The Tipping Point

I've been meaning to put this down for quite some time now, so please indulge me as I attempt to recount my Haitian experience.  As many of my friends know I spent 2 weeks working in a tent hospital in Haiti last spring.  Prior to signing up for the trip and departing I had discussed with friends and co-workers my desire to travel and give back to the community at large, utilizing my skills as a paramedic and former educator.  It had seemed to simply be a pipe dream and then suddenly I found myself on an airplane flying above the ocean towards a country I knew next to nothing about...  As we winged towards the darkened city of Port au Prince I looked around at the others on board and looked into myself, wondering what the hell am I doing?  Then it dawned on me, I had no idea what I was doing, no altruistic desire to "do good", no religious obligations, no clear picture of why I had signed up for this trip.  All I knew was that I had felt a compulsion to volunteer and now I was letting myself follow that invisible path that leads one through their life.
     The plane circled the darkened airfield and I did not feel nervous or apprehensive, only intrigued and curious as to what lay ahead.  I looked around, into the faces of my fellow volunteers and it dawned on me that this must be what army recruits look like on their way to basic training.  Our clothes were clean, we were all showered, relatively well rested, well fed, and excited, we were fresh.  One volunteer sitting near me was returning and looked over and passed on the most valuable piece of information that I would receive on that trip, "Don't fill your water at the main spigot, go to the silver bullet, its better."  As with most sage advice this was cryptic and easilly dismissed until several days later.
     The plane touched down and we all piled out onto a darkened tarmac, and an organized chaos ensued.  We shuffled through the dark and dimly lit customs area with no clear direction and then people began piling into cars that were pulling up, filling to the brim with passengers and then screeching into oblivion.    I tried to keep track of the few people from Flagstaff that I knew but then I was piled on top of strangers and whisked off to the hospital.
    We rolled into the gravel lot that was the driveway of the hospital and we all piled out of the car and looked dazedly at the array of tents in front of us.  With little time to adjust to the new settings we were directed to the main volunteer sleeping tent, which was the size of perhaps a circus tent with row upon row of narrow cots lining the center and encircling the perimeter.  Tattered mosquito netting draped over the cots and scraps of trash and other detritus blended with the mud and gravel of the floor.  Over head bare bulbs illuminated the interior as we tried to find the ideal cot.
  Upon finding a suitable sleeping cot I exited the tent looking for the other ER personnel, Jamey Kreun, PJ Lingley, and Becca Sacora.  A tall guy came running down one of the wooden plankways towards the sleeping tent shouting for an ER doc.  I told him that we hadn't brought an ER doc, but that I was a medic and there were several more ER staff around somewhere.  He looked disgusted, or perhaps frustrated as he grabbed me and headed towards the ER...
    (What follows are the few journal entries that I made while in Haiti exactly as they were written in my journal, punctuation and all.)
May 1, 2010
     After many delays landed in Haiti and literally hit the ground running.  Not 10mins in camp and through and through GSW, followed by 5 other pts. who would be deemed critical or at least urgent trauma stateside.  Now in tent under mosquito net.  7a.m. will come fast.


May 2, 2010 Haiti
     Woke at 5 a.m. because someone was one hour off!  Camp quite until 0750, just after morning brief.  2 GSW arrived at gate.  One a thief who shot a man and was in turn shot.  The man shot by thief x-rayed and quickly moved to diff. unit.  Thief had been stabilized and moved to diff. unit where police collected him.  Last seen in back of pick up.

Steady flow of usual ER pts. until truck arrives with 8 y.o. girl who had been hit by a vehicle.  RT degloved from mid calf to foot w/fx.  Both arms fx.  Mandible fx w/avulsion.  Probable skull fx.  For 3 hrs worked to stabilize, 2 burr holes drilled to some improvement.  Pt. temp spikes to 105F neuro called from somewhere?  Arrives 1 hr later pt. not viable and aunt informed.  At same time woman comes in in active labor.  I find no pulse in child and death declared.(girl hit by vehicle)  PJ, JT, and I place child in body bag and dead transporters called.  I walk across to the other tent and see the delivery of child.  Life is a cycle.

  Must remember to drink.  Heat is stifling but bearable.  This evening shower was amazing.  Torrential rain storm ER flooded.  Water drips from everywhere and rises towards the ankles.  This is our first day.  This is Haiti 5 months after.

     
May 4
     Late evening of May 2 woke to screaming that pt. tent was on fire.  Entire camp mobilized and evacuated all pts.  Tent full of smoke from overhead lights catching fire.  Minimal damage to structure yet all pts outdoors until area secured and then all moved into one tent w/assistance from Army.  2 deaths due to inability to continue care. 

 In morning camp in disarray but spirits up.  People exhausted but pt. care continued to be as good as possible.  Fellow staff is amazing pts. are amazing.  ED shut down and used as ICU.  One pt. coded, very frustrating to watch as a Medic, to many people wth no direction or leader.  It is still before 9 a.m.  Temperature increases.  Unbearable in ED/ICU.  Everyone drenched with sweat.  Haitian staff is working hard.  Finally decision made and Ortho tent appropriated and new ICU made.  A/C everyone feels better.  Got to go for helicopter ride w/pt.  Hill country is amazing.  German pilot hilarious!  Med student pukes!  On return ED still closed air of relief.  Staff seems calm.  Long night drinking gatorade/vodka.  Beautiful night.  Good people.  Miss home but immersed in this time.  Wake up early on 4th ED/triage open one of first pts critically ill hypotensive, tachy, in pain, abdomen rigid.  Don't know why.  Dying no facilities to treat him here.  Transfered to other facility.  Dies en route.  Several pregnant women transfered.  Many pts. seen.  Never has "working" been so fun.  Evening at Mango Mango and mango stew(?)  Very good.  Dominoes.  RN passes out, over analyzed, too many people but good to see the concern.  Probably didn't need the neuro consult!  Another nice night.  Another late night!
This was my last journal entry before I lost track of time and the concept of journaling.  I will continue to update this post with more memories as they come.  Thanks for reading.  Dean.