Goodbyes

I walked into her room and almost cried at the sight of her. She had been my patient a number of times in the past two years. Over that time she changed, I changed, we got to know each other a little more with each visit. She had become emaciated since the last time she was here. Her cheeks were sucked in, the petechia present on her cheeks was spiderwebbing down into her neck. Her body, once full and plump, was now just a sack. Her bones were sticking out in odd angles. I turned her to the other side when I assessed her, not knowing how long she had been laying on her left. The redness to her ribs was plain to see, non-blanching. The pressure ulcers were present on every prominance, the one on her coccyx looked especially angry - there were discussions that it was a possible Kennedy ulcer...

I looked through the MDs notes and saw that she was on comfort care - minimal position changes. Crap. I can see why though, she was in so much pain with movement, despite the continuous infusion of morphine. I gave her some more morphine prior to turnings to help ease some of the pain, with only minimal success.

I entered her room every hour, would touch her head, let her know I was there. She was never verbal, she opened her eyes a little when I talked her, but not for long. Once she was settled in, she would quickly relax back into sleep.

I left for lunch, came back then had someone help me change her position. That was at 1:30. She opened her eyes and looked into mine. I touched her forehead and told her it was okay, I was there with her. When I looked in her room 15 minutes later, she was gone. Making that phone call is difficult, I always feel inadequate when I deliver the news.

There is something very touching about post-mortem care. I like to wash my patients with warm water and place fresh gowns on them, even if I am the only one that will see them. It's my time to grieve for them, to say my goodbyes, to tell them I have been honored to care for them.

Death doesn't get easier.

Haiti on my mind

I've been home for almost two weeks now. It's hard to answer all the questions people have about Haiti, my answers are inadequate. Nothing I can say will ever come close to being able to have people understand the amount of devastation that was seen there. And even with that, the incredible amount of joy and love that was present everyday continues to blow my mind.

I go to sleep thinking of Haiti, and when I wake, my first thought is of Haiti. The time spent there was like trying to drain the ocean with a thimble.

My daughter will be making her third trip to New Orleans this summer to continue in that effort to help rebuild the city. If a place like New Orleans, which is in the United States, one of the richest nations worldwide, is still in recovery from August 2005, what chance does Haiti have?

Back home

I'm still processing things that happened in Haiti. There were great joys indeed, but I also saw the downside of humanity, mostly in the form of disrespect from my fellow americans. That's a good place to start as any.

There was a Code blue in the ED of the hospital where we were working. I was working on med-surg, so I don't know all the particulars, but I went down to ED to get a glucometer from one of our doctors I arrived in time to see the patient being carrier via stretcher into the ambulance. I was hanging back with the Haitians watching the scene unfold. What I saw will stay with me a long time. As the patient was placed into the ambulance about 6 americans had their cameras out and were taking pictures, leaning over the workers to do so. Some were crowding the windows to take a picture of what was happening inside the ambulance. Then, to my surprise, a co-worker had 3 other people line up in front of the ambulance, they put their arms around each other and another picture was taken. To say I'm disappointed is an understatement. This behavior would not be allowed in states, so why was it okay here? Here, a woman and her family were going through a life changing moment, possibly would be the last memory they have of her, and we americans were disrespecting that memory. It's not okay. I completely understand the term "ugly americans" now. I get it. A part of me still wishes I was naive.

Well, my camera has malfunctioned and 60 pictures are gone. Of course, it was the pictures of smiling patients and wonderful moments that are gone. What I have left are the pictures I took my last day. The road on the way to the airport, part of the LEAP team, some of my co-workers. I have nothing of my time with Dr.Ryan, or Bermann, one of our interpreters, or Nadine, who smiled and called my name every time she saw me, or Frantzy, who told me he loved me when I held his hand during his dressing change. Their faces are permanently etched in my mind and engraved on my heart. But I miss having their pictures just the same.

There are so many moments that I have been reliving since I came home. So many.

14/5/10

Today is my first day in Haiti. I woke up at 4am at my sister's house, then a quick trip to the Miami airport, then a 2 hour flight to Port au Prince. Then the adventure really began. I thought that getting through customs was nerve racking, but the trip outside the airport to the gate was enough to cause anyone to have a nervous breakdown. There were people everywhere that wanted to "help" Unfortunately, each time someone "helped" you by touching your luggage you needed to tip them. Saying "No" did not mean anything. It was overwhelming and terrifying. BUt I made it through, not too much poorer.



We had an hour long drive from the airpot to the hospital. When I had heard the roads were not paved, I was expecting something that resembled a friends driveway. If only. What there was instead was cobblestones with raw sewage everywhere, dirty and wet. The cars were zooming in and out of traffic at speeds that aren't normally used in traffic that close. I doubt there are any traffic laws here. People dodge the cars with inches to spare, and if you want to go around the car in front of you, why make your own lane, or better yet, go into the oncoming traffic. Nonetheless, we arrived safely. But it was a ride I will not soon forget.

Less than 48 hours

In less than 48 hours I will be at the Port au Prince airport. Already, I'm nervous. It's times like these that I start doubting myself. Which I know is silly, but my inner doubts have a way of rearing their ugly heads.

I've been through this before, the first time I lead a preteens to feed the homeless in San Francisco I doubted about whether I could keep the youth safe and be able to teach about God's love and compassion when I myself didn't know if I had it in me. When I went with high schoolers to Arizona and we were faced with politics and gender roles that were so different from the Northern California mentality I didn't think that I would be able to maintain my calm in the face of such differences. Somehow, though, I managed.

While I was writing this I have come to the realization that I'm not in this alone. Not only is there a fabulous team of UVMCers that are going to be there with me, but my friends and family here at home, and of course God, will be in my heart and my hands. Now, what do I have to be nervous about?

Getting ready

2 Days before I leave for Haiti. I've decided that I didn't have enough to do, so I started this blog as well. Hopefully, I will be able to keep you up-to-date while I'm in Port au Prince. I'll find out tomorrow when I make a trip to the T-mobile store to find out about international calling and data service.

As most of you know I had a scare Mother's day night while I was at work. My heart started racing and didn't stop. By the time I put the tele monitor on, the rate was well into the 180s. Thankfully, I work with some great people, who made sure I visited the ED. If I were at home, instead of work, I probably would have sat down until it passed. Thankfully, I was at work. This was a wake-up call for me. I need to start taking better care of myself. The hardest thing I did that night was to tell my daughter what happened. I want to be around for a long time. I see the Doc this afternoon.

So, this journey is starting out with some excitement. Just not the excitement I had in mind.