Indivisible and indispensable

Surgery cannot be optional guacamole

Mark Shrime, MD, PhD
5 min readApr 2, 2023


“Everybody—from the border of Mali, all the way to Dakar—knows my son.”

Daouda’s father is a tall, articulate Senegalese man who lives with his family in a small town on the Malian border. His son, now fourteen years old, first noticed a benign tumor on his left upper jaw when he was six.

Daouda (credit: Mercy Ships)

The tumor started small — they all do — but by the time I met him it had grown large enough to interfere with the way he spoke and how much he could eat.

It’s a benign tumor, but that’s just a technicality. The larger it grows, the more it will interfere with the basic things Daouda has to do to live. Soon enough, it’ll grow large enough to block his breathing.

Daouda’s father knows this. And of course he does: he sees his child’s face every day. The boy has grown increasingly isolated, and increasingly ostracized. People don’t look him in the eye, they look him in the tumor.

The problem is, it isn’t easy to find treatment for his son’s condition where he lives. He’s been trying for eight years.

His first stop was at the health posts near him, but they weren’t equipped to offer the sort of treatment Daouda needed. They sent him to Tambacounda, the Senegalese city nearest him, about 150 km away…



Mark Shrime, MD, PhD

Author, SOLVING FOR WHY | Global surgeon | Decision analyst | Climber | 3x American Ninja Warrior Competitor