Haiti Journey: Clinic Time Begins

The following has been re-posted to HCPLive.com with permission from Dr. Jan Gurley. You can visit her blog, Doc Gurley, at www.docgurley.com.

There’s something about the constant drone of a generator — the relentless, unremitting growl that hangs in the air. It’s like the smell and the dust and the fear of the rainy season, the way it creeps under your skin so quickly, and then sinks so deepely that you’re not even aware that you’re aware of it. All the time.

Today we packed into the bus and then added translators. And then more translators. And then two police. Our bus tried to grind its way up hills to big for her, burdened as she was. Our phenomenal driver would let her sink back, then take a running start again. We got out and walked, and I realized that it’s not just driving in Haiti that takes superhuman reflexes — walking does too. Even on the side of the rubble. Wires still drape like thin shrouds, listing to the ground.

I sat next to one of our translators, a man who solemnly thanked me. “For help.” I felt my insides clench at the way his eyes wouldn’t meet mine, the way the little muscle in his jaw jumped after he finished talking. I’d seen this the night before when we were eating in the “market” cafeteria style and one of our team’s first translators, equally solemn, in a low, urgent voice, thanked us. And told us that “people need you.” All without making eye contact.

Maybe I’m just sensitive from asking for things for the trip, but I felt like I recognized that squirmy feeling I was so recently reacquainted with — the moment when you know you need soemthing, something urgent, but you are an independent soul, unused to asking and letting others, but the people you want to help depend on you voicing things you’d rather not have to proclaim. That we need.

And there was also, for both, an odd thread of fear, as though we would just change our minds, and leave.

There was nothing to do but pat an arm and talk about how crucial his just as translator is too, that we too need. We need his skills and his patience. And that we are all here to help. The tension thinned and faded a bit.

It was the same with our hosts. At one point, as we women joked together about dumping a bucket of water to make the toilet flush, one of us mentioned the Loma Prieta earthquake. We talked about how the Bay Bridge waved and a piece fell, and our hostess said in a voice that started out sounding normal, “I have never, never seen anything like that day. The way, the way…” She dwindled as she spoke to near-silence. And we stood, not meeting her eyes, as she added, “and the bodies. I have never seen so many, so many dead bodies, so many people. I have never seen…” she had to stop then.

In the long and awkward silence, there was, again, nothing to do but rub an arm and say, as gently as one could, as though the words were too harsh, no matter what was said, ”No one, no one should ever see that.”

We ran out into the waning day, all of us vibrating with urgency to get to people, our bus eeking its way through impossibly narrow gaps. Twice we had to stop while the driver and translators got out to explain to people that the semi-permanent dwelling they had built since yesterday into the road (a thoroughfare), must be moved. One such dwelling was even meticulously barricaded by a semi-circle of lumps of rubble that extended halfway into the one-lane road. Our translators helped move the lumps, hauling the heavy rocks while the family stood, angry, occasionally shouting, off to the side.

And then the whirlwind began. We saw 44 people in a little over 2 hours. I stopped counting after 10 pelvic exams. Women seemed to hear that there was a woman doctor available, and some found their way to me without ever going through the check-in/triage. I am now jokingly known as “Doctor Gurley” the girl doctor. I think it may be all-pelvics all-the-time while I am here. I have finally earned my name.

In medicine in America, so many people work together to try to help a patient, that almost no one can ever truly claim credit for a great outcome. It’s true — think of your ambulance driver, your teams of healthcare providers, your in-hospital team, your outpatient team, even, many times, your operating room team. There’s an insider joke about this – if one person (or even just a few), do something that’s clearly amazing, it’s called “a clean save.” meaning they can claim credit. This afternoon, our team had a clean save. A small, severely malnourished and dehydrated child with pneumonia, sizzling with fever. She would not respond and she gave little, irregular gasps. Dr. Choi worked the cellphones while others rushed to try to do something, anything with what we had. There was nowhere to take the babe, and no way to get her there. And then, propped and cajoled and aroused by the excruciating pain of attempted IVs and shots, she aroused enough to just sip, and then she began, Hollywood-style, to smack lips and swallow and suddenly she was a heart-clenching time-lapse video of a watered plant, near-death and then moments later, drinking and drinking. We’ll see her again in the morning, we hope. She had nowhere to go, but back to her place lying with her family, like so many people here, on dirt, under a suspended sheet. While we all wait for the rainy season to begin, the threat of it growling, incessant, in the background.

[Please note - patient details have been changed enough to protect confidentiality and identity]