Life is Calling...
September 17, 2011
A boy died today. He had a temp of 110 degrees farenheit and was probably a lost cause before his mom brought him in. Nobody knew what to do, not even the 'doctor' that was there. He just stood there looking for a femoral and carotid pulse the whole time. I tried to take over and instructed the sisters to start an IV to cool him down. I didn't really know what to do either. I was thrown off - way off - by the lack of supplies and resources. I wanted a bag valve mask, some oxygen, even just a mask would suffice. They didn't have one or even know what I was talking about. It took me too long to realize that the boy wasn't even breathing, too long to listen for a heart beat myself and subsequently find none. I started CPR and the women looked at me as if I was dumb. All this took about 10 minutes. Having gone without oxygen for that long, the boy would have been brain dead even if we managed to get him back. It was too hectic to even think. There were wound care patients lining the walls, staring at us move about frantically. A baby in the next bed with ulcers on her face screaming. 15 people in a 20x20 foot room with two beds, a work table, and expired supplies lining the walls is not an area conducive to saving lives.
I told a sister to take over CPR, she had no idea what to do. After instructing her, I got some epinephrine and injected him with it. All while the doctor played dumb, still looking for a pulse. I eventually went to the head of the baby to inspect his pupils and basically do anything I could think of in futility. After working this kid for the better part of 30 minutes I finally looked at the doctor, who didn't speak any english, and said to him in my best creole something to the tune of: "Sir, it is bad. The baby is finished. Dead" At that point we called it. We had taken off his shirt and pants, everything but his diaper. He was probably 7 years old. Everybody dispersed except a portugese nun and I. I started to dress him again and she followed my lead. She buttoned his shirt when I cradled his head and lifted him up. She started cutting his nails, making him look more presentable, giving some dignity back. His eyes were glassy, with a hint of blue around the whites. Contrary to popular belief, one cannot close the eyelids of the dead. They tend to move back to the position they were in when death came. In this case, his were half open, enough to see that his eyes were brown. His mouth was slightly open too, where some froth was resting. The nuns had tried to get a line in his scalp and removed half of the hair on his head to look for what was not there. So while he looked.... presentable, he head was a mass of knotted hair, bare scalp and skin. I crossed his hands over his chest.
At this point I don't think the mother knew. All the sisters were busy helping others, so I brought the mother in to see him and found a sister to translate what I was saying to her, that her child was dead. She went in, saw that his eyes were half open and tried to close them herself, crying the whole time. She went back to sit down and I brought her water. She stopped crying and calmed down and remained calm until we had to remove her son. I had him covered in a translucent surgeons gown. It was very eerie since you could see his body outlined throughout. A priest came, or a brother or something, and put a trash bag over the boy. Actually he put the bag over his head, so that his legs were sticking out. He picked him up and brought him out, carrying him like a heavy box. Not like the dead boy he was actually carrying. He went by the mother, who upon seeing her son in the black trash bag erupted in screams. She calmed down sooner or later, but I was busy. I had to get back to work.
September 19, 2011
I have been thinking a lot about this boy, whose name I don't know. Also about the other children here who have died because of fever. I was working in a clinic today, and saw about 100 patients. The only one I remember is a 3 year old kid whose care I was charged with. He came in with a fever of 104 - high, but not about to kill him. He stayed all day and the fever refused to come down despite many rounds of ibuprofen, acetaminophen (both orally and rectally), cooling compresses and starting him on an antibiotic. All I was thinking about was having another kid die from an uncontrolled fever. At the end of the day, I consulted with the doctor - who I had been doing so with the whole day. We sent the child to get a malaria test in the morning. But that was the morning. He had all night to get through. Eventually his mom took him home, against our advice of taking him to a hospital. I hope I see him tomorrow morning.
People come to Haiti, or any suffering country, with the aim of doing good. But something has to be stressed to those that provide medical care: you can't expect to save everyone. Not because of lack of knowledge or trying, but because things are SO different here. The boy on September 17th, if I had brought him back, what kind of life would he had lived? He would have been brain dead, there are no automated ventilators here that could have kept him alive. He would have brought down everybody around him even further than they already are. There is not much farther down one can go when you are already living in a hut, on the side of the road, with no drinkable water, no toilet to speak of, and not to mention living within spitting distance of tens of thousands of others. What I just described is a tent city here in Port-au-Prince. There are tons of them, and tens of thousands live in them.
So what I've learned is to get some perspective on what is really able to get done here and anywhere really. Lives can be saved, for certain they are saved everyday. But there are lives that cannot be saved, because so many events, situations, and happenings conspire to create something so abhorring, so unfortunate, that I simply cannot hope to overcome. Not just here in Haiti, but everywhere in the world. It pains me to realize this, and in fact, I don’t believe I fully realize it. I am just beginning to realize what this world can have in store for those who live in it.
Thank you for sharing your experience and for the work you are doing. It is easy to forget the conditions in other parts of the world as we move through our day-to-day routines.
ReplyDelete