Also, a short lecture on congenital facial deformities...

The Huang family newsletter

By the time we will have left our medical specialties in Saskatoon and restarted our medical practice in Gabon, it will have been almost a year-and-a-half. (For anDrew, the time between safety-wiring aviation bolts will have been even longer.) Thus, we often get asked: do you miss medicine?

The answer is easy, but not straightforward. Yes, we miss medicine. We miss plying our trade, practicing our art, doing the things we were trained (for the better part of a decade) to do. We miss feeling competent in something, speaking at an advanced and technical level, working on a task that requires communication rather than simply working on our communication. That being said, we also sincerely enjoy French language school. It is challenging and fun in its own peculiar way, with goals and deadlines and levels of accomplishment not indistinct from our medical education. We also recognize what a privilege it is to in fact take time off and focus non-stop on language study. It is not an opportunity we take lightly or for granted.
Wintertime at the gardens of Versailles.
Still, sometimes our hands get itchy for the familiar. For instance, we both were very keen to observe particulars of the operating theatre during Kimberley’s recent Caesarean section. As it turned out, having the father present in theatre during a C-section was not a given in France : it required the express permission of the anesthetist (not, as we had incorrectly assumed, the surgeon). Fortunately, the anesthesiologist on-call was amenable, and Kimberley was keen to be a good patient, bending her back as much as possible during the injection of spinal anesthesia and noting her vital signs on the anesthetic monitors. anDrew spent a fair amount of time looking across the blue barrier to Kimberley’s exposed uterus and Solène’s emerging head.
Normally (or perhaps stereotypically), after the birth of a child, the parents are often overwhelmed with joy, emotion, and a sense of accomplishment. They stare lovingly at their newborn, who is, almost always and even by the strictest of Calvinists, described by one word: "perfect."

This was not true of Solène’s birth. The midwife had performed the obligatory newborn physical exam : No choanal atresia, no imperforate anus, no cleft palate, etc. She then handed over the baby girl (who, by the way, was still a bit cyanotic, despite the Apgar score being registered at 10) to the waiting arms of anDrew. Almost immediately, anDrew noticed something abnormal with his firstborn daughter.

It was her right ear.
Solène's right ear, one day after her birth
It wasn’t a particularly severe variant of the deformity, but it was certainly present. It is called a Stahl’s ear deformity, noted by the presence of third antihelical crus that abnormally unfurls the normally rounded edge of the auricular helix. Stahl’s ear is occasionally nicknamed the Vulcan ear or Spock ear, as it can make the top of the ear abnormally pointy, as portrayed by the Vulcan alien Spock in the television and movie series Star Trek.
The areas highlighted in purple correspond to the normal antihelical folds of the ear. The abnormal "third crus" is highlighted in yellow.
An external ear deformity like this is caused by misshapen ear cartilage. Ear cartilage itself is a fascinating and unique tissue. It is aptly named elastic cartilage, because it is extremely flexible, yet always bounces back to its original shape.

That is, it almost always bounces back to its original shape. As all of our otolaryngology and plastic surgery friends reading this will know (and, hopefully and more critically, our pediatric and family medicine friends as well), elastic cartilage is in fact moldable for the first several weeks and months of life. The external ear can be reshaped, thanks to the presence of maternal estrogens in the baby’s circulation immediately after birth. These hormones mean that the elastic cartilage, if held constantly in a different position, will eventually accept its new position over time. However, the window of opportunity is short. After 3 to 6 months, the maternal estrogens will have disappeared, the moldability will have recessed, and the ear will bounce back to its original shape no matter what deformational forces are acted upon it.

anDrew knew that time was of the essence, so a few days after Kimberley and Solène were discharged from the hospital, he ordered EarBuddies, a medical product from the UK specifically designed for children with congenital ear deformities amenable to ear-molding therapy. Unfortunately, it was the holiday season, so there was a delay in getting the product shipped and delivered across La Manche.
And then, by the time it arrived, it was no longer needed. Somehow, the abnormal third crus of the right ear had spontaneously resolved, and Solène’s ear was now, in fact, perfect. (Spontaneous resolution of ear deformities do occasionally occur, usually within the first two weeks of life…which is about how long it took for Solène.)
With the medical case of the month now resolved, the EarBuddies was returned to the UK ; and we proceeded to observe the more mundane medical aspects of Solène’s health, like her height (50th percentile), weight (90th percentile!), and chunky cheeks (100 percent cute!).

And now...for some family pictures!

We were thrilled to have both sets of parents meet us in Paris for the lunar new year! (Happy Year of the Dog!) From left: Wesley [Kim's brother in Hong Kong], then anDrew's parents from Portland, ourselves, and then Kim's parents from Taipei, Taiwan.
anDrew's parents came back to stay with us for a few weeks in Albertville, and we also enjoyed a day in Annecy with his Korean uncle (far right), passing through Europe on a business trip from Seoul.
Kimberley planned a surprise party for anDrew's birthday! Pictured here are all of the current Samaritan's Purse families in French language school. Besides us going to Gabon, these other families are heading to Niger and Burundi.
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Copyright © 2018 The Huang Dynasty, All rights reserved.

This newsletter is about Andrew, Kimberley, Nolan and Solène Huang: their journey from the US to Canada to France and, ultimately, to Bongolo Hospital in Gabon, West Africa, with the Post-Residency Program of Samaritan's Purse (World Medical Mission).

The views and opinions expressed here are solely ours, and they do not necessarily represent those of Samaritan's Purse or World Medical Mission.

In France: The Huang Dynasty PO Box 820152 Vancouver, WA 98682 USA

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