Well, Ruth, Beth and I are all back from Haiti General Hospital where we gave a unit each so Fidel (not his real name) can have his surgery tomorrow. It was an interesting experience. Adventiste is fairly close to being back to normal now, but there was a time early on when there was a mini-tent city out on the grounds, and indoors there were lots of patients who had to sleep on cots out in the hallways. We may have thought that was a little inconvenient for the patients - until today when we saw patients on cots out on the sidewalk at the General. Again, somone's always got it worse. So we get our blood pressure and hemoglobin checked, and fill out the standard questionnaire you fill out anywhere when you give blood. We all must be a little dehydrated cause Beth's hemoglobin is 12 and mine is 16, both of which are high for our normal values. Unfortunately we forget to bring the crossmatch sample of our patient's blood so we can donate for him but we can't pick up his units until tomorrow when we come back with the sample. One of those things you take for granted back home, because it's someone's job to do that, and a whole sequence of events automatically happens when you write "type and crossmatch 2 units of blood" and "transfuse 2 units of blood." Here, you do it all yourself and it gives you newfound appreciation for systems and the people that make up those systems back home. We're all a little nervous about giving blood in Haiti but the whole process actually goes really, really smoothly and by the books. We make sure to let them know we're there to give blood for Fidel (not his real name) so he gets credit for 3 units of blood. My tech was really good about sterile technique and gracious enough to pose for a photo op. The three of us are in and out within an hour. Unfortunately, Randy's a bit late with our ride back so we wait about an hour. At dinner a few nights ago somene had talked about the five languages of love. Well, tonight we learn about Ruth's seven levels of annoyance. When applied to a situation like this when you're waiting for someone, this scale would range from a very mild level I (Someone's late picking you up, but you're at home - annoying, but at least you're at home so you can go to the bathroom and watch TV) to the absolute maximum, level VII. We figure that waiting for a ride for an hour on a street curb with a random dude peeing on a wall in front of you and you don't speak the local laguage and you're a tad dizzy from just having given blood and being a little dehydrated might not be a level VII, but is a bit past level I. At any rate Randy shows up, we're very thankful for the ride, Fidel (not his real name!) gets to have blood ready for his surgery tomorrow, and it's all good!
It's been good having Pat Ebeling here cause there's enough to do to keep two docs busy. For example, today before we left to go give blood we got to run clinic and OR simultaneously. Normally, any normal orthopaedic surgeon would rather be in the OR than clinic, but today I feel like I dodged a bullet as the first case turns out to be what Jeff Brewer from HCMC (self-described "just a low-life tech") likes to call a Horrendo-plasty. It's four or five hours of rebuilding this kid's foot. The plan changes a bit right before surgery since most of these cases were booked a few weeks ago by other docs and they keep getting pushed back to the following week because OR's are always being overbooked because there's just so much to do. But the foot looks great by the end of the case, as I see when I poke my head in on a 5-minute break from clinic. Speaking of clinic, today in clinic I had a lot of fun. It was super busy, always go go go, people lined up in the hallway all waiting to see you, a bit chaotic, sometimes with two people trying to edge their way through the door at the same time. Most of them have been there since 7am since it's first come, first served. But everyone's super polite, really appreciative, well-dressed, and very understanding of having to wait for up to seven hours. I also get to meet the oldest person I've met in Haiti, a 101-year-old lady with left hip pain who fell last week but luckily didn't break anything. Must be made of some pretty strong stuff!
Tonight we get a call from Charlene, who's left Adventiste for Bernard Mevs / Project Medishare hospital. They have a poor chap there who broke his hip about 4 weeks ago and was seen at one of the MSF hospitals. Unfortunately they don't havethe means to fix him there so they're wondering if they can transfer him to us tomorrow. Of course we can take him, and in general the sooner the better with this sort of thing, except for two factors: (1) the roads here are bad enough and dangerous enough during the day that getting someone to us at night is probably a bad idea, and (2) it's already been a month since he broke it. So he's coming down tomorrow. We got a full slate of surgeries already, but this is something you just gotta do and take care of, and somehow we'll make it work.
Well, Ruth, Beth and I are all back from Haiti General Hospital where we gave a unit each so Fidel (not his real name) can have his surgery tomorrow. It was an interesting experience. Adventiste is fairly close to being back to normal now, but there was a time early on when there was a mini-tent city out on the grounds, and indoors there were lots of patients who had to sleep on cots out in the hallways. We may have thought that was a little inconvenient for the patients - until today when we saw patients on cots out on the sidewalk at the General. Again, somone's always got it worse. So we get our blood pressure and hemoglobin checked, and fill out the standard questionnaire you fill out anywhere when you give blood. We all must be a little dehydrated cause Beth's hemoglobin is 12 and mine is 16, both of which are high for our normal values. Unfortunately we forget to bring the crossmatch sample of our patient's blood so we can donate for him but we can't pick up his units until tomorrow when we come back with the sample. One of those things you take for granted back home, because it's someone's job to do that, and a whole sequence of events automatically happens when you write "type and crossmatch 2 units of blood" and "transfuse 2 units of blood." Here, you do it all yourself and it gives you newfound appreciation for systems and the people that make up those systems back home. We're all a little nervous about giving blood in Haiti but the whole process actually goes really, really smoothly and by the books. We make sure to let them know we're there to give blood for Fidel (not his real name) so he gets credit for 3 units of blood. My tech was really good about sterile technique and gracious enough to pose for a photo op. The three of us are in and out within an hour. Unfortunately, Randy's a bit late with our ride back so we wait about an hour. At dinner a few nights ago somene had talked about the five languages of love. Well, tonight we learn about Ruth's seven levels of annoyance. When applied to a situation like this when you're waiting for someone, this scale would range from a very mild level I (Someone's late picking you up, but you're at home - annoying, but at least you're at home so you can go to the bathroom and watch TV) to the absolute maximum, level VII. We figure that waiting for a ride for an hour on a street curb with a random dude peeing on a wall in front of you and you don't speak the local laguage and you're a tad dizzy from just having given blood and being a little dehydrated might not be a level VII, but is a bit past level I. At any rate Randy shows up, we're very thankful for the ride, Fidel (not his real name!) gets to have blood ready for his surgery tomorrow, and it's all good! 
It's been good having Pat Ebeling here cause there's enough to do to keep two docs busy. For example, today before we left to go give blood we got to run clinic and OR simultaneously. Normally, any normal orthopaedic surgeon would rather be in the OR than clinic, but today I feel like I dodged a bullet as the first case turns out to be what Jeff Brewer from HCMC (self-described "just a low-life tech") likes to call a Horrendo-plasty. It's four or five hours of rebuilding this kid's foot. The plan changes a bit right before surgery since most of these cases were booked a few weeks ago by other docs and they keep getting pushed back to the following week because OR's are always being overbooked because there's just so much to do. But the foot looks great by the end of the case, as I see when I poke my head in on a 5-minute break from clinic. Speaking of clinic, today in clinic I had a lot of fun. It was super busy, always go go go, people lined up in the hallway all waiting to see you, a bit chaotic, sometimes with two people trying to edge their way through the door at the same time. Most of them have been there since 7am since it's first come, first served. But everyone's super polite, really appreciative, well-dressed, and very understanding of having to wait for up to seven hours. I also get to meet the oldest person I've met in Haiti, a 101-year-old lady with left hip pain who fell last week but luckily didn't break anything. Must be made of some pretty strong stuff!
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