Roots & Wings

I don’t think it’s surprising that after having the madre that I do, I currently feel like I’m living in a vacuum cleaner. For the last few weeks I feel like my mind is constantly going in at least 17 different directions. Which is why nothing in this blog post will be cohesive. But I figured it was time for another one nonetheless.

I worked at Medishare pretty much the entire month of April. I really really loved it, but it was exhausting at times. It was pretty apparent I needed a break the night I started laughing at a dead man. (Who had, in fact, died while I was putting an IV in him and drawing blood). One afternoon when I was working in the ER, they brought in a boy who’d been in a moto accident. His left leg had been partially amputated. When I think back on it now, the whole process really took a long time. Something that would’ve taken minutes in the States took hours in Haiti’s trauma 1 hospital. The tourniquet on his leg wasn’t terribly effective and he probably lost two units of blood just while laying on our table. So I was scrounging around looking for ace wraps or anything to put pressure on his leg. I’m not sure how long it actually took to get blood to do surgery. Mark and I had gone for blood the week before, and even though we told them it was an emergency, it took two hours (three if you include travel time). While we were waiting, I was talking to one of the doctors. He mentioned that he’d come to Haiti before to work in a different area through his church. I’ve gotten really good at condensing the last eight months, but I like to start out with, “Well, I initially came down through Eastern Mennonite Missions…” The exchange made me think of early Christians drawing half a fish in the sand – his brief comment to say, “I’m a Christian,” and my EMM comment to say, “Hey, I’m a Christian, too!”

The boy went to surgery not long after that, and he did make it through. But he’d lost too much blood and he died early the next morning.

One evening we were getting ready to leave when the doctor in triage asked if we could do a transport. Mark and I groaned a little bit inwardly but agreed. I think I may have groaned out loud when I found out it was a cholera patient. The last thing I felt like doing that night was boiling clothes. We were getting ready to head out, had the family in the back of the truck, and the doctor (who I affectionately called Hurricane Barbara) was giving me her report/commentary like a squirrel on speed. As she was about to hand me the baby, I caught a glimpse of her eyes. “She doesn’t have cholera.” Yep, the 9-month-old RN (or 7 months if you count the time I’ve actually practiced) blatantly told the doctor her diagnosis was incorrect. It took her about four seconds to regroup, then she started questioning me. “Well do you think it could be malaria? Typhoid? She had a fever of 104. Let’s ask the family again, they said she was having diarrhea and vomiting…” I don’t know, I can’t really give you a whole lot of pathophysiological answers, I just know she doesn’t smell like cholera and that it doesn’t manifest with fevers. Is that an acceptable answer after I contradict you? She really was quite understanding and told me that she’s never seen cholera before. Unfortunately she then also said, “It’s your call. You just tell me what you would do.” I’d been pretty sure of myself until I was the one with the final say. I decided she should stay and get fluids and be monitored. The whole way home I second guessed myself. Luckily, the next day Barbara shouted to me from across the compound as she was whizzing by that I’d been right.

That was one of the least disconcerting things (for others) that she shouted at me during her trip. One week I had been filling in for five days until some EMTs came to work in the ER. It was a father/son pair, the son newly certified (they don’t get much newer than that kid). The dad walked up and introduced himself to me, then immediately said, “Don’t you have to be 18 to work here?” I’ve grown quite accustomed to the comments about how young I look, so I responded with, “Well usually, but I’ll be 18 next month so they made an exception.” I mostly found it ironic that he chose to pick on me when his son looked 14. Barbara was rounding on a patient the next morning and asked me to check on something because “those EMTs, they’re fresh, they don’t know anything. And what is that kid, 12?” I proceeded to tell her the introduction story. She looked at me a little confused and then walked away. She returned a few minutes later with another nurse who was laughing. She had believed my sarcastic comment and pulled someone aside to say that even if I had a license, she felt a little uncomfortable having someone who was only 18 taking care of patients. Heather just asked her if she was crazy. A few days later, I was in the ER with a new batch of Medishare volunteers when Barbara yelled from the unit next door, “Sarah! I talked to your mom last night and I’ll be at your high school graduation!” She winked at me then was off, while everyone else just stared at me.

One afternoon, Mark came into the ER to say we might have to leave to transport a patient. There was a 7-year-old boy up north who’d fallen three stories and they were going to fly him down. It must’ve taken a little too long to try to find someone to pay for the flight and organize the transport, because eventually Mark came back and said that if the transport happened, it wasn’t going to be until the next day. Luckily, the little boy made it through the night. Less fortunate was Mark coming to me the next day and saying we had to fly up to get him. It was a little missionary Cessna, not medically equipped. So we ran around collecting everything we thought we could possibly need. My pockets were full of different syringes of medications.

The flight up was uneventful. When we found the little boy, there were no medical professionals with him. Just his family members. Who were holding a bag of IV fluid. Not good. I thought that one of the cardinal rules of head injuries (especially when you can’t measure the intracranial pressure) was that you don’t want to load someone with fluid and increase the pressure in their head. Ai yi yi.

I wasn’t happy with what I was finding while assessing him. He wasn’t following my commands (I gave him a bit of grace in that since my Creole probably left a bit to be desired), he wasn’t talking, and he didn’t withdraw when I poked his feet with a needle. I gave Mark one of my syringes and some brief instructions on where to hit his leg with the med if the boy started seizing.

About five minutes into the flight, I was reassessing and was trying to get him to open his eyes. He wasn’t responding to me, and I started freaking out. It was only a few moments, maybe 30 seconds, until I agitated him enough that he opened his eyes. But the things that went through my mind and the conclusion I drew that really there wasn’t much I could do while in the air with an ambu bag and some blood pressure meds made it seem much longer.

Thankfully, that was the scariest moment of the flight. Unfortunately, it was also one of the best. We had to fly pretty low because of the head injury/pressure situation, and low = bumpy. I just do not do well in small aircrafts. Shortly after my heart attack, I started feeling funny. Really hot and sweaty and like I was going to pass out. I remember thinking to myself, “This feels familiar…kind of like that time in the helicopter in Hawaii…” And I proceeded to throw up the rest of the way back to Port-au-Prince. I’m sure that was quite comforting for the patient’s mother. Once we were on the ground and on our way for a CT scan, I discovered that while vomiting, I had been able to squirt the medications in my pocket all over my scrubs. Who’s wearing the Labetalol? Yeah, that was me.

Nothing has compared with the stress of this past week, however. This is day 27 without power. The neighbors had been using their generators as well, and when we asked they told us they didn’t have city power either. But since then, we found out that the power to our house has been turned off because we haven’t paid the bill. I don’t think we’ve paid an electric bill the whole time I’ve been here. And the rent for the next year comes due at the end of this month. After talking through some options, we were a little hopeful that the landlord might let us pay month to month rather than the whole year. But we can’t even do that right now. One night earlier this week I was talking to a friend about this and he reminded me about Jesus telling one of his disciples to pull tax money out of a fishes mouth. It was really difficult for me to try and stop worrying, but after telling Jesus that we need $3000, there was really nothing else to do.

Yesterday morning I was laying on my bed in such distress about how I was letting DIRT fail that I couldn’t move, when Mark started hollering from the big room. One of his good friends unexpectedly got a ton of money, and he was willing to loan us $8000. Thank you, Jesus, for being an overachiever. (But I think I’m done learning patience now…)

In other news, the rat is dead. Last week Mark managed to sneak up on him and trap him under this plastic thing that keeps the flies off our food. He didn’t want to kill the rat until our volunteers had left for the clinic, so he set a nursing book and a saw on top of it. The next thing I knew, he was freaking out. The kitchen lady was walking out of the house holding the plastic thing. She claims she didn’t see the rat. A few days later, however, a curious smell was pervading the downstairs. After a little searching, we found the dead rat. Unfortunately, some maggots had found him first. We let Mark take care of it.

In exactly a week (or 167 hours and 44 minutes) I will be home for a few weeks. I’m a little bit excited. (Just a little). Today I was laying on the hammock thinking of all the things I’m going to do, like drink myself into a caffeinated craze at Starbucks with my cousins, take random road trips because I’ll be allowed to drive again, finally be able to go to family night, and get one of my best friends married off. Mark interrupted my daydreaming to ask about an ambulance policy. Ambulance reminds me of fast cars, which reminds me that I get to watch the Coke 600. Must focus. (167 hours, 35 mintes…)