Hernias for Haiti and the Condom Lady

OK Guys It is midnight so I am going to have to make this short. We have such great teams here, so many good things are going on in this hospital. We have a plastic surgery team from Washington State. They came in a few days ago in the evening. That night it rained real hard and part of the house fell on a teenage girl and mangled one side of her face, the ER nurse said it looked like she was going to loose her eye, her ear and that brain matter was showing. Don't get too sick because she was wrong about all three. In the middle of the night they woke up the team they took the lucky girl in to surgery and made her perfectly beautiful. That was better care than we could get in Ukiah, we would have had to be flown to the bay area.

Laura and I are on a mission to find an orphanage to sponsor in Port au Prince. We are planning a big music festival benefit on Aug 21, to help the orphaned children here(save the date!!). Laura made friends with one of our interpreters and found out that he had placed his two girls in the Adventist sponsored orphanage (another story). Today was our day to go visit, we took off with 2 interpreters, Laura, Lynn Patti, Dale and Leanna. Oh my goodness did we fall in love with those 20 beautiful girls. What a loving, healthy home their parents are making for them. Our hearts were opened as we had fun singing, playing games and holding girls on our laps. You will be hearing more about this. They are in the picture with all of the cute girls.

Laura has been saving me these past 2 days. She has broken her vow to never do pediatrics and has joined us in the Peds ward. We are preparing to loose Charlie, so she has no choice. She will also be an ER doctor in 48 hours. Laura is the Condom Lady. News spreads fast around here and the guys know when she is coming, even patients family members are asking her for condoms. She says,"It s so funny, you do not need to know English to ask for condoms, it is the same word in Creole". We are putting condoms down in little baggies in the clinics and they just disappear.

My babies are looking good today, the tides have turned and the planets are lining up.
My sweetest girl was sitting up on her own. Leanna's baby boy was pushing up on his belly a holding his head up. I am telling you these things are miracles.

One more story and then I have to go to sleep. On the way home from the orphanage Dale, Leanna and I were dropped off at the General Public Hospital with Gregory our interpreter. It turned out that Charlie had gone there to round in the TB ward with our own ER Doc Toby Salz who is volunteering there. The driver was committed to taking Charlie back to the to the hotel and there was not enough room in the car for everyone, so Dale, Leanna, Lynn and Gregory stayed behind at the hospital to wait for the driver to come back for us. Now this hospital is huge, many buildings, some cracked, many tents of patients and it was dark. There is a gate, like at a military base and the guards only let certain people through, they are constantly arguing with people who want to get in and and are not allowed through. I had fleeting thoughts that we might get shot.

We were dressed in our scrubs sitting on a wall and a guy comes up and asks me in English if I will come help his grandmother who is over there bleeding to death. I told him I would not go unless Gregory told me it was OK. So Gregory goes off for a few minutes and comes back and says, "Yes his grandmother is over there bleeding, there is a lot of blood and yes I think you can help her. There are a lot of people around her so we might get mobbed, we have to be careful. I say, "I do not want to get mobbed". He says, "No, it will be OK". So off we go with gallant Dale ready to protect. So we go down this dark corridor around this corner and sure enough there are lots of people standing in this tight walkway and an old woman is sitting on the wall with her foot up, blood running down the wall into a pool and all over the wall. I am putting on gloves and getting some towels out of my pack and then this commotion begins and we all have to stop what we are doing and back up against the wall it is so tight with people. Suddenly a man emerges from the throng carrying a writhing 2 year old boy who is naked and crying in pain. First thing you see is his gigantic scrotum the size of a large orange, tense as it can be sticking up above his body. OMG, this is an emergency. The father asks me if I can help him, can I fix it, is there anything I can do. They have been waiting to get into the hospital and they won't let them in. I tell him he has to get in, this kid needs to go to surgery right now. He says they will not let him in. So I tell him to go to the Hopital Adventiste, we have a surgeon on duty. Gregory explains and they take of running. I find out later they did not have a car. I finally get to the bleeding woman and show the grandson how to put pressure on the wound and hold it until she can be seen in the hospital. I knew that the bleeding had stopped and she would be fine. He was afraid and I told him to pray for the healing power of God to come through his hand, to have faith that she would be healed. He smiled and beamed at me and thanked me profusely for praying with him. We took off running as more people started pressing forward to get to me.

Our driver showed up soon and we went back to the hospital. Sure enough our boy arrived at the same time. By this time he was vomiting, screaming and his scrotum was bigger. I took him to the ER and there was no doctor to be found. I ran upstairs and woke up Mohammad. He came down and said immediately it was an incarcerated hernia. The surgery team fell into place and the boy was healed!!! They saved him, his bowel was saved and he is resting downstairs. I gave Mohammad a big hug, he is our new best friend.

Mohammad has done 18 hernias in 2 days and has 11 scheduled for today, he is calling this "Hernias for Haiti". The surgery picture above is Mohammad with the little boy.

Tears and Laughter

It feels like the planets are in retrograde today. One faux pas after another. I had to apologize so many times though my interpreter I felt like an idiot. No telling what they thought of me. Leanna and I have our babies and we love them. The one child that was looking good, spiked a high fever and deterioated to join the others who were lethargic and weak. That set us back. What is wrong with her?

We are learning their beautiful french names. We have a little girl who is nine months and and weighs 15 pounds. Her hair is turning red from malnutrition. Her mother is pregnant with twins. They live in a tent because their house "cracked". The father lost his job because of the earthquake and they have no food for themselves or their other two children in the tent. The mother is sad, overwhelmed, suffering in silence. She sits quietly, and her baby has been lying in the bed rarely moving so weak and tiny, hope lost. Yesterday she made progress as she began to eat and drink with steady coaxing from Leanna and Mom. Today from across the room I saw her grabbing her foot held up in the air. Wow, that was the first normal baby thing I had ever seen her do. I had this urge, and wrapped her in a new receiving blanket and took her outside for some fresh air. We bounced and walked and talked. I kept up a steady diatribe of encouragement telling her I loved her and there was hope. She fixed her eyes on me and was listening - then cracked the littlest smile. Wow, Leanna and I went for it and we got her to crack a big smile and then she laughed! From the depths of my soul I can tell you that it was a miracle. We went back to the nursery and shared our happy baby with her Mom who smiled and laughed too, then all the Moms would laugh and cheer when our little girl would smile and spread her hope around the room.

I sat with her Mom and talked about her stress and situation. I told her I was sorry and that I wanted to carry some of the burden for her, and then I started crying and almost couldn't stop. It took everything I had to hold it together, and keep going. We talked about infant stimulation, and that I had a book and clothes for our little one and the two little ones inside of her. After dinner I went back to check on everyone and the mom was lying on her bed, a piece of cardboard next to the crib.

When I decided to come to Haiti, my fundamental motivation was to bring hope. Right now I am feeling sad and tenuous because I do not know if our precious little girl will be able to make it out there, I wonder if I was telling her the truth...

Some Hard Lessons and Hope

Early today I learned that when a person dies in Haiti you do not cover their head with a the sheet. Charlie woke up at 6 am and was immediately called to the ER for a pediatric emergency. A few minutes later I went down to bring him coffee and found him putting an interosseous line in the leg bone of a baby that was septic, within a few minutes the beautiful boy stopped breathing, we did CPR which failed. So sad to let him go.

It was Monday morning and the hospital was buzzing, we all took our stations. Forget the plan of Charlie coming to help me round in the pediatric ward. The ER had Charlie I was on my own. Yesterday we decided that I needed to take responsibility for the peds unit. In Ukiah we would fly these babies to a pediatric/neonatal intensive care unit, no kidding. Nine critically ill infants depending on an ER PA to keep them alive. Leanna stayed at my side and we made it through. Here is a list of the diagnosis: Typhoid, severe dehydration, kwashiokor, staph bullous empetigo sepsis, newborn umbilical cord infection, pneumonia, septic newborn, and so on. I have the perfect volunteer translator Jean, a teacher who studied linguistics, the earthquake took his school. He stayed with me the whole day with every patient, attentive, kind and so accurate, I am worried that he has no income and is hungry.

The twins are doing well, the little one is taking formula and seems spunky, I hope she makes it. It was really hot and humid in the afternoon, our 3 day old with the cord infection would not nurse. His Mom had milk and needed help. The perfect boy was getting dehydrated, there was so much hope for him this was an emergency! We set the Mom up with a new receiving blanket like a throne, tried every stimulation trick to no avail. He was hot, lethargic and would not suck. Leanna stayed with them and finally got a cold washcloth and wiped him down, that freaked him out, he woke up and started sucking like a mad man, everyone in the unit cheered.

At the end of the day Laura, Tami and Sheila gravitated to the Peds ward to get their baby fix. One baby's mother offered to do hair in corn rows to show appreciation for their loving service to her baby. Laura said it felt like a village, the women hugging, braiding, laughing, and feeding each others children.

Lin and Kathleen were sequestered in surgery until after 9 pm. Dale wandered the halls doling out drugs. Patti was the ever steady wound nurse, she says, " I feel like my patients are warming up to me and vice versa, they are very warm and affectionate people when they get to know you".

Famous quotes of the day:
Tami: I will be happy if the only thing I come home with is scabies.
Lynn: My goal is to use every condom we have.
Patti: I love being around all of the volunteers and their contagious enthusiasm.
Tami: I will never complain about not having supplies again.
Charlie: Doing this work makes you so appreciate your friends, family, and the opportunities we enjoy.

Remind me to tell you about Charlies late night machete guy.

In a Good Place

We have been here 2 days and it seems like a week. We start rounds at 6 am, the most complicated ortho patients you can imagine. Most from the earthquake, with bone infections, and multiple broken bones. Patti RN has taken on the wound care and it takes her 12 hours to get to everyone. Charlie MD has the ER, working with the wonderful Haitian Doctors, many of whom speak Spanish, which is fabulous for us since we speak Spanish, and do not speak French. Tami RN, Sheila RN, and Leanna hold down the pediatric unit. They are hydrating babies and putting in IVs, which fall off because the tape will not stick in this humidity. Dale our pharmacist is all over the place helping us get the meds we need or making substitutions with what he can find. I graduated him to instant emergency PA today to help Laura MD staff the ER so Charlie and I could get over to the pediatric unit. Last thing I saw was Laura and Dale down on their knees cleaning the multiple lacerations on the face of a women who was in a car accident. One of my complicated OB patients needed a c-section with twins, I think our whole team was there we were so excited to be helping this mother have the chance for 2 healthy girls, her only children. One weighed 2 pounds and the other 5. They came out kicking. Lin and Kathleen our OR nurses were right in there for the surgery. Now the volunteer midwives from "Midwives for Haiti" are helping the mom and babies around the clock, syringe feeding the little one every 3 hours. I was working in the ER and this man came in with his 27 day old baby that was so sick that Charlie said he was over his head (now that is bad). Malnourished with scaling rash and blind. By the miracle of the modern age I was able to send pictures of the baby to an infectious disease MD in the US and he consulted over the phone, probably Vitamin A deficiency, maybe measles. I have seen so many sick malnourished babies it seems normal..

Yesterday I thought I was having an appendicitis for about 2 hours. I had abdominal pain and had to sneak away and go lie on my cot (abandon my comrades). We only had vascular, ob/gyn, and ortho surgeons so I was trying to figure out who would be the best at finding my appendix. I wanted one of our team to be in charge of swatting any flies that were in the OR. My pain was in the right lower quadrant, but luckily it went away. I was not going to tell my family until the surgery was over. Thank goodness Mohammad the general surgeon arrived last night!!

Pictures of our twins, of Charlie in his stylish woman's scrubs and socks, Leanna with her baby that she has been taking care of around the clock.

Hot in Haiti

We made it! The streets are full of activity, school children in their uniforms, bright red, green, and blue with hair ribbons to match. We were literally surrounded at the airport by 50 porters shouting and dragging our carts piled high with luggage. I was hanging on to my cart for dear life. All 10 of us made it to the hospital, Lin and Kathleen our OR nurses got dragged off to surgery the minute we got here for a hernia repair and hysterectomy. We set up our beds, rounded on the pediatric and OB units, now we are eating rehydrated food. There is frustration, sadness, dysfunction and filth here. As Charlie said, "We are not here to change the world but to spread compassion, patient by patient". This is not going to be easy. Please pray for us and the people of Haiti. Love Lynn

Trauma Dream Come True

Today they called CODE BLACK over the PA at our hospital. "All leadership staff report to the main conference room". I looked at Dr. Trotter and we both said , "What does that mean, do you suppose they want us?" Yes we were needed it was a disaster (drill). We were expecting 20 to 40 victims in 30 minutes. I ended up outside in the disaster tent doing the triage and making decisions on where our mass casualties should go. It was very exciting. I had so much power! Every time the patient was looking bad I ordered them out of there to the ER. Mono my Paramedic buddy was there and someone snapped us with his cell phone. 20 years of working at UVMC and I was finally there for a disaster drill, a dream come true for the Trauma Queen.
Haiti in 2 days.

Packing Like Crazy

Yesterday a substantial number of our Ukiah Haiti Team were working at UVMC. We grabbed people from the ER, Med Surg and the ICU, took a moment to put on our new t-shirts and pose in our room full of donations. Our team has grown to 50 health care workers that will go to the Hopital Adventiste d'Haiti in Port au Prince in teams every Friday for the next 6 weeks. Hopefully we can get all of our supplies down in our luggage. We are taking 4000 condoms!!