By JENNIFER MALARET Special to the Palisadian-Post I’ve always admired my brother, Dr. Tim Lander, a pediatric ENT-facial plastic surgeon who participates in overseas missions to help children with cleft palate and other craniofacial disorders. In January, I traveled with Tim and Children’s Surgery International to the Republic of Liberia in West Africa. CSI is a nonprofit that provides free surgeries for impoverished children and medical training to local doctors and nurses.   I began the trip eagerly, with a sense of adventure. At the same time, I wasn’t na’ve about Liberia’s conditions, given decades of civil war, political instability and poverty. Still, what I encountered shocked me. It also continues to inspire me.

Monrovia, Republic of Liberia

  CSI was operating out of the Firestone Medical Center in Duside, about 23 miles inland from the coastal capital city of Monrovia.   It was not safe for me and my two other mission partners (volunteers without medical training who made a charitable donation in order to participate) to travel alone to the capital. Our host sponsor, Firestone Natural Rubber Company, provided drivers to escort us from our secure compound to the coast.   January is the dry season. Liberia’s coast was covered in haze from the northern Harmattan winds and pollution from natural fires, burning garbage and lead fuel emissions.   One-third of Liberia’s estimated 3 million people live in Monrovia. The government remains years away from providing substantial roads, electricity, sanitation and clean water systems. The unemployment rate is above 80 percent and there are virtually no subsidies or welfare. The public school system is largely made up of volunteers. English is the primary language; however, locals’ thick dialect is often difficult to understand.   In Monrovia, I noticed an absence of stray dogs or cats’I never heard a single bark. When I asked our guide, Rufus, where the scavengers were, he replied, ‘Well, there are none here . . . we eat them.’   As we walked in the heat, anxious street vendors tried to sell what passed for meat from un-refrigerated wooden boxes. I watched toddlers take bony carcasses from tubs of water, chew and toss the bones back into the murk.   We stopped in a market, where a box of cereal cost $8. When we tried to leave, a crowd of vendors mobbed us. As the circle around us grew, our driver rushed us out of the area. Moments later, a motorcycle and car collided at an intersection in front of us. As another crowd began to gather, our guide yelled at us to get out of the van and into a nearby building where we remained until traveling back to Duside.

The Mission

  CSI hoped to qualify 150 children for surgery, limiting its scope to ‘quality of life’ procedures to correct facial deformities, and physical anomalies and injuries that impair urination, bowel movements and other bodily functions. As lead surgeon, my brother was responsible for matching medical priorities with CSI’s time, personnel and equipment. We were told to prepare for moments when children in serious need (burns, orthopedic defects) would be turned away.

Surgical Screenings ‘ Day One

  CSI expected 300 people to show up for pre-screening. The reception area quickly filled with far more. Families came by bus, car or Firestone-provided transportation. Some children had walked for days to get to the hospital, sleeping on the ground overnight. One family was driven 150 miles by a country doctor, only to be turned away.   Our screening room was on the second floor. My job was ‘runner,’ meaning ‘useless person with no medical knowledge.’ I ran down to the entrance where I chose head and neck patients first. I was sure this was the first time that these children with deformed faces were rewarded for how they looked. I swore to myself that I would escort each of them with smiles and gigantic hugs. Some children jumped into my arms. Many were stoic, quiet and polite. Some cried out in fear.   Tim and the other doctors were screening patients nonstop. Controversial cases arose and critical decisions had to be made. My brother screened two infants, both in need of cleft-palate repairs. The first was undernourished, and the second was neurologically impaired. The CSI team conferred in heated discussion. Medical staff hoped that, with feeding, the first baby’s iron levels would support a successful surgery and admitted that infant to the hospital. The lead anesthesiologist feared complications in the second case and the team unanimously decided to send the family away.   Then we screened a 19-year-old man, Abraham, with acid burns on his face. Abraham’s entire right eyeball was fully exposed, leaving him with a ghoulish appearance and the inability to blink. Since the injury was recent, he had not yet lost his sight. The surgeons were reluctant to schedule Abraham since his profile was outside the scope of CSI’s primary mission. My brother delivered the news ‘ but Abraham was determined to have a chance. He refused to leave, sitting respectfully on the floor for 10 hours. He earned our affectionate nickname ‘Eye Guy.’   As my brother built his schedule, my job was to complete paperwork. We began an informal process ‘ Tim’s Post-its and my simple pieces of paper became evidence of a families’ approval for surgery. I was thrilled to help local hospital workers tell the lucky families that their children would be operated on for free and Firestone would provide them with needed lodging and food.   Our instructions were to leave the hospital at 6 p.m., but with more than 100 patients still waiting, we stayed. Eye Guy was approved last. If all went as planned, he would be Tim’s final surgery.

Hospital ‘ Day Two

  Early the next morning, our bus pulled up to the hospital entrance. Most in the crowd had slept on the ground all night. Unfortunately, the surgical schedule had been almost completely filled the day before. I was still surrounded by children asking for help. A small barefooted boy stood before me and held up his light-green shirt to show me cuts on his belly, as he pressed a dirty towel against his skin to stem the bleeding. It broke my heart to leave him in the crowd where (if he were lucky) a local doctor would stitch him up. There were many others who needed help, so part of our team began performing surgery that afternoon’a day earlier than planned. We added three more children to the final surgery schedule.

Operating Room ‘ Days Three and Four

  Tim and the other two surgeons, David Vandersteen (pediatric urologist) and Steven Muehlstedt (pediatric surgeon), began operating on a very aggressive schedule. The other mission partners and I ‘scrubbed in.’ There were four operating tables in two rooms. Three had active surgeries and the fourth was used to transfer patients, so the surgeons could work without stopping.   I watched Tim perform cleft lip and palate repairs, remove tumors and reconstruct the faces of babies and children. I observed Dave and Steve perform colostomies, hernia repairs and other urological reconstructive work. Our doctors were assisted by and also taught the local medical professionals during the procedures.

Monrovia / Paynesville ‘ Days Five and Six

  The day after our trip to Monrovia, we traveled to the Francis Gaskin Orphanage to distribute de-worming pills, as well as feed and play with 150 orphans and local children. We cooked a special lunch of jollof (a Liberian dish with chicken, rice and tomatoes), Kool-Aid, apples and cookies. We brought toys and books donated by CSI, the mission partners and Firestone.   Two young girls in particular moved me. Jolene had been bitten on the forehead by a snake and, considered by her tribe to be an ‘evil child,’ was cast out into the interior. Found near death by travelers, she was taken to the orphanage. Another, Marlene, refused to let go of a broken piece of mirror. Some Liberian children hold trash the way ours hold teddy bears. The trash becomes a ‘special item’ because it is something that belongs to them which won’t be stolen away. I talked with Marlene for a long time about how I loved her item in particular because we could look at it together and see how beautiful she was in the reflection. It was an exchange that I will never forget.

Operating Room ‘ Day Seven

Awful realities struck. Steve opened a gigantic neck tumor on a seven-year-old girl. Malignant cancer had wrapped itself around her spinal cord and lung. The team consulted and agreed to close the incision, knowing that the girl would die from asphyxiation or cancer absent intervening medical care.   Tim then began surgery on a nine-year-old boy with a fibrous neck tumor. Timely HIV screening results had not been received. During surgery, doctors confirmed the boy’s positive HIV results. The local staff did a noble job of communicating to the boy’s grandmother the tragic news: tumors that would repeat, HIV/AIDS, and eventual death.   After watching these surgeries, I gladly retreated to the office to work on our surgical database, grateful for the break from the intense emotion. The seasoned medical professionals continued on.

Operating Room ‘ Days Eight and Nine

  It was our last two days of surgeries and I felt ready to go home.   Eye Guy returned to the hospital a day early to be sure we wouldn’t forget him. The CSI team and entire Liberian staff knew that without surgery now, Abraham would become blind.   I held his hand and spoke to him reassuringly as he was anesthetized. It took Tim nearly three hours to graft skin in various attempts to rebuild his eyelid and facial structure, each far from perfect (because burned skin doesn’t stretch or move). But Tim was able to save Abraham’s sight and drastically improved his appearance.   We were at his side when he woke up on the OR table. I held his hands, speaking to him calmly through his disorientation and never let go as he was wheeled into post-op. Doctors checked his vitals, gave him morphine and I kept holding his hand. Over and over, he said, ‘You are my angel, thank you.’   He was already so grateful and he hadn’t even asked for a mirror.

Theater Review

An actor once noted that performing a Neil Simon play is just like boiling an egg. All of the hard work has already been done. ‘All you’ve got to do is learn your lines, turn up the heat and watch the magic happen.’ In ‘Rumors,’ directed by Sherman Wayne at Pierson Playhouse through May 8, the ‘work,’ even for a master like Simon, was required. His first foray into farce was a challenge for the veteran playwright, who had enjoyed great success with many of his character-driven comedies. But farce is a different vehicle’it’s all plot, pace and timing, sapped by leisurely exposition and murdered by lulls. Simon rather facetiously said ‘the simplest aspect of farce is you need a lot of doors, and you need people to go running in and out of them, just missing each other.’ True enough, but Simon’s more important challenge was feeding the plot-eating audience. In ‘Rumors,’ there is no underlying angst to be explored beneath the thickly layered plot, as in Simon’s more serious comedies such as ‘The Odd Couple,’ so the jokes and tumbling one-liners must carry the action. The situation suits Simon well. He chose a clutch of characters rich enough and successful, placed them in an upscale mansion in the New York suburbs, ‘ la Noel Coward, and dressed them in stunning eveningwear. Wayne’s set is sleek and sophisticated and the costumes by June Lissandrello match the class and taste Simon demands. As the curtain opens, we come in on high-strung married lawyers Ken and Chris who have just arrived for the 10th anniversary party of New York City deputy mayor Charley Brock and his wife Myra, only to find that the hostess and the help are nowhere to be seen and the host has a bloody ear from what might be a self-inflicted gunshot wound. From then on we’re off to the races, as Ken and Chris set up the ensuing hilarity in their efforts to conceal or reveal the dilemma to each successive party guest. It would be bad press were the inconvenient circumstances of Charley’s gunshot to leak. Although the play is almost 25 years old, Simon’s characters are every bit as recognizable today. His pen expertly ridicules the rich and successful and their piddling and weird relationships, and we are given full rein to laugh at them. The second couple to arrive, Claire and Lenny, burst in with their own misadventure’someone plowed into Lenny’s new BMW and he has been left with whiplash, which remains a running gag throughout the play as he walks head cocked to the denouement. He telephones Dr. Dudley, who is paged and pulled out from the theater (‘The Phantom of the Opera’), setting up the familiar device of the one-sided telephone conversation. This, as you would expect, is repeated numerous times throughout the evening as one guest after another suffers chance ailments (a temporary loss of hearing here, burned fingers and a gunshot wound there). The writing is efficient and sidesplitting. I was so exhausted from laughing that I desperately needed intermission to catch my breath. The second act is, as they say, the hard act that follows, as by this time we have tired of some of the guests and their shtick. Simon may be a genius, but the success of this production rests entirely on the actors under Wayne’s expert direction. Farce is demanding not only as it depends on perfect ensemble timing but also for its tongue-twisting, rapid-fire dialogue. When Claire reveals that Harold Green, a proxy member of the tennis club, told her about Myra’s affair, Lenny lets loose with us a string of outrageous adjectives”that proxy, social member, spreading rumors Harold Green,’ he bellows as the audience guffaws. This bit falls flat in the retelling, but goes to show just how important timing and pace are to this play. Philip Bartolf’s Lenny is deliciously wry and Julie Urbanek’s Claire plays the self-satisfied, entitled suburbanite with deadpan sass. While all the characters are laughable, Richard Little as Ernie (a psychiatrist) offers Simon digs at psychiatrists’ standing on the wealthy’s calendars and Martha Hunter as Cookie (a cooking show host) showcases the silly, pure corniness of Simon’s writing. The slapstick antics in the second act wind along too slowly, halting the fun, only to recover in the last, great scene when Lenny spins a whopper, a tall tale gone ballistic to end the mystery. ‘Rumors’ plays Fridays and Saturday at 8 p.m. and Sundays at 2 p.m. at Pierson Playhouse, 941 Temescal Canyon Rd. For tickets, call (310) 454-1970.

  Lily Tomlin and Jane Wagner present ‘Carlie & Doni ‘Help Save the Theatre,” a fundraiser hosted by Tomlin on Friday, April 8 at 8 p.m. at Santa Monica Playhouse, 1211 4th St. (between Wilshire & Arizona).   All proceeds benefit the Save the Playhouse Campaign, which is raising funds to keep the Santa Monica Playhouse doors open and secure a permanent home for this theatrical treasure after 50 years of renting in the same location.   The one-hour irreverent musical comedy is by Carlie and Doni, two best friends who met in 2005 at Los Angeles Community College Theater and later formed a musical/comedy act. They have performed at The Comedy Festival in San Francisco, are regulars at the Jon Lovitz Comedy Club and have been a headline attraction at The Improv.   This year, Carlie and Doni did their first commercial for Toyota, writing and performing a song they wrote called ‘My First Ride.’ They wrote another song and will appear as troubadours in the comedy film, ‘When Harry Marries.’   Tomlin, one of the best-loved comediennes in America, has won two Tonys, two Peabodys, six Emmys, a Grammy and many more awards over her 40-year career. She lives in Los Angeles with Wagner, a writer who has been nominated for nine and won three Emmy Awards. For tickets, which include pre- and-post-show receptions ($25-$30 at the door), call (310) 394-9779, ext. 1 or visit santamonicaplayhouse.com.