream interleaved and a big dollop of nutella on top. 

We were so 'fat-and-happy' that we decided to skip the port and head straight home for bed.  Finally, nearly done with our trip we found a great meal in Italy.

Wednesday, August 1, 2012

La Specolla

From the outside looking in it may seem like we always have things under control.  Reality is unfortunately, slightly different.  For example, usually we're well researched regarding trips, and having things well planned in advance.  For this trip, however life got in the way.  Despite advice and books from the Girls in NC, and numerous tips from our newest biking buddy in Indy we both failed to plan ahead to get reservations for the Academia and the Uffizi gallery.  So, we traveled to Florence without doing the quintessential visit of David. 

On the other hand, it's not much different from visiting NYC twice without seeing the Statue of Liberty, which is the case for both of us.  Fortunately, Lisa had a backup plan.  She had heard about a museum called La Specola.  It's famous for it's collection of taxidermied animals, and fantastic 18th century wax anatomic models.  Basically, right up our alley.

The first few rooms were filled with great bug specimens from all over the world.  Lisa was horrified about several of the larger ones (as seen above).

One of the particularly awesome bugs were some of the butterflies that impersonate leaves.  Take a close look at the picture above and see if you can identify the leaves from the butterflies.

The collection of taxidermied animals was pretty impressive, going on for several rooms.  The range and breadth of the collection was broad including a rhinocerous and a lion (which was quite a bit better than  Unfortunately for the whole museum they were all behind these awful glass and wood cases with the most depressing fluorescent lighting possible.

The bird rooms were particularly impressive.

Next we moved on to the anatomy rooms - there were again several (at least five) that were each filled with at least 50 individual models and usually at least one full-size model standing or laying down.  Each highlighted a different portion of anatomy:

Muscles and bones

Vascular anatomy and the lymphatic system

Neuro-anatomy.  Of course, there was a room dedicated completely to obstetrics with different models demonstraing different stages of pregnancy as well as a model of different types of ectopics.  Due to the poor lighting, and plate-glass they were all difficult to photograph.  I felt lucky to get the few pics shared above.

In the final room, there were four particularly detailed and graphic wax models representing 'life' during the black plague and this head.  The pieces in this room were obviously special, since they were actually well lit and much easier to photograph.  They were part of a collection by a particularly gifted wax artist named Guilio Gaetano Zumbo and were created in the 1700s.  This model of a human head exposing the muscles of the face, and the salivary glands was particularly vivid and actually utilized a human skull as the basis for the model.

Overall, it was a great little museum off the beaten path.  I'm not sure that I'm sad we missed David.

Tuesday, July 31, 2012

A Three Hour Tour

(It was really only two hours)

After the great fun we had on the walking tour in NYC, Lisa found - a company that specalizes in walking tours.  Ours was a tour of architecture called the Colors of Florence. It turned out to be just the two of us and Elizabeth Butler - our guide.  Elizabeth is from the US but has lived in Florence for the last 9 years studying art history.   In a surreal happenstance, her sister lives in Indy!  She was saying that she normally goes to the states in August and loves going to our state fair with her nieces.

The tour itself was fantastic.  She definitely knew her stuff.  It was great to go beneath the surface to learn special details about different buildings.  What follows are a few stories from our tour.

The picture above is the Basilica Santa Maria Novella.  It was built over literally hundreds of years.   There were even times when it sat unoccupied.  If you take a close look at the photo you can tell that it's truly a facade - the fancy white and green marble is only on the front side of the building with the rougher local stone in the background (see right side).  Also, if you look closely the facade has two different levels of detail on the top vs. the bottom half.  These were built in different eras with improved construction techniques on the top.  This church is quite a bit older than the duomo and you can tell that the carving skills were not yet developed as this is all inlaid marble without much carving.  This church, which now is firmly within the city limits was once in the countryside and even had a nickname "vineyards church" because it was surrounded by vineyards.

Next, we walked over to the palace of the Strozzi family.  They were another rich family that rivaled the Medici family in Florence history.  On the outside of their palace, there was a long stone bench that ran the entire perimeter of the building.  We learned that this bench was where all of the clients of the bank run by the Strozzi family would wait.  We also learned that our work bankrupt comes from the Italian 'banca rotta'  which means broken bench, a fantastic connection.  If you look at the courtyard above, there is a new type of marble - the grey marble.  At the time that the church in the first picture was built this type of marble was not available.  It's inclusion here led to the warmth and welcome of the palace.  Elizabeth also mentioned that the courtyard also served other important functions for the palace; there is a cistern beneath the courtyard that collected rainwater for use throughout the palace.

Next we headed over to the Piazza della Repubblica, which among other things is the site of a famous cafe called Caffè le Giubbe Rosse.  Founded by two Germans in 1900, it has been frequented by literati including Hemmingway throughout the century.

There were two tiny features that Elizabeth pointed out that would have very easily been missed.   The first (above) is a flood water marker.  In November of 1966 it rained almost non-stop for 60 days and Florence was badly flooded.  This was about three feet off of the ground, and closer to the river the water was even higher.  Famously, the bronze doors from the Duomo's baptistry were torn off of their hinges and carried away by the flood.  The flood cleanup was extensive and many young people (dubbed Mud Angels) moved to the city to aid in the restoration work.  Many of the techniques for restoring fresco paintings in use today were quickly developed after the flood out of sheer necessity.

The second tiny detail is this line cut into the stone near a fabric shop.  This was a government-sanctioned and protected measuring device (1m) so that customers could verify that they weren't being ripped off.

 Next, we headed over to the Piazza della Signoria where the current-day government is held.  There is a large building that included several details from medieval times including large holes in the roof line where flaming arrows or hot oil could be dropped.  One of the most beautiful parts of this Piazza is the gallery of sculptures overlooking the square.  The most striking sculpture is of Perseus holding Medusa's head and standing on her body.  We learned about bronze casting and the lost-wax technique used to form the sculpture.  The artist was lucky to be supported by the duke of the time which allowed him to practice and refine this art of bronze sculpture.

Right behind the sculpture gallery is the Galeria degli Uffizi - a famous art museum that boasts the best collection of Italian paintings in the world.  The picture above is from the walkway between the two large wings which looks out onto the river Arno. It was quite a beautiful scene in the late morning.

We concluded our tour with a beautiful view of the Ponte Vecchio. As you can see, it's a very old bridge that is actually lined with shops, and has a walkway across the top.  This was built by Cosimo I de' Medici so that he could walk from the government building, through the Uffuzi, across the river to one of his palaces on the hill.  In 1593, in order to establish the prestige of the bridge Cosimo banned the butchers that had set up shop along the bridge.  They were quickly replaced by gold merchants, who remain on the bridge to this day. 

The elaborate wooden security doors that completely cover the glass storefronts still exist to this day. Many of them have a small peephole that allows a look into the shop from the street.

Overall it was a fantastic tour and an opportunity to see many things we wouldn't have otherwise noticed.

Saturday, July 28, 2012

July Kenya Wrapup

This trip to Kenya has been excellent.  We made some good progress for the short three week visit.  It's never enough, but it's more than nothing. 

We've been waiting and working on trying to get our mobile X-ray system up and running.  We're currently hung up on getting design and radiation protection finished.  It then will take 8 weeks to actually build the body for the truck.  So, it's looking doubtful that it will be on the road before the end of the year. 

From the informatics/coding portions of my work, we're getting a lot closer to establishing an electronic results feed from our system into the AMPATH medical record system.  I was able to make sure that the X-rays from the truck can be uploaded to the system easily by the workers at the hospital at the last minute, on the last day, which was really sweet.

Working with the registrars continues to be one of the great pleasures of my trip to Kenya.  I gave them a total of about 4 hours worth of lectures that I had prepared.  Their thirst for knowledge continues to be quite strong and it's great to work with them.  One of the major projects that I'm going to be working on when we get back home is fundraising for an endowment to support travel and lodging expenses for Kenyan residents to visit the states.  Let me know if you'd like to donate - we'll start soon.

One of the unexpected pleasures from this trip was finding a new bond of friendship with Val.  It's usually hard traveling with people, but this trip has been absolutely easy.  I was worried that we wouldn't have much to talk about, but conversation was effortless.  Will have to add another friendship to those solidified in Kenya. 

I can't wait to come back, maybe sometime before next July?

Thursday, July 26, 2012

2012 Kenya Unknown Case #3

9 yo male with history of exophthalmos.  

Non-contrast orbital CT scan.

Contrast Enhanced Orbital CT

Sunday, July 22, 2012

Nakuru Safari

Safari is an important part of a trip to Kenya - especially first trips.  Because we didn't have much time this go-round I decided to take Val (my chairman) to Lake Nakuru for a short weekend trip.  It's not far from Eldoret and the road between here and there is pretty good.

We had a nice trip, it only took about 3.5 hours.  On the way into the park we were greeted by the usual assortment of baboons, monkeys, antelopes and birds.

The place where we're staying, Lake Nakuru Lodge, is nice.  Especially because it sits on a hill overlooking the park and the views are fantastic.

Last night after our evening game drive we had about an hour before dinner was served.  We spent time on the porch to Val's room drinking white wine and chatting.  Looking over the park to the cliffs on the far side we could see fires from houses on the cliffs flickering like fireflies along the hills.  The stars at night were also quite nice, especially compared with Indianapolis.

We've seen some great birds - I don't have many pictures of them because I'm traveling light without my telephoto lens as I'm continuing on to Italy.  Val has taken tons of pictures so she may be able to fill in for me.

It turns out that the hotel only has a very low electified fence that is quite easily conquered by the baboons.  This has led to some interesting encounters.  One out-right begged Val for food, one tried to steal my camera, another tried to break into my room via a sliding glass door opened for ventillation, and countless others have danced across the porch and pulled tiles from the roof trying to scale it.  I got some pretty good video of them playing outside my room - will upload when I get back to better bandwidth.

On our early morning drive, we were treated to two rare finds: we saw a leopard (my first good look ever) and we also saw a single lion try to take down a cape buffalo.  When the lion's friends didn't close in quickly the buffalo went on the offensive and chased the lion away.  It was pretty amazing to watch.

We topped off our late morning drive with an amazing symphony of pelicans flying in formation over the van repeatedly.  I shot some video of this and hope to also get it edited and posted soon.

Our final game drive took us to see the waterfall at the edge of the park.  It was probably about 30 stories tall and quite easy to access and photograph.  We drove up to the top of baboon cliff, where it was raining slightly and the small structure was occupied by very loud people smoking :-(  Otherwise the views were fantastic. There weren't any other big animal sightings but we had a good time taking pictures of the numerous birds.

This was definitely my best trip to Nakuru, and Val had a fantastic time.

Saturday, July 21, 2012

Dinner with the O'Mearas

I was lucky to have an invitation to have a home-cooked meal from Patrick and Wendy O'Meara.  Patrick is an engineer who has been working on the design and fabrication of the mobile X-ray truck.  Wendy is one of the co-field directors for research at AMPATH on the facutly at Duke.

Luckily, I had a bar of dark chocolate Santander (Lisa's favorite) to take as a gift for my hosts, it was well received as good dark chocolate is hard to find in Kenya.  For dinner, they shared salad from their garden, tasty beef stew made with slow cooker imported from Scotland, and a whole-grain bread that includes spent grain from Patrick's home brewing. 

Yes, I said home brewing.  Apparently when they moved to Kenya six years ago they decided that they needed to start learning to brew if they were going to survive.  Kenyan beer, while refreshing and quaint for the occasional visiter, it looses it's luster quickly.  It would be akin to drinking Budweiser and nothing else for years on end.

Over the past six years Patrick has definitely had some practice.  I was able to enjoy a wonderfully made IPA, which put a nice cap on the week.

The salad was particularly nice because I thought that it was an impossibility for my trip.  Lisa and I had lots of salads and even picked a dinner restaurant based on salad before I left.  Typically vegetables that need to be washed before cooking are a bad idea in places where the water can be suspect.  Wendy went all out with the cleaning process to ensure that I wouldn't get sick.

After the general formalities - what do you do here etc - we had some great conversations about places to hike, travel, and food.  It's obvious that Patrick and Wendy care about food quite a bit so we had a lot of stories to share.  They showed me some large blocks of exotic salts from their recent trip to Nepal and shared some peppercorns that had a strong orange note.  The one salt was a dark-brown almost black color and apparently had some sulfur content which gave it a pungent odor.

Oh yeah - and their pup is ridiculously cute, lives indoors and doesn't smell badly like most kenyan dogs.

It was the second special dinner of the week, life doesn't get much better.

Friday, July 20, 2012

Val's Arrival and Dinner at Abuya's

I'm very pleased to say that Dr. Jackson - the chairwoman of our department has joined me in Kenya.  While she is quite well traveled, this is her first visit to Africa.

The residents and radiologists greeted her warmly.  They had even moved up their week of exams in order to spend more time with Dr. Jackson.  After the welcoming gathering we were treated to a tour of the department and other areas of the hospital with the two chief residents - Daniel and Lois.

The following next evening, Dr. Abuya and his wife hosted a wonderful dinner of three courses.  We started with a tasty vegetable-pea soup, then enjoyed a range of entrees from chapati and rice to fried chicken and mutton curry.  For dinner we were joined by Dr. Kimutai and several of the registrars: Cornelius, Grace, Mary, and Lois.  After dinner we were treated to an array of beverages including: coffee, tea, tusker, tusker lite, kingfisher orange fruit wine, tropical strawberry cooler, and sparkling soft red wine.

The after dinner conversation was an affirmation of both side's commitment to continued partnership and exchange.  Everyone had a great night.