Tuesday, November 30, 2010

Update from Terry, 30 Nov 2010

Nov 30 Hopital Adventiste D'Haiti

The last week has seen a major preoccupation with the presidential election. Administration pushed hard to get the new front gate installed before Sunday. The crew worked late into the night to get the job done. Even with the compound ‘secured’ we were notified that the UN was prepared to evacuate us should things get really rowdy. I could envision 'Saigon II' with me hanging onto the skid of an overloaded helicopter straining to lift off from the top of the hospital while taking on sniper fire and RPGs and such. That’s what an overactive imagination will do. The evening passed about as quiet as a typical Sunday night in Appleton. I wasn’t disappointed. My golf and tennis this summer didn’t get me in great shape for dodging Stinger missiles. Being confined to the campus for four days was no change for me. I haven’t been anywhere since my arrival on the 19th. I haven’t worn through the tile floor yet on my path from our room to the clinic and OR but it is probably imminent.

The epidemic seems to have subsided, at least for us. At last count we had zero cholera patients except for my little girl who is still getting IV antibiotics and has a wound vac in place for her leg infection. She is doing great. She might be discharged in a few days.

Fortunately, we haven’t been slammed with trauma, especially since the Haitian anesthesiologist informed me last Wednesday that she wouldn’t be back until Monday. I got in a little 4 year old with a displaced supracondylar humerus fracture on Friday and wasn’t able to do her for 4 days. They are so much easier to do right away. It was a struggle, but it went well even though I didn’t have a C-arm. I had a new experience today. I accepted a transfer of a patient with an open tibia fracture from a hospital more than 2 hours away. By the time he got here, the anesthesiologist had left and would not return. The fracture was 8 hours old so I took him to the OR and did the debridement and washout under ‘conscious” sedation. Titrated Fentanyl and Valium(no Versed available) worked great along with Marcaine at the fracture site. He slept through most of it and of course remembers nothing of the event. I didn’t think I could put in an interlocking rod given the circumstances, so I splinted him and will take him back for the fixation tomorrow(assuming I have anesthesia.) I also had a partial thumb tip amputation to clean up and repair. There was a bit of damage since he did it with a hammer.

I am thoroughly enjoying teaching Jean Joel Boyer to be my orthopedic assistant. He has been one of the OR translators and was the unanimous recommendation of all who had worked in patient care in orthopedics. He is enthusiastic and a quick learner. I am optimistic that he will be able to relieve Jeannie of the heavy burden that she feels to keep things going smoothly for me.

All the translators are doing their best to help me learn Creole “pad kwah”* It’s fun to see them shake their heads as I butcher the phrases time after time. The patients, without exception, seem to appreciate my efforts and smile as I try. The translators have different and interesting personalities. Their enthusiastic greetings every morning are music to me and their smiles are infectious. Emmanuel is my main guy in the clinic, but Roosevelt, Junior, Jeanty, Dorgil, Calvin, and even Frantz supplement as necessary.

Harold works in Central Supply. He is an art teacher. He lost all of his paints and brushes in the earthquake. He had several paintings in the national cathedral which was destroyed as well. I am going to have him paint us a picture of Haitians dancing as soon as I can get him some paints and brushes. We need a little something on a wall in our unfinished hospital room to make it a bit more homey.

I am delighted to watch the You-tube video of Staille that Karen posted on Sunday. She will be coming in next week to remove the external fixators from her tibias (the devices seen attached to her legs in the video). I’ll get some more video of her then. I really hope that the video of her changed life will help raise funds for the indigent care here.

Enough for now *You’re welcome

Terry Dietrich

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