The pace has clearly slowed and instead of 80-100 volunteers on site, we are fluctuating in the low teens. I am the only doctor this week, given the holidays and return to school. Jerry Bernard, the local Haitian surgeon, had taken a vacation, and cases had been scheduled for me. Arriving at the compound, I was warmly greeted by the CRUDEM volunteers, who heard I was coming. Included were Donna and Sophie. While it is not unusual for parents and children to serve together, this was a grandmother, who attended nursing school in the 50’s and later worked in Ob, and her 26 year old granddaughter, who was a nursing student just starting out. As we had something to eat, each reflected on their own experiences, with Donna remembering dodging flying instruments and starched caps, while Sophie was idealistic, excited, and scared of what she would be asked to do. The rest of the group was primarily from Seattle, with the addition of Phil and Blair a premed and prenursing couple who had met at U Va, and signed on for 10 months, prior to starting school.
Monday afternoon, I did a short case of a soft tissue infection in a diabetic.
There were no translators, and I struggled with my poor French to communicate with the local staff. Although we were able to care for the patient, the process made me concerned about getting through the next day’s schedule. I asked Donna if she would be willing to first assist me, and it turns out that Sophie was fluent in French and was working on her Creole. We did several small cases, then a call came from the emergency ward. A 9 year old was there with an acute abdomen. Concommitantly I looked up, and there was Gilbert Wilkins, a surgery resident from Justinian Hospital in Cap Haitian. It turns out one of the local doctors I met was an attending there and asked in passing, if a surgical resident could observe. I agreed, but didn’t think it would happen. Gilbet had spent time in Canada, and his English and skills were excellent. He saw the child, began the resuscitation, and got her prepped for the OR. I thought it was delayed perforated appendicitis, but when we opened, the appendix was normal, yet there was pus throughout the belly. “Perforated typhoid,” he said quietly, and he located the hole in the ileum, which we fixed. Donna retracted and later admitted she wouldn’t have been able to help me. The Haitian nurse could have, but the language barrier was great.
This morning the child is doing well, and the resident took the bus back from Cap to help with cases today. And is typical for surgery residents, he had a different opinion as to technique and incision placement – and on more than a few occasions, his ideas were better.
In the evening, we meet at 8 pm to review the day. It’s not as structured as when I was here in March, and everyone has a chance to share their feelings and struggles. This was a first time for everyone but me, and they asked how to deal with the degree of suffering and poverty, as well as explaining to others back home what they had seen. I didn’t have any good answers, and tried to share with them some of what I’ve shared with you. But as I looked around, I saw people at various stages of their lives, some with unmitigated enthusiasm and idealism, a few with multiple battle scars, and others who quietly listened and appreciated the moment. What I realized is that each age and each generation has similar goals – self actualization, support of family and friends, and the need to make a difference. And each of us, based on the history of the time, made decisions that reflected those needs. Today 3 generations with disparate histories, experiences, and hopes gathered in a small hospital in the north of Haiti, and synergized each other to do far more than we could alone.
Not quite as good a plot of dysfunction as you see on most of the TV series on Fox…
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