Day 3- Monday

Today we drive around looking for more trouble. At General, there are 2 American teams- one from Maine with 2 Ortho surgeons, an advanced practice nurse first assist, an anesthetist, a PACU nurse and a nephrologist who has spent a lot of time here and serves mostly as an interpreter. We are a ragtag group consisting of a cardiac nurse from NYC an Ortho surgeon from Atlanta, a retired Ortho surgeon from Eugene and me, the labor and delivery nurse. We are a team only because we are sharing housing and a driver, but are seeming to work better together than the Maine crew. There's some friction between the two groups- (Survivor-Les Cayes General...) add that to the chaos of the situation and communication difficulties between all of us Americans and the 2 Haitian surgeons and... Well, we thought we'd see if we could be helpful elsewhere.
Cité Med was crowded and had tiny private rooms. It seemed more a clinic and less a hospital, but there were two cute sisters on the 2nd floor recovering from similar leg fractures who grinned and giggled at us.
Hopiteaux Brenda is usually an ear-nose-throat clinic, but now has big UN tents outside and is seeing all patients. Some American, Canadian, Brazilian and Uruguayan medical staff seemed to have things under control. A nurse that we spoke briefly with told us that without interpreters to help us give care we would be in the way and we could help organize the stock room but that was it. I considered staying to do whatever I could, I could call our driver to fetch me at any time... I should have stayed. I am finding I do better with some structure, and have not had much success at finding my own opportunities or my own way. I have found some security with my new friends and am clinging to them. I hope they don't mind.
I want to be self-sufficient but fear a little for my safety and am not as confident as I want to be. Need my H here, or something. What did I think I was going to do? Start IVs, change dressings, organize paperwork... The nurses here sit behind a desk and chart. I have yet to see one change an IV bottle or give a medication. Not all that different from home I guess- who am I to judge? Language barrier makes it difficult to give instructions or explain a procedure, but I have to remember that love, caring and comfort are universal. And every little thing we can do helps.

Day 2- Sunday

Frustrated by finding a different opportunity than we imagined. Chaos, somewhat. Inefficiency somewhat. No lack of patients, that's for sure but we don't feel like we are doing disaster medicine per say. There are lots of fractures that need fixing, on top of the usual chronic human diseases complicated by scarcity of resources, trained personnel, and wellness knowledge. What these people have in plenty, though, is family, quality relationships and a faith in god. They have more prayer than anything. I am not sure it's helping. Everyone is dressed in their Sunday best- frills and ribbons, tucks and pleats. Another of many ironies here- little girls in fluffy dresses picking their way across filthy, cracked streets, through trash and poisoned water, motorcycle exhaust and skinny dogs to school or church. Chaos, yes they have in plenty.
Maggots. Maggots keep the wound clean, at least. This is a 92 year old gentleman with peripheral vascular disease. His poor circulation has caused what I am sure was a scratch at one point to brew into a large hole in his shin with tunnels that host little friends. They squirm away from the light when we remove his filthy yellow bandage. I am not as squicked out as I would be normally. I am not sure why. The little worms keep the wound a little cleaner, at least. Giving the pseudomonas and staph and whatever else less dead material to grow in and infect the rest of him.
How do they get there? Do flies lay their eggs there? Do all maggots look the same? I wonder about the fly's lifecycle. I wonder about my lifecycle.
Too many doctors, not enough nurses. Doctors fight over cases, try to organize themselves into an effective OR, but without anyone to structure things, they flail a little.
We all do.
Haitians are stoic in the face of pain and laugh, joke and tease their way through daily life. They shout, sing and stomp their prayers, but intense pain is met with a quiet "Oh-oh-oh..." I wonder if we subject them to more pain than is necessary because they do not complain about it. There is no 5th vital sign, here. I saw morphine on one man's chart but haven't seen any evidence of it being used. "Beaucoup doule?" I have learned to ask, despite having nothing but a smile and a pat to help when sometimes the answer is "Oui, oui."

First day.

Sooooo unhappy about having to pare everything down to 20 pounds. Food or notebook. Water purifier or batteries. iPod or socks. This is a game of what do I need, rather than want. This may be a lesson in "enough" rather than strength, fortitude or skill. Flying into Les Cayes, over barren brown hilltops, roads on the ridges mirror the rivers in the valleys. Dusty tracks wind without reason- Haitians create roads where they are needed, not according to any plan. Like everything else in their haphazard, chaotic existence. They cling wherever they can find a ledge or scrap, through political unrest, pseudooccupation, a thousand insults to stability, growth and country (I learned about how the charcoal industry stripped the entire country of it's trees...).
It's a stark contrast to the neatly ordered waterfront estates I flew over in Ft. Lauderdale less than 24 hours ago- each fenced in it's own pool of isolationist narcissism.
I am getting away from myself and am a little jaded.
Namaste, namaste. The God in mee recognizes and honors the God in you. "Hey give me food!". "Hey give me money!" the kids chant at the fence while we unload the plane. A smashed box of donuts swelters in it's embarrassment atop our pile of bags. Each if us brought more clothes (well, I am still a little miffed about my paltry three sets of scrubs...) than these kids will own in their lifetimes. "Hey give me food!" it's the same empty phrase called at fences and ditches and breadlines around the world, with white people on one side... "I need, you have." They cry, fingers bunched at their lips: the international sign for "please, I am hungry."
The language changes, but the words stay the same. Americans get fat on their own privilege.
Here I wax jaded again. Salvation or empowerment? Do we need to give these people food, or teach them...? Do we perpetuate their dependence because it gives us more glory, more gore, more to do, more to save... More to prove?

DFW-FLL

My nurse pen works, but not the black or blue... Technicolor thoughts, crash course in French in green and red. Wishing I had my "kindness" necklace, but my first wedding token and "namaste" rock will do just fine to remind me both why I am here and where I am home. "The God in me recognizes and honors the God in you.". Namastizzle!!
The state of Florida has interesting topography. A giant swamp; trees stand in isolated groves, clumped like a skin cancer. Like colonies of staphylococcus in an agar plate with their burned- out cores. I thought: look at this, miles of dead trees! There are spots of green here and there, but all the thousands of dead ones! And here, a house in the center! What virus, what beetle or chemical hath wrought it's wrath here and aren't the inhabitants of these houses concerned....?
Oh. Yeah. It's January. All the trees here are deciduous, even the coniferous ones. They aren't dead, just denuded of leaves, hibernating for the winter. I must be from the Pacific Northwest.

The night before.

Stuffed a small orange teddybear down in my bag, down past the box of sutures, the baby bottle, the IV needles & electrocautery. It's wrapped around my big serrated knife- who's protecting whom in this disquieting juxtaposition? I just have no idea what to expect.

Haiti.

And the show, it goes on.
Wish I knew a little better where we stand.
Knee-deep? 'Elbow deep inside the borderline'?
'Leaving on a jet plane, don't know when I'll be back again.'
We all sang that in the cab on the way to the airport, home from Thailand. I don't remember leaving home, I just remember the journey back.
Chance to learn, chance to grow...
It seems I am only fully living when I am riding the ragged edge of disaster.
Riding this disaster, thank you for the 'chance to be alive and breathing'.
I will be back, but not all of me. I know it will be different, I will be different.
I am afraid.
A little of what I'll see and feel, but mostly of the big bugs. Somewhat of the possibility of danger. But, statistically it's either cancer, heart disease or a car wreck that's gonna get me in the end. Given the choice, I'll take my chances with the confusion and the mosquitos.
'I have no regrets, except that I wish I had danced with you.'
It was so nice to hear such love, encouragement, and approval from everyone. I know there is a piece of your heart that is terrified too, but another piece would go with me if you could, or at least realizes why I am thus compelled.
Glad I stayed to dance a little tonight, even though I smell a little like a stripper.
Glad I am taking the opportunity. The universe always presents me with the right one.
Here goes.

Last.

Head up.
Eyes on the prize.
Just breathe, keep it together
Keep it all close in.
Breathe now, tighten up a little.
Suck it in, burning in all the right places.
Focus sharp and narrow.
No room for doubt, no space for what if
No wavering.
There is no fence, only the dull roar behind the heat.
Turn it up a little.
More.
Faster.
A reaching whine, a yearning ache
Pit.
Higher.
Almost, even, drag, falter.
Close, slow, fail, wide.
Fail.
Finishing's just not as sweet, anymore.