Back in the saddle

One of the few good things about getting older (perhaps the only good thing) is that you need less sleep. As the old man of the group (Beth is 26, Adam is 28, Beer is 32, Paige is 34, Tom is 36, and JBice is 38), this guy (Pat) knocking at the doorstep of his 40's is up before 5 which gives me some time to catch up on some nerdy fantasy reading (last book in the Song of Ice and Fire series). After the youngsters all get up, it's morning meeting and off to our respective duties!

This morning, while Pat and Beth went to clinic, Amy "Uno" and I (Tom), went to the peds ward and distribute stuffed animals to the kids. As of right now, the peds unit is a free-standing cinder block structure...with now air-flow whatsoever.  There were 13 infants over there, none over the age of 18 months.  While I put on a puppet show for one little angelic girl, Amy did amazing cutsie-wootsie faces with another little girl across the room.  Conditions for these children will change, once they move the little ones in where the adminstration office currently are (hopefully in a couple of weeks).  Adam joined Amy and I shortly thereafter, as we all pitched in to help Amy Lindsay clean out the "storage room".  Now let me explain said room: a cinder block structure on the hospital grounds, with no light, no floor, jammed floor to ceiling with hospital supplies, some of which have been there since before the earthquake...and it's hot in there, like cook some bacon on my head hot.  As the thought of bacon entered my mind, I soon realized it was already ab out 1pm, which meant...time for beans and rice!!!

In the meantime, me (Pat), Beth, Matt, and Terry are wrapping up a busy morning clinic of about 50 patients jamming the hallway. People are pretty orderly and there's really no incidents to speak of. We start a little late because the xray guy doesn't show up till 9:30am, and there's one surgery to squeeze in before clinic anyway. But there's no complaining, no shoving matches, no "I've been waiting 6 hours for my appointment." Pretty remarkable considering they're seen on a first come first served basis so people start lining up at 7am, so a few people actually have been waiting 6 hours for their appointment. Makes me think of the last time we were here in November when Hurricane Tomas hit the channel between Haiti and Cuba. Clinic shut down early one day and the patients were told to come back the next morning, and a few people actually did stick around overnight to wait for their visit the next morning. The patience and resilience of these folks is formidable. What makes it even more remarkable is that since our last visit the hospital has now started to charge orthopaedic patients 50 goudes (a little over a buck) for their clinic visits - about half a day's wages for the average Haitian - and people still line up. The rationale is that there are a few well-to-do Haitians who can clearly afford private care but come here anyway; moreover, having a free source of orthopaedic care in the area (i.e., us) makes it difficult for the local guys to make a living. My personal opinion is that it's better to let a few rich folks get in for free than shut out a poor person who can't pay. But that's the system that's in place, and we're the guests here.

One guy's elbow is full of pus after a surgery a few weeks ago  - a poor guy with an ununited both bones forearm fracture from the January 12th 2010 quake (after awhile you start feeling silly asking people when they hurt themselves). Stuck in the needle, and bam, 35cc's of mustard colored pus in the syringe. Along with another woman with an infected toe who needs an amputation, and another gentleman in the hospital with an open tibia nonunion who needs another washout, we've got a few surgeries to do today after clinic. So I quickly follow Tom's lead and wolf down some rice, beans, and eggplant as well before heading to the OR.

Beans and rice for the crew, check.  With two more cases about to go, I (Tom), encourage Pat to finish quickly, as one of the two patients, is ready to take a "little nap", so we may rid her of her sore toe.  Heather mixes up a fine coctail for her, and Pat works his magic,  Paige tries to be funny as usual ... heavy on the "tries."  As a few others watch in awe, I decide I better go see how Dr. Dietrich is coming along with the VAC change next door.  That patient there is actually Spanish-speaking, so I chime right in, exclaiming how awesome his Talor Spatial Frame looks.  By his laughing, and smiling face, I figured Amy had been more than successful in her first spinal in four years.  With the surgical resident Matt (a third year surgical resident from Temple University) putting the final touches on ensuring the VAC seal stays intact, I meander back to see if Pat's managed to finish the amputation, and get the wound dressed.  After a completely full day of clinic, and four cases, not to mention working outside in the sauna ... we are all slightly more than tired and sweaty.

 

In the final analysis the sweaty wins out over tired, so after Heather finishes her Skype date with her son and husband back home in Blaine, we head back over to the Auberge du Quebec for some beer and food. One of the only veggie options on the menu is the Creole rice and beans, so guess what, it's rice and beans again for me (Pat). The walk there and back through a maze of twisty little alleyways is a little daunting and we have to backtrack more than a few times as we run into dead ends. Fortunately the locals are super helpful in guiding us the right way with a pointed finger, a smile, and a "Bonswa." Which is the parting word that we're going to leave you with tonight!