What Next?

I have been leaving teasers and hints for some time now about how frustrated I have felt regarding my ill-preparedness in leveraging the human resource that I have been blessed with to good effectiveness. I have been working hard in the background of all this earthquake and blog stuff at stepping up my game in this regard and am ready to reveal just what it is I'm up to.

I leave for Haiti this afternoon, gone for just a week this time, home next Sunday. I plan on returning to the field hospital where I can help out a few days. (I just received an email from a doctor friend of mine who said that they had been treating nearly 600 patients a day there!). But mostly I'll be working on my next phase... Can you say "teaser?" I knew you could. Seriously though, it is not my intention to make a big melodrama out of the big reveal. I won't string it out and will, over the next several communiques, tell you all about it.

During my time in Haiti this week I will be writing and would love to post a blog daily. But internet access will be very iffy this time around, so if you don't see a post any certain day, keep coming back. I AM WRITING, and will get them up first time I get a chance.

Continue to pray for Haiti. Word is that 300,000 people have now perished as a result of the earthquake. This number continues to rise.

More tomorrow, from precious Haiti.

Steve

Navy Troops

These guys wouldn't let me bring this baby home. Just kidding. This baby is one that had meningitis that improved enough that we were eventually able to send her home with her mom. The troops were all just the nicest guys. Good thing, because their guns looked like they might have been able to shoot real bullets.

Sacramental Mindfulness

This very sick child's sunken eyes and racing heart betrayed his dehydrated condition, in his case probably related to Typhoid Fever, a severe gastroenteritis caused from a virulent species of Salmonella. Contracted by drinking tainted water, Typhoid Fever is endemic in Haiti.

Next time you drink a glass of water from the tap, be thankful you don't have to worry about getting Typhoid Fever.

As I've said in earlier posts, I am someone that tends to wax reflective, paying attention to everyday realities and events in order to see if there might lie truth beyond the obvious. Here's my thinking...

Our basic inclination, I think, as earthly creatures, is to hold physical and spiritual realities at arm’s length from each other, sequestering the spiritual from the physical. I believe we have been duped by modernity, which asks: “If we can examine it, measure it, quantify it, analyze it and predict it, then how could there possibly be anything divine about it?” In our dualism we lose the reverence of what God has made. Ken Gire, in his book, The Reflective Life quotes Abraham Heschel on this point: “Let your conceit diminish your ability to revere and the universe becomes a marketplace for you.” (Abraham Heschel, God in Search of Man: A Philosphy of Judaism). Gire goes on to state: “We can objectify the world or sanctify it. When we objectify the world, we view it and all that is in it as existing solely for our use, whether that use is for pleasure or profit or patriotism. When we sanctify the world, we view it and all that is in it with appreciation. In doing so, we recognize them not simply as objects, but as objects created by God that in some way reflect Him and all that is dear to Him, the way a work of art in some way reflects the artist and what is dear to the artist’s heart.”

“We tend to confine the sacred to a fenced-in-area,” Philip Yancey states in Rumors of Another World, “the ‘spiritual,’ reserved for church activities. Many people rarely give God a thought apart from an hour on Sunday morning, when they sing songs of praise, listen to a sermon, and then reenter the secular world as if passing through air lock.”

How do we rediscover, then, the art of seeing the divine in the ordinary, of regarding created things and created order less as physical, chemical, and physiological marvels so much as testimonials of their Originator? Philip Yancey, in his book Rumors of Another World, articulates it best: “As a start,” he states, “I can aim to make daily life sacramental, which means literally to keep the sacred (sacra) in mind (mental). In other words, I seek a mindfulness - a mind full- of God’s presence in the world. I have no desire to escape the natural world, the pattern of Gnostics, desert monks, and fundamentalists who flee “worldliness.” Nor do I deny the supernatural, the error of the reducers. Rather, I want to bring the two together, to reconnect life into the whole that God intended. This world, all of it, either belongs to God or it does not. If I take seriously the sacred origin of this world, at the very least I must learn to treat it as God’s work of art, something that gave God enormous pleasure.”

Lord, God… Creator of all that is…. Creator of me… please awaken me to the reality of Your presence in the world you have placed me in. Help me to see at least some of the “glimpses of truth Thou hast for me.” Amen.

“In every act of creation God is present, waiting to be discovered. The essence of the spiritual journey is the discovery of the presence of the sacred in everyday things, in everyday people, in everyday life.” Leonard Sweet, Soul Salsa

The Lurking Presence of God

"Our world is saturated with grace, and the lurking presence of God is revealed not only in spirit but in matter--in a deer leaping across a meadow, in the flight of an eagle, in fire and water, in a rainbow after a summer storm, in a gentle doe streaking through a forest, in Beethoven's Ninth Symphony, in a child licking a chocolate ice cream cone, in a woman with windblown hair. God intended for us to discover His loving presence in the world around us." Brennan Manning, The Ragamuffin Gospel

God rarely shouts for our attention. He is often subtle and quiet. Lurking, even. Hoping we'll perceive His presence in the room. Hoping we'll see that He has carefully and deliberately planted clues about Himself all around, and hopes we'll recognize them for what they really are. Leonard Sweet refers to them as "small-scale epiphanies."

"Life's treasures are buried right under our noses. Can we relish the wonders of small-scale epiphanies and everyday events?" Leonard Sweet, Soul Salsa

"What Just Happened?"

OK gang, I've been chided for not letting people outside of my practice community know about the presentation I'm giving this Saturday night entitled, "What Just Happened?... a remarkable story of compassion unleashed."

Of course, you're all welcome. Just, please... no making out in the back row. (You know who you are).

Steve

Pharmacist

This is always a fascinating site to me. Every so often we'll pass a guy selling medicines out on the street like this. How would you like to buy your medicines from this pharmacist? Some day I'm going to stop the car and get a closer look at this drug store.

Enlarge the picture so you can look closely at this man's surroundings. This is urban Haiti.

Resuscitation

"I will make breath enter you, and you will come to life." Ezekiel 37:5

Though not all that uncommon, it is always scary when a baby emerges from the womb and doesn't breath right away.The first baby born (pictured left, watch video) born at the field hospital was such a child, and required infant resuscitation.

That word, "resuscitation" is interesting. Imbedded deeply within the word is the Latin word, "citar," which means "to summon" or "to call." We we are resus-citated, we are literally "re-summoned"... called again to enjoy life. "Summon me and I will answer," was once Job's prayer.

A patient in cardiopulmonary arrest will die without external intervention. A dead man can do nothing to save himself. "For it is by grace you have been saved, through faith--and this not from yourselves, it is the gift of God." Ephesians 2:8. Breathless we lay, dying. Unable to help ourselves. God then, in mercy, stoops down and freely offers us His Breath. Resuscitative breath. Reviving breath. "Re-summoning" breath. Divine CPR.

God is our Resuscitator.

The Eyes Have It

Many of the people we saw in the early days following the earthquake had eyes that looked like this. These "subconjunctival hemorrhages" are more startling than they are worrisome. Most cases will slowly resolve over a couple of weeks or so.

I couldn't help but wonder, though, what their eyes had seen. These eyes have seen much trouble, no doubt.... even before the quake. At its best, life is very hard here. On top of poverty, hunger and disease, throw in the annual hurricane season (Haiti was barraged by four hurricanes during one two-week period in 2008), and now earthquakes. It reminds me of the old Negro spiritual Louis Armstrong used to sing....

Nobody knows de trouble I've seen.

Nobody knows but Jesus.

Nobody knows de trouble I've seen

Glory Hallelujah!

Sometimes I'm up, sometimes I'm down

Oh, yes, Lord

Sometimes I'm almost to de ground

Oh, yes, Lord

Although you see me goin' long so

Oh, yes, Lord

I have my trials here below

Oh, yes, Lord

If you get there before I do

Oh, yes, Lord

Tell all-a my friends I'm coming too

Oh, yes, Lord

I Was Thirsty . . .

I was thirsty and you gave me something to drink... Matthew 25:35

This is my new favorite picture, just sent to me by Alex Boerner, the photographer imbedded in our group. In it I am slowly and tediously giving electrolyte solution via syringe to this little dehydrated boy, near death from malaria. To this day I don't know if he survived or not.

Photo courtesy of Alex Boerner, Scripps Treasure Coast Newspapers

Books of Sacred Doctrine

"If your heart were right, then every created thing would be a mirror of life, and a book of sacred doctrine. There is no creature so small and worthless that it does not show forth the goodness of God." Thomas Kempis, The Imitation of Christ

Life is a textbook about God.

No one's life is like another's. Every person who has ever lived has a unique life story to tell. We each have unique perspectives of God that we have gathered from uniquely different sets of life experiences. Our individual stories could one day, perhaps, be compiled into one gigantic book. One chapter, my story. Another chapter, yours.

Many of my own "books of sacred doctrine" have come from my experiences a family practice doctor, insights I have compiled mentally for twenty-some years now. Countless "mirrors of life" I can no longer keep to myself.

Books and mirrors come and go. Quietly. Not screaming for our attention. I shudder to think how many I've let go by without so much as a grunt. I am getting better at noticing the God-lessons in the everyday, but surely I still miss things. Precious poignancies, missed for lack of attention.

Maybe it is "the everyday" that is the problem. We tend to brush off the common. Hang a priceless painting on your wall today and you'll notice it every time you walk by it. For awhile. Walk by the same painting years from now, however, and you hardly give it a thought. A priceless painting has become common, our regard for it... blunted by daily exposure. They say that familiarity breeds contempt. I say it breeds indifference.

A brisk knee reflex eventually fatigues if you keep tapping it with a reflex hammer. We have hyporeflexia. We have lost our ability to react to the stimuli of God.

This journal is my own attempt in noticing... in acknowledging that familiarity has blunted my ability to recognize that God has passed through here. Oh to regain my once-brisk reflexes to God's tappings! To recover my appreciation of priceless paintings...

There

I know it is obvious to all you blog diehards that I tend to wax reflective. That is my nature; that is my curse. I cannot help it.

"Go down to the potter's house, and there I will give you my message," God said to Jeremiah (18:1). That quote is interesting to me. I think it is significant that God's intention for that particular day was that Jeremiah would receive His message NOT by staying at home studying scripture, but as he went out and interfaced his cultural context. Why didn't God just say, "Look, Jerry, I've got something really important to tell you today and I want you to study the writings of Isaiah, especially 64:8, where it says, 'We are the clay, you are the potter; we are all the work of your hand.' Stay home, Jerry. Work on your kitchen table. Look it up on Wikipedia. Think about that verse, Jerry, then get back to me in a couple of days to tell me what you've learned." Couldn't God have saved Jeremiah a lot of time and expense that day if He had just laid His truth out there in broad daylight for Jeremiah to see?

Seems not. Seems sometimes field trips are necessary. Today was such a day in Jeremiah's life. A day when God said, "Go... there I will give you my message." Today, too, was such a day in my life.

My experiences in Haiti could never be matched by any amount of news reports or documentaries on the subject. Knowing this is a source of frustration as I process my feelings online for others to read. I'm frustrated because I know that no one can know Haiti unless they've been there... in person. To see and feel and smell and taste Haiti. To breath Haiti's heavy air and hear the cries of her mourning.

There. The vast majority of our days are spent there. In context. Engaging culture. And it is while we are there, busy and "in the fray," that truth often comes.

I have never more been "in the fray" than these past weeks. And God has certainly spoken truth to my heart.

I return to Haiti in two weeks....

Sensitivity to Culture

This photo was a funny diversion during an otherwise heavy experience. Here I am after pretty much demolishing this chair, having also just broken that green bench there at the side. My good lifelong friend Dr. Steve Foley (OB/Gyn, Colorado Springs) helped me up. I'm pretty sure the chair was irreparable.

Anytime I tell someone my blog address they look at me like I'm crazy. As if I came up with the most obscure, hardest-to-remember web address I could think of. Well, remember I didn't exactly have time to consult a marketing firm when I started this. Plus, I really didn't anticipate the interest that there has been in it (at least interest outside my current circles).

(And as just an aside here... I do so appreciate all you who have been reading this "experiment" of mine. And for your kind, affirming words. Although I have generally not taken the time to answer your comments on my posts, please know that I have read every one... more than once. They, along with your in-person and on-the-phone comments have been very encouraging to me).

All this said, I hereby dub this blog experiment a success and will continue to use it as my online journal of thoughts and essays.

And just so you know I'm not a complete nut case (just a partial one)..... the term "culture and sensitivity" comes from the medical practice of sending a specimen to the lab to culture it for microorganisms and to run tests on the culture to see which antibiotics those microbes are sensitive to. Not all staphylococcus bacteria, for example, are predictably sensitive to methicillin-type antibiotics. Hence the term MRSA: methicillin-resistant staph aureus. Based on sensitivity testing, therefore, we choose treatments that will bring the cure we desire.

This journal is my exercise in sensitivity... in paying attention to culture and to life and to events. Not to make more out of them than there really is, but at least to notice them and be receptive to what God could teach me through them.

Like Jeremiah, a prophet......

Evolution of Sterilization

It is interesting to see how our methods of sterilization improved over time. At first we were limited to a method called "cold sterilization," depending on chemicals to sterilize our surgical instruments. This is actually an acceptable method, just not the best. And it is slow. H2O at 212 degrees is a great sterilizer. Check out our crude steam sterilizer. The last pic shows a great step forward in sophistication (for us)... a pressure cooker created specifically for use in remote medical clinics and hospitals. We received this from International Aid one day before the first plane departed for Haiti. It made it on the 3rd plane's cargo. We were very happy to see it arrive later in the week.

Cleanliness and sterility is difficult here. Infectious disease is prevalent. Sterile technique, wound irrigation ("the solution to pollution is dilution"), and antibiotics not withstanding... microbes rule in Haiti: tetanus, typhoid, measles, malaria... ad infinitum. And much of it is so unnecessary when you consider what we know we can do. For example, tetanus is so unnecessary. Typhoid can be prevented. And on and on.

We must do better. And I believe we can.

Heartmelt

Someone just facebooked me this photo. I love it.

One Earthquake Begets Another

Exactly one month ago, January 12th, the earth's foundations shook beneath Haiti, toppling infrastructures and devastating families. A 7.0, they say, whatever that means. (Seems strange, applying numbers to such cataclysms. I guarantee you, no one in Haiti this morning is talking in integers. I mean, if you're dead or paraplegic or family-less, who cares if it's 7.0 or 0.7 or 700?).

I, too, felt the earthquake. And, although I didn't lose family or limbs, I did lose a bit of inhibition that day. Pushed past the tipping point we all (don't we?) summon courage and muster from deep within and step forward to confront our enemy.... in this case: human suffering. "Enough is enough!" we say, adrenaline surging. We must respond in kind... with an earthquake of our own. And, with not just a little trembling and quaking, we put our money and our day-planners where our mouths are and actually do something.

Thus, one earthquake begets another. My going there was just a warning tremor....

Juxtaposed

Almost two weeks after the quake this woman was brought to our hospital on this homemade stretcher. Her back was broken and she was paralyzed from the waist down, the third paraplegic we saw during the week.

I just heard that yesterday seven babies delivered at the hospital. What? Generally, of course, babies are born in homes, but there is something desirable in the minds of many Haitians that their baby would be born in a hospital, so in they come. This is not why we opened the hospital, but what are you going to do? Say, "no, not here, not today. We're busy with paraplegics today"? Tell that to a mother who's pushing.

Death and suffering juxtaposed with new birth. Welcome to Haiti.

You're Invited

Just an FYI for anyone interested. I will be sharing about my experiences of the past month in a talk entitled, "What Just Happened?... a remarkable story of compassion unleashed" on Saturday, February 27th at 7:00 PM at Saranac High School auditorium in Saranac, MI.

It's free, but worth it.

Field Hospital Update

Not 3 minutes ago I hung up the phone having learned that our 22-day old field hospital is seeing upwards of 400 patients per day, and admitting patients as inpatients. Inpatients in an outdoor hospital. More and more surgeries are being performed. Word has it that the earthquake-damaged hospital in the village is now completely non-operational, adding to the patient load at ours. There is tremendous strain on staff and supplies. Add to all this the continued difficulties moving people (i.e. medical teams) into and out of country. There is STILL no commercial air traffic being allowed into the country. Please pray with me that we will be able to meet needs without running out (or burning out) our resources.

The need is great. Just because Haiti's plight is dropping out of front page status means nothing. This is continuing to be a grave humanitarian crisis. Last word was 210,000 dead from the earthquake. Sadly, there will be MANY more who will not survive, maybe not from a cinder block crashing down on their necks, but from homelessness and hunger and all that they bring (e.g., cholera, etc.). Haiti is no where near out of the woods.

Sorry for the tone, but I am very concerned. Please pray for the precious people of Haiti.

The Least of These

After the first three or four days of seeing primarily earthquake-related wounds and injuries, the crowds of folks waiting to be seen every day swelled to upwards of 300 which was a severe test of our abilities to take care of in one day. We worked as hard as we could, but you can only do so much. Alot of people from the village started showing up with minor (relatively speaking, of course) or chronic problems, such as headaches or scabies, or whatever. At first we got them all seen, but as word got out in the village, we simply got too busy. (Hey, when you're good, you're good). I felt bad when we had to announce to the crowds that we could not see chronic conditions that day. Here we were, the first medical people to show up, and we didn't have time to see them. It felt so wrong, but we had to take care of those most sick or injured.

The precious people of Haiti are so hungry for someone to sit and listen to them, to hear what they have to say, to lay a compassionate hand on them. They soak you in, as if unable to get enough of you. And they're sooo appreciative.

I think of Jesus's words when He said, "Inasmuch as you have done it unto the least of these, you have done it unto me." Is it possible? Is it possible that I actually encountered the living Jesus in one of my patients today? I wonder which of the least of those... was him.

Miracle Michael

Here is the MSNBC clip of the little boy who was brought to our field hospital after being rescued from the rubble of his house eight days after the earthquake. Watch video.

This Particular Scandal

"One generation will commend your works to another; they will tell of your mighty acts.

They will speak of the glorious splendor of your majesty, and I will meditate on your wonderful works.

They will tell of the power of your awesome works, and I will proclaim your great deeds."

Psalms 145:4-6

Commending. Telling. Proclaiming. We must tell. If we don't we'll just die. When thinking of what God has done we cannot keep secrets. We must share with each other what we have witnessed in the works of the Creator.

Galileo felt it boil up when he said, "In order to maintain and increase the renown of these discoveries, it appears to me necessary... to have the truth seen and recognized, by means of the effect itself, by as many people as possible." I resonate with Galileo who, confronted with the truth that Earth was not the center of the universe, thought he would explode unless he shared it.

How can I go through an experience like what I've been through these past several weeks, and not share with others what I have discovered... about myself, about God? Aha!... I guess I'm not the center of the universe! So I will continue to share my discoveries, fresh insights I've picked up along the way. Discovery, you see, is not for hobbyists, treating wonders and truths like collectibles, placing them in lock boxes for safe keeping. It is not an exclusive privilege reserved for doctors or scientists or theologians. Discovery is not only the stomping grounds of shepherds and poets, but of astronomers, too. And grocers and greenskeepers and teachers and salesmen and second-basemen. Discovery is for all who want to know God. As Annie Dillard puts it, "We're all up to our necks in this particular scandal" (Pilgrim at Tinker Creek).

Evening News

This MSNBC camera crew followed a 5 year-old boy, Michael, to our hospital who had been pulled from the rubble eight days after the earthquake. What I want to know is, where did they come from? Had they been lurking back, hiding behind trees the whole time, with out us aware of them, waiting for a good story? Watch the MSNBC report on "Miracle Michael" that aired in the States that night.

Crime of Fashion

There was some comfort in knowing that the US Marines and Navy established a base camp just a few hundred yards down the road from where we were. A couple of us walked down there to introduce ourselves and to let them know that we were there and that they could bring an apple pie by our place any ol' time.

A few days later, I did have the interesting pleasure of revisiting the base, this time with Florida Congressman Rooney (to this date I don't know if he is Democrat or Republican. Besides, does it really matter in times like these?).

Yet another time, at their suggestion, we came up with a wish list of medical supply needs that would help us out alot (the Navy half of the military presence, I guess, were the medical folks. They had the big Navy hospital parked out in the Gulf). At any rate, they came through for us, showing up a few days later with lots of large boxes of supplies.

Check out the pic. They wanted to throw me in the brig for committing a heinous crime of fashion, but I talked them out of it with some bottles of Coca Cola.

Whew. Close one.

Boy Were My Hands Tired

We worked hard every day, all day, all week. When Sunday came we had brief thoughts of taking the day off. We decided to press on, however, knowing our time in Haiti was brief. I suspected that not too many people would show up but I was wrong and we attended to the sick and wounded all day long.

Francis of Assissi said, "Preach the gospel at all times. If necessary, use words." Well, I preached all day long that day.

And boy were my hands tired.

Degage

It's called "degage" ... making do with what we have. Check out this water bottle we "degaged" as a protective covering for the intra-osseous infusion needle we had just placed into this child's tibia (see photo).

MacGiver would have been proud.

Moved to Tears, Moved to Action

I hesitated adding these photos but decided to anyway. They are repulsive and they are sad. But THIS IS HAITI right now. Repulsive and sad. And rather than look away in politeness, we should allow ourselves to be disgusted and to be moved by this stuff.

Moved to tears. Moved to action.

This child was burned at the time of the earthquake because she was near where her mother was cooking when the quake hit. These horrible wounds were over a week old by the time her mother brought her to us.

Pray for this little girl and her mom. In addition to her painful burns and the complications of such burns (infection, fluid and electrolyte abnormalities), it is obvious that this little girl is malnourished in the first place.

Wound Care

By far, severe flesh wounds were the most common problems we saw. Typically we would irrigate the wounds with saline, remove dirt and debris and pus and dead tissue. Then we would apply antibiotic ointment and then bandage it all up. Many times this was so painful that we would have use local anesthetic shots. Most received antibiotics and pain medications. The tetanus shots we secured did not get to us until half-way through the week, so many did not receive them. We had many (if not most) patients return every day or two to have us do it all over again.

Check out the picture. The tarp I'm working under is the same tarp I used to haul leaves around my yard last Fall. Also, check out the onlookers. In the States, I would be written up for violating HIPPA privacy law. In Haiti, medical entourage is the norm.

Pediatrics

These children were near death when they arrived, both suffering from malaria. Both severely dehydrated. One, fortunately, was able to take oral fluids, albeit very slowly via syringe. The other (in the foreground of the lower photo) was so dehydrated that we were unable to get intravenous access. We resorted to intra-osseous access, penetrating into the hollow, marrow-producing part of the tibia (shin bone) with a large bore needle. Once in, we can infuse fluids fairly rapidly that way. The baby was nearly comatose during this procedure, and reacted minimally to what would otherwise be a very painful ordeal. She responded to the fluids, waking up enough for us to give her life-saving oral malaria medicine.

Superstition Remedies

This young woman's forearm was broken during the quake a week ago. In that no conventional medical care was available until we got there, she had seen a "leaf doctor" who applied a paste of ground leaves on the wounded area. Haiti abounds with superstition remedies like this. We splinted her arm and we believe she will recover well.

Meningitis

This mother's infant twins were near death when they presented to the field hospital. Meningitis. After a full day of fluids and antibiotic shots, their condition improved. She carried them home, returning the next morning for more of the same. My heart went out to her.

Richter 6.1

We had several tremors that first day, a disturbing feeling. When one would occur, we'd suspend all activity and just wait. They never lasted all that long. But they certainly got our attention. When it would quit, we'd all look at each other and say, "Did you feel that?"

After the first day of seeing the sick and injured we were all completely pooped, both mentally and physically. We all took our turns taking frigid-yet-refreshing bucket showers, then took very little time collapsing into our dormitory bunks for the night.

At around 6 AM Wednesday morning we were still sleeping when Haiti's second earthquake (measuring Richter 6.1) struck, just eight days following the 7.0 magnitude first one. At some personal risk, mind you, I am going to share with you my own account of Richter 6.1 . . .

Not that I'm an expert in quakes and tremors, I knew IMMEDIATELY this was no tremor. Not only did the ground shake, but our building shook and it rumbled. In the 112 milliseconds it took me to spring from my bed, all I could think of was cinder blocks of this building falling down on me, just as they had on so many thousands of Haitians a week earlier. Usually a slow waker-upper, today I instantaneously converted. In the twinkling of an eye, I became a fast waker-upper. A very, very fast waker upper.

It was still dark. I don't know just how I could have reacted so quickly, but I jumped immediately out of bed and immediately started running toward the door. In hindsight I think I must have still been half asleep, or eyes not open, or both, because as accelerated toward the doorway I did not take time to notice that the doorway had a closed door in it.

My head and body impacted the door much like I imagine a right tackle hits his man across the line of scrimmage. Problem was, I wasn't wearing my helmet. BOOM. Everyone in the building heard my little encounter with the door above the noise of the earthquake. I fell, sprawling across a bunch of boxes that were stacked in the corner next to the door.

Somehow I picked myself up and staggered outside with everyone else. When the shaking stopped we had a good laugh (OK, so everyone else had a good laugh). Somebody said I reminded them of the YouTube video of that crazy sleepwalking dog. You decide (watch video).

I am still taking Motrin for neck cramps suffered from Richter 6.1 But what am I complaining about? They say that one Richter point represents the power of 10. That is, last week's 7.0 quake was almost 10 times as violent as this morning's 6.1 This is unimaginable to me. Though I am here to see its consequences, I still cannot imagine a 7.0.

God in Heaven, please calm the terrified nerves of these who went through ten times the terror I just did. They are still so afraid. They so need Your peace right now, as do I.

WMFH Waiting Room

Initiation By Fire

Before even starting, we knew the first clinic day would be hard... in many ways. Hard because of uncertainty: not knowing exactly what to expect in patient turn-out. Hard organizationally: we had not yet unpacked our boxes of supplies. Hard secondary to sheer terror: were we up to the challenge of what would be presented to us that day? Time would tell.

At 7 AM, not knowing how long it would take for word to get out in the village that medical help had arrived, Dr. Kris and I walked around the outside of our central supply building to find 70 - 80 severely-injured men, women, and children patiently waiting on the wooden benches we had set up the night before. Word was definitely out!

So far our team consisted of Dr. Tim Chamberlain (a general surgeon buddy of mine who I have worked with before in Haiti), Dr. Bill Cunningham (an ER doctor and hospital Chief Medical Officer), Dr Kris Thede (a missionary family practitioner who serves in northern Haiti), (soon-to-be Dr.) Hilary Schmid (a medical student getting ready to begin her ER residency), Joel Currie (placed in charge of organizing our central supply), Diane Busch (a physician's assistant missionary serving on the island of LaGonave, Haiti), and Dr. Jim (a general surgeon who had been working at a hospital in another region of Haiti when the earthquake struck).

We quickly got to work, opening boxes and stocking shelves as quickly as possible, knowing that perfectionism was out the window. Patients were here and they were suffering. We quickly came up with a triage strategy, one we would adjust many times over the next days. We mutually agreed which treatment area each of us would work.

By 9:00 that first morning, the first of well-over 1,500 patients we would see over the next week were brought into our new hospital, one we now call Wesleyan Mission Field Hospital.

We were initiated by fire. The very first person we saw was had suffered a very terrible fracture of his left femur. Dr. Bill?! First one is yours! I saw reality set in for Bill, who had said he was pretty good at casting and splinting. Bill's wide eyes betrayed his disbelief. "If this is the first patient," he was thinking, "what else?" Today would be interesting. And heart-wrenching. And hard.

We saw many bad problems that first day. Bad, disfiguring fractures. Lots of terrible skin wounds... most of them infected. It's easy to spot the infected ones. They're the ones that have the gnats and flies swirling around the wounds. That, plus they smell really bad. I remember making the observation that perhaps half the wounds were inflicted from the inside out, meaning that the skin had been punctured from jagged bones being pushed out through the skin from the inside. If we weren't sure, we would ask them, "Did you see bone sticking out?" "Wi," they'd reply. "Yes."

That first day we saw two bad spinal fractures, both men. One (see picture) was brought to us carried on a blanket by 3 or 4 guys. He was paralyzed from the waist down. No bladder control. No feeling, no movement in the legs. A falling cinder block took away this man's hope of ever walking again. His life will be very, very hard.

And the morning and the evening were the first day. And we all agreed it was sad.

Airport Crowd Control

Journey to Petit Goave

The airport was chaotic, a far cry from the usual. Our gorgeous Gulfstream seemed to shrink as we approached the gigantic military cargo planes lining the tarmac. We quickly unloaded our cargo, found a large cargo cart and lugged it up toward the heavily-damaged and unoccupied terminal building. All along the edge of the building were tents and cordoned off groups of chairs. I saw Geraldo Rivera doing his thing under one of the tents.

First a 7.0 magnitude earthquake, now Geraldo.... will the suffering never end?

Several of us stayed with our cargo while Dr. Tim and I tried to figure out how to contact our ride. We went briefly into the terminal building but quickly realized that it would not factor in to our exit strategy. We walked several hundred yards east toward the United Nations-guarded gate, which turned out to be THE only way in or out of the airport. There was a mob scene at the gate when we first arrived, perhaps 500 or so riled-up Haitians pressing against the gate, with troops (US and UN) facing them from the inside.

It was obvious we would not exit any time soon. As we continued our attempts to contact our driver, we watched first-hand something one sees only on TV or in the movies. Troops with shields and clubs pushing back crowds of the desperate. A few rocks were thrown back toward us, answered by gunshots of something non-lethal back into the crowds... I don't know what it was. A big white UN tank came out through the gate to let the crowds know that they were serious about preserving order. It worked, and after finally connecting with our ride (three vehicles, including a sizable truck for our cargo), we exited out that same gate, made our way safely through the crowds, and headed west toward Leogane... earthquake epicenter.

I must admit, the whole airport scene unnerved me a bit. I felt very responsible for the safety of my team. I mean, first Geraldo, and then the riot scene. What next? Another earthquake?

Our caravan traveled about an hour to a rendezvous point where we connected with the missionaries who had been investigating possible sites for a field hospital. After a rice-and-beans lunch, we moved on, continuing our journey west. We traveled through the village of Leogane which had been totally and absolutely decimated by the quake. What a pitiful site. We contemplated setting up in Leogane, but decided to keep moving, coming soon to the next village... Petit Goave. We were the first medical (or otherwise!) relief people to arrive since the quake. Many, many people here died in the quake. Many others severely wounded. Everyone hungry and thirsty. Here we found an old, run-down, though beautiful mission compound right on the sea. We showed up without warning, spoke with the caretakers, and found ourselves a home.

We wandered the property a bit, getting our bearings, checking out the structural integrity of the buildings, and decided to make our supply house out of a small school building. It looked safe enough. Just outside this building was an area suitable to have our outside hospital. Large trees would provide good shade, with the help of a few large tarps we had brought along.

We unloaded our cargo, putting the medical supplies in the little school building. Close to this was a small, four-room dormitory with plenty of bunk beds. No running water. Electricity could be made available if we fired up a generator. There was a fairly nice bathroom / shower facility, but again no running water. All showering and flushing was with buckets.

And since water in Haiti is a precious commodity, the toilet credo was:

"If it's yellow let it mellow. If it's brown flush it down."

We crashed for the night, knowing the following day would change us forever.

Welcome to Haiti.

Happier times

My last time in Haiti was just two months ago. This orphanage is a short distance from the hospital I go to down there. This photo was taken in November, just eight weeks prior to the earthquake. Precious kids.

From Heaven to Hell

By Saturday night the team was assembled. It would consist of surgeons (general, orthopedic, ob/gyne), family practitioners, ER doctors, RN's, NP's, medical students, pastors, paramedics, and Creole translators. They would come down over the course of three days (Monday, Tuesday, Wednesday), each escorting a Gulfstream 500 full of the supplies we had collected and staged at the hangar.

Sometime on Saturday, during all the scurrying, one of the missionaries I was keeping in close touch with contacted me about their worries about a South Dakota-based team that had been in Haiti when the earthquake hit and how their rations were starting to run thin. I took a chance and contacted my new favorite airline about what would be the possibility of evacuating them from trouble. Amway jumped at the opportunity ("why deadhead home," they said, "when we could fill the plane and help folks out?") and, with no small amount of stress in retrieving the necessary customs information on all of them, we were able to get them safely home to their stressed out families.

In the wee hours of Monday morning the first wave of our mission to establish a medical presence near the epicenter of Haiti's recent earthquake ascended from a cold Grand Rapids runway.

Despite not having slept hardly at all over the previous 48 hours, I didn't feel the need during our three and one-half our direct flight to Port-au-Prince. Dawn was breaking just as we flew into Haiti airspace. From the air, the rural Haitian country side looked no different, really, than all the other times I'd flown over it. The descent into Port-au-Prince, however, would shake me.

Please understand, on a good day Port-au-Prince is a pitiful thing to see, especially if you're seeing it for the first time. Closely-packed homes of tin and cinder, garbage piled along the roads and beach. Looking over it as you fly in you wonder, "How can this be?... just 700 miles from our own country?" That's on a good day. Pre-earthquake. That's baseline for Haiti.

Adding a 7.0 earthquake to these conditions is like a very bad science experiment, combining two bad chemicals, corrosive in themselves, creating a ne'er-seen-before monster.

Pressing our heads against the windows we saw an urban landscape that looked as if it had just been bombed. Through a haze of smoke, you could see little fires and smoke billows peppering the tiny neighborhoods. Mind you, this was six days after the earthquake.

I didn't take pictures. I wasn't in the mood. The past three and one-half hours had transitioned us from heaven to hell.