Wild West

I think the budget director at EMM had a word with someone in Port-au-Prince, because today the technician showed up and fixed our internet, just in time for me to send in my finance report! (I'll let you remain anonymous unless you want to defend yourself).
This week has been somewhat crazy at the clinic. But I have company now, which is fantastic. Duncan, an ER nurse practitioner from England is living at the base until mid-December and spends the mornings working with us. At one point, I explained to him about how we had a patient last week who desperately needed stitches but there was no one to do them. He responded that he'd teach me how, and I am really really excited about that.
Before I had a chance to learn, though, we had a guy come into the clinic after being in a fight. He had cuts on his head and on his shoulders and steri strips just weren't going to do it. I ran around the clinic looking for the doctor, and after confirming that he left I again asked Yvena if anyone knew how to do stitches. She responded with a "no." I spent 15 minutes trying to call people so I could get Duncan to come back, but to no avail. I returned to where the patient was, trying desperately to figure out what to do. Thats when I found a nurse holding silk and a syringe of lidocaine. Apparently, they don't know how to do stitches, but they do know how to do sutures.
The craziness continued early Wednesday. An elderly man came shuffling through the doors, accompanied by his two daughters. He had a splint on his left arm, but one of the nurses used that arm to take his blood pressure anyways. It was 12/8 (we use only two digits here), or roughly 120/80, which is textbook. He was seen by the doctor and then returned to us. I believe his complaint was a week of diarrhea, so we were going to try to rehydrate him. Dehydration often shows in blood pressure, so the aggressive treatment was a little confusing. Nevertheless, the man needed an IV. I offered to assist the nurse who was going to start it, so I tore tape and got the fluid ready. She stuck him, and even though she didn't get a flash of blood, she took the needle out and wanted me to hook him up. I repeated, "No, no, it's not in the vein" a few times, and after the fluid formed a wheal under his skin, she said, "Oh, yeah," and removed the catheter. Another nurse took a crack at it then, finding three gorgeous veins on his forearm. She got a flash, we hooked up the tubing, and again a wheal formed, indicating that we'd lost the vein. She removed the catheter, and I quickly scooped it up because I am the sharps/biohazard police. I then discovered that she'd never removed the needle from the catheter. Yikes. She made the third attempt on the splinted arm. It was another miss. By this time, I desperately wanted to stick this guy, especially after seeing the veins in his right arm, but am still trying to form relationships and not be overbearing. I heard murmurings of "dokte" and was disappointed that they were really going to wait for the doctor to come try. But then Hermicia looked at me and said, "You can." She then told me I had to wait until he got a drink. While I waited for one of his daughters to bring him back some water, I looked at his paper and discovered that he was 87 years old. She returned then, not with water, but a bottle of beer. This is when I began to feel like I was in the movie Two Mules for Sister Sara, so from here on out I'll refer to this gentleman as "Clint." So Clint explained to his daughter that they stuck him three times and still had to do it again. He drank the entire beer before my needles and I were allowed close to his bed. He also wanted to know my nationality. Then I was permitted to tie the glove around his arm (our tourniquet broke during Hermicia's first attempt). I got the stick, and they frantically tried to hook the line up before I could get the tape to hold it in place. This caused my catheter to come part way out and bend, but it still ran. I went to adjust the rate and was met with protests. The orders were to give Clint 2 liters of fluid, the first liter wide open. By the time he left, his blood pressure was 15/9. Hermicia said, "Good!" Duncan and I didn't really share the sentiment.
Yesterday afternoon we were sitting at the table when a guy ran in covered in blood, holding his head. He may or may not have fallen off a moto, I didn't really get the story. But I got to assist with those stitches. Soon after he left, a girl came in saying she'd fallen and she had a big goose egg and cut on her forehead. After watching someone suture three times, I'm ready to try it myself.
Today was pretty slow, due to the fact that it poured for awhile last night and Haitians will avoid going out in such weather. So this afternoon I was sitting with Hermicia and Anedzia, wishing the minutes away, when Hermicia decided she wanted to practice English. We worked on the days of the week and I started singing the song we learned in Spanish class in high school. So for quite awhile, three 20-something professionals sat around singing the days of the week in English, Spanish, and Creole. During this time, the guy who got stitches  yesterday returned because the bandage wasn't staying on his head. I asked the nurses if I could show them something and then introduced them to tegaderms. After he left, I found an ace bandage and showed them how to wrap someones head so to cover the top without the bandage coming off. We all practiced on each other while singing the days of the week song. This is how the receptionist guy found us when he brought another patient in.
Please keep Velouse, one of the nurses, in mind when you pray. She is very pregnant and left the clinic early yesterday. When I asked about her today, they told me that she went in to the hospital and "the baby is coming Saturday or Sunday." I'm not sure how they know that, since they don't induce labor here. But regardless, her husband died a few months ago and Yvena told me that Velouse is scared. Leah and I are going to try to go visit her tomorrow. Hopefully by the time the baby is born I will have figured out how to upload pictures onto this.