My First Trip to Haiti: Day 2

30 01 2010

[Sun. Jan. 17, 2010]

Once I had cleared all the bodies I thought I’d close my eyes for an hour or two. The rest of the team was up and about. It was early and the air was still relatively cool. All the cots were in use so I fashioned a couple empty crates into position. I padded them with some cushioning and curled up in a fetal position.

My “nap” only lasted for 15 minutes. It seemed as soon as I had gotten to sleep someone was claiming that we had to move our operation. I don’t know who they were or even if they were “official,” and I didn’t care. There was no way we were moving anything. We had too many patients and too much equipment. They said they would gather a crew of people and move everything for us.

The discussion went on for about a half hour and almost everyone on our crew got in on it. One of the locals who was there with her son took me aside. She spoke English and overheard parts of the conversation that was going on in private. It seemed that the intent was to get us to move to a place that was more convenient for them. The main thing they wanted was our supplies.

Medicine, painkillers, antibiotics, first aid supplies were like gold. There simply wasn’t enough and I could understand their desperation. But instead of asking they came in under false pretenses and that pissed me off. At one point they said, “we have a truck and we can load up those crates now and come back for the rest.”

That was obviously a give away because no truck could get to the area they were talking about. All the roads were closed due to the rubble. The conversation kept going back and forth and I it seemed their story kept changing as it went along.

I finally stood up on the crate that was my bed and shouted at the top of my lungs, “If you really do have a truck then you can bring your injured to us and I’ll make sure they are taken care of, but we are not moving and that is final. Now get out of here.”

Complete silence. Everyone stopped and stared at me. I was kind of surprised that I said it and hoped that I hadn’t overstepped my boundary. I was hoping to get a nod of approval from my brother and/or the other doctors, but then decided I didn’t need it. They put me in charge of operations and it was my decision. I just looked around at them and said “Back to work.”

It was a pivotal moment for me. Until that point I thought of myself as a helper, an assistant to whomever. Now I realized the best assistance I could give it is to take charge so the medical team could be free to do their thing. If the incident we just witnessed was any indication of what was to come, someone had to be vigilant so it might as well be me.

The next few hours were relatively peaceful. It gave everyone an opportunity to develop a routine and finish getting ourselves set up. But the quiet time was just a lull before the storm. By noon there were lines of people bringing in the injured. Someone used the term mangled masses and that is exactly what it was. A sea of crushed bodies.

I don’t want to go into details about the injuries I saw. It upsets me just to think about them and there isn’t anything I can report that you haven’t already seen on CNN. But what I can say is that you learn to dissociate yourself in such a situation. It is a constant balance to not get lost in who you are and what your purpose is. I found myself showing empathy when needed, to comfort the injured or their family, but not to allow the emotions to get the best of me.

Showing empathy was like dispensing medicine. You can give too much. You want people to know you care, but that you are not lost in all you feel. Trained medical professionals learn to balance emotions early in their training. For me, keeping my emotions in check for any sustained amount of time was all new and more difficult than I thought.

And it was becoming overwhelming. By mid afternoon I found myself going down the line of people waiting to get in and telling them that if they can find any other place it would be better. The reality was that we wouldn’t be able to treat them for many hours and probably not even till the next day. All the while I knew that many of them wouldn’t live that long.

But how do you turn people away? It was like issuing a death sentence. That was the real lesson of the day. I was sobered up to the fact that we would have to let people die and refuse treatment to many. There were many cases that were so bad no amount of medical care would save them. All you can do is comfort them in their passing.

So many of them had no one. Most were in some degree of shock. Some had traumatic shock, others were just shocked into a state of confusion. You could tell by looking in their eyes they did not fully comprehend what was going on around them. They were filled with so much fear and so little hope. The uncertainty of not knowing if any of your family is alive or if you will ever see a familiar face again is unimaginable.

The doctors had to prioritize who they would treat and who they would set aside. Who they would attend to first and who they would walk away from. And I had to learn to do the same. In many incidents there were children who the doctors could have saved if only they had a parent or guardian there to look after them for the weeks to come.

Surgery is more than just what goes on in the operating room. It is the post care that has to be provided 24/7. For the orphaned child that is badly injured there is no hope. Even for an orphan with minor injuries the long term prognosis is grim at best. And if they are an infant there is no milk, no formula, no place for them to go.

The line continued to deepen. Many had been turned away from other facilities and I would have to either ignore them or turn them away again. It is probably the hardest thing I ever did.

At one point my brother said to me, “Saying ‘no’ to someone who will die is saying ‘yes’ to someone who will live.”

[As many of you know I am preparing to go back down in a few days. I hope to get Days 3 & 4 posted before I go so please check back. If you haven’t read Day 1 I recommend it.]

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