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Thursday, March 11, 2010

3/10/10 - Team 7, Day 4

Update from James Dudley, MD:

It is nearly midnight, and the camp-style singing, tonight a gift of our college colleagues, continued until nearly 10. I don't know if the guitar lives here, awaiting the next player, or if one of the others brought it. It definitely seems that college aged men and women definitely have more energy this time of day compared to some of us middle aged doctors and nurses. They have probably done a lot more hard physical work today than we doctors and nurses, but most of our group has turned in while many of them are still giggly. Ah, to be so carefree. Mission of Hope-Haiti lies above the northern shore of a large horse-shoe shaped bay that is also ringed by mountains on the south and east. The opening of the bay faces west, and the south eastern edge of Cuba lies fewer than a hundred miles away. The Mission property sits on the foothills, no more than a few miles from shore, probably about five hundred feet above sea level. Its views of the Caribbean are spectacular. The 70 acres are basically a large narrow rectangular of land with the long borders running more or less in a south to north direction, up the hillsides. The gates of the compound are at the downhill, southern edge, and it is there, at the gates, where the queue forms each morning. The Guest House, where we stay, lies well up the hillside, probably a half mile up from the gates. The rocky road winds up the eastern side of the property. As one travels north, up from the gates, the large church, which holds hundreds of worshipers, sits to the left, or west. It has a large low-pitched A-framed roof and only posts hold up the roof and its trusses; its walls are open. Beyond the church is the cafeteria for the schools and to its west, a substantial concrete two-story rectangular High School. Each floor has a long central hall with classrooms on each side. After the earthquake, the school was needed for medical purposes and now it houses a hospital ward. There, our nurses, two at a time, around the clock, staff the downstairs ward, where patients are arranged up to four in a room. Family members stay with each patient. Tons of supplies are packed into the upstairs classrooms, but these temporary quarters have to find a new home soon, since the Haitian government expects school to reopen in April. In one of the store rooms is a box labeled "Tents for discharged patients". A hundred yards up the hill from the ward is the Clinic, and as the doctors and the day shift nurses walk down for rounds and change of shift in the morning, the gates open and several hundred people of all ages, a few at a time, wind their way up the hill. It is a sight to behold, a quarter mile line of people, hurrying as best they can the first in line.The Operating Room team heads directly to the clinic, and finishes their last minute preparations. As the patients gather outside the clinic one of nurses greets those assembled and matter of factly leads them in song. This morning's hymn was a beautiful Creole version of "Praise God from Whom All Blessings Flow". The conviction the Haitians expressed as they embraced the message in those words left me shaky. Following the hymn was a prayer. The rhythm seemed vaguely familiar as the phrases, some long, others shorter, rolled into the clinic from the waiting area, but its Creole words were lost on my untrained ear. The nurse told me later it was the 23rd Psalm, about walking through the valley of death. We have no time to dwell on those moments as the pace of the day's work overtakes us. Each person has a story to tell, or a hundred stories, and we each gather bits and pieces as we do our respective work. The team comes together a little more smoothly each day. The medics transport patients up from the ward to Pre-Op then triage the masses. The ER fills and treatments begin on the sickest of the group. The exam rooms fill and we move as many as we can as fast as we can, trying not miss those who are truly acutely sick, and not simply exhausted, hungry, burdened by parasites or lingering grief. Then, as before, almost suddenly, they are gone except for the late OR cases, and those awakening from surgery. In some ways, we all struggle to regain our bearings. So, at the end of the day, to share food and stories and music, brings peace and closure and allows us to drift off without worry.

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