tag:blogger.com,1999:blog-66540163447157534812024-03-13T08:53:16.185-07:00Project Ortho: From Hennepin to HaitiThese are the thoughts of a group of friends from Minnesota and elsewhere doing orthopaedic surgery in Haiti. Our volunteer group works at Hopital Adventiste d'Haiti, in Carrefour, near Port-au-Prince. We went in July 2010, November 2010, May 2011, and September 2011, and are excited about our March 2012 trip! Read on, and learn about the adventures of this hard-working, fun-loving group of misfits as they battle bugs, sweat, and fatigue!Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.comBlogger40125tag:blogger.com,1999:blog-6654016344715753481.post-82304875261922286802012-03-12T20:25:00.003-07:002012-03-12T20:39:07.337-07:00Some more photos from the trip we wanted to share! We'd love to have the opportunity to serve again if we they'd like to have us back! Working at Adventiste was a great experience!<br />
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<br />Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-3870229408265715412012-03-11T09:00:00.001-07:002012-03-11T09:36:49.773-07:00This is the first post in a few days because internet service at Adventist has been down for awhile. (Rumor has it that someone forgot to pay the bill - shh!!) As always, the week has flown by way too fast and sadly it's already time to return home. But again, as always, we're all happy to see friends and family again.<br />
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On Wednesday night there was a magnitude 4.5 earthquake. We only felt it as a slight vibration where we were, but it very understandably caused a lot of concern. Everything seems OK here. Then on Thursday there was some unrest downtown with public display of strong sentiments for and against President Martelly; apparently there was a claim that he was born in Italy and was not a Haitian citizen which seemed to finally settle down a bit after he spoke in front of the UN and showed his Haitian passport.</div>
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<a href="http://4.bp.blogspot.com/-uWk4-5Pnn6k/T1zNexUBnoI/AAAAAAAACH8/m6OcU0Nkizw/s1600/IMG_20120307_165439.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="149" src="http://4.bp.blogspot.com/-uWk4-5Pnn6k/T1zNexUBnoI/AAAAAAAACH8/m6OcU0Nkizw/s200/IMG_20120307_165439.jpg" width="200" /></a>So we had a mildly nervous couple of days but everything's OK. Looking back on the week there have been some encouraging signs of progress here in Haiti... organized teams of workers sweeping the streets. Stoplights. Road crews pouring concrete. It gives you a lot of hope for the future of Haiti and we look forward to seeing even more progress the next time around!</div>
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On our last working day, Friday, we all tag team our way through clinic, and Pat and Beth excise a ganglion cyst from the wrists of two patients, who also happen to be hospital employees. One's dorsal (back of your wrist), and one's volar (front side of your wrist). They do them under local anesthesia, which often (even at home) is a touch uncomfortable, which we usually supplement with "OK, breathe deep." Unfortunately "breathe deep" anesthesia only works if one understands "breathe deep"! Despite that, they both do great afterwards and in fact the first lady works right afterwards, helping out with the surgery right after hers! Quoth Pat E.: "I don't think I'll ever again do a case where the patient then circulates the next case."</div>
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<a href="http://2.bp.blogspot.com/-3T9tiMOcLo0/T1zUG1kC9nI/AAAAAAAACIk/ZUytckwzj_I/s1600/IMG_20120310_085514.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="http://2.bp.blogspot.com/-3T9tiMOcLo0/T1zUG1kC9nI/AAAAAAAACIk/ZUytckwzj_I/s1600/IMG_20120310_085514.jpg" width="180" /></a></div>
<a href="http://4.bp.blogspot.com/-jlRIWkybEdw/T1zQOSEVoII/AAAAAAAACIM/c_aApMleIto/s1600/IMG_20120310_090432.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="http://4.bp.blogspot.com/-jlRIWkybEdw/T1zQOSEVoII/AAAAAAAACIM/c_aApMleIto/s200/IMG_20120310_090432.jpg" width="149" /></a>As on previous trips, we visit Franz Bastien's family's orphanage on Saturday and visit with the children. For me this is always the high point of the trip! If someone needs a second and third washout of an infected femur fracture the week we're there, as necessary as that is, it might not give them that much immediate joy. In fact it gives them a lot of immediate pain. But visiting the kids, playing Changez Movement with them, and handing out joys and treats is both fun for us and gives the kids a lot of immediate joy. Just one more reminder to them that despite living on a dusty concrete floor with siding for a roof and sleeping multiple kids to a bunk smelling of pee, they are not forgotten and someone outside their four walls, the outside world, cares about them. Pat E. and Beth have made up about 50 little packs of pens and notepads and brought a bunch of beanie babies. Tom has brought a bunch of soccer balls so the kids don't have to play soccer with an empty pop bottle. I've got the leftover flipflops and shoes we couldn't fit in our bags on our last trip - thanks to Tom Slater and Paige Saunders, who couldn't make it this time, but are there in spirit (<i>everyone </i>asks about them ... where's Tom? where's Paige?). And again as previously, it's hard to leave. There are little things I'll never forget. The flies buzzing around three dirty toilets - three toilets for 45 kids. The complete, rapt attention the kids give you when we get up in front of the class to address them - so well behaved! Handing out packs of nuts (thanks Leah Otterlei!!), and watching one 5-year-old boy, without being asked, share his with a little girl who didn't get one. So touching!<br />
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Haiti's never followed daylight savings time before, but this morning Nathan informs us as we're getting ready to leave that the president's decided that they'll start following DST all of a sudden. So our ride to the airport is leaving now, which isn't 6:30am, but 7:30am. We throw our gear together (which is a lot lighter after leaving some food and clothes behind) and load it up onto the hospital's truck for the ride to the airport. Liz's flight is at 9, whereas the other six of us have the noon flight, so she takes off earlier. (Priya left for Ft. Lauderdale last night so the group of eight is now seven). We pass by the large open air market on the coast road from Carrefour to Port-au-Prince. Mounds of trash the size of Rhode Island. A thick miasma of rotten fish that I swear one breath of is the equivalent of smoking about 7.5 cartons of cigarettes. A huge canal filled with styrofoam containers, so huge you could make a bounce house type play palace out of it - you know, the kind they have at McDonalds, except multiply that times 4 or 5. Folks chopping up chicken and goat with big ole meat cleavers making me so glad I don't eat meat even back home, let alone here. Lots of mixed feelings as we ride back. Feeling good about helping people ... feeling humbled by what others are doing, and how much more they've sacrificed than we have. Wanting to go home ... but wanting to come back and do more.<br />
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When we arrive, after dodging the skycaps (watch out - let them touch one bag and they own it, and it takes a buck to get it back) and artists hawking their canvas paintings, we see Liz in the checkin line, a mere five minutes ahead of us in the line despite having left for the airport an hour ahead of us! We feel kinda bad about it and joke that even if our line overtakes hers we'll let other people pass us so she can still beat us to the gate and feel like leaving an hour ahead was worth it. We say bye to Liz again. The other six of us will split up later, some in Miami, some back in Minneapolis.<br />
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Sitting in the American airlines departure gate area lounge is a world apart from the large unfinished warehouse we arrived in last week. There's coffee and we all promptly get some. I unabashedly turn in my membership in the Man club as I buy a girlie iced espresso blended fufu type concotion (they call it the Rebo Frappe) and drink the !@# out of it. The other guys are playing Euchre, and as much as I really miss having my butt handed to me in a sling to the sounds of derisive laughter at forgetting the rules, I decline (wait, I thought hearts were the trump suit ... so the jack of diamonds is a trump card too? and it's not a diamond anymore?).<br />
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<a href="http://3.bp.blogspot.com/-CHhth18Vj-k/T1zSlVF5TlI/AAAAAAAACIc/R-QAQBXnaZQ/s1600/IMG_20120306_124214.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="149" src="http://3.bp.blogspot.com/-CHhth18Vj-k/T1zSlVF5TlI/AAAAAAAACIc/R-QAQBXnaZQ/s200/IMG_20120306_124214.jpg" width="200" /></a>Haiti has left us all with lasting impressions. Despite the mixed emotions, some things aren't mixed. The people are beautiful, both inside and out. The country despite the poverty and trash has a lot of natural beauty. As we all split up, Priya back to project management and an uncertain future in trauma at DePuy, Liz back to nursing at Hennepin County, Fil back to Macallan TX for Teach for America, Tom back to Michigan state to study medicine, Pat and Pat back to our orthopaedic surgery practices, Kris back to putting people under anesthesia at Hennepin County, and Beth back to assisting and setting up surgery at an ambulatory surgery center, we're all going back to our normal lives, but a little different as a result of having our horizons widened a bit. Taking back some lessons home. First but not necessarily foremost, learning to be flexible - you can really get by in the OR and outside the OR with simple things and a bit of resourcefulness (like the hip spica cast table we improvised out of a board and few boxes). Appreciating what you have. Appreciating that everyone has something to offer you. Appreciating that everyone's an expert in something and knows more than you about something. Realizing what really matters in life, and how happy you can be with how little material stuff. Realizing that the dream of a life we all live back home isn't reality, it's an unsustainable fantasy world that the rest of the people on this planet can only dream of. These lessons that are different for each of the eight of us I'm sure, about what's important in life and how we'd all like to grow as a result of this brief sojourn in this beautiful country.</div>Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com1tag:blogger.com,1999:blog-6654016344715753481.post-76145873315554011992012-03-07T20:03:00.001-08:002012-03-07T20:03:38.879-08:00Wednesday! Hard to believe the week's already half over. Our fearless local leader here, Nathan Lindsey, is now back which is nice cause he's always been a welcome face to return to and you just get this feeling that with him at the helm everything, despite the chaos, will somehow end up all right. He leads morning huddle today. A Time reporter in Afghanistan remarked that one smelled like Camembert cheese after a week without a shower, which is how we all smell this morning in huddle after only a morning without water, it's that humid. Which foreshadows some more odors to come today ...<br />
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Wednesday is clubfoot clinic day, which Francel (our local orthopedist here) heads up with Jacques, the cast tech. In the meantime Pat and Pat share the other clinic room, along with Liz, Priya, Tom, Fil, and an interpreter, jammed into a tiny room packed tighter than a Tokyo subway at rush hour. Somehow it all works out and we make our way through a hallway's worth of patients who've all been queued up since 7:30am. As Fil and I inject a knee and thread our way to the sharps container in the back, we're hit by a malodorous ton of bricks wafting from an elbow that the other' Pat's just undressed. After he pulls the pin and cleans the pus and treats it with some silver nitrate things get a little better and we all regain consciousness and return to work. Fil remarks that "every Haitian kid I see is the absolute cutest kid ever ... until I see the next one" and that's totally true.<br />
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I stay behind in clinic while the other Pat goes off to the OR to do some surgeries that he added on from Monday's clinic. (Tuesday and Thursday were already booked full before we got here.) In the middle, of course, we take 5 minutes to shove down a plateful of rice and beans. Tom is looking rather cachectic so Priya takes it upon herself to make sure he's well fed by filling his plate with her rice. The food is actually rather good. I wonder if that's because it's nice and salty ... which may explain the juicy cankles we are all now starting to sport after a few days here. Hmm...<br />
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<a href="http://1.bp.blogspot.com/-Y512FtwQLWA/T1gtgIUqCFI/AAAAAAAACHM/I1vBOf2_pUE/s1600/IMG_20120307_162040.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="149" src="http://1.bp.blogspot.com/-Y512FtwQLWA/T1gtgIUqCFI/AAAAAAAACHM/I1vBOf2_pUE/s200/IMG_20120307_162040.jpg" width="200" /></a><a href="http://2.bp.blogspot.com/-zm_M27oe7ag/T1gtK1yU6NI/AAAAAAAACG8/mExG6TLpivE/s1600/IMG_20120307_160413.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="149" src="http://2.bp.blogspot.com/-zm_M27oe7ag/T1gtK1yU6NI/AAAAAAAACG8/mExG6TLpivE/s200/IMG_20120307_160413.jpg" width="200" /></a>After the OR and clinic, Jimmy Decilia (he's from Brooklyn but has lived here in Haiti for the last 5 years) tells us about the nearby orphanage he and Joe McIntyre sponsor. We all walk down to a local market and buy a poop-ton of rice, dry spaghetti, and oil, load it into the back of a tap-tap, and drive about a mile up the road to the orphanage ... well almost to the orphanage. The last 100 yards is an uphill climb up a rocky path that the producers of Survivor must have engineered to weed out the weak, by adding obstacles such as fine slippery gravel and piles of trash. And did I mention we're each carrying a big sack of rice, spaghetti, or a crate of cooking oil? Once we get to the top however it's totally worth it: an orphanage of 15 smiling kids who are just the cutest things and so grateful to have friends to play with, sing with, and pretend kung fu with (yeah, I know, you just gotta play along). Way up here above the rest of Carrefour I can totally see how one would get the impression that the rest of the world has forgotten about you.<br />
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After the orphanage we hang out on the rooftop with some sodas enjoying the sunset and watching the moonrise. You can see a little bit of the bay from here and the surrounding countryside. The juxtaposition of the abject poverty and the incredible natural beauty is nothing less than striking. The rooftop's also a good place for the paler ones among us to suntan and for Priya to show off her Yoga moves.<br />
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Priya and I remark how people back home think we're being selfless for doing this, but we're really not. Compared to the guys who live down here and are helping out long-term, full-time, like Joe and Jimmy with their orphanage, Nathan and Amy with their hospital, and of course all the other long-term volunteers at Adventist, it's nothing. Moreover we're the ones who benefit - by helping our understanding of the world beyond our own borders, beyond the tiny fraction of us lucky to live a nonsustainable fantasy life at home that some people think is all there is to the real world. As we're walking through the alleys back to the hospital from dinner tonight, Celeste, a Haitian-American nurse down here with us, stops to chat with a fellow who's standing under a lamppost reading. Why? Cause he's a senior in high school studying to get into dental school, and there's no electricity at home.Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-42410379085567734272012-03-06T17:57:00.000-08:002012-03-06T17:57:20.614-08:00March 6, 2012Its Filip and I's (Liz) privelage to narrate the blog today. We started the day with breakfast, met Celeste, a Haitian OR nurse who is from New York but she comes back here regularly for volunteering. Fil beat everyone to the shower at 5am, followed by Priya, who is always awake by 5. I should mention that comparing this trip to our first trip here in July of 2010 after the earthquake, a lot of things have changed. First of all, the weather is PERFECT this time of year. It's a breezy 85 degrees with the beautiful sunshine, no rain yet, beautifully comfortable nights, and minimal mosquitos (mostly because we have our very own personalized bug magnet catchers with us: Pat Yoon and Priya Prasad). Driving through Port-au-prince was also very different than in 2010. Post-disaster streets were cluttered with rubble piles, and endless rivers of trash filled water. The memories were so vivid as we were driving through PAP this time. The streets were very clean, the sidewalks were swept, the air was more clear, the jail was being rebuilt, the gates on the schools were built up...standing from the roof of the hospital I could see the city clearly. I do not remember that being visible 2 years ago.<br />
9:00am; Pat Ebeling in the small procedural room, tore-up (no pun intended...lol!) a Carpal Tunnel case<br />
9:00am; Pat Yoon in OR#2 removed 8-plates on a knock-knee/bow-legged four year old cutie that him and Francel (Haitian Ortho Surgeon) had fixed on their trip 6 months ago. Tom (med student) scrubbed in with Pat, and he actually gets all the credit for removing the screws and the 8-plate. <br />
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Side-note; Filip might not know how to speak Creole, but he has found a mutual language to communicate with some of the haitians...He and Jean Joel both speak spanish having many deep involved conversations.<br />
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I might add that Beth (Scrub Tech) has really been a rockstar in the OR, she and Pat E. work really well together, and my guess is that she can scrub for just about anything.<br />
10:00am; Pat E takes care of a toe amputation from crush injury, and the patient woke up from it and requested Cortisone shots in both knees and his back, easily done.<br />
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Priya was all over signing us up for random assignments from Emily to make ourselves useful...Me, Tom, Fil, and Priya organized the last of the medication (almost out of Morphine, but we have a huge stock of Ketamine and Solu-medrol...wonder how that happens:) I have to say, Priya has quite the organization skills and she is very good at directing us:) In the meantime, the surgeons were taking off a hip-spica from a 3 year old and replacing it with a new one as her hip displasia was not healed according to the XRAY (that took us 3 hours to get b/c we had to call Franz from home...)<br />
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1:30pm; removal of beads in an infected hip<br />
3:30pm; biopsy of a tumor<br />
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our day in the OR ended 6pm adn we are exhausted, relaxing on the roof of the hospital in the breeze<br />
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So, this is Haiti! ....now ...a game of Eucher and out for some nice cold ones....!!!!!!<br />
Until Next Time,<br />
AurevoirAnonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-28468642880704862452012-03-04T19:35:00.002-08:002012-03-04T19:35:22.311-08:00It's been a long time coming but it's good to be back!Well, it's been six months since we've been back here, but it's been our lucky break (haha) that the guys down here at Adventiste have allowed us to come back! Thanks for being one of the paltry few - er, I mean one of the distinguished, discerning readers - who've chosen to follow us. This time the team is a little different. Liz Slauson (those loyal readers who've been following from the beginning will remember her of course!), an RN in med-surg at HCMC; Fil Drambarean, her brother-in-law (and currently doing Teach for America in Macallan, TX); Pat Ebeling, an orthopaedic surgeon (and my buddy from residency) at Twin Cities Orthopaedics in Burnsville and also at the Veterans Affairs); Beth Ward, his scrub tech (and one of the few meat eaters the group); Priya Prasad, a project manager at DePuy trauma in Miami; Tom Wechter, a second-year medical student at Michigan State and the younger brother of one of our current residents at the University of Minnesota, John Wechter; and Kris Kline, a nurse anesthetist from Hennepin County Medical Center. Somehow, it's not quite the same without Tom Slater, who's been on all of our other trips. But he's with us in spirit, and it's good to see that Beth has taken over his mantle and has brought beef jerky and the other Pat is sporting a bandana, albeit a little less sweat-stained than Tom's.<div class="separator" style="clear: both; text-align: center;">
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The trip down gets off to a rather inauspicious start. Kris somehow reads on his ticket that we arrive in Miami at 11:25 and figures that's a good time to show up for the flight from Minneapolis to Miami. I forget that I've just had a temporary crown put in (sheesh, you hit 40 and everything starts falling apart!) and it comes loose when I chew into a piece of gum during our layover.</div>
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Fortunately once we hit the ground in Port-au-Prince, things fall back into place. Those of us from the Twin Cities meet up with Tom and Priya who arrived just ahead of us, and we hook up with Adventiste's driver Richard for the ride to Adventiste. The entire day, we've been wondering what Tom looks like. He's from Michigan and none of us have ever seen him. We figure he was a college wrestler so he must look like John - 6'1", big huge cauliflower ears, and wide as a truck. Imagine our surprise when he's built more like Pat and I. There's a cool breeze in the air (relatively speaking of course; "cool" means you can breathe it and only discern a touch of burning trash smell) and we spent the next few hours setting up our army cots, jury-rigging our mosquito netting, and catching up with good old friends! Long-term US volunterrs Emily Rivas and Randy, our Haitian interpreter Frantz Bastien (whose mom runs the orphanage we visit), and Jacques the cast tech all make us feel super welcome.</div>
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Loyal readers from Trip 1 might remember us hitting the ground running as soon as we arrived. The same thing happens tonight when some poor chap comes in with a closed tibia-fibula fracture after a rock hit his leg, i.e., he broke his leg. Fortunately, it's not too displaced (meaning it lines up pretty good) and his compartments are soft and it's closed (meaning no wounds and no bone poking through), so appropriate for non-surgical treatment. The two Pats tag-team putting him into a long-leg cast. As I'm chatting to him trying to get the story in my broken Kreyol, he subtly informs me that he does speak English.</div>
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We discuss afterwards that had this been back home, most surgeons would have recommended surgery - an intramedullary nail to essentially shish-kebab the pieces together. Not, as you might suspect, because it's a better treatment that's not available here (on the contrary, we can and do do lots of nailings here), but because people back home are financially incentivized to do more surgery. Pat and I still would have done the same thing, because a cast is exactly all this guy needs. It's certainly what I would have wanted if it'd been me.</div>Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com2tag:blogger.com,1999:blog-6654016344715753481.post-48663658928953983902011-09-29T19:36:00.000-07:002011-09-29T20:57:22.138-07:00A bottle of Coke<a href="http://1.bp.blogspot.com/-wB_bysRqSOQ/ToU6kXsPk0I/AAAAAAAACA0/g3YrLyiXKqI/s1600/IMG_9037.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="http://1.bp.blogspot.com/-wB_bysRqSOQ/ToU6kXsPk0I/AAAAAAAACA0/g3YrLyiXKqI/s320/IMG_9037.jpg" width="239" /></a>Thursday. Today's a surgery day so it's time to put those rollerskates on. Up at 5:45, shower (I don't know why I bother because you get sticky again in about 3.2 seconds after you get out), and down to the lab to retrieve our young patien'ts blood sample to take down to General Hospital to get a crossmatch so they can find the correct type of blood for him. Fortunately Randy, who's an electrician back home in Yakima, WA but the de facto local jack of all trades guy here at Adventist, has volunteered to bring it down to the General for us and pick up the blood so we can keep operating. As the day goes on, we're wondering how his quest is going ... until we find out it's for a patient at the MSF hospital. We suspect the staffers at the General assumed he was from MSF, and gave him the MSF guy's blood. And we're not about to give our guy the wrong unit of blood. Well, I feel a little unsafe about operating on our poor guy without blood ready to transfuse him with - he broke his femur 8 months ago and you know it's going to be a bloody mess taking it apart and putting it back together. So unfortunately for our guy, it means another chat with him explaining that I'm sorry but the General sent us the wrong blood and it'd be safer for him to wait till tomorrow. It's a conversation, unfortunately, that you have to have with folks a lot here. Fortunately he's really understanding, shrugs, and start to tuck into the sandwich sitting previously untouched at his bedside - happy that he can now finally eat.<br />
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Tonight it's raining farily hard. This is the rainy season so it rains most nights here. Pat Ebeling has a hankering for a Diet Coke so we put on our shells and venture out down the street with Jimmy in search of a convenience store. There's a pretty big one just off the main road that runs parallel to the coast and connects Carrefour (where we are) with Port-au-Prince. As we walk down the side road that connects Adventist with the main road, rivulets of water are running down the gutters, washing away piles of trash. You try not to think about what your feet getting wet with. But it's hard not too. You don't flush poopy TP down the toilet here, but rather throw it in the trashbin. The hospital burns its trash, but a lot of people simply dump it on the sidewalks. Yup, that's what you're walking through. As we approach the main road, these little rivuelts converge into a huge flowing brown river running alongside the busy thoroughfare. There's no overpass, no underpass, no raised blocks of stone to cross the road with like they had in ancient Rome. As we walk up and down the sidewalk looking for a way to cross, we see more streams of brown sludge feeding into the brown river. A ripe, putrid stench wafts up to us and suddenly I really don't want to eat or drink anything. So get across the Port-au-Prince road tonight, you'd have to wade through the brown river, dodging cars, in the dark, with pouring rain. Folks are doing it left and right - wearing flip-flops. It's tantalizing to see the convenience store across the street - so close, yet so far. We turn back. There's a small mom and pop stand on the way back to Adventist with bottles of Star, the local brand of cola, and we pay 8 Haitian dollars for 2 bottles, or 1 US dollar. Sounds like a small price to pay for avoiding the big brown river. Even now, warm and dry inside the hospital, we're bathed in a fetid miasma of sewer gas. Well, at least it goes well with the Star cola.<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-Z4DhuitPrLo/ToU74C68FaI/AAAAAAAACBA/Bl8O0J0qN3w/s1600/IMG_9041.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="http://3.bp.blogspot.com/-Z4DhuitPrLo/ToU74C68FaI/AAAAAAAACBA/Bl8O0J0qN3w/s320/IMG_9041.jpg" width="258" /></a></div>Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-82974637558485885942011-09-28T21:55:00.000-07:002011-09-28T21:55:39.697-07:00Due credit<div class="separator" style="clear: both; text-align: center;"></div><a href="http://3.bp.blogspot.com/-3z0VjuI94p0/ToP4ydI6QrI/AAAAAAAACAw/Y8c5k6sH7lw/s1600/IMG_9015.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="221" src="http://3.bp.blogspot.com/-3z0VjuI94p0/ToP4ydI6QrI/AAAAAAAACAw/Y8c5k6sH7lw/s320/IMG_9015.jpg" width="320" /></a><a href="http://3.bp.blogspot.com/-WlidDg5hNzo/ToP4WcNUcjI/AAAAAAAACAs/qahRso6tadQ/s1600/IMG_9018.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://3.bp.blogspot.com/-WlidDg5hNzo/ToP4WcNUcjI/AAAAAAAACAs/qahRso6tadQ/s320/IMG_9018.jpg" width="320" /></a>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! <br />
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<a href="http://1.bp.blogspot.com/-tJaMpk34d8M/ToP0wroOU6I/AAAAAAAACAc/YPlyVmPD2pM/s1600/IMG_9000.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="296" src="http://1.bp.blogspot.com/-tJaMpk34d8M/ToP0wroOU6I/AAAAAAAACAc/YPlyVmPD2pM/s320/IMG_9000.jpg" width="320" /></a>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!<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-3th7wcK5hi4/ToP3Z1NEsuI/AAAAAAAACAk/XVPM4zg6scY/s1600/IMG_9029.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://3.bp.blogspot.com/-3th7wcK5hi4/ToP3Z1NEsuI/AAAAAAAACAk/XVPM4zg6scY/s320/IMG_9029.jpg" width="320" /></a></div>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.Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-63354181607524274422011-09-28T13:05:00.000-07:002011-09-28T13:05:17.542-07:00Making it happenThings have been hopping this week here at Haiti Adventist Hospital. The new team is working out just great. Pat Ebeling and I are the orthopods, Paige Saunders and Chris Kline are the anesthetists, Beth Bard is our fourth-year med student from the U of M (that's the Twin Cities, not Ann Arbor, for you Michganders), and Ruth Bowen is a medical device rep. Right now Beth and I are about to head out to the Red Cross in downtown Port-au-Prince. We're chock full of fluids and I just downed an Annie's mac n cheese so we don't how up hypotensive after being in the OR and clinic all day. Why are we going you ask? Well, there's this poor chap who's been hanging out for the past 8 months with a right femur (thigh bone) fracture and bone overlapping by a few inches. He had actually been put on the schedule for a rodding (with a SIGN nail), but we cancelled him last week because his hemoglobin was too low, and trying to put back together a femur that's 8 months out is a long, bloody process. So the way it works here is that the patient or the family have to donate blood to get blood from the Red Cross. Unfortunately this gent doesn't have any family around, so Beth, Ruth, and I are off downtown donate blood. Wish us luck!Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-2156258813386956352011-09-25T21:52:00.000-07:002011-09-25T21:52:24.063-07:00Halfway there!This morning discover that the little 3-year-old boy we added on the schedule for this morning didn't show up to have his external fixator removed and his leg casted. Perhaps it's just as well, since we soon find out that there are two C-sections the local docs have added on for this morning that would have bumped us anyway. Funny how things work out. We make rounds. The 9-year-old girl we fixed on Wednesday has already been up and about on crutches for the past few days. Not too shabby at all. The elderly lady with the hip fracture we fixed Friday afternoon has also been up and about. Not too shabby either. We note to ourselves how little pain people have here, or rather how little they let their pain prevent them from wanting to get better and get out of the hospital. The lady with the metatsatic tumor in her humerus that we put the Kuntscher nail in a few days ago is also looking up and up, especially now that she's had her first BM in many days. I'm sure that's gotta feel great!<br />
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Tom and Amy are leaving for the airport, and the other 4 of us - Beth, Kris, Paige, and myself - hop along for the ride to say bye and to get over to the Hotele Ibalola to meet a friend of mine, Al Ingersoll, and hang out and relax for the day. Al's a prosthetist, husband, father to two girls, father to an adopted son from Haiti who also happens to be a double amputee (above the knee and you'd never know if from watching him walk!), soon to be grandfather, and just all-around an amazing guy. Last summer he and his wife Deb sold their home in Minnesota and moved full-time to Haiti, where he is the country director for Healing Hands and she works with Catholic Relief Services. We have an amazing view of Port-au-Prince below us to the north. Again, the central highlands off in the distance to the northeast and the words of that Haitian proverb come to mind again. Something about overcoming osbstacles reveal the presence of more obstacles - or more opportunities.<br />
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Deb notes how many of the expats around us at the hotel - we're hanging out at the poolside having Prestiges and rum punches - are European or South American, and how few are American. This pretty much jives with her experience working in CRS for over the past year here. I swallow my Creole omelet and think to myself, we gotta get some more people down here to help out! After a thoroughly relaxing afternoon lounging around, enjoying the view, and cooling off with the mountain breezes, it's back to Adventiste where we meet up with Pat Ebeling, a buddy of mine I've known and kept in touch with since residency, an Ruth Bowen, a rep from Wright Medical, who've just arrived from the airport. It's a new team. The two of us who've been here since the week before are refreshed after a much needed break after working full steam ahead for the past week. We're ready to hit it again tomorrow morning!Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-6428152975517882712011-09-24T22:17:00.000-07:002011-09-25T21:33:30.774-07:00Beads ... Now you see them, now you don't!Friday began with Jameson (just like the Irish whiskey) pretending to kick ZJ in the butt with a BKA prosthesis in the chapel. Nothing like a little humor to jump start your day and kick you in the pants! Our goal after making morning rounds was to see everyone in clinic, and then try and tackle a few cases in the afternoon. And, of course, it's Friday? Which means MAC AND CHEESE for lunch! Amazing how the little things can really make a big difference. Like the light at the end of the tunnel, or the thought of a big swig of lukewarm Crystal Light after a long case, Mac and cheese on Fridays here at Adventiste motivates Tom and Amy as they do their dressing change rounds, and Beth and I as we slog through a busy morning clinc. Unfortunately the ortho clinic X-ray machine's been down all week so people either have to pay $20 to use the main hospital's X-ray machine, or we just go without, or if we absolutely need it we just pay for it ourselves. It really makes you think what X-rays you need and what you don't and it's a lesson I hope to carry home. Meanwhile, Tom and Amy spend some time with patients in the "White House" above and beyond what they're out there to do. An extra five minutes with each patient isn't really too much time to spend, but it makes a huge difference in these people's day. A smile here, a wink there, a few softly spoken words, and a clean dressing go a long way even if you don't speak Kreyol (what we'd call Haitian Creole). Amy and Tom then run over to the peds ward to do some more changes, visiting, and of course the all-important Sticker Therapy (yep, look it up, it's a valid medical treatment and it works better than 99% of the drugs we use on kids).<br />
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Lunchtime can't come soon enough. We get done with clinic and Tom and Amy get done with sticker therapy around the same time, about 2pm, and we all congregate on our cots upstairs to eat - no, inhale - our feast of mac 'n cheese. This tastes better, Tom swears, than any ribeye dinner from Manny's. We then burp contentedly and go downstairs to take care of the lady with the hip fracture who got cancelled last night. Normall this kind of fracture (called an intertrochanteric fracture) gets fixed on a fracture table back home in the States but here, our "Fracture Table" is Tom bent over the table pulling on the foot like a water skier trying to get up. Hopefully he doesn't throw out is back because then both he and the patient would be in a world of hurt! Beth graciously steps into the role of X-ray technician and does all of our C-arm pictures, and I take Dr. Francel Aleksei through the case. He does great, the patient's doing just fine, X-rays look good, and we're on to the next. This is an 82 year old woman who had a hemi-hip arthroplasty back in July. Unfortunately her would became infected post operatively. A previous surgeon placed cement beads impregnated with antibiotics in the wound, in attempts to clear up the infection. This type of procedure is commonly done back in the United States. Once Uno (Amy) performs her anesthesia wizardry, Beth (astutely) recommends we take a couple of X-rays, to make sure there are in fact beads present (this happened a few days prior, where there were supposed to beads removed from a patient, only to find out there were none...). Kudos to Beth's idea, because once we fired up those X-rays, we come to find once again...the beads, we were supposed to see them, but now we don't. PLEASE NOTE: As Pat and I are typing this, we've heard four gunshots in the past hour, and...ummm...they appear to be getting closer. So, things are back on track, however now it has come to our attention the woman's sutures had yet to be reomoved. Given the length of time since her original surgery, Beth steps up to the challenge of removing all 30 stitches from a wound that is over 10 weeks old. So, with the help of a headlamp, and some bacitracin to soften the incision scar up, Beth successfully removes all those little buggers, and our lady's wound is already looking 117% better than it had 30 minutes earlier.<br />
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Now our caseload has been completed, we decide it's in the best interest of everyone involved, that we make another trek to the Auberge de Quebec, for a tomato & onion pizza...oh yeah, and a few Prestiges too! However this time, as we stretch our weary legs, and lick our dry lips, that there is no pizza this evening...not a single one. Our hearts crushed, our stomachs screaming, we order french fries, and papaya juice (we'll get to that one later). **more gunshots** As we digress, we notice a young gentleman waling out of the interior of the restaurant carrying to pizzas to go...and five minutes later, yet another person leaves with not two but three boxes of pizza!!! We look around at one another and laugh, we've come to expect this...and it's almost an edearing quality we've learned to love about this little oasis in a desert of rubble. Let me preface this next little story by saying I "did not" order the papaya juice. After being here for the fourth time, I've gotten more wise. I watch Beth, Uno, and Pat each take a nice big pull from the straw of their juice...I look at their expressions, and all at once it's decided the papaya juice tastes like the way a room full of sweaty people would taste if you had the ability to bottle it up and drink it...we shortened it up by calling it 115/4...our own little nickname for papaya juice from here on out.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-Ow6s7XaqUQQ/ToAAKq9veSI/AAAAAAAACAQ/G2NqsQaDq90/s1600/IMG_8827.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-Ow6s7XaqUQQ/ToAAKq9veSI/AAAAAAAACAQ/G2NqsQaDq90/s1600/IMG_8827.jpg" /></a></div>Saturday morning, today, we all wake up excited for our tradition of going back to the orphanage. We're excited to see the little kiddos, excited to give them stuff we've brought and see the smiles it brings to their faces. We're also really curious to see how they've grown and changed since we were last here in May. First we make our patient rounds in the hospital, and pack the bags for the orphanage with toys, shoes, leftover hand-me-down clothes from Tom's kid Cole, and little care packages courtesy of Jaewon Woo. As we walk into the orphanage, Tom is immediately bombarded by a horde of cute little tykes who surround him and jump all over him like football players on a fumble. We then find out that they've got a new nickname for him: Changez Movement, after the game we play with the kids every time we go, which is kind of like musical/dance version of Simon Says. Turns out the bubbles in the care packages are the hit of the party and the kids spend a lot of time blowing bubbles everywhere. After a few songs and dances, and after a lot of hugs and holding, the time to leave comes too soon and we're off. There are so many kids there each of us would love to take home if we could (think this little guy might fit into my carryon?), but we can't. The orphanage maintains a fairly steady number of 45 or so kids ... new kids come in, and older kids leave. Very few are adopted and we're not really sure where the others have ended up. One of the ones we saw back in May was a twelve-year-old boy who I played catch with, and who at the time reminded Paige of her son. He's no longer at the orphanage.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-HITYaGzMSEI/ToAAURZ-GGI/AAAAAAAACAU/L8QOCo71Cr8/s1600/IMG_8896.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="263" src="http://3.bp.blogspot.com/-HITYaGzMSEI/ToAAURZ-GGI/AAAAAAAACAU/L8QOCo71Cr8/s320/IMG_8896.jpg" width="320" /></a></div>Afterwards we have lunch in Petionville at La Reserve, then it's off to Fort Jacques for some sightseeing. This is a 200-year-old fort the French built overlooking the city of Port-au-Prince from the south. You have a great view of the city to the north and on a clear day can see all the way to the beginning of the northern peninsula of the island. Off to the northeast, the massive central highlands are easily seen... one can't help but think, just beyond that is Cange where Paul Farmer and his Partners in Health have been working for decades. One can also imagine that mountains like these fading off into the distance were the same moutains that inspired the creation of the Haitian proverb "beyond mountains there are mountains."<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-t5KG13xQ2qc/ToAABv6RWHI/AAAAAAAACAM/jlhV0GbQmCY/s1600/IMG_8830.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://4.bp.blogspot.com/-t5KG13xQ2qc/ToAABv6RWHI/AAAAAAAACAM/jlhV0GbQmCY/s1600/IMG_8830.jpg" /></a></div>Soon after we get back to Adventiste, Paige and Kris arrive. They're going to fill Amy's ample shoes in the role of the human painkillers - anesthesia. Tom and Amy get their things packed as they're leaving tomorrow morning. Beth and I are staying behind for another week along with Paige and Kris who've just arrived. We're all sitting around reflecting on the week that's past and the week that's coming up. All in all, it was a very rewarding week. Success isn't just measured in the number of cases done or the number of patients seen in clinic. These were tough cases that would have been hard to do under any circumstances, let alone in an OR with mosquitoes buzzing around, using batteries that die out in a few seconds, in less space than your mudroom at home, and on fractures that were sitting malreduced for days, weeks, months, and in a few cases years. Success was found in the satisfaction of a job well done no matter how tough the cirucmstances, in keeping our cool (for the most part!) despite the frustration involved, and in the poignancy of an orphan's smile when you sat down with him for a few hours, blowing bubbles, and drawing with crayons and paper.<br />
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Tom and Amy may be gone, but we hope to keep the positive vibe going for the coming week.Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-84469967352350595412011-09-22T21:28:00.001-07:002011-09-24T20:57:01.786-07:00Promises<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-vZdFYB9vGew/TnweB6WTJWI/AAAAAAAAB_4/sDuRyp2riJw/s1600/IMG_8747.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="http://1.bp.blogspot.com/-vZdFYB9vGew/TnweB6WTJWI/AAAAAAAAB_4/sDuRyp2riJw/s320/IMG_8747.jpg" width="320" /></a></div><a href="http://1.bp.blogspot.com/-l0NMrv_Ol4g/Tn6lvhJsvbI/AAAAAAAACAE/uRUU6qpdtaw/s1600/IMG_8744.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://1.bp.blogspot.com/-l0NMrv_Ol4g/Tn6lvhJsvbI/AAAAAAAACAE/uRUU6qpdtaw/s320/IMG_8744.jpg" width="320" /></a>After a late night last night working past midnight, we're back up and at it for morning huddle with Amy who's standing in for Nathan today, and morning rounds on the ortho patients on the service. The first case on is a cute little tyke who needs a cast change. He's staying over in the "white house," which is a nice little euphemism for a one-room bungalow on the hospital grounds where long-term patients can go and stay if they've come from far away and need frequent trips to the OR or dressing changes that otherwise would have required them to travel a long way multiple times in a short period. I bring him back to the OR (if you want to start early or work late you bring the patients back yourself, which I suppose is only fair). The poor kid's an orphan but he's been staying here at Adventiste for the past few weeks all by himself. Patients like him are cared for by other patients or family members they share a room with. They share food, change bedpans (food and bedpans are family responsibilities here, not the nurses'), and generally keep an eye out for each other.I found this out when I had to run back to his room because I'd forgotten his chart. "Le dossier de l'enfant?" I ask the older gentleman in the bed next to the kid's. All at once everyone chimed in and almost in unison pointed out where they were keeping it for him. (You keep all your paperwork and xrays and carry them around with you, and that's the medical record system.) I also discovered this last night when I checked up on the last patient of the night, the one who got done at midnight. He couldn't have been in his room more than a few minutes, but as he was stable and it was a relatively small surgery, his father was already back to caring for an older gentleman who didn't have a family and was in the bed on the other side of the room. It's really touching to see. It gives you hope that with all the crap these folks have been through that because they stick together like this, this country will see a much brighter day in years to come.<br />
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<a href="http://4.bp.blogspot.com/-SwD7SY1V0B4/TnweH_w83NI/AAAAAAAAB_8/hiPMGbMxdUg/s1600/IMG_8755.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://4.bp.blogspot.com/-SwD7SY1V0B4/TnweH_w83NI/AAAAAAAAB_8/hiPMGbMxdUg/s1600/IMG_8755.jpg" /></a><a href="http://2.bp.blogspot.com/-XZo_PPdBx3M/TnweSS5z5qI/AAAAAAAACAA/LCnS29J-rpY/s1600/DSC01121.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="http://2.bp.blogspot.com/-XZo_PPdBx3M/TnweSS5z5qI/AAAAAAAACAA/LCnS29J-rpY/s320/DSC01121.jpg" width="203" /></a>Another highlight for me today was putting in a Kuntscher nail. Never done one before. Gerhard Kuntscher was a German surgeon charged who pioneered the technique of fixing tibia fractures (your lower leg bone) with intramedullary rods back in World War II. He'd get Luftwaffe pilots back up flying in a few weeks may not even have been healed enough to walk, but could push pedals well enough to fly. He performed this for American POW's, which prompted some people to call for trying Dr. Kuntscher on war crimes! Now, it's the standard of care for femur fractures that occur in the shaft (the long tubular part in the middle) and one of the mainstays of treatment for tibia fractures. Funny how times change. Anyway, you never see these things anymore back home in the States, unless it's on the x-ray of an older patient. They still have them here at Adventiste and they are stll commonly used in the developing world. They used them back in Uganda when I volunteered there a few years ago. We used one today to fix a pathologic humerus fracture in a poor lady's arm who's got skeletal metastases all over her body from cancer. Most of the time broken humeri heal pretty well but there are certain instances when you fix them, generally with plates and screws, or rods. I think hers is one of those instances. She's hurting a lot when I see her after surgery but all I can do is order pain medications and promise that things will get better tomorrow. And a little bit better that day after tomorrow.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-mI0sKfOESuo/Tn6mCA4WzJI/AAAAAAAACAI/CyIs348OiuE/s1600/DSC01129.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="305" src="http://4.bp.blogspot.com/-mI0sKfOESuo/Tn6mCA4WzJI/AAAAAAAACAI/CyIs348OiuE/s320/DSC01129.jpg" width="320" /></a></div>The last case we were going to do tonight was another lady with a broken hip. Unfortunately there's a lady with a bowel obstruction who needs emergency surgery, and there's only one working anesthesia machine in the hospital right now and it won't get working again until they can fly in a technician from the States. So I go talk to her and let her know that she's waited all day without anything to eat or drink for nothing, with the promise that we will definitely, definitely get to her tomorrow. It's simply one more promise you end up making a lot here. You can only do your best to keep it.Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-27485391344804029302011-09-21T19:51:00.000-07:002011-09-22T21:11:00.610-07:00Oh, there's no place like Foam<div class="MsoNormal" style="margin: 0in 0in 10pt; text-indent: 0.5in;"><a href="http://1.bp.blogspot.com/-vP8d_JCCgGA/TnuDFZSHP2I/AAAAAAAAB_o/Wuy2SErhvas/s1600/IMG_8694.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="http://1.bp.blogspot.com/-vP8d_JCCgGA/TnuDFZSHP2I/AAAAAAAAB_o/Wuy2SErhvas/s320/IMG_8694.jpg" width="320" /></a><span style="font-family: Calibri;">Sometimes it’s funny how things work out. The little things you do that end up making a huge difference. As she was getting ready before one of our cases yesterday, Amy was testing her anesthesia circuit. No problems. For some reason the thought came to her that maybe she ought to check it again. A little voice inside her head said, “You’re just freaking out, relax, it’ll be fine.” Nonetheless Amy tested her anesthesia circuit for the second time. Why, even now she couldn’t say exactly. As she did so a second time, a bunch of foamy bubbles spouted out from the machine into the tubes. Back home this would have essentially caused mass hysteria. That OR room would have shut down temporarily and all the cases booked for it would have gotten delayed or rerouted to other rooms while the anesthesia machine was cleaned out top to bottom. Here, we simply took some Q-tips & rubbing alcohol to the anesthesia machine…cleaned that puppy out real good, sent the circuit tubing back to get rinsed out again, and went on with business as usual. I mean, what else are you gonna do? It’s the only functioning anesthesia machine, and without it, well, no one would get operated on that day.<o:p></o:p></span></div><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;"><div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-HzUFDNHo0cM/TnuDu37EAJI/AAAAAAAAB_s/njCC9pfrbNQ/s1600/IMG_8691.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="http://4.bp.blogspot.com/-HzUFDNHo0cM/TnuDu37EAJI/AAAAAAAAB_s/njCC9pfrbNQ/s320/IMG_8691.jpg" width="240" /></a></div><span style="font-family: Calibri;"><span style="mso-tab-count: 1;"> </span>During our first trip down in July 2010, about half the patients we saw in clinic and operated on in surgery were there because of the injuries caused by the January 12, 2010 earthquake, or because of complications thereof.<span style="mso-spacerun: yes;"> </span>Over the next three trips, we’ve noticed successively fewer and fewer injuries related to the quake and more and more injuries that simply happen in the day to day life of a country of 9 million people and a city of a million. Kids falling while playing, people getting hit by cars and motorcycles. However, we have to remember that that earthquake killed about 250,000 people and injured another 250,000, though no one really knows how many, in a country with between 35 and 40 orthopaedic surgeons.. Let’s face it, for months, years, and probably decades to come, there are going to be a lot of people out there who’ve never gotten treatment. So it should really come as no surprise that a 63-year-old lady comes in with a left distal humerus fracture, her arm broken just above the elbow, never having seen a doctor since the injury. For the last year and 8 months she’s walked around with her arm flopping around completely uselessly.<span style="mso-spacerun: yes;"> </span>She looks at me like I’m her knight in shining amour, because I’ve helped her into her wheelchair and into her bed a few times so far this week.<span style="mso-spacerun: yes;"> </span>Despite her situation, she talks my ear off about this and that, holds my hand, and thanks me for adjusting her fan to keep her cool.<span style="mso-spacerun: yes;"> </span>Let me take this time to remind all of you there is only A/C in the operating rooms (when the power is on), not in any of the patient rooms or wards.<span style="mso-spacerun: yes;"> </span>Families tend to their own, providing them with food, drink, and in this case a fan.<span style="mso-spacerun: yes;"> </span>This brings me to the long-term patient housing.<span style="mso-spacerun: yes;"> </span>This is a separate building on the hospital grounds, having 5 beds, and a new armoire made of pine, for patients to keep their clothing.<span style="mso-spacerun: yes;"> </span>In the bed closest to the door is Daphne, and 18 year old girl, who is cute and sweet as pie.<span style="mso-spacerun: yes;"> </span>We took care of her heel the other day, and I went over to change her dressing.<span style="mso-spacerun: yes;"> </span>Daphne’s bed is covered with soft floral print sheets, she has a new comforter, a silk pillow case with ruffles, stuffed animals, and an afghan all on her bed.<span style="mso-spacerun: yes;"> </span>She’s wearing a nice nightgown, and is watching a movie on a portable DVD player.<span style="mso-spacerun: yes;"> </span>The others are two men, each having on merely a pair of shorts, with a white hospital bed sheet.<span style="mso-spacerun: yes;"> </span>It is apparent some have money, and some do not.<span style="mso-spacerun: yes;"> </span>However, I was able to notice something in all three of these people, while Uno and I were there…without any of them speaking a word, I could see their appreciation, the gratitude in their eyes…the smile on each of their faces…a simple smile, letting me know each one was glad we were there.<span style="mso-spacerun: yes;"> </span>That’s all we’re trying to do; make people smile.<span style="mso-spacerun: yes;"> </span>Every now and then, I’m able to look down at the world, stretch out my legs, wiggle my toes and say to myself…”see Tom, life ain’t that bad, yer making people smile”.<span style="mso-spacerun: yes;"> </span>Often life is conveyed as serious, complex, and difficult…but really, it can be so simple.<span style="mso-spacerun: yes;"> </span>Make people smile.<o:p></o:p></span></div><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;"><div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-CB_Jpq5T3rs/TnuEmFICzkI/AAAAAAAAB_w/G4M-tONlDsY/s1600/IMG_8682.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://3.bp.blogspot.com/-CB_Jpq5T3rs/TnuEmFICzkI/AAAAAAAAB_w/G4M-tONlDsY/s1600/IMG_8682.jpg" /></a></div><span style="font-family: Calibri;">I headed back to the main hospital, Uno in tow, and we slowly made our way upstairs to the volunteer area…beans & rice baby!<span style="mso-spacerun: yes;"> </span>I saw Jay Leno (aka Nathan Lindsey) emerge from his room, where he’s been resting from being slightly ill, and having to see Pat and I for the fourth time in just over a year.<span style="mso-spacerun: yes;"> </span>He reminds me of the hot sauce he’s got to kick the afternoon meal up a notch.<span style="mso-spacerun: yes;"> </span>I would’ve accepted, however I had just taken my third breath, and well, the food was gone…breathe in, breathe out…breathe in, breathe out…food gone!<o:p></o:p></span></div><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;"><a href="http://3.bp.blogspot.com/-ePV0BLp6_Mg/TnwGFXxf5fI/AAAAAAAAB_0/gRr1PTYOh-w/s1600/DSC01109.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://3.bp.blogspot.com/-ePV0BLp6_Mg/TnwGFXxf5fI/AAAAAAAAB_0/gRr1PTYOh-w/s320/DSC01109.jpg" width="320" /></a><span style="font-family: Calibri;">So I started drawing smiley faces on my mask, making balloons with faces out of exam gloves, to go along with the teeny Beanie Babies Beth’s sister gave her to bring down.<span style="mso-spacerun: yes;"> </span>How much cuter can it get when a little one has a Beanie Baby in one hand, and chewing on a latex-free glove finger in the other…I’ve also taken a liking to room temperature Crystal Light it seems…when its 8pm, you’ve not had dinner yet, waiting for the next patient to be rolled on down, wearing a lead apron that’s at least 20 years old, and you’re sweating so much your arms are slipping off the keyboard…there’s nothing like putting some sweet 80 degree grape Crystal Light to your lips, and taking a big swig…heaven just arrived on earth…HEAVEN BABY! The only other thing that’s a little better, is when Pat steals some of Uno’s candy, and hides it in his backpack in the OR…then I eat all of it, but Pat still gets blamed for stealing…so much fun! <o:p></o:p></span></div>Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-64430085892701445412011-09-20T21:48:00.000-07:002011-09-21T23:32:45.050-07:00The end of peanut butter as we know it<div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Tuesday, 20 September 2011<o:p></o:p></span></div><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;"><span style="mso-tab-count: 1;"> </span>I think I would be shortchanging you if I neglected to tell you about the ant story from last night. During our last case, I felt these creepy crawly things all over my face. I thought to myself, Oh well, that kind of stuff just happens down here, I suppose, deal with it. I asked Bonhomme (who was our circulating Haitian nurse) to take care of it for me, and I just kept working. Problem solved, no more ant crawling around on my cheek. Until it happened again … and again … and again. These little suckers were crawling all over my head having a freakin’ picnic! My entire head and face were itching like crazy and Bonhomme had her hands full swatting my head with her hands killing ants.<span style="mso-spacerun: yes;"> </span>I look back and think Holy cow, I was jumping around swatting my arms about like I’m crazy in the coconut, no wonder people were giving me funny looks. At the end of the case I took my headlamp off, opened up the battery case, and lo and behold, it was full of ants! Looks like the little buggers were making a little ant colony for themselves there. I kinda cringe when I think of putting that thing on my head. More than that I was relieved that it wasn’t all in my head – just <i style="mso-bidi-font-style: normal;">on</i> it.<o:p></o:p></span></div><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;"><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-XLMfrpTg7KQ/TnrV4WrtvWI/AAAAAAAAB_g/1MJOzib6BVY/s1600/IMG_8667.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://1.bp.blogspot.com/-XLMfrpTg7KQ/TnrV4WrtvWI/AAAAAAAAB_g/1MJOzib6BVY/s320/IMG_8667.jpg" width="320" /></a></div><a href="http://1.bp.blogspot.com/-AYHqzuvnFQ0/TnrSfAdXFQI/AAAAAAAAB_U/E0x9JoQghPA/s1600/IMG_8637.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="http://1.bp.blogspot.com/-AYHqzuvnFQ0/TnrSfAdXFQI/AAAAAAAAB_U/E0x9JoQghPA/s320/IMG_8637.jpg" width="317" /></a><span style="font-family: Calibri;"><span style="mso-tab-count: 1;"> </span>So we’re up and at it again at 6:30 this morning. We eat a yummy breakfast of energy bars while we check email, followed by morning huddle in the chapel. Nathan’s message today is about the two fish and five loaves of bread story that most of us are probably familiar with. The idea being that whether in abundance or in small subtler amounts, we’re provided for. I start thinking, I wish I was provided with an umbrella so the sweat off Tom’s forehead doesn’t drip all over me. But I also start thinking about healthcare. If you live in the States you’re like the guys with thousands of leftover fish and bread at the end of the day – more plastic surgeons, same-day appointment MRI scanners, and Lasik sweatshops than you can shake a stick at. If you live in Haiti you simply get volunteers like us, just enough flour and oil to make it to another day if you’re lucky. Five volunteers from Loma Linda, including Marq the “lifer” from Adventiste, and Heather, Sarah, and Vanessa <span style="mso-spacerun: yes;"> </span>from Loma Linda are off to fly to Cap Haitien to run am outreach clinic there for a few days. Story is there’s 300 patients out there waiting to see them. I think, holy noodles, good luck with that! There’s also a full slate of surgery cases for us today. After rounds, surgery starts off with two bilateral clubfoot cast changes, and a knee manipulation under anesthesia. The knee manipulation kid previously had a 7cm limb length discrepancy and is being lengthened with an external fixator and the principle of distraction osteogenesis. This is basically where you break someone’s bone and stretch it out gradually with time, like a millimeter a day divided into four quarter-millimeter intervals, and new bone grows in the gap, Unfortunately this kid has lengthened about as far as he’s gonna get, at about 4cm (so he’s still 3cm short) as his knee is getting pretty stiff, hence the knee manipulation. Now the key with this is to push hard enough to move the stuck knee but not so hard you break his leg. That would obviously not make someone’s day, so after CJ and I nearly give ourselves hernias pushing on this lil’ tyke’s knee, caution wins out over making the knee move better and he’s unfortunately still stuck. A definite whomp, whomp moment.<o:p></o:p></span></div><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;"><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-myuhArHnpsI/TnrWXPgSnII/AAAAAAAAB_k/bffq8JrGoZ0/s1600/IMG_8661.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://2.bp.blogspot.com/-myuhArHnpsI/TnrWXPgSnII/AAAAAAAAB_k/bffq8JrGoZ0/s320/IMG_8661.jpg" width="320" /></a></div><span style="font-family: Calibri;"><span style="mso-tab-count: 1;"> </span>After a few more cases, the last case of the day is a 68-year-old woman with a broken hip. Believe it or not she actually comes in as a scheduled elective case for this, and has been at home for the past few days waiting for surgery.<span style="mso-spacerun: yes;"> </span>Amy notes that this is the sweetest little old lady you’ve ever met and didn’t complain about one thing or say peep during the whole case. We lay her lateral decubitus, or on her right side, to perform a left hip hemiarthroplasty, or partial hip replacement. Once inside the hip it becomes apparent it looks like more than a few days old, more like a few weeks. After a lot of struggling we eventually get things done and things turn out just fine. As we’re getting the nice old lady off the table and back onto her gurney, Tom and I are undoing her “seat belt” which is strapping her securely on her side. Back home this is a real seat belt made of leather with metal buckles. Here it’s a roll of this semisticky stuff called Coban which is a 3M product (go Minnesota).<span style="mso-spacerun: yes;"> </span>Now they’ve been known to reuse everything under the sun here (ventilator tubing, bloody laparotomy sponges, screws that come out of other patients) out of sheer necessity, so I ask Tom, “Do they reuse this stuff?” meaning the Coban which I’m about to unwrap. Tom pulls out his scissors and – Snip! – “Not this one!” Hahahaha!!<o:p></o:p></span></div><a href="http://3.bp.blogspot.com/-CiFRC5f98uE/TnrTSBLxp-I/AAAAAAAAB_Y/qCKmgJg60ps/s1600/IMG_8633.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://3.bp.blogspot.com/-CiFRC5f98uE/TnrTSBLxp-I/AAAAAAAAB_Y/qCKmgJg60ps/s320/IMG_8633.jpg" width="320" /></a><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt; text-indent: 0.5in;"><span style="font-family: Calibri;">Besides thinking that everything’s funny, we’re all too pooped at 9:30 pm to do much else besides sit in a zombielike trance, eating food and sitting in puddles of our own catatonic drool. The danger with having jobs where you work ridiculously hard (this actually refers to memories I have of residency, not volunteering here at Adventiste – it’s too much fun here to be considered work) is that you feel entitled to eat whatever the heck you want to eat when you get home because you justify it and say, “Hey, I worked 118 hours last week, I deserve a whole bag of tortilla chips and a whole jar of salsa.” We all exemplify this rule as we spend the next hour sitting, mechanically shoveling food into our mouths.<span style="mso-spacerun: yes;"> </span>I speciously justify my gluttony with the convenient argument above and eschew peanut butter (not having pb for the third night in a row, no way!) for some Annie’s mac ‘n cheese and half a box of Puffins … of course not to mention a few handfuls of Beth’s honey roasted almond mix. Sitting here kind of reminds me of the 60-hour stretch of continuously being awake I had early in my career. (You may wonder “Wait a minute, don’t they have that 80-hour work week and a 30-hour workday rule? – Nope, only for residency!) <span style="mso-spacerun: yes;"> </span>After a while, you’re too punchy to really fall asleep. Everything becomes funnier. The vibe is similar here at Adventiste. We’re not nearly that overworked here, but we’re all truly working our tails off. We’re having fun<span style="mso-spacerun: yes;"> </span>- meaning the work itself is fun, not that we’re goofing off. The camaraderie is great. We’re making cool friends from Haiti and other parts of the US. We socialize and laugh with our patients and try to make them feel comfortable. It’s fun down here because every single one of us down here – not just our group of 4, but the “lifers” Lynne and Marq and Brian and Nathan and Amy and CJ … and Heather and Sarah from Loma Linda … and our awesome Haitian friends like Jean Joel and Jeanty and Albert<span style="mso-spacerun: yes;"> </span>and Aleksei<span style="mso-spacerun: yes;"> </span>- are all here at Adventiste for the same reason, to help a brother out. Just cause we can.<o:p></o:p></span></div><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt; text-indent: 0.5in;"><span style="font-family: Calibri;">Then to our surprise we run into Marq, Sarah, Heather, and Vanessa walking back into the hospital – they were supposed to be in Cap Haitien till Friday. You know the cliché about thinking your day being crappy until you hear about someone else’s misfortune? Turns out these five never made it to Cap Haitien. Rather, their plane actually made it, but after circling above the thunder and lightning for a while in a pattern, their Salsa Air pilot flew them back to Port-au-Prince. The pilot flying the Tortuga Air flight 5 minutes ahead of them wasn’t so cautious. He apparently tried to land his plane at Cap Haitien in the thunderstorm. Our friends were in a holding pattern in the air right above the other plane when this happened. The plane below them crashed and all three people aboard were killed.<o:p></o:p></span></div>Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-3330623693577798212011-09-19T22:42:00.001-07:002011-09-20T05:29:43.454-07:00Puffins - Not just for breaktast anymore!<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-IagUUtSIXz8/TngxUCTaFxI/AAAAAAAAB-8/RyUuJWYMfTU/s1600/DSC01083.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="480" src="http://1.bp.blogspot.com/-IagUUtSIXz8/TngxUCTaFxI/AAAAAAAAB-8/RyUuJWYMfTU/s640/DSC01083.jpg" width="640" /></a></div><a href="http://1.bp.blogspot.com/-QoHc-CKX66Y/Tng0tbRDpMI/AAAAAAAAB_I/ARC9Sbw1K2M/s1600/IMG_8628.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://1.bp.blogspot.com/-QoHc-CKX66Y/Tng0tbRDpMI/AAAAAAAAB_I/ARC9Sbw1K2M/s320/IMG_8628.jpg" width="320" /></a>Well, after a day like yesterday’s, no one really had too much of a problem sleeping last night, and we all wake up this morning refreshed and ready to hit the ground running. We start off with a hastily gulped breakfast of energy bars, coffee, oatmeal, etc., as we rush down to the traditional morning huddle led by our fearless leader Nathan (or should I say one-half of the fearless leader of a couple), and introduced by his warm-up act Lynne, a nurse from Loma Linda who’s here long-term. Or should we call her act the monologue? I could imagine her saying, “Well guys, we got a great team for you here today, they’ve come all the way from Minneapolis, Minnesota to fix broken bones, heal the sick, and contribute their pound of sweat … let’s give it up for Team Hennepin! And of course, the one you’ve all been waiting for … heeeeerrreee’s Nathan! Woohoo!” Alas, no. But Lynne’s awesome and she’s kind of like the glue that holds the orthopaedic service here together, the link between successive groups, the institutional memory for a hospital that runs on lots of groups of volunteers. She also maintains our inpatient census which we refer to as we make rounds on all the orthopedic patients in the hospital after breakfast.<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-1JIxl71Ja50/Tng0F1b8qrI/AAAAAAAAB_E/_AcgoutjE2E/s1600/DSC01080.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="http://1.bp.blogspot.com/-1JIxl71Ja50/Tng0F1b8qrI/AAAAAAAAB_E/_AcgoutjE2E/s200/DSC01080.jpg" width="200" /></a></div><a href="http://3.bp.blogspot.com/-F-sCtKrZmRk/TngqY7IF4FI/AAAAAAAAB-o/YwVWAACx0hs/s1600/DSC01097.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="http://3.bp.blogspot.com/-F-sCtKrZmRk/TngqY7IF4FI/AAAAAAAAB-o/YwVWAACx0hs/s320/DSC01097.jpg" width="240" /></a>One patient we meet on rounds is a beautiful 20-year-old woman with a large thigh mass and a pathologic hip fracture and probably has a sarcoma. It turns out no one’s told her yet that a malignant bone tumor is one of the things we’re worried about so we try to break the possibility to her as gently as possible. She doesn’t cry or even miss a beat. She might be in denial, or it might just be one more load of bad news that life’s thrown at her and everyone else here, and the only way to survive is to shrug and deal with it. In her case, dealing with it may mean nothing more than simply pain medications. There’s no adjuvant chemotherapy here (chemotherapy after you remove someone’s tumor, assuming we could even do that), no neoadjuvant chemotherapy (chemotherapy before you remove someone’s tumor), and no radiation, even for palliative purposes.<br />
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<a href="http://2.bp.blogspot.com/-CSLtPygdEXQ/TniG4fYQfhI/AAAAAAAAB_Q/dO4RBd_Z4A4/s1600/IMG_0134.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="http://2.bp.blogspot.com/-CSLtPygdEXQ/TniG4fYQfhI/AAAAAAAAB_Q/dO4RBd_Z4A4/s200/IMG_0134.jpg" width="150" /></a><a href="http://4.bp.blogspot.com/-Eu-x7lMMyro/TngwJe1_F0I/AAAAAAAAB-4/VW4WBkvBThU/s1600/IMG_8626.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://4.bp.blogspot.com/-Eu-x7lMMyro/TngwJe1_F0I/AAAAAAAAB-4/VW4WBkvBThU/s320/IMG_8626.jpg" width="320" /></a>Then it’s off to clinic for me and Beth and getting the OR set up for Tom and Amy. We find out that the xray machine in orthopedic clinic is down for the week. At first it might seem it would slow you down immensely. The only way to get xrays to have them go over to the main hospital, pay 500 goudes, 125 Haitian dollars, or about 20 US dollars over in the main hospital radiology department, which almost nobody here can afford. It actually turns out not to be so bad. You quickly learn to hone in on your physical exam skills and trust your senses. Clinic actually goes faster when you don’t sweat the xrays (uh, how about when you don’t have xrays). Kind of reminds me of the Calvin ‘n Hobbes cartoon where Calvin flips through the pages of his reading assignment in about 2 seconds and proudly declares “reading goes faster if you don’t sweat comprehension.” Not necessarily the most ideal situation if you had more resources, but you do what you can. There’s one patient who actually does need an xray emergently but can’t afford it, so the only thing to do of course is just pay the hospital for the xray out of our own pockets.<br />
<br />
<a href="http://4.bp.blogspot.com/-Y53n6P7WgZo/Tngr_wyPaDI/AAAAAAAAB-s/lrIGUXJKR_g/s1600/DSC01081.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="http://4.bp.blogspot.com/-Y53n6P7WgZo/Tngr_wyPaDI/AAAAAAAAB-s/lrIGUXJKR_g/s200/DSC01081.jpg" width="200" /></a>In the middle of clinic of course there’s the one meal the hospital gives us a day, a lunch of – you guessed it – rice and beans! We’ve actually been looking forward to it since the last time we were here, believe it or not! This gets wolfed down among the four of us in about 3.2 seconds. Tom’s never tasted anything so good that didn’t have meat in it! We supplement this with our own snacks we’ve brought from home, including some Puffins cereal I bought last minute in a shopping spree at Kowalski’s at about ten o’clock last Saturday night, or about eight hours before our departure Sunday morning. They’re surprisingly tasty for something that looks suspiciously like cardboard and comes out of a card board box without any cartoon characters on the front panel. They do the trick and are just fine in a pinch.<br />
<br />
<a href="http://3.bp.blogspot.com/-7yJUVdIVU_g/Tng5w1aQydI/AAAAAAAAB_M/Et7AVz4u3-8/s1600/DSC01096.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="160" src="http://3.bp.blogspot.com/-7yJUVdIVU_g/Tng5w1aQydI/AAAAAAAAB_M/Et7AVz4u3-8/s200/DSC01096.jpg" width="200" /></a><a href="http://4.bp.blogspot.com/-i48qUr2gv1Y/TngtOekVzDI/AAAAAAAAB-w/-f6HMGHDyS8/s1600/DSC01075.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="192" src="http://4.bp.blogspot.com/-i48qUr2gv1Y/TngtOekVzDI/AAAAAAAAB-w/-f6HMGHDyS8/s200/DSC01075.jpg" width="200" /></a>By the time clinic gets done Tom and Amy have gotten the OR all set up, Lynne nurse coordinator extraordinare has pre-opped our two patients we’ve added on the schedule for this afternoon (one woman whose heel wound was looking a little worse this morning on rounds, and one woman who’s scheduled antibiotic bead removal for tomorrow we moved up to today because tomorrow’s schedule is already shaping up to be a freaking NIGHTMARE), and Jean-Joel (that’s JJ to you and me) has brought the patients down. One goes very quickly, and the other takes forever. The lady with the beads has had about a jillion previous surgeries on her hip which all began with an infection. She’s unfortunately got no hip left, just a big wad of scar tissue the size of Alaska with a small string of 17 beads encased somewhere inside like a piece of spaghetti encased in a slab of Lucite the size of a small suitcase. Because it’d been so long since they were implanted, the string has partially dissolved and to our dismay breaks apart into multiple little strands, and here we go skipping through the forest excitedly hunting for loose beads very close to large arteries and nerves as we cheerfully sing songs, which is close enough to the truth as long as you substitute “spew out” for sing, and “colorful epithets not fit for publication” for songs. The mood is tense which is an odd juxtaposition with Vampire Weekend playing on Beth's iPad in the background. After a lot of singing we eventually locate a few beads behind the femur in the region of the sciatic nerve, a few beads way out in front, and a few beads juuuust a bit inside, just like a baseball pitch. As the 17th bead is found snugly tucked away in a little safe haven of pus we break out into cheer. Fortunately, our patient does well and we finish for the day.<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-Q13y-EBq0Qg/TngyJwLJwzI/AAAAAAAAB_A/DNkXVbryucg/s1600/DSC01090.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="http://4.bp.blogspot.com/-Q13y-EBq0Qg/TngyJwLJwzI/AAAAAAAAB_A/DNkXVbryucg/s200/DSC01090.JPG" width="200" /></a></div><a href="http://1.bp.blogspot.com/-KZKDJOjG7ms/Tngu_W0NBuI/AAAAAAAAB-0/KCxnJojtToo/s1600/DSC01093.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="126" src="http://1.bp.blogspot.com/-KZKDJOjG7ms/Tngu_W0NBuI/AAAAAAAAB-0/KCxnJojtToo/s200/DSC01093.jpg" width="200" /></a>And so we finally get a chance to sit down and have dinner at 10:30pm, about two hours ago, and just decompress and talk about the day. Bummer that this was supposed to be the light day before the poop really hits the fan tomorrow! Oh well. Realistically we know there’s no way we’re going to get through all the cases in the schedule, but … optimism is key. And, of course, a pair of kings wouldn’t be so bad either. Cause you gotta play the hand you’re dealt, and do what you can.Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-81606212378620948382011-09-18T18:53:00.000-07:002011-09-19T22:47:56.654-07:00"Welcome home!"<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-Y5PPDqYYxI4/TngbKKNuVlI/AAAAAAAAB-Y/NEkGVwSkBZw/s1600/IMG_8612.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="480" src="http://4.bp.blogspot.com/-Y5PPDqYYxI4/TngbKKNuVlI/AAAAAAAAB-Y/NEkGVwSkBZw/s640/IMG_8612.jpg" width="640" /></a></div>Those were the words Frantz Bastien, one of our translators, use to welcome us back to Adventiste. And indeed, as we shrugged off our backpacks and 50-lb. hockey bags full of medical supplies and subject Nathan and Amy to four sweaty hugs, it does feel like home.<br />
<br />
<a href="http://2.bp.blogspot.com/-JwBaBiUatlE/TngZjaCIvwI/AAAAAAAAB-U/_RXVULT-VvE/s1600/IMG_8611.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="229" src="http://2.bp.blogspot.com/-JwBaBiUatlE/TngZjaCIvwI/AAAAAAAAB-U/_RXVULT-VvE/s320/IMG_8611.jpg" width="320" /></a>Beth Bard, Amy Beer, Tom Slater, and I are here at Hopital Adventiste d'Haiti. It's the third trip for Beth, the second for Amy, and the fourth for Tom and I (in 14 months). We're down here for a 2-week stint to do orthopaedic surgery for indigent patients in Haiti. We feel excited to be back among old friends -Haitian and American - fortunate to have the opportunity to do what we love, tired after getting up this morning at 3am, and of course, despite the banter and lightheartedness, aware of why we're here, and how badly people down here really need a helping hand. Despite hundreds of millions of dollars in international aid and countless man- and woman-hours of human work, all it takes is a look around us in Port-au-Prince to realize that there's still a lot of rubble, a lot of people still living in tent cities, and a traffic system and infrastructure that still encourages a lot of road traffic accidents. We're here to work, to fix broken bones, to help some people out.<br />
<br />
<a href="http://3.bp.blogspot.com/-UJQmmHF9j6U/TngZMWEcxYI/AAAAAAAAB-Q/3ZzRUUJsePA/s1600/IMG_8615.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://3.bp.blogspot.com/-UJQmmHF9j6U/TngZMWEcxYI/AAAAAAAAB-Q/3ZzRUUJsePA/s320/IMG_8615.jpg" width="320" /></a>Our preparations for this trip began, as usual, with several months of collecting supplies. Tom's new job as Tissue Recovery Coordinator (TRC) at LifeSource has proved very helpful, as evidenced by the volume of spare/excess gowns, gloves, sterile OR packs, and prep kids, as well as by the low back pain we've all developed today schlepping this stuff around. We've also got to put in a great word for everyone back home at HCMC (Hennepin County Medical Center) who pitched into donate extra items from the OR. Speaking of Hennepin, this might be a good time to say that despite being "Hennepin to Haiti," until Paige and Chris join us next week, right now I'm the only one left from HCMC in the current group, although it remains the common factor among all 4 of us. Tom used to be surgical tech extraordinaire there until lured away by the promise of being a surgeon to the deceased (and a hope for the living); Amy rotated through here for a stint back when she was in anesthesia school but now works at Methodist; and Beth is a medical student at the University of Minnesota, and about to embark on a year studying and practicing medicine abroad! Haiti is simply her first step in a journey that will include Sweden, India, and Uganda. The next step was, as usual, a fundraiser. Previous themes were Help us Help you Help Us Help Haiti, Halloween for Haiti, 80's for Haiti, and for this trip, Haiti-Five-O. Most of you reading this were probably there and we do want to thank you for your moral support in showing up and having fun - yeah, I know it was hard - as well as your financial support, whether it be the loose change between your car seats as you frantically looked for something to donate, or whether it be the many generous large checks. (p.s. you can now write checks to Project Ortho and we're currently applying for 501c3 status.)<br />
<br />
<a href="http://1.bp.blogspot.com/-cddGzIvKzbg/TngdpCPxt0I/AAAAAAAAB-g/6OcGvoLexjM/s1600/DSC01060.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="http://1.bp.blogspot.com/-cddGzIvKzbg/TngdpCPxt0I/AAAAAAAAB-g/6OcGvoLexjM/s320/DSC01060.jpg" width="320" /></a>I almost didn't make it down here today. The ticketing agent at MSP apparently took issue with the "water damage" on my passport as evidenced by small blue dots, and instructed me to go to the local passport office tomorrow, get a new one, and get back on the first flight out on Tuesday (the day after tomorrow). Fortunately we run into a group of eight volunteers from Children's Surgery International, and a friend of mine, Peter Melchert, pep talks us into going back and at least getting down to Miami and if they won't accept my passport to get checked in there, well then deal with that then. Fortunately it all worked out! Turns out the "water damage" wasn't really that big of a deal, at least by the customs officials here ... though it apparently wouldn't hold water (hahaha) in Costa Rica or Bolivia.<br />
<br />
<a href="http://3.bp.blogspot.com/-u6VW4gkpfXA/TngefC8baJI/AAAAAAAAB-k/rMmzxKGawX8/s1600/DSC01062.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="http://3.bp.blogspot.com/-u6VW4gkpfXA/TngefC8baJI/AAAAAAAAB-k/rMmzxKGawX8/s200/DSC01062.jpg" width="200" /></a>As soon as we hit the ground in Port-au-Prince and step out of the arrival terminal to board the bus to the customs building (looks like a huge Costco warehouse btw), Tom and Beth immediately start engaging in an inadvertent Sweat-Off. The battle is still raging on but I've got $10 on Tom to out-sweat Beth by the end of round One. Luckily Tom's brought along 12 bandanas to stave off sweat, bugs, and spittle from excited co-workers.<br />
<a href="http://4.bp.blogspot.com/-MYbR-TWqJT4/Tngb3M3CcvI/AAAAAAAAB-c/EMO9IMCArfw/s1600/IMG_8620.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="http://4.bp.blogspot.com/-MYbR-TWqJT4/Tngb3M3CcvI/AAAAAAAAB-c/EMO9IMCArfw/s200/IMG_8620.jpg" width="150" /></a><br />
One interesting change I've noticed this time is ... now hold onto your seats ... Tom's brought down absolutely NO beef jerky! Tom says it's in an effort to prevent the cankles we all got the last two trips by decreasing salt intake. I think that makes just perfect sense, so we'll see how that works ... though of course it doesn't explain him devouring - no, the word is punishing - a large serving of Chef-Boy-ar-dee Beef Ravioli. Just in case he goes thru Jack's Link withdrawls, I did bring him an emergency supply of two bags (see photo and the look of sheer pleasure on Tom's face).<br />
<br />
At any rate, as we were talking about before, we all feel like we're kind of returning home here. Besides our fearless leaders Nathan and Amy, who are a couple from Loma Linda who've dedicated two years of their lives to running this place, we'refortunate to have many good friends here, both American and Haitian. We meet our luggage handler, Robert, at the airport, and are picked up by Richard, who's the driver for the hospital and welcomes us each with a warm (albeit sweaty, but no more so than we) embrace. After driving a half hour west to Carrefour, dodging potholes, stray dogs, and intrepid pedestrians scurrying away always just in the nick of time, we arrive at Adventiste. As we unload, bring our bags up to the converted patient ward where we sleep communally on army cots, amd unpack, we run the gauntlet of the long-term American volunteers, Haitian security personnel, and OR instrument room people downstairs. We finally plop down to rapidly stuff our faces with peanut butter sandwiches, instant ramen, mac 'n cheese, and of course Tom's ravioli, and unwind and talk about the day and prepare for hitting the ground running tomorrow. It's good to be back!Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-87709416955158400592011-05-16T00:14:00.000-07:002011-05-16T00:14:08.484-07:00The end of the trip<div class="separator" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-PmuiooBalsY/TdDLUA0oikI/AAAAAAAAB8U/rCUnYAjT6Zc/s1600/palace.JPG" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" j8="true" src="http://1.bp.blogspot.com/-PmuiooBalsY/TdDLUA0oikI/AAAAAAAAB8U/rCUnYAjT6Zc/s200/palace.JPG" width="200" /></a><a href="http://3.bp.blogspot.com/-njU3isufySs/TdDLM91nTgI/AAAAAAAAB8Q/39An8suFkCM/s1600/3+kiddos.JPG" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" j8="true" src="http://3.bp.blogspot.com/-njU3isufySs/TdDLM91nTgI/AAAAAAAAB8Q/39An8suFkCM/s320/3+kiddos.JPG" width="240" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://1.bp.blogspot.com/-xyx93DSvxd0/TdDLXD4FLRI/AAAAAAAAB8Y/vr0_j2UgrXw/s1600/bunion+group.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" j8="true" src="http://1.bp.blogspot.com/-xyx93DSvxd0/TdDLXD4FLRI/AAAAAAAAB8Y/vr0_j2UgrXw/s200/bunion+group.jpg" width="200" /></a>Just got back home to Minneapolis. I'm thankful for a lot of things one takes for granted - clean drinking water that doesn't taste like bleach, streets that don't have a lot of trash you have to wade through, being able to flush TP down the toilet ... but I'm more thankful for the opportunity to serve and to help some people out who just need a helping hand. As we all said our good-byes at Minneapolis-St. Paul airport after we arrived home earlier tonight, the contrasts struck me. We got into multiple cars. We were all full from dinner on our layover in Miami. All of us had all four of our limbs. It's understandable to feel guilty when you've just been to a place where people go hungry, where over 300,000 people died in an earthquake 16 months ago, where people walk through trash every day - but it's also an impetus to try and do more to help out. Everyone in our group was enthusiastic about going down again. It served to strengthen our resolve to do something about it, to not sit back and feel helpless.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://3.bp.blogspot.com/-deVWcQkC0TQ/TdDLawk73pI/AAAAAAAAB8c/FxKUOBgDgXA/s1600/me+jbice+clubfoot+kid.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" j8="true" src="http://3.bp.blogspot.com/-deVWcQkC0TQ/TdDLawk73pI/AAAAAAAAB8c/FxKUOBgDgXA/s200/me+jbice+clubfoot+kid.jpg" width="200" /></a>What made this a little easier was the evidence that people can actually make a difference. Not just expat aid workers like ourselves ... but the Haitian people themselves most of all. There were a few striking examples on this past week's trip, our third time back. The trash situation, at least in downtown Port-au-Prince, was noticeably better. There were stretches almost a block long with clear sidewalks, no trash visible on them. Most of the rubble, again in downtown PAP at least, seems to have been cleared away. And perhaps most importantly, on the day before our departure, a new president was inaugurated - peacefully. Yes, there was violence around the election and runoffs. Armed UN troops and vehicles were on every major corner around the presidential palace where the inauguration took place, still in ruins. But the actual transfer of power went smoothly. A president voluntarily stepped down after his second term, obeying the constitution, and handed over the reins of government to his popularly elected successor - a first in 207 years of Haitian history as a republic. It gave us hope that things would continue to get better.</div><br />
<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://1.bp.blogspot.com/-2tyc9aE7R2g/TdDLgTaICbI/AAAAAAAAB8g/7guarWfrKAc/s1600/tom+teach+Jean+Joel.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" j8="true" src="http://1.bp.blogspot.com/-2tyc9aE7R2g/TdDLgTaICbI/AAAAAAAAB8g/7guarWfrKAc/s200/tom+teach+Jean+Joel.jpg" width="200" /></a><a href="http://2.bp.blogspot.com/-5bfkrOw5-YM/TdDLJNEQeJI/AAAAAAAAB8M/-mWjDeP6etw/s1600/beth+hair.JPG" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" j8="true" src="http://2.bp.blogspot.com/-5bfkrOw5-YM/TdDLJNEQeJI/AAAAAAAAB8M/-mWjDeP6etw/s320/beth+hair.JPG" width="320" /></a>On a more personal note, we saw this week what one small, motivated group of people could do. Those of you who remember our last blog from November might recall us staying up all night with one poor lady who got admitted to Adventist with acetabular (hip socket) and femur (thighbone) fractures from a motorcycle crash. Despite fluid resuscitation and blood transfusions we thought she might not make it. Well, this lovely young lady survived - Jessica Scott and Elinor Shank kept us posted on her progress after we left. Her femur got rodded (kind of like shish-kebabing two pieces of bone together to stabilize them) by the team following us the next week once her hemoglobin stabilized. And as chance would have it, she came back to us this week! We operated on her Thursday to help treat an infection in her femur (we implanted an antibiotic cement nail into her femur). I talked to her beforehand, and she said she remembered us from last fall. Anytime someone asks me, "Don't you feel like what you're doing is just a drop in the bucket and so hopeless? How can you make a difference?" I'll just remember her ... and the difference we made in her life.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://3.bp.blogspot.com/-MCQ90qmah80/TdDK-kQ4VPI/AAAAAAAAB8I/wkS5jVh8NcE/s1600/adam+kids.JPG" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" j8="true" src="http://3.bp.blogspot.com/-MCQ90qmah80/TdDK-kQ4VPI/AAAAAAAAB8I/wkS5jVh8NcE/s200/adam+kids.JPG" width="200" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Over the past week I feel like we worked hard - multiple 14 to 15 hour days, power outages, operating with lead aprons on while working in 90 degree weather and drenched in sweat, sleeping on army cots and eating rice and beans ... but it was an infinitessimally small price to pay for the chance to make a difference in a few people's lives. We returned to the orphanage run by Franz's parents on Friday and delivered multiple large hockey bags' worth of toys, soccer balls, clothes, and shoes generously donated by churches, friends, and co-workers. As we played with the kids and saw the sheer joy in their faces (yes, we did play "changez mouvement" again this time!), it made us forget our own discomfort. It made us feel like whatever our own problems we might have had, which seemed so huge before, now seem so petty, so irrelevant. And in our own small way, for these kids just as much as for the people we operated on, we made a difference in their lives too.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://2.bp.blogspot.com/-xSMMjVEAZ-A/TdDNQUwJ4fI/AAAAAAAAB8k/0Q8jDdRnVIM/s1600/mts.JPG" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" j8="true" src="http://2.bp.blogspot.com/-xSMMjVEAZ-A/TdDNQUwJ4fI/AAAAAAAAB8k/0Q8jDdRnVIM/s320/mts.JPG" width="320" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">It's true our contribution was relatively small. After all, we were spending the week working with Terry and Jeannie Dietrich, an orthopaedic surgeon and nurse couple who are in the middle of a year down there, and Nathan and Amy Lindsey, who run the Adventist hospital where we worked, and who are down there for already over a year. But as the saying goes, you do what you can. We all hope to go back sometime soon to this island nation with its natural beauty and its wonderful people. If you're reading this, at some point we hope to talk to you about our experiences in person. And we look forward to continuing to make a difference in a few people's lives, one surgery at a time.</div>Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-38468983647256974252011-05-14T21:05:00.000-07:002011-05-14T21:55:10.856-07:00Tom: "...it's only a dollar yo! Pat: ...bahahahaha, free yo!!!:"We finally get a chance to sleep in today. Which means still getting up before 7 because we'd heard the night before that the power was going to go off at 7, so if we wanted to shower, we better get our rear ends in the shower earlier. We had made plans to take a personal day today and take a tour of the city and the mountains around Port-au-Prince, and were all looking forward to finally getting a chance to relax. We pack our bags, say a myriad of tearful goodbyes, and get on the van to go on a tour. Today also happens to be the inauguration of president-elect Martelly, so we see people swarming in droves towards the plaza outside the ruins of the presidential palace, where people have gathered to see the inaugural address. Rumour has it that Mr. Martelly had earlier promised to dance naked on the roof of the palace if he got elected ... never found out if he welshe<img class="gl_italic" border="0" alt="Italic" src="http://www.blogger.com/img/blank.gif" />d on his promise or not. Everyone's wearing pink, because that's his theme color, which Heather has fortuitously chosen to wear as well. Martelly's nickname is "tete kalee," or bald head, which automatically makes him a favorite of Tom's.<br /><br />Thanks Pat. Agreed; although we did get to "sleep in", as per usual, I was up somewhere around the butt-crack of dawn. I packed, showered, made fun of Chalupa as she was sleeping, thought about taking a video of Uno sleeping with her mouth open, spraying J.Bice with Steris foam and scaring her, or drawing ants on B, making her think she was being attacked. Instead, I took a cup of cold coffee, hauled myself up onto the roof of the hospital, and reflected upon the grueling week we've had. That was short-lived, as I spilled my coffee on my shorts, wanted to pop my blister, and realized I still had some beef jerky left. As Pat had said, we took a little R&R trip up into the mountains today, and I seriously have to tell you, it was the most amazing experience ever. Haiti is an absolutely beautiful country, and I think I'd like to come back...<br />Our bodies tapped, our minds burnt out, we witnessed history today, in a city that needs so much help...the innaguration of their new president. In case you didn't read Pat's last entry here...he's toatlly a favorite of mine...I'm passing the mike on to Uno...<br /><br />Soooo, after several doses 0f Dramamine we head on our vacation day into the mountains. We started our day driving around Port-au-Prince. We photographed some gingerbread houses, graffiti, and the cathedral. We then went to the top of this incredible mountain where of course Tom asked 'what elevation are we at?' We dined at a restaurant where of course 9 our of 10 dinners came out as ordered. I know there is a language barrier but we have yet to receive a meal as it was ordered. We order a pepperoni pizza and we receive the 'special.' We did receive the rum and cokes as ordered. Are you supposed to be drunk after two sips? I was close to wasted. On the way back down the mountain we all pass out except for Beth. I feel she is still young and her P450's are still in their prime or she too would have been passed out. Aging does suck.<br /><br />It's our last day and it feels unusually quiet especially since two of our groups members have left us. It would be nice for Adam Schuda and Paige Saunders to have been with us to the end, but unfortunately we are without our fellow teammates on our last night in Haiti. We worked extremely hard this past week and it has all gone by in a complete blur. It was nice to have one day and evening completely to ourselves to decompress after a week of hard work, a lot of memories, and a great time getting to know new friends...although we definitely miss our friends Adam and Paige on our last night in Haiti. As much as we are all excited to go home, I know I don't speak only for myself when I say that we all are a little sad to leave Haiti. We've helped a lot of people, we have created a lot of great memories, we have become closer friends, and we cannot wait to start planning our next trip. So from our last night in Haiti, good night, and thank you for all your support.<br /><br />Ok, jess's turn...I'm going to start off by saying that i'm typing this at 11:47 so forgive my rambling. I was super excited for our "fun" day the guide, Jackie who took us on the city tour and up to the mountains was fabulous with all her local knowledge and insight on the haitian culture/history/people. It was also great to see another side of Haiti, the mountains had a much cooler(temp wise) atmosphere and the architecture was different from the crumbled and cramped buildings of the city. The farm feilds on the sides of the mountains are amazing and unfathomable how they get their crops to market. The greenery was refreshing. You could almost imagine vacationing in a place like this, the view was that good. So much more to tell but i"m loosing steTom Slaterhttp://www.blogger.com/profile/12334156307606839828noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-89550707523883545322011-05-14T05:39:00.000-07:002011-05-14T06:21:30.555-07:00Oh Yeah...Rolling With the Punches...<div><br /><br /><br /><br /><div><br /><br /><br /><br /><br /><br /><div><br /><br /><img style="TEXT-ALIGN: center; MARGIN: 0px auto 10px; WIDTH: 320px; DISPLAY: block; HEIGHT: 240px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5606559761310601090" border="0" alt="" src="http://4.bp.blogspot.com/-HE_jiU7n1dE/Tc6AZejqz4I/AAAAAAAAAIQ/ivbO4tlt4_Q/s320/IMG_8332.JPG" />It's 7:40am...I've been up for three hours, after going to bed five hours ago. Like I said before, there'll be time to sleep when I get back home. The General (Adam "Schupa" Schuda) left yesterday, while we were up to our elbows in children at the orphanage. "P" (Paige Saunders) left at 5:30am this morning...we're down to six of us now. We've exhausted all of our surgical and anesthesia knowledge; after 32 cases, never working less than 10 hours a da<a href="http://2.bp.blogspot.com/-BUrRz-UenkA/Tc5_I0Bm8KI/AAAAAAAAAII/Gj4RqsvoswY/s1600/DSC00410.JPG"><img style="MARGIN: 0px 0px 10px 10px; WIDTH: 320px; FLOAT: right; HEIGHT: 240px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5606558375503917218" border="0" alt="" src="http://2.bp.blogspot.com/-BUrRz-UenkA/Tc5_I0Bm8KI/AAAAAAAAAII/Gj4RqsvoswY/s320/DSC00410.JPG" /></a>y (most were 14-15 hour days), we're spent...with pitting edema, ridiculous ant bites, and waking up in your own pool of sweat, it's time we relax for an entire day. We'll be heading up to the mountains today, to see aome more of this amazingly beautiful country. It would've been so so nice to not have to return from the orphanage yesterday and work, but there were cases to do...patients needed our help...we came here to serve, so we did just that. We adapted, we did what we could...we wanted to rest, to sleep, to eat...but when life throws you a curve ball (or a wrist shot in the 5 hole for you hockey fans)...you just roll with the punches.<br /><a href="http://3.bp.blogspot.com/-7qEMnrA6ICk/Tc596GmGSBI/AAAAAAAAAIA/ndoqC148COI/s1600/DSC00593.JPG"><img style="MARGIN: 0px 10px 10px 0px; WIDTH: 320px; FLOAT: left; HEIGHT: 240px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5606557023279138834" border="0" alt="" src="http://3.bp.blogspot.com/-7qEMnrA6ICk/Tc596GmGSBI/AAAAAAAAAIA/ndoqC148COI/s320/DSC00593.JPG" /></a>We were informed late last night there might be a strong possibility the power would be out around 7am (imagine that). Alas, here we sit around a table full of laptops, drinking instant Starbucks, in air-conditioning...aahhh, the simple pleasures in life. =) I'm glancing around the table, and I see amazing women (Pat not included) who gave their time, their money, lots of their sweat, and their huge hearts. I couldn't have asked to be with such wonderful people...Schupa and P included. It takes a special someone to be a missionary, the right heart, and the right mind. As we get ready to relax, and explore the countryside today, I'd like to show you the awesome team I've been blessed with...these are the people that make it happen...all of you helped make it happen for all of us, and for that...we thank you. Take a look, and we'll talk to you later tonight...<img style="TEXT-ALIGN: center; MARGIN: 0px auto 10px; WIDTH: 320px; DISPLAY: block; HEIGHT: 240px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5606560719261412642" border="0" alt="" src="http://1.bp.blogspot.com/-KoGaS7cUe7A/Tc6BRPM8LSI/AAAAAAAAAIY/Bmt7NT7jFeE/s320/DSCF4703.JPG" /></div></div></div>Tom Slaterhttp://www.blogger.com/profile/12334156307606839828noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-2813096936408204472011-05-14T00:23:00.000-07:002011-05-14T00:23:17.256-07:00Lead - it's not just for paint anymoreI'm not going to kid myself and think there are a ton of you who've missed us, but in case you're one of the few who really have nothing better to do on a Friday night than read our insipid ramblings, there's a good reason we haven't posted since Monday night... We've been busy! Tuesday and Wednesday we did 20 cases, and the power went out Wednesday night anyway so we couldn't post even if we wanted to.<a href="http://1.bp.blogspot.com/-RE6VNzF72Ss/Tc4UUHuQErI/AAAAAAAAB78/470QUQ45JZ0/s1600/Shhh+1.bmp" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="234" j8="true" src="http://1.bp.blogspot.com/-RE6VNzF72Ss/Tc4UUHuQErI/AAAAAAAAB78/470QUQ45JZ0/s320/Shhh+1.bmp" width="320" /></a> In fact, the we've been running around so much getting cases ready, turning rooms over, doing surgeries, and seeing patients that the past few days have been a blur. Unfortunately, it's turned us into such eating, drinking, working, and sleeping (OK well maybe not so much sleeping) automatons that we've had left little time until now for reflection. The days have blurred together a little bit, but these are the salient points I remember...<br />
<br />
The power goes out here a lot. The hospital does have a generator which gets turned off every day. When this happens, there is battery backup power which now runs the OR lights (no more operating in pitch black like last time) and vital equipment like the ventilator (breathes for you while you're asleep in surgery) and the C-arm (yes, we can now take xrays in surgery!). What we can't run on invertor power is the air conditioning. Which leads us to ...<br />
<br />
<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">It's really hot here. Maybe not so much outside, which is just plain hot, but specifically the OR, which is really hot.. They do have one steam autoclave to sterilize our operating room equipment, and when they open it up to retrieve our instruments it gets the entire area hot. The employees can't open windows to let the heat out because of the problem we've had with flies and mosquitoes buzzing aorund the OR. There is an air conditioning unit in two of the three OR's, but it goes down of course for hours at a time when the power goes out. Somehow this always seems to be during the hardest case of the day when you're wearing your lead apron and already sweating your brains out. Spekaing of mosquitoes and flies ...</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://2.bp.blogspot.com/-svHmIRQvIvM/Tc4nOqHWT0I/AAAAAAAAB8A/zQxUpUGGUUM/s1600/Flyswatter.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" j8="true" src="http://2.bp.blogspot.com/-svHmIRQvIvM/Tc4nOqHWT0I/AAAAAAAAB8A/zQxUpUGGUUM/s320/Flyswatter.jpg" width="320" /></a>We've learned to be flexible. I know we've posted this in previous Haiti trip blogs, and I've mentioned this in talks about our trips to Haiti, but it's grown every time. No more freaking out when a mosquito or fly buzzes around and lands on the sterile field. Just try and make a note of everywhere it hits, and cover that area up or change it if it happens to be on your person. Sometimes this all happens in such quick succession that it's hard to remember it all. Yesterday it started to feel like a game of Twister - OK, Matt's left sleeve, my right glove, the patient's right foot, and the corner of the table here! The flypaper above the OR table has been replaced with a handheld fly zapper that zaps the animal into oblivion. I suppose that when you have an air conditioning unit that is blowing air, dust, and germs, onto tthe OR "sterile" back table, you have to have an understanding about some things.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Haitians are some of the happiest people on earth. Despite everything they've been through, from colonialism, a revolutionary war, abject poverty, violent transfers of power, earthquakes, hurricanes, and cholera outbreaks, they still retain a lot of optimism and believe that the future will be better. The patient who doesn't smile back with just the awesomest smille when you offer one is very, very, rare. We went to an orphanage today and saw the same kids we saw there on our last trip in November. We brought them toys (including a boatload of soccer balls donated by Nancy Wallentine from ortho clinic at HCMC) and they were in aboslute heaven as they happily played their new toys. No fighting, no whining about what they could have gotten, and no steaing toys they want from other kids. These were some of the politest kids I've ever seen. And somehow a cheap piece of plastic manufactured in China just made their day.</div><div class="separator" style="clear: both; text-align: left;"><br />
</div><div class="separator" style="clear: both; text-align: left;"><a href="http://2.bp.blogspot.com/-Q26RRQ9xcVg/Tc4oMe3lJVI/AAAAAAAAB8E/5uf37gz22C0/s1600/what+are+you+doing.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" j8="true" src="http://2.bp.blogspot.com/-Q26RRQ9xcVg/Tc4oMe3lJVI/AAAAAAAAB8E/5uf37gz22C0/s320/what+are+you+doing.jpg" width="320" /></a>We are now finally done. Earlier tonight, about three hours ago, we finished our last case of the week, sat down, aired out our sweaty scrubs, and breathed a huge sigh of relief and satisfaction. Somehow, with all the stress of 15-hour days, physical demands of trying to operate on difficult cases while wearing lead and drenched in sweat while dodging mosquitoes and flies, we've all managed to get through the week - all 8 of us - without any major confrontations, no fighting, no whining (OK well maybe just a little), and no personality clashes (at least not that I'm aware of ...). I'm really proud of the team, each and every one of them, for the great job they did this week. Beth, Amy, Heather, Jessica, Paige, Tom, Adam, and I survived another week down in Haiti doing 10-surgery days in 90+ degree heat while wearing lead radiation gowns and when power would be down for hours at a time. And yet I feel like it's a small price to pay for the incredible opportunity to learn from these incredible people here... who paid reparations to France for the "privilege" of winning their independence... who sustained an earthquake that killed 300,000 people... who have had almost every transfer of government power marred by violence... and who somehow manage to always come to the doctor meticulously dressed, wearing the world's biggest smile on their faces, and who are simply thankful that you're there trying to help them.</div>Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-37077587753812198172011-05-11T04:19:00.000-07:002011-05-14T05:38:41.975-07:00The Return Of The 15 Hour Work Day<img style="TEXT-ALIGN: center; MARGIN: 0px auto 10px; WIDTH: 585px; DISPLAY: block; HEIGHT: 240px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5606546783519625474" border="0" alt="" src="http://4.bp.blogspot.com/-SwrlGKBe65M/Tc50mEhL0QI/AAAAAAAAAH4/P2Be2zd2OVM/s320/IMG_3927.JPG" /><a href="http://1.bp.blogspot.com/-HD74nn5z1Lg/Tc5zQKOQcAI/AAAAAAAAAHw/AqvoOHCkYyE/s1600/DSC00489.JPG"><img style="TEXT-ALIGN: center; MARGIN: 0px auto 10px; WIDTH: 454px; DISPLAY: block; HEIGHT: 240px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5606545307582099458" border="0" alt="" src="http://1.bp.blogspot.com/-HD74nn5z1Lg/Tc5zQKOQcAI/AAAAAAAAAHw/AqvoOHCkYyE/s320/DSC00489.JPG" /></a> <a href="http://4.bp.blogspot.com/-qs_xgRAbs-c/Tc5vjzU4S_I/AAAAAAAAAHo/Y8hnN9ynhak/s1600/DSC00578.JPG"><img style="MARGIN: 0px 10px 10px 0px; WIDTH: 200px; FLOAT: left; HEIGHT: 150px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5606541246986734578" border="0" alt="" src="http://4.bp.blogspot.com/-qs_xgRAbs-c/Tc5vjzU4S_I/AAAAAAAAAHo/Y8hnN9ynhak/s200/DSC00578.JPG" /></a> As I awoke at 4am in a kiddie pool of sweat, I thought how peaceful the air was. Knowing we had more than a day's worth of cases, I decided to shower before the other's did...and I figured a 4am start was pretty good. After Uno downed her oatmeal, Chalupa drank her coffee, Pat had his prunes, and of course Paige staring aimlessly at the wall, J.Bice, Adam, and myself begin preparing the supplies and instrumentation for the first cases of the day. Jeannie (Dr. Dietrich's wife) plays conductor, and orchestrates the patient flow. On tap first, a cast & pin re<a href="http://4.bp.blogspot.com/-_pwpFcjEY2o/Tc5to8V0-MI/AAAAAAAAAHg/yykvH2XH0hc/s1600/DSCF0774.JPG"><img style="MARGIN: 0px 0px 10px 10px; WIDTH: 200px; FLOAT: right; HEIGHT: 150px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5606539136282720450" border="0" alt="" src="http://4.bp.blogspot.com/-_pwpFcjEY2o/Tc5to8V0-MI/AAAAAAAAAHg/yykvH2XH0hc/s200/DSCF0774.JPG" /></a>moval on a very sweet 3 yr old boy. Then another cast removal & straightening out of a club foot on a 5 year old girl (club foot is essentially where the foot turns 90 degrees sideways inward, so basically you'd be walking on the outside of your foot). Again, it's amazing how a gentle hand, exam glove balloon, and a little stuffed animal can put a child at ease. This little girl was an absolute sweetheart. She clung onto J.Bice like Pat with tofu. After the removal of an antibiotic spacer on a 13 year old boy, and a quick knee scope, what proved to be the longest case of the day began...<br /><br /><br /><div><br /><div><br /><div><br /><div>With the proper implants, and more importantly, the proper instrumentation, an ankle fusion can be pretty straight forward. Did I mention the part about proper instrumentation? Yeah, here's where "rolling with the punches" really fits. When you're in someone else's house, you may not like their silverware, or their couch, or even the television for that matter...so is it in a third world country. From crutial screwdrivers which are manufacturer specific, to operating room tables (or lack there of)...missing instrumentation, missing medication "...ummm, what's the dosage of ketamine again?!?...", to patient x-rays, and whenthe last time this patient ate...<a href="http://4.bp.blogspot.com/-BUxTuquosuw/Tc5smujJdTI/AAAAAAAAAHY/xdPUebK-nds/s1600/DSC00705.JPG"><img style="MARGIN: 0px 10px 10px 0px; WIDTH: 320px; FLOAT: left; HEIGHT: 240px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5606537998709126450" border="0" alt="" src="http://4.bp.blogspot.com/-BUxTuquosuw/Tc5smujJdTI/AAAAAAAAAHY/xdPUebK-nds/s320/DSC00705.JPG" /></a></div><br /><br /><div>What I'm trying to get at, is that we come here to supplement the local staff already here. None of us comes in, starts changing things around to do it "our way"...we work hand in hand with the Haitian staff...not against them. They do things differently...many things differently; we adapt, make it work for the patient's benefit...because sometimes, you just have to roll with the punches. I'll let you know right now, I typed up the first 2/3 of this entry a few days ago...falling asleep at the laptop...the power goes out...patient is already in the room...gotta go to the bathroom...put on dry scrubs...power goes out (again)...remove a cast...pull some pins...beans and rice (again)...oh, was that the power that just went out, hmmm...bummer. It has been anything but easy, to sit down and update our little blog here...and we apologize.</div><br /><br /><div>So as you all read this blog, keep this in mind: we've been exhausted every single day; our bodies literally ache; we're tired, hungry, and thirsty...but it's not about us...it's about the people of Haiti who surround us...we're here to help...we do what we can. We enter this country, and we adapt...we greet each day with optimism...because, often times in life...you just need to roll with the punches...this is Haiti people...it's not an ideal scenario here. These men and women need our help, the children need our help...they need our smiles; so we adapt, we make it work, we do what we can...because when you need to make a smoothie without a blender...or do 20 cases in two days...you just have to roll with the punches.</div></div></div></div><br /><br /><br /><br /><br /><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dx1ZWeb0MXWxMVXCnWy4qQvN6T7ur3_0l9LcCUAypicdr_P53mWn7RZj5FGprpPgO46Wmu3lt_CwBVaGBMpHQ' class='b-hbp-video b-uploaded' frameborder='0'></iframe>Tom Slaterhttp://www.blogger.com/profile/12334156307606839828noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-4786167447283467072011-05-09T21:42:00.000-07:002011-05-09T21:42:24.567-07:00Back in the saddle<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://3.bp.blogspot.com/-4yNNIEAkN5E/Tci6mb3WqnI/AAAAAAAAB7w/U1uu27BBS40/s1600/IMG_3925.JPG" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" j8="true" src="http://3.bp.blogspot.com/-4yNNIEAkN5E/Tci6mb3WqnI/AAAAAAAAB7w/U1uu27BBS40/s320/IMG_3925.JPG" width="320" /></a>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!</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">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!!!</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://3.bp.blogspot.com/-OEKp5ROyruM/Tci6ozEo5-I/AAAAAAAAB70/ARTvGt2B8jk/s1600/IMG_3927.JPG" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" j8="true" src="http://3.bp.blogspot.com/-OEKp5ROyruM/Tci6ozEo5-I/AAAAAAAAB70/ARTvGt2B8jk/s320/IMG_3927.JPG" width="320" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">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 <em>have</em> 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 <em>still</em> 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.</div><br />
<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">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.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://4.bp.blogspot.com/-gmaSoNS5V9I/Tci57W3zM5I/AAAAAAAAB7s/6RZBUV6Phns/s1600/IMG_3923.JPG" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" j8="true" src="http://4.bp.blogspot.com/-gmaSoNS5V9I/Tci57W3zM5I/AAAAAAAAB7s/6RZBUV6Phns/s320/IMG_3923.JPG" width="320" /></a>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.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://3.bp.blogspot.com/-vzYrhJxQenI/Tci2xG6WO-I/AAAAAAAAB7o/yZOVMdH2d-4/s1600/IMG_8304.JPG" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" j8="true" src="http://3.bp.blogspot.com/-vzYrhJxQenI/Tci2xG6WO-I/AAAAAAAAB7o/yZOVMdH2d-4/s200/IMG_8304.JPG" width="150" /></a> </div>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!Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com3tag:blogger.com,1999:blog-6654016344715753481.post-50392512680925410282011-05-08T21:57:00.000-07:002011-05-10T19:09:56.626-07:00... and we're back!<a href="http://4.bp.blogspot.com/-JjF7sMSc2VE/Tcdw-_uYk8I/AAAAAAAAB7g/H-miA4aPiRg/s1600/DSCF0721.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="300" src="http://4.bp.blogspot.com/-JjF7sMSc2VE/Tcdw-_uYk8I/AAAAAAAAB7g/H-miA4aPiRg/s400/DSCF0721.JPG" width="400" /></a>Welcome back readers!<br />
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Well, after a six month hiatus, your favorite orthopaedic surgery team is back down in Haiti! If you're reading us for the first time, glad to have you following. We'll try and have something informative and maybe even mildly entertaining for you to read on a nightly basis this week! We just arrived yesterday at Hopital Adventiste d'Haiti in Carrefour, just west of Port-au-Prince. This time, we've got all the bases covered - Tom and I; Paige Saunders, Heather Ross Chalupnik, and Amy Beer for anesthesia; Jessica Bice OR nurse extraordinaire; Beth Bard MS4 and soon to be world traveler (she's doing medical stints in Uganda, India, and Sweden); and General Adam Schuda, surgical technologist, US Army Reserve. Now Tom being at a new job as tissue recovery coordinator for LifeSource, and Amy being from Methodist, we're no longer the Hennepin team, strictly speaking, but "Hennepin to Hait" sounded better than "Various Medical Professionals from the Twin Cities to Haiti".<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-N_6UuRUiakg/Tcnv07Or1II/AAAAAAAAB74/2fV8r9qowvI/s1600/IMG_3871.JPG" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" j8="true" src="http://1.bp.blogspot.com/-N_6UuRUiakg/Tcnv07Or1II/AAAAAAAAB74/2fV8r9qowvI/s200/IMG_3871.JPG" width="200" /></a></div><a href="http://4.bp.blogspot.com/-aRZJrF84efE/Tcdu7qyTfTI/AAAAAAAAB7E/bylwjg7q7Nw/s1600/DSC00410.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="http://4.bp.blogspot.com/-aRZJrF84efE/Tcdu7qyTfTI/AAAAAAAAB7E/bylwjg7q7Nw/s200/DSC00410.JPG" width="200" /></a>Taking a cue from our previous three trips we had a fundraising party (Eighties for Haiti, check out the photos on our facebook pages) which raised $1167. Combined with everyone's individual fundraising efforts, including several thousand dollars raised by Tom, Amy, and Heather on GoFundMe.com, as well as $1000 from the Rotary Club of Duluth on behalf of Beth, we were able to recoup a large part of our costs on the trip. This helped a lot since each of us is paying for this ourselves and taking vacation time to come down here.<br />
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<a href="http://2.bp.blogspot.com/-pXX3qog01g0/TcdvJ051IUI/AAAAAAAAB7I/MCUX9Bw7sG4/s1600/DSC00460.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="http://2.bp.blogspot.com/-pXX3qog01g0/TcdvJ051IUI/AAAAAAAAB7I/MCUX9Bw7sG4/s200/DSC00460.JPG" width="200" /></a>With snow flurries in the Twin Cities earlier this month, one might think that the heat would be a welcome respite, but that relieved feeling only lasted, oh, about 15 minutes. Which is about how long it took Tom to soak through the first of 12 bandanas he brought down. After haggling with a team of porters for our bags, we found our driver and made the trip to Adventiste. Along the way, we see the first signs of change here in Port-au-Prince: things actually seem cleaner! Now you certainly wouldn't eat off the streets (the 8-second rule is a zero-second rule) but the long stretches of road and sidewalk completely covered with trash are much shorter. The tent cities are still here in the capital however, and as we travel west to Carrefour, things are not quite as clean. The piles of trash are back, and in the middle of them picking out yummy tidbits you still see dogs with engorged teats and crooked limbs, pooping where they like and kicking back dirt with their hindpaws just like dogs everywhere.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-cmUz-BxWJSQ/Tcdv-6zzd-I/AAAAAAAAB7M/T7tarC1i_dw/s1600/DSC00490.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="http://1.bp.blogspot.com/-cmUz-BxWJSQ/Tcdv-6zzd-I/AAAAAAAAB7M/T7tarC1i_dw/s200/DSC00490.JPG" width="200" /></a></div>Fortunately things seem to be going well at Adventiste. We unload our 8 hockey bags full of donated items ... OR supplies from Tom's job at Lifesource, masks and VAC (vacuum assisted closure) dressings donated from HCMC's ortho clinic, gloves from my neighbor Liz Sschuerer down the street, patient gowns from Jill Davidson, and tons and tons of kids' clothes, shoes, and toys rounded up by everyone on the team.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-8dByfgj9JqM/TcdwRJsD26I/AAAAAAAAB7Q/8CMPoLRV3Cs/s1600/DSC00497.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="http://4.bp.blogspot.com/-8dByfgj9JqM/TcdwRJsD26I/AAAAAAAAB7Q/8CMPoLRV3Cs/s200/DSC00497.JPG" width="200" /></a></div><a href="http://1.bp.blogspot.com/-Cn4IqPOu20k/TcdwhK39OwI/AAAAAAAAB7U/Z-SeSBtrhZk/s1600/DSC00548.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="http://1.bp.blogspot.com/-Cn4IqPOu20k/TcdwhK39OwI/AAAAAAAAB7U/Z-SeSBtrhZk/s200/DSC00548.JPG" width="200" /></a>Our first night in we meet Dr. Terry Dietrich from Appleton, WI, who's out here for the year, and he fills us in on what's new down here. As we make our evening rounds the first thing we note is that the hallways are cleared out. Those of you who followed last trip's blog in July and November 2010, might recall the lack of space and lots of people having to recuperate from or wait for surgery in the hallways (including one poor soul with no family who balled up his poopy adult diapers and threw them down the hall). They've really made an effort to switch from crisis charity hospital mode to some compromise with their pre-earthquake fee-for-service mode. Along the way, they've built a system that ironically has provided a level of orthopaedic care that has never been seen before in Haiti ... a hospital with one full time and multiple part-time US-trained orthopaedic surgeons. A hospital where Drs. Dror Paley and John Herzenberg, two world-renowned experts in limb deformity correction, bring residents to learn. A hospital where a 11-year-old girl with Blount's disease and a botched prior correction (which her original local orthopaedist charged her family $16,000 for) can have her severely bowed legs straightened correctly this time - for free.<br />
<a href="http://4.bp.blogspot.com/-rzrJMQwch0o/Tcdw34oCyyI/AAAAAAAAB7c/ch1HkiVPcyY/s1600/DSCF0704.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="http://4.bp.blogspot.com/-rzrJMQwch0o/Tcdw34oCyyI/AAAAAAAAB7c/ch1HkiVPcyY/s200/DSCF0704.JPG" width="200" /></a> <br />
<a href="http://1.bp.blogspot.com/-RPj_JC20_JQ/TcdxGSFNgqI/AAAAAAAAB7k/XS7KDKiqb40/s1600/DSCF0726.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="http://1.bp.blogspot.com/-RPj_JC20_JQ/TcdxGSFNgqI/AAAAAAAAB7k/XS7KDKiqb40/s200/DSCF0726.JPG" width="200" /></a>Although we didn't hit the ground running as hard as the prior two trips, we do notice one girl on rounds whose wound is looking fairly soupy so she needs a washout and dressing change in the OR the night of our arrival. Today, we have three cases in the morning - washout and bilateral long leg casts on a 16-month-old, washout and VAC change on a poor guy with an open (that's "compound" in plain English) tibia fracture, and removal of bilateral Taylor Spatial Frame external fixators on the 11-year-old girl above. Adam has the ubiquitous health care professional's fanny pack which at first glance looks amusingly like a stuffed Speedo worn over his scrub pants. After OR, we have some free time for a day trip to the beach near Jacmel, about 3 hours' drive away. The road does wind its way zigzag through the mountains, and we're all crammed into the back of two pickup trucks. With the thought of those mountains fresh in his mind, Tom - as we are all just standing waist-deep in the warm Caribbean waters - asks, "so, what elevation do you think we're at now?" There's a long pause as Amy and I look at each other, wondering is this a trick question, before I answer, "uh, zero?" and Tom, followed immediately by the rest of us, starts laughing is rear off.<br />
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<a href="http://2.bp.blogspot.com/-1OswOrn1NLA/TcdwwSYAMmI/AAAAAAAAB7Y/iP1tXuOZUs4/s1600/DSC00568.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" src="http://2.bp.blogspot.com/-1OswOrn1NLA/TcdwwSYAMmI/AAAAAAAAB7Y/iP1tXuOZUs4/s200/DSC00568.JPG" width="200" /></a>Well, it promises to be a busy week like the last two trips, and we're all looking forward to the upcoming clinics and surgery days. We're also curious to see how we'll fit into the existing team down here and be busy and productive while at the same time respecting the people who've devoted a year to being here. Well, here's to a great week!Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-54160224425557465982010-11-10T14:04:00.000-08:002010-11-11T15:11:21.789-08:00Tom's reflections on the past 9 daysMonday, 8 November 2010<br />
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(These are Tom's final thoughts looking back on our return trip to Haiti - a snapshot in time as to how we feel right now ... the thoughts going through our minds as we return home from 9 days of travel, hurricane, sleepless nights, serving the Haitian people, and sharing time with our good Haitian friends. -Pat)<br />
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I caught myself this morning being bummed out we missed our flight by less than a couple of minutes...literally. I had to take a moment; I thought about how grateful I should be for having the luxury of riding in an airplane, to a country where I can be free...a place where I have air conditioning (and heat)...a home that has carpeting, drinkable water, and a refridgerator to keep food cold. In a land of flat screen tvs, name brand clothing, and food that makes us obese, life's necessities are lost in the glitz, the glamor, and the $5 footlong. We left behind an amazing culture, a land where people simply don't have the basic necessities to live...and some of those people die because of that. We have health insurance that may make us pay $10 or more for a visit to the doctor...so many of the people of Haiti don't have the $1 for an ER visit. It saddens me...it completely breaks my heart to be perfectly honest. I arrived home this morning, and had a great cup of coffee at good old MSP airport, and a turkey sandwich. Those two items would be a pretty hot commodity back in Haiti. I chugged down two cans of pop as Pat and I got caught up on the blog...I'm willing to bet those children at the orphanage have never even had pop in their lives. As we all stood amongst those 44 children the other day, I shed a tear that nobody saw (becaue I was sweating profusely). How these children make the absolute most out of nothing; in America we have everything, yet complain we have nothing. Five children played with one empty bottle of sprite in the middle of a sewage-ridden street...in America we'll fight tooth and nail to make sure our children have the latest and greatest video game. How ironic is that...<br />
We amputated the leg of a gentleman who was so excited to have it removed, he was "bumpin' knucks and blowin' it up" post-op. A little girl smiled as the pin sites on her external fixator were cleaned. Pat and I witnessed a miracle in Andre, who back in July was paralyzed in a halo...and now walks around and does yoga. (Andre has JRA, or juvenile rheumatoid arthritis, and was a partial quadriplegic due to cervical spine subluxation when we were last here back in July. In the previous 3 months he's made a complete recovery - Pat.) I'd also like to say he has no home. Andre has no parents, but has an uncle, so no orphanage will take him. It isn't a safe environment for him to be with his uncle, so he lives at the hospital. He loves to color, loves to read, and doesn't like to let go when you hug him. Andre's story is all too common in Haiti...it makes my soul cry. We don't share these stories with you because we're trying to make you feel bad. There's nothing wrong with having some blessings. We share these stories, because it's important to let people know what really goes on in a country that's not our own. That having material goods and living in the comfort that we are accustomed to is a pipe dream that we should not take for granted and that most of the world would be dying to achieve. We saw people bathing in ditch water and kids playing soccer with an empty Sprite bottle. We saw homeless people taking a bath in the sink in orthopaedic clinic late at night. Earthquake aside, Haiti had a lot of problems begin with, but it's slowly making changes. You can only see these changes if you've been there...we want everyone to understand it's an ongoing effort, unknowing if the end is in sight...but you do what you can, and you leave it all out on the field.<br />
We had a spectacular team this time around, and each and every person got worked to the bone, literally (our bones were aching). As we said before, it's not about how many cases we did, or about how much we could donate...it's about each minute of our time we gave to each patient, each Haitian hospital worker...each innocent child. I can't speak for everyone, but if an experience such as the one we just had doesn't make you pause, and thank the good Lord for the life each of us has, you might want to get your heart examined...because it might be missing. Every person has a breaking point, and we each hit ours on the same day...but we overcame, we conquered those 9 days we were there...we did what we hope was some really good stuff, at least for the few people we were able to touch. There is so much need, so many people we weren't able to touch, but at least we were able to touch a few. Each person in that hospital should get an award, because our supporting cast was unbelievable...bring-the-house-down awesome! In a situation like we were in, we always wanted to do more, give more money, donate more supplies, hand out more food, including our own, clothe one more child...but we're human...and you do what you can...and you leave it all out on the field. We did that every single day.<br />
Looking back at this trip, I realized more it's the relationships you develop, it's the 5 minutes here, and the 15 minutes there you spend with the patients, with the children, with the workers who sleep on the countertops at the hospital. It's the smile you smile, the hand you shake, the hug you give, sometimes that's all the medicine someone needs. There is still much work to be done, and we left an awful lot of it for the incoming team, and they'll do the same for the one after that, and the one after that...<br />
We'll go back again. We'll continue to fight for every inch, strive for every yard, and help as many Haitians as our bodies give us strength for. The six of us did just that...we did what we could...we left it all out on the field...and we'll go back for another season.Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com3tag:blogger.com,1999:blog-6654016344715753481.post-85340062839941256492010-11-08T17:20:00.000-08:002010-11-08T18:18:28.240-08:00Our last Day: A day of Sadness and a Day of Joy<div class="separator" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgkhgMnFCI/AAAAAAAAB3c/G-XO5lQswiY/s1600/IMG_20101106_095153-1.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="120" px="true" src="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgkhgMnFCI/AAAAAAAAB3c/G-XO5lQswiY/s200/IMG_20101106_095153-1.jpg" width="200" /></a></div> Saturday, 6 Novemer 2010<a href="http://1.bp.blogspot.com/_wio2Ul0tv1A/TNgnSwVvWBI/AAAAAAAAB3k/U-yHGlCzLwE/s1600/dsc00253.2.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="121" px="true" src="http://1.bp.blogspot.com/_wio2Ul0tv1A/TNgnSwVvWBI/AAAAAAAAB3k/U-yHGlCzLwE/s200/dsc00253.2.jpg" width="200" /></a><br />
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<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">So the morning began with a 7:30am church service. All of a sudden, Nathan is called out immediately, and Paige follows suit. We wouldn't find out until after church, that a new born baby had just arrived unresponsive from one of the tent cities. An anesthetist from one of the tent cities an hour and fifteen minutes away went to check on this little soul, who was born at 36 weeks. The baby had no pulse, and was not breathing. Upon arrival, CPR was performed, and Paige intubated the child, as the local anesthetist was unsuccessful. Unfortunately, the baby did not survive. This death added to the weeks' toll...it is without que<a href="http://4.bp.blogspot.com/_wio2Ul0tv1A/TNgoO1JjocI/AAAAAAAAB38/Bk-kGEKpakI/s1600/dsc00222.2.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="143" px="true" src="http://4.bp.blogspot.com/_wio2Ul0tv1A/TNgoO1JjocI/AAAAAAAAB38/Bk-kGEKpakI/s200/dsc00222.2.jpg" width="200" /></a>stion gut-wrenching, that I say there were four deaths at the<a href="http://4.bp.blogspot.com/_wio2Ul0tv1A/TNgp8GZDUDI/AAAAAAAAB4o/lDEYPEUAAvk/s1600/IMG_20101106_131946.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="149" px="true" src="http://4.bp.blogspot.com/_wio2Ul0tv1A/TNgp8GZDUDI/AAAAAAAAB4o/lDEYPEUAAvk/s200/IMG_20101106_131946.jpg" width="200" /></a><a href="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgoe-hlp7I/AAAAAAAAB4A/kQwKDi0dkx0/s1600/DSC00172.JPG" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" px="true" src="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgoe-hlp7I/AAAAAAAAB4A/kQwKDi0dkx0/s200/DSC00172.JPG" width="200" /></a> hospital during our stay. Sometimes, even when you do what you can, and you leave it all out on the field, you end up with heartache. This is again one of those times. On a more positive note, we've been following the poor lady with the pelvic and acetabular fracture (and did we mention she also has a left femur fracture that needs to be fixed) closely and day by day her hemoglobin is slowly inching upwards, she's making more urine (those beans are working again!), and her blood pressure is holding steady. She actually might pull through. Once Paige breaks the news about the poor newobrn to all of us, we look that much more forward to visiting all of the children at the orphanage that Frantz's parents run. The six of us, as well as Sarah Carignan from Boston, and guided by Frantz, Claudy, and Roosevelt, the Adventiste translators who've become our friends, gather our backpacks and a few other donated goods we have, and head out into the sweltering heat. Along <a href="http://3.bp.blogspot.com/_wio2Ul0tv1A/TNgoy64RDmI/AAAAAAAAB4E/sWWwbWQGi_Q/s1600/IMG_20101106_132413.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="149" px="true" src="http://3.bp.blogspot.com/_wio2Ul0tv1A/TNgoy64RDmI/AAAAAAAAB4E/sWWwbWQGi_Q/s200/IMG_20101106_132413.jpg" width="200" /></a>the way, heaps of trash, piles of rubble, and homeless Haitians line the streets. This is nothing new. Ten months after the quake, little has changed. We noticed more of the streets are getting<a href="http://3.bp.blogspot.com/_wio2Ul0tv1A/TNitM7xrp-I/AAAAAAAAB4w/0WxLCsyVCew/s1600/IMG_20101107_105033.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="149" px="true" src="http://3.bp.blogspot.com/_wio2Ul0tv1A/TNitM7xrp-I/AAAAAAAAB4w/0WxLCsyVCew/s200/IMG_20101107_105033.jpg" width="200" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">cleaned; we actually saw more than one garbage truck, and some people were sweeping the sidewalks. Although a lot of aid groups are pulling out (for example, MSF Holland and the German Red Cross) because the disaster phase of the earthquake is over, other advancements have been made, like Wycleaf Jean's group clearing rubble, and money to the government for cleanup. So despite things still looking pretty desolate to the casual observer, there are some unglamorous but important changes being made. We are all looking forward to visiting the orphanage that Frantz's mother runs here in Carrefour. Upon arriving at the orphanage it hit me; the sight of 45 children, huddled together under a tarp. In an area smlller than most apartments, these children e<a href="http://4.bp.blogspot.com/_wio2Ul0tv1A/TNgnz0TAKMI/AAAAAAAAB3w/nOz2Xa1QH8k/s1600/dsc00149.2.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="110" px="true" src="http://4.bp.blogspot.com/_wio2Ul0tv1A/TNgnz0TAKMI/AAAAAAAAB3w/nOz2Xa1QH8k/s200/dsc00149.2.jpg" width="200" /></a>at, sleep, play, and live with remnants of sheet metal and tarps held up by tree branches. Their carpet is dirt and rubble. A faint, hauntingly familiar odor hovers in the air, in the background of your awareness, making you wonder where you've smelt that before, and then you realize it's stale urine. They had one toy that everyone shared...one toy. It's difficult to write this, as my memory is instantly haunted. The<a href="http://1.bp.blogspot.com/_wio2Ul0tv1A/TNgoDPzTE3I/AAAAAAAAB34/mFlBJo0Y2SI/s1600/dsc00174.2.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" px="true" src="http://1.bp.blogspot.com/_wio2Ul0tv1A/TNgoDPzTE3I/AAAAAAAAB34/mFlBJo0Y2SI/s200/dsc00174.2.jpg" width="200" /></a>y have so little; we already saw children with some of Cole (my 4-year-old son)'s flip-flops and clothes on... the same one's I'd brought when I came down with Pat back in July. You can see these flip-flops in the photo... Amidst all of this...they never stopped smiling. We all spent time singing and playing games with them...looking into their sweet innocent eyes, and wishing we could take all of them back with us...but we know we can't (eve though Tom's bag could probably hide a few<a href="http://1.bp.blogspot.com/_wio2Ul0tv1A/TNgp2g1cy_I/AAAAAAAAB4k/p_O5vbSBh8w/s1600/IMG_20101106_130009.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="149" px="true" src="http://1.bp.blogspot.com/_wio2Ul0tv1A/TNgp2g1cy_I/AAAAAAAAB4k/p_O5vbSBh8w/s200/IMG_20101106_130009.jpg" width="200" /></a> inside it - sorry, couldn't help adding that in - Pat.). These kids range in age from 2 to 16. Among them is Jean Junior, or just Junior, whom everyone at Adventiste knows well and has been a constant source of joy to all at the hospital, with his charm, energy, and infectious smile. He's right there near the front, in red, his smile a mile wide as he dances and sings to all the songs that the kids sing at the orphanage. You'd never know his father had just passed away on a Wednesday morning in July, the last time we were here. (He passed away due to an AIDS-related opportunistic infection.) Among the games we play is Detective. It goes somehin like this ... one kid, the detective, leaves the room. The kids pick a leader who beats out a rhythm using his or her arms and/or legs ... as he or she changes the rhythm, everyone else follows suit. This can be hand clapping, fist pumping, or my favorite, the chest pounding. The detective comes back in and has to guess who the leader is. The whole time, the rhythm is punctuated by collective chants of "Changez movement!" to the beat ("Change movement!"). It's catchy, fun, and makes you forget you're surrounded by the smell of urine and the filth of the street. The kids, especially Junior, seem to love anything that involves them getting to jump around and sing, and frankly so do we. <a href="http://3.bp.blogspot.com/_wio2Ul0tv1A/TNgpW7oo-cI/AAAAAAAAB4M/CewecI_NS8s/s1600/IMG_20101106_124758.jpg" imageanchor="1" style="clear: left; cssfloat: right; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="149" px="true" src="http://3.bp.blogspot.com/_wio2Ul0tv1A/TNgpW7oo-cI/AAAAAAAAB4M/CewecI_NS8s/s200/IMG_20101106_124758.jpg" width="200" /></a>Beth, Sarah, Paige and Tom do a great job of whooping it up as leaders of Changez movement. Tom in particular brings down the house. Something about the sight of large bald bandana-covedred dome and his big blue eyes really captivate the kids. Looking at the roomful of adorable face makes you want to bring them all home with you ... Unfortunately, as big as Tom's bag is, I'm not sure how many of them we could sneak home in it! As it is, the odds are not good. Junior is the only one I know of of the whole lot of them who's been adopted. As it came time to leave, we became rejuvenated with some awesome Haitian hip-hop music. Frantz is kind of a mover and shaker and stops the tap-tap every so often to jump off at this kiosk or that to get another CD for Beth so that by the end of the trip she's amassed quite the collection of Haitian hip-hop, pop, and </div><div class="separator" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; clear: both; text-align: center;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">boy-band stuff. This is what we needed, despite these conditions, we found joy in the day, just like these amazing people we're her<a href="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgkuk9gRWI/AAAAAAAAB3g/HdwI4-gFvIg/s1600/DSC00229.JPG" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" px="true" src="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgkuk9gRWI/AAAAAAAAB3g/HdwI4-gFvIg/s200/DSC00229.JPG" width="200" /></a>e to help. You see, if you didn't know what had happened last January, and had never seen the filth, the tents,the unemployed, the homeless...you'd be awestruck at the outlook these people have. A strong faith, and a big smile gets these Haitians through each day...take a minute, and it's easy to see. As Beth and Sarah groove with Francesca (Frantz's niece) in the back of the tap-tap, we head back to the hospital to gather our gear. We need to decompess some, have a little bit of relaxation, reflect on what we've done, sweat a little more, and have a cold one...for Andrea this would mean an ice cold Mountain Dew. We leave Pat at the hospital to do the hand off to the incoming orthopedic team, Andrea to complete the census, and the rest of us load the gear (why is my bag the heaviest?) and bring it to the hotel.<a href="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgnc6iajsI/AAAAAAAAB3o/ucwlcnw2dBE/s1600/dsc00228.2.jpg" imageanchor="1" style="clear: left; cssfloat: right; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="136" px="true" src="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgnc6iajsI/AAAAAAAAB3o/ucwlcnw2dBE/s200/dsc00228.2.jpg" width="200" /></a> <a href="http://3.bp.blogspot.com/_wio2Ul0tv1A/TNgpCIOcRyI/AAAAAAAAB4I/1zL07s6MQnk/s1600/IMG_20101106_130918.jpg" imageanchor="1" style="clear: left; cssfloat: right; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="149" px="true" src="http://3.bp.blogspot.com/_wio2Ul0tv1A/TNgpCIOcRyI/AAAAAAAAB4I/1zL07s6MQnk/s200/IMG_20101106_130918.jpg" width="200" /></a>..</div></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">As Tom and the rest of the crew bring all of our stuff to the Auberge du Quebec (we've decided to take a break there for our last night before heading home tomorrow morning), Andrea and I go over the census with the new team from Dallas. Unfortunately, despite the week's worth of work (including three consecutive 20+ hour days), we've still left them with 7 patients in-house who still need surgery and at least that many who are out there in Carrefour with instructions to return to clinic to meet the new team on Monday who also need surgery. Fortunately, this group includes three orthopods, their own jet, and a <em>lot</em> of equipment. The funny thing is, no matter how hard you work, and how much you bring (and all six of us truly felt that we gave it our all and left it all out there on the field), there's always going to be that feeling of regret, that you could have done more, seen more patients, operated longer at night, stayed longer ... I suppose it's a natural feeling when you're in a country of 9 million million people, surrounded by so much need. One of the HCMC residents had asked me after our last trip, did I get the feeling that it was just spitting into a bucket and didn't I get the feeling that there's no way you could do enough? Well of course you can't do enough for everyone. Out of a country of 9 million people, did it really matter that we saw x many patients in clinic and did x many surgeries? The more appropos question to ask would be, for the people we did operate on, how much did it matter to them? And did helping them out make your trip, the preparations, your time, and the lack of sleep worthwhile? I think if you look at it that way, the answer is clearly <em>yes</em>. For the 44 kids at the orphanage who didn't get adopted, the weekly groups of doctors visiting them may not have made much of a difference. Junior is one kid whom if you asked him, I bet 100% he'd say <em>yes</em> as well.</div></div></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br />
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</div>Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0tag:blogger.com,1999:blog-6654016344715753481.post-60712418938478280032010-11-06T01:41:00.000-07:002010-11-08T08:24:35.070-08:00The Breaking PointDay 6: Friday, November 5, 2010<br />
<br />
<div class="separator" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNggPx4f4jI/AAAAAAAAB3Q/xWlODjnN5tU/s1600/IMG_20101104_220758.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="149" px="true" src="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNggPx4f4jI/AAAAAAAAB3Q/xWlODjnN5tU/s200/IMG_20101104_220758.jpg" width="200" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">The day started with us waking up and realizing that the hospital was still standing. Last night we moved our cots from the open ward (open because the walls are actually open) to the hallway inside - our temporary hurricane shelter. Fortunately there wasn't too much damage so we're all pretty thankful for that. We are still officially supposed to be on standby for potential victims but it looks safe enough to try and do a few cases as time allows. Morning rounds are highlighted by the two awesomest kids ever, a little boy and girl both of whom have external fixators on. The few kids on he ward are very social and are often going up and down the hallways in their HAH wheelchairs<a href="http://1.bp.blogspot.com/_wio2Ul0tv1A/TNgd-uGX_qI/AAAAAAAAB3I/2BI9v18-5JI/s1600/dsc001115.2.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="93" px="true" src="http://1.bp.blogspot.com/_wio2Ul0tv1A/TNgd-uGX_qI/AAAAAAAAB3I/2BI9v18-5JI/s200/dsc001115.2.jpg" width="200" /></a>, visiting each other in their rooms. Fortunately the lady with the pelvic fracture is hanging in there. She's now starting to mobilize all the fluid we've been pumping in to her to keep her pressure up, and is peeing like the proverbial racehorse. Her hemoglobin is back up to 7.5 (still low) after 4 units of blood. So things are not completely out of the woods yet, and we don't feel comfortable yet rodding her femur fracture (best to wait until she's more stable).The guy downstairs smearing poop on the walls is doing it less. Sarah is happy for once that she hasn't gotten any new bugbites, which is a particularly good thing for her since she has a scratched out bugite on her right arm the size of Rhode Island. The rest of the team is in a pretty good mood as well. Tom and I have a thing going where both of us see how much facial hair we can grow in the 9 days of the trip and compare growth at the end. Tom's is coming in nice and thick, wereas mine is coming in in patches like a badly reseeded lawn. However, we've all been working so</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgjjtvnQaI/AAAAAAAAB3U/iY5kaurr5NM/s1600/dsc00118.2.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="112" px="true" src="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgjjtvnQaI/AAAAAAAAB3U/iY5kaurr5NM/s200/dsc00118.2.jpg" width="200" /></a> hard the past few days on such little sleep that fatigue sets in quickly for all of us, particularly after tough cases like trying to do a hip fracture without C-arm (the machine hasn't been working the whole time we've been here, though the next team has apparently planned on bringing the parts to fix it). During the third case of the day today, I'm so tired I start nodding off, and the team suggests that we finally wrap things up and tell the remaining patients that we've done all we can do.Tom comes up to me after the case, flapping hi<a href="http://1.bp.blogspot.com/_wio2Ul0tv1A/TNgf85nGdsI/AAAAAAAAB3M/LArbDJNwAJE/s1600/IMG_20101103_221637-1.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; height: 223px; margin-bottom: 1em; margin-left: 1em; width: 318px;"><img border="0" height="226" px="true" src="http://1.bp.blogspot.com/_wio2Ul0tv1A/TNgf85nGdsI/AAAAAAAAB3M/LArbDJNwAJE/s320/IMG_20101103_221637-1.jpg" width="320" /></a>s hands in the air with elbows bent like an ostrich trying to fly, and says emphatically, "Pat, let's be done." after all, one of the mantras that we've been guding ourselves by over the past week, besides "Do what you can" is "Don't leave the country without Tom." The team is at a breaking point, and it's about time for all of us to get some much-earned rest. We should be happy with what we did and leave it at that. Sure we could try and squeeze in more surg</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">eries but what would happen if out of fatigue we hurt someone. Fortunately it hasn't come to that yet but we all know w're at the breaking point. If we by some chance had the capacity to do 100 surgeries a day, we'd still be unhappy about not being able to help the million other people we couldn't get to. We should be happy with being able to help out those whom we did, and remember that it's not about the number of surgeries but rather more about the individual people we were able to help. It not about us ... it's about them!</div><div class="separator" style="clear: both; text-align: center;"><br />
</div><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgjqAXAgNI/AAAAAAAAB3Y/-Hta3XlFDJ8/s1600/dsc000121.2.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="88" px="true" src="http://2.bp.blogspot.com/_wio2Ul0tv1A/TNgjqAXAgNI/AAAAAAAAB3Y/-Hta3XlFDJ8/s200/dsc000121.2.jpg" width="200" /></a></div>Anonymoushttp://www.blogger.com/profile/04582140837354497220noreply@blogger.com0