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…)   

A Stitch In Time

I don’t like mornings. And I don’t like the phone. So when I get a phone call at 7:30am, and while I’m on the phone, another phone gets a text, and yet another phone starts ringing, I’m not terribly amused. Adam is still out of the country since earthquakes are becoming pretty popular, and Mark went back to the States for a week last Monday, so I have both of their phones in addition to my own. I’ll go ahead and admit to the panic attack I had that morning before we took him to the airport. We were getting three volunteers in that afternoon, and as of 6 hours before their arrival, I had yet to get confirmation on any of the things I was trying to set up for them. I told one of my friends that I was really hoping this was one of those things where God was trying to teach me patience and to trust his timing, and thankfully I was right.

After dropping off Mark at the airport, we picked up Isabella, an Italian photographer staying with a friend’s organization, and we took her to Sister Marcella’s for a few hours. The place looks really different – it’s painted and there are babies and toys and equipment – all signs of life. I know I say this every time I write about going back there, but it’s just so strange. I was telling Stephen (a friend of Adam’s from previous Haiti and Pakistan work who was here for a few weeks) how every time I walk in that building I see all of our patients. An 11-year-old girl who just wouldn’t get better, a guy with pink crocs who also had worms, and a little old lady with orange hair who we all affectionately called “Grandma” who got 26 bags of fluid.

After taking Isabella back to Brenda’s house, Stephen and I headed to the airport to pick up our volunteers. Mike and Justin had worked cholera with us at Sister Marcella’s in November, and Justin was also bringing his girlfriend along. Even though I’d only been with them for a week back then, there are only eight other people who can understand that experience, and it was so good to have two of them back. I’ve definitely enjoyed the other volunteers we’ve had since, but I loved when, for example, we’d drive past something and one of them would say, “Hey, isn’t this where Brenden fell out of the truck?” For once, I had people that remembered all the stories I told. And they were also quite impressed by the fact that we now have a refrigerator and running water.

The downside, however, of having people come back who worked with us in a crisis, is that there’s no longer a crisis. We had something to do each day, but it wasn’t nearly as stimulating for them as keeping people alive. Saturday morning we picked up a baby from the Germans and took her to Medishare, so it was nice that they got to have the experience of hanging out on the tarmac and checking out all the broken down/wrecked planes and helicopters that take up most of the space. But after returning to the house, we didn’t have any other work plans. So we decided we’d hang out for a little just in case we needed to do another transport and then head up to Ibolele to get some food and watch basketball. About 45 minutes after coming up with that plan, I got a call from the head nurse at Medishare asking us to come back and work. So Justin and Mike went to triage and I worked in Med/Surg. Some combination of us continued working there for the rest of their trip. Katie came with us on Sunday because they needed help feeding and holding babies in Pediatrics. At one point I went over to check on her and she had a baby in each arm. So cute. I spent the rest of the week there, which I absolutely loved. The only thing that I was kind of bummed out about was that Monday and Tuesday we had set up a couple locations for Katie to do cholera education at and I was looking forward to it because that’s something we haven’t done before.

So many random patients came into the hospital this week. We had some births, we had some deaths, we had mystery diagnoses, and pressure ulcers. I’ll save the detailed stories, because when one of the Medishare nurses (they volunteer for a week) asked me some questions about cholera, she told me I should see a counselor after she heard my responses. No, I did not get to deliver the baby. But we’ve now had four in a matter of three days, so I’m figuring if there’s another one and I happen to be there, the doctor just might let me help out. I did, however, finally get to suture someone! I’ve only been practicing for this day since October 31. I was filling in in triage on Friday morning, and in the midst of seizing babies, a woman with an abscess on her bum, and a patient with an infected leg, a woman came in with a sliced hand. Becca, another nurse who had done sutures for the first time earlier that morning, asked if I wanted to take care of her. Then we asked the doctor if he was okay with that, and after saying yes, he left. So Becca and I decided that to do sutures you either need one doctor or two nurses. At one point while I was getting stuff together, a translator asked me if this was my first time. “Yes it is. Don’t tell the patient.” And Becca agreed, “Yeah, we never tell the patient that.” After I’d finished, the ER doctor was passing by and stopped to see what we were up to. Apparently the silk we used was a bit too big, but hey, stitch and learn. I thought it was pretty. My very first stitch was a little tight, so she’ll have a bit of a bigger scar there. But now that I’ve had someone that legit needs stitches, I’m ready to take volunteers. Adam once said he’d let me practice on him, and now I’d be okay with that. Maybe that’s why he’s staying in Japan…

Another interesting aspect to the week was that I had nursing students! How very strange. At one point during one of the days, I was sitting on the counter charting (that took some getting used to – paper charting…all during clinicals I just scanned things, clicked things, and checked boxes) when one of the students starting asking me questions about drugs. Then she started writing down what I was saying. That’s when I was like, “Shoot, I need to find a drug book.” Before I knew it, I had 8 girls in white uniforms around me listening to me talk about medications. One day, my student was giving me a report on my patients vitals (they just did baths and vital signs) and she told me that the patient’s temperature was 91.6 F. I’m not quite sure what my translator told her, but what I said was, “Mmm no, I don’t think so.” Upon further investigation, I discovered that she had no idea what normal was. After telling her, I asked what she thought we might want to do if we had a temperature of 91.6. She didn’t know. So I suggested taking it again. While we waited the five and a half minutes it takes for the thermometer, I tried to explain to her what our patient might look like if that was an accurate temp. But the fact that she was sitting up and complaining of pain indicated that we should probably double check for accuracy. I’m not sure how effective my teaching was. After that is when I started semi-joking about starting a nursing school here. The next day one of the nurses I’d been working with asked if I was serious because she’d be willing to come down and teach… 

'Almost' Doesn't Count

So close, and yet so far. Today I was working with a friend’s organization doing a mobile clinic, and the doctor asked me to bandage up a kid’s leg. Lo and behold, this child had sliced open his leg quite nicely and needed stitches. I told the doctor what I thought and she asked if I was going to do the suturing. Silly question. I’ve taken to carrying around Brenden’s suture kit with me wherever we go. So I had the translator tell the little guy that I needed to give him some shots with medicine to take the pain away and that it was going to burn a little bit at first. I had a teeny tiny little needle, and it was pretty tough to get that into his skin to give him the lidocaine. But after four shots of that, he was all numbed up (and probably hating me). Let me just say, this little Haitian boy did not have skin at all like the banana and mango peels that I practiced on. In fact, his skin was so tough that I couldn’t get my needle through. I tried two different sizes and types of silk and got nothing. I asked the doctor if she wanted to try and she said, “Well if you can’t get it, I won’t be able to either.” So at least she had confidence in my skills. But I had to just bandage him up and hope he went to the hospital like we told him.

About three weeks ago, I got to accompany a patient on a med-evac flight to Philadelphia. It was a 13-year-old boy who was injured in November when he was climbing a tree and someone threw a rock at him. It hit him in the head and he fell out of the tree, landing on his face/stomach and breaking his back. That left him paralyzed from the waist down. He needed surgery to stabilize his spine, and they don’t have the capability of doing that anywhere in Haiti. He lives with his Grandma, and Grandma was going on the flights as well. The patient did very well and the flights were uneventful from a medical perspective. During the first flight (5 hours on a missionary plane built in 1943), Grandma leaned over and told me she needed to go to the bathroom. So I was walking her back because I didn’t want her to fall. There was an area behind the seats where the luggage was before the bathroom, and when we reached that area, she started to squat. I managed to say “NO!” enough times that she didn’t pee there and I got her to the bathroom. Unfortunately, before I could show her the toilet and put the lid up, she started peeing on the floor. Not just the floor, but the door, the shelf, and her foot as well. Thankfully, there was a roll of paper towels and lots of Lysol in the bathroom.

Once in Miami, Grandma and I went to do paperwork in customs while they transferred the patient to the air ambulance. It went really smoothly considering they didn’t have passports and I was trying to read Creole on their birth certificates. We were in the air before I realized that I should’ve had Grandma use the bathroom. All I could think was, “Dear Jesus, please don’t let her pee on this airplane…especially not while she’s practically sitting on top of me.” Well, the Lord was gracious. Grandma waited until we landed in Philly and then just peed right on the tarmac while the flight nurses freaked out behind me. “You can’t leave the hospital until you explain to her that she needs to use a bathroom!” “I know, I will. But you have to understand that she’s probably never seen a bathroom before.” “Well, she’ll get arrested for doing that here!” Luckily, the EMT driving the ambulance happened to have a step-grandfather who is Haitian and she called him and had him explain to Grandma how to use the bathroom.

We went to Shriner’s Hospital and I stayed for a little while waiting for my dad to pick me up. At one point (this was around midnight), the charge nurse told me I had a phone call. I was confused about why my dad didn’t just call my cell phone. But what I found on the other end of the line was a woman crying because she was so happy that the patient was finally in the States. Apparently she works for Sky Hope, an NGO in the States that does these flights, and she had been the one working to set up this flight for the past few months. So I had a 20 minute conversation with her about how it went and things like that. It was strange. Not that she called, just the fact that I was having a conversation with someone that I’ve never met and will probably never meet. It was one of those “surreal…but nice” moments. And then, since I was already in Philly, I got to spend a long weekend at home. The flight conveniently coincided with butchering weekend, which was wonderful. There are few things more beautiful than sitting down for lunch and seeing my entire family around me. And gut buckets. Just kidding. (Mostly). I told my Grandma that I wish I could be in two places at once. But I haven’t figured that out yet, so I’m back in Haiti, where I am hopefully succeeding in implementing the tips my family gave me for making my blog posts shorter…

Yesterday morning in between teaching our groundskeeper how to properly clean the bathrooms, I was sitting in my house in my mostly broken camping chair talking to my friend on chat. She’s been telling me for days that I need to blog, but I haven’t had anything to write about. The previous day involved me picking up barrels to burn our trash, getting a water truck to come to the house, singing obnoxiously loudly while I thought I was home alone and then the kitchen lady walked in, and then using our new staple gun to put screen over the faux transom on my balcony door. Not blogworthy at all, but I was trying to figure out how to make it so when Mark’s phone rang. He was nowhere to be found, so I answered it. It was the CNO from Medishare, and she said she had an American aid worker who came in the night before with malaria and dengue fever and needed to be med-evac’ed out, but he didn’t have med-evac insurance, so could we help figure that out? I told her I’d talk to Mark and call her back. Usually I get off those calls feeling really frustrated because I always have to say, “I don’t know, let me talk to Adam,” and I really need to be able to do this myself in a short amount of time. So Mark and I conferenced really quick and he started calling people to see if they knew of anyone and we were coming up short. Then I remembered crying Sky Hope lady. After a series of emails, she pulled through for me and was checking into flights. Mark and I decided we’d head over to Medishare and check the patient out ourselves.

The report I got from the doctor when we got there was ferocious (nurses, nursing students – ask me about it because it’s incredible and I’ve saved all my notes – making this guy better is my ICU dream job). After we were there for a little bit, the director for the patient’s organization discovered that he did have insurance after all, which was fantastic. That meant we could get an air ambulance to come right to PAP for him. And miraculously, they were going to be able to do it the same day, when usually no one can fly out of Port after dark. So all we ended up having to do was work out how to get us and our truck through security so we could take him right onto the tarmac and out to the jet. He was stable enough when we transported, considering he’d spent the past two days with nausea, vomiting, diarrhea, and had low blood pressure, a cough, fluid building up in his one lung, and very low red blood cell, white blood cell, and platelet counts, among other things. They gave me a bag full of injections to take with us just in case, but thankfully he didn’t need any of them.

This evening we got an email from the patient’s director. He said the night went relatively well, considering, but the patient has gone downhill today. He had to be intubated this morning and his platelet counts continue to be very low. Acute respiratory distress syndrome was something the doctor briefly mentioned to me that she was concerned about, among other very serious complications. So please pray for this man, specifically for his lungs and his blood cells/platelets counts.

Occasionally I still struggle with my decision to leave EMM, especially considering my original return date is 13 days from now, and wonder about how the support shifts when someone goes from “missionary” to “humanitarian aid worker.” Sometimes I just think it’s interesting that the support shifts at all. But this past weekend I got encouragement from one of our volunteers. The rest of the group was going out for the evening, and I was staying home hoping to have the house to myself. Unfortunately, one particular volunteer decided he wanted a quiet evening as well. Eventually we got into the two standard questions: “So how do your parents feel about you being down here?” and “What are the Mennonites?” Somewhere amongst my ramblings of trying to distinguish Mennonites and Amish (it’s more difficult than you’d think to try and explain something that is so ordinary to you), he brought up evangelism. And then someone who will only say that he “tries to go to church sometimes” told me that he thinks I’m exactly where I need to be to share my faith with people. 

Advocacy vs. Animosity

If I had a dime for every time one of my clinical instructors wrote that I was quiet or needed to be more assertive, I would be a very rich woman. Or at least a lot less in debt. In fact, I got so annoyed with seeing that on my papers, that one time I wrote an evaluation stating that I might not be a social butterfly but that doesn't imply in any way that I won't advocate for my patients. (I'd just like to add that the response I got was, "Fair enough, this is true. See you guys? Sarah doesn't talk much but when she does it's good. And she gets you extra points on quizzes." Thanks, thanks very much). I wish my instructors (especially the L&D one who told me I'd get eaten alive as a nurse) had seen me yesterday. Not necessarily because I'm proud of what I did, but because sometimes I just like proving people wrong.
Yesterday morning, Ashley, Adam, and I went to the airport and put Leah on a plane for home. I arrived in this country exactly five months ago, and I've never been here without her. It's weird to still be in the same place but have entered into a new season of life. After that, we dropped Adam off to go flying with some people, and then Ashley and I came back to the house. Mark got a call about mid-morning from the MTI clinic that there was a woman in active labor. There were two random things that I prayed for before coming to Haiti in September: that there would be a piano in my house and that I would get to deliver a baby. I can only expect that since I had a keyboard in Saint-Marc, that there is some midwifery in my future as well. So when I heard the words "active labor," all volunteer rotations went out the window. After I was already in scrubs ready to go I asked Ashley if maybe I was a bit overzealous and I should stay back. She said no, and that was all the affirmation I needed.
During our trip out to the clinic (which was longer than necessary because our driver didn't know where we were going even though we've been there like five times and the translator told me he knew where we were going and he didn't), I got about three calls asking how soon we'd be there and if we were comfortable with delivering a baby. I was afraid they were going to try to find someone else to take her if we didn't get there soon. But when we finally got to the clinic, the woman was up walking around with contractions about 15 minutes apart. The person who kept calling me wasn't even at the clinic. Oh Haiti.
Needless to say, we did not get to deliver a baby en route. But her contractions were getting a lot closer together. I wanted to let the volunteers handle it, so they walked her to the gate. Then some sort of commotion ensued. One of the EMTs asked me to come over and see what they were saying (not that I could really tell), so I pushed my way to the front of the crowd. By now, our patient is hunched over trying to breathe and the security guard was yelling at people. Our translator said they weren't going to let her in because they didn't want her husband and sister to come with. I started telling the security guard (for no apparent reason because he didn't understand me), "Okay, well this woman needs to come in right now!" He continued yelling and closed the gate. I start muttering about how I'm just going to do it myself. So I flung open the gate. Security guard freaks out and is trying to close it against me trying to keep it open. Then I start yelling in an attempt to convey to this man that my patient is going to have a baby on the sidewalk. Somehow we end up pushing through, though the security guard shoved the patient's sister out of the way. Then our translator came behind and the security guard tried to stop him. In turn, our translator smacked the security guards arm and there was nearly a fight. This was when I was like, "Shoot...just keep walking, just keep walking..." We always joke around our house about things causing international incidents. As I listened to all the yelling going on behind me while we calmly walked our patient inside, I was afraid that I may have actually been the cause of one.
Later yesterday afternoon, true to form, I began analyzing the situation. I had definitely stood up for my patient and made sure she got the care she really needed, but I probably could've done it in a different way. Was it really necessary for me to start yelling just because everyone else was or try to force my way inside? I can't decide. Either way, I felt  like I needed to apologize to the rest of the volunteers for my temper. It was one of those times where I realize how far I have to go before I'm a calm, wise medical professional instead of a spitfire young gun.
Sidenote, since I've been asked by quite a few people. Yes! I did get to watch the Super Bowl! And it was absolutely glorious. We went back to La Reserve (sadly, no former dictators were sighted this time) and ate really good food. I was harassed because I was not jumping out of my seat or yelling or clapping, but the people sitting around me will attest to the fact that I was squealing and twitching quite a bit. I'm sure I looked special. Such a good game. It brings so much happiness, love, joy, and other fuzzy feelings to my heart that I can't even make any mean comments about the Eagles. At age eight I remember sitting in church drawing pictures of the Packers for my grandpa (as all good little Mennonite girls do), but I don't actually remember watching that Super Bowl. The next year I spent an obscene amount of time arguing with a boy in my class about whether the Pack or the Broncos would win. I finally feel vindicated over that loss. It's a beautiful day.    

Balancing Act

A few hours ago, us girls were sitting on the floor (because we don’t have enough chairs to all sit at the table) and I asked what time it was to see if it would be absolutely ridiculous if I just went to bed. When we found out it was 9pm, we were all kind of excited about sleeping. Then the power came back on and we were suddenly rejuvenated.

Adam likes to say he’s an “extreme humanitarian.” I think the ‘extreme’ part comes from the fact that we live a life of extremes. Extreme action or extreme boredom. This past week was the first that I feel like I had such a good balance of the two. Sunday morning we had the opportunity to go to church. This was the first time that happened because we don’t have any transportation on the weekends. We’ve gotten to know some of the staff at MTI (a faith-based organization) on a more personal level and when we asked about churches in the area, they offered to come pick us up. So Leah, Ashley, and I walked to the end of our road to catch our ride. Thank goodness I threw a skirt into my suitcase at the last minute. Sometime before the amazing music started, Alex (our ride) asked if anyone was going to be watching the football games that afternoon. Luckily for me, I was sitting down when that happened. Luckily for everyone else, church was about to start. I had literally been praying for days that I would end up at Hotel Ibolele to watch the championship games. I pretty much didn’t think that would possibly happen, and I’m pretty sure the people that kept hearing me pray about it didn’t think it could happen either. But after Alex asked and Leah and Ashley had to respond because I couldn’t speak, we arranged for him to pick us up later in the afternoon to go watch the games. At Ibolele.

We had a wonderful time (or I did, at least) watching the Packers thoroughly trounce the Bears. (Let’s take a moment to relish the victory…I know all you Eagles fans will begrudgingly join me.) Then Alex suggested we go to another place to watch the second game. I forget what it was called, but he told us as we pulled into the parking lot that it’s the place where most foreigners get kidnapped. Awesome, thanks for sharing. Apparently we were safe because we didn’t bring a security brigade to announce our arrival. At that point I didn’t care as long as they had food.

Sometime during the second half of the game when we’d finally eaten and I was again able to be happy and speak to people, Alex got a phone call. Apparently one of the volunteers at GRU had been in an accident with a moto and broken his femur. (Forget cholera, we now have an outbreak of femur fractures.) Then Leah got on the phone with Corinne, the medical director at GRU (who is ironically not medical) to get the details and see how we could help. After a few discussions with her and a call to Adam (still in the States), we arranged to pick the volunteer up the next morning and take him to the airport to be flown to Miami, with the possibility of me going along on the flight. Leah and I returned to the rest of the group and she was catching them up on details. “Blah blah blah … IS THAT BABY DOC?!” Sure enough, there he sat a few yards away. So for anyone who read that he’s been arrested or that he’s hiding in the mountains, disregard that. He’s eating shrimp with former US Congressmen.

Monday morning we set out early to make sure we would be on time for his 1pm flight out. It’s good we did, because we sat in traffic on the road up to Petionville for nearly 2 hours. That road is kind of like 95. Every 5-10 minutes you get stuck in a traffic jam for no apparent reason. While we were sitting there, we discussed how it would probably be ridiculous and pretty painful to bring him back down that way to the airport. Mark, who used to work at JPHRO, mentioned that they have a landing zone. So Leah called someone else we know who used to work there to see if that was a possibility and then called the Germans. The Germans were actually there already for some other reason and they agreed to wait for us.

When we finally got to the hospital, it was kind of like playing a video game to get into his room. We talked to the receptionist, who called someone and then let us go up a flight of stairs. Then we talked to the receptionist at the top of those stairs, who called someone else. Then the doctor appeared and we talked to him, and then we were shown where his room was. Aaron, a GRU staff was with him at the time of the accident, and he walked out of the room to meet us. He looked exhausted, the first time I’d ever seen him that way. Then Mark and I went in to assess the volunteer. The whole situation was even weirder because we’d just seen this guy a few days before when we gave him a ride from the airport back to GRU. I was checking him out and when I got to comparing his legs I found that the calf and foot on his broken leg were much cooler than the other leg. That’s when he told me that he was feeling “pins and needles” in his foot. I conferenced with Leah and Mark in the hallway. Compartment syndrome…pain, pallor, pulselessness, paresthesia… I had no idea what to do, because they teach that the treatment for that is a fasciotomy, so I’d have to cut this guy’s leg open. I offhandedly mentioned that I wished I could just call Brenden and be like, “Please help me!” Next thing I know, Leah is handing me the phone. “It’s Doc.” He made some more practical suggestions. “I know, I know,” I told him, “I know just enough to kill somebody.” When Brenden was here he’d frequently shake his head and comment on how new nurses know just enough to kill someone. That may have had something to do with the fact that I automatically assume something is a tumor or an aneurysm…

Anyways, we thought we’d try loosening the straps on his external fixation device. So Mark held traction on his leg while I opened the straps, and thankfully that seemed to help.

While Mark and some other strong people were loading him into the truck, I asked Aaron about what exactly happened. Apparently, the two of them were standing on the side of the street talking to the driver of a Mack truck. A moto drove between the truck and them, and must’ve accidentally jerked his wrist or something. Aaron said he couldn’t remember. But the moto hit the volunteer at a high speed and threw him into a pole, breaking his femur in three places. We got him to JP with no trouble. The only issue was that the Germans had their logistician with them, who was taking up a seat in the helicopter. I realize that it was literally a three minute flight from JP to the airport, but it was going to take our truck 30 minutes at absolute best to get there, and if there wasn’t a nurse to go along to the States, he’d be up a creek. But Leah somehow weaseled me in, and then managed to get herself in, too.

The plane taking him to Miami arrived shortly after we did. I talked briefly with someone who told me there was no nurse with them. I didn’t really feel like flying to the States and having to try to figure out how to get back, but the patient needed someone medical with him. So I was talking with the pilot and came to discover that she really didn’t want to take me along. She told me that there were people waiting in Miami to take him right to the hospital. “Okay…so…what about if something happens between Haiti and Miami?” I asked. She responded to this by telling me that she had a physical therapist with her. Good, how very helpful. I had a miniature conference and minor freak out with Leah because I couldn’t decide what to do. In theory, he was stable, having minimal pain, and would be fine on the flight. But I can’t really bank on “in theory.” The pilot kept saying, “Well, it’s your call, but I’d rather not…” So I eventually decided I’d stay and give report to the PT. He was very gracious and listened to everything I said. At one point he said to me, “I’ve read about compartment syndrome…is that a concern?” I’m pretty sure I laughed at him. So I gave the patient another dose of pain medication, gave the x-rays, hospital chart, and my own ghetto charting on a scrap piece of paper to the PT, and sent them off. In retrospect, I still have no idea if I made the right decision. Should I have pushed more and not cared about offending the pilot? Who knows? We got word from the PT later that the patient did just fine on the flight and was awaiting surgery. Later that night, Leah and I were talking about why that particular transfer felt so much more exhausting than the rest. He was, essentially, one of us. None of us know this guy very well at all, but we’ve worked with him and his team, and we know what they do on a daily basis.

The next day we were up early for another transfer. We were going to Medishare to pick up the femur patient from the previous week and take him to meet German Air 2 so they could take him home. After a slight miscommunication at the hospital where an EMT thought she lost the patient, he walked out to us on crutches. He was obviously still in quite a bit of pain, and they really went to town putting the staples in his leg, but we were amazed that he was walking. It was pretty sweet to actually be able to help send a well patient home for once, especially one we’d taken to the hospital when he was broken.

We were pretty excited about Wednesday. We had appointments scheduled, and Leah and I were finally getting to meet with the directors at We Advance to iron out some details. We’ve been trying to pin them down for weeks and we’d finally been successful. So the plan was to walk down the street to change the bandage on our neighbor boy’s head at 8:30, get to a warehouse to pick up supplies at 9:00, have the supplies, Mark, and our new volunteer Irene out to We Advance by 10:15, meet with Aleda and Alison before their own meetings began, then head over to the airport to pick up Adam. At 7:15, Leah’s phone rang. It only woke me up, but it was G and I can’t talk to him. So I had to wake Leah up (not an easy task) and get her to call him back. I was trying to ignore it, but then I heard her say that she was going to talk to me and call him back. Apparently, G had run out of gas and had to push his truck home the night before, so he couldn’t come get us. I’m not sure why he didn’t think of calling us the previous night, but whatever. So we called him back and told him he needed to get here somehow, take our gas can, go buy gas, then get it in his truck and come back. A little while later, Ashley walked into our room and said, “Guys? G just pulled up on a moto…” There was nothing else to do but laugh.

So after successfully missing all our scheduled appointment times, we headed over to the warehouse. We were picking up cots and two exam tables. The Haitians put the exam table into the back of our truck on its wheels instead of upside down, which just made the ride all the more interesting. But now I can add to my resume that I can successfully balance an exam table in the back of a truck in traffic while drinking a bag of water.

Thursday and Friday were more filled with running errands. We went to another warehouse and did some supply drops. We also had the chance to just hang out and walk around the neighborhood, buy sodas, and buy street food, hang out with our street food lady. Friday we also got another volunteer, a Canadian paramedic. Adam didn’t want her to be sitting around the house bored all weekend (since we have no transportation), and Irene is only here for a week, so we wanted to get her involved in as much as possible. So Leah tried calling some other people we know to see if we could borrow their truck for Saturday so that some of the team could go out to Cite Soleil to work on setting up the We Advance clinic. She couldn’t get through.

Saturday morning we got a call from the head nurse at Medishare. She had a patient who needed blood and wasn’t able to find any, so she called us. Then Leah had me call the nurse back to get the report on the patient. Apparently, there was a woman in her 30s who was septic and had a hemoglobin of 4 (it should be 12). She was on oxygen and not doing well at all. The Red Cross was closed. The woman had the blood type AB+, which is the universal recipient, so she could get any type of blood. First of all, we had no access to blood. Second of all, even if we decided that DIRT was going to donate blood, we had no vehicle. I asked the nurse, “So, she’s AB+?” “Right.” “Okay, so then anyone at Medishare should be able to give her blood, yes?” She responded, “Well, today’s our turnover day, so the staff has to go to orientation.” I’ll leave the story at that, because I have no further productive words on the subject.

Soon after that, Leah got a call back from the people with the vehicle. They were willing to let us borrow it for the day, and after Leah gave their driver directions, he headed over. Mark, Irene, and Kyle (our newest Marine – we’ll soon have all of Bravo company down here) were about to leave when Leah got another phone call from Fabienne at the MTI clinic. She passed it over to me. A young woman came in and they suspected she was having a miscarriage and she had a fever and needed transport. So we jumped into the truck instead and headed over.

When we were getting close to the airport, Adam got a call from the Germans. So we pulled in there first and picked up a 16 year old with a tumor that was pushing his eye out. And I mean, literally pushing it out. It was covered with a cup, but one of the medics showed us a picture, and it was sticking out from his head a good 2.5 inches. I can’t even describe it. So we took him to Medishare, then headed to the MTI clinic. When we got there, they told us they had another woman who was 7 months pregnant and possibly had cholera. So we loaded them both up.

And thus ends another week in Haiti, complete with candlelight dinner because our inverter still doesn’t work…

Textbooks & Toolbelts

I started writing this to post at one point last week, and then we left Le Plaza (the place we go to get internet when our power is out) and I figured I’d finish it later. Then things got crazy. So here’s two blog posts in one – congratulations to anyone who makes it to the end.

I was having a conversation with one of the volunteers earlier this evening, and he asked if I’d ever seen really crazy stuff when I was here. I told him that there wasn’t anything that insane, just some people that would come into the clinic after machete fights every now and then. He looked at me for a little then responded, “Do you realize what you just said?”

My return to Haiti has been fairly calm thus far, considering the things that happened this fall. Global DIRT is working on setting up an EMS, so we’ve been overrun with logistical work. Actually, I don’t think “overrun” is the right word, because it implies that there’s action. This morning I rolled out of bed and went to the kitchen where Adam (DIRT director) began giving some sort of dissertation. He’s so ridiculously smart and his brain never stops working, and quite frankly, it’s pretty overwhelming. So he rambled on for a very long time, most of it went over my head, and then I got bored and started thinking how helpful it would be to have a textbook for his mind. The further I went with the textbook thought, the more I felt like I was sitting in an 8am Monday morning Nursing Theory class – hoping I got the important parts and figuring that between Leah and her friend Ashley (she arrived Saturday and is here to help us out for about a month), I’d get the general idea. So we’ll see if the numbers I worked out for this budget are what I was supposed come up with.

I did get to play nurse a few times in the past week. Tuesday afternoon we were driving somewhere to pick up some thoracotomy kits (those would’ve been helpful in the Saint-Marc clinic). These situations get kind of fuzzy and slow-motion in my mind, but I remember hearing a crash and then a seeing a bus more or less ramp the sidewalk. Two full buses and a water truck collided somehow a few hundred feet in front of our truck. No one was seriously hurt, which was amazing since the people were packed in the vehicles like it was a clown car. The most dangerous part was probably me walking around in all the broken glass with my flip flops on.

The next day was the anniversary of the earthquake (and also my 100^th day in Haiti). Some of our team was going to a new clinic in Cite Soleil to meet with the founders and take pictures and things like that. On the way there, we came across marches in the streets. Thousands of people streamed past our truck, singing and dancing. It was actually mildly disconcerting because I’m pretty sure they could’ve carried us and our vehicle away if they wanted to. Anyways, we got to the We Advance clinic before everyone showed up so we went back to Sister Marcella’s clinic (where we started our string of cholera night shifts) to visit. She wasn’t there, but Leah, Sully, and I looked around the clinic for a little and talked about how strange it was to be back under different circumstances. Then we returned to We Advance and waited. We were waiting to set up a dome which is going to be used for triage and supplies. The truck carrying the various dome parts, however, got caught in a ditch. Typical. So a few hours later, they began the 30 minute process of setting it up. While we were standing around, one of the clinic founders called me over to look at this little boy. He had stitches in his forehead which looked completely healed and ready to come out. I gladly would’ve removed them just to kill time, but we eventually heard (though not from the kid himself) that it happened Sunday. Whether it was the Sunday four days prior or 11 days prior we’re not really sure. But either way, I suppose, he healed nicely.

When we finally left Cite Soleil, we were really hungry and tired from standing in the sun all day. So on the way back to Le Plaza to pick up the rest of our team, we stopped for street food. After everyone had their supper, Sully went to start the truck and nothing happened. The guys looked under the hood and messed around with it for awhile. Then some random Haitians appear out of nowhere carrying a new car battery. It sounds strange, but things like that happen here all the time.  

Saturday I went out to an orphanage in Kenscoff, an area up in the mountains, with some people we know from another organization. We ended up walking the last ½ mile or so because the hills were too steep for the truck. Between another nurse and myself, we saw between 60-70 children. We started out doing well-child checkups, but eventually it turned into treating only symptoms. Everyone got treated for worms and given vitamins, and I also gave out some antibiotics. Someone said we should get shirts made that say, “I’m not a doctor, but I play one in Haiti.” So true.

Part Two. “It’s really quiet around here” is a phrase that makes pretty much every medical professional, or at least nurse, want to club the person who says it. I’d been saying it for a good ten days, trying to get something to happen because I can only be cooperative with office work for so long. It finally worked.

This past Tuesday, we got in contact with German Air Two, these random helicopter pilots who transport patients. I’m sure someone else in the DIRT house knows how this happened, but I missed that memo. I just go where I’m told. The day started far too early, which is probably why I missed the details. Adam was wandering around looking for someone’s phone, muttering something about a car accident and a helicopter. Apparently, there was an accident up north and German Air Two was transporting the patients down here to us, and we’d then transport them to the hospitals. So Leah, Ashley, and I went with our driver to this field behind the UN base. We think it was some sort of driving school, because there were a few cones and people making laps. There were also various cows strewn about. Adam and Jon, a paramedic who was volunteering with us for about 10 days, went to a different location to wait for the other patient. Before they left, Adam warned us about how much stuff was going to be flying everywhere when the helicopter was landing. That was a bit of an understatement. It was like a dust storm. When I could manage to open my eyes, I could see maybe a couple inches in front of my face. I don’t know how long that actually lasted, but I started to get worried that I wouldn’t ever be able to see again.

The dust eventually settled and the patient and a priest emerged. This priest was also a doctor – kind of a curious combination, but it made for some interesting discussion. The patient was stable and could walk by himself, he just had a cervical collar on. We took him to the hospital and I stayed with him while he got x-rays. Getting a polo shirt off someone with a neck and shoulder injury when you can’t just cut it off because he probably only has that shirt is kind of difficult. But good news everybody, the patient still told me I’d make a good wife.

Wednesday we were to be meeting German Air Two again. This was supposed to happen at the airport. Unfortunately, it wasn’t going to be until the afternoon, and Adam had to fly back to the states. He’s the one with the capabilities and connections to be in restricted places or at least get away with things. So Leah, Jon, Ashley, and I headed to the airport hours early to get details worked out and hope we could get permission for various things we intended to do. First of all, let me just say what I got through airport security with. I was carrying a combat trauma bag that Brenden left with us. That’s what I bothered to put through the x-ray machine. In my pockets I had scissors, needles, a penlight, thermometer, a pen, and my phone. Leah and Jon talked to some security people who led them away to talk to a director so we could attempt to obtain permission to pull our pickup truck right onto the tarmac. Ashley and I waited inside the airport for a little while. At one point I got a text from Leah that served as report on our patient – that was definitely a first. Especially since it originally came from nonmedical personnel who said the patient had been “nbo since last night.” I’m going to go ahead and assume she meant “npo” based on the fact that the patient told me he was hungry and “nbo” doesn’t mean a thing to me.

Before too terribly long, Leah and Jon were back. The director decided to waive the paperwork we would’ve needed to do, and we had G (our driver) pull the truck up. While we were waiting for the Germans to land, we discussed the other call we’d gotten from them en route. Apparently after they dropped off the first patient, they wanted someone to ride with them to go pick up a baby. Jon and I decided we’d assess the femur patient and then decide which one of us was going to go along for the baby. I decided that I didn’t care much either way. I am really excited about potentially getting to be in that helicopter at some point, but then I also remember that unfortunate helicopter incident in Hawaii last summer. Moving on…

The helicopter landed with much less flair and flying debris than the previous day. We greeted the Germans then Jon and I went to assess the patient. Before we could that, however, we were physically lined up by the pilot for pictures. When they opened the door to transfer the patient, we saw a cast on the patient’s foot. We looked at each other, a little confused, because we’d just heard that he had a fractured femur. When we actually got him out, we saw that the cast was only on his foot, and the flight medic told us that it wasn’t necessary because the patient did not have a foot injury. Jon did a brief assessment, then we loaded him into the truck and I began my own assessment while Jon took off with the Germans.

This patient was a young man who had been in an accident 11 days prior. He was driving a moto that got hit by a car. According to him, the doctor wanted $2500-$3000 American to do surgery and he didn’t have that, so the doctor did nothing. This guy’s leg wasn’t splinted at all. His femur was turned out and very swollen. Long bone fractures like that are really dangerous because you can lose a lot of blood, and with this bone broken, it could tear the femoral artery. So this guy was lucky. He also wasn’t having a lot of pain, considering the injury. My guess was that this was due to the fact that he had so much swelling that the nerves were more or less squashed, and my madre confirmed that this was a legit possibility. Nevertheless, we transported him to the hospital, where he has now had surgery and is doing well. Hopefully he’ll be able to walk again.

We were on our way back in the truck when we get a semi-frantic call from Jon in the helicopter. We were expecting it to be more of a routine health problem and transport (yes, a routine bowel obstruction), but the baby was not doing well at all. The three of us were stuck in traffic on the way to meet him back at the airport and there was no way we were going to get there in a timely manner. My dad always jokes about slowing the car down enough for someone to jump out. That’s pretty much what happened. Leah was still on the phone, the two of us jump out of the moving truck and start running to a guy I’m yelling at because we hope he’s a taxi. Taxis are just so much faster because, in general we’ll say we have a two lane road. Most of the time it’s three wide. The motos just ride between the lanes of traffic, weaving in and out as necessary. So we were racing to the airport, and Leah was on both of her phones trying to find a place for this baby, or at least ask if we could land a chopper at a hospital, and Jon called back so I was on the phone with him. Basically, we redirected the moto driver about three times before eventually ending up back at the airport. The helicopter had landed about ten minutes before, and there was randomly an ambulance there, so the baby left with them. We have no idea why they showed up there or who sent them.

There are so many more stories I could tell from this week, but believe it or not, I really am trying to keep this short (mostly because I’m supposed to be doing office work and writing emails…but I guess when your office is a rug you can be a little more flexible?). Anyways, yesterday morning we were transporting supplies and a volunteer to work at the We Advance clinic for the day. Leah, Ashley, and I intended to drop him off then head over to Le Plaza to have an office work day since the internet has been off at our house for three days. But while we sat there waiting for someone to unlock the clinic, Leah got a call from someone working with Medical Teams International. They have a clinic out in a village somewhere and they had a child come in who was really sick with cholera. About this time, the director arrived and we more or less threw supply boxes and were like, “Okay, thanks, peace out!” I had scrubs in a bag with me so I ran inside quick to change, and they joked that I was being a cholera superhero changing in a phone booth. Anyways, we didn’t have any IV solution or tubing for this child, so we ran up the road to Sister Marcella’s, where we had visited again that morning and she gave us what we needed.

After some confusion regarding where we were going, we arrived at the MTI clinic. I find it odd that it was so much easier to connect with people in Saint-Marc where the directions included goats and big rocks than it is here in Port where there are road names. But while we met the people working at the clinic and got report on the little boy, they started asking us if we would come back and transport another patient. He came in with what they suspected was TB as a result of HIV/AIDS and was projectile vomiting blood. So we agreed to come back for him. Our little cholera patient was perking up fairly well by the time we were en route, and only tried to climb out of the truck once. He was pretty angry with me because I wouldn’t let him drink all the water he wanted. I might be used to cholera and be able to spot it in someone’s eyes from a mile away, but its been awhile since I’ve been vomited on and I haven’t really missed it.

After dropping off the patient at St. Damiens, we went over to Grass Roots United to pick up supplies to transport a TB patient. While Ashley was in the container looking for things, one of their volunteers came up to the truck to show us an injury. He had a nice slice on his arm from sheet metal. It needed just a couple stitches. I had been waiting for this moment for months now. There were only two of us who were medical, and I had seniority, since Mark, our new volunteer, was only certified as an EMT a few weeks ago. EMTB’s aren’t qualified to stick people with anything. Unfortunately, we really had to get back to the MTI clinic. I told him I’d come back after our transfer. He asked, “Isn’t it kind of useless after an hour or so?” Quite frankly, I have no idea what the answer is to that because nurses don’t do sutures. My only point of reference was the time I got stitches after a butchering injury, and my family wouldn’t take me to the hospital until more help could get there so I was exposed to the elements a good 7 hours before I got stitched up. But I just told the volunteer it would be fine and that I’d be back.

The clinic had closed down by the time we made it back, so a nurse and a pediatrician had gotten permission to ride along with us and get picked up somewhere. We determined that we didn’t really need the masks and isolation gowns we’d brought along, but then we also thought we might be able to get our truck through the ferocious Port-au-Prince traffic more effectively if we looked intense. Maybe ridiculous is a better word choice, since I have now seen pictures of myself dressed for airborne precautions with sunglasses on in the bed of a pickup truck. Nevertheless, the transport went smoothly and there wasn’t a whole lot of traffic.

We were on our way back to the MTI house to drop off their staff and stop by Grass Roots when we stopped by the airport to return bottles to a lady we had bought drinks from the night before. There was a large crowd gathered, and they started yelling and running towards us. In retrospect, it was probably not wise for us to do what we did next, but we seem to have a fleet of angels wherever we go, so we all jumped out of the truck and ran to the crowd. They were yelling about a stabbing. We found a young man on the ground who had a bloody hand. Then we saw a 2x2 on his chest. Apparently he’d been stabbed with an ice pick. Leah was controlling the crowd, and according to her they were very respectful. I still thought they were really loud, but I was trying to hear breath sounds. We got him onto our backboard, secured him with our ratchet straps, and loaded him into the truck which G had pulled around. The doctor began assessing the injury and I was cleaning his hand. It appeared that he may have grabbed the pick to try to stop it, because he had lacerations between his fingers and onto his palm. I did a ghetto wrap job with the stuff I could find in the CLS bag. The problem with having a combat trauma bag is that it’s usually not practical for every-day injuries. Although I guess if getting stabbed with an ice pick is an every-day injury, you just can never be too prepared.

So basically, the entrance wound was very tiny, about the size of the tip of a pinky. However, we didn’t know how far it went in, or what it hit. The doctor was monitoring for signs of a pneumothorax. Mark kept trying to wake him up and keep him talking, and I was trying to figure out if he was bleeding internally because his extremities were cool. We arrive at the hospital only to discover that they have no beds. The doctor with us was talking to one of the staff and asking if they could at least do a chest x-ray. Unfortunately, their machine was broken. Awesome. But it gets more awesome. It was then that the MTI nurse told us she’d gotten a phone call from one of their directors and that she and the doctor were to stay at the hospital and wait to be picked up. I was feeling okay until the doctor was saying things like, “This patient is going to die before he gets to the general.” She asked me if we had a big needle. This is where the CLS bag comes in handy. Brenden had shown me the decompression needles and given me a crash course in using one. But that was a month ago now, and there was no way I was going to remember in a moment of panic. So before hopping out of the truck, the doctor reviewed with me what to do and what to keep looking for. It was kind of like sweet-hearted slap in the face. I already knew this stuff, I just needed to calm down.

The patient had been starting to get tachypneic (breathing too fast), and was also having brief periods of apnea before we left Medishare. However, he stabilized a bit and remained stable enough during the transport. Again there was very little traffic, uncharacteristic for that time of day in Port. The doctors at the general seemed a little bewildered about exactly what to do with him, and were kind of looking to us for orders. I might be white, but I’m still just a nurse. Leah and I looked at each other and had one of our trademark “non-verbal communication” conversations. We weren’t sure how long we should stay with the patient, but she then told them that we were just doing the transport and the patient was in their hands now.

After that, we finally headed back to Grass Roots (GRU). It had been hours, and it was way past the time when G gets off, but I felt bad because I told the guy I’d come back. When we arrived, however, they were in the midst of a meeting. Leah had tried to call the two directors to let them know we were coming (they have a strict evening visitor policy), but they never answered. So, hopefully the injured guy doesn’t feel like I abandoned him. And once again, the suturing is elusive.

If for some reason you just can’t get enough of Global DIRT stories or you want a different perspective, feel free to check out Leah’s blog

http://www.dirtyinhaiti.wordpress.com

She has a video of this week’s first transports. I’m not yet that technologically advanced.

Picture Poacher

The thing about being a nurse is you don't have time to take pictures of your work. But here's my attempt to add some pictures I stole from other people. I'll probably add more later, but I've now grown impatient with waiting for pictures to upload.

 Little boy in the Cite Soleil clinic. This child bit me four times while Brenden was putting in his IV.

 Back in the 5th Section of Saint-Marc. We were two hours off the main road doing cholera education. This is how the people traveled to see us - through the river of cholera water.

 Front room of the clinic in Cite Soleil. This was intended to be an oral rehydration area, but ended up being an IV overflow area.

 Twins in St. Damien's clinic. I thought we ought to "adopt" them, but some other people didn't really think that was a good idea.

Global DIRT team working hard at St. Damien's.