one year ago today...January 19th

I'm not sure how long I'm going to continue these posts....another couple days maybe. I like the idea of looking back, reflecting, remembering.

You can read what I wrote one year ago today here.

Within a few hours of our clinic opening on January 18th, we realized we would need an inpatient ward. Many people's injuries were too severe to send them "home", especially when "home" was a ragged tarp stretched between 2 trees (or worse). We quickly decided to keep patients at the clinic overnight that first night, but by the second day, as we collected more and more patients, we knew we'd need a better solution. We decided to convert the former Heartline boy's home (for boys waiting for their adoptions to be completed) to a hospital. Because I was so busy in the clinic/ER/OR house, I didn't know much of what was going on at the newly-established hospital. Many of our volunteer staff stepped up and agreed to work nights to help cover all of the shifts. Coordinating the logistics of providing medical care at 2 separate sites (even though they were only separated by one street) was challenging, but we made it work, and over time, we got better at it.

We didn't have much morphine in those early days, but thanks to visiting anesthesiologists (Dr. Tami and Dr. Steve), we had a LOT of ketamine. And we put it to good use. Everyone who underwent a painful procedure was given some sort of anesthesia, usually ketamine. Ketamine is a wonderful medication--it has anesthetic, analgesic, and amnestic properties, and is very safe to use in basically anyone. It felt like a little bit of justice to be able to provide proper anesthesia to people when performing painful procedures. Most had already experienced terrible pain. Some had already undergone horribly painful procedures without any pain medications. But we were able to tell them that it wasn't going to hurt this time. And that was very gratifying.

While re-reading my post from a year ago, I was remembering some of the children we treated who seemed to not feel as much pain as we expected they would. It is a sad reality that the psychological trauma experienced by these children had already had an effect on their physical health and neurologic response to pain by the time we saw them one week later.

Back to 2011...It's been a privilege to work with Lori and Licia and many of their Haitian staff at Real Hope for Haiti this week. I hope to get out here again next week. Tomorrow I head back into Port for the weekend. I'm looking forward to seeing my friends the Ericksons who work with Providence (an organization I'm also involved with). Also looking forward to hopefully having some fun in the water this weekend if a few things fall into place. The type of water (salt water versus chlorine) remains to be seen and kind of depends on whether or not Duvalier behaves himself.