Update: Chadasha Foundation #8

Dear Family and Friends,

First of all, I deeply appreciate all the love, prayers and support
you are sending my way. I feel very honored to receive such grace.


So today from chaos, some order. We got up with roosters making noise
just before sun-up. Mike Cobb and I were in the OR by 7:30 AM and
worked together until about 6PM. We made up for yesterday’s
frustration thanks to my new hero, Dr. Ben an ortho/hand surgeon from
Boston (last names hard to come by here). Looks like Harry Connick,
Jr. so Ben Hollywood could do. He arrived yesterday, and was stymied
by the lack of an OR for him to use. Within hours he happily accepted
his new calling in life to run the OR schedule for 5 operating rooms,
11 orthpaedists, 2 plastic surgeons and an unknown number of pending
patients. Without picking up a scalpel he did more than enough to
credit him with the gold star of the day. We sent our #1 OR ortho
nurse, Danya from Omaha/Creighton , to the orphanage/hospital to line
up surgeries since she understood our capabilities. Patients have to
be moved by ambulance the 200 yards from orphanage to hospital. Lots
of bumps, dust and heat. Lots of lifting up and down, carrying
stretchers. No one complains. Ben said we did 58 surgeries (still
without Xray) with only one cranky surgeon from CA giving him a hard
time. So do we feel well accomplished? I just don’t know how to even
measure progress here.


As we worked along thru the day we heard various reports. Some are
checking in with CNN, some have family sending odd news reports asking
if we can confirm. Luke, I saw your note about US support. I hope
your “tree shaking” reaches the right person. So from “rumor” the
USS Comfort is either full or not doing anything. The U of Miami has
a field trauma unit at the airport in PAP, and may take some critical
patients from us, but the critical probably can’t handle the car/truck
ride. Clint/Dave Vanderpool/Luke are all pushing for help to get
patients moved out of here, we all wonder which agency is going to
step up to the plate.


We still saw patients today who had no significant care since their
injuries. I honestly don’t know how they are getting here. One was a
70 year old lady for whom Mike did external fixation for a femur
fracture, completely by feel, since no Xray. We are all amazed by the
strength they show. They have tolerated so much pain, and frankly we
sometimes just look at each other in the OR wondering HOW DID THIS
PERSON SURVIVE THE LAST 10 DAYS? The Haitians look after each other
quietly and with dignity in the most bare of surroundings. We had one
woman today whose right arm was cut off to get her out of the rubble.
Mike revised the amputation and has her lined up with plastic surgeons
from Gainesville for skin grafts on Sunday. She never stopped
smiling, never complained, yet I am sure she is in pain. And there
are far more just like her.


I have so many stories, I may not be able to keep them straight. Some
are just too terrible to put to writing. This is a small part of one,
with a lot omitted that goes into the too terrible category. Our
OB-GYN professor from Lincoln Memorial Medical School in TN saved a
young woman’s life early today. Dr. John Williamson has been coming
to Jimani with Clint for years. A nurse came looking for him late
last night. The patient was about 20 weeks pregnant when she was
crushed in the quake. The baby died and she appeared here out of
nowhere with high fever. I really don’t want to go into the medical
issues, but when John told her husband emergency surgery was needed
at 2AM, he agreed without question. When John said, “Do you
understand how serious this is?”, he replied “Because you are doing it
now at 2AM I know it is very serious and you are doing the right thing
because no one in my country would ever have an operation at this
time”. Clint was there for the whole surgery, and I know he will have
much more to say about it.


There was a very minor tremor here about dark, none of us felt it but
the patients and their families lying on mattresses on concrete floors
did and ran out of the orphanage into the parking lot area. I did not
see this, but 2 patients with IV’s jumped from the second floor. 3
docs went to check them out. Danya was just getting things in order
again, putting people back to bed, when we felt another, bigger jolt.
This is the first thing I have noticed so I am now in our bus typing
away for awhile. I’ll go check on my post-op patients in a little
bit.


When we occasionally stop and look beyond the Jimani Project at the
surrounding views, this is a beautiful spot. There is a large lake
with vistas to green cliffs in the distance. Hawaii is the only place
I can compare this to. But, it is much hotter than Hawaii! Must
have been 100 degrees in the sun at midday and 90 in the OR. I
consumed well over a gallon of fluid today. I can’t imagine how this
adds to the stress on our patients, we keep pushing fluids and using
antibiotics far more easily than I ever would at Twin Rivers. Thank
God we have all of that we need.


The CRNA’s (nurse anesthetists) working with me have kept my patients
magnificently pain free with little of our usual 21st century devices.
We can’t even monitor oxygen levels appropriately. Bill Ragon who
came with us from Jackson, TN “trained in” 2 new arrivals from
Knoxville today during surgeries Mike and I were doing. There we are
in a OR with screens covering open windows, doing surgery, while Bill
quietly gave his replacements (I do believe it will take 2 to replace
him) his advice given our resources. By the way, I have not heard a
patient crying in pain in the recovery area immediately post-op. The
anesthesiologists and nurses running the recovery/post-op areas are
just incredible. We keep pushing them to discharge patients so we can
bring in more. They have 6-8 patients on cots in small, hot rooms
plus patients in the hallways, the laundry room, and every alcove
available. They have never said a sour word doing the toughest of
jobs.


Speaking of jobs, I really love what I do. My Dad said he enjoyed 20%
of what he did in dentistry, and that made up for the other 80%. I
have always felt fortunate to enjoy 80% of what I do, more than making
up for the other less enjoyable 20%. And come to think of it, at this
moment, I don’t know what the 20% I thought I didn’t enjoy is anymore!


The volunteers here are just amazing. Not just the docs and nurses,
but everyone. I just met Caleb Pal from Huntsville. Luke, he is the
man (I swear he looks 13 and has never shaved) Troy Moore got to come
down to hook up the satellite link. I decided his IQ is too high for
me to count to. He put a blow up bubble on the roof with the dish
inside and is working on a second. He brought a black box smaller
than a carry on suitcase that will be a cell tower giving a mile
radius for our phones to connect to it. We can then call US through
any cell provider one would have just as if in US. He says we are a
“cell service provider”. He’s working on how to call in to Jimani
right now, next to me here in my dorm room. I am sure he hasn’t had
any time to think about why he got into this. I think 99% of
volunteers are here because they felt called by God. This is one of
our usual discussion topics over power bars and bottled water. I met
a young surgeon yesterday on his arrival. He was so arrogant the
nurses told me they wouldn’t work with him. But today he was crying
along with the rest of us, his eyes the “Jimani red”. And he started
asking for advice in the OR, which I guarantee never happened before.
And he does great work! He did a “free flap” of skin from the abdomen
to a calf wound for one of my 11 year old patients to cover a huge,
painful open wound in record time. And within minutes had figured out
how to use orthopaedic hardware to fix a 7 year old’s jaw, that was
broken in 2 places. So I guess he just didn’t know where the phone
call that got him here originated from until today. We are all being
changed by our time here, but it was incredible to see this man become
so different so fast.


Several of us rode our bus into the town of Jimani tonight. The local
hospital looks more like a bus depot to me. 40 people milling around
outside, tiny windows, little light. Would not pass for anything
medical in the US except a warehouse. We just gawked, speechless. I
have truly led a sheltered and charmed life, and assure you all of my
pals here feel exactly the same.


So we now have enough orthpaedic surgeons here that I feel comfortable
leaving. I had always planned to return 1/23, but with the
reservation that I couldn’t if I was needed. Mike Cobb came planning
to stay for 2 weeks. We both feel comfortable about going since we
have more than enough colleagues to hand off to. The humanitarian
crisis may be more apparent on CNN, but so far we all agreed the many
(over 100, 58 the last 2 days I think) patients we put external
fixators on have to stay here. Where can we send them with pins and
bars on their legs? They can’t walk on these and many have both legs
injured and can’t even use crutches, which we actually do have. And
some need further surgery.


So far we’ve had by one count 500 patients here at one time. We just
have no next place to send them, so many will stay and limit the input
of more. Clint won’t turn anyone away, he has faith that his
pleadings will hit the right ears soon.


Everyone is heading back into the buildings now, but our bus driver,
Francisco, is keeping me under protective custody on the bus for a
while longer. I don’t think I can get off!


If you look at a map of Haiti and the Dominican Republic, Jimani can
be found due east of PAP, just inside the DR. I am told evacuees
can’t go south to Jacmel on the coast because the roads are impassable
and the same to the west. Most will head east? We all wonder,
another topic of usual discussion.


This is disjointed due to several interruptions to check patients in
recovery, plan a last minute surgery for someone else to do in AM, try
to convince Clint to go to bed (took 3 of us on that one), and calm a
young journalist shaken by the jolt we got. Francisco finally allowed
me off the bus and we’ll let her sleep there. I actually have a bed
tonight for the first time! With a nurse anesthetist waiting to take
over in the morning when I leave.


So tomorrow I get back on Chuck Strickland’s jet for our trip back to
Knoxville. I have hugely mixed feelings about leaving but I know this
was only Phase 1, I can’t imagine not coming back some day, especially
since Clint has learned I know how to get here.


Again, thanks for your thoughts and prayers,


Love,

Dad/Ed